Minnesota Legislature
SF 1458
3rd Engrossment - 89th Legislature (2015 - 2016) Posted on 07/01/2015 04:23pm
3.12 3.13
3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32
3.33 3.34 3.35 3.36 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 4.36 5.1 5.2 5.3 5.4 5.5 5.6 5.7
5.8 5.9 5.10 5.11 5.12
5.13
5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22
5.23 5.24 5.25 5.26 5.27 5.28 5.29
5.30 5.31 6.1 6.2 6.3 6.4 6.5
6.6
6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14
6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30
6.31 6.32 6.33 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16
7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 7.35 8.1 8.2
8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 8.34 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12
9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 10.35 10.36 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17
11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 11.34 11.35 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 12.34 12.35
13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9
13.10 13.11 13.12 13.13 13.14 13.15 13.16
13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25
13.26 13.27 13.28 13.29 13.30
13.31 13.32 14.1 14.2 14.3 14.4
14.5 14.6 14.7 14.8 14.9 14.10
14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31
14.32 14.33 15.1 15.2
15.3 15.4 15.5 15.6 15.7 15.8
15.9 15.10 15.11 15.12 15.13
15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 16.1 16.2
16.3
16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21
16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35 18.1 18.2
18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30
18.31 18.32 18.33 18.34 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16
19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 19.35 20.1 20.2
20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13
20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24
20.25 20.26 20.27 20.28 20.29
20.30 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 21.36 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26
22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 22.35 23.1 23.2 23.3 23.4 23.5 23.6
23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 23.35 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8
24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18
24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29
24.30
24.31 24.32 24.33 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8
25.9
25.10 25.11 25.12 25.13 25.14
25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27
25.28
25.29 25.30 25.31 25.32 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 26.34 26.35 26.36 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 27.35 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 28.35 29.1 29.2 29.3 29.4 29.5 29.6
29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14
29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33 29.34 30.1 30.2 30.3 30.4 30.5 30.6 30.7
30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 30.34 31.1 31.2 31.3
31.4 31.5 31.6 31.7 31.8 31.9 31.10
31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32
32.33 32.34 32.35 33.1 33.2 33.3 33.4 33.5 33.6
33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 33.34 33.35 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11
34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 34.34 34.35 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28
35.29 35.30 35.31 35.32 35.33 35.34 35.35 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31
36.32 36.33 36.34 36.35 37.1 37.2 37.3
37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32
37.33
37.34 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 38.34 38.35 38.36 39.1 39.2 39.3 39.4
39.5
39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 39.34 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 40.33 40.34 40.35 40.36
41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8
41.9 41.10 41.11 41.12 41.13 41.14 41.15
41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 41.34 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 42.33 42.34 42.35 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 43.35 44.1 44.2
44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 44.34 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 45.34 45.35 45.36 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33 46.34 46.35 46.36 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 47.34 47.35 47.36 48.1 48.2 48.3
48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30
48.31 48.32 48.33 48.34 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8
49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 49.33 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 50.34 50.35 50.36 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 51.34 51.35 51.36 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15
52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 52.34 52.35 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 53.34 53.35 54.1 54.2
54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11
54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9
55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24
55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31
56.32 56.33 56.34 56.35 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10
57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27
57.28 57.29 57.30 57.31 57.32 57.33 58.1 58.2
58.3
58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14
58.15
58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28
58.29
58.30 58.31 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26
59.27
59.28 59.29 59.30 59.31 59.32 59.33 59.34 59.35 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 60.35 60.36
61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27
61.28 61.29 61.30 61.31 61.32 61.33 61.34 61.35 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 62.34 62.35 62.36 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18
63.19
63.20 63.21 63.22 63.23 63.24
63.25
63.26 63.27 63.28 63.29 63.30 63.31 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13
64.14
64.15 64.16 64.17 64.18 64.19 64.20 64.21
64.22
64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22
65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 65.33 65.34 65.35 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12
66.13
66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 66.34 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 67.35 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16
68.17 68.18
68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28
68.29
68.30 68.31 68.32 68.33 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25
69.26
69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 69.35 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9
70.10
70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 70.34 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25
71.26
71.27 71.28 71.29 71.30 71.31 71.32 71.33 71.34 71.35 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18
72.19
72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 73.1 73.2 73.3 73.4 73.5 73.6
73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33 73.34 73.35
74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 74.34 74.35 74.36 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33 75.34 75.35 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 76.34 76.35 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 77.33 77.34 77.35 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33 78.34 78.35 78.36 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 79.33 79.34 79.35 80.1 80.2
80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 80.34 80.35 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23
81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 81.33 81.34 81.35
82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33 82.34 82.35 82.36 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24
83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 83.33 83.34 83.35 84.1 84.2 84.3
84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 84.33 84.34 84.35 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 85.33 85.34 85.35 85.36 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 86.34 86.35 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 87.34 87.35 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 88.33 88.34 88.35 88.36 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 89.34 89.35 89.36 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11
90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 90.33 90.34 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 91.34 91.35 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22
92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 92.33 92.34 92.35 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8
93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23
93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 93.33 93.34 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24
94.25 94.26 94.27 94.28 94.29 94.30 94.31 94.32 94.33 94.34 94.35 95.1 95.2 95.3
95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15
95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 96.1 96.2 96.3 96.4 96.5 96.6
96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 96.33 96.34
97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15
97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 97.33 97.34 97.35 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28
98.29 98.30 98.31 98.32 98.33 98.34 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18
99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27
99.28 99.29 99.30 99.31 99.32 99.33 99.34 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10
100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 100.33 100.34 100.35 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14
101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 101.33 101.34 102.1 102.2
102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19
102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31
102.32 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 103.34
103.35 104.1 104.2 104.3 104.4 104.5 104.6 104.7
104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26
104.27 104.28 104.29 104.30 104.31 104.32 104.33 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14
105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 105.33 105.34 105.35 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15
106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28
106.29 106.30 106.31 106.32 107.1 107.2 107.3 107.4 107.5 107.6 107.7
107.8 107.9 107.10 107.11 107.12 107.13
107.14
107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 107.34 108.1 108.2 108.3
108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 108.33 108.34 108.35 109.1 109.2 109.3
109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18
109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27
109.28 109.29 109.30 109.31 109.32 109.33 110.1 110.2 110.3
110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 110.34 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10
111.11
111.12 111.13 111.14
111.15 111.16
111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 111.33 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 112.34 112.35 112.36 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 113.33 113.34 113.35 113.36 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 114.34 114.35 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 115.33 115.34 115.35 116.1 116.2
116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 116.33 116.34 116.35 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22
117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 117.33 117.34
118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18
118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 118.33 118.34 118.35 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 119.35 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 120.34 120.35 120.36 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 121.33 121.34 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27
122.28 122.29 122.30 122.31 122.32 122.33 122.34 122.35 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15
123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30
123.31 123.32 123.33 123.34 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11
124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 124.34 124.35 125.1 125.2 125.3 125.4 125.5 125.6 125.7
125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 125.34 125.35 126.1
126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14
126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28
126.29 126.30 126.31 126.32 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10
127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 127.33 127.34 127.35 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18
128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30
128.31 128.32 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 129.34 129.35 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18
130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 130.34 130.35
131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25
131.26
131.27 131.28 131.29 131.30 131.31 131.32 131.33 131.34 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26
132.27 132.28
132.29 132.30 132.31 132.32 132.33 132.34 132.35 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 133.34 133.35 133.36 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29
134.30 134.31 134.32 134.33 134.34 134.35 135.1 135.2 135.3 135.4 135.5 135.6
135.7 135.8 135.9 135.10 135.11 135.12
135.13 135.14 135.15 135.16 135.17 135.18
135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24
136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 136.34 137.1 137.2 137.3 137.4 137.5 137.6
137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23
137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 137.34 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18
138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 138.34 138.35
139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 139.34 139.35 139.36 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 140.34 140.35 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11
141.12 141.13 141.14 141.15 141.16 141.17
141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31
141.32 141.33 142.1 142.2 142.3
142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33
143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18
143.19 143.20 143.21
143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 143.33
144.1 144.2 144.3 144.4 144.5 144.6
144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14
144.15 144.16 144.17 144.18 144.19 144.20 144.21
144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 145.1 145.2
145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16
145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19
146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 146.34 146.35 147.1 147.2 147.3 147.4 147.5 147.6
147.7 147.8 147.9 147.10
147.11 147.12
147.13 147.14 147.15 147.16 147.17 147.18 147.19
147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 148.33 148.34 148.35 148.36 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 149.33 149.34 149.35 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15
150.16 150.17 150.18 150.19 150.20 150.21 150.22
150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 150.33 150.34 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22
151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 151.33 151.34 151.35 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 152.34 152.35 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24
153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 153.33 153.34 153.35 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10
154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 154.35 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12
155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 155.35 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 156.34
156.35 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 157.33 157.34 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 158.33 158.34 158.35 158.36 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 159.34 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13
160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32
160.33 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18
161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 161.34 161.35 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31
162.32 162.33 162.34 162.35 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27
163.28 163.29 163.30 163.31 163.32 163.33 163.34 163.35 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 164.34 164.35 164.36 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16
165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 165.33 165.34 165.35 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 166.34 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19
167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 167.33 167.34 167.35 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 168.34 168.35 168.36 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 169.33
169.34 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10
170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33
170.34 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18
171.19 171.20 171.21 171.22 171.23
171.24 171.25 171.26 171.27 171.28 171.29 171.30
172.1 172.2
172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 172.33
173.1 173.2
173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26
173.27 173.28
173.29 173.30 173.31 173.32 173.33 173.34 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17
174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 174.34 174.35 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20
175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32
175.33 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16
176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 176.33 176.34 176.35 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17
177.18 177.19 177.20 177.21 177.22
177.23 177.24 177.25 177.26 177.27 177.28 177.29
177.30 177.31 177.32 177.33 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18
178.19 178.20 178.21 178.22 178.23 178.24 178.25
178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 178.34 179.1 179.2 179.3
179.4 179.5 179.6 179.7
179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15
179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 179.33 180.1 180.2
180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13
180.14 180.15 180.16 180.17 180.18 180.19 180.20
180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29
180.30 180.31 180.32 181.1 181.2 181.3 181.4 181.5 181.6 181.7
181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 181.33 181.34 181.35 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11
182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30
182.31 182.32 182.33 182.34 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 183.33 183.34 183.35 183.36 184.1 184.2
184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10
184.11 184.12 184.13 184.14 184.15
184.16 184.17 184.18 184.19 184.20
184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29
184.30 184.31 185.1 185.2
185.3 185.4 185.5 185.6
185.7 185.8 185.9 185.10 185.11
185.12 185.13 185.14 185.15 185.16 185.17 185.18
185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9
186.10 186.11 186.12 186.13 186.14
186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23
187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 187.33 187.34 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 188.34 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15
189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 189.33 189.34 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 190.33 190.34 190.35 190.36 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32 191.33 191.34 191.35 191.36 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29
192.30 192.31 192.32 192.33
192.34 193.1
193.2 193.3 193.4
193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 193.33 193.34 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26
194.27 194.28 194.29 194.30 194.31 194.32 194.33 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 195.34 195.35 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 196.33 196.34 196.35 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 197.34 197.35 197.36 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 198.33 198.34 198.35 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33 199.34 199.35 199.36 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 200.34 200.35 200.36 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 201.34 201.35 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30
202.31 202.32 202.33 202.34 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 203.33 203.34 203.35 203.36 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 204.34 204.35 204.36 205.1 205.2
205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 205.33 205.34 205.35 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17
206.18
206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 206.34 206.35 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33 207.34 207.35 207.36
208.1
208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 208.33 208.34 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 209.33 209.34 209.35 209.36 210.1 210.2 210.3 210.4
210.5
210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 210.33 210.34 210.35 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 211.33 211.34 211.35 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 212.33 212.34
212.35 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 213.32 213.33 213.34 213.35 213.36 214.1 214.2 214.3 214.4 214.5 214.6 214.7
214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 214.32 214.33 214.34 214.35 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 215.32 215.33 215.34 215.35 215.36 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12
216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28
216.29 216.30 216.31 216.32 216.33 216.34 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20
217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 217.34
218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28
218.29 218.30 218.31 218.32 218.33 218.34 219.1 219.2
219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13
219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26
219.27 219.28 219.29 219.30 219.31
219.32 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22
220.23 220.24 220.25 220.26 220.27 220.28 220.29
220.30 220.31 220.32
220.33 221.1 221.2 221.3 221.4 221.5 221.6
221.7 221.8 221.9 221.10 221.11 221.12
221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 221.32 221.33 221.34 222.1 222.2 222.3 222.4 222.5 222.6 222.7
222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23
222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 222.34 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11
223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19
223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 223.34 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16
224.17 224.18 224.19 224.20 224.21 224.22 224.23
224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10
225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20
225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 226.34
226.35 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9
227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 227.33 227.34 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19
228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33
228.34 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 229.34 230.1 230.2 230.3 230.4 230.5 230.6
230.7 230.8 230.9 230.10 230.11 230.12 230.13
230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29
230.30 230.31 230.32 230.33 231.1 231.2 231.3 231.4
231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13
231.14 231.15
231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26
231.27 231.28 231.29 231.30 231.31 231.32 231.33 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9
232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 232.34 232.35 233.1 233.2 233.3 233.4 233.5
233.6 233.7 233.8 233.9 233.10 233.11
233.12
233.13 233.14 233.15
233.16 233.17
233.18 233.19 233.20 233.21 233.22
233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24
234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 234.34 235.1 235.2 235.3 235.4 235.5
235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24
235.25 235.26 235.27 235.28 235.29 235.30
235.31 235.32 235.33 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10
236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 236.34 236.35 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 237.33
237.34 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 238.33 238.34 238.35 238.36 239.1 239.2 239.3 239.4
239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20
239.21 239.22 239.23 239.24
239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16
240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 240.33 240.34 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32
241.33 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 242.33 242.34 242.35 242.36 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13
243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 243.33 243.34 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15
244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 244.33 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17
245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31 245.32
245.33 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 246.33 246.34 246.35 247.1 247.2
247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27
247.28 247.29 247.30 247.31 247.32 247.33 247.34 248.1 248.2 248.3 248.4 248.5 248.6 248.7
248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20
248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29
248.30 248.31 248.32 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8
249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16
249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 249.33 249.34 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 250.33 250.34 250.35 250.36 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 251.34 251.35 251.36 252.1 252.2 252.3 252.4 252.5 252.6 252.7
252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17
252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 252.33 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 253.33 253.34 253.35 253.36 254.1 254.2 254.3 254.4 254.5 254.6
254.7
254.8 254.9 254.10 254.11 254.12 254.13 254.14
254.15
254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 255.32 255.33 255.34 255.35 255.36 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19
256.20
256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 256.32 256.33 256.34 256.35 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26
257.27 257.28 257.29 257.30 257.31 257.32 257.33 257.34 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18
258.19
258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 258.32 258.33
258.34
259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14
259.15
259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32 259.33 259.34 259.35 260.1 260.2 260.3 260.4 260.5 260.6 260.7
260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31
260.32 260.33 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 261.32 261.33 261.34 261.35 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24
262.25 262.26 262.27 262.28 262.29 262.30 262.31 262.32 262.33 262.34 262.35 263.1 263.2 263.3 263.4 263.5
263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32 263.33 263.34 263.35 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 264.31 264.32 264.33 264.34 264.35 264.36 265.1 265.2 265.3 265.4 265.5
265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 265.32 265.33 265.34 265.35 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30
266.31 266.32 266.33 266.34 266.35 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33
267.34 267.35 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 268.33 268.34 268.35 268.36 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 269.34 269.35 269.36 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12
270.13
270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31 270.32 270.33 270.34 270.35 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34 271.35 271.36 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14
272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31
272.32 272.33 272.34 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 273.33 273.34 273.35 273.36 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8
274.9
274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18
274.19 274.20 274.21
274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 274.33 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 275.33 275.34 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19
276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 276.34 277.1 277.2 277.3 277.4
277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 277.34 277.35 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25
278.26 278.27 278.28 278.29 278.30 278.31 278.32 278.33 278.34 278.35 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23
279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 279.34 280.1 280.2
280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25
280.26 280.27 280.28 280.29
280.30
280.31 280.32 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10
281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 281.33
282.1 282.2 282.3
282.4 282.5 282.6 282.7 282.8 282.9 282.10
282.11 282.12 282.13 282.14 282.15 282.16 282.17
282.18 282.19 282.20 282.21 282.22 282.23 282.24
282.25 282.26 282.27
282.28 282.29
282.30 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18
283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 283.31 283.32 283.33 283.34 283.35 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 284.33 284.34 284.35 284.36 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 285.33 285.34 285.35 285.36 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 286.32 286.33 286.34 286.35 286.36 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22
287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 287.33 287.34 287.35 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 288.33 288.34 288.35 288.36 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 289.32 289.33 289.34 289.35 289.36 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 290.32 290.33 290.34 290.35 290.36 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 291.33 291.34 291.35 291.36 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 292.32 292.33 292.34 292.35 292.36 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 293.32 293.33 293.34 293.35 293.36 294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9
294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20
294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 294.32 294.33 295.1 295.2 295.3
295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 295.33 295.34 295.35 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 296.34
296.35 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31
297.32 297.33 297.34 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 298.33 298.34 298.35 298.36
299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16
299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 300.1 300.2 300.3
300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15
300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 300.32 300.33 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32
301.33 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32
302.33 302.34 302.35 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16
303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32 303.33 303.34 303.35 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14
304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 304.32 304.33 304.34 304.35 305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 305.32 305.33
305.34 305.35 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30 306.31 306.32 306.33 306.34 306.35 307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 307.32 307.33 307.34 307.35 307.36 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33 308.34 308.35 308.36 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 309.33 309.34 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24 310.25 310.26 310.27 310.28 310.29 310.30 310.31 310.32 310.33
310.34 311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 311.33 311.34 311.35 311.36 312.1 312.2 312.3 312.4 312.5 312.6 312.7
312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23
312.24
312.25 312.26 312.27 312.28 312.29 312.30 312.31 312.32 312.33 312.34 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23
313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 313.33 313.34 313.35
314.1 314.2 314.3 314.4 314.5 314.6 314.7
314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26
314.27 314.28 314.29 314.30 314.31 314.32 314.33 314.34 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 315.32 315.33 315.34 315.35 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21
316.22 316.23
316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 316.33 316.34 316.35 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 317.32 317.33 317.34 317.35 317.36 318.1 318.2 318.3 318.4 318.5 318.6
318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 318.32 318.33 318.34 318.35 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18
319.19 319.20 319.21 319.22
319.23 319.24 319.25 319.26 319.27
319.28 319.29 319.30 319.31 319.32 319.33
320.1
320.2 320.3 320.4 320.5 320.6 320.7 320.8
320.9
320.10 320.11 320.12 320.13 320.14
320.15
320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 320.31 320.32 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 321.32 321.33 321.34 321.35 321.36 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 322.34 322.35 322.36 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 323.33 323.34 323.35
323.36
324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32 324.33 324.34 324.35 324.36 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 325.33 325.34 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27
326.28
326.29 326.30 326.31 326.32 326.33 326.34 326.35 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19 327.20 327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 327.32 327.33 327.34 327.35 327.36 328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 328.33 328.34 328.35 328.36
329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10
329.11 329.12 329.13 329.14 329.15 329.16
329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 329.32 329.33 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21
330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 330.32 330.33 330.34 330.35 331.1 331.2 331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 331.34 331.35 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25
332.26 332.27 332.28 332.29 332.30 332.31 332.32 332.33 332.34
333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15
333.16
333.17 333.18 333.19 333.20
333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 333.33 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 334.33
334.34 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 335.32 335.33 335.34 335.35 335.36 336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12
336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26 336.27 336.28 336.29 336.30 336.31 336.32 336.33 336.34 336.35 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11 337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 337.32 337.33 337.34 337.35 337.36 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14
338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30
338.31 338.32 338.33 338.34 339.1 339.2
339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 339.33 339.34 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12
340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27
340.28 340.29 340.30 340.31 340.32 340.33 340.34 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12
341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 341.33 341.34 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8
342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21
342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 342.33 342.34 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19
343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28
343.29 343.30 343.31 343.32 343.33 343.34 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16
344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31
344.32 344.33 344.34 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20
345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32 345.33
345.34
346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 346.32 346.33 346.34 346.35 346.36 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13
347.14
347.15 347.16 347.17 347.18 347.19 347.20
347.21
347.22 347.23
347.24 347.25
347.26
347.27 347.28 347.29 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 348.34 348.35 348.36
349.1
349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32
349.33
349.34 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 350.33 350.34 350.35 350.36 351.1 351.2 351.3
351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16
351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 351.33 351.34 352.1 352.2 352.3
352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13
352.14 352.15 352.16 352.17 352.18 352.19 352.20
352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30
352.31 352.32 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 353.32 353.33
353.34 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14
354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 354.34 354.35 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32
355.33 355.34 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 356.32 356.33 356.34 356.35 356.36 357.1 357.2 357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19
357.20
357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 357.32 357.33 357.34 357.35 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 358.33 358.34 358.35 359.1 359.2 359.3 359.4 359.5 359.6 359.7
359.8 359.9
359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 359.31 359.32 359.33 359.34 359.35 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 360.31 360.32 360.33 360.34 360.35 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 361.32 361.33 361.34
361.35 361.36
362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 362.33 362.34 362.35 362.36
363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13
363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 363.33 363.34 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11
364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24
364.25 364.26
364.27 364.28 364.29 364.30 364.31 364.32 364.33 365.1 365.2 365.3
365.4 365.5 365.6 365.7
365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31
365.32 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24
366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 366.33 366.34 366.35
367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11
367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26
367.27 367.28 367.29 367.30 367.31
368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15
368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 368.32 368.33 368.34 368.35 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 369.34 369.35 369.36 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 370.32 370.33 370.34 370.35 370.36 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21
371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 371.32 371.33 371.34 371.35 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20
372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 372.33 372.34 372.35 373.1 373.2 373.3 373.4
373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14
373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29
373.30 373.31 373.32 373.33 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 374.33 374.34 374.35 374.36 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 375.32 375.33 375.34 375.35 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 376.32 376.33 376.34 376.35 376.36 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 377.32
377.33 377.34 377.35 378.1 378.2 378.3 378.4
378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16
378.17 378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28
378.29 378.30 378.31 378.32 379.1 379.2 379.3
379.4 379.5 379.6 379.7 379.8 379.9
379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19
379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28
379.29 379.30 380.1 380.2 380.3
380.4 380.5 380.6 380.7 380.8 380.9
380.10 380.11 380.12 380.13 380.14 380.15
380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23
380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29 381.30 381.31 381.32 381.33 381.34 381.35 381.36 382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14
382.15 382.16 382.17 382.18 382.19 382.20
382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 382.31 382.32 382.33 382.34 383.1 383.2 383.3 383.4 383.5 383.6 383.7
383.8 383.9
383.10 383.11 383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24 383.25 383.26 383.27 383.28
383.29 383.30 383.31 383.32 383.33 384.1
384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29
384.30 384.31 384.32 384.33
385.1 385.2
385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 385.31 385.32 385.33 385.34 385.35 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29 386.30
386.31 386.32 386.33 386.34 386.35 387.1 387.2 387.3 387.4 387.5 387.6 387.7 387.8 387.9
387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21
387.22
387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 387.32 387.33 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8
388.9
388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 388.32 388.33 388.34 388.35 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9
389.10
389.11 389.12 389.13 389.14 389.15 389.16 389.17
389.18
389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 389.31 389.32 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14 390.15 390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24
390.25
390.26 390.27 390.28 390.29 390.30
390.31
390.32 390.33 391.1 391.2 391.3 391.4 391.5
391.6
391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 391.31 391.32 391.33 391.34
392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14
392.15 392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 392.31 392.32 392.33 392.34 392.35 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14 393.15 393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28 393.29 393.30 393.31 393.32 393.33 393.34 393.35 393.36 394.1 394.2 394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 394.32 394.33 394.34 394.35 394.36 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25
395.26 395.27 395.28 395.29 395.30 395.31 395.32 395.33 395.34 396.1 396.2
396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29 396.30 396.31 396.32 396.33 396.34 396.35 397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8 397.9 397.10 397.11 397.12 397.13 397.14 397.15 397.16 397.17 397.18 397.19 397.20 397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29 397.30 397.31 397.32 397.33 397.34 397.35 397.36 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16
398.17 398.18 398.19 398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27 398.28 398.29 398.30 398.31 398.32 398.33 398.34 398.35 399.1 399.2 399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12
399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 399.30 399.31 399.32 399.33 399.34 400.1 400.2 400.3 400.4 400.5 400.6 400.7 400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 400.32 400.33 400.34 400.35 400.36 401.1 401.2 401.3
401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16 401.17 401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 401.29 401.30 401.31 401.32 401.33 401.34 401.35 402.1 402.2 402.3 402.4 402.5 402.6 402.7 402.8 402.9 402.10 402.11 402.12 402.13 402.14 402.15
402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25 402.26
402.27 402.28 402.29 402.30 402.31 402.32 402.33 402.34 403.1 403.2 403.3 403.4 403.5 403.6 403.7 403.8 403.9 403.10 403.11 403.12
403.13 403.14 403.15 403.16 403.17 403.18 403.19 403.20 403.21 403.22 403.23 403.24 403.25 403.26 403.27 403.28 403.29 403.30 403.31 403.32 403.33 403.34 403.35 404.1 404.2 404.3 404.4 404.5 404.6 404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14 404.15 404.16 404.17 404.18 404.19 404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 404.32 404.33 404.34 404.35 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21
405.22 405.23 405.24 405.25 405.26 405.27 405.28 405.29 405.30 405.31 405.32 405.33 405.34 406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12 406.13 406.14 406.15 406.16 406.17 406.18 406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29 406.30 406.31 406.32 406.33 406.34 406.35 406.36 407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8 407.9 407.10 407.11 407.12 407.13 407.14 407.15 407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27 407.28 407.29 407.30 407.31 407.32 407.33 407.34 407.35 407.36 408.1 408.2 408.3 408.4 408.5 408.6 408.7 408.8 408.9 408.10 408.11 408.12 408.13 408.14 408.15 408.16 408.17 408.18 408.19 408.20 408.21 408.22 408.23 408.24 408.25 408.26 408.27 408.28 408.29 408.30 408.31 408.32 408.33 408.34 408.35 408.36 409.1 409.2 409.3 409.4 409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16 409.17 409.18 409.19 409.20 409.21 409.22 409.23 409.24 409.25 409.26 409.27 409.28 409.29 409.30 409.31 409.32 409.33 409.34 409.35 409.36 410.1 410.2 410.3 410.4 410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14 410.15 410.16 410.17 410.18
410.19
410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27 410.28 410.29 410.30 410.31
410.32
411.1 411.2 411.3 411.4 411.5 411.6 411.7 411.8 411.9 411.10 411.11 411.12 411.13 411.14 411.15 411.16 411.17
411.18
411.19 411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28 411.29 411.30 411.31 411.32 411.33 411.34 411.35 412.1 412.2 412.3 412.4 412.5 412.6 412.7
412.8
412.9 412.10 412.11 412.12 412.13 412.14 412.15 412.16 412.17 412.18 412.19 412.20 412.21 412.22
412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 412.31 412.32 412.33 413.1 413.2 413.3 413.4 413.5 413.6 413.7 413.8 413.9 413.10 413.11 413.12 413.13 413.14 413.15 413.16 413.17 413.18 413.19 413.20 413.21 413.22 413.23 413.24 413.25
413.26 413.27 413.28 413.29 413.30 413.31 413.32 413.33 413.34 414.1 414.2 414.3 414.4
414.5
414.6 414.7 414.8 414.9 414.10 414.11 414.12 414.13
414.14 414.15 414.16 414.17 414.18 414.19 414.20 414.21 414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29 414.30 414.31 414.32 414.33 415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8 415.9 415.10 415.11 415.12 415.13 415.14 415.15 415.16 415.17 415.18 415.19 415.20 415.21 415.22 415.23 415.24 415.25 415.26 415.27 415.28 415.29 415.30 415.31 415.32 415.33 415.34 415.35 415.36 416.1 416.2 416.3 416.4 416.5 416.6 416.7 416.8 416.9 416.10 416.11 416.12 416.13 416.14 416.15 416.16 416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24 416.25
416.26 416.27
416.28 416.29 416.30 416.31 416.32 416.33 416.34 416.35 417.1 417.2 417.3 417.4 417.5 417.6 417.7 417.8 417.9 417.10 417.11 417.12 417.13 417.14 417.15 417.16 417.17 417.18 417.19 417.20 417.21 417.22 417.23 417.24 417.25 417.26 417.27 417.28 417.29 417.30 417.31 417.32 417.33 417.34 417.35 418.1 418.2 418.3 418.4 418.5 418.6 418.7 418.8 418.9 418.10 418.11 418.12 418.13 418.14 418.15 418.16 418.17 418.18 418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26 418.27 418.28 418.29 418.30 418.31 418.32 418.33 418.34 418.35 418.36 419.1 419.2 419.3 419.4 419.5 419.6 419.7 419.8 419.9 419.10 419.11 419.12 419.13 419.14 419.15 419.16 419.17 419.18 419.19 419.20 419.21 419.22 419.23 419.24 419.25 419.26 419.27 419.28 419.29 419.30 419.31 419.32 419.33 419.34 420.1 420.2 420.3 420.4 420.5 420.6 420.7 420.8 420.9 420.10 420.11 420.12 420.13 420.14 420.15 420.16 420.17 420.18 420.19 420.20 420.21 420.22 420.23 420.24
420.25 420.26 420.27 420.28 420.29 420.30 420.31 420.32 420.33 420.34 420.35 421.1 421.2 421.3 421.4 421.5 421.6 421.7 421.8 421.9 421.10 421.11 421.12 421.13 421.14 421.15 421.16 421.17 421.18 421.19 421.20 421.21 421.22 421.23 421.24 421.25 421.26 421.27 421.28 421.29 421.30 421.31 421.32 421.33 421.34 421.35 421.36 422.1 422.2 422.3 422.4 422.5 422.6 422.7 422.8 422.9 422.10 422.11 422.12 422.13 422.14 422.15 422.16 422.17 422.18 422.19 422.20 422.21 422.22 422.23 422.24 422.25 422.26 422.27 422.28 422.29 422.30 422.31 422.32 422.33 422.34 422.35
423.1 423.2 423.3
423.4 423.5 423.6 423.7 423.8 423.9 423.10 423.11 423.12 423.13 423.14 423.15 423.16 423.17
423.18 423.19 423.20 423.21 423.22 423.23 423.24 423.25 423.26 423.27 423.28 423.29 423.30 423.31 423.32 423.33 423.34 424.1 424.2 424.3 424.4 424.5 424.6 424.7 424.8 424.9 424.10 424.11 424.12 424.13 424.14 424.15 424.16 424.17 424.18 424.19 424.20 424.21 424.22 424.23 424.24 424.25 424.26 424.27 424.28 424.29 424.30 424.31 424.32 424.33 424.34 424.35 424.36 425.1 425.2 425.3 425.4 425.5 425.6 425.7 425.8 425.9 425.10 425.11 425.12 425.13 425.14 425.15 425.16 425.17 425.18 425.19 425.20 425.21 425.22 425.23 425.24 425.25 425.26 425.27 425.28 425.29 425.30 425.31 425.32 425.33 425.34 425.35 426.1 426.2 426.3 426.4 426.5 426.6 426.7 426.8 426.9 426.10 426.11 426.12 426.13 426.14 426.15 426.16 426.17 426.18 426.19 426.20 426.21 426.22 426.23 426.24 426.25 426.26 426.27 426.28 426.29 426.30 426.31 426.32 426.33 426.34 426.35 427.1 427.2 427.3 427.4 427.5 427.6 427.7 427.8 427.9 427.10 427.11 427.12 427.13 427.14 427.15 427.16 427.17 427.18 427.19
427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 427.32 427.33 427.34 428.1 428.2 428.3 428.4 428.5 428.6 428.7 428.8 428.9 428.10 428.11 428.12 428.13 428.14 428.15 428.16 428.17 428.18 428.19 428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 428.30 428.31 428.32 428.33 428.34 428.35 429.1 429.2 429.3 429.4 429.5 429.6 429.7 429.8 429.9 429.10 429.11 429.12 429.13 429.14 429.15 429.16 429.17 429.18 429.19 429.20 429.21
429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30 429.31 429.32 429.33 429.34 429.35 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16 430.17 430.18 430.19 430.20 430.21 430.22 430.23 430.24 430.25 430.26 430.27 430.28 430.29 430.30 430.31 430.32 430.33 430.34 430.35 430.36 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17 431.18 431.19 431.20 431.21 431.22 431.23 431.24
431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 431.33 431.34 431.35 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11 432.12 432.13 432.14 432.15 432.16 432.17 432.18 432.19 432.20 432.21 432.22 432.23 432.24 432.25 432.26 432.27 432.28 432.29 432.30 432.31 432.32 432.33 432.34 432.35 433.1 433.2 433.3 433.4 433.5 433.6 433.7 433.8 433.9 433.10 433.11 433.12 433.13 433.14 433.15 433.16 433.17 433.18 433.19 433.20 433.21 433.22 433.23 433.24 433.25 433.26 433.27
433.28 433.29 433.30 433.31 433.32 433.33 433.34 433.35 434.1 434.2 434.3 434.4 434.5 434.6
434.7 434.8 434.9 434.10 434.11 434.12 434.13 434.14 434.15 434.16 434.17 434.18 434.19 434.20 434.21 434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29 434.30 434.31 434.32 434.33 434.34 435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8 435.9 435.10 435.11 435.12 435.13 435.14 435.15
435.16 435.17 435.18 435.19 435.20 435.21 435.22 435.23 435.24 435.25 435.26 435.27 435.28 435.29 435.30 435.31 435.32 435.33 435.34 436.1 436.2 436.3 436.4 436.5 436.6 436.7 436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 436.31 436.32 436.33 436.34 436.35 436.36 437.1 437.2 437.3 437.4 437.5 437.6 437.7 437.8 437.9 437.10
437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19 437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27 437.28 437.29 437.30 437.31 437.32 437.33 437.34 437.35 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16 438.17 438.18 438.19 438.20 438.21 438.22 438.23 438.24 438.25 438.26 438.27 438.28
438.29 438.30 438.31 438.32 438.33 438.34 438.35 439.1 439.2 439.3 439.4 439.5 439.6 439.7 439.8 439.9 439.10 439.11 439.12 439.13 439.14 439.15 439.16 439.17 439.18 439.19 439.20 439.21 439.22 439.23 439.24 439.25 439.26 439.27 439.28 439.29 439.30 439.31 439.32 439.33 439.34 439.35
440.1 440.2 440.3 440.4 440.5 440.6 440.7 440.8 440.9 440.10 440.11 440.12 440.13 440.14 440.15 440.16 440.17 440.18 440.19 440.20
440.21 440.22 440.23 440.24 440.25 440.26 440.27 440.28 440.29 440.30 440.31 440.32 440.33 441.1 441.2 441.3 441.4 441.5 441.6 441.7 441.8 441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19 441.20 441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 441.31 441.32 441.33 441.34 441.35 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9 442.10 442.11 442.12
442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24 442.25 442.26 442.27 442.28 442.29 442.30 442.31 442.32 442.33 442.34 443.1 443.2 443.3 443.4 443.5 443.6 443.7
443.8 443.9 443.10 443.11 443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19 443.20 443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28 443.29 443.30 443.31 443.32 443.33 443.34 443.35 444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12 444.13 444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26 444.27 444.28 444.29 444.30 444.31 444.32 444.33 444.34 444.35 445.1 445.2 445.3 445.4 445.5 445.6 445.7 445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16 445.17 445.18 445.19 445.20 445.21 445.22 445.23 445.24 445.25 445.26 445.27 445.28 445.29
445.30 445.31 445.32 445.33 445.34 445.35 446.1 446.2 446.3 446.4 446.5
446.6
446.7 446.8 446.9 446.10
446.11
446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 446.32 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16 447.17
447.18 447.19 447.20
447.21 447.22 447.23 447.24 447.25 447.26
447.27
447.28 447.29 447.30 447.31 447.32 448.1 448.2
448.3
448.4 448.5 448.6 448.7 448.8 448.9 448.10
448.11
448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21 448.22 448.23 448.24 448.25 448.26 448.27 448.28 448.29 448.30 448.31
448.32 449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14
449.15
449.16 449.17 449.18 449.19 449.20 449.21 449.22
449.23
449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 449.32 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16
450.17
450.18 450.19 450.20 450.21 450.22 450.23 450.24 450.25 450.26 450.27 450.28 450.29 450.30 450.31 450.32
450.33 451.1 451.2 451.3 451.4 451.5 451.6 451.7 451.8 451.9 451.10 451.11 451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30
451.31 451.32 451.33 451.34 452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13 452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28
452.29
452.30 452.31 452.32 452.33 452.34 452.35 452.36 453.1 453.2 453.3 453.4 453.5 453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 453.31 453.32 453.33 453.34 454.1 454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 454.32 454.33 454.34 454.35 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 455.32 455.33 455.34 455.35 455.36 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8 456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19 456.20
456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29
456.30
456.31 456.32 456.33 457.1 457.2 457.3 457.4
457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26 457.27 457.28 457.29 457.30 457.31 457.32 457.33 457.34 458.1 458.2 458.3 458.4 458.5 458.6 458.7 458.8 458.9 458.10 458.11 458.12 458.13 458.14 458.15 458.16 458.17 458.18 458.19 458.20 458.21 458.22 458.23 458.24 458.25 458.26 458.27 458.28 458.29 458.30 458.31 458.32 458.33 458.34 458.35 459.1 459.2 459.3 459.4 459.5 459.6 459.7 459.8 459.9 459.10
459.11 459.12 459.13 459.14 459.15 459.16 459.17 459.18 459.19 459.20 459.21 459.22 459.23 459.24 459.25 459.26 459.27 459.28 459.29 459.30 459.31 459.32 459.33 459.34 460.1 460.2
460.3 460.4 460.5 460.6 460.7 460.8
460.9 460.10 460.11 460.12 460.13 460.14 460.15
460.16 460.17
460.18 460.19 460.20 460.21 460.22 460.23 460.24 460.25 460.26 460.27 460.28 460.29 460.30 460.31 460.32 460.33 461.1 461.2 461.3 461.4
461.5 461.6 461.7 461.8 461.9 461.10 461.11 461.12 461.13 461.14 461.15 461.16 461.17 461.18 461.19 461.20 461.21 461.22 461.23 461.24 461.25 461.26 461.27 461.28 461.29 461.30 461.31 461.32 461.33 461.34 461.35 462.1 462.2 462.3 462.4 462.5 462.6 462.7 462.8 462.9 462.10 462.11 462.12 462.13 462.14 462.15 462.16 462.17 462.18 462.19
462.20 462.21 462.22 462.23 462.24 462.25 462.26 462.27 462.28 462.29 462.30 462.31 462.32 462.33 462.34 463.1 463.2 463.3 463.4 463.5 463.6 463.7 463.8 463.9 463.10 463.11 463.12 463.13 463.14 463.15 463.16 463.17 463.18 463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27 463.28 463.29 463.30 463.31 463.32
463.33 463.34 464.1 464.2 464.3 464.4 464.5 464.6 464.7 464.8 464.9 464.10 464.11 464.12 464.13 464.14 464.15 464.16 464.17 464.18 464.19 464.20 464.21 464.22 464.23 464.24 464.25 464.26 464.27 464.28 464.29 464.30 464.31 464.32
464.33 465.1 465.2 465.3 465.4 465.5 465.6 465.7 465.8 465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23
465.24 465.25 465.26 465.27 465.28
465.29 465.30 465.31 465.32 465.33 465.34 466.1 466.2 466.3 466.4 466.5 466.6 466.7 466.8 466.9 466.10 466.11
466.12
466.13 466.14 466.15 466.16 466.17 466.18 466.19 466.20 466.21 466.22 466.23 466.24
466.25 466.26
466.27 466.28
466.29 466.30 466.31 466.32 467.1 467.2 467.3 467.4 467.5 467.6 467.7
467.8 467.9 467.10 467.11 467.12 467.13 467.14 467.15 467.16 467.17 467.18 467.19 467.20 467.21 467.22 467.23 467.24 467.25 467.26 467.27 467.28 467.29 467.30 467.31 467.32 467.33 468.1 468.2
468.3 468.4
468.5 468.6
468.7 468.8 468.9 468.10 468.11 468.12 468.13 468.14 468.15 468.16 468.17 468.18
468.19 468.20 468.21 468.22 468.23 468.24 468.25 468.26 468.27 468.28 468.29 468.30 468.31 468.32 468.33 468.34 469.1 469.2 469.3 469.4 469.5 469.6 469.7 469.8 469.9 469.10 469.11 469.12 469.13 469.14 469.15 469.16 469.17 469.18 469.19 469.20 469.21 469.22 469.23 469.24 469.25 469.26 469.27 469.28 469.29 469.30 469.31 469.32 469.33 469.34 469.35 470.1 470.2 470.3 470.4 470.5 470.6 470.7 470.8 470.9 470.10 470.11 470.12 470.13 470.14 470.15 470.16 470.17 470.18 470.19 470.20 470.21 470.22 470.23 470.24 470.25 470.26 470.27 470.28 470.29 470.30 470.31 470.32 470.33 470.34 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18 471.19 471.20 471.21 471.22 471.23 471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 471.32 471.33 471.34 471.35 472.1 472.2 472.3 472.4 472.5 472.6 472.7 472.8 472.9 472.10 472.11 472.12 472.13 472.14 472.15 472.16 472.17 472.18 472.19 472.20 472.21 472.22 472.23 472.24 472.25 472.26 472.27 472.28 472.29 472.30 472.31 472.32 472.33 472.34 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11 473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19 473.20 473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29 473.30 473.31 473.32 473.33 474.1 474.2 474.3 474.4 474.5 474.6 474.7 474.8 474.9 474.10 474.11 474.12 474.13 474.14 474.15 474.16 474.17 474.18 474.19 474.20 474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29 474.30 474.31 474.32 474.33 474.34 474.35 475.1 475.2 475.3 475.4 475.5 475.6 475.7 475.8 475.9 475.10 475.11 475.12 475.13 475.14 475.15 475.16 475.17 475.18 475.19 475.20 475.21 475.22 475.23 475.24 475.25 475.26 475.27 475.28 475.29 475.30 475.31 475.32 475.33 475.34 475.35 476.1 476.2 476.3 476.4 476.5 476.6 476.7 476.8 476.9 476.10 476.11 476.12 476.13 476.14 476.15 476.16 476.17 476.18 476.19 476.20 476.21 476.22 476.23 476.24 476.25 476.26 476.27 476.28 476.29 476.30 476.31 476.32 476.33 477.1 477.2 477.3 477.4 477.5 477.6 477.7 477.8 477.9 477.10 477.11 477.12 477.13 477.14 477.15 477.16 477.17 477.18 477.19 477.20 477.21 477.22 477.23 477.24 477.25 477.26 477.27 477.28 477.29 477.30 477.31 477.32 478.1 478.2 478.3 478.4 478.5 478.6 478.7 478.8 478.9 478.10 478.11 478.12 478.13 478.14 478.15 478.16 478.17 478.18 478.19 478.20 478.21 478.22 478.23 478.24 478.25 478.26 478.27 478.28 478.29 478.30 478.31 478.32 478.33 479.1 479.2 479.3 479.4 479.5 479.6 479.7 479.8 479.9 479.10 479.11 479.12 479.13 479.14 479.15 479.16 479.17 479.18 479.19 479.20 479.21 479.22 479.23 479.24 479.25 479.26 479.27 479.28 479.29 479.30 479.31 479.32 479.33 479.34 480.1 480.2 480.3 480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20 480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 480.32 480.33 481.1 481.2 481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10 481.11 481.12 481.13 481.14 481.15 481.16 481.17 481.18 481.19 481.20 481.21 481.22 481.23 481.24 481.25 481.26 481.27 481.28 481.29 481.30 481.31 481.32 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10 482.11 482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21 482.22 482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31 482.32 482.33 482.34 483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10 483.11 483.12 483.13 483.14 483.15 483.16 483.17 483.18 483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28 483.29 483.30 483.31 483.32 483.33 483.34 484.1 484.2 484.3 484.4 484.5 484.6 484.7 484.8 484.9 484.10 484.11 484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21 484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 484.30 484.31 484.32 484.33 484.34 485.1 485.2 485.3 485.4 485.5 485.6 485.7 485.8 485.9 485.10 485.11 485.12 485.13 485.14 485.15 485.16 485.17 485.18 485.19 485.20 485.21 485.22 485.23 485.24 485.25 485.26 485.27 485.28 485.29 485.30 485.31 485.32 485.33 485.34 485.35 486.1 486.2 486.3 486.4 486.5 486.6 486.7 486.8 486.9 486.10 486.11 486.12 486.13 486.14 486.15 486.16 486.17 486.18 486.19 486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29 486.30 486.31 486.32 486.33 486.34 486.35 487.1 487.2 487.3 487.4 487.5 487.6 487.7 487.8 487.9 487.10 487.11 487.12 487.13 487.14 487.15 487.16 487.17 487.18 487.19 487.20 487.21 487.22 487.23 487.24 487.25 487.26 487.27 487.28 487.29 487.30 487.31 487.32 487.33 487.34 487.35 488.1 488.2 488.3 488.4 488.5 488.6 488.7 488.8 488.9 488.10 488.11 488.12 488.13 488.14 488.15 488.16 488.17 488.18 488.19 488.20 488.21 488.22 488.23 488.24 488.25 488.26 488.27 488.28 488.29 488.30 488.31 488.32 488.33 488.34 488.35 489.1 489.2 489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14 489.15 489.16 489.17 489.18 489.19 489.20 489.21 489.22 489.23 489.24 489.25 489.26 489.27 489.28 489.29 489.30 489.31 489.32 489.33 489.34 489.35 490.1 490.2 490.3 490.4 490.5 490.6 490.7 490.8 490.9 490.10 490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27 490.28 490.29 490.30 490.31 490.32 490.33 490.34 490.35 490.36 491.1 491.2 491.3 491.4 491.5 491.6 491.7 491.8 491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20 491.21 491.22 491.23 491.24 491.25 491.26 491.27 491.28 491.29 491.30 491.31 491.32 491.33 491.34 491.35 491.36 492.1 492.2 492.3 492.4 492.5 492.6 492.7 492.8 492.9 492.10 492.11 492.12 492.13 492.14 492.15 492.16 492.17 492.18 492.19 492.20 492.21 492.22 492.23 492.24 492.25 492.26 492.27 492.28 492.29 492.30 492.31 492.32 492.33 492.34 492.35 492.36 493.1 493.2 493.3 493.4 493.5 493.6 493.7 493.8 493.9 493.10 493.11 493.12 493.13 493.14 493.15 493.16 493.17 493.18 493.19 493.20 493.21 493.22 493.23 493.24 493.25 493.26 493.27 493.28 493.29 493.30 493.31 493.32 493.33 493.34 493.35 493.36 494.1 494.2 494.3 494.4 494.5 494.6 494.7 494.8 494.9 494.10 494.11 494.12 494.13 494.14 494.15 494.16 494.17 494.18 494.19 494.20 494.21 494.22 494.23 494.24 494.25 494.26 494.27 494.28 494.29 494.30 494.31 494.32 494.33 494.34 495.1 495.2 495.3 495.4 495.5 495.6 495.7 495.8 495.9
495.10 495.11 495.12 495.13 495.14 495.15 495.16 495.17 495.18 495.19 495.20 495.21 495.22 495.23 495.24 495.25 495.26 495.27 495.28 495.29 495.30 495.31 495.32 495.33 495.34 495.35 496.1 496.2 496.3 496.4 496.5 496.6 496.7 496.8 496.9 496.10 496.11 496.12 496.13 496.14 496.15 496.16 496.17 496.18 496.19 496.20 496.21 496.22 496.23 496.24 496.25 496.26 496.27 496.28 496.29 496.30 496.31 496.32 496.33 496.34 496.35 497.1 497.2 497.3 497.4 497.5 497.6 497.7 497.8 497.9 497.10 497.11 497.12 497.13 497.14 497.15 497.16 497.17 497.18 497.19 497.20 497.21 497.22 497.23 497.24 497.25 497.26 497.27 497.28 497.29 497.30 497.31 497.32 497.33 497.34 497.35 498.1 498.2 498.3 498.4 498.5 498.6 498.7 498.8 498.9 498.10 498.11 498.12 498.13 498.14 498.15 498.16 498.17 498.18 498.19 498.20 498.21 498.22 498.23 498.24 498.25 498.26 498.27 498.28 498.29 498.30 498.31 498.32 498.33 498.34 498.35 499.1 499.2 499.3 499.4 499.5 499.6 499.7 499.8 499.9 499.10 499.11 499.12 499.13 499.14 499.15 499.16 499.17 499.18 499.19 499.20 499.21 499.22 499.23 499.24 499.25 499.26 499.27 499.28 499.29 499.30 499.31 499.32 499.33 499.34 499.35 500.1 500.2 500.3 500.4 500.5 500.6 500.7 500.8 500.9 500.10 500.11 500.12 500.13 500.14 500.15 500.16 500.17 500.18 500.19 500.20 500.21 500.22 500.23 500.24 500.25 500.26 500.27 500.28 500.29 500.30 500.31 500.32 500.33 500.34 500.35 500.36 501.1 501.2 501.3 501.4 501.5 501.6 501.7 501.8 501.9 501.10 501.11 501.12 501.13 501.14 501.15 501.16 501.17 501.18 501.19 501.20 501.21 501.22 501.23 501.24 501.25 501.26 501.27 501.28 501.29 501.30 501.31 501.32 501.33 501.34 501.35 501.36 502.1 502.2 502.3 502.4 502.5 502.6 502.7 502.8 502.9 502.10 502.11 502.12 502.13 502.14 502.15 502.16 502.17 502.18 502.19 502.20 502.21 502.22 502.23 502.24 502.25 502.26 502.27 502.28 502.29 502.30 502.31 502.32 502.33 502.34 502.35 503.1 503.2 503.3 503.4 503.5 503.6 503.7 503.8 503.9 503.10 503.11 503.12 503.13 503.14 503.15 503.16 503.17 503.18 503.19 503.20 503.21 503.22 503.23 503.24 503.25 503.26 503.27 503.28 503.29 503.30 503.31 503.32 503.33 503.34 504.1 504.2 504.3 504.4 504.5 504.6 504.7 504.8 504.9 504.10 504.11 504.12 504.13 504.14 504.15 504.16 504.17 504.18 504.19 504.20 504.21 504.22 504.23 504.24 504.25 504.26 504.27 504.28 504.29 504.30 504.31 504.32 504.33 504.34 504.35 505.1 505.2 505.3 505.4 505.5 505.6 505.7 505.8 505.9 505.10 505.11 505.12 505.13 505.14 505.15 505.16 505.17 505.18 505.19 505.20 505.21 505.22 505.23 505.24 505.25 505.26 505.27 505.28 505.29 505.30 505.31 505.32 505.33 505.34 506.1 506.2 506.3 506.4 506.5 506.6 506.7 506.8 506.9 506.10 506.11 506.12 506.13 506.14 506.15 506.16 506.17 506.18 506.19 506.20 506.21 506.22 506.23
506.24 506.25 506.26 506.27 506.28 506.29 506.30 506.31 507.1 507.2 507.3 507.4 507.5 507.6 507.7 507.8 507.9 507.10 507.11 507.12 507.13 507.14 507.15 507.16 507.17 507.18 507.19 507.20 507.21 507.22 507.23 507.24 507.25 507.26 507.27 507.28 507.29 507.30 507.31 507.32 507.33 507.34 507.35 508.1 508.2 508.3 508.4 508.5 508.6 508.7 508.8 508.9 508.10 508.11 508.12 508.13 508.14 508.15 508.16 508.17 508.18 508.19 508.20 508.21 508.22 508.23 508.24 508.25 508.26 508.27 508.28 508.29 508.30 508.31 508.32 508.33
509.1 509.2 509.3 509.4 509.5 509.6 509.7 509.8 509.9 509.10 509.11 509.12 509.13 509.14 509.15 509.16 509.17 509.18 509.19 509.20 509.21 509.22 509.23 509.24 509.25 509.26 509.27 509.28 509.29
509.30
509.31 509.32 509.33
510.1
510.2 510.3 510.4 510.5 510.6 510.7 510.8 510.9 510.10
510.11 510.12 510.13 510.14
510.15
510.16 510.17 510.18 510.19 510.20
510.21 510.22 510.23 510.24 510.25 510.26 510.27 510.28 510.29 510.30 510.31 511.1 511.2 511.3 511.4 511.5 511.6 511.7 511.8 511.9 511.10
511.11 511.12 511.13
511.14 511.15 511.16
511.17 511.18
A bill for an act
relating to state government; establishing the health and human services budget;
modifying provisions governing children and family services, chemical and
mental health services, withdrawal management programs, direct care and
treatment, health care, continuing care, Department of Health and public
health programs, health care delivery, health licensing boards, and MNsure;
making changes to medical assistance, MFIP, Northstar Care for Children,
MinnesotaCare, child care assistance, and group residential housing programs;
establishing uniform requirements for public assistance programs related
to income calculation, reporting income, and correcting overpayments and
underpayments; modifying requirements for reporting maltreatment of minors
and juvenile safety and placement; establishing the Minnesota ABLE plan
and accounts; modifying child support provisions; establishing standards for
withdrawal management programs; modifying requirements for background
studies; making changes to provisions governing the health information
exchange; providing for protection of born alive infants; authorizing rulemaking;
requiring reports and studies; making technical changes; modifying certain fees
for Department of Health programs; modifying fees of certain health-related
licensing boards; making human services forecast adjustments; appropriating
money; amending Minnesota Statutes 2014, sections 13.46, subdivisions 2, 7;
13.461, by adding a subdivision; 16A.724, subdivision 2; 43A.241; 62A.02,
subdivision 2; 62A.045; 62J.498; 62J.4981; 62J.4982, subdivisions 4, 5;
62J.692, subdivision 4; 62Q.37, subdivision 2; 62Q.55, subdivision 3; 62U.02,
subdivisions 1, 2, 3, 4; 62U.04, subdivision 11; 62U.10, by adding subdivisions;
62V.03, subdivision 2; 62V.05, subdivisions 6, 7, 8, by adding a subdivision;
119B.011, subdivision 15; 119B.025, subdivision 1; 119B.035, subdivision
4; 119B.09, subdivision 4; 119B.125, by adding a subdivision; 119B.13,
subdivision 6; 144.057, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.291,
subdivision 2; 144.293, subdivisions 5, 6, 8; 144.298, subdivisions 2, 3; 144.551,
subdivision 1; 144.9501, subdivisions 6d, 22b, 26b, by adding subdivisions;
144.9505; 144.9508; 144A.071, subdivision 4a; 144A.70, subdivision 6, by
adding a subdivision; 144A.71; 144A.72; 144A.73; 144A.75, subdivision
13; 144D.01, by adding a subdivision; 144E.001, by adding a subdivision;
144E.275, subdivision 1, by adding a subdivision; 145.4131, subdivision 1;
145.423; 145.56, subdivisions 2, 4; 145.928, subdivision 13, by adding a
subdivision; 145.986, subdivisions 1a, 2, 4; 145A.131, subdivision 1; 148.52;
148.54; 148.57, subdivisions 1, 2, by adding a subdivision; 148.574; 148.575,
subdivision 2; 148.577; 148.59; 148.603; 148E.075; 148E.080, subdivisions 1, 2;
148E.180, subdivisions 2, 5; 149A.20, subdivisions 5, 6; 149A.40, subdivision
11; 149A.65; 149A.92, subdivision 1; 149A.97, subdivision 7; 150A.06,
subdivision 1b; 150A.091, subdivisions 4, 5, 11, by adding subdivisions;
150A.31; 151.01, subdivisions 15a, 27; 151.02; 151.065, subdivisions 1, 2, 3, 4;
151.102; 151.58, subdivisions 2, 5; 157.15, subdivision 8; 174.29, subdivision
1; 174.30, subdivisions 3, 4, by adding subdivisions; 245.4661, subdivisions
5, 6, by adding subdivisions; 245.467, subdivision 6; 245.4876, subdivision
7; 245.4889, subdivision 1, by adding a subdivision; 245A.06, by adding a
subdivision; 245A.155, subdivisions 1, 2; 245A.65, subdivision 2; 245C.03, by
adding subdivisions; 245C.04, by adding a subdivision; 245C.08, subdivision 1;
245C.10, by adding subdivisions; 245C.12; 245D.02, by adding a subdivision;
245D.05, subdivisions 1, 2; 245D.06, subdivisions 1, 2, 7; 245D.07, subdivision
2; 245D.071, subdivision 5; 245D.09, subdivisions 3, 5; 245D.22, subdivision
4; 245D.31, subdivisions 3, 4, 5; 246.18, subdivision 8; 246.54, subdivision 1;
252.27, subdivision 2a; 253B.18, subdivisions 4c, 5; 254B.05, subdivision 5, as
amended; 254B.12, subdivision 2; 256.01, by adding subdivisions; 256.015,
subdivision 7; 256.017, subdivision 1; 256.478; 256.741, subdivisions 1, 2;
256.969, subdivisions 1, 2b, 2d, 3a, 3c, 9; 256.975, by adding a subdivision;
256B.056, subdivision 5c; 256B.057, subdivision 9; 256B.059, subdivision
5; 256B.06, by adding a subdivision; 256B.0615, subdivision 3; 256B.0622,
subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, by adding a subdivision; 256B.0624,
subdivision 7; 256B.0625, subdivisions 3b, 13, 13e, 13h, 17, 17a, 18a, 18e,
28a, 31, 48, 57, 58, by adding subdivisions; 256B.0631; 256B.072; 256B.0757;
256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h; 256B.0916,
subdivisions 2, 11, by adding a subdivision; 256B.431, subdivisions 2b, 36;
256B.434, subdivision 4, by adding a subdivision; 256B.441, subdivisions 1,
5, 6, 13, 14, 17, 30, 31, 33, 35, 40, 44, 46c, 48, 50, 51, 51a, 53, 54, 55a, 56,
63, by adding subdivisions; 256B.49, subdivision 26, by adding a subdivision;
256B.4913, subdivisions 4a, 5; 256B.4914, subdivisions 2, 6, 8, 10, 14, 15;
256B.492; 256B.50, subdivision 1; 256B.69, subdivisions 5a, 5i, 9c, 9d, by
adding a subdivision; 256B.75; 256B.76, subdivisions 1, 2, 4, as amended;
256B.762; 256B.766; 256B.767; 256D.01, subdivision 1a; 256D.02, subdivision
8, by adding subdivisions; 256D.06, subdivision 1; 256D.405, subdivision 3;
256E.35, subdivision 2, by adding a subdivision; 256I.03, subdivisions 3,
7, by adding subdivisions; 256I.04, subdivisions 1, 1a, 2a, 2b, 2c, 3, 4, by
adding subdivisions; 256I.05, subdivisions 1c, 1g, 2; 256I.06, subdivisions
2, 6, 7, 8; 256J.08, subdivisions 26, 86; 256J.21, subdivision 2, as amended;
256J.24, subdivision 5a; 256J.30, subdivisions 1, 9; 256J.33, subdivision
4; 256J.35; 256J.40; 256J.95, subdivision 19; 256K.45, subdivisions 1a, 6;
256L.01, subdivisions 3a, 5; 256L.03, subdivision 5; 256L.04, subdivisions
1c, 7b; 256L.05, subdivisions 3, 3a, 4, by adding a subdivision; 256L.06,
subdivision 3; 256L.121, subdivision 1; 256L.15, subdivisions 1, 2; 256N.22,
subdivisions 9, 10; 256N.24, subdivision 4; 256N.25, subdivision 1; 256N.27,
subdivision 2; 256P.001; 256P.01, subdivision 3, by adding subdivisions;
256P.02, by adding a subdivision; 256P.03, subdivision 1; 256P.04, subdivisions
1, 4; 256P.05, subdivision 1; 257.75, subdivisions 3, 5; 259A.75; 260C.007,
subdivisions 27, 32; 260C.203; 260C.212, subdivision 1, by adding subdivisions;
260C.221; 260C.331, subdivision 1; 260C.451, subdivisions 2, 6; 260C.515,
subdivision 5; 260C.521, subdivisions 1, 2; 260C.607, subdivision 4; 518A.26,
subdivision 14; 518A.32, subdivision 2; 518A.39, subdivision 1, by adding
a subdivision; 518A.41, subdivisions 1, 3, 4, 14, 15; 518A.43, by adding
a subdivision; 518A.46, subdivision 3, by adding a subdivision; 518A.51;
518A.53, subdivisions 1, 4, 10; 518A.60; 518C.802; 626.556, subdivisions 1, as
amended, 2, 3, 6a, 7, as amended, 10, 10e, 10j, 10m, 11c, by adding subdivisions;
626.559, by adding a subdivision; Laws 2008, chapter 363, article 18, section 3,
subdivision 5; Laws 2014, chapter 189, sections 5; 9; 10; 11; 16; 17; 18; 19; 23;
24; 27; 28; 29; 31; 43; 50; 51; 52; 73; Laws 2014, chapter 312, article 24, section
45, subdivision 2; proposing coding for new law in Minnesota Statutes, chapters
62A; 144; 144D; 148; 245; 245A; 256B; 256E; 256M; 256P; 518A; proposing
coding for new law as Minnesota Statutes, chapters 245F; 256Q; repealing
Minnesota Statutes 2014, sections 62V.11, subdivision 3; 148.57, subdivisions 3,
4; 148.571; 148.572; 148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, 6;
148.576; 148E.060, subdivision 12; 148E.075, subdivisions 4, 5, 6, 7; 256.01,
subdivision 35; 256.969, subdivisions 23, 30; 256B.434, subdivision 19b;
256B.441, subdivisions 14a, 19, 50a, 52, 55, 58, 62; 256B.69, subdivision 32;
256D.0513; 256D.06, subdivision 8; 256D.09, subdivision 6; 256D.49; 256J.38;
256L.02, subdivision 3; 256L.05, subdivisions 1b, 1c, 3c, 5; Laws 2012, chapter
247, article 4, section 47, as amended; Minnesota Rules, parts 3400.0170,
subparts 5, 6, 12, 13; 8840.5900, subparts 12, 14.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
CHILDREN AND FAMILY SERVICES
Section 1.
Minnesota Statutes 2014, section 119B.125, is amended by adding a
subdivision to read:
new text begin Subd. 7. new text end
new text begin Failure to comply with attendance record requirements. new text end
new text begin
(a) In
establishing an overpayment claim for failure to provide attendance records in compliance
with section 119B.125, subdivision 6, the county or commissioner is limited to the six
years prior to the date the county or the commissioner requested the attendance records.
new text end
new text begin
(b) The commissioner may periodically audit child care providers to determine
compliance with section 119B.125, subdivision 6.
new text end
new text begin
(c) When the commissioner or county establishes an overpayment claim against a
current or former provider, the commissioner or county must provide notice of the claim to
the provider. A notice of overpayment claim must specify the reason for the overpayment,
the authority for making the overpayment claim, the time period in which the overpayment
occurred, the amount of the overpayment, and the provider's right to appeal.
new text end
new text begin
(d) The commissioner or county shall seek to recoup or recover overpayments paid
to a current or former provider.
new text end
new text begin
(e) When a provider has been disqualified or convicted of fraud under section
256.98, theft under section 609.52, or a federal crime relating to theft of state funds
or fraudulent billing for a program administered by the commissioner or a county,
recoupment or recovery must be sought regardless of the amount of overpayment.
new text end
Sec. 2.
Minnesota Statutes 2014, section 119B.13, subdivision 6, is amended to read:
Subd. 6.
Provider payments.
(a) The provider shall bill for services provided
within ten days of the end of the service period. If bills are submitted within ten days of
the end of the service period, payments under the child care fund shall be made within 30
days of receiving a bill from the provider. Counties or the state may establish policies that
make payments on a more frequent basis.
(b) If a provider has received an authorization of care and been issued a billing form
for an eligible family, the bill must be submitted within 60 days of the last date of service on
the bill. A bill submitted more than 60 days after the last date of service must be paid if the
county determines that the provider has shown good cause why the bill was not submitted
within 60 days. Good cause must be defined in the county's child care fund plan under
section 119B.08, subdivision 3, and the definition of good cause must include county error.
Any bill submitted more than a year after the last date of service on the bill must not be paid.
(c) If a provider provided care for a time period without receiving an authorization
of care and a billing form for an eligible family, payment of child care assistance may only
be made retroactively for a maximum of six months from the date the provider is issued
an authorization of care and billing form.
(d) A county new text begin or the commissioner new text end may refuse to issue a child care authorization
to a licensed or legal nonlicensed provider, revoke an existing child care authorization
to a licensed or legal nonlicensed provider, stop payment issued to a licensed or legal
nonlicensed provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed
provider if:
(1) the provider admits to intentionally giving the county materially false information
on the provider's billing forms;
(2) a county new text begin or the commissioner new text end finds by a preponderance of the evidence that the
provider intentionally gave the county materially false information on the provider's
billing formsnew text begin , or provided false attendance records to a county or the commissionernew text end ;
(3) the provider is in violation of child care assistance program rules, until the
agency determines those violations have been corrected;
(4) the provider is operating after deleted text begin receipt ofdeleted text end new text begin :new text end
new text begin (i) new text end an order of suspension deleted text begin ordeleted text end new text begin of the provider's license issued by the commissioner;
new text end
new text begin (ii) new text end an order of revocation of the provider's licensedeleted text begin ,deleted text end new text begin ;new text end or
deleted text begin
the provider has been issued an order citing violations of licensing standards that
affect the health and safety of children in care due to the nature, chronicity, or severity
of the licensing violations, until the licensing agency determines those violations have
been corrected;
deleted text end
new text begin
(iii) a final order of conditional license issued by the commissioner for as
long as the conditional license is in effect;
new text end
(5) the provider submits false attendance reports or refuses to provide documentation
of the child's attendance upon request; or
(6) the provider gives false child care price information.
new text begin (e) For purposes of paragraph (d), clauses (3), (5), and (6), new text end the county new text begin or the
commissioner new text end may withhold the provider's authorization or payment for a period of time
not to exceed three months beyond the time the condition has been corrected.
deleted text begin (e)deleted text end new text begin (f) new text end A county's payment policies must be included in the county's child care plan
under section 119B.08, subdivision 3. If payments are made by the state, in addition to
being in compliance with this subdivision, the payments must be made in compliance
with section 16A.124.
Sec. 3.
Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin
Providers of group residential housing or supplementary services.
new text end
new text begin
The commissioner shall conduct background studies on any individual required under
section 256I.04 to have a background study completed under this chapter.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 4.
Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin
Child protection workers or social services staff having responsibility
for child protective duties.
new text end
new text begin
(a) The commissioner must complete background studies,
according to paragraph (b) and 245C.04, subdivision 10, when initiated by a county social
services agency or by a local welfare agency according to section 626.559, subdivision 1b.
new text end
new text begin
(b) For background studies completed by the commissioner under this subdivision,
the commissioner shall not make a disqualification decision, but shall provide the
background study information received to the county that initiated the study.
new text end
Sec. 5.
Minnesota Statutes 2014, section 245C.04, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin
Child protection workers or social services staff having responsibility
for child protective duties.
new text end
new text begin
The commissioner shall conduct background studies of
employees of county social services and local welfare agencies having responsibility
for child protection duties when the background study is initiated according to section
626.559, subdivision 1b.
new text end
Sec. 6.
Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin
Providers of group residential housing or supplementary services.
new text end
new text begin
The commissioner shall recover the cost of background studies initiated by providers of
group residential housing or supplementary services under section 256I.04 through a fee
of no more than $20 per study. The fees collected under this subdivision are appropriated
to the commissioner for the purpose of conducting background studies.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 7.
Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin
Child protection workers or social services staff having responsibility
for child protective duties.
new text end
new text begin
The commissioner shall recover the cost of background studies
initiated by county social services agencies and local welfare agencies for individuals
who are required to have a background study under section 626.559, subdivision 1b,
through a fee of no more than $20 per study. The fees collected under this subdivision are
appropriated to the commissioner for the purpose of conducting background studies.
new text end
Sec. 8.
Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision
to read:
new text begin Subd. 12a. new text end
new text begin
Department of Human Services child fatality and near fatality
review team.
new text end
new text begin
The commissioner shall establish a Department of Human Services child
fatality and near fatality review team to review child fatalities and near fatalities due to
child maltreatment and child fatalities and near fatalities that occur in licensed facilities
and are not due to natural causes. The review team shall assess the entire child protection
services process from the point of a mandated reporter reporting the alleged maltreatment
through the ongoing case management process. Department staff shall lead and conduct
on-site local reviews and utilize supervisors from local county and tribal child welfare
agencies as peer reviewers. The review process must focus on critical elements of the case
and on the involvement of the child and family with the county or tribal child welfare
agency. The review team shall identify necessary program improvement planning to
address any practice issues identified and training and technical assistance needs of
the local agency. Summary reports of each review shall be provided to the state child
mortality review panel when completed.
new text end
Sec. 9.
Minnesota Statutes 2014, section 256.017, subdivision 1, is amended to read:
Subdivision 1.
Authority and purpose.
The commissioner shall administer a
compliance system for the Minnesota family investment program, the food stamp or food
support program, emergency assistance, general assistance, medical assistance, emergency
general assistance, Minnesota supplemental assistancenew text begin , group residential housingnew text end ,
preadmission screening, alternative care grants, the child care assistance program, and
all other programs administered by the commissioner or on behalf of the commissioner
under the powers and authorities named in section 256.01, subdivision 2. The purpose of
the compliance system is to permit the commissioner to supervise the administration of
public assistance programs and to enforce timely and accurate distribution of benefits,
completeness of service and efficient and effective program management and operations,
to increase uniformity and consistency in the administration and delivery of public
assistance programs throughout the state, and to reduce the possibility of sanctions and
fiscal disallowances for noncompliance with federal regulations and state statutes. The
commissioner, or the commissioner's representative, may issue administrative subpoenas
as needed in administering the compliance system.
The commissioner shall utilize training, technical assistance, and monitoring
activities, as specified in section 256.01, subdivision 2, to encourage county agency
compliance with written policies and procedures.
Sec. 10.
Minnesota Statutes 2014, section 256.741, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) The term "direct support" as used in this chapter and
chapters 257, 518, 518A, and 518C refers to an assigned support payment from an obligor
which is paid directly to a recipient of public assistance.
(b) The term "public assistance" as used in this chapter and chapters 257, 518, 518A,
and 518C, includes any form of assistance provided under the AFDC program formerly
codified in sections 256.72 to 256.87, MFIP and MFIP-R formerly codified under chapter
256, MFIP under chapter 256J, work first program formerly codified under chapter 256K;
child care assistance provided through the child care fund under chapter 119B; any form
of medical assistance under chapter 256B; deleted text begin MinnesotaCare under chapter 256L;deleted text end and foster
care as provided under title IV-E of the Social Security Act.new text begin MinnesotaCare and health
plans subsidized by federal premium tax credits or federal cost-sharing reductions are not
considered public assistance for purposes of a child support referral.
new text end
(c) The term "child support agency" as used in this section refers to the public
authority responsible for child support enforcement.
(d) The term "public assistance agency" as used in this section refers to a public
authority providing public assistance to an individual.
(e) The terms "child support" and "arrears" as used in this section have the meanings
provided in section 518A.26.
(f) The term "maintenance" as used in this section has the meaning provided in
section 518.003.
Sec. 11.
Minnesota Statutes 2014, section 256.741, subdivision 2, is amended to read:
Subd. 2.
Assignment of support and maintenance rights.
(a) An individual
receiving public assistance in the form of assistance under any of the following programs:
the AFDC program formerly codified in sections 256.72 to 256.87, MFIP under chapter
256J, MFIP-R and MFIP formerly codified under chapter 256, or work first program
formerly codified under chapter 256K is considered to have assigned to the state at the
time of application all rights to child support and maintenance from any other person the
applicant or recipient may have in the individual's own behalf or in the behalf of any other
family member for whom application for public assistance is made. An assistance unit is
ineligible for the Minnesota family investment program unless the caregiver assigns all
rights to child support and maintenance benefits according to this section.
(1) The assignment is effective as to any current child support and current
maintenance.
(2) Any child support or maintenance arrears that accrue while an individual is
receiving public assistance in the form of assistance under any of the programs listed in
this paragraph are permanently assigned to the state.
(3) The assignment of current child support and current maintenance ends on the
date the individual ceases to receive or is no longer eligible to receive public assistance
under any of the programs listed in this paragraph.
(b) An individual receiving public assistance in the form of medical assistancedeleted text begin ,
including MinnesotaCare,deleted text end is considered to have assigned to the state at the time of
application all rights to medical support from any other person the individual may have
in the individual's own behalf or in the behalf of any other family member for whom
medical assistance is provided.
(1) An assignment made after September 30, 1997, is effective as to any medical
support accruing after the date of medical assistance deleted text begin or MinnesotaCaredeleted text end eligibility.
(2) Any medical support arrears that accrue while an individual is receiving public
assistance in the form of medical assistancedeleted text begin , including MinnesotaCare,deleted text end are permanently
assigned to the state.
(3) The assignment of current medical support ends on the date the individual ceases
to receive or is no longer eligible to receive public assistance in the form of medical
assistance deleted text begin or MinnesotaCaredeleted text end .
(c) An individual receiving public assistance in the form of child care assistance
under the child care fund pursuant to chapter 119B is considered to have assigned to the
state at the time of application all rights to child care support from any other person the
individual may have in the individual's own behalf or in the behalf of any other family
member for whom child care assistance is provided.
(1) The assignment is effective as to any current child care support.
(2) Any child care support arrears that accrue while an individual is receiving public
assistance in the form of child care assistance under the child care fund in chapter 119B
are permanently assigned to the state.
(3) The assignment of current child care support ends on the date the individual
ceases to receive or is no longer eligible to receive public assistance in the form of child
care assistance under the child care fund under chapter 119B.
Sec. 12.
new text begin
[256E.28] CHILD PROTECTION GRANTS TO ADDRESS CHILD
WELFARE DISPARITIES.
new text end
new text begin Subdivision 1. new text end
new text begin Child welfare disparities grant program established. new text end
new text begin
The
commissioner may award grants to eligible entities for the development, implementation,
and evaluation of activities to address racial disparities and disproportionality in the child
welfare system by:
new text end
new text begin
(1) identifying and addressing structural factors that contribute to inequities in
outcomes;
new text end
new text begin
(2) identifying and implementing strategies to reduce racial disparities in treatment
and outcomes;
new text end
new text begin
(3) using cultural values, beliefs, and practices of families, communities, and tribes
for case planning, service design, and decision-making processes;
new text end
new text begin
(4) using placement and reunification strategies to maintain and support relationships
and connections between parents, siblings, children, kin, significant others, and tribes; and
new text end
new text begin
(5) supporting families in the context of their communities and tribes to safely divert
them from the child welfare system, whenever possible.
new text end
new text begin Subd. 2. new text end
new text begin State-community partnerships; plan. new text end
new text begin
The commissioner, in partnership
with the legislative task force on child protection; culturally based community
organizations; the Indian Affairs Council under section 3.922; the Council on Affairs of
Chicano/Latino People under section 3.9223; the Council on Black Minnesotans under
section 3.9225; the Council on Asian-Pacific Minnesotans under section 3.9226; the
American Indian Child Welfare Advisory Council under section 260.835; counties; and
tribal governments, shall develop and implement a comprehensive, coordinated plan to
award funds under this section for the priority areas identified in subdivision 1.
new text end
new text begin Subd. 3. new text end
new text begin Measurable outcomes. new text end
new text begin
The commissioner, in consultation with the
state-community partners listed in subdivision 2, shall establish measurable outcomes to
determine the effectiveness of the grants and other activities funded under this section in
reducing disparities identified in subdivision 1. The development of measurable outcomes
must be completed before any funds are distributed under this section.
new text end
new text begin Subd. 4. new text end
new text begin Process. new text end
new text begin
(a) The commissioner, in consultation with the state-community
partners listed in subdivision 2, shall develop the criteria and procedures to allocate
competitive grants under this section. In developing the criteria, the commissioner shall
establish an administrative cost limit for grant recipients. A county awarded a grant shall
not spend more than three percent of the grant on administrative costs. When a grant
is awarded, the commissioner must provide a grant recipient with information on the
outcomes established according to subdivision 3.
new text end
new text begin
(b) A grant recipient must coordinate its activities with other entities receiving funds
under this section that are in the grant recipient's service area.
new text end
new text begin
(c) Grant funds must not be used to supplant any state or federal funds received
for child welfare services.
new text end
new text begin Subd. 5. new text end
new text begin Grant program criteria. new text end
new text begin
(a) The commissioner shall award competitive
grants to eligible applicants for local or regional projects and initiatives directed at
reducing disparities in the child welfare system.
new text end
new text begin
(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
coordination activities, and development of community-supported strategies.
new text end
new text begin
(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, counties, and tribal
governments. Applicants must submit proposals to the commissioner. A proposal must
specify the strategies to be implemented to address one or more of the priority areas in
subdivision 1 and must be targeted to achieve the outcomes established according to
subdivision 3.
new text end
new text begin
(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:
new text end
new text begin
(1) is supported by the community the applicant will serve;
new text end
new text begin
(2) is evidence-based;
new text end
new text begin
(3) is designed to complement other related community activities;
new text end
new text begin
(4) utilizes strategies that positively impact priority areas;
new text end
new text begin
(5) reflects culturally appropriate approaches; or
new text end
new text begin
(6) will be implemented through or with community-based organizations that reflect
the culture of the population to be reached.
new text end
new text begin Subd. 6. new text end
new text begin Evaluation. new text end
new text begin
(a) Using the outcomes established according to subdivision
3, the commissioner shall conduct a biennial evaluation of the grant program funded under
this section. Grant recipients shall cooperate with the commissioner in the evaluation and
shall provide the commissioner with the information needed to conduct the evaluation.
new text end
new text begin
(b) The commissioner shall consult with the legislative task force on child protection
during the evaluation process and shall submit a biennial evaluation report to the task
force and to the chairs and ranking minority members of the house of representatives and
senate committees with jurisdiction over child protection funding.
new text end
new text begin Subd. 7. new text end
new text begin American Indian child welfare projects. new text end
new text begin
Of the amount appropriated for
purposes of this section, the commissioner shall award $75,000 to each tribe authorized to
provide tribal delivery of child welfare services under section 256.01, subdivision 14b. To
receive funds under this subdivision, a participating tribe is not required to apply to the
commissioner for grant funds. Participating tribes are also eligible for competitive grant
funds under this section.
new text end
Sec. 13.
Minnesota Statutes 2014, section 256E.35, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) The definitions in this subdivision apply to this section.
new text begin
(b) "Eligible educational institution" means the following:
new text end
new text begin
(1) an institution of higher education described in section 101 or 102 of the Higher
Education Act of 1965; or
new text end
new text begin
(2) an area vocational education school, as defined in subparagraph (C) or (D) of
United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational
and Applied Technology Education Act), which is located within any state, as defined in
United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only
to the extent section 2302 is in effect on August 1, 2008.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end "Family asset account" means a savings account opened by a household
participating in the Minnesota family assets for independence initiative.
deleted text begin (c)deleted text end new text begin (d)new text end "Fiduciary organization" means:
(1) a community action agency that has obtained recognition under section 256E.31;
(2) a federal community development credit union serving the seven-county
metropolitan area; or
(3) a women-oriented economic development agency serving the seven-county
metropolitan area.
new text begin
(e)
new text end
new text begin
"Financial coach" means a person who:
new text end
new text begin
(1) has completed an intensive financial literacy training workshop that includes
curriculum on budgeting to increase savings, debt reduction and asset building, building a
good credit rating, and consumer protection;
new text end
new text begin
(2) participates in ongoing statewide family assets for independence in Minnesota
(FAIM) network training meetings under FAIM program supervision; and
new text end
new text begin
(3) provides financial coaching to program participants under subdivision 4a.
new text end
deleted text begin (d)deleted text end new text begin (f)new text end "Financial institution" means a bank, bank and trust, savings bank, savings
association, or credit union, the deposits of which are insured by the Federal Deposit
Insurance Corporation or the National Credit Union Administration.
new text begin
(g) "Household" means all individuals who share use of a dwelling unit as primary
quarters for living and eating separate from other individuals.
new text end
deleted text begin (e)deleted text end new text begin (h)new text end "Permissible use" means:
(1) postsecondary educational expenses at an eligible educational institution as
defined in paragraph deleted text begin (g)deleted text end new text begin (b)new text end , including books, supplies, and equipment required for
courses of instruction;
(2) acquisition costs of acquiring, constructing, or reconstructing a residence,
including any usual or reasonable settlement, financing, or other closing costs;
(3) business capitalization expenses for expenditures on capital, plant, equipment,
working capital, and inventory expenses of a legitimate business pursuant to a business
plan approved by the fiduciary organization; and
(4) acquisition costs of a principal residence within the meaning of section 1034 of
the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area
purchase price applicable to the residence determined according to section 143(e)(2) and
(3) of the Internal Revenue Code of 1986.
deleted text begin
(f) "Household" means all individuals who share use of a dwelling unit as primary
quarters for living and eating separate from other individuals.
deleted text end
deleted text begin
(g) "Eligible educational institution" means the following:
deleted text end
deleted text begin
(1) an institution of higher education described in section 101 or 102 of the Higher
Education Act of 1965; or
deleted text end
deleted text begin
(2) an area vocational education school, as defined in subparagraph (C) or (D) of
United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational
and Applied Technology Education Act), which is located within any state, as defined in
United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only
to the extent section 2302 is in effect on August 1, 2008.
deleted text end
Sec. 14.
Minnesota Statutes 2014, section 256E.35, is amended by adding a subdivision
to read:
new text begin Subd. 4a. new text end
new text begin Financial coaching. new text end
new text begin
A financial coach shall provide the following
to program participants:
new text end
new text begin
(1) financial education relating to budgeting, debt reduction, asset-specific training,
and financial stability activities;
new text end
new text begin
(2) asset-specific training related to buying a home, acquiring postsecondary
education, or starting or expanding a small business; and
new text end
new text begin
(3) financial stability education and training to improve and sustain financial security.
new text end
Sec. 15.
Minnesota Statutes 2014, section 256I.03, subdivision 3, is amended to read:
Subd. 3.
Group residential housing.
"Group residential housing" means a group
living situation that provides at a minimum room and board to unrelated persons who
meet the eligibility requirements of section 256I.04. deleted text begin This definition includes foster care
settings or community residential settings for a single adult.deleted text end To receive payment for a
group residence rate, the residence must meet the requirements under section 256I.04,
deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 2anew text begin to 2fnew text end .
Sec. 16.
Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:
Subd. 7.
Countable income.
"Countable income" means all income received by
an applicant or recipient less any applicable exclusions or disregards. For a recipient of
any cash benefit from the SSI program, countable income means the SSI benefit limit in
effect at the time the person is deleted text begin in a GRHdeleted text end new text begin a recipient of group residential housingnew text end , less the
medical assistance personal needs allowancenew text begin under section 256B.35new text end . If the SSI limit
deleted text begin has beendeleted text end new text begin or benefit isnew text end reduced for a person due to events deleted text begin occurring prior to the persons
entering the GRH settingdeleted text end new text begin other than receipt of additional incomenew text end , countable income means
actual income less any applicable exclusions and disregards.
Sec. 17.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 9. new text end
new text begin Direct contact. new text end
new text begin
"Direct contact" means providing face-to-face care,
training, supervision, counseling, consultation, or medication assistance to recipients of
group residential housing.
new text end
Sec. 18.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Habitability inspection. new text end
new text begin
"Habitability inspection" means an inspection to
determine whether the housing occupied by an individual meets the habitability standards
specified by the commissioner. The standards must be provided to the applicant in writing
and posted on the Department of Human Services Web site.
new text end
Sec. 19.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Long-term homelessness. new text end
new text begin
"Long-term homelessness" means lacking a
permanent place to live:
new text end
new text begin
(1) continuously for one year or more; or
new text end
new text begin
(2) at least four times in the past three years.
new text end
Sec. 20.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Professional statement of need. new text end
new text begin
"Professional statement of need" means
a statement about an individual's illness, injury, or incapacity that is signed by a qualified
professional. The statement must specify that the individual has an illness or incapacity
which limits the individual's ability to work and provide self-support. The statement
must also specify that the individual needs assistance to access or maintain housing, as
evidenced by the need for two or more of the following services:
new text end
new text begin
(1) tenancy supports to assist an individual with finding the individual's own
home, landlord negotiation, securing furniture and household supplies, understanding
and maintaining tenant responsibilities, conflict negotiation, and budgeting and financial
education;
new text end
new text begin
(2) supportive services to assist with basic living and social skills, household
management, monitoring of overall well-being, and problem solving;
new text end
new text begin
(3) employment supports to assist with maintaining or increasing employment,
increasing earnings, understanding and utilizing appropriate benefits and services,
improving physical or mental health, moving toward self-sufficiency, and achieving
personal goals; or
new text end
new text begin
(4) health supervision services to assist in the preparation and administration of
medications other than injectables, the provision of therapeutic diets, taking vital signs, or
providing assistance in dressing, grooming, bathing, or with walking devices.
new text end
Sec. 21.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Prospective budgeting. new text end
new text begin
"Prospective budgeting" means estimating the
amount of monthly income a person will have in the payment month.
new text end
Sec. 22.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Qualified professional. new text end
new text begin
"Qualified professional" means an individual as
defined in section 256J.08, subdivision 73a, or Minnesota Rules, part 9530.6450, subpart
3, 4, or 5; or an individual approved by the director of human services or a designee
of the director.
new text end
Sec. 23.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Supportive housing. new text end
new text begin
"Supportive housing" means housing with support
services according to the continuum of care coordinated assessment system established
under Code of Federal Regulations, title 24, section 578.3.
new text end
Sec. 24.
Minnesota Statutes 2014, section 256I.04, subdivision 1, is amended to read:
Subdivision 1.
Individual eligibility requirements.
An individual is eligible for
and entitled to a group residential housing payment to be made on the individual's behalf
if the agency has approved the individual's residence in a group residential housing setting
and the individual meets the requirements in paragraph (a) or (b).
(a) The individual is aged, blind, or is over 18 years of age and disabled as
determined under the criteria used by the title II program of the Social Security Act, and
meets the resource restrictions and standards of section 256P.02, and the individual's
countable income after deducting the (1) exclusions and disregards of the SSI program,
(2) the medical assistance personal needs allowance under section 256B.35, and (3) an
amount equal to the income actually made available to a community spouse by an elderly
waiver participant under the provisions of sections 256B.0575, paragraph (a), clause
(4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's
agreement with the provider of group residential housing in which the individual resides.
(b) The individual meets a category of eligibility under section 256D.05, subdivision
1, paragraph (a),new text begin clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable,new text end and
the individual's resources are less than the standards specified by section 256P.02, and
the individual's countable income as determined under sections 256D.01 to 256D.21, less
the medical assistance personal needs allowance under section 256B.35 is less than the
monthly rate specified in the agency's agreement with the provider of group residential
housing in which the individual resides.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2015.
new text end
Sec. 25.
Minnesota Statutes 2014, section 256I.04, subdivision 1a, is amended to read:
Subd. 1a.
County approval.
(a) A county agency may not approve a group
residential housing payment for an individual in any setting with a rate in excess of the
MSA equivalent rate for more than 30 days in a calendar year unless the deleted text begin county agency
has developed or approveddeleted text end new text begin individual hasnew text end a deleted text begin plan for the individual which specifies that:
deleted text end
deleted text begin
(1) the individual has an illness or incapacity which prevents the person from living
independently in the community; and
deleted text end
deleted text begin
(2) the individual's illness or incapacity requires the services which are available in
the group residence.
deleted text end
deleted text begin The plan must be signed or countersigned by any of the following employees of the
county of financial responsibility: the director of human services or a designee of the
director; a social worker; or a case aidedeleted text end new text begin professional statement of need under section
256I.03, subdivision 12new text end .
(b) If a county agency determines that an applicant is ineligible due to not meeting
eligibility requirements under this section, a county agency may accept a signed personal
statement from the applicant in lieu of documentation verifying ineligibility.
new text begin
(c) Effective July 1, 2016, to be eligible for supplementary service payments,
providers must enroll in the provider enrollment system identified by the commissioner.
new text end
Sec. 26.
Minnesota Statutes 2014, section 256I.04, subdivision 2a, is amended to read:
Subd. 2a.
License requirednew text begin ; staffing qualificationsnew text end .
deleted text begin A countydeleted text end new text begin (a) Except
as provided in paragraph (b), annew text end agency may not enter into an agreement with an
establishment to provide group residential housing unless:
(1) the establishment is licensed by the Department of Health as a hotel and
restaurant; a board and lodging establishment; deleted text begin a residential care home;deleted text end a boarding care
home before March 1, 1985; or a supervised living facility, and the service provider
for residents of the facility is licensed under chapter 245A. However, an establishment
licensed by the Department of Health to provide lodging need not also be licensed to
provide board if meals are being supplied to residents under a contract with a food vendor
who is licensed by the Department of Health;
(2) the residence is: (i) licensed by the commissioner of human services under
Minnesota Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services
agency prior to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050
to 9555.6265; (iii) deleted text begin a residencedeleted text end licensed by the commissioner under Minnesota Rules, parts
2960.0010 to 2960.0120, with a variance under section 245A.04, subdivision 9; or (iv)
licensed under section 245D.02, subdivision 4a, as a community residential setting by
the commissioner of human services;new text begin or
new text end
(3) the establishment is registered under chapter 144D and provides three meals a
daydeleted text begin , or is an establishment voluntarily registered under section 144D.025 as a supportive
housing establishment; ordeleted text end new text begin .
new text end
deleted text begin
(4) an establishment voluntarily registered under section 144D.025, other than
a supportive housing establishment under clause (3), is not eligible to provide group
residential housing.
deleted text end
new text begin (b) new text end The requirements under deleted text begin clauses (1) to (4)deleted text end new text begin paragraph (a)new text end do not apply to
establishments exempt from state licensure because they arenew text begin :
new text end
new text begin (1)new text end located on Indian reservations and subject to tribal health and safety
requirementsdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(2) a supportive housing establishment that has an approved habitability inspection
and an individual lease agreement and that serves people who have experienced long-term
homelessness and were referred through a coordinated assessment in section 256I.03,
subdivision 15.
new text end
new text begin
(c) Supportive housing establishments and emergency shelters must participate in
the homeless management information system.
new text end
new text begin
(d) Effective July 1, 2016, an agency shall not have an agreement with a provider
of group residential housing or supplementary services unless all staff members who
have direct contact with recipients:
new text end
new text begin
(1) have skills and knowledge acquired through one or more of the following:
new text end
new text begin
(i) a course of study in a health- or human services-related field leading to a bachelor
of arts, bachelor of science, or associate's degree;
new text end
new text begin
(ii) one year of experience with the target population served;
new text end
new text begin
(iii) experience as a certified peer specialist according to section 256B.0615; or
new text end
new text begin
(iv) meeting the requirements for unlicensed personnel under sections 144A.43
to 144A.483;
new text end
new text begin
(2) hold a current Minnesota driver's license appropriate to the vehicle driven
if transporting recipients;
new text end
new text begin
(3) complete training on vulnerable adults mandated reporting and child
maltreatment mandated reporting, where applicable; and
new text end
new text begin
(4) complete group residential housing orientation training offered by the
commissioner.
new text end
Sec. 27.
Minnesota Statutes 2014, section 256I.04, subdivision 2b, is amended to read:
Subd. 2b.
Group residential housing agreements.
new text begin (a) new text end Agreements between deleted text begin county
deleted text end agencies and providers of group residential housing new text begin or supplementary services new text end must be in
writingnew text begin on a form developed and approved by the commissionernew text end and must specify the name
and address under which the establishment subject to the agreement does business and
under which the establishment, or service provider, if different from the group residential
housing establishment, is licensed by the Department of Health or the Department of
Human Services; the specific license or registration from the Department of Health or the
Department of Human Services held by the provider and the number of beds subject to
that license; the address of the location or locations at which group residential housing is
provided under this agreement; the per diem and monthly rates that are to be paid from
group residential housing new text begin or supplementary service new text end funds for each eligible resident at each
location; the number of beds at each location which are subject to the deleted text begin group residential
housingdeleted text end agreement; whether the license holder is a not-for-profit corporation under section
501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to
the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections.
new text begin
(b) Providers are required to verify the following minimum requirements in the
agreement:
new text end
new text begin
(1) current license or registration, including authorization if managing or monitoring
medications;
new text end
new text begin
(2) all staff who have direct contact with recipients meet the staff qualifications;
new text end
new text begin
(3) the provision of group residential housing;
new text end
new text begin
(4) the provision of supplementary services, if applicable;
new text end
new text begin
(5) reports of adverse events, including recipient death or serious injury; and
new text end
new text begin
(6) submission of residency requirements that could result in recipient eviction.
new text end
deleted text begin Group residential housingdeleted text end new text begin (c)new text end Agreements may be terminated with or without cause by
deleted text begin eitherdeleted text end the deleted text begin countydeleted text end new text begin commissioner, the agency,new text end or the provider with two calendar months prior
notice.new text begin The commissioner may immediately terminate an agreement under subdivision 2d.
new text end
Sec. 28.
Minnesota Statutes 2014, section 256I.04, subdivision 2c, is amended to read:
Subd. 2c.
deleted text begin Crisis sheltersdeleted text end new text begin Background study requirementsnew text end .
deleted text begin
Secure crisis shelters
for battered women and their children designated by the Minnesota Department of
Corrections are not group residences under this chapter.
deleted text end
new text begin
(a) Effective July 1, 2016, a
provider of group residential housing or supplementary services must initiate background
studies in accordance with chapter 245C of the following individuals:
new text end
new text begin
(1) controlling individuals as defined in section 245A.02;
new text end
new text begin
(2) managerial officials as defined in section 245A.02; and
new text end
new text begin
(3) all employees and volunteers of the establishment who have direct contact
with recipients, or who have unsupervised access to recipients, their personal property,
or their private data.
new text end
new text begin
(b) The provider of group residential housing or supplementary services must
maintain compliance with all requirements established for entities initiating background
studies under chapter 245C.
new text end
new text begin
(c) Effective July 1, 2017, a provider of group residential housing or supplementary
services must demonstrate that all individuals required to have a background study
according to paragraph (a) have a notice stating either that:
new text end
new text begin
(1) the individual is not disqualified under section 245C.14; or
new text end
new text begin
(2) the individual is disqualified, but the individual has been issued a set-aside of
the disqualification for that setting under section 245C.22.
new text end
Sec. 29.
Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
to read:
new text begin Subd. 2d. new text end
new text begin
Conditions of payment; commissioner's right to suspend or terminate
agreement.
new text end
new text begin
(a) Group residential housing or supplementary services must be provided
to the satisfaction of the commissioner, as determined at the sole discretion of the
commissioner's authorized representative, and in accordance with all applicable federal,
state, and local laws, ordinances, rules, and regulations, including business registration
requirements of the Office of the Secretary of State. A provider shall not receive payment
for services or housing found by the commissioner to be performed or provided in
violation of federal, state, or local law, ordinance, rule, or regulation.
new text end
new text begin
(b) The commissioner has the right to suspend or terminate the agreement
immediately when the commissioner determines the health or welfare of the housing or
service recipients is endangered, or when the commissioner has reasonable cause to believe
that the provider has breached a material term of the agreement under subdivision 2b.
new text end
new text begin
(c) Notwithstanding paragraph (b), if the commissioner learns of a curable material
breach of the agreement by the provider, the commissioner shall provide the provider
with a written notice of the breach and allow ten days to cure the breach. If the provider
does not cure the breach within the time allowed, the provider shall be in default of the
agreement and the commissioner may terminate the agreement immediately thereafter. If
the provider has breached a material term of the agreement and cure is not possible, the
commissioner may immediately terminate the agreement.
new text end
Sec. 30.
Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
to read:
new text begin Subd. 2e. new text end
new text begin Providers holding health or human services licenses. new text end
new text begin
(a) Except
for facilities with only a board and lodging license, when group residential housing or
supplementary service staff are also operating under a license issued by the Department of
Health or the Department of Human Services, the minimum staff qualification requirements
for the setting shall be the qualifications listed under the related licensing standards.
new text end
new text begin
(b) A background study completed for the licensed service must also satisfy the
background study requirements under this section, if the provider has established the
background study contact person according to chapter 245C and as directed by the
Department of Human Services.
new text end
Sec. 31.
Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
to read:
new text begin Subd. 2f. new text end
new text begin Required services. new text end
new text begin
In licensed and registered settings under subdivision
2a, providers shall ensure that participants have at a minimum:
new text end
new text begin
(1) food preparation and service for three nutritional meals a day on site;
new text end
new text begin
(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or
service;
new text end
new text begin
(3) housekeeping, including cleaning and lavatory supplies or service; and
new text end
new text begin
(4) maintenance and operation of the building and grounds, including heat, water,
garbage removal, electricity, telephone for the site, cooling, supplies, and parts and tools
to repair and maintain equipment and facilities.
new text end
Sec. 32.
Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
to read:
new text begin Subd. 2g. new text end
new text begin Crisis shelters. new text end
new text begin
Secure crisis shelters for battered women and their
children designated by the Minnesota Department of Corrections are not group residences
under this chapter.
new text end
Sec. 33.
Minnesota Statutes 2014, section 256I.04, subdivision 3, is amended to read:
Subd. 3.
Moratorium on development of group residential housing beds.
(a)
deleted text begin Countydeleted text end Agencies shall not enter into agreements for new group residential housing beds
with total rates in excess of the MSA equivalent rate except:
(1) for group residential housing establishments licensed under Minnesota Rules,
parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction
targets for persons with developmental disabilities at regional treatment centers;
(2) up to 80 beds in a single, specialized facility located in Hennepin County that will
provide housing for chronic inebriates who are repetitive users of detoxification centers
and are refused placement in emergency shelters because of their state of intoxication,
and planning for the specialized facility must have been initiated before July 1, 1991,
in anticipation of receiving a grant from the Housing Finance Agency under section
462A.05, subdivision 20a, paragraph (b);
(3) notwithstanding the provisions of subdivision 2a, for up to 190 supportive
housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a
mental illness, a history of substance abuse, or human immunodeficiency virus or acquired
immunodeficiency syndrome. For purposes of this section, "homeless adult" means a
person who is living on the street or in a shelter or discharged from a regional treatment
center, community hospital, or residential treatment program and has no appropriate
housing available and lacks the resources and support necessary to access appropriate
housing. At least 70 percent of the supportive housing units must serve homeless adults
with mental illness, substance abuse problems, or human immunodeficiency virus or
acquired immunodeficiency syndrome who are about to be or, within the previous six
months, has been discharged from a regional treatment center, or a state-contracted
psychiatric bed in a community hospital, or a residential mental health or chemical
dependency treatment program. If a person meets the requirements of subdivision 1,
paragraph (a), and receives a federal or state housing subsidy, the group residential housing
rate for that person is limited to the supplementary rate under section 256I.05, subdivision
1a, and is determined by subtracting the amount of the person's countable income that
exceeds the MSA equivalent rate from the group residential housing supplementary rate.
A resident in a demonstration project site who no longer participates in the demonstration
program shall retain eligibility for a group residential housing payment in an amount
determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service
funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching
funds are available and the services can be provided through a managed care entity. If
federal matching funds are not available, then service funding will continue under section
256I.05, subdivision 1a;
(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in
Hennepin County providing services for recovering and chemically dependent men that
has had a group residential housing contract with the county and has been licensed as a
board and lodge facility with special services since 1980;
(5) for a group residential housing provider located in the city of St. Cloud, or a county
contiguous to the city of St. Cloud, that operates a 40-bed facility, that received financing
through the Minnesota Housing Finance Agency Ending Long-Term Homelessness
Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
(6) for a new 65-bed facility in Crow Wing County that will serve chemically
dependent persons, operated by a group residential housing provider that currently
operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
(7) for a group residential housing provider that operates two ten-bed facilities, one
located in Hennepin County and one located in Ramsey County, that provide community
support and 24-hour-a-day supervision to serve the mental health needs of individuals
who have chronically lived unsheltered; and
(8) for a group residential facility in Hennepin County with a capacity of up to 48
beds that has been licensed since 1978 as a board and lodging facility and that until August
1, 2007, operated as a licensed chemical dependency treatment program.
(b) deleted text begin A countydeleted text end new text begin Annew text end agency may enter into a group residential housing agreement for
beds with rates in excess of the MSA equivalent rate in addition to those currently covered
under a group residential housing agreement if the additional beds are only a replacement
of beds with rates in excess of the MSA equivalent rate which have been made available
due to closure of a setting, a change of licensure or certification which removes the beds
from group residential housing payment, or as a result of the downsizing of a group
residential housing setting. The transfer of available beds from one deleted text begin countydeleted text end new text begin agencynew text end to
another can only occur by the agreement of both deleted text begin countiesdeleted text end new text begin agenciesnew text end .
Sec. 34.
Minnesota Statutes 2014, section 256I.04, subdivision 4, is amended to read:
Subd. 4.
Rental assistance.
For participants in the Minnesota supportive housing
demonstration program under subdivision 3, paragraph (a), clause (5), notwithstanding
the provisions of section 256I.06, subdivision 8, the amount of the group residential
housing payment for room and board must be calculated by subtracting 30 percent of the
recipient's adjusted income as defined by the United States Department of Housing and
Urban Development for the Section 8 program from the fair market rent established for the
recipient's living unit by the federal Department of Housing and Urban Development. This
payment shall be regarded as a state housing subsidy for the purposes of subdivision 3.
Notwithstanding the provisions of section 256I.06, subdivision 6, the recipient's countable
income will only be adjusted when a change of greater than $100 in a month occurs or
upon annual redetermination of eligibility, whichever is sooner. deleted text begin The commissioner is
directed to study the feasibility of developing a rental assistance program to serve persons
traditionally served in group residential housing settings and report to the legislature by
February 15, 1999.
deleted text end
Sec. 35.
Minnesota Statutes 2014, section 256I.05, subdivision 1c, is amended to read:
Subd. 1c.
Rate increases.
deleted text begin A countydeleted text end new text begin Annew text end agency may not increase the rates
negotiated for group residential housing above those in effect on June 30, 1993, except as
provided in paragraphs (a) to (f).
(a) deleted text begin A countydeleted text end new text begin An agencynew text end may increase the rates for group residential housing settings
to the MSA equivalent rate for those settings whose current rate is below the MSA
equivalent rate.
(b) deleted text begin A countydeleted text end new text begin Annew text end agency may increase the rates for residents in adult foster care
whose difficulty of care has increased. The total group residential housing rate for these
residents must not exceed the maximum rate specified in subdivisions 1 and 1a. deleted text begin County
deleted text end Agencies must not include nor increase group residential housing difficulty of care rates
for adults in foster care whose difficulty of care is eligible for funding by home and
community-based waiver programs under title XIX of the Social Security Act.
(c) The room and board rates will be increased each year when the MSA equivalent
rate is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase,
less the amount of the increase in the medical assistance personal needs allowance under
section 256B.35.
(d) When a group residential housing rate is used to pay for an individual's room
and board, or other costs necessary to provide room and board, the rate payable to
the residence must continue for up to 18 calendar days per incident that the person is
temporarily absent from the residence, not to exceed 60 days in a calendar year, if the
absence or absences have received the prior approval of the county agency's social service
staff. Prior approval is not required for emergency absences due to crisis, illness, or injury.
(e) For facilities meeting substantial change criteria within the prior year. Substantial
change criteria exists if the group residential housing establishment experiences a 25
percent increase or decrease in the total number of its beds, if the net cost of capital
additions or improvements is in excess of 15 percent of the current market value of the
residence, or if the residence physically moves, or changes its licensure, and incurs a
resulting increase in operation and property costs.
(f) Until June 30, 1994, deleted text begin a countydeleted text end new text begin annew text end agency may increase by up to five percent the
total rate paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33
to 256D.54 who reside in residences that are licensed by the commissioner of health as
a boarding care home, but are not certified for the purposes of the medical assistance
program. However, an increase under this clause must not exceed an amount equivalent to
65 percent of the 1991 medical assistance reimbursement rate for nursing home resident
class A, in the geographic grouping in which the facility is located, as established under
Minnesota Rules, parts 9549.0050 to 9549.0058.
Sec. 36.
Minnesota Statutes 2014, section 256I.05, subdivision 1g, is amended to read:
Subd. 1g.
Supplementary service rate for certain facilities.
deleted text begin On or after July 1,
2005, a countydeleted text end new text begin Annew text end agency may negotiate a supplementary service rate for recipients of
assistance under section 256I.04, subdivision 1, paragraphnew text begin (a) ornew text end (b), who deleted text begin relocate from a
homeless shelter licensed and registered prior to December 31, 1996, by the Minnesota
Department of Health under section 157.17, todeleted text end new text begin have experienced long-term homelessness
and who live innew text end a supportive housing establishment deleted text begin developed and funded in whole or in
part with funds provided specifically as part of the plan to end long-term homelessness
required under Laws 2003, chapter 128, article 15, section 9, not to exceed $456.75deleted text end new text begin under
section 256I.04, subdivision 2a, paragraph (b), clause (2)new text end .
Sec. 37.
Minnesota Statutes 2014, section 256I.06, subdivision 2, is amended to read:
Subd. 2.
Time of payment.
A county agency may make payments to a group
residence in advance for an individual whose stay in the group residence is expected
to last beyond the calendar month for which the payment is made deleted text begin and who does not
expect to receive countable earned income during the month for which the payment is
madedeleted text end . Group residential housing payments made by a county agency on behalf of an
individual who is not expected to remain in the group residence beyond the month for
which payment is made must be made subsequent to the individual's departure from the
group residence. deleted text begin Group residential housing payments made by a county agency on behalf
of an individual with countable earned income must be made subsequent to receipt of a
monthly household report form.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective April 1, 2016.
new text end
Sec. 38.
Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:
Subd. 6.
Reports.
Recipients must report changes in circumstances that affect
eligibility or group residential housing payment amountsnew text begin , other than changes in earned
income,new text end within ten days of the change. Recipients with countable earned income must
complete a deleted text begin monthlydeleted text end household report formnew text begin at least once every six monthsnew text end . If the report
form is not received before the end of the month in which it is due, the county agency
must terminate eligibility for group residential housing payments. The termination shall
be effective on the first day of the month following the month in which the report was due.
If a complete report is received within the month eligibility was terminated, the individual
is considered to have continued an application for group residential housing payment
effective the first day of the month the eligibility was terminated.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective April 1, 2016.
new text end
Sec. 39.
Minnesota Statutes 2014, section 256I.06, subdivision 7, is amended to read:
Subd. 7.
Determination of rates.
Thenew text begin agency in thenew text end county in which a deleted text begin group
deleted text end residence is located deleted text begin willdeleted text end new text begin shallnew text end determine the amount of group residential housing rate to
be paid on behalf of an individual in the deleted text begin groupdeleted text end residence regardless of the individual's
deleted text begin countydeleted text end new text begin agencynew text end of financial responsibility.
Sec. 40.
Minnesota Statutes 2014, section 256I.06, subdivision 8, is amended to read:
Subd. 8.
Amount of group residential housing payment.
new text begin (a) new text end The amount of
a group residential housing payment to be made on behalf of an eligible individual is
determined by subtracting the individual's countable income under section 256I.04,
subdivision 1, for a whole calendar month from the group residential housing charge for
that same month. The group residential housing charge is determined by multiplying the
group residential housing rate times the period of time the individual was a resident or
temporarily absent under section 256I.05, subdivision 1c, paragraph (d).
new text begin
(b) For an individual with earned income under paragraph (a), prospective budgeting
must be used to determine the amount of the individual's payment for the following
six-month period. An increase in income shall not affect an individual's eligibility or
payment amount until the month following the reporting month. A decrease in income shall
be effective the first day of the month after the month in which the decrease is reported.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (b) is effective April 1, 2016.
new text end
Sec. 41.
Minnesota Statutes 2014, section 256J.21, subdivision 2, as amended by Laws
2015, chapter 21, article 1, section 60, is amended to read:
Subd. 2.
Income exclusions.
The following must be excluded in determining a
family's available income:
(1) payments for basic care, difficulty of care, and clothing allowances received for
providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, payments for family foster care
for children under section 260C.4411 or chapter 256N, and payments received and used
for care and maintenance of a third-party beneficiary who is not a household member;
(2) reimbursements for employment training received through the Workforce
Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
(3) reimbursement for out-of-pocket expenses incurred while performing volunteer
services, jury duty, employment, or informal carpooling arrangements directly related to
employment;
(4) all educational assistance, except the county agency must count graduate student
teaching assistantships, fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary educational expenses, shall
count scholarships or grants awarded to graduate students that do not require teaching
or research as unearned income;
(5) loans, regardless of purpose, from public or private lending institutions,
governmental lending institutions, or governmental agencies;
(6) loans from private individuals, regardless of purpose, provided an applicant or
participant documents that the lender expects repayment;
(7)(i) state income tax refunds; and
(ii) federal income tax refunds;
(8)(i) federal earned income credits;
(ii) Minnesota working family credits;
(iii) state homeowners and renters credits under chapter 290A; and
(iv) federal or state tax rebates;
(9) funds received for reimbursement, replacement, or rebate of personal or real
property when these payments are made by public agencies, awarded by a court, solicited
through public appeal, or made as a grant by a federal agency, state or local government,
or disaster assistance organizations, subsequent to a presidential declaration of disaster;
(10) the portion of an insurance settlement that is used to pay medical, funeral, and
burial expenses, or to repair or replace insured property;
(11) reimbursements for medical expenses that cannot be paid by medical assistance;
(12) payments by a vocational rehabilitation program administered by the state
under chapter 268A, except those payments that are for current living expenses;
(13) in-kind income, including any payments directly made by a third party to a
provider of goods and services;
(14) assistance payments to correct underpayments, but only for the month in which
the payment is received;
(15) payments for short-term emergency needs under section 256J.626, subdivision 2;
(16) funeral and cemetery payments as provided by section 256.935;
(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
a calendar month;
(18) any form of energy assistance payment made through Public Law 97-35,
Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
providers by other public and private agencies, and any form of credit or rebate payment
issued by energy providers;
(19) Supplemental Security Income (SSI), including retroactive SSI payments and
other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
(20) Minnesota supplemental aid, including retroactive payments;
(21) proceeds from the sale of real or personal property;
(22) adoption or kinship assistance payments under chapter 256N or 259A and
Minnesota permanency demonstration title IV-E waiver payments;
(23) state-funded family subsidy program payments made under section 252.32 to
help families care for children with developmental disabilities, consumer support grant
funds under section 256.476, and resources and services for a disabled household member
under one of the home and community-based waiver services programs under chapter 256B;
(24) interest payments and dividends from property that is not excluded from and
that does not exceed the asset limit;
(25) rent rebates;
(26) income earned by a minor caregiver, minor child through age 6, or a minor
child who is at least a half-time student in an approved elementary or secondary education
program;
(27) income earned by a caregiver under age 20 who is at least a half-time student in
an approved elementary or secondary education program;
(28) MFIP child care payments under section 119B.05;
(29) all other payments made through MFIP to support a caregiver's pursuit of
greater economic stability;
(30) income a participant receives related to shared living expenses;
(31) reverse mortgages;
(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
42, chapter 13A, sections 1771 to 1790;
(33) benefits provided by the women, infants, and children (WIC) nutrition program,
United States Code, title 42, chapter 13A, section 1786;
(34) benefits from the National School Lunch Act, United States Code, title 42,
chapter 13, sections 1751 to 1769e;
(35) relocation assistance for displaced persons under the Uniform Relocation
Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
Code, title 12, chapter 13, sections 1701 to 1750jj;
(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
12, part 2, sections 2271 to 2322;
(37) war reparations payments to Japanese Americans and Aleuts under United
States Code, title 50, sections 1989 to 1989d;
(38) payments to veterans or their dependents as a result of legal settlements
regarding Agent Orange or other chemical exposure under Public Law 101-239, section
10405, paragraph (a)(2)(E);
(39) income that is otherwise specifically excluded from MFIP consideration in
federal law, state law, or federal regulation;
(40) security and utility deposit refunds;
(41) American Indian tribal land settlements excluded under Public Laws 98-123,
98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
(42) all income of the minor parent's parents and stepparents when determining the
grant for the minor parent in households that include a minor parent living with parents or
stepparents on MFIP with other children;
(43) income of the minor parent's parents and stepparents equal to 200 percent of the
federal poverty guideline for a family size not including the minor parent and the minor
parent's child in households that include a minor parent living with parents or stepparents
not on MFIP when determining the grant for the minor parent. The remainder of income is
deemed as specified in section 256J.37, subdivision 1b;
(44) payments made to children eligible for relative custody assistance under section
257.85;
(45) vendor payments for goods and services made on behalf of a client unless the
client has the option of receiving the payment in cash;
(46) the principal portion of a contract for deed payment;
(47) cash payments to individuals enrolled for full-time service as a volunteer under
AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
National, and AmeriCorps NCCC; deleted text begin and
deleted text end
(48) housing assistance grants under section 256J.35, paragraph (a)new text begin ; and
new text end
new text begin (49) child support payments of up to $100 for an assistance unit with one child and
up to $200 for an assistance unit with two or more childrennew text end .
Sec. 42.
Minnesota Statutes 2014, section 256J.24, subdivision 5a, is amended to read:
Subd. 5a.
Food portion of MFIP transitional standard.
The commissioner shall
adjust the food portion of the MFIP transitional standard as needed to reflect adjustments
to the Supplemental Nutrition Assistance Programnew text begin and maintain compliance with federal
waivers related to the Supplemental Nutrition Assistance Program under the United States
Department of Agriculturenew text end . The commissioner shall publish the transitional standard
including a breakdown of the cash and food portions for an assistance unit of sizes one to
ten in the State Register whenever an adjustment is made.
Sec. 43.
Minnesota Statutes 2014, section 256J.33, subdivision 4, is amended to read:
Subd. 4.
Monthly income test.
A county agency must apply the monthly income test
retrospectively for each month of MFIP eligibility. An assistance unit is not eligible when
the countable income equals or exceeds the MFIP standard of need or the family wage level
for the assistance unit. The income applied against the monthly income test must include:
(1) gross earned income from employment, prior to mandatory payroll deductions,
voluntary payroll deductions, wage authorizations, and after the disregards in section
256J.21, subdivision 4, and the allocations in section 256J.36, unless the employment
income is specifically excluded under section 256J.21, subdivision 2;
(2) gross earned income from self-employment less deductions for self-employment
expenses in section 256J.37, subdivision 5, but prior to any reductions for personal or
business state and federal income taxes, personal FICA, personal health and life insurance,
and after the disregards in section 256J.21, subdivision 4, and the allocations in section
256J.36;
(3) unearned income after deductions for allowable expenses in section 256J.37,
subdivision 9, and allocations in section 256J.36, unless the income has been specifically
excluded in section 256J.21, subdivision 2;
(4) gross earned income from employment as determined under clause (1) which
is received by a member of an assistance unit who is a minor child or minor caregiver
and less than a half-time student;
(5) child support deleted text begin anddeleted text end new text begin received by an assistance unit, excluded under section 256J.21,
subdivision 2, clause (49), or section 256P.06, subdivision 3, clause (2), item (xvi);
new text end
new text begin (6) new text end spousal support received by an assistance unit;
deleted text begin (6)deleted text end new text begin (7)new text end the income of a parent when that parent is not included in the assistance unit;
deleted text begin (7)deleted text end new text begin (8)new text end the income of an eligible relative and spouse who seek to be included in
the assistance unit; and
deleted text begin (8)deleted text end new text begin (9)new text end the unearned income of a minor child included in the assistance unit.
Sec. 44.
Minnesota Statutes 2014, section 256K.45, subdivision 1a, is amended to read:
Subd. 1a.
Definitions.
(a) The definitions in this subdivision apply to this section.
(b) "Commissioner" means the commissioner of human services.
(c) "Homeless youth" means a person deleted text begin 21deleted text end new text begin 24new text end years of age or younger who is
unaccompanied by a parent or guardian and is without shelter where appropriate care and
supervision are available, whose parent or legal guardian is unable or unwilling to provide
shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
following are not fixed, regular, or adequate nighttime residences:
(1) a supervised publicly or privately operated shelter designed to provide temporary
living accommodations;
(2) an institution or a publicly or privately operated shelter designed to provide
temporary living accommodations;
(3) transitional housing;
(4) a temporary placement with a peer, friend, or family member that has not offered
permanent residence, a residential lease, or temporary lodging for more than 30 days; or
(5) a public or private place not designed for, nor ordinarily used as, a regular
sleeping accommodation for human beings.
Homeless youth does not include persons incarcerated or otherwise detained under
federal or state law.
(d) "Youth at risk of homelessness" means a person deleted text begin 21deleted text end new text begin 24 new text end years of age or younger
whose status or circumstances indicate a significant danger of experiencing homelessness
in the near future. Status or circumstances that indicate a significant danger may include:
(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
youth whose parents or primary caregivers are or were previously homeless; (4) youth
who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
with parents due to chemical or alcohol dependency, mental health disabilities, or other
disabilities; and (6) runaways.
(e) "Runaway" means an unmarried child under the age of 18 years who is absent
from the home of a parent or guardian or other lawful placement without the consent of
the parent, guardian, or lawful custodian.
Sec. 45.
Minnesota Statutes 2014, section 256K.45, subdivision 6, is amended to read:
Subd. 6.
Funding.
Funds appropriated for this section may be expended on
programs described under subdivisions 3 to 5, technical assistance, and capacity building
to meet the greatest need on a statewide basisnew text begin . The commissioner will provide outreach,
technical assistance, and program development support to increase capacity to new and
existing service providers to better meet needs statewide, particularly in areas where
services for homeless youth have not been established, especially in greater Minnesotanew text end .
Sec. 46.
new text begin
[256M.41] CHILD PROTECTION GRANT ALLOCATION.
new text end
new text begin Subdivision 1. new text end
new text begin Formula for county staffing funds. new text end
new text begin
(a) The commissioner shall
allocate state funds appropriated under this section to each county board on a calendar
year basis in an amount determined according to the following formula:
new text end
new text begin
(1) 50 percent must be distributed on the basis of the child population residing in the
county as determined by the most recent data of the state demographer;
new text end
new text begin
(2) 25 percent must be distributed on the basis of the number of screened-in
reports of child maltreatment under sections 626.556 and 626.5561, and in the county as
determined by the most recent data of the commissioner; and
new text end
new text begin
(3) 25 percent must be distributed on the basis of the number of open child
protection case management cases in the county as determined by the most recent data of
the commissioner.
new text end
new text begin
(b) Notwithstanding this subdivision, no county shall be awarded an allocation of
less than $75,000.
new text end
new text begin Subd. 2. new text end
new text begin Prohibition on supplanting existing funds. new text end
new text begin
Funds received under this
section must be used to address staffing for child protection or expand child protection
services. Funds must not be used to supplant current county expenditures for these
purposes.
new text end
new text begin Subd. 3. new text end
new text begin Payments based on performance. new text end
new text begin
(a) The commissioner shall make
payments under this section to each county board on a calendar year basis in an amount
determined under paragraph (b).
new text end
new text begin
(b) Calendar year allocations under subdivision 1 shall be paid to counties in the
following manner:
new text end
new text begin
(1) 80 percent of the allocation as determined in subdivision 1 must be paid to
counties on or before July 10 of each year;
new text end
new text begin
(2) ten percent of the allocation shall be withheld until the commissioner determines
if the county has met the performance outcome threshold of 90 percent based on
face-to-face contact with alleged child victims. In order to receive the performance
allocation, the county child protection workers must have a timely face-to-face contact
with at least 90 percent of all alleged child victims of screened-in maltreatment reports.
The standard requires that each initial face-to-face contact occur consistent with timelines
defined in section 626.556, subdivision 10, paragraph (i). The commissioner shall make
threshold determinations in January of each year and payments to counties meeting the
performance outcome threshold shall occur in February of each year. Any withheld funds
from this appropriation for counties that do not meet this requirement shall be reallocated
by the commissioner to those counties meeting the requirement; and
new text end
new text begin
(3) ten percent of the allocation shall be withheld until the commissioner determines
that the county has met the performance outcome threshold of 90 percent based on
face-to-face visits by the case manager. In order to receive the performance allocation, the
total number of visits made by caseworkers on a monthly basis to children in foster care
and children receiving child protection services while residing in their home must be at
least 90 percent of the total number of such visits that would occur if every child were
visited once per month. The commissioner shall make such determinations in January
of each year and payments to counties meeting the performance outcome threshold
shall occur in February of each year. Any withheld funds from this appropriation for
counties that do not meet this requirement shall be reallocated by the commissioner to
those counties meeting the requirement. For 2015, the commissioner shall only apply
the standard for monthly foster care visits.
new text end
new text begin
(c) The commissioner shall work with stakeholders and the Human Services
Performance Council under section 402A.16 to develop recommendations for specific
outcome measures that counties should meet in order to receive funds withheld under
paragraph (b), and include in those recommendations a determination as to whether
the performance measures under paragraph (b) should be modified or phased out. The
commissioner shall report the recommendations to the legislative committees having
jurisdiction over child protection issues by January 1, 2018.
new text end
Sec. 47.
Minnesota Statutes 2014, section 256N.22, subdivision 9, is amended to read:
Subd. 9.
Death new text begin or incapacity new text end of relative custodian or deleted text begin dissolutiondeleted text end new text begin modification
new text end of custody.
The Northstar kinship assistance agreement ends upon death or deleted text begin dissolution
deleted text end new text begin incapacity of the relative custodian or modification new text end of new text begin the order for new text end permanent legal and
physical custody deleted text begin of both relative custodians in the case of assignment of custody to two
individuals, or the sole relative custodian in the case of assignment of custody to one
individualdeleted text end new text begin in which legal or physical custody is removed from the relative custodiannew text end .
new text begin In the case of a relative custodian's death or incapacity, new text end Northstar kinship assistance
eligibility may be continued according to subdivision 10.
Sec. 48.
Minnesota Statutes 2014, section 256N.22, subdivision 10, is amended to read:
Subd. 10.
Assigning a new text begin successor relative custodian for a new text end child's Northstar
kinship assistance deleted text begin to a court-appointed guardian or custodiandeleted text end .
(a) deleted text begin Northstar kinship
assistance may be continued with the written consent of the commissioner todeleted text end new text begin In the event
of the death or incapacity of the relative custodian, eligibility for Northstar kinship
assistance and title IV-E assistance, if applicable, is not affected if the relative custodian
is replaced by a successor named in the Northstar kinship assistance benefit agreement.
Northstar kinship assistance shall be paid to a named successor who is not the child's legal
parent, biological parent or stepparent, or other adult living in the home of the legal parent,
biological parent, or stepparent.
new text end
new text begin
(b) In order to receive Northstar kinship assistance, a named successor must:
new text end
new text begin
(1) meet the background study requirements in subdivision 4;
new text end
new text begin
(2) renegotiate the agreement consistent with section 256N.25, subdivision 2,
including cooperating with an assessment under section 256N.24;
new text end
new text begin
(3) be ordered by the court to be the child's legal relative custodian in a modification
proceeding under section 260C.521, subdivision 2; and
new text end
new text begin
(4) satisfy the requirements in this paragraph within one year of the relative
custodian's death or incapacity unless the commissioner certifies that the named successor
made reasonable attempts to satisfy the requirements within one year and failure to satisfy
the requirements was not the responsibility of the named successor.
new text end
new text begin
(c) Payment of Northstar kinship assistance to the successor guardian may be
temporarily approved through the policies, procedures, requirements, and deadlines under
section 256N.28, subdivision 2. Ongoing payment shall begin in the month when all the
requirements in paragraph (b) are satisfied.
new text end
new text begin (d) Continued payment of Northstar kinship assistance may occur in the event of the
death or incapacity of the relative custodian when no successor has been named in the
benefit agreement when the commissioner gives written consent tonew text end an individual who is a
guardian or custodian appointed by a court for the child upon the death of both relative
custodians in the case of assignment of custody to two individuals, or the sole relative
custodian in the case of assignment of custody to one individual, unless the child is under
the custody of a county, tribal, or child-placing agency.
deleted text begin (b)deleted text end new text begin (e)new text end Temporary assignment of Northstar kinship assistance may be approved
for a maximum of six consecutive months from the death new text begin or incapacity new text end of the relative
custodian or custodians as provided in paragraph (a) and must adhere to the policies deleted text begin anddeleted text end new text begin ,
new text end proceduresnew text begin , requirements, and deadlines under section 256N.28, subdivision 2, that are
new text end prescribed by the commissioner. If a court has not appointed a permanent legal guardian
or custodian within six months, the Northstar kinship assistance must terminate and must
not be resumed.
deleted text begin (c)deleted text end new text begin (f)new text end Upon assignment of assistance payments under deleted text begin this subdivisiondeleted text end new text begin paragraphs
(d) and (e)new text end , assistance must be provided from funds other than title IV-E.
Sec. 49.
Minnesota Statutes 2014, section 256N.24, subdivision 4, is amended to read:
Subd. 4.
Extraordinary levels.
(a) The assessment tool established under
subdivision 2 must provide a mechanism through which up to five levels can be added
to the supplemental difficulty of care for a particular child under section 256N.26,
subdivision 4. In establishing the assessment tool, the commissioner must design the tool
so that the levels applicable to the portions of the assessment other than the extraordinary
levels can accommodate the requirements of this subdivision.
(b) These extraordinary levels are available when all of the following circumstances
apply:
(1) the child has extraordinary needs as determined by the assessment tool provided
for under subdivision 2, and the child meets other requirements established by the
commissioner, such as a minimum score on the assessment tool;
(2) the child's extraordinary needs require extraordinary care and intense supervision
that is provided by the child's caregiver as part of the parental duties as described in the
supplemental difficulty of care rate, section 256N.02, subdivision 21. This extraordinary
care provided by the caregiver is required so that the child can be safely cared for in the
home and community, and prevents residential placement;
(3) the child is physically living in a foster family setting, as defined in Minnesota
Rules, part 2960.3010, subpart 23, new text begin in a foster residence setting, new text end or physically living in the
home with the adoptive parent or relative custodian; and
(4) the child is receiving the services for which the child is eligible through medical
assistance programs or other programs that provide necessary services for children with
disabilities or other medical and behavioral conditions to live with the child's family, but
the agency with caregiver's input has identified a specific support gap that cannot be met
through home and community support waivers or other programs that are designed to
provide support for children with special needs.
(c) The agency completing an assessment, under subdivision 2, that suggests an
extraordinary level must document as part of the assessment, the following:
(1) the assessment tool that determined that the child's needs or disabilities require
extraordinary care and intense supervision;
(2) a summary of the extraordinary care and intense supervision that is provided by
the caregiver as part of the parental duties as described in the supplemental difficulty of
care rate, section 256N.02, subdivision 21;
(3) confirmation that the child is currently physically residing in the foster family
setting or in the home with the adoptive parent or relative custodian;
(4) the efforts of the agency, caregiver, parents, and others to request support services
in the home and community that would ease the degree of parental duties provided by the
caregiver for the care and supervision of the child. This would include documentation of
the services provided for the child's needs or disabilities, and the services that were denied
or not available from the local social service agency, community agency, the local school
district, local public health department, the parent, or child's medical insurance provider;
(5) the specific support gap identified that places the child's safety and well-being at
risk in the home or community and is necessary to prevent residential placement; and
(6) the extraordinary care and intense supervision provided by the foster, adoptive,
or guardianship caregivers to maintain the child safely in the child's home and prevent
residential placement that cannot be supported by medical assistance or other programs
that provide services, necessary care for children with disabilities, or other medical or
behavioral conditions in the home or community.
(d) An agency completing an assessment under subdivision 2 that suggests
an extraordinary level is appropriate must forward the assessment and required
documentation to the commissioner. If the commissioner approves, the extraordinary
levels must be retroactive to the date the assessment was forwarded.
Sec. 50.
Minnesota Statutes 2014, section 256N.25, subdivision 1, is amended to read:
Subdivision 1.
Agreement; Northstar kinship assistance; adoption assistance.
(a)
In order to receive Northstar kinship assistance or adoption assistance benefits on behalf
of an eligible child, a written, binding agreement between the caregiver or caregivers,
the financially responsible agency, or, if there is no financially responsible agency, the
agency designated by the commissioner, and the commissioner must be established prior
to finalization of the adoption or a transfer of permanent legal and physical custody. The
agreement must be negotiated with the caregiver or caregivers under subdivision 2new text begin and
renegotiated under subdivision 3, if applicablenew text end .
(b) The agreement must be on a form approved by the commissioner and must
specify the following:
(1) duration of the agreement;
(2) the nature and amount of any payment, services, and assistance to be provided
under such agreement;
(3) the child's eligibility for Medicaid services;
(4) the terms of the payment, including any child care portion as specified in section
256N.24, subdivision 3;
(5) eligibility for reimbursement of nonrecurring expenses associated with adopting
or obtaining permanent legal and physical custody of the child, to the extent that the
total cost does not exceed $2,000 per child;
(6) that the agreement must remain in effect regardless of the state of which the
adoptive parents or relative custodians are residents at any given time;
(7) provisions for modification of the terms of the agreement, including renegotiation
of the agreement; deleted text begin and
deleted text end
(8) the effective date of the agreementnew text begin ; and
new text end
new text begin (9) the successor relative custodian or custodians for Northstar kinship assistance,
when applicable. The successor relative custodian or custodians may be added or changed
by mutual agreement under subdivision 3new text end .
(c) The caregivers, the commissioner, and the financially responsible agency, or, if
there is no financially responsible agency, the agency designated by the commissioner, must
sign the agreement. A copy of the signed agreement must be given to each party. Once
signed by all parties, the commissioner shall maintain the official record of the agreement.
(d) The effective date of the Northstar kinship assistance agreement must be the date
of the court order that transfers permanent legal and physical custody to the relative. The
effective date of the adoption assistance agreement is the date of the finalized adoption
decree.
(e) Termination or disruption of the preadoptive placement or the foster care
placement prior to assignment of custody makes the agreement with that caregiver void.
Sec. 51.
Minnesota Statutes 2014, section 256N.27, subdivision 2, is amended to read:
Subd. 2.
State share.
The commissioner shall pay the state share of the maintenance
payments as determined under subdivision 4, and an identical share of the pre-Northstar
Care foster care program under section 260C.4411, subdivision 1, the relative custody
assistance program under section 257.85, and the pre-Northstar Care for Children adoption
assistance program under chapter 259A. deleted text begin The commissioner may transfer funds into the
account if a deficit occurs.
deleted text end
Sec. 52.
Minnesota Statutes 2014, section 257.75, subdivision 3, is amended to read:
Subd. 3.
Effect of recognition.
new text begin (a) new text end Subject to subdivision 2 and section 257.55,
subdivision 1, paragraph (g) or (h), the recognition has the force and effect of a judgment or
order determining the existence of the parent and child relationship under section 257.66. If
the conditions in section 257.55, subdivision 1, paragraph (g) or (h), exist, the recognition
creates only a presumption of paternity for purposes of sections 257.51 to 257.74. Once a
recognition has been properly executed and filed with the state registrar of vital statistics,
if there are no competing presumptions of paternity, a judicial or administrative court may
not allow further action to determine parentage regarding the signator of the recognition.
An action to determine custody and parenting time may be commenced pursuant to
chapter 518 without an adjudication of parentage. Until deleted text begin andeleted text end new text begin a temporary or permanent
new text end order is entered granting custody to another, the mother has sole custody.
new text begin
(b) Following commencement of an action to determine custody or parenting time
under chapter 518, the court may, pursuant to section 518.131, grant temporary parenting
time rights and temporary custody to either parent.
new text end
new text begin (c) new text end The recognition is:
(1) a basis for bringing an action new text begin for the following:
new text end
new text begin (i) new text end to award new text begin temporary custody or parenting time pursuant to section 518.131;
new text end
new text begin (ii) to award permanent new text end custody or parenting time to either parentdeleted text begin ,deleted text end new text begin ;
new text end
new text begin (iii) new text end establishing a child support obligation which may include up to the two years
immediately preceding the commencement of the actiondeleted text begin ,deleted text end new text begin ;
new text end
new text begin (iv)new text end ordering a contribution by a parent under section 256.87deleted text begin , ordeleted text end new text begin ;
new text end
new text begin (v)new text end ordering a contribution to the reasonable expenses of the mother's pregnancy and
confinement, as provided under section 257.66, subdivision 3deleted text begin ,deleted text end new text begin ;new text end or
new text begin (vi) new text end ordering reimbursement for the costs of blood or genetic testing, as provided
under section 257.69, subdivision 2;
(2) determinative for all other purposes related to the existence of the parent and
child relationship; and
(3) entitled to full faith and credit in other jurisdictions.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2016.
new text end
Sec. 53.
Minnesota Statutes 2014, section 257.75, subdivision 5, is amended to read:
Subd. 5.
Recognition form.
new text begin (a) new text end The commissioner of human services shall prepare
a form for the recognition of parentage under this section. In preparing the form, the
commissioner shall consult with the individuals specified in subdivision 6. The recognition
form must be drafted so that the force and effect of the recognition, the alternatives to
executing a recognition, deleted text begin anddeleted text end the benefits and responsibilities of establishing paternitynew text begin , and
the limitations of the recognition of parentage for purposes of exercising and enforcing
custody or parenting timenew text end are clear and understandable. deleted text begin The form must include a notice
regarding the finality of a recognition and the revocation procedure under subdivision
2. The form must include a provision for each parent to verify that the parent has read
or viewed the educational materials prepared by the commissioner of human services
describing the recognition of paternity. The individual providing the form to the parents
for execution shall provide oral notice of the rights, responsibilities, and alternatives to
executing the recognition. Notice may be provided by audiotape, videotape, or similar
means. Each parent must receive a copy of the recognition.
deleted text end
new text begin
(b) The form must include the following:
new text end
new text begin
(1) a notice regarding the finality of a recognition and the revocation procedure
under subdivision 2;
new text end
new text begin
(2) a notice, in large print, that the recognition does not establish an enforceable right
to legal custody, physical custody, or parenting time until such rights are awarded pursuant
to a court action to establish custody and parenting time;
new text end
new text begin
(3) a notice stating that when a court awards custody and parenting time under
chapter 518, there is no presumption for or against joint physical custody, except when
domestic abuse, as defined in section 518B.01, subdivision 2, paragraph (a), has occurred
between the parties;
new text end
new text begin
(4) a notice that the recognition of parentage is a basis for:
new text end
new text begin
(i) bringing a court action to award temporary or permanent custody or parenting time;
new text end
new text begin
(ii) establishing a child support obligation that may include the two years
immediately preceding the commencement of the action;
new text end
new text begin
(iii) ordering a contribution by a parent under section 256.87;
new text end
new text begin
(iv) ordering a contribution to the reasonable expenses of the mother's pregnancy
and confinement, as provided under section 257.66, subdivision 3; and
new text end
new text begin
(v) ordering reimbursement for the costs of blood or genetic testing, as provided
under section 257.69, subdivision 2; and
new text end
new text begin
(5) a provision for each parent to verify that the parent has read or viewed the
educational materials prepared by the commissioner of human services describing the
recognition of paternity.
new text end
new text begin
(c) The individual providing the form to the parents for execution shall provide oral
notice of the rights, responsibilities, and alternatives to executing the recognition. Notice
may be provided in audio or video format, or by other similar means. Each parent must
receive a copy of the recognition.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2016.
new text end
Sec. 54.
Minnesota Statutes 2014, section 259A.75, is amended to read:
259A.75 REIMBURSEMENT OF CERTAIN AGENCY COSTS; PURCHASE
OF SERVICE CONTRACTSnew text begin AND TRIBAL CUSTOMARY ADOPTIONSnew text end .
Subdivision 1.
General information.
(a) Subject to the procedures required by
the commissioner and the provisions of this section, a Minnesota county deleted text begin or tribal social
services agencydeleted text end shall receive a reimbursement from the commissioner equal to 100 percent
of the reasonable and appropriate cost for contracted adoption placement services identified
for a specific child that are not reimbursed under other federal or state funding sources.
(b) The commissioner may spend up to $16,000 for each purchase of service
contract. Only one contract per child per adoptive placement is permitted. Funds
encumbered and obligated under the contract for the child remain available until the terms
of the contract are fulfilled or the contract is terminated.
(c) The commissioner shall set aside an amount not to exceed five percent of the
total amount of the fiscal year appropriation from the state for the adoption assistance
program to reimbursenew text begin a Minnesota county or tribal social servicesnew text end placing deleted text begin agenciesdeleted text end new text begin agency
new text end for child-specific adoption placement services. When adoption assistance payments for
children's needs exceed 95 percent of the total amount of the fiscal year appropriation from
the state for the adoption assistance program, the amount of reimbursement available to
placing agencies for adoption services is reduced correspondingly.
Subd. 2.
new text begin Purchase of service contract new text end child eligibility criteria.
(a) A child who is
the subject of a purchase of service contract must:
(1) have the goal of adoption, which may include an adoption in accordance with
tribal law;
(2) be under the guardianship of the commissioner of human services or be a ward of
tribal court pursuant to section 260.755, subdivision 20; and
(3) meet all of the special needs criteria according to section 259A.10, subdivision 2.
(b) A child under the guardianship of the commissioner must have an identified
adoptive parent and a fully executed adoption placement agreement according to section
260C.613, subdivision 1, paragraph (a).
Subd. 3.
Agency eligibility criteria.
(a) A Minnesota county deleted text begin or tribaldeleted text end social
services agency shall receive reimbursement for child-specific adoption placement
services for an eligible child that it purchases from a private adoption agency licensed in
Minnesota or any other state or tribal social services agency.
(b) Reimbursement for adoption services is available only for services provided
prior to the date of the adoption decree.
Subd. 4.
Application and eligibility determination.
(a) A county deleted text begin or tribaldeleted text end social
services agency may request reimbursement of costs for adoption placement services by
submitting a complete purchase of service application, according to the requirements and
procedures and on forms prescribed by the commissioner.
(b) The commissioner shall determine eligibility for reimbursement of adoption
placement services. If determined eligible, the commissioner of human services shall
sign the purchase of service agreement, making this a fully executed contract. No
reimbursement under this section shall be made to an agency for services provided prior to
the fully executed contract.
(c) Separate purchase of service agreements shall be made, and separate records
maintained, on each child. Only one agreement per child per adoptive placement is
permitted. For siblings who are placed together, services shall be planned and provided to
best maximize efficiency of the contracted hours.
Subd. 5.
Reimbursement process.
(a) The agency providing adoption services is
responsible to track and record all service activity, including billable hours, on a form
prescribed by the commissioner. The agency shall submit this form to the state for
reimbursement after services have been completed.
(b) The commissioner shall make the final determination whether or not the
requested reimbursement costs are reasonable and appropriate and if the services have
been completed according to the terms of the purchase of service agreement.
Subd. 6.
Retention of purchase of service records.
Agencies entering into
purchase of service contracts shall keep a copy of the agreements, service records, and all
applicable billing and invoicing according to the department's record retention schedule.
Agency records shall be provided upon request by the commissioner.
new text begin Subd. 7. new text end
new text begin Tribal customary adoptions. new text end
new text begin
(a) The commissioner shall enter into
grant contracts with Minnesota tribal social services agencies to provide child-specific
recruitment and adoption placement services for Indian children under the jurisdiction
of tribal court.
new text end
new text begin
(b) Children served under these grant contracts must meet the child eligibility
criteria in subdivision 2.
new text end
Sec. 55.
Minnesota Statutes 2014, section 260C.007, subdivision 27, is amended to read:
Subd. 27.
Relative.
"Relative" means a person related to the child by blood,
marriage, or adoptiondeleted text begin ,deleted text end new text begin ; the legal parent, guardian, or custodian of the child's siblings;new text end or an
individual who is an important friend with whom the child has resided or had significant
contact. For an Indian child, relative includes members of the extended family as defined
by the law or custom of the Indian child's tribe or, in the absence of law or custom, nieces,
nephews, or first or second cousins, as provided in the Indian Child Welfare Act of 1978,
United States Code, title 25, section 1903.
Sec. 56.
Minnesota Statutes 2014, section 260C.007, subdivision 32, is amended to read:
Subd. 32.
Sibling.
"Sibling" means one of two or more individuals who have one or
both parents in common through blood, marriage, or adoptiondeleted text begin , includingdeleted text end new text begin . This includes
new text end siblings as defined by the child's tribal code or custom.new text begin Sibling also includes an individual
who would have been considered a sibling but for a termination of parental rights of one
or both parents, suspension of parental rights under tribal code, or other disruption of
parental rights such as the death of a parent.
new text end
Sec. 57.
Minnesota Statutes 2014, section 260C.203, is amended to read:
260C.203 ADMINISTRATIVE OR COURT REVIEW OF PLACEMENTS.
(a) Unless the court is conducting the reviews required under section 260C.202,
there shall be an administrative review of the out-of-home placement plan of each child
placed in foster care no later than 180 days after the initial placement of the child in foster
care and at least every six months thereafter if the child is not returned to the home of the
parent or parents within that time. The out-of-home placement plan must be monitored and
updated at each administrative review. The administrative review shall be conducted by
the responsible social services agency using a panel of appropriate persons at least one of
whom is not responsible for the case management of, or the delivery of services to, either
the child or the parents who are the subject of the review. The administrative review shall
be open to participation by the parent or guardian of the child and the child, as appropriate.
(b) As an alternative to the administrative review required in paragraph (a), the court
may, as part of any hearing required under the Minnesota Rules of Juvenile Protection
Procedure, conduct a hearing to monitor and update the out-of-home placement plan
pursuant to the procedure and standard in section 260C.201, subdivision 6, paragraph
(d). The party requesting review of the out-of-home placement plan shall give parties to
the proceeding notice of the request to review and update the out-of-home placement
plan. A court review conducted pursuant to section 260C.141, subdivision 2; 260C.193;
260C.201, subdivision 1; 260C.202; 260C.204; 260C.317; or 260D.06 shall satisfy the
requirement for the review so long as the other requirements of this section are met.
(c) As appropriate to the stage of the proceedings and relevant court orders, the
responsible social services agency or the court shall review:
(1) the safety, permanency needs, and well-being of the child;
(2) the continuing necessity for and appropriateness of the placement;
(3) the extent of compliance with the out-of-home placement plan;
(4) the extent of progress that has been made toward alleviating or mitigating the
causes necessitating placement in foster care;
(5) the projected date by which the child may be returned to and safely maintained in
the home or placed permanently away from the care of the parent or parents or guardian; and
(6) the appropriateness of the services provided to the child.
(d) When a child is age deleted text begin 16deleted text end new text begin 14new text end or older, in addition to any administrative review
conducted by the agency, at the in-court review required under section 260C.317,
subdivision 3, clause (3), or 260C.515, subdivision 5 or 6, the court shall review the
independent living plan required under section 260C.212, subdivision 1, paragraph (c),
clause deleted text begin (11)deleted text end new text begin (12)new text end , and the provision of services to the child related to the well-being of
the child as the child prepares to leave foster care. The review shall include the actual
plans related to each item in the plan necessary to the child's future safety and well-being
when the child is no longer in foster care.
(e) At the court review required under paragraph (d) for a child age deleted text begin 16deleted text end new text begin 14new text end or older,
the following procedures apply:
(1) six months before the child is expected to be discharged from foster care, the
responsible social services agency shall give the written notice required under section
260C.451, subdivision 1, regarding the right to continued access to services for certain
children in foster care past age 18 and of the right to appeal a denial of social services
under section 256.045. The agency shall file a copy of the notice, including the right to
appeal a denial of social services, with the court. If the agency does not file the notice by
the time the child is age 17-1/2, the court shall require the agency to give it;
(2) consistent with the requirements of the independent living plan, the court shall
review progress toward or accomplishment of the following goals:
(i) the child has obtained a high school diploma or its equivalent;
(ii) the child has completed a driver's education course or has demonstrated the
ability to use public transportation in the child's community;
(iii) the child is employed or enrolled in postsecondary education;
(iv) the child has applied for and obtained postsecondary education financial aid for
which the child is eligible;
(v) the child has health care coverage and health care providers to meet the child's
physical and mental health needs;
(vi) the child has applied for and obtained disability income assistance for which
the child is eligible;
(vii) the child has obtained affordable housing with necessary supports, which does
not include a homeless shelter;
(viii) the child has saved sufficient funds to pay for the first month's rent and a
damage deposit;
(ix) the child has an alternative affordable housing plan, which does not include a
homeless shelter, if the original housing plan is unworkable;
(x) the child, if male, has registered for the Selective Service; and
(xi) the child has a permanent connection to a caring adult; and
(3) the court shall ensure that the responsible agency in conjunction with the
placement provider assists the child in obtaining the following documents prior to the
child's leaving foster care: a Social Security card; the child's birth certificate; a state
identification card or driver's license, new text begin tribal enrollment identification card, new text end green card, or
school visa; the child's school, medical, and dental records; a contact list of the child's
medical, dental, and mental health providers; and contact information for the child's
siblings, if the siblings are in foster care.
(f) For a child who will be discharged from foster care at age 18 or older, the
responsible social services agency is required to develop a personalized transition plan as
directed by the youth. The transition plan must be developed during the 90-day period
immediately prior to the expected date of discharge. The transition plan must be as
detailed as the child may elect and include specific options on housing, health insurance,
education, local opportunities for mentors and continuing support services, and work force
supports and employment services. The agency shall ensure that the youth receives, at
no cost to the youth, a copy of the youth's consumer credit report as defined in section
13C.001 and assistance in interpreting and resolving any inaccuracies in the report. The
plan must include information on the importance of designating another individual to
make health care treatment decisions on behalf of the child if the child becomes unable
to participate in these decisions and the child does not have, or does not want, a relative
who would otherwise be authorized to make these decisions. The plan must provide the
child with the option to execute a health care directive as provided under chapter 145C.
The agency shall also provide the youth with appropriate contact information if the youth
needs more information or needs help dealing with a crisis situation through age 21.
Sec. 58.
Minnesota Statutes 2014, section 260C.212, subdivision 1, is amended to read:
Subdivision 1.
Out-of-home placement; plan.
(a) An out-of-home placement plan
shall be prepared within 30 days after any child is placed in foster care by court order or a
voluntary placement agreement between the responsible social services agency and the
child's parent pursuant to section 260C.227 or chapter 260D.
(b) An out-of-home placement plan means a written document which is prepared
by the responsible social services agency jointly with the parent or parents or guardian
of the child and in consultation with the child's guardian ad litem, the child's tribe, if the
child is an Indian child, the child's foster parent or representative of the foster care facility,
and, where appropriate, the child. new text begin When a child is age 14 or older, the child may include
two other individuals on the team preparing the child's out-of-home placement plan. new text end For
a child in voluntary foster care for treatment under chapter 260D, preparation of the
out-of-home placement plan shall additionally include the child's mental health treatment
provider. As appropriate, the plan shall be:
(1) submitted to the court for approval under section 260C.178, subdivision 7;
(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and
(3) signed by the parent or parents or guardian of the child, the child's guardian ad
litem, a representative of the child's tribe, the responsible social services agency, and, if
possible, the child.
(c) The out-of-home placement plan shall be explained to all persons involved in its
implementation, including the child who has signed the plan, and shall set forth:
(1) a description of the foster care home or facility selected, including how the
out-of-home placement plan is designed to achieve a safe placement for the child in the
least restrictive, most family-like, setting available which is in close proximity to the home
of the parent or parents or guardian of the child when the case plan goal is reunification,
and how the placement is consistent with the best interests and special needs of the child
according to the factors under subdivision 2, paragraph (b);
(2) the specific reasons for the placement of the child in foster care, and when
reunification is the plan, a description of the problems or conditions in the home of the
parent or parents which necessitated removal of the child from home and the changes the
parent or parents must make in order for the child to safely return home;
(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:
(i) the specific actions to be taken by the parent or parents of the child to eliminate
or correct the problems or conditions identified in clause (2), and the time period during
which the actions are to be taken; and
(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made
to achieve a safe and stable home for the child including social and other supportive
services to be provided or offered to the parent or parents or guardian of the child, the
child, and the residential facility during the period the child is in the residential facility;
(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if
not, the basis for the denial of the services or resources;
(5) the visitation plan for the parent or parents or guardian, other relatives as defined
in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed
together in foster care, and whether visitation is consistent with the best interest of the
child, during the period the child is in foster care;
(6) when a child cannot return to or be in the care of either parent, documentation
of steps to finalize new text begin adoption as new text end the permanency plan for the childdeleted text begin , including: (i)deleted text end new text begin through
new text end reasonable efforts to place the child for adoption. At a minimum, the documentation must
include consideration of whether adoption is in the best interests of the child, child-specific
recruitment efforts such as relative search and the use of state, regional, and national
adoption exchanges to facilitate orderly and timely placements in and outside of the state.
A copy of this documentation shall be provided to the court in the review required under
section 260C.317, subdivision 3, paragraph (b); deleted text begin and
deleted text end
deleted text begin
(ii) documentation necessary to support the requirements of the kinship placement
agreement under section 256N.22 when adoption is determined not to be in the child's
best interests;
deleted text end
new text begin
(7) when a child cannot return to or be in the care of either parent,
documentation of steps to finalize the transfer of permanent legal and physical custody
to a relative as the permanency plan for the child. This documentation must support the
requirements of the kinship placement agreement under section 256N.22 and must include
the reasonable efforts used to determine that it is not appropriate for the child to return
home or be adopted, and reasons why permanent placement with a relative through a
Northstar kinship assistance arrangement is in the child's best interest; how the child meets
the eligibility requirements for Northstar kinship assistance payments; agency efforts to
discuss adoption with the child's relative foster parent and reasons why the relative foster
parent chose not to pursue adoption, if applicable; and agency efforts to discuss with the
child's parent or parents the permanent transfer of permanent legal and physical custody or
the reasons why these efforts were not made;
new text end
deleted text begin (7)deleted text end new text begin (8)new text end efforts to ensure the child's educational stability while in foster care, including:
(i) efforts to ensure that the child remains in the same school in which the child was
enrolled prior to placement or upon the child's move from one placement to another,
including efforts to work with the local education authorities to ensure the child's
educational stability; or
(ii) if it is not in the child's best interest to remain in the same school that the child
was enrolled in prior to placement or move from one placement to another, efforts to
ensure immediate and appropriate enrollment for the child in a new school;
deleted text begin (8)deleted text end new text begin (9)new text end the educational records of the child including the most recent information
available regarding:
(i) the names and addresses of the child's educational providers;
(ii) the child's grade level performance;
(iii) the child's school record;
(iv) a statement about how the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of placement; and
(v) any other relevant educational information;
deleted text begin (9)deleted text end new text begin (10)new text end the efforts by the local agency to ensure the oversight and continuity of
health care services for the foster child, including:
(i) the plan to schedule the child's initial health screens;
(ii) how the child's known medical problems and identified needs from the screens,
including any known communicable diseases, as defined in section 144.4172, subdivision
2, will be monitored and treated while the child is in foster care;
(iii) how the child's medical information will be updated and shared, including
the child's immunizations;
(iv) who is responsible to coordinate and respond to the child's health care needs,
including the role of the parent, the agency, and the foster parent;
(v) who is responsible for oversight of the child's prescription medications;
(vi) how physicians or other appropriate medical and nonmedical professionals
will be consulted and involved in assessing the health and well-being of the child and
determine the appropriate medical treatment for the child; and
(vii) the responsibility to ensure that the child has access to medical care through
either medical insurance or medical assistance;
deleted text begin (10)deleted text end new text begin (11)new text end the health records of the child including information available regarding:
(i) the names and addresses of the child's health care and dental care providers;
(ii) a record of the child's immunizations;
(iii) the child's known medical problems, including any known communicable
diseases as defined in section 144.4172, subdivision 2;
(iv) the child's medications; and
(v) any other relevant health care information such as the child's eligibility for
medical insurance or medical assistance;
deleted text begin (11)deleted text end new text begin (12)new text end an independent living plan for a child age deleted text begin 16deleted text end new text begin 14new text end or older. The plan should
include, but not be limited to, the following objectives:
(i) educational, vocational, or employment planning;
(ii) health care planning and medical coverage;
(iii) transportation including, where appropriate, assisting the child in obtaining a
driver's license;
(iv) money management, including the responsibility of the agency to ensure that
the youth annually receives, at no cost to the youth, a consumer report as defined under
section 13C.001 and assistance in interpreting and resolving any inaccuracies in the report;
(v) planning for housing;
(vi) social and recreational skills; deleted text begin and
deleted text end
(vii) establishing and maintaining connections with the child's family and
community; and
new text begin
(viii) regular opportunities to engage in age-appropriate or developmentally
appropriate activities typical for the child's age group, taking into consideration the
capacities of the individual child; and
new text end
deleted text begin (12)deleted text end new text begin (13)new text end for a child in voluntary foster care for treatment under chapter 260D,
diagnostic and assessment information, specific services relating to meeting the mental
health care needs of the child, and treatment outcomes.
(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time
of placement of the child. The child shall also have the right to a guardian ad litem.
If unable to employ counsel from their own resources, the court shall appoint counsel
upon the request of the parent or parents or the child or the child's legal guardian. The
parent or parents may also receive assistance from any person or social services agency
in preparation of the case plan.
After the plan has been agreed upon by the parties involved or approved or ordered
by the court, the foster parents shall be fully informed of the provisions of the case plan
and shall be provided a copy of the plan.
Upon discharge from foster care, the parent, adoptive parent, or permanent legal and
physical custodian, as appropriate, and the child, if appropriate, must be provided with
a current copy of the child's health and education record.
Sec. 59.
Minnesota Statutes 2014, section 260C.212, is amended by adding a
subdivision to read:
new text begin Subd. 13. new text end
new text begin
Protecting missing and runaway children and youth at risk of sex
trafficking.
new text end
new text begin
(a) The local social services agency shall expeditiously locate any child
missing from foster care.
new text end
new text begin
(b) The local social services agency shall report immediately, but no later than
24 hours, after receiving information on a missing or abducted child to the local law
enforcement agency for entry into the National Crime Information Center (NCIC)
database of the Federal Bureau of Investigation, and to the National Center for Missing
and Exploited Children.
new text end
new text begin
(c) The local social services agency shall not discharge a child from foster care or
close the social services case until diligent efforts have been exhausted to locate the child
and the court terminates the agency's jurisdiction.
new text end
new text begin
(d) The local social services agency shall determine the primary factors that
contributed to the child's running away or otherwise being absent from care and, to
the extent possible and appropriate, respond to those factors in current and subsequent
placements.
new text end
new text begin
(e) The local social services agency shall determine what the child experienced
while absent from care, including screening the child to determine if the child is a possible
sex trafficking victim as defined in section 609.321, subdivision 7b.
new text end
new text begin
(f) The local social services agency shall report immediately, but no later than 24
hours, to the local law enforcement agency any reasonable cause to believe a child is, or is
at risk of being, a sex trafficking victim.
new text end
new text begin
(g) The local social services agency shall determine appropriate services as described
in section 145.4717 with respect to any child for whom the local social services agency has
responsibility for placement, care, or supervision when the local social services agency
has reasonable cause to believe the child is, or is at risk of being, a sex trafficking victim.
new text end
Sec. 60.
Minnesota Statutes 2014, section 260C.212, is amended by adding a
subdivision to read:
new text begin Subd. 14. new text end
new text begin
Support age-appropriate and developmentally appropriate activities
for foster children.
new text end
new text begin
Responsible social services agencies and child-placing agencies shall
support a foster child's emotional and developmental growth by permitting the child
to participate in activities or events that are generally accepted as suitable for children
of the same chronological age or are developmentally appropriate for the child. Foster
parents and residential facility staff are permitted to allow foster children to participate in
extracurricular, social, or cultural activities that are typical for the child's age by applying
reasonable and prudent parenting standards. Reasonable and prudent parenting standards
are characterized by careful and sensible parenting decisions that maintain the child's
health and safety, and are made in the child's best interest.
new text end
Sec. 61.
Minnesota Statutes 2014, section 260C.221, is amended to read:
260C.221 RELATIVE SEARCH.
(a) The responsible social services agency shall exercise due diligence to identify
and notify adult relatives prior to placement or within 30 days after the child's removal
from the parent. The county agency shall consider placement with a relative under this
section without delay and whenever the child must move from or be returned to foster
care. The relative search required by this section shall be comprehensive in scope. After a
finding that the agency has made reasonable efforts to conduct the relative search under
this paragraph, the agency has the continuing responsibility to appropriately involve
relatives, who have responded to the notice required under this paragraph, in planning
for the child and to continue to consider relatives according to the requirements of
section 260C.212, subdivision 2. At any time during the course of juvenile protection
proceedings, the court may order the agency to reopen its search for relatives when it is in
the child's best interest to do so.
new text begin (b)new text end The relative search required by this section shall include both maternal deleted text begin relatives
deleted text end and paternal new text begin adult new text end relatives of the childnew text begin ; all adult grandparents; all legal parents, guardians
or custodians; the child's siblings; and any other adult relatives suggested by the child's
parents, subject to the exceptions due to family violence in paragraph (c)new text end . The search shall
also include getting information from the child in an age-appropriate manner about who
the child considers to be family members and important friends with whom the child has
resided or had significant contact. The relative search required under this section must
fulfill the agency's duties under the Indian Child Welfare Act regarding active efforts
to prevent the breakup of the Indian family under United States Code, title 25, section
1912(d), and to meet placement preferences under United States Code, title 25, section
1915. The relatives must be notified:
(1) of the need for a foster home for the child, the option to become a placement
resource for the child, and the possibility of the need for a permanent placement for the
child;
(2) of their responsibility to keep the responsible social services agency and the court
informed of their current address in order to receive notice in the event that a permanent
placement is sought for the child and to receive notice of the permanency progress review
hearing under section 260C.204. A relative who fails to provide a current address to the
responsible social services agency and the court forfeits the right to receive notice of the
possibility of permanent placement and of the permanency progress review hearing under
section 260C.204. A decision by a relative not to be identified as a potential permanent
placement resource or participate in planning for the child at the beginning of the case
shall not affect whether the relative is considered for placement of the child with that
relative later;
(3) that the relative may participate in the care and planning for the child, including
that the opportunity for such participation may be lost by failing to respond to the notice
sent under this subdivision. "Participate in the care and planning" includes, but is not
limited to, participation in case planning for the parent and child, identifying the strengths
and needs of the parent and child, supervising visits, providing respite and vacation visits
for the child, providing transportation to appointments, suggesting other relatives who
might be able to help support the case plan, and to the extent possible, helping to maintain
the child's familiar and regular activities and contact with friends and relatives;
(4) of the family foster care licensing requirements, including how to complete an
application and how to request a variance from licensing standards that do not present a
safety or health risk to the child in the home under section 245A.04 and supports that are
available for relatives and children who reside in a family foster home; and
(5) of the relatives' right to ask to be notified of any court proceedings regarding
the child, to attend the hearings, and of a relative's right or opportunity to be heard by the
court as required under section 260C.152, subdivision 5.
deleted text begin (b)deleted text end new text begin (c)new text end A responsible social services agency may disclose private data, as defined
in sections 13.02 and 626.556, to relatives of the child for the purpose of locating and
assessing a suitable placement and may use any reasonable means of identifying and
locating relatives including the Internet or other electronic means of conducting a search.
The agency shall disclose data that is necessary to facilitate possible placement with
relatives and to ensure that the relative is informed of the needs of the child so the
relative can participate in planning for the child and be supportive of services to the child
and family. If the child's parent refuses to give the responsible social services agency
information sufficient to identify the maternal and paternal relatives of the child, the
agency shall ask the juvenile court to order the parent to provide the necessary information.
If a parent makes an explicit request that a specific relative not be contacted or considered
for placement due to safety reasons including past family or domestic violence, the agency
shall bring the parent's request to the attention of the court to determine whether the
parent's request is consistent with the best interests of the child and the agency shall not
contact the specific relative when the juvenile court finds that contacting the specific
relative would endanger the parent, guardian, child, sibling, or any family member.
deleted text begin (c)deleted text end new text begin (d)new text end At a regularly scheduled hearing not later than three months after the child's
placement in foster care and as required in section 260C.202, the agency shall report to
the court:
(1) its efforts to identify maternal and paternal relatives of the child and to engage
the relatives in providing support for the child and family, and document that the relatives
have been provided the notice required under paragraph (a); and
(2) its decision regarding placing the child with a relative as required under section
260C.212, subdivision 2, and to ask relatives to visit or maintain contact with the child in
order to support family connections for the child, when placement with a relative is not
possible or appropriate.
deleted text begin (d)deleted text end new text begin (e)new text end Notwithstanding chapter 13, the agency shall disclose data about particular
relatives identified, searched for, and contacted for the purposes of the court's review of
the agency's due diligence.
deleted text begin (e)deleted text end new text begin (f)new text end When the court is satisfied that the agency has exercised due diligence to
identify relatives and provide the notice required in paragraph (a), the court may find that
reasonable efforts have been made to conduct a relative search to identify and provide
notice to adult relatives as required under section 260.012, paragraph (e), clause (3). If the
court is not satisfied that the agency has exercised due diligence to identify relatives and
provide the notice required in paragraph (a), the court may order the agency to continue its
search and notice efforts and to report back to the court.
deleted text begin (f)deleted text end new text begin (g)new text end When the placing agency determines that permanent placement proceedings
are necessary because there is a likelihood that the child will not return to a parent's
care, the agency must send the notice provided in paragraph deleted text begin (g)deleted text end new text begin (h)new text end , may ask the court to
modify the duty of the agency to send the notice required in paragraph deleted text begin (g)deleted text end new text begin (h)new text end , or may
ask the court to completely relieve the agency of the requirements of paragraph deleted text begin (g)deleted text end new text begin (h)new text end .
The relative notification requirements of paragraph deleted text begin (g)deleted text end new text begin (h)new text end do not apply when the child is
placed with an appropriate relative or a foster home that has committed to adopting the
child or taking permanent legal and physical custody of the child and the agency approves
of that foster home for permanent placement of the child. The actions ordered by the
court under this section must be consistent with the best interests, safety, permanency,
and welfare of the child.
deleted text begin (g)deleted text end new text begin (h)new text end Unless required under the Indian Child Welfare Act or relieved of this duty
by the court under paragraph deleted text begin (e)deleted text end new text begin (f)new text end , when the agency determines that it is necessary to
prepare for permanent placement determination proceedings, or in anticipation of filing a
termination of parental rights petition, the agency shall send notice to the relatives, any
adult with whom the child is currently residing, any adult with whom the child has resided
for one year or longer in the past, and any adults who have maintained a relationship or
exercised visitation with the child as identified in the agency case plan. The notice must
state that a permanent home is sought for the child and that the individuals receiving the
notice may indicate to the agency their interest in providing a permanent home. The notice
must state that within 30 days of receipt of the notice an individual receiving the notice must
indicate to the agency the individual's interest in providing a permanent home for the child
or that the individual may lose the opportunity to be considered for a permanent placement.
Sec. 62.
Minnesota Statutes 2014, section 260C.331, subdivision 1, is amended to read:
Subdivision 1.
Care, examination, or treatment.
(a) Except where parental rights
are terminated,
(1) whenever legal custody of a child is transferred by the court to a responsible
social services agency,
(2) whenever legal custody is transferred to a person other than the responsible social
services agency, but under the supervision of the responsible social services agency, or
(3) whenever a child is given physical or mental examinations or treatment under
order of the court, and no provision is otherwise made by law for payment for the care,
examination, or treatment of the child, these costs are a charge upon the welfare funds of
the county in which proceedings are held upon certification of the judge of juvenile court.
(b) The court shall order, and the responsible social services agency shall require,
the parents or custodian of a child, while the child is under the age of 18, to use the
total income and resources attributable to the child for the period of care, examination,
or treatment, except for clothing and personal needs allowance as provided in section
256B.35, to reimburse the county for the cost of care, examination, or treatment. Income
and resources attributable to the child include, but are not limited to, Social Security
benefits, Supplemental Security Income (SSI), veterans benefits, railroad retirement
benefits and child support. When the child is over the age of 18, and continues to receive
care, examination, or treatment, the court shall order, and the responsible social services
agency shall require, reimbursement from the child for the cost of care, examination, or
treatment from the income and resources attributable to the child less the clothing and
personal needs allowance. Income does not include earnings from a child over the age of
18 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c),
clause deleted text begin (11)deleted text end new text begin (12)new text end , to transition from foster care, or the income and resources from sources
other than Supplemental Security Income and child support that are needed to complete
the requirements listed in section 260C.203.
(c) If the income and resources attributable to the child are not enough to reimburse
the county for the full cost of the care, examination, or treatment, the court shall inquire
into the ability of the parents to support the child and, after giving the parents a reasonable
opportunity to be heard, the court shall order, and the responsible social services agency
shall require, the parents to contribute to the cost of care, examination, or treatment of
the child. When determining the amount to be contributed by the parents, the court shall
use a fee schedule based upon ability to pay that is established by the responsible social
services agency and approved by the commissioner of human services. The income of
a stepparent who has not adopted a child shall be excluded in calculating the parental
contribution under this section.
(d) The court shall order the amount of reimbursement attributable to the parents
or custodian, or attributable to the child, or attributable to both sources, withheld under
chapter 518A from the income of the parents or the custodian of the child. A parent or
custodian who fails to pay without good reason may be proceeded against for contempt, or
the court may inform the county attorney, who shall proceed to collect the unpaid sums,
or both procedures may be used.
(e) If the court orders a physical or mental examination for a child, the examination
is a medically necessary service for purposes of determining whether the service is
covered by a health insurance policy, health maintenance contract, or other health
coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan
requirements for medical necessity. Nothing in this paragraph changes or eliminates
benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions,
or other requirements in the policy, contract, or plan that relate to coverage of other
medically necessary services.
(f) Notwithstanding paragraph (b), (c), or (d), a parent, custodian, or guardian of the
child is not required to use income and resources attributable to the child to reimburse
the county for costs of care and is not required to contribute to the cost of care of the
child during any period of time when the child is returned to the home of that parent,
custodian, or guardian pursuant to a trial home visit under section 260C.201, subdivision
1, paragraph (a).
Sec. 63.
Minnesota Statutes 2014, section 260C.451, subdivision 2, is amended to read:
Subd. 2.
Independent living plan.
Upon the request of any child in foster care
immediately prior to the child's 18th birthday and who is in foster care at the time
of the request, the responsible social services agency shall, in conjunction with the
child and other appropriate parties, update the independent living plan required under
section 260C.212, subdivision 1, paragraph (c), clause deleted text begin (11)deleted text end new text begin (12)new text end , related to the child's
employment, vocational, educational, social, or maturational needs. The agency shall
provide continued services and foster care for the child including those services that are
necessary to implement the independent living plan.
Sec. 64.
Minnesota Statutes 2014, section 260C.451, subdivision 6, is amended to read:
Subd. 6.
Reentering foster care and accessing services after age 18.
(a)
Upon request of an individual between the ages of 18 and 21 who had been under the
guardianship of the commissioner and who has left foster care without being adopted, the
responsible social services agency which had been the commissioner's agent for purposes
of the guardianship shall develop with the individual a plan to increase the individual's
ability to live safely and independently using the plan requirements of section 260C.212,
subdivision 1, paragraph deleted text begin (b)deleted text end new text begin (c)new text end , clause deleted text begin (11)deleted text end new text begin (12)new text end , and to assist the individual to meet
one or more of the eligibility criteria in subdivision 4 if the individual wants to reenter
foster care. The agency shall provide foster care as required to implement the plan. The
agency shall enter into a voluntary placement agreement under section 260C.229 with the
individual if the plan includes foster care.
(b) Individuals who had not been under the guardianship of the commissioner of
human services prior to age 18 and are between the ages of 18 and 21 may ask to reenter
foster care after age 18 and, to the extent funds are available, the responsible social
services agency that had responsibility for planning for the individual before discharge
from foster care may provide foster care or other services to the individual for the purpose
of increasing the individual's ability to live safely and independently and to meet the
eligibility criteria in subdivision 3a, if the individual:
(1) was in foster care for the six consecutive months prior to the person's 18th
birthday and was not discharged home, adopted, or received into a relative's home under a
transfer of permanent legal and physical custody under section 260C.515, subdivision 4; or
(2) was discharged from foster care while on runaway status after age 15.
(c) In conjunction with a qualifying and eligible individual under paragraph (b) and
other appropriate persons, the responsible social services agency shall develop a specific
plan related to that individual's vocational, educational, social, or maturational needs
and, to the extent funds are available, provide foster care as required to implement the
plan. The agency shall enter into a voluntary placement agreement with the individual
if the plan includes foster care.
(d) Youth who left foster care while under guardianship of the commissioner of
human services retain eligibility for foster care for placement at any time between the
ages of 18 and 21.
Sec. 65.
Minnesota Statutes 2014, section 260C.515, subdivision 5, is amended to read:
Subd. 5.
Permanent custody to agency.
The court may order permanent custody to
the responsible social services agency for continued placement of the child in foster care
but only if it approves the responsible social services agency's compelling reasons that no
other permanency disposition order is in the child's best interests and:
(1) the child has reached age deleted text begin 12deleted text end new text begin 16 and has been asked about the child's desired
permanency outcomenew text end ;
deleted text begin
(2) the child is a sibling of a child described in clause (1) and the siblings have a
deleted text end
deleted text begin
significant positive relationship and are ordered into the same foster home;
deleted text end
deleted text begin (3)deleted text end new text begin (2)new text end the responsible social services agency has made reasonable efforts to locate
and place the child with an adoptive family or a fit and willing relative who would either
agree to adopt the child or to a transfer of permanent legal and physical custody of the
child, but these efforts have not proven successful; and
deleted text begin (4)deleted text end new text begin (3)new text end the parent will continue to have visitation or contact with the child and will
remain involved in planning for the child.
Sec. 66.
Minnesota Statutes 2014, section 260C.521, subdivision 1, is amended to read:
Subdivision 1.
Child in permanent custody of responsible social services agency.
(a) Court reviews of an order for permanent custody to the responsible social services
agency for placement of the child in foster care must be conducted at least yearly at an
in-court appearance hearing.
(b) The purpose of the review hearing is to ensure:
(1) the order for permanent custody to the responsible social services agency for
placement of the child in foster care continues to be in the best interests of the child and
that no other permanency disposition order is in the best interests of the child;
(2) that the agency is assisting the child to build connections to the child's family
and community; and
(3) that the agency is appropriately planning with the child for development of
independent living skills for the child and, as appropriate, for the orderly and successful
transition to independent living that may occur if the child continues in foster care without
another permanency disposition order.
(c) The court must review the child's out-of-home placement plan and the reasonable
efforts of the agency to finalize an alternative permanent plan for the child including the
agency's efforts to:
(1) ensure that permanent custody to the agency with placement of the child in
foster care continues to be the most appropriate legal arrangement for meeting the child's
need for permanency and stability or, if not, to identify and attempt to finalize another
permanency disposition order under this chapter that would better serve the child's needs
and best interests;
(2) identify a specific foster home for the child, if one has not already been identified;
(3) support continued placement of the child in the identified home, if one has been
identified;
(4) ensure appropriate services are provided to address the physical health, mental
health, and educational needs of the child during the period of foster care and also ensure
appropriate services or assistance to maintain relationships with appropriate family
members and the child's community; and
(5) plan for the child's independence upon the child's leaving foster care living as
required under section 260C.212, subdivision 1.
(d) The court may find that the agency has made reasonable efforts to finalize the
permanent plan for the child when:
(1) the agency has made reasonable efforts to identify a more legally permanent
home for the child than is provided by an order for permanent custody to the agency
for placement in foster care; deleted text begin and
deleted text end
new text begin
(2) the child has been asked about the child's desired permanency outcome; and
new text end
deleted text begin (2)deleted text end new text begin (3)new text end the agency's engagement of the child in planning for independent living is
reasonable and appropriate.
Sec. 67.
Minnesota Statutes 2014, section 260C.521, subdivision 2, is amended to read:
Subd. 2.
Modifying order for permanent legal and physical custody to a
relative.
new text begin (a) new text end An order for a relative to have permanent legal and physical custody of a
child may be modified using standards under sections 518.18 and 518.185.
new text begin
(b) When a child is receiving Northstar kinship assistance under chapter 256N, if
a relative named as permanent legal and physical custodian in an order made under this
chapter becomes incapacitated or dies, a successor custodian named in the Northstar
Care for Children kinship assistance benefit agreement under section 256N.25 may file
a request to modify the order for permanent legal and physical custody to name the
successor custodian as the permanent legal and physical custodian of the child. The court
may modify the order to name the successor custodian as the permanent legal and physical
custodian upon reviewing the background study required under section 245C.33 if the
court finds the modification is in the child's best interests.
new text end
new text begin (c)new text end The social services agency is a party to the proceeding and must receive notice.
Sec. 68.
Minnesota Statutes 2014, section 260C.607, subdivision 4, is amended to read:
Subd. 4.
Content of review.
(a) The court shall review:
(1) the agency's reasonable efforts under section 260C.605 to finalize an adoption
for the child as appropriate to the stage of the case; and
(2) the child's current out-of-home placement plan required under section 260C.212,
subdivision 1, to ensure the child is receiving all services and supports required to meet
the child's needs as they relate to the child's:
(i) placement;
(ii) visitation and contact with siblings;
(iii) visitation and contact with relatives;
(iv) medical, mental, and dental health; and
(v) education.
(b) When the child is age deleted text begin 16deleted text end new text begin 14new text end and older, and as long as the child continues in foster
care, the court shall also review the agency's planning for the child's independent living
after leaving foster care including how the agency is meeting the requirements of section
260C.212, subdivision 1, paragraph (c), clause deleted text begin (11)deleted text end new text begin (12)new text end . The court shall use the review
requirements of section 260C.203 in any review conducted under this paragraph.
Sec. 69.
Minnesota Statutes 2014, section 518A.26, subdivision 14, is amended to read:
Subd. 14.
Obligor.
"Obligor" means a person obligated to pay maintenance or
support. deleted text begin A person who has primary physical custody of a child is presumed not to be
an obligor for purposes of a child support order under section 518A.34, unless section
518A.36, subdivision 3, applies or the court makes specific written findings to overcome
this presumption.deleted text end For purposes of ordering medical support under section 518A.41, a
parent who has primary physical custody of a child may be an obligor subject to a payment
agreement under section 518A.69.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2016.
new text end
Sec. 70.
Minnesota Statutes 2014, section 518A.32, subdivision 2, is amended to read:
Subd. 2.
Methods.
Determination of potential income must be made according
to one of three methods, as appropriate:
(1) the parent's probable earnings level based on employment potential, recent
work history, and occupational qualifications in light of prevailing job opportunities and
earnings levels in the community;
(2) if a parent is receiving unemployment compensation or workers' compensation,
that parent's income may be calculated using the actual amount of the unemployment
compensation or workers' compensation benefit received; or
(3) the amount of income a parent could earn working deleted text begin full time at 150deleted text end new text begin 30 hours per
week at 100new text end percent of the current federal or state minimum wage, whichever is higher.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2016.
new text end
Sec. 71.
Minnesota Statutes 2014, section 518A.39, subdivision 1, is amended to read:
Subdivision 1.
Authority.
After an order under this chapter or chapter 518 for
maintenance or support money, temporary or permanent, or for the appointment of trustees
to receive property awarded as maintenance or support money, the court may from time to
time, on motion of either of the parties, a copy of which is served on the public authority
responsible for child support enforcement if payments are made through it, or on motion
of the public authority responsible for support enforcement, modify the order respecting
the amount of maintenance or support moneynew text begin or medical supportnew text end , and the payment of it,
and also respecting the appropriation and payment of the principal and income of property
held in trust, and may make an order respecting these matters which it might have made
in the original proceeding, except as herein otherwise provided. A party or the public
authority also may bring a motion for contempt of court if the obligor is in arrears in
support or maintenance payments.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 72.
Minnesota Statutes 2014, section 518A.39, is amended by adding a
subdivision to read:
new text begin Subd. 8. new text end
new text begin Medical support-only modification. new text end
new text begin
(a) The medical support terms of
a support order and determination of the child dependency tax credit may be modified
without modification of the full order for support or maintenance, if the order has been
established or modified in its entirety within three years from the date of the motion, and
upon a showing of one or more of the following:
new text end
new text begin
(1) a change in the availability of appropriate health care coverage or a substantial
increase or decrease in health care coverage costs;
new text end
new text begin
(2) a change in the eligibility for medical assistance under chapter 256B;
new text end
new text begin
(3) a party's failure to carry court-ordered coverage, or to provide other medical
support as ordered;
new text end
new text begin
(4) the federal child dependency tax credit is not ordered for the same parent who is
ordered to carry health care coverage; or
new text end
new text begin
(5) the federal child dependency tax credit is not addressed in the order and the
noncustodial parent is ordered to carry health care coverage.
new text end
new text begin
(b) For a motion brought under this subdivision, a modification of the medical
support terms of an order may be made retroactive only with respect to any period during
which the petitioning party has pending a motion for modification, but only from the date
of service of notice of the motion on the responding party and on the public authority if
public assistance is being furnished or the county attorney is the attorney of record.
new text end
new text begin
(c) The court need not hold an evidentiary hearing on a motion brought under this
subdivision for modification of medical support only.
new text end
new text begin
(d) Sections 518.14 and 518A.735 shall govern the award of attorney fees for
motions brought under this subdivision.
new text end
new text begin
(e) The PICS originally stated in the order being modified shall be used to determine
the modified medical support order under section 518A.41 for motions brought under
this subdivision.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 73.
Minnesota Statutes 2014, section 518A.41, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
The definitions in this subdivision apply to this chapter
and chapter 518.
(a) "Health care coverage" means medical, dental, or other health care benefits that
are provided by one or more health plans. Health care coverage does not include any
form of public coverage.
(b) "Health carrier" means a carrier as defined in sections 62A.011, subdivision
2, and 62L.02, subdivision 16.
(c) "Health plan" means a plan, other than any form of public coverage, that provides
medical, dental, or other health care benefits and is:
(1) provided on an individual or group basis;
(2) provided by an employer or union;
(3) purchased in the private market; or
(4) available to a person eligible to carry insurance for the joint child, including a
party's spouse or parent.
Health plan includes, but is not limited to, a plan meeting the definition under section
62A.011, subdivision 3, except that the exclusion of coverage designed solely to provide
dental or vision care under section 62A.011, subdivision 3, clause (6), does not apply to
the definition of health plan under this section; a group health plan governed under the
federal Employee Retirement Income Security Act of 1974 (ERISA); a self-insured plan
under sections 43A.23 to 43A.317 and 471.617; and a policy, contract, or certificate issued
by a community-integrated service network licensed under chapter 62N.
(d) "Medical support" means providing health care coverage for a joint child by
carrying health care coverage for the joint child or by contributing to the cost of health
care coverage, public coverage, unreimbursed medical expenses, and uninsured medical
expenses of the joint child.
(e) "National medical support notice" means an administrative notice issued by the
public authority to enforce health insurance provisions of a support order in accordance
with Code of Federal Regulations, title 45, section 303.32, in cases where the public
authority provides support enforcement services.
(f) "Public coverage" means health care benefits provided by any form of medical
assistance under chapter 256B deleted text begin or MinnesotaCare under chapter 256Ldeleted text end .new text begin Public coverage
does not include MinnesotaCare or health plans subsidized by federal premium tax credits
or federal cost-sharing reductions.
new text end
(g) "Uninsured medical expenses" means a joint child's reasonable and necessary
health-related expenses if the joint child is not covered by a health plan or public coverage
when the expenses are incurred.
(h) "Unreimbursed medical expenses" means a joint child's reasonable and necessary
health-related expenses if a joint child is covered by a health plan or public coverage and
the plan or coverage does not pay for the total cost of the expenses when the expenses
are incurred. Unreimbursed medical expenses do not include the cost of premiums.
Unreimbursed medical expenses include, but are not limited to, deductibles, co-payments,
and expenses for orthodontia, and prescription eyeglasses and contact lenses, but not
over-the-counter medications if coverage is under a health plan.
Sec. 74.
Minnesota Statutes 2014, section 518A.41, subdivision 3, is amended to read:
Subd. 3.
Determining appropriate health care coverage.
In determining whether
a parent has appropriate health care coverage for the joint child, the court must consider
the following factors:
(1) comprehensiveness of health care coverage providing medical benefits.
Dependent health care coverage providing medical benefits is presumed comprehensive if
it includes medical and hospital coverage and provides for preventive, emergency, acute,
and chronic carenew text begin ; or if it meets the minimum essential coverage definition in United States
Code, title 26, section 5000A(f)new text end . If both parents have health care coverage providing
medical benefits that is presumed comprehensive under this paragraph, the court must
determine which parent's coverage is more comprehensive by considering what other
benefits are included in the coverage;
(2) accessibility. Dependent health care coverage is accessible if the covered joint
child can obtain services from a health plan provider with reasonable effort by the parent
with whom the joint child resides. Health care coverage is presumed accessible if:
(i) primary care is available within 30 minutes or 30 miles of the joint child's residence
and specialty care is available within 60 minutes or 60 miles of the joint child's residence;
(ii) the health care coverage is available through an employer and the employee can
be expected to remain employed for a reasonable amount of time; and
(iii) no preexisting conditions exist to unduly delay enrollment in health care
coverage;
(3) the joint child's special medical needs, if any; and
(4) affordability. Dependent health care coverage is affordable if it is reasonable
in cost. If both parents have health care coverage available for a joint child that is
comparable with regard to comprehensiveness of medical benefits, accessibility, and the
joint child's special needs, the least costly health care coverage is presumed to be the most
appropriate health care coverage for the joint child.
Sec. 75.
Minnesota Statutes 2014, section 518A.41, subdivision 4, is amended to read:
Subd. 4.
Ordering health care coverage.
(a) If a joint child is presently enrolled
in health care coverage, the court must order that the parent who currently has the joint
child enrolled continue that enrollment unless the parties agree otherwise or a party
requests a change in coverage and the court determines that other health care coverage is
more appropriate.
(b) If a joint child is not presently enrolled in health care coverage providing medical
benefits, upon motion of a parent or the public authority, the court must determine whether
one or both parents have appropriate health care coverage providing medical benefits
for the joint child.
(c) If only one parent has appropriate health care coverage providing medical
benefits available, the court must order that parent to carry the coverage for the joint child.
(d) If both parents have appropriate health care coverage providing medical benefits
available, the court must order the parent with whom the joint child resides to carry the
coverage for the joint child, unless:
(1) a party expresses a preference for health care coverage providing medical
benefits available through the parent with whom the joint child does not reside;
(2) the parent with whom the joint child does not reside is already carrying
dependent health care coverage providing medical benefits for other children and the cost
of contributing to the premiums of the other parent's coverage would cause the parent with
whom the joint child does not reside extreme hardship; or
(3) the parties agree as to which parent will carry health care coverage providing
medical benefits and agree on the allocation of costs.
(e) If the exception in paragraph (d), clause (1) or (2), applies, the court must
determine which parent has the most appropriate coverage providing medical benefits
available and order that parent to carry coverage for the joint child.
(f) If neither parent has appropriate health care coverage available, the court must
order the parents to:
(1) contribute toward the actual health care costs of the joint children based on
a pro rata share; or
(2) if the joint child is receiving any form of public coverage, the parent with whom
the joint child does not reside shall contribute a monthly amount toward the actual cost of
public coverage. The amount of the noncustodial parent's contribution is determined by
applying the noncustodial parent's PICS to the premium deleted text begin schedule for public coveragedeleted text end new text begin scale
for MinnesotaCare under section 256L.15, subdivision 2, paragraph (d)new text end . If the noncustodial
parent's PICS meets the eligibility requirements for deleted text begin public coveragedeleted text end new text begin MinnesotaCarenew text end , the
contribution is the amount the noncustodial parent would pay for the child's premium. If
the noncustodial parent's PICS exceeds the eligibility requirements deleted text begin for public coveragedeleted text end , the
contribution is the amount of the premium for the highest eligible income on the deleted text begin appropriate
deleted text end premium deleted text begin schedule for public coveragedeleted text end new text begin scale for MinnesotaCare under section 256L.15,
subdivision 2, paragraph (d)new text end . For purposes of determining the premium amount, the
noncustodial parent's household size is equal to one parent plus the child or children who
are the subject of the child support order. The custodial parent's obligation is determined
under the requirements for public coverage as set forth in chapter 256B deleted text begin or 256L.deleted text end new text begin ; or
new text end
new text begin
(3) if the noncustodial parent's PICS meet the eligibility requirement for public
coverage under chapter 256B or the noncustodial parent receives public assistance, the
noncustodial parent must not be ordered to contribute toward the cost of public coverage.
new text end
(g) If neither parent has appropriate health care coverage available, the court may
order the parent with whom the child resides to apply for public coverage for the child.
(h) The commissioner of human services must publish a table with the premium
schedule for public coverage and update the chart for changes to the schedule by July
1 of each year.
(i) If a joint child is not presently enrolled in health care coverage providing dental
benefits, upon motion of a parent or the public authority, the court must determine whether
one or both parents have appropriate dental health care coverage for the joint child, and the
court may order a parent with appropriate dental health care coverage available to carry
the coverage for the joint child.
(j) If a joint child is not presently enrolled in available health care coverage
providing benefits other than medical benefits or dental benefits, upon motion of a parent
or the public authority, the court may determine whether that other health care coverage
for the joint child is appropriate, and the court may order a parent with that appropriate
health care coverage available to carry the coverage for the joint child.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2015.
new text end
Sec. 76.
Minnesota Statutes 2014, section 518A.41, subdivision 14, is amended to read:
Subd. 14.
Child support enforcement services.
The public authority must take
necessary steps to establish deleted text begin and enforcedeleted text end new text begin , enforce, and modifynew text end an order for medical support
if the joint child receives public assistance or a party completes an application for services
from the public authority under section 518A.51.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 77.
Minnesota Statutes 2014, section 518A.41, subdivision 15, is amended to read:
Subd. 15.
Enforcement.
(a) Remedies available for collecting and enforcing child
support apply to medical support.
(b) For the purpose of enforcement, the following are additional support:
(1) the costs of individual or group health or hospitalization coverage;
(2) dental coverage;
(3) medical costs ordered by the court to be paid by either party, including health
care coverage premiums paid by the obligee because of the obligor's failure to obtain
coverage as ordered; and
(4) liabilities established under this subdivision.
(c) A party who fails to carry court-ordered dependent health care coverage is liable
for the joint child's uninsured medical expenses unless a court order provides otherwise.
A party's failure to carry court-ordered coverage, or to provide other medical support as
ordered, is a basis for modification of deleted text begin adeleted text end new text begin medicalnew text end support deleted text begin orderdeleted text end under section 518A.39,
subdivision deleted text begin 2deleted text end new text begin 8, unless it meets the presumption in section 518A.39, subdivision 2new text end .
(d) Payments by the health carrier or employer for services rendered to the dependents
that are directed to a party not owed reimbursement must be endorsed over to and forwarded
to the vendor or appropriate party or the public authority. A party retaining insurance
reimbursement not owed to the party is liable for the amount of the reimbursement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 78.
Minnesota Statutes 2014, section 518A.43, is amended by adding a
subdivision to read:
new text begin Subd. 1a. new text end
new text begin Income disparity between parties. new text end
new text begin
The court may deviate from the
presumptive child support obligation under section 518A.34 and elect not to order a party
who has between ten and 45 percent parenting time to pay basic support where such a
significant disparity of income exists between the parties that an order directing payment
of basic support would be detrimental to the parties' joint child.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2016.
new text end
Sec. 79.
Minnesota Statutes 2014, section 518A.46, subdivision 3, is amended to read:
Subd. 3.
Contents of pleadings.
(a) In cases involving establishment or
modification of a child support order, the initiating party shall include the following
information, if known, in the pleadings:
(1) names, addresses, and dates of birth of the parties;
(2) Social Security numbers of the parties and the minor children of the parties,
which information shall be considered private information and shall be available only to
the parties, the court, and the public authority;
(3) other support obligations of the obligor;
(4) names and addresses of the parties' employers;
(5) gross income of the parties as calculated in section 518A.29;
(6) amounts and sources of any other earnings and income of the parties;
(7) health insurance coverage of parties;
(8) types and amounts of public assistance received by the parties, including
Minnesota family investment plan, child care assistance, medical assistance,
deleted text begin MinnesotaCare,deleted text end title IV-E foster care, or other form of assistance as defined in section
256.741, subdivision 1; and
(9) any other information relevant to the computation of the child support obligation
under section 518A.34.
(b) For all matters scheduled in the expedited process, whether or not initiated by
the public authority, the nonattorney employee of the public authority shall file with the
court and serve on the parties the following information:
(1) information pertaining to the income of the parties available to the public
authority from the Department of Employment and Economic Development;
(2) a statement of the monthly amount of child support, medical support, child care,
and arrears currently being charged the obligor on Minnesota IV-D cases;
(3) a statement of the types and amount of any public assistance, as defined in
section 256.741, subdivision 1, received by the parties; and
(4) any other information relevant to the determination of support that is known to
the public authority and that has not been otherwise provided by the parties.
The information must be filed with the court or child support magistrate at least
five days before any hearing involving child support, medical support, or child care
reimbursement issues.
Sec. 80.
Minnesota Statutes 2014, section 518A.46, is amended by adding a
subdivision to read:
new text begin Subd. 3a. new text end
new text begin Contents of pleadings for medical support modifications. new text end
new text begin
(a) In cases
involving modification of only the medical support portion of a child support order
under section 518A.39, subdivision 8, the initiating party shall include the following
information, if known, in the pleadings:
new text end
new text begin
(1) names, addresses, and dates of birth of the parties;
new text end
new text begin
(2) Social Security numbers of the parties and the minor children of the parties,
which shall be considered private information and shall be available only to the parties,
the court, and the public authority;
new text end
new text begin
(3) names and addresses of the parties' employers;
new text end
new text begin
(4) gross income of the parties as stated in the order being modified;
new text end
new text begin
(5) health insurance coverage of the parties; and
new text end
new text begin
(6) any other information relevant to the determination of the medical support
obligation under section 518A.41.
new text end
new text begin
(b) For all matters scheduled in the expedited process, whether or not initiated by
the public authority, the nonattorney employee of the public authority shall file with the
court and serve on the parties the following information:
new text end
new text begin
(1) a statement of the monthly amount of child support, medical support, child care,
and arrears currently being charged the obligor on Minnesota IV-D cases;
new text end
new text begin
(2) a statement of the amount of medical assistance received by the parties; and
new text end
new text begin
(3) any other information relevant to the determination of medical support that is
known to the public authority and that has not been otherwise provided by the parties.
new text end
new text begin
The information must be filed with the court or child support magistrate at least five
days before the hearing on the motion to modify medical support.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 81.
Minnesota Statutes 2014, section 518A.51, is amended to read:
518A.51 FEES FOR IV-D SERVICES.
(a) When a recipient of IV-D services is no longer receiving assistance under the
state's title IV-A, IV-E foster care,new text begin ornew text end medical assistancedeleted text begin , or MinnesotaCaredeleted text end programs, the
public authority responsible for child support enforcement must notify the recipient,
within five working days of the notification of ineligibility, that IV-D services will be
continued unless the public authority is notified to the contrary by the recipient. The
notice must include the implications of continuing to receive IV-D services, including the
available services and fees, cost recovery fees, and distribution policies relating to fees.
deleted text begin
(b) An application fee of $25 shall be paid by the person who applies for child
support and maintenance collection services, except persons who are receiving public
assistance as defined in section 256.741 and the diversionary work program under section
256J.95, persons who transfer from public assistance to nonpublic assistance status, and
minor parents and parents enrolled in a public secondary school, area learning center, or
alternative learning program approved by the commissioner of education.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end In the case of an individual who has never received assistance under a state
program funded under title IV-A of the Social Security Act and for whom the public
authority has collected at least $500 of support, the public authority must impose an
annual federal collections fee of $25 for each case in which services are furnished. This
fee must be retained by the public authority from support collected on behalf of the
individual, but not from the first $500 collected.
deleted text begin (d)deleted text end new text begin (c)new text end When the public authority provides full IV-D services to an obligee who
has applied for those services, upon written notice to the obligee, the public authority
must charge a cost recovery fee of two percent of the amount collected. This fee must
be deducted from the amount of the child support and maintenance collected and not
assigned under section 256.741 before disbursement to the obligee. This fee does not
apply to an obligee who:
(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,new text begin or
new text end medical assistancedeleted text begin , or MinnesotaCaredeleted text end programs; or
(2) has received assistance under the state's title IV-A or IV-E foster care programs,
until the person has not received this assistance for 24 consecutive months.
deleted text begin (e)deleted text end new text begin (d)new text end When the public authority provides full IV-D services to an obligor who has
applied for such services, upon written notice to the obligor, the public authority must
charge a cost recovery fee of two percent of the monthly court-ordered child support and
maintenance obligation. The fee may be collected through income withholding, as well
as by any other enforcement remedy available to the public authority responsible for
child support enforcement.
deleted text begin (f)deleted text end new text begin (e)new text end Fees assessed by state and federal tax agencies for collection of overdue
support owed to or on behalf of a person not receiving public assistance must be imposed
on the person for whom these services are provided. The public authority upon written
notice to the obligee shall assess a fee of $25 to the person not receiving public assistance
for each successful federal tax interception. The fee must be withheld prior to the release
of the funds received from each interception and deposited in the general fund.
deleted text begin (g)deleted text end new text begin (f)new text end Federal collections fees collected under paragraph deleted text begin (c)deleted text end new text begin (b)new text end and cost recovery
fees collected under paragraphsnew text begin (c) andnew text end (d) deleted text begin and (e)deleted text end retained by the commissioner of human
services shall be considered child support program income according to Code of Federal
Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
account established under paragraph deleted text begin (i)deleted text end new text begin (h)new text end . The commissioner of human services must
elect to recover costs based on either actual or standardized costs.
deleted text begin (h)deleted text end new text begin (g)new text end The limitations of this section on the assessment of fees shall not apply to
the extent inconsistent with the requirements of federal law for receiving funds for the
programs under title IV-A and title IV-D of the Social Security Act, United States Code,
title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
deleted text begin (i)deleted text end new text begin (h)new text end The commissioner of human services is authorized to establish a special
revenue fund account to receive the federal collections fees collected under paragraph deleted text begin (c)
deleted text end new text begin (b)new text end and cost recovery fees collected under paragraphsnew text begin (c) andnew text end (d) deleted text begin and (e)deleted text end .
deleted text begin (j)deleted text end new text begin (i)new text end The nonfederal share of the cost recovery fee revenue must be retained by the
commissioner and distributed as follows:
(1) one-half of the revenue must be transferred to the child support system special
revenue account to support the state's administration of the child support enforcement
program and its federally mandated automated system;
(2) an additional portion of the revenue must be transferred to the child support
system special revenue account for expenditures necessary to administer the fees; and
(3) the remaining portion of the revenue must be distributed to the counties to aid the
counties in funding their child support enforcement programs.
deleted text begin (k)deleted text end new text begin (j)new text end The nonfederal share of the federal collections fees must be distributed to the
counties to aid them in funding their child support enforcement programs.
deleted text begin (l)deleted text end new text begin (k)new text end The commissioner of human services shall distribute quarterly any of the
funds dedicated to the counties under paragraphsnew text begin (i) andnew text end (j) deleted text begin and (k)deleted text end using the methodology
specified in section 256.979, subdivision 11. The funds received by the counties must be
reinvested in the child support enforcement program and the counties must not reduce the
funding of their child support programs by the amount of the funding distributed.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016, except that the
amendments striking MinnesotaCare are effective July 1, 2015.
new text end
Sec. 82.
Minnesota Statutes 2014, section 518A.53, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For the purpose of this section, the following terms
have the meanings provided in this subdivision unless otherwise stated.
(b) "Payor of funds" means any person or entity that provides funds to an obligor,
including an employer as defined under chapter 24 of the Internal Revenue Code,
section 3401(d), an independent contractor, payor of worker's compensation benefits or
unemployment benefits, or a financial institution as defined in section 13B.06.
(c) "Business day" means a day on which state offices are open for regular business.
(d) "Arrears" deleted text begin means amounts owed under a support order that are past duedeleted text end new text begin has the
meaning given in section 518A.26, subdivision 3new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 83.
Minnesota Statutes 2014, section 518A.53, subdivision 4, is amended to read:
Subd. 4.
Collection services.
(a) The commissioner of human services shall prepare
and make available to the courts a notice of services that explains child support and
maintenance collection services available through the public authority, including income
withholding, and the fees for such services. Upon receiving a petition for dissolution of
marriage or legal separation, the court administrator shall promptly send the notice of
services to the petitioner and respondent at the addresses stated in the petition.
(b) Either the obligee or obligor may at any time apply to the public authority for
either full IV-D services or for income withholding only services.
(c) For those persons applying for income withholding only services, a monthly
service fee of $15 must be charged to the obligor. This fee is in addition to the amount of
the support order and shall be withheld through income withholding. The public authority
shall explain the service options in this section to the affected parties and encourage the
application for full child support collection services.
(d) If the obligee is not a current recipient of public assistance as defined in section
256.741, the person who applied for services may at any time choose to terminate either
full IV-D services or income withholding only services regardless of whether income
withholding is currently in place. The obligee or obligor may reapply for either full IV-D
services or income withholding only services at any time. deleted text begin Unless the applicant is a
recipient of public assistance as defined in section 256.741, a $25 application fee shall be
charged at the time of each application.
deleted text end
(e) When a person terminates IV-D services, if an arrearage for public assistance as
defined in section 256.741 exists, the public authority may continue income withholding,
as well as use any other enforcement remedy for the collection of child support, until all
public assistance arrears are paid in full. Income withholding shall be in an amount equal
to 20 percent of the support order in effect at the time the services terminatednew text begin , unless the
court has ordered a specific monthly payback amount to be applied toward the arrears. If a
support order includes a specific monthly payback amount, income withholding shall be
for the specific monthly payback amount orderednew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 84.
Minnesota Statutes 2014, section 518A.53, subdivision 10, is amended to read:
Subd. 10.
Arrearage order.
(a) This section does not prevent the court from
ordering the payor of funds to withhold amounts to satisfy the obligor's previous arrearage
in support order payments. This remedy shall not operate to exclude availability of other
remedies to enforce judgments. The employer or payor of funds shall withhold from
the obligor's income an additional amount equal to 20 percent of the monthly child
support or maintenance obligation until the arrearage is paidnew text begin , unless the court has ordered
a specific monthly payback amount toward the arrears. If a support order includes a
specific monthly payback amount, the employer or payor of funds shall withhold from
the obligor's income an additional amount equal to the specific monthly payback amount
ordered until all arrearages are paidnew text end .
(b) Notwithstanding any law to the contrary, funds from income sources included
in section 518A.26, subdivision 8, whether periodic or lump sum, are not exempt from
attachment or execution upon a judgment for child support arrearage.
(c) Absent an order to the contrary, if an arrearage exists at the time a support
order would otherwise terminate, income withholding shall continue in effect or may be
implemented in an amount equal to the support order plus an additional 20 percent of the
monthly child support obligation, until all arrears have been paid in full.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 85.
Minnesota Statutes 2014, section 518A.60, is amended to read:
518A.60 COLLECTION; ARREARS ONLY.
(a) Remedies available for the collection and enforcement of support in this chapter
and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
for whom support is owed are emancipated and the obligor owes past support or has an
accumulated arrearage as of the date of the youngest child's emancipation. Child support
arrearages under this section include arrearages for child support, medical support, child
care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
section 518A.41, subdivision 1, paragraph (h).
(b) This section applies retroactively to any support arrearage that accrued on or
before June 3, 1997, and to all arrearages accruing after June 3, 1997.
(c) Past support or pregnancy and confinement expenses ordered for which the
obligor has specific court ordered terms for repayment may not be enforced using drivers'
and occupational or professional license suspensiondeleted text begin ,deleted text end new text begin and new text end credit bureau reporting, deleted text begin and
additional income withholding under section 518A.53, subdivision 10, paragraph (a),
deleted text end unless the obligor fails to comply with the terms of the court order for repayment.
(d) If an arrearage exists at the time a support order would otherwise terminate
and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
arrearage shall be repaid in an amount equal to the current support order until all arrears
have been paid in full, absent a court order to the contrary.
(e) If an arrearage exists according to a support order which fails to establish a
monthly support obligation in a specific dollar amount, the public authority, if it provides
child support services, or the obligee, may establish a payment agreement which shall
equal what the obligor would pay for current support after application of section 518A.34,
plus an additional 20 percent of the current support obligation, until all arrears have been
paid in full. If the obligor fails to enter into or comply with a payment agreement, the
public authority, if it provides child support services, or the obligee, may move the district
court or child support magistrate, if section 484.702 applies, for an order establishing
repayment terms.
(f) If there is no longer a current support order because all of the children of the
order are emancipated, the public authority may discontinue child support services and
close its case under title IV-D of the Social Security Act if:
(1) the arrearage is under $500; or
(2) the arrearage is considered unenforceable by the public authority because there
have been no collections for three years, and all administrative and legal remedies have
been attempted or are determined by the public authority to be ineffective because the
obligor is unable to pay, the obligor has no known income or assets, and there is no
reasonable prospect that the obligor will be able to pay in the foreseeable future.
(g) At least 60 calendar days before the discontinuation of services under paragraph
(f), the public authority must mail a written notice to the obligee and obligor at the
obligee's and obligor's last known addresses that the public authority intends to close the
child support enforcement case and explaining each party's rights. Seven calendar days
after the first notice is mailed, the public authority must mail a second notice under this
paragraph to the obligee.
(h) The case must be kept open if the obligee responds before case closure and
provides information that could reasonably lead to collection of arrears. If the case is
closed, the obligee may later request that the case be reopened by completing a new
application for services, if there is a change in circumstances that could reasonably lead to
the collection of arrears.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 86.
new text begin
[518A.685] CONSUMER REPORTING AGENCY; REPORTING
ARREARS.
new text end
new text begin
(a) If a public authority determines that an obligor has not paid the current monthly
support obligation plus any required arrearage payment for three months, the public
authority must report this information to a consumer reporting agency.
new text end
new text begin
(b) Before reporting that an obligor is in arrears for court-ordered child support,
the public authority must:
new text end
new text begin
(1) provide written notice to the obligor that the public authority intends to report the
arrears to a consumer reporting agency; and
new text end
new text begin
(2) mail the written notice to the obligor's last known mailing address at least 30
days before the public authority reports the arrears to a consumer reporting agency.
new text end
new text begin
(c) The obligor may, within 21 days of receipt of the notice, do the following to
prevent the public authority from reporting the arrears to a consumer reporting agency:
new text end
new text begin
(1) pay the arrears in full; or
new text end
new text begin
(2) request an administrative review. An administrative review is limited to issues
of mistaken identity, a pending legal action involving the arrears, or an incorrect arrears
balance.
new text end
new text begin
(d) If the public authority has reported that an obligor is in arrears for court-ordered
child support and subsequently determines that the obligor has paid the court-ordered
child support arrears in full, or is paying the current monthly support obligation plus any
required arrearage payment, the public authority must report to the consumer reporting
agency that the obligor is currently paying child support as ordered by the court.
new text end
new text begin
(e) A public authority that reports arrearage information under this section must
make monthly reports to a consumer reporting agency. The monthly report must be
consistent with credit reporting industry standards for child support.
new text end
new text begin
(f) For purposes of this section, "consumer reporting agency" has the meaning given
in section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 87.
Minnesota Statutes 2014, section 518C.802, is amended to read:
518C.802 CONDITIONS OF RENDITION.
(a) Before making demand that the governor of another state surrender an individual
charged criminally in this state with having failed to provide for the support of an obligee,
the governor of this state may require a prosecutor of this state to demonstrate that at least
60 days previously the obligee had initiated proceedings for support pursuant to this
chapter or that the proceeding would be of no avail.
(b) If, under this chapter or a law substantially similar to this chapter, deleted text begin the Uniform
Reciprocal Enforcement of Support Act, or the Revised Uniform Reciprocal Enforcement
of Support Act,deleted text end the governor of another state makes a demand that the governor of
this state surrender an individual charged criminally in that state with having failed to
provide for the support of a child or other individual to whom a duty of support is owed,
the governor may require a prosecutor to investigate the demand and report whether
a proceeding for support has been initiated or would be effective. If it appears that a
proceeding would be effective but has not been initiated, the governor may delay honoring
the demand for a reasonable time to permit the initiation of a proceeding.
(c) If a proceeding for support has been initiated and the individual whose rendition is
demanded prevails, the governor may decline to honor the demand. If the petitioner prevails
and the individual whose rendition is demanded is subject to a support order, the governor
may decline to honor the demand if the individual is complying with the support order.
Sec. 88.
Minnesota Statutes 2014, section 626.556, subdivision 1, as amended by Laws
2015, chapter 4, section 1, is amended to read:
Subdivision 1.
Public policy.
(a) The legislature hereby declares that the public
policy of this state is to protect children whose health or welfare may be jeopardized
through physical abuse, neglect, or sexual abuse. While it is recognized that most parents
want to keep their children safe, sometimes circumstances or conditions interfere with
their ability to do so. When this occurs, the health and safety of the children deleted text begin shalldeleted text end new text begin mustnew text end be
of paramount concern. Intervention and prevention efforts deleted text begin shalldeleted text end new text begin mustnew text end address immediate
concerns for child safety and the ongoing risk of abuse or neglect and should engage the
protective capacities of families. In furtherance of this public policy, it is the intent of the
legislature under this section to:
(1) protect children and promote child safety;
(2) strengthen the family;
(3) make the home, school, and community safe for children by promoting
responsible child care in all settings; and
(4) provide, when necessary, a safe temporary or permanent home environment for
physically or sexually abused or neglected children.
(b) In addition, it is the policy of this state to:
(1) require the reporting of neglect or physical or sexual abuse of children in the
home, school, and community settings;
(2) provide for the voluntary reporting of abuse or neglect of children; deleted text begin to require
a family assessment, when appropriate, as the preferred response to reports not alleging
substantial child endangerment;deleted text end
(3) require an investigation when the report alleges new text begin sexual abuse or new text end substantial
child endangerment;
new text begin (4) provide a family assessment, if appropriate, when the report does not allege
sexual abuse or substantial child endangerment; new text end and
deleted text begin (4)deleted text end new text begin (5)new text end provide protective, family support, and family preservation services when
needed in appropriate cases.
Sec. 89.
Minnesota Statutes 2014, section 626.556, subdivision 2, is amended to read:
Subd. 2.
Definitions.
As used in this section, the following terms have the meanings
given them unless the specific content indicates otherwise:
(a) "Family assessment" means a comprehensive assessment of child safety, risk of
subsequent child maltreatment, and family strengths and needs that is applied to a child
maltreatment report that does not allegenew text begin sexual abuse ornew text end substantial child endangerment.
Family assessment does not include a determination as to whether child maltreatment
occurred but does determine the need for services to address the safety of family members
and the risk of subsequent maltreatment.
(b) "Investigation" means fact gathering related to the current safety of a child
and the risk of subsequent maltreatment that determines whether child maltreatment
occurred and whether child protective services are needed. An investigation must be used
when reports involvenew text begin sexual abuse ornew text end substantial child endangerment, and for reports of
maltreatment in facilities required to be licensed under chapter 245A or 245D; under
sections 144.50 to 144.58 and 241.021; in a school as defined in sections 120A.05,
subdivisions 9, 11, and 13, and 124D.10; or in a nonlicensed personal care provider
association as defined in section 256B.0625, subdivision 19a.
(c) "Substantial child endangerment" means a person responsible for a child's care,
deleted text begin and in the case of sexual abuse includes a person who has a significant relationship to the
child as defined in section 609.341, or a person in a position of authority as defined in
section 609.341, whodeleted text end by act or omissionnew text begin ,new text end commits or attempts to commit an act against a
child under their care that constitutes any of the following:
(1) egregious harm as defined in section 260C.007, subdivision 14;
(2) deleted text begin sexual abuse as defined in paragraph (d);
deleted text end
deleted text begin (3)deleted text end abandonment under section 260C.301, subdivision 2;
deleted text begin (4)deleted text end new text begin (3)new text end neglect as defined in paragraph (f), clause (2), that substantially endangers
the child's physical or mental health, including a growth delay, which may be referred to
as failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
deleted text begin (5)deleted text end new text begin (4)new text end murder in the first, second, or third degree under section 609.185, 609.19, or
609.195;
deleted text begin (6)deleted text end new text begin (5)new text end manslaughter in the first or second degree under section 609.20 or 609.205;
deleted text begin (7)deleted text end new text begin (6)new text end assault in the first, second, or third degree under section 609.221, 609.222, or
609.223;
deleted text begin (8)deleted text end new text begin (7)new text end solicitation, inducement, and promotion of prostitution under section 609.322;
deleted text begin (9)deleted text end new text begin (8)new text end criminal sexual conduct under sections 609.342 to 609.3451;
deleted text begin (10)deleted text end new text begin (9)new text end solicitation of children to engage in sexual conduct under section 609.352;
deleted text begin (11)deleted text end new text begin (10)new text end malicious punishment or neglect or endangerment of a child under section
609.377 or 609.378;
deleted text begin (12)deleted text end new text begin (11)new text end use of a minor in sexual performance under section 617.246; or
deleted text begin (13)deleted text end new text begin (12)new text end parental behavior, status, or condition which mandates that the county
attorney file a termination of parental rights petition under section 260C.503, subdivision 2.
(d) "Sexual abuse" means the subjection of a child by a person responsible for the
child's care, by a person who has a significant relationship to the child, as defined in
section 609.341, or by a person in a position of authority, as defined in section 609.341,
subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
abuse also includes any act which involves a minor which constitutes a violation of
prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
threatened sexual abuse which includes the status of a parent or household member
who has committed a violation which requires registration as an offender under section
243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
243.166, subdivision 1b, paragraph (a) or (b).
(e) "Person responsible for the child's care" means (1) an individual functioning
within the family unit and having responsibilities for the care of the child such as a
parent, guardian, or other person having similar care responsibilities, or (2) an individual
functioning outside the family unit and having responsibilities for the care of the child
such as a teacher, school administrator, other school employees or agents, or other lawful
custodian of a child having either full-time or short-term care responsibilities including,
but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
and coaching.
(f) "Neglect" means the commission or omission of any of the acts specified under
clauses (1) to (9), other than by accidental means:
(1) failure by a person responsible for a child's care to supply a child with necessary
food, clothing, shelter, health, medical, or other care required for the child's physical or
mental health when reasonably able to do so;
(2) failure to protect a child from conditions or actions that seriously endanger the
child's physical or mental health when reasonably able to do so, including a growth delay,
which may be referred to as a failure to thrive, that has been diagnosed by a physician and
is due to parental neglect;
(3) failure to provide for necessary supervision or child care arrangements
appropriate for a child after considering factors as the child's age, mental ability, physical
condition, length of absence, or environment, when the child is unable to care for the
child's own basic needs or safety, or the basic needs or safety of another child in their care;
(4) failure to ensure that the child is educated as defined in sections 120A.22 and
260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
(5) nothing in this section shall be construed to mean that a child is neglected solely
because the child's parent, guardian, or other person responsible for the child's care in
good faith selects and depends upon spiritual means or prayer for treatment or care of
disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
if a lack of medical care may cause serious danger to the child's health. This section does
not impose upon persons, not otherwise legally responsible for providing a child with
necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
(6) prenatal exposure to a controlled substance, as defined in section 253B.02,
subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
symptoms in the child at birth, results of a toxicology test performed on the mother at
delivery or the child at birth, medical effects or developmental delays during the child's
first year of life that medically indicate prenatal exposure to a controlled substance, or the
presence of a fetal alcohol spectrum disorder;
(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
(8) chronic and severe use of alcohol or a controlled substance by a parent or
person responsible for the care of the child that adversely affects the child's basic needs
and safety; or
(9) emotional harm from a pattern of behavior which contributes to impaired
emotional functioning of the child which may be demonstrated by a substantial and
observable effect in the child's behavior, emotional response, or cognition that is not
within the normal range for the child's age and stage of development, with due regard to
the child's culture.
(g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
inflicted by a person responsible for the child's care on a child other than by accidental
means, or any physical or mental injury that cannot reasonably be explained by the child's
history of injuries, or any aversive or deprivation procedures, or regulated interventions,
that have not been authorized under section 125A.0942 or 245.825.
Abuse does not include reasonable and moderate physical discipline of a child
administered by a parent or legal guardian which does not result in an injury. Abuse does
not include the use of reasonable force by a teacher, principal, or school employee as
allowed by section 121A.582. Actions which are not reasonable and moderate include,
but are not limited to, any of the following deleted text begin that are done in anger or without regard to the
safety of the childdeleted text end :
(1) throwing, kicking, burning, biting, or cutting a child;
(2) striking a child with a closed fist;
(3) shaking a child under age three;
(4) striking or other actions which result in any nonaccidental injury to a child
under 18 months of age;
(5) unreasonable interference with a child's breathing;
(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
(7) striking a child under age one on the face or head;
new text begin
(8) striking a child who is at least age one but under age four on the face or head,
which results in an injury;
new text end
deleted text begin (8)deleted text end new text begin (9)new text end purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
substances which were not prescribed for the child by a practitioner, in order to control or
punish the child; or other substances that substantially affect the child's behavior, motor
coordination, or judgment or that results in sickness or internal injury, or subjects the
child to medical procedures that would be unnecessary if the child were not exposed
to the substances;
deleted text begin (9)deleted text end new text begin (10)new text end unreasonable physical confinement or restraint not permitted under section
609.379, including but not limited to tying, caging, or chaining; or
deleted text begin (10)deleted text end new text begin (11)new text end in a school facility or school zone, an act by a person responsible for the
child's care that is a violation under section 121A.58.
(h) "Report" means any deleted text begin reportdeleted text end new text begin communicationnew text end received by the local welfare agency,
police department, county sheriff, or agency responsible for deleted text begin assessing or investigating
maltreatmentdeleted text end new text begin child protectionnew text end pursuant to this sectionnew text begin that describes neglect or physical or
sexual abuse of a child and contains sufficient content to identify the child and any person
believed to be responsible for the neglect or abuse, if knownnew text end .
(i) "Facility" means:
(1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed under sections 144.50 to
144.58, 241.021, or 245A.01 to 245A.16, or chapter 245D;
(2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
124D.10; or
(3) a nonlicensed personal care provider organization as defined in section
256B.0625, subdivision 19a.
(j) "Operator" means an operator or agency as defined in section 245A.02.
(k) "Commissioner" means the commissioner of human services.
(l) "Practice of social services," for the purposes of subdivision 3, includes but is
not limited to employee assistance counseling and the provision of guardian ad litem and
parenting time expeditor services.
(m) "Mental injury" means an injury to the psychological capacity or emotional
stability of a child as evidenced by an observable or substantial impairment in the child's
ability to function within a normal range of performance and behavior with due regard to
the child's culture.
(n) "Threatened injury" means a statement, overt act, condition, or status that
represents a substantial risk of physical or sexual abuse or mental injury. Threatened
injury includes, but is not limited to, exposing a child to a person responsible for the
child's care, as defined in paragraph (e), clause (1), who has:
(1) subjected a child to, or failed to protect a child from, an overt act or condition
that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
similar law of another jurisdiction;
(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph
(b), clause (4), or a similar law of another jurisdiction;
(3) committed an act that has resulted in an involuntary termination of parental rights
under section 260C.301, or a similar law of another jurisdiction; or
(4) committed an act that has resulted in the involuntary transfer of permanent
legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
260C.201, subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a
similar law of another jurisdiction.
A child is the subject of a report of threatened injury when the responsible social
services agency receives birth match data under paragraph (o) from the Department of
Human Services.
(o) Upon receiving data under section 144.225, subdivision 2b, contained in a
birth record or recognition of parentage identifying a child who is subject to threatened
injury under paragraph (n), the Department of Human Services shall send the data to the
responsible social services agency. The data is known as "birth match" data. Unless the
responsible social services agency has already begun an investigation or assessment of the
report due to the birth of the child or execution of the recognition of parentage and the
parent's previous history with child protection, the agency shall accept the birth match
data as a report under this section. The agency may use either a family assessment or
investigation to determine whether the child is safe. All of the provisions of this section
apply. If the child is determined to be safe, the agency shall consult with the county
attorney to determine the appropriateness of filing a petition alleging the child is in need
of protection or services under section 260C.007, subdivision 6, clause (16), in order to
deliver needed services. If the child is determined not to be safe, the agency and the county
attorney shall take appropriate action as required under section 260C.503, subdivision 2.
(p) Persons who conduct assessments or investigations under this section shall take
into account accepted child-rearing practices of the culture in which a child participates
and accepted teacher discipline practices, which are not injurious to the child's health,
welfare, and safety.
(q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
occurrence or event which:
(1) is not likely to occur and could not have been prevented by exercise of due
care; and
(2) if occurring while a child is receiving services from a facility, happens when the
facility and the employee or person providing services in the facility are in compliance
with the laws and rules relevant to the occurrence or event.
(r) "Nonmaltreatment mistake" means:
(1) at the time of the incident, the individual was performing duties identified in the
center's child care program plan required under Minnesota Rules, part 9503.0045;
(2) the individual has not been determined responsible for a similar incident that
resulted in a finding of maltreatment for at least seven years;
(3) the individual has not been determined to have committed a similar
nonmaltreatment mistake under this paragraph for at least four years;
(4) any injury to a child resulting from the incident, if treated, is treated only with
remedies that are available over the counter, whether ordered by a medical professional or
not; and
(5) except for the period when the incident occurred, the facility and the individual
providing services were both in compliance with all licensing requirements relevant to the
incident.
This definition only applies to child care centers licensed under Minnesota
Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
substantiated maltreatment by the individual, the commissioner of human services shall
determine that a nonmaltreatment mistake was made by the individual.
Sec. 90.
Minnesota Statutes 2014, section 626.556, subdivision 3, is amended to read:
Subd. 3.
Persons mandated to reportnew text begin ; persons voluntarily reportingnew text end .
(a) A
person who knows or has reason to believe a child is being neglected or physically or
sexually abused, as defined in subdivision 2, or has been neglected or physically or
sexually abused within the preceding three years, shall immediately report the information
to the local welfare agency, agency responsible for assessing or investigating the report,
police department, deleted text begin or thedeleted text end county sheriffnew text begin , tribal social services agency, or tribal police
departmentnew text end if the person is:
(1) a professional or professional's delegate who is engaged in the practice of
the healing arts, social services, hospital administration, psychological or psychiatric
treatment, child care, education, correctional supervision, probation and correctional
services, or law enforcement; or
(2) employed as a member of the clergy and received the information while
engaged in ministerial duties, provided that a member of the clergy is not required by
this subdivision to report information that is otherwise privileged under section 595.02,
subdivision 1, paragraph (c).
deleted text begin
The police department or the county sheriff, upon receiving a report, shall
immediately notify the local welfare agency or agency responsible for assessing or
investigating the report, orally and in writing. The local welfare agency, or agency
responsible for assessing or investigating the report, upon receiving a report, shall
immediately notify the local police department or the county sheriff orally and in writing.
The county sheriff and the head of every local welfare agency, agency responsible
for assessing or investigating reports, and police department shall each designate a
person within their agency, department, or office who is responsible for ensuring that
the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
this subdivision shall be construed to require more than one report from any institution,
facility, school, or agency.
deleted text end
(b) Any person may voluntarily report to the local welfare agency, agency
responsible for assessing or investigating the report, police department, deleted text begin or thedeleted text end county
sheriffnew text begin , tribal social services agency, or tribal police departmentnew text end if the person knows,
has reason to believe, or suspects a child is being or has been neglected or subjected to
physical or sexual abuse. deleted text begin The police department or the county sheriff, upon receiving
a report, shall immediately notify the local welfare agency or agency responsible for
assessing or investigating the report, orally and in writing. The local welfare agency or
agency responsible for assessing or investigating the report, upon receiving a report, shall
immediately notify the local police department or the county sheriff orally and in writing.
deleted text end
(c) A person mandated to report physical or sexual child abuse or neglect occurring
within a licensed facility shall report the information to the agency responsible for
licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
chapter 245D; or a nonlicensed personal care provider organization as defined in section
256B.0625, subdivision 19. A health or corrections agency receiving a report may request
the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 10b. A
board or other entity whose licensees perform work within a school facility, upon receiving
a complaint of alleged maltreatment, shall provide information about the circumstances of
the alleged maltreatment to the commissioner of education. Section 13.03, subdivision 4,
applies to data received by the commissioner of education from a licensing entity.
(d) deleted text begin Any person mandated to report shall receive a summary of the disposition of
any report made by that reporter, including whether the case has been opened for child
protection or other services, or if a referral has been made to a community organization,
unless release would be detrimental to the best interests of the child. Any person who is
not mandated to report shall, upon request to the local welfare agency, receive a concise
summary of the disposition of any report made by that reporter, unless release would be
detrimental to the best interests of the child.deleted text end new text begin Notification requirements under subdivision
10 apply to all reports received under this section.
new text end
(e) For purposes of this section, "immediately" means as soon as possible but in
no event longer than 24 hours.
Sec. 91.
Minnesota Statutes 2014, section 626.556, subdivision 6a, is amended to read:
Subd. 6a.
Failure to notify.
If a local welfare agency receives a report under
subdivision 3, paragraph (a) or (b), and fails to notify the local police department or county
sheriff as required by subdivision deleted text begin 3, paragraph (a) or (b)deleted text end new text begin 10new text end , the person within the agency
who is responsible for ensuring that notification is made shall be subject to disciplinary
action in keeping with the agency's existing policy or collective bargaining agreement on
discipline of employees. If a local police department or a county sheriff receives a report
under subdivision 3, paragraph (a) or (b), and fails to notify the local welfare agency as
required by subdivision deleted text begin 3, paragraph (a) or (b)deleted text end new text begin 10new text end , the person within the police department
or county sheriff's office who is responsible for ensuring that notification is made shall be
subject to disciplinary action in keeping with the agency's existing policy or collective
bargaining agreement on discipline of employees.
Sec. 92.
Minnesota Statutes 2014, section 626.556, subdivision 7, as amended by Laws
2015, chapter 4, section 2, is amended to read:
Subd. 7.
Report; information provided to parentnew text begin ; reporternew text end .
(a) An oral report
shall be made immediately by telephone or otherwise. An oral report made by a person
required under subdivision 3 to report shall be followed within 72 hours, exclusive
of weekends and holidays, by a report in writing to the appropriate police department,
the county sheriff, the agency responsible for assessing or investigating the report, or
the local welfare agency.
new text begin (b) new text end The local welfare agency shall determine if the report is deleted text begin accepted for an
assessment or investigationdeleted text end new text begin to be screened in or outnew text end as soon as possible but in no event
longer than 24 hours after the report is received.new text begin When determining whether a report will
be screened in or out, the agency receiving the report must consider, when relevant, all
previous history, including reports that were screened out. The agency may communicate
with treating professionals and individuals specified under subdivision 10, paragraph
(i), clause (3), item (iii).
new text end
deleted text begin (b)deleted text end new text begin (c)new text end Any report shall be of sufficient content to identify the child, any person
believed to be responsible for the abuse or neglect of the child if the person is known, the
nature and extent of the abuse or neglect and the name and address of the reporter. The
local welfare agency or agency responsible for assessing or investigating the report shall
accept a report made under subdivision 3 notwithstanding refusal by a reporter to provide
the reporter's name or address as long as the report is otherwise sufficient under this
paragraph. Written reports received by a police department or the county sheriff shall be
forwarded immediately to the local welfare agency or the agency responsible for assessing
or investigating the report. The police department or the county sheriff may keep copies of
reports received by them. Copies of written reports received by a local welfare department
or the agency responsible for assessing or investigating the report shall be forwarded
immediately to the local police department or the county sheriff.
deleted text begin (c)deleted text end new text begin (d)new text end When requested, the agency responsible for assessing or investigating a
report shall inform the reporter within ten days after the report was made, either orally or
in writing, whether the report was accepted or not. If the responsible agency determines
the report does not constitute a report under this section, the agency shall advise the
reporter the report was screened out. new text begin Any person mandated to report shall receive a
summary of the disposition of any report made by that reporter, including whether the case
has been opened for child protection or other services, or if a referral has been made to a
community organization, unless release would be detrimental to the best interests of the
child. Any person who is not mandated to report shall, upon request to the local welfare
agency, receive a concise summary of the disposition of any report made by that reporter,
unless release would be detrimental to the best interests of the child.
new text end
new text begin
(e) Reports that are screened out must be maintained in accordance with subdivision
11c, paragraph (a).
new text end
new text begin
(f) A local welfare agency or agency responsible for investigating or assessing a
report may use a screened-out report for making an offer of social services to the subjects
of the screened-out report. A local welfare agency or agency responsible for evaluating a
report alleging maltreatment of a child shall consider prior reports, including screened-out
reports, to determine whether an investigation or family assessment must be conducted.
new text end
deleted text begin (d)deleted text end new text begin (g)new text end Notwithstanding paragraph (a), the commissioner of education must inform
the parent, guardian, or legal custodian of the child who is the subject of a report of
alleged maltreatment in a school facility within ten days of receiving the report, either
orally or in writing, whether the commissioner is assessing or investigating the report
of alleged maltreatment.
deleted text begin (e)deleted text end new text begin (h)new text end Regardless of whether a report is made under this subdivision, as soon as
practicable after a school receives information regarding an incident that may constitute
maltreatment of a child in a school facility, the school shall inform the parent, legal
guardian, or custodian of the child that an incident has occurred that may constitute
maltreatment of the child, when the incident occurred, and the nature of the conduct
that may constitute maltreatment.
deleted text begin (f)deleted text end new text begin (i)new text end A written copy of a report maintained by personnel of agencies, other than
welfare or law enforcement agencies, which are subject to chapter 13 shall be confidential.
An individual subject of the report may obtain access to the original report as provided
by subdivision 11.
Sec. 93.
Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision
to read:
new text begin Subd. 7a. new text end
new text begin Guidance for screening reports. new text end
new text begin
(a) Child protection staff, supervisors,
and others involved in child protection screening shall follow the guidance provided
in the child maltreatment screening guidelines issued by the commissioner of human
services and, when notified by the commissioner, shall immediately implement updated
procedures and protocols.
new text end
new text begin
(b) Any modifications to the screening guidelines must be preapproved by the
commissioner of human services and must not be less protective of children than is
mandated by statute. The county agency must consult with the county attorney before
proposing modifications to the commissioner. The guidelines may provide additional
protections for children but must not limit reports that are screened in or provide
additional limits on consideration of reports that were screened out in making screening
determinations.
new text end
Sec. 94.
Minnesota Statutes 2014, section 626.556, subdivision 10, is amended to read:
Subd. 10.
Duties of local welfare agency and local law enforcement agency upon
receipt of reportnew text begin ; mandatory notification between police or sheriff and agencynew text end .
(a)
new text begin The police department or the county sheriff shall immediately notify the local welfare
agency or agency responsible for child protection reports under this section orally and
in writing when a report is received. The local welfare agency or agency responsible
for child protection reports shall immediately notify the local police department or the
county sheriff orally and in writing when a report is received. The county sheriff and the
head of every local welfare agency, agency responsible for child protection reports, and
police department shall each designate a person within their agency, department, or office
who is responsible for ensuring that the notification duties of this paragraph are carried
out. When the alleged maltreatment occurred on tribal land, the local welfare agency or
agency responsible for child protection reports and the local police department or the
county sheriff shall immediately notify the tribe's social services agency and tribal law
enforcement orally and in writing when a report is received.
new text end
new text begin (b) new text end Upon receipt of a report, the local welfare agency shall determine whether to
conduct a family assessment or an investigation as appropriate to prevent or provide a
remedy for child maltreatment. The local welfare agency:
(1) shall conduct an investigation on reports involving new text begin sexual abuse ornew text end substantial
child endangerment;
(2) shall begin an immediate investigation if, at any time when it is using a family
assessment response, it determines that there is reason to believe that new text begin sexual abuse or
new text end substantial child endangerment or a serious threat to the child's safety exists;
(3) may conduct a family assessment for reports that do not allege new text begin sexual abuse or
new text end substantial child endangerment. In determining that a family assessment is appropriate,
the local welfare agency may consider issues of child safety, parental cooperation, and
the need for an immediate response; and
(4) may conduct a family assessment on a report that was initially screened and
assigned for an investigation. In determining that a complete investigation is not required,
the local welfare agency must document the reason for terminating the investigation and
notify the local law enforcement agency if the local law enforcement agency is conducting
a joint investigation.
If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian,
or individual functioning within the family unit as a person responsible for the child's
care, or sexual abuse by a person with a significant relationship to the child when that
person resides in the child's household or by a sibling, the local welfare agency shall
immediately conduct a family assessment or investigation as identified in clauses (1)
to (4). In conducting a family assessment or investigation, the local welfare agency
shall gather information on the existence of substance abuse and domestic violence and
offer services for purposes of preventing future child maltreatment, safeguarding and
enhancing the welfare of the abused or neglected minor, and supporting and preserving
family life whenever possible. If the report alleges a violation of a criminal statute
involving sexual abuse, physical abuse, or neglect or endangerment, under section
609.378, the local law enforcement agency and local welfare agency shall coordinate the
planning and execution of their respective investigation and assessment efforts to avoid a
duplication of fact-finding efforts and multiple interviews. Each agency shall prepare a
separate report of the results of its investigation new text begin or assessmentnew text end . In cases of alleged child
maltreatment resulting in death, the local agency may rely on the fact-finding efforts of a
law enforcement investigation to make a determination of whether or not maltreatment
occurred. When necessary the local welfare agency shall seek authority to remove the
child from the custody of a parent, guardian, or adult with whom the child is living. In
performing any of these duties, the local welfare agency shall maintain appropriate records.
If the family assessment or investigation indicates there is a potential for abuse of
alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota
Rules, part 9530.6615.
deleted text begin (b)deleted text end new text begin (c) new text end When a local agency receives a report or otherwise has information indicating
that a child who is a client, as defined in section 245.91, has been the subject of physical
abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section
245.91, it shall, in addition to its other duties under this section, immediately inform the
ombudsman established under sections 245.91 to 245.97. The commissioner of education
shall inform the ombudsman established under sections 245.91 to 245.97 of reports
regarding a child defined as a client in section 245.91 that maltreatment occurred at a
school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.
deleted text begin (c)deleted text end new text begin (d) new text end Authority of the local welfare agency responsible for assessing or
investigating the child abuse or neglect report, the agency responsible for assessing or
investigating the report, and of the local law enforcement agency for investigating the
alleged abuse or neglect includes, but is not limited to, authority to interview, without
parental consent, the alleged victim and any other minors who currently reside with or
who have resided with the alleged offender. The interview may take place at school or at
any facility or other place where the alleged victim or other minors might be found or the
child may be transported to, and the interview conducted at, a place appropriate for the
interview of a child designated by the local welfare agency or law enforcement agency.
The interview may take place outside the presence of the alleged offender or parent, legal
custodian, guardian, or school official. For family assessments, it is the preferred practice
to request a parent or guardian's permission to interview the child prior to conducting the
child interview, unless doing so would compromise the safety assessment. Except as
provided in this paragraph, the parent, legal custodian, or guardian shall be notified by
the responsible local welfare or law enforcement agency no later than the conclusion of
the investigation or assessment that this interview has occurred. Notwithstanding rule 32
of the Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after
hearing on an ex parte motion by the local welfare agency, order that, where reasonable
cause exists, the agency withhold notification of this interview from the parent, legal
custodian, or guardian. If the interview took place or is to take place on school property,
the order shall specify that school officials may not disclose to the parent, legal custodian,
or guardian the contents of the notification of intent to interview the child on school
property, as provided under this paragraph, and any other related information regarding
the interview that may be a part of the child's school record. A copy of the order shall be
sent by the local welfare or law enforcement agency to the appropriate school official.
deleted text begin (d)deleted text end new text begin (e)new text end When the local welfare, local law enforcement agency, or the agency
responsible for assessing or investigating a report of maltreatment determines that an
interview should take place on school property, written notification of intent to interview
the child on school property must be received by school officials prior to the interview.
The notification shall include the name of the child to be interviewed, the purpose of the
interview, and a reference to the statutory authority to conduct an interview on school
property. For interviews conducted by the local welfare agency, the notification shall
be signed by the chair of the local social services agency or the chair's designee. The
notification shall be private data on individuals subject to the provisions of this paragraph.
School officials may not disclose to the parent, legal custodian, or guardian the contents
of the notification or any other related information regarding the interview until notified
in writing by the local welfare or law enforcement agency that the investigation or
assessment has been concluded, unless a school employee or agent is alleged to have
maltreated the child. Until that time, the local welfare or law enforcement agency or the
agency responsible for assessing or investigating a report of maltreatment shall be solely
responsible for any disclosures regarding the nature of the assessment or investigation.
Except where the alleged offender is believed to be a school official or employee,
the time and place, and manner of the interview on school premises shall be within the
discretion of school officials, but the local welfare or law enforcement agency shall have
the exclusive authority to determine who may attend the interview. The conditions as to
time, place, and manner of the interview set by the school officials shall be reasonable and
the interview shall be conducted not more than 24 hours after the receipt of the notification
unless another time is considered necessary by agreement between the school officials and
the local welfare or law enforcement agency. Where the school fails to comply with the
provisions of this paragraph, the juvenile court may order the school to comply. Every
effort must be made to reduce the disruption of the educational program of the child, other
students, or school staff when an interview is conducted on school premises.
deleted text begin (e)deleted text end new text begin (f)new text end Where the alleged offender or a person responsible for the care of the alleged
victim or other minor prevents access to the victim or other minor by the local welfare
agency, the juvenile court may order the parents, legal custodian, or guardian to produce
the alleged victim or other minor for questioning by the local welfare agency or the local
law enforcement agency outside the presence of the alleged offender or any person
responsible for the child's care at reasonable places and times as specified by court order.
deleted text begin (f)deleted text end new text begin (g)new text end Before making an order under paragraph deleted text begin (e)deleted text end new text begin (f)new text end , the court shall issue an order
to show cause, either upon its own motion or upon a verified petition, specifying the basis
for the requested interviews and fixing the time and place of the hearing. The order to
show cause shall be served personally and shall be heard in the same manner as provided
in other cases in the juvenile court. The court shall consider the need for appointment of a
guardian ad litem to protect the best interests of the child. If appointed, the guardian ad
litem shall be present at the hearing on the order to show cause.
deleted text begin (g)deleted text end new text begin (h)new text end The commissioner of human services, the ombudsman for mental health and
developmental disabilities, the local welfare agencies responsible for investigating reports,
the commissioner of education, and the local law enforcement agencies have the right to
enter facilities as defined in subdivision 2 and to inspect and copy the facility's records,
including medical records, as part of the investigation. Notwithstanding the provisions of
chapter 13, they also have the right to inform the facility under investigation that they are
conducting an investigation, to disclose to the facility the names of the individuals under
investigation for abusing or neglecting a child, and to provide the facility with a copy of
the report and the investigative findings.
deleted text begin (h)deleted text end new text begin (i)new text end The local welfare agency responsible for conducting a family assessment or
investigation shall collect available and relevant information to determine child safety,
risk of subsequent child maltreatment, and family strengths and needs and share not public
information with an Indian's tribal social services agency without violating any law of the
state that may otherwise impose duties of confidentiality on the local welfare agency in
order to implement the tribal state agreement. The local welfare agency or the agency
responsible for investigating the report shall collect available and relevant information
to ascertain whether maltreatment occurred and whether protective services are needed.
Information collected includes, when relevant, information with regard to the person
reporting the alleged maltreatment, including the nature of the reporter's relationship to the
child and to the alleged offender, and the basis of the reporter's knowledge for the report;
the child allegedly being maltreated; the alleged offender; the child's caretaker; and other
collateral sources having relevant information related to the alleged maltreatment. The
local welfare agency or the agency responsible for investigating the report may make a
determination of no maltreatment early in an investigation, and close the case and retain
immunity, if the collected information shows no basis for a full investigation.
Information relevant to the assessment or investigation must be asked for, and
may include:
(1) the child's sex and agedeleted text begin ,deleted text end new text begin ;new text end prior reports of maltreatment, new text begin including any
maltreatment reports that were screened out and not accepted for assessment or
investigation; new text end information relating to developmental functioningdeleted text begin ,deleted text end new text begin ;new text end credibility of the child's
statementdeleted text begin ,deleted text end new text begin ;new text end and whether the information provided under this clause is consistent with other
information collected during the course of the assessment or investigation;
(2) the alleged offender's age, a record check for prior reports of maltreatment, and
criminal charges and convictions. The local welfare agency or the agency responsible for
assessing or investigating the report must provide the alleged offender with an opportunity
to make a statement. The alleged offender may submit supporting documentation relevant
to the assessment or investigation;
(3) collateral source information regarding the alleged maltreatment and care of the
child. Collateral information includes, when relevant: (i) a medical examination of the
child; (ii) prior medical records relating to the alleged maltreatment or the care of the
child maintained by any facility, clinic, or health care professional and an interview with
the treating professionals; and (iii) interviews with the child's caretakers, including the
child's parent, guardian, foster parent, child care provider, teachers, counselors, family
members, relatives, and other persons who may have knowledge regarding the alleged
maltreatment and the care of the child; and
(4) information on the existence of domestic abuse and violence in the home of
the child, and substance abuse.
Nothing in this paragraph precludes the local welfare agency, the local law
enforcement agency, or the agency responsible for assessing or investigating the report
from collecting other relevant information necessary to conduct the assessment or
investigation. Notwithstanding sections 13.384 or 144.291 to 144.298, the local welfare
agency has access to medical data and records for purposes of clause (3). Notwithstanding
the data's classification in the possession of any other agency, data acquired by the
local welfare agency or the agency responsible for assessing or investigating the report
during the course of the assessment or investigation are private data on individuals and
must be maintained in accordance with subdivision 11. Data of the commissioner of
education collected or maintained during and for the purpose of an investigation of
alleged maltreatment in a school are governed by this section, notwithstanding the data's
classification as educational, licensing, or personnel data under chapter 13.
In conducting an assessment or investigation involving a school facility as defined
in subdivision 2, paragraph (i), the commissioner of education shall collect investigative
reports and data that are relevant to a report of maltreatment and are from local law
enforcement and the school facility.
deleted text begin (i)deleted text end new text begin (j)new text end Upon receipt of a report, the local welfare agency shall conduct a face-to-face
contact with the child reported to be maltreated and with the child's primary caregiver
sufficient to complete a safety assessment and ensure the immediate safety of the child.
The face-to-face contact with the child and primary caregiver shall occur immediately
if new text begin sexual abuse ornew text end substantial child endangerment is alleged and within five calendar
days for all other reports. If the alleged offender was not already interviewed as the
primary caregiver, the local welfare agency shall also conduct a face-to-face interview
with the alleged offender in the early stages of the assessment or investigation. At the
initial contact, the local child welfare agency or the agency responsible for assessing or
investigating the report must inform the alleged offender of the complaints or allegations
made against the individual in a manner consistent with laws protecting the rights of the
person who made the report. The interview with the alleged offender may be postponed if
it would jeopardize an active law enforcement investigation.
deleted text begin (j)deleted text end new text begin (k)new text end When conducting an investigation, the local welfare agency shall use a
question and answer interviewing format with questioning as nondirective as possible to
elicit spontaneous responses. For investigations only, the following interviewing methods
and procedures must be used whenever possible when collecting information:
(1) audio recordings of all interviews with witnesses and collateral sources; and
(2) in cases of alleged sexual abuse, audio-video recordings of each interview with
the alleged victim and child witnesses.
deleted text begin (k)deleted text end new text begin (l)new text end In conducting an assessment or investigation involving a school facility
as defined in subdivision 2, paragraph (i), the commissioner of education shall collect
available and relevant information and use the procedures in paragraphs deleted text begin (i),deleted text end new text begin (j) andnew text end (k),
and subdivision 3d, except that the requirement for face-to-face observation of the child
and face-to-face interview of the alleged offender is to occur in the initial stages of the
assessment or investigation provided that the commissioner may also base the assessment
or investigation on investigative reports and data received from the school facility and
local law enforcement, to the extent those investigations satisfy the requirements of
paragraphs deleted text begin (i) anddeleted text end new text begin (j) andnew text end (k), and subdivision 3d.
Sec. 95.
Minnesota Statutes 2014, section 626.556, subdivision 10e, is amended to read:
Subd. 10e.
Determinations.
(a) The local welfare agency shall conclude the family
assessment or the investigation within 45 days of the receipt of a report. The conclusion of
the assessment or investigation may be extended to permit the completion of a criminal
investigation or the receipt of expert information requested within 45 days of the receipt
of the report.
(b) After conducting a family assessment, the local welfare agency shall determine
whether services are needed to address the safety of the child and other family members
and the risk of subsequent maltreatment.
(c) After conducting an investigation, the local welfare agency shall make two
determinations: first, whether maltreatment has occurred; and second, whether child
protective services are needed. No determination of maltreatment shall be made when the
alleged perpetrator is a child under the age of ten.
(d) If the commissioner of education conducts an assessment or investigation,
the commissioner shall determine whether maltreatment occurred and what corrective
or protective action was taken by the school facility. If a determination is made that
maltreatment has occurred, the commissioner shall report to the employer, the school
board, and any appropriate licensing entity the determination that maltreatment occurred
and what corrective or protective action was taken by the school facility. In all other cases,
the commissioner shall inform the school board or employer that a report was received,
the subject of the report, the date of the initial report, the category of maltreatment alleged
as defined in paragraph (f), the fact that maltreatment was not determined, and a summary
of the specific reasons for the determination.
(e) When maltreatment is determined in an investigation involving a facility,
the investigating agency shall also determine whether the facility or individual was
responsible, or whether both the facility and the individual were responsible for the
maltreatment using the mitigating factors in paragraph (i). Determinations under this
subdivision must be made based on a preponderance of the evidence and are private data
on individuals or nonpublic data as maintained by the commissioner of education.
(f) For the purposes of this subdivision, "maltreatment" means any of the following
acts or omissions:
(1) physical abuse as defined in subdivision 2, paragraph (g);
(2) neglect as defined in subdivision 2, paragraph (f);
(3) sexual abuse as defined in subdivision 2, paragraph (d);
(4) mental injury as defined in subdivision 2, paragraph (m); or
(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (i).
(g) For the purposes of this subdivision, a determination that child protective
services are needed means that the local welfare agency has documented conditions
during the assessment or investigation sufficient to cause a child protection worker, as
defined in section 626.559, subdivision 1, to conclude that a child is at significant risk of
maltreatment if protective intervention is not provided and that the individuals responsible
for the child's care have not taken or are not likely to take actions to protect the child
from maltreatment or risk of maltreatment.
(h) This subdivision does not mean that maltreatment has occurred solely because
the child's parent, guardian, or other person responsible for the child's care in good faith
selects and depends upon spiritual means or prayer for treatment or care of disease
or remedial care of the child, in lieu of medical care. However, if lack of medical care
may result in serious danger to the child's health, the local welfare agency may ensure
that necessary medical services are provided to the child.
(i) When determining whether the facility or individual is the responsible party, or
whether both the facility and the individual are responsible for determined maltreatment in
a facility, the investigating agency shall consider at least the following mitigating factors:
(1) whether the actions of the facility or the individual caregivers were according to,
and followed the terms of, an erroneous physician order, prescription, individual care plan,
or directive; however, this is not a mitigating factor when the facility or caregiver was
responsible for the issuance of the erroneous order, prescription, individual care plan, or
directive or knew or should have known of the errors and took no reasonable measures to
correct the defect before administering care;
(2) comparative responsibility between the facility, other caregivers, and
requirements placed upon an employee, including the facility's compliance with related
regulatory standards and the adequacy of facility policies and procedures, facility training,
an individual's participation in the training, the caregiver's supervision, and facility staffing
levels and the scope of the individual employee's authority and discretion; and
(3) whether the facility or individual followed professional standards in exercising
professional judgment.
The evaluation of the facility's responsibility under clause (2) must not be based on the
completeness of the risk assessment or risk reduction plan required under section 245A.66,
but must be based on the facility's compliance with the regulatory standards for policies and
procedures, training, and supervision as cited in Minnesota Statutes and Minnesota Rules.
(j) Notwithstanding paragraph (i), when maltreatment is determined to have been
committed by an individual who is also the facility license holder, both the individual and
the facility must be determined responsible for the maltreatment, and both the background
study disqualification standards under section 245C.15, subdivision 4, and the licensing
actions under sections 245A.06 or 245A.07 apply.
deleted text begin
(k) Individual counties may implement more detailed definitions or criteria that
indicate which allegations to investigate, as long as a county's policies are consistent
with the definitions in the statutes and rules and are approved by the county board. Each
local welfare agency shall periodically inform mandated reporters under subdivision 3
who work in the county of the definitions of maltreatment in the statutes and rules and any
additional definitions or criteria that have been approved by the county board.
deleted text end
Sec. 96.
Minnesota Statutes 2014, section 626.556, subdivision 10j, is amended to read:
Subd. 10j.
Release of data to mandated reporters.
new text begin (a)new text end A local social services or
child protection agency, or the agency responsible for assessing or investigating the report
of maltreatment, deleted text begin maydeleted text end new text begin shall new text end provide relevant private data on individuals obtained under
this section to new text begin a new text end mandated deleted text begin reportersdeleted text end new text begin reporter who made the report and new text end who deleted text begin havedeleted text end new text begin has new text end an
ongoing responsibility for the health, education, or welfare of a child affected by the data,
new text begin unless the agency determines that providing the data would not be new text end in the best interests
of the child. new text begin The agency may provide the data to other mandated reporters with ongoing
responsibility for the health, education, or welfare of the child. new text end Mandated reporters with
ongoing responsibility for the health, education, or welfare of a child affected by the data
include the child's teachers or other appropriate school personnel, foster parents, health
care providers, respite care workers, therapists, social workers, child care providers,
residential care staff, crisis nursery staff, probation officers, and court services personnel.
Under this section, a mandated reporter need not have made the report to be considered a
person with ongoing responsibility for the health, education, or welfare of a child affected
by the data. Data provided under this section must be limited to data pertinent to the
individual's responsibility for caring for the child.
new text begin
(b) A reporter who receives private data on individuals under this subdivision must
treat the data according to that classification, regardless of whether the reporter is an
employee of a government entity. The remedies and penalties under sections 13.08 and
13.09 apply if a reporter releases data in violation of this section or other law.
new text end
Sec. 97.
Minnesota Statutes 2014, section 626.556, subdivision 10m, is amended to
read:
Subd. 10m.
Provision of child protective servicesnew text begin ; consultation with county
attorneynew text end .
new text begin (a) new text end The local welfare agency shall create a written plan, in collaboration with
the family whenever possible, within 30 days of the determination that child protective
services are needed or upon joint agreement of the local welfare agency and the family
that family support and preservation services are needed. Child protective services for a
family are voluntary unless ordered by the court.
new text begin
(b) The local welfare agency shall consult with the county attorney to determine the
appropriateness of filing a petition alleging the child is in need of protection or services
under section 260C.007, subdivision 6, if:
new text end
new text begin
(1) the family does not accept or comply with a plan for child protective services;
new text end
new text begin
(2) voluntary child protective services may not provide sufficient protection for the
child; or
new text end
new text begin
(3) the family is not cooperating with an investigation or assessment.
new text end
Sec. 98.
Minnesota Statutes 2014, section 626.556, subdivision 11c, is amended to read:
Subd. 11c.
Welfare, court services agency, and school records maintained.
Notwithstanding sections 138.163 and 138.17, records maintained or records derived
from reports of abuse by local welfare agencies, agencies responsible for assessing or
investigating the report, court services agencies, or schools under this section shall be
destroyed as provided in paragraphs (a) to (d) by the responsible authority.
(a) For new text begin reports alleging child maltreatment that were not accepted for assessment
or investigation, new text end family assessment casesnew text begin ,new text end and cases where an investigation results in no
determination of maltreatment or the need for child protective services, the deleted text begin assessment or
investigationdeleted text end records must be maintained for a period of deleted text begin fourdeleted text end new text begin fivenew text end years after the datenew text begin the
report was not accepted for assessment or investigation ornew text end of the final entry in the case
record. new text begin Records of reports that were not accepted must contain sufficient information to
identify the subjects of the report, the nature of the alleged maltreatment, and the reasons
as to why the report was not accepted. new text end Records under this paragraph may not be used for
employment, background checks, or purposes other than to assist in future new text begin screening
decisions and new text end risk and safety assessments.
(b) All records relating to reports which, upon investigation, indicate either
maltreatment or a need for child protective services shall be maintained for ten years after
the date of the final entry in the case record.
(c) All records regarding a report of maltreatment, including any notification of intent
to interview which was received by a school under subdivision 10, paragraph (d), shall be
destroyed by the school when ordered to do so by the agency conducting the assessment or
investigation. The agency shall order the destruction of the notification when other records
relating to the report under investigation or assessment are destroyed under this subdivision.
(d) Private or confidential data released to a court services agency under subdivision
10h must be destroyed by the court services agency when ordered to do so by the local
welfare agency that released the data. The local welfare agency or agency responsible for
assessing or investigating the report shall order destruction of the data when other records
relating to the assessment or investigation are destroyed under this subdivision.
deleted text begin
(e) For reports alleging child maltreatment that were not accepted for assessment
or investigation, counties shall maintain sufficient information to identify repeat reports
alleging maltreatment of the same child or children for 365 days from the date the report
was screened out. The commissioner of human services shall specify to the counties the
minimum information needed to accomplish this purpose. Counties shall enter this data
into the state social services information system.
deleted text end
Sec. 99.
Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision
to read:
new text begin Subd. 16. new text end
new text begin
Commissioner's duty to provide oversight; quality assurance reviews;
annual summary of reviews.
new text end
new text begin
(a) The commissioner shall develop a plan to perform
quality assurance reviews of local welfare agency screening practices and decisions.
The commissioner shall provide oversight and guidance to counties to ensure consistent
application of screening guidelines, thorough and appropriate screening decisions, and
correct documentation and maintenance of reports. Quality assurance reviews must begin
no later than September 30, 2015.
new text end
new text begin
(b) The commissioner shall produce an annual report of the summary results of the
reviews. The report must only contain aggregate data and may not include any data that
could be used to personally identify any subject whose data is included in the report. The
report is public information and must be provided to the chairs and ranking minority
members of the legislative committees having jurisdiction over child protection issues.
new text end
Sec. 100.
Minnesota Statutes 2014, section 626.559, is amended by adding a
subdivision to read:
new text begin Subd. 1b. new text end
new text begin Background studies. new text end
new text begin
(a) County employees hired on or after July 1,
2015, who have responsibility for child protection duties or current county employees who
are assigned new child protection duties on or after July 1, 2015, are required to undergo a
background study. A county may complete these background studies by either:
new text end
new text begin
(1) use of the Department of Human Services NetStudy 2.0 system according to
sections 245C.03 and 245C.10; or
new text end
new text begin
(2) an alternative process defined by the county.
new text end
new text begin
(b) County social services agencies and local welfare agencies must initiate
background studies before an individual begins a position allowing direct contact with
persons served by the agency.
new text end
Sec. 101.
Laws 2014, chapter 189, section 5, is amended to read:
Sec. 5.
Minnesota Statutes 2012, section 518C.201, is amended to read:
518C.201 BASES FOR JURISDICTION OVER NONRESIDENT.
(a) In a proceeding to establishdeleted text begin ,deleted text end new text begin ornew text end enforcedeleted text begin , or modifydeleted text end a support order or to determine
parentage of a child, a tribunal of this state may exercise personal jurisdiction over a
nonresident individual or the individual's guardian or conservator if:
(1) the individual is personally served with a summons or comparable document
within this state;
(2) the individual submits to the jurisdiction of this state by consent, by entering a
general appearance, or by filing a responsive document having the effect of waiving any
contest to personal jurisdiction;
(3) the individual resided with the child in this state;
(4) the individual resided in this state and provided prenatal expenses or support
for the child;
(5) the child resides in this state as a result of the acts or directives of the individual;
(6) the individual engaged in sexual intercourse in this state and the child may have
been conceived by that act of intercourse;
(7) the individual asserted parentage of a child under sections 257.51 to 257.75; or
(8) there is any other basis consistent with the constitutions of this state and the
United States for the exercise of personal jurisdiction.
(b) The bases of personal jurisdiction in paragraph (a) or in any other law of this state
may not be used to acquire personal jurisdiction for a tribunal of this state to modify a child
support order of another state unless the requirements of section 518C.611 are met, or, in
the case of a foreign support order, unless the requirements of section 518C.615 are met.
Sec. 102.
Laws 2014, chapter 189, section 9, is amended to read:
Sec. 9.
Minnesota Statutes 2012, section 518C.205, is amended to read:
518C.205 CONTINUING, EXCLUSIVE JURISDICTION TO MODIFY
CHILD SUPPORT ORDER.
(a) A tribunal of this state that has issued a support order consistent with the law
of this state has and shall exercise continuing, exclusive jurisdiction to modify its child
support order if the order is the controlling order and:
(1) at the time of the filing of a request for modification this state is the residence of the
obligor, the individual obligee, or the child for whose benefit the support order is issued; or
(2) even if this state is not the residence of the obligor, the individual obligee, or the
child for whose benefit the support order is issued, the parties consent in a record or in open
court that the tribunal of this state may continue to exercise jurisdiction to modify its order.
(b) A tribunal of this state that has issued a child support order consistent with the
law of this state may not exercise continuing, exclusive jurisdiction to modify the order if:
(1) all of the parties who are individuals file consent in a record with the tribunal of
this state that a tribunal of another state that has jurisdiction over at least one of the parties
who is an individual or that is located in the state of residence of the child may modify
the order and assume continuing, exclusive jurisdiction; or
(2) its order is not the controlling order.
(c) If a tribunal of another state has issued a child support order pursuant to deleted text begin this
chapter or a law substantially similar to this chapterdeleted text end new text begin the Uniform Interstate Family Support
Act new text end which modifies a child support order of a tribunal of this state, tribunals of this state
shall recognize the continuing, exclusive jurisdiction of the tribunal of the other state.
(d) A tribunal of this state that lacks continuing, exclusive jurisdiction to modify a
child support order may serve as an initiating tribunal to request a tribunal of another state
to modify a support order issued in that state.
(e) A temporary support order issued ex parte or pending resolution of a jurisdictional
conflict does not create continuing, exclusive jurisdiction in the issuing tribunal.
Sec. 103.
Laws 2014, chapter 189, section 10, is amended to read:
Sec. 10.
Minnesota Statutes 2012, section 518C.206, is amended to read:
518C.206 deleted text begin ENFORCEMENT AND MODIFICATION OF SUPPORT ORDER
BY TRIBUNAL HAVINGdeleted text end CONTINUING JURISDICTIONnew text begin TO ENFORCE CHILD
SUPPORT ORDERnew text end .
(a) A tribunal of this state that has issued a child support order consistent with the
law of this state may serve as an initiating tribunal to request a tribunal of another state
to enforce:
(1) the order if the order is the controlling order and has not been modified by
a tribunal of another state that assumed jurisdiction pursuant to deleted text begin this chapter or a law
substantially similar to this chapterdeleted text end new text begin the Uniform Interstate Family Support Actnew text end ; or
(2) a money judgment for arrears of support and interest on the order accrued before
a determination that an order of a tribunal of another state is the controlling order.
(b) A tribunal of this state having continuingdeleted text begin , exclusivedeleted text end jurisdiction over a support
order may act as a responding tribunal to enforce the order.
Sec. 104.
Laws 2014, chapter 189, section 11, is amended to read:
Sec. 11.
Minnesota Statutes 2012, section 518C.207, is amended to read:
518C.207 deleted text begin RECOGNITIONdeleted text end new text begin DETERMINATIONnew text end OF CONTROLLING CHILD
SUPPORT ORDER.
(a) If a proceeding is brought under this chapter and only one tribunal has issued a
child support order, the order of that tribunal deleted text begin is controllingdeleted text end new text begin controlsnew text end and must be recognized.
(b) If a proceeding is brought under this chapter, and two or more child support
orders have been issued by tribunals of this state, another state, or a foreign country with
regard to the same obligor and child, a tribunal of this state having personal jurisdiction
over both the obligor and the individual obligee shall apply the following rules and by
order shall determine which order controls and must be recognized:
(1) If only one of the tribunals would have continuing, exclusive jurisdiction under
this chapter, the order of that tribunal deleted text begin is controllingdeleted text end new text begin controlsnew text end .
(2) If more than one of the tribunals would have continuing, exclusive jurisdiction
under this chapter:
(i) an order issued by a tribunal in the current home state of the child controls; or
(ii) if an order has not been issued in the current home state of the child, the order
most recently issued controls.
(3) If none of the tribunals would have continuing, exclusive jurisdiction under this
chapter, the tribunal of this state shall issue a child support order, which controls.
(c) If two or more child support orders have been issued for the same obligor and
child, upon request of a party who is an individual or that is a support enforcement agency,
a tribunal of this state having personal jurisdiction over both the obligor and the obligee
who is an individual shall determine which order controls under paragraph (b). The
request may be filed with a registration for enforcement or registration for modification
pursuant to sections 518C.601 to 518C.616, or may be filed as a separate proceeding.
(d) A request to determine which is the controlling order must be accompanied
by a copy of every child support order in effect and the applicable record of payments.
The requesting party shall give notice of the request to each party whose rights may
be affected by the determination.
(e) The tribunal that issued the controlling order under paragraph (a), (b), or (c) has
continuing jurisdiction to the extent provided in section 518C.205, or 518C.206.
(f) A tribunal of this state which determines by order which is the controlling order
under paragraph (b), clause (1) or (2), or paragraph (c), or which issues a new controlling
child support order under paragraph (b), clause (3), shall state in that order:
(1) the basis upon which the tribunal made its determination;
(2) the amount of prospective support, if any; and
(3) the total amount of consolidated arrears and accrued interest, if any, under all of
the orders after all payments made are credited as provided by section 518C.209.
(g) Within 30 days after issuance of the order determining which is the controlling
order, the party obtaining that order shall file a certified copy of it with each tribunal that
issued or registered an earlier order of child support. A party or support enforcement
agency obtaining the order that fails to file a certified copy is subject to appropriate
sanctions by a tribunal in which the issue of failure to file arises. The failure to file does
not affect the validity or enforceability of the controlling order.
(h) An order that has been determined to be the controlling order, or a judgment for
consolidated arrears of support and interest, if any, made pursuant to this section must be
recognized in proceedings under this chapter.
Sec. 105.
Laws 2014, chapter 189, section 16, is amended to read:
Sec. 16.
Minnesota Statutes 2012, section 518C.301, is amended to read:
518C.301 PROCEEDINGS UNDER THIS CHAPTER.
(a) Except as otherwise provided in this chapter, sections 518C.301 to 518C.319
apply to all proceedings under this chapter.
deleted text begin
(b) This chapter provides for the following proceedings:
deleted text end
deleted text begin
(1) establishment of an order for spousal support or child support pursuant to
section 518C.401;
deleted text end
deleted text begin
(2) enforcement of a support order and income-withholding order of another state or
a foreign country without registration pursuant to sections 518C.501 and 518C.502;
deleted text end
deleted text begin
(3) registration of an order for spousal support or child support of another state or a
foreign country for enforcement pursuant to sections 518C.601 to 518C.612;
deleted text end
deleted text begin
(4) modification of an order for child support or spousal support issued by a tribunal
of this state pursuant to sections 518C.203 to 518C.206;
deleted text end
deleted text begin
(5) registration of an order for child support of another state or a foreign country for
modification pursuant to sections 518C.601 to 518C.612;
deleted text end
deleted text begin
(6) determination of parentage of a child pursuant to section 518C.701; and
deleted text end
deleted text begin
(7) assertion of jurisdiction over nonresidents pursuant to sections 518C.201 and
518C.202.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end An individual petitioner or a support enforcement agency may commence
a proceeding authorized under this chapter by filing a petition in an initiating tribunal
for forwarding to a responding tribunal or by filing a petition or a comparable pleading
directly in a tribunal of another state or a foreign country which has or can obtain personal
jurisdiction over the respondent.
Sec. 106.
Laws 2014, chapter 189, section 17, is amended to read:
Sec. 17.
Minnesota Statutes 2012, section 518C.303, is amended to read:
518C.303 APPLICATION OF LAW OF THIS STATE.
Except as otherwise provided by this chapter, a responding tribunal of this state shall:
(1) apply the procedural and substantive lawdeleted text begin , including the rules on choice of law,
deleted text end generally applicable to similar proceedings originating in this state and may exercise all
powers and provide all remedies available in those proceedings; and
(2) determine the duty of support and the amount payable in accordance with the
law and support guidelines of this state.
Sec. 107.
Laws 2014, chapter 189, section 18, is amended to read:
Sec. 18.
Minnesota Statutes 2012, section 518C.304, is amended to read:
518C.304 DUTIES OF INITIATING TRIBUNAL.
(a) Upon the filing of a petition authorized by this chapter, an initiating tribunal of
this state shall forward the petition and its accompanying documents:
(1) to the responding tribunal or appropriate support enforcement agency in the
responding state; or
(2) if the identity of the responding tribunal is unknown, to the state information
agency of the responding state with a request that they be forwarded to the appropriate
tribunal and that receipt be acknowledged.
(b) If requested by the responding tribunal, a tribunal of this state shall issue a
certificate or other documents and make findings required by the law of the responding
state. If the responding tribunal is in a foreign country, new text begin upon request new text end the tribunal of this
state shall specify the amount of support sought, convert that amount into the equivalent
amount in the foreign currency under applicable official or market exchange rate as
publicly reported, and provide other documents necessary to satisfy the requirements of
the responding foreign tribunal.
Sec. 108.
Laws 2014, chapter 189, section 19, is amended to read:
Sec. 19.
Minnesota Statutes 2012, section 518C.305, is amended to read:
518C.305 DUTIES AND POWERS OF RESPONDING TRIBUNAL.
(a) When a responding tribunal of this state receives a petition or comparable
pleading from an initiating tribunal or directly pursuant to section 518C.301, paragraph deleted text begin (c)
deleted text end new text begin (b)new text end , it shall cause the petition or pleading to be filed and notify the petitioner where and
when it was filed.
(b) A responding tribunal of this state, to the extent deleted text begin otherwise authorized bydeleted text end new text begin not
prohibited by othernew text end law, may do one or more of the following:
(1) establish or enforce a support order, modify a child support order, determine the
controlling child support order, or to determine parentage of a child;
(2) order an obligor to comply with a support order, specifying the amount and
the manner of compliance;
(3) order income withholding;
(4) determine the amount of any arrearages, and specify a method of payment;
(5) enforce orders by civil or criminal contempt, or both;
(6) set aside property for satisfaction of the support order;
(7) place liens and order execution on the obligor's property;
(8) order an obligor to keep the tribunal informed of the obligor's current residential
address, electronic mail address, telephone number, employer, address of employment,
and telephone number at the place of employment;
(9) issue a bench warrant for an obligor who has failed after proper notice to appear
at a hearing ordered by the tribunal and enter the bench warrant in any local and state
computer systems for criminal warrants;
(10) order the obligor to seek appropriate employment by specified methods;
(11) award reasonable attorney's fees and other fees and costs; and
(12) grant any other available remedy.
(c) A responding tribunal of this state shall include in a support order issued under
this chapter, or in the documents accompanying the order, the calculations on which
the support order is based.
(d) A responding tribunal of this state may not condition the payment of a support
order issued under this chapter upon compliance by a party with provisions for visitation.
(e) If a responding tribunal of this state issues an order under this chapter, the
tribunal shall send a copy of the order to the petitioner and the respondent and to the
initiating tribunal, if any.
(f) If requested to enforce a support order, arrears, or judgment or modify a support
order stated in a foreign currency, a responding tribunal of this state shall convert the
amount stated in the foreign currency to the equivalent amount in dollars under the
applicable official or market exchange rate as publicly reported.
Sec. 109.
Laws 2014, chapter 189, section 23, is amended to read:
Sec. 23.
Minnesota Statutes 2012, section 518C.310, is amended to read:
518C.310 DUTIES OF STATE INFORMATION AGENCY.
(a) The unit within the Department of Human Services that receives and disseminates
incoming interstate actions under title IV-D of the Social Security Act is the State
Information Agency under this chapter.
(b) The State Information Agency shall:
(1) compile and maintain a current list, including addresses, of the tribunals in this
state which have jurisdiction under this chapter and any support enforcement agencies in
this state and transmit a copy to the state information agency of every other state;
(2) maintain a register of new text begin names and addresses of new text end tribunals and support enforcement
agencies received from other states;
(3) forward to the appropriate tribunal in the place in this state in which the
individual obligee or the obligor resides, or in which the obligor's property is believed
to be located, all documents concerning a proceeding under this chapter received from
another state or a foreign country; and
(4) obtain information concerning the location of the obligor and the obligor's
property within this state not exempt from execution, by such means as postal verification
and federal or state locator services, examination of telephone directories, requests for the
obligor's address from employers, and examination of governmental records, including, to
the extent not prohibited by other law, those relating to real property, vital statistics, law
enforcement, taxation, motor vehicles, driver's licenses, and Social Security.
Sec. 110.
Laws 2014, chapter 189, section 24, is amended to read:
Sec. 24.
Minnesota Statutes 2012, section 518C.311, is amended to read:
518C.311 PLEADINGS AND ACCOMPANYING DOCUMENTS.
(a) A petitioner seeking to establish or modify a support order, determine parentage
of a child, or register and modify a support order of a tribunal of another state or a foreign
country, in a proceeding under this chapter must file a petition. Unless otherwise ordered
under section 518C.312, the petition or accompanying documents must provide, so far
as known, the name, residential address, and Social Security numbers of the obligor and
the obligeenew text begin or parent and alleged parentnew text end , and the name, sex, residential address, Social
Security number, and date of birth of each child for whom support is sought or whose
deleted text begin parenthooddeleted text end new text begin parentagenew text end is to be determined. new text begin Unless filed at the time of registration, new text end the
petition must be accompanied by a deleted text begin certifieddeleted text end copy of any support order deleted text begin in effectdeleted text end new text begin known
to have been issued by another tribunalnew text end . The petition may include any other information
that may assist in locating or identifying the respondent.
(b) The petition must specify the relief sought. The petition and accompanying
documents must conform substantially with the requirements imposed by the forms
mandated by federal law for use in cases filed by a support enforcement agency.
Sec. 111.
Laws 2014, chapter 189, section 27, is amended to read:
Sec. 27.
Minnesota Statutes 2012, section 518C.314, is amended to read:
518C.314 LIMITED IMMUNITY OF PETITIONER.
(a) Participation by a petitioner in a proceeding under this chapter before a
responding tribunal, whether in person, by private attorney, or through services provided
by the support enforcement agency, does not confer personal jurisdiction over the
petitioner in another proceeding.
(b) A petitioner is not amenable to service of civil process while physically present
in this state to participate in a proceeding under this chapter.
(c) The immunity granted by this section does not extend to civil litigation based on
acts unrelated to a proceeding under this chapter committed by a party while new text begin physically
new text end present in this state to participate in the proceeding.
Sec. 112.
Laws 2014, chapter 189, section 28, is amended to read:
Sec. 28.
Minnesota Statutes 2012, section 518C.316, is amended to read:
518C.316 SPECIAL RULES OF EVIDENCE AND PROCEDURE.
(a) The physical presence of deleted text begin the petitionerdeleted text end new text begin a nonresident party who is an individual
new text end in a deleted text begin respondingdeleted text end tribunal of this state is not required for the establishment, enforcement,
or modification of a support order or the rendition of a judgment determining parentage
of a child.
(b) deleted text begin A verified petition,deleted text end new text begin Annew text end affidavit, new text begin a new text end document substantially complying with
federally mandated forms, deleted text begin anddeleted text end new text begin ornew text end a document incorporated by reference in any of them,
not excluded under the hearsay rule if given in person, is admissible in evidence if given
under deleted text begin oathdeleted text end new text begin penalty of perjurynew text end by a party or witness residing outside this state.
(c) A copy of the record of child support payments certified as a true copy of the
original by the custodian of the record may be forwarded to a responding tribunal. The copy
is evidence of facts asserted in it, and is admissible to show whether payments were made.
(d) Copies of bills for testing for parentage of a child, and for prenatal and postnatal
health care of the mother and child, furnished to the adverse party at least ten days before
trial, are admissible in evidence to prove the amount of the charges billed and that the
charges were reasonable, necessary, and customary.
(e) Documentary evidence transmitted from outside this state to a tribunal of this state
by telephone, telecopier, or other electronic means that do not provide an original record
may not be excluded from evidence on an objection based on the means of transmission.
(f) In a proceeding under this chapter, a tribunal of this state shall permit a party
or witness residing outside this state to be deposed or to testify under penalty of perjury
by telephone, audiovisual means, or other electronic means at a designated tribunal or
other location. A tribunal of this state shall cooperate with other tribunals in designating
an appropriate location for the deposition or testimony.
(g) If a party called to testify at a civil hearing refuses to answer on the ground that
the testimony may be self-incriminating, the trier of fact may draw an adverse inference
from the refusal.
(h) A privilege against disclosure of communications between spouses does not
apply in a proceeding under this chapter.
(i) The defense of immunity based on the relationship of husband and wife or parent
and child does not apply in a proceeding under this chapter.
(j) A voluntary acknowledgment of paternity, certified as a true copy, is admissible
to establish parentage of a child.
Sec. 113.
Laws 2014, chapter 189, section 29, is amended to read:
Sec. 29.
Minnesota Statutes 2012, section 518C.317, is amended to read:
518C.317 COMMUNICATIONS BETWEEN TRIBUNALS.
A tribunal of this state may communicate with a tribunal outside this state in
deleted text begin writing, by e-mail, ordeleted text end new text begin a record, ornew text end by telephonenew text begin , electronic mail,new text end or other means, to obtain
information concerning the laws of that state, the legal effect of a judgment, decree, or
order of that tribunal, and the status of a proceeding. A tribunal of this state may furnish
similar information by similar means to a tribunal outside this state.
Sec. 114.
Laws 2014, chapter 189, section 31, is amended to read:
Sec. 31.
Minnesota Statutes 2012, section 518C.319, is amended to read:
518C.319 RECEIPT AND DISBURSEMENT OF PAYMENTS.
(a) A support enforcement agency or tribunal of this state shall disburse promptly
any amounts received pursuant to a support order, as directed by the order. The agency
or tribunal shall furnish to a requesting party or tribunal of another state or a foreign
country a certified statement by the custodian of the record of the amounts and dates
of all payments received.
(b) If neither the obligor, deleted text begin notdeleted text end new text begin nornew text end the obligee who is an individual, nor the child
resides in this state, upon request from the support enforcement agency of this state or
another state, the support enforcement agency of this state or a tribunal of this state shall:
(1) direct that the support payment be made to the support enforcement agency in
the state in which the obligee is receiving services; and
(2) issue and send to the obligor's employer a conforming income-withholding order
or an administrative notice of change of payee, reflecting the redirected payments.
(c) The support enforcement agency of this state receiving redirected payments from
another state pursuant to a law similar to paragraph (b) shall furnish to a requesting party
or tribunal of the other state a certified statement by the custodian of the record of the
amount and dates of all payments received.
Sec. 115.
Laws 2014, chapter 189, section 43, is amended to read:
Sec. 43.
Minnesota Statutes 2012, section 518C.604, is amended to read:
518C.604 CHOICE OF LAW.
(a) Except as otherwise provided in paragraph (d), the law of the issuing state or
foreign country governs:
(1) the nature, extent, amount, and duration of current payments under a registered
support order;
(2) the computation and payment of arrearages and accrual of interest on the
arrearages under the support order; and
(3) the existence and satisfaction of other obligations under the support order.
(b) In a proceeding for arrearagesnew text begin under a registered support ordernew text end , the statute of
limitation under the laws of this state or of the issuing state or foreign country, whichever
is longer, applies.
(c) A responding tribunal of this state shall apply the procedures and remedies of
this state to enforce current support and collect arrears and interest due on a support order
of another state or a foreign country registered in this state.
(d) After a tribunal of this state or another state determines which is the controlling
order and issues an order consolidating arrears, if any, a tribunal of this state shall
prospectively apply the law of the state or foreign country issuing the controlling order,
including its law on interest on arrears, on current and future support, and on consolidated
arrears.
Sec. 116.
Laws 2014, chapter 189, section 50, is amended to read:
Sec. 50.
Minnesota Statutes 2012, section 518C.611, is amended to read:
518C.611 MODIFICATION OF CHILD SUPPORT ORDER OF ANOTHER
STATE.
(a) If section 518C.613 does not apply, upon petition a tribunal of this state may
modify a child support order issued in another state that is registered in this state if, after
notice and hearing, it finds that:
(1) the following requirements are met:
(i) neither the child, nor the obligee who is an individual, nor the obligor resides
in the issuing state;
(ii) a petitioner who is a nonresident of this state seeks modification; and
(iii) the respondent is subject to the personal jurisdiction of the tribunal of this state; or
(2) this state is the residence of the child, or a party who is an individual is subject to
the personal jurisdiction of the tribunal of this state and all of the parties who are individuals
have filed deleted text begin writtendeleted text end consents in a record in the issuing tribunal for a tribunal of this state to
modify the support order and assume continuing, exclusive jurisdiction deleted text begin over the orderdeleted text end .
(b) Modification of a registered child support order is subject to the same
requirements, procedures, and defenses that apply to the modification of an order issued
by a tribunal of this state and the order may be enforced and satisfied in the same manner.
(c) A tribunal of this state may not modify any aspect of a child support order that
may not be modified under the law of the issuing state, including the duration of the
obligation of support. If two or more tribunals have issued child support orders for the
same obligor and child, the order that controls and must be recognized under section
518C.207 establishes the aspects of the support order which are nonmodifiable.
(d) In a proceeding to modify a child support order, the law of the state that is
determined to have issued the initial controlling order governs the duration of the
obligation of support. The obligor's fulfillment of the duty of support established by that
order precludes imposition of a further obligation of support by a tribunal of this state.
(e) On issuance of an order new text begin by a tribunal of this state new text end modifying a child support order
issued in another state, a tribunal of this state becomes the tribunal having continuing,
exclusive jurisdiction.
(f) Notwithstanding paragraphs (a) to deleted text begin (d)deleted text end new text begin (e)new text end and section 518C.201, paragraph (b),
a tribunal of this state retains jurisdiction to modify an order issued by a tribunal of this
state if:
(1) one party resides in another state; and
(2) the other party resides outside the United States.
Sec. 117.
Laws 2014, chapter 189, section 51, is amended to read:
Sec. 51.
Minnesota Statutes 2012, section 518C.612, is amended to read:
518C.612 RECOGNITION OF ORDER MODIFIED IN ANOTHER STATE.
If a child support order issued by a tribunal of this state is modified by a tribunal of
another state which assumed jurisdiction deleted text begin according to this chapter or a law substantially
similar to this chapterdeleted text end new text begin pursuant to the Uniform Interstate Family Support Act,new text end a tribunal of
this state:
(1) may enforce its order that was modified only as to arrears and interest accruing
before the modification;
(2) may provide appropriate relief for violations of its order which occurred before
the effective date of the modification; and
(3) shall recognize the modifying order of the other state, upon registration, for the
purpose of enforcement.
Sec. 118.
Laws 2014, chapter 189, section 52, is amended to read:
Sec. 52.
Minnesota Statutes 2012, section 518C.613, is amended to read:
518C.613 JURISDICTION TO MODIFY SUPPORT ORDER OF ANOTHER
STATE WHEN INDIVIDUAL PARTIES RESIDE IN THIS STATE.
(a) If all of the parties who are individuals reside in this state and the child does not
reside in the issuing state, a tribunal of this state has jurisdiction to enforce and to modify
the issuing state's child support order in a proceeding to register that order.
(b) A tribunal of this state exercising jurisdiction as provided in this section shall apply
sections 518C.101 to deleted text begin 518C.209deleted text end new text begin 518C.211 new text end and 518C.601 to 518C.616 to the enforcement
or modification proceeding. Sections 518C.301 to 518C.508 and 518C.701 to 518C.802
do not apply and the tribunal shall apply the procedural and substantive law of this state.
Sec. 119.
Laws 2014, chapter 189, section 73, is amended to read:
Sec. 73. EFFECTIVE DATE.
This act deleted text begin becomesdeleted text end new text begin isnew text end effective deleted text begin on the date that the United States deposits the
instrument of ratification for the Hague Convention on the International Recovery of Child
Support and Other Forms of Family Maintenance with the Hague Conference on Private
International Lawdeleted text end new text begin July 1, 2015new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2015.
new text end
Sec. 120. new text begin GROUP RESIDENTIAL HOUSING REPORT ON PROGRAM
IMPROVEMENTS.
new text end
new text begin
(a) The commissioner shall, in coordination with stakeholders and advocates, build
on the group residential housing (GRH) reforms made in the 2015 legislative session
related to program integrity and uniformity, by restructuring the payment rates, exploring
assessment tools, and proposing any other necessary modifications that will result in a
more cost-effective program, and report to the members of the legislative committees
having jurisdiction over GRH issues by December 15, 2016.
new text end
new text begin
(b) The working group, consisting of the commissioner, stakeholders, and advocates,
shall examine the feasibility and fiscal implications of restructuring service rates by
eliminating the supplemental service rates, and developing a plan to fund only those
services, based on individual need, that are not covered by medical assistance, other
insurance, or other programs. In addition, the working group shall analyze the payment
structure, and explore different options, including tiered rates for services, and provide the
plan and analysis under this paragraph in the report under paragraph (a).
new text end
new text begin
(c) To determine individual need, the working group shall explore assessment tools,
and determine the appropriate assessment tool for the different populations served by the
GRH program, which include homeless individuals, individuals with mental illness, and
individuals who are chemically dependent. The working group shall coordinate efforts
with agency staff who have expertise related to these populations, and use relevant
information and data that is available, to determine the most appropriate and effective
assessment tool or tools, and provide the analysis and an assessment recommendation in
the report under paragraph (a).
new text end
Sec. 121. new text begin CHILD SUPPORT WORK GROUP.
new text end
new text begin
(a) A child support work group is established to review the parenting expense
adjustment in Minnesota Statutes, section 518A.36, and to identify and recommend
changes to the parenting expense adjustment.
new text end
new text begin
(b) Members of the work group shall include:
new text end
new text begin
(1) two members of the house of representatives, one appointed by the speaker of the
house and one appointed by the minority leader;
new text end
new text begin
(2) two members of the senate, one appointed by the majority leader and one
appointed by the minority leader;
new text end
new text begin
(3) the commissioner of human services or a designee;
new text end
new text begin
(4) one staff member from the Child Support Division of the Department of Human
Services, appointed by the commissioner;
new text end
new text begin
(5) one representative of the Minnesota State Bar Association, Family Law section,
appointed by the section;
new text end
new text begin
(6) one representative of the Minnesota County Attorney's Association, appointed
by the association;
new text end
new text begin
(7) one representative of the Minnesota Legal Services Coalition, appointed by
the coalition;
new text end
new text begin
(8) one representative of the Minnesota Family Support and Recovery Council,
appointed by the council; and
new text end
new text begin
(9) two representatives from parent advocacy groups, one representing custodial
parents and one representing noncustodial parents, appointed by the commissioner of
human services.
new text end
new text begin
The commissioner, or the commissioner's designee, shall appoint the work group chair.
new text end
new text begin
(c) The work group shall be authorized to retain the services of an economist to help
create an equitable parenting expense adjustment formula. The work group may hire an
economist by use of a sole-source contract.
new text end
new text begin
(d) The work group shall issue a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over civil law, judiciary, and health and
human services by January 15, 2016. The report must include recommendations for
changes to the computation of child support and recommendations on the composition
of a permanent child support task force.
new text end
new text begin
(e) Terms, compensation, and removal of members and the filling of vacancies are
governed by Minnesota Statutes, section 15.059.
new text end
new text begin
(f) The work group expires January 16, 2016.
new text end
Sec. 122. new text begin INSTRUCTIONS TO THE COMMISSIONER; CHILD
MALTREATMENT SCREENING GUIDELINES.
new text end
new text begin
(a) No later than October 1, 2015, the commissioner of human services shall update
the child maltreatment screening guidelines to require agencies to consider prior reports that
were not screened in when determining whether a new report will or will not be screened
in. The updated guidelines must emphasize that intervention and prevention efforts are to
focus on child safety and the ongoing risk of child abuse or neglect, and that the health and
safety of children are of paramount concern. The commissioner shall work with a diverse
group of community representatives who are experts on limiting cultural and ethnic bias
when developing the updated guidelines. The guidelines must be developed with special
sensitivity to reducing system bias with regard to screening and assessment tools.
new text end
new text begin
(b) No later than November 1, 2015, the commissioner shall publish and distribute
the updated guidelines and ensure that all agency staff have received training on the
updated guidelines.
new text end
new text begin
(c) Agency staff must implement the guidelines by January 1, 2016.
new text end
Sec. 123. new text begin COMMISSIONER'S DUTY TO PROVIDE TRAINING TO CHILD
PROTECTION SUPERVISORS.
new text end
new text begin
The commissioner shall establish requirements for competency-based initial
training, support, and continuing education for child protection supervisors. This includes
developing a set of competencies specific to child protection supervisor knowledge, skills,
and attitudes based on the Minnesota Child Welfare Practice Model. Competency-based
training of supervisors must advance continuous emphasis and improvement in skills that
promote the use of the client's culture as a resource and the ability to integrate the client's
traditions, customs, values, and faith into service delivery.
new text end
Sec. 124. new text begin CHILD PROTECTION UPDATED FORMULA.
new text end
new text begin
The commissioner of human services shall evaluate the formulas in Minnesota
Statutes, section 256M.41, and recommend an updated equitable distribution formula
beginning in fiscal year 2018, for funding child protection staffing and expanded services
to counties and tribes, taking into consideration any relief to counties and tribes for child
welfare and foster care costs, additional tribes delivering social services, and any other
relevant information that should be considered in developing a new distribution formula.
The commissioner shall report to the legislative committees having jurisdiction over child
protection issues by December 15, 2016.
new text end
Sec. 125. new text begin LEGISLATIVE TASK FORCE; CHILD PROTECTION.
new text end
new text begin
(a) A legislative task force is created to:
new text end
new text begin
(1) review the efforts being made to implement the recommendations of the
Governor's Task Force on the Protection of Children, including a review of the roles and
functions of the Office of Ombudsperson for Families;
new text end
new text begin
(2) expand the efforts into related areas of the child welfare system;
new text end
new text begin
(3) work with the commissioner of human services and community partners to
establish and evaluate child protection grants to address disparities in child welfare
pursuant to Minnesota Statutes, section 256E.28; and
new text end
new text begin
(4) identify additional areas within the child welfare system that need to be addressed
by the legislature.
new text end
new text begin
(b) Members of the legislative task force shall include:
new text end
new text begin
(1) the four legislators who served as members of the Governor's Task Force on
the Protection of Children;
new text end
new text begin
(2) two members from the house of representatives appointed by the speaker, one
from the majority party and one from the minority party; and
new text end
new text begin
(3) two members from the senate appointed by the majority leader, one from the
majority party and one from the minority party.
new text end
new text begin
The speaker and the majority leader shall each appoint a chair and vice-chair from the
membership of the task force. The gavel shall rotate after each meeting, and the house of
representatives shall assume the leadership of the task force first.
new text end
new text begin
(c) The task force may provide oversight and monitoring of:
new text end
new text begin
(1) the efforts by the Department of Human Services, counties, and tribes to
implement laws related to child protection;
new text end
new text begin
(2) efforts by the Department of Human Services, counties, and tribes to implement
the recommendations of the Governor's Task Force on the Protection of Children;
new text end
new text begin
(3) efforts by agencies, including but not limited to the Minnesota Department
of Education, the Minnesota Housing Finance Agency, the Minnesota Department of
Corrections, and the Minnesota Department of Public Safety, to work with the Department
of Human Services to assure safety and well-being for children at risk of harm or children
in the child welfare system; and
new text end
new text begin
(4) efforts by the Department of Human Services, other agencies, counties, and
tribes to implement best practices to ensure every child is protected from maltreatment
and neglect and to ensure every child has the opportunity for healthy development.
new text end
new text begin
(d) The task force, in cooperation with the commissioner of human services, shall
issue a report to the legislature and governor February 1, 2016. The report must contain
information on the progress toward implementation of changes to the child protection
system, recommendations for additional legislative changes and procedures affecting child
protection and child welfare, and funding needs to implement recommended changes.
new text end
new text begin
(e) The task force shall convene upon the effective date of this section and shall
continue until the last day of the 2016 legislative session.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 126. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
The revisor of statutes shall alphabetize the definitions in Minnesota Statutes, section
626.556, subdivision 2, and correct related cross-references.
new text end
ARTICLE 2
CHEMICAL AND MENTAL HEALTH SERVICES
Section 1.
Minnesota Statutes 2014, section 13.46, subdivision 2, is amended to read:
Subd. 2.
General.
(a) Data on individuals collected, maintained, used, or
disseminated by the welfare system are private data on individuals, and shall not be
disclosed except:
(1) according to section 13.05;
(2) according to court order;
(3) according to a statute specifically authorizing access to the private data;
(4) to an agent of the welfare system and an investigator acting on behalf of a county,
the state, or the federal government, including a law enforcement person or attorney in the
investigation or prosecution of a criminal, civil, or administrative proceeding relating to
the administration of a program;
(5) to personnel of the welfare system who require the data to verify an individual's
identity; determine eligibility, amount of assistance, and the need to provide services
to an individual or family across programs; new text begin coordinate services for an individual or
family; new text end evaluate the effectiveness of programs; assess parental contribution amounts;
and investigate suspected fraud;
(6) to administer federal funds or programs;
(7) between personnel of the welfare system working in the same program;
(8) to the Department of Revenue to assess parental contribution amounts for
purposes of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit
programs and to identify individuals who may benefit from these programs. The following
information may be disclosed under this paragraph: an individual's and their dependent's
names, dates of birth, Social Security numbers, income, addresses, and other data as
required, upon request by the Department of Revenue. Disclosures by the commissioner
of revenue to the commissioner of human services for the purposes described in this clause
are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
but are not limited to, the dependent care credit under section 290.067, the Minnesota
working family credit under section 290.0671, the property tax refund and rental credit
under section 290A.04, and the Minnesota education credit under section 290.0674;
(9) between the Department of Human Services, the Department of Employment
and Economic Development, and when applicable, the Department of Education, for
the following purposes:
(i) to monitor the eligibility of the data subject for unemployment benefits, for any
employment or training program administered, supervised, or certified by that agency;
(ii) to administer any rehabilitation program or child care assistance program,
whether alone or in conjunction with the welfare system;
(iii) to monitor and evaluate the Minnesota family investment program or the child
care assistance program by exchanging data on recipients and former recipients of food
support, cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance
under chapter 119B, or medical programs under chapter 256B, 256D, or 256L; and
(iv) to analyze public assistance employment services and program utilization,
cost, effectiveness, and outcomes as implemented under the authority established in Title
II, Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of
1999. Health records governed by sections 144.291 to 144.298 and "protected health
information" as defined in Code of Federal Regulations, title 45, section 160.103, and
governed by Code of Federal Regulations, title 45, parts 160-164, including health care
claims utilization information, must not be exchanged under this clause;
(10) to appropriate parties in connection with an emergency if knowledge of
the information is necessary to protect the health or safety of the individual or other
individuals or persons;
(11) data maintained by residential programs as defined in section 245A.02 may
be disclosed to the protection and advocacy system established in this state according
to Part C of Public Law 98-527 to protect the legal and human rights of persons with
developmental disabilities or other related conditions who live in residential facilities for
these persons if the protection and advocacy system receives a complaint by or on behalf
of that person and the person does not have a legal guardian or the state or a designee of
the state is the legal guardian of the person;
(12) to the county medical examiner or the county coroner for identifying or locating
relatives or friends of a deceased person;
(13) data on a child support obligor who makes payments to the public agency
may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
determine eligibility under section 136A.121, subdivision 2, clause (5);
(14) participant Social Security numbers and names collected by the telephone
assistance program may be disclosed to the Department of Revenue to conduct an
electronic data match with the property tax refund database to determine eligibility under
section 237.70, subdivision 4a;
(15) the current address of a Minnesota family investment program participant
may be disclosed to law enforcement officers who provide the name of the participant
and notify the agency that:
(i) the participant:
(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
jurisdiction from which the individual is fleeing; or
(B) is violating a condition of probation or parole imposed under state or federal law;
(ii) the location or apprehension of the felon is within the law enforcement officer's
official duties; and
(iii) the request is made in writing and in the proper exercise of those duties;
(16) the current address of a recipient of general assistance or general assistance
medical care may be disclosed to probation officers and corrections agents who are
supervising the recipient and to law enforcement officers who are investigating the
recipient in connection with a felony level offense;
(17) information obtained from food support applicant or recipient households may
be disclosed to local, state, or federal law enforcement officials, upon their written request,
for the purpose of investigating an alleged violation of the Food Stamp Act, according
to Code of Federal Regulations, title 7, section 272.1(c);
(18) the address, Social Security number, and, if available, photograph of any
member of a household receiving food support shall be made available, on request, to a
local, state, or federal law enforcement officer if the officer furnishes the agency with the
name of the member and notifies the agency that:
(i) the member:
(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
(B) is violating a condition of probation or parole imposed under state or federal
law; or
(C) has information that is necessary for the officer to conduct an official duty related
to conduct described in subitem (A) or (B);
(ii) locating or apprehending the member is within the officer's official duties; and
(iii) the request is made in writing and in the proper exercise of the officer's official
duty;
(19) the current address of a recipient of Minnesota family investment program,
general assistance, general assistance medical care, or food support may be disclosed to
law enforcement officers who, in writing, provide the name of the recipient and notify the
agency that the recipient is a person required to register under section 243.166, but is not
residing at the address at which the recipient is registered under section 243.166;
(20) certain information regarding child support obligors who are in arrears may be
made public according to section 518A.74;
(21) data on child support payments made by a child support obligor and data on
the distribution of those payments excluding identifying information on obligees may be
disclosed to all obligees to whom the obligor owes support, and data on the enforcement
actions undertaken by the public authority, the status of those actions, and data on the
income of the obligor or obligee may be disclosed to the other party;
(22) data in the work reporting system may be disclosed under section 256.998,
subdivision 7;
(23) to the Department of Education for the purpose of matching Department of
Education student data with public assistance data to determine students eligible for free
and reduced-price meals, meal supplements, and free milk according to United States
Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
state funds that are distributed based on income of the student's family; and to verify
receipt of energy assistance for the telephone assistance plan;
(24) the current address and telephone number of program recipients and emergency
contacts may be released to the commissioner of health or a community health board as
defined in section 145A.02, subdivision 5, when the commissioner or community health
board has reason to believe that a program recipient is a disease case, carrier, suspect case,
or at risk of illness, and the data are necessary to locate the person;
(25) to other state agencies, statewide systems, and political subdivisions of this
state, including the attorney general, and agencies of other states, interstate information
networks, federal agencies, and other entities as required by federal regulation or law for
the administration of the child support enforcement program;
(26) to personnel of public assistance programs as defined in section 256.741, for
access to the child support system database for the purpose of administration, including
monitoring and evaluation of those public assistance programs;
(27) to monitor and evaluate the Minnesota family investment program by
exchanging data between the Departments of Human Services and Education, on
recipients and former recipients of food support, cash assistance under chapter 256, 256D,
256J, or 256K, child care assistance under chapter 119B, or medical programs under
chapter 256B, 256D, or 256L;
(28) to evaluate child support program performance and to identify and prevent
fraud in the child support program by exchanging data between the Department of Human
Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
and (b), without regard to the limitation of use in paragraph (c), Department of Health,
Department of Employment and Economic Development, and other state agencies as is
reasonably necessary to perform these functions;
(29) counties operating child care assistance programs under chapter 119B may
disseminate data on program participants, applicants, and providers to the commissioner
of education; deleted text begin or
deleted text end
(30) child support data on the child, the parents, and relatives of the child may be
disclosed to agencies administering programs under titles IV-B and IV-E of the Social
Security Act, as authorized by federal lawdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(31) to a health care provider governed by sections 144.291 to 144.298, to the extent
necessary to coordinate services.
new text end
(b) Information on persons who have been treated for drug or alcohol abuse may
only be disclosed according to the requirements of Code of Federal Regulations, title
42, sections 2.1 to 2.67.
(c) Data provided to law enforcement agencies under paragraph (a), clause (15),
(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected
nonpublic while the investigation is active. The data are private after the investigation
becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are
not subject to the access provisions of subdivision 10, paragraph (b).
For the purposes of this subdivision, a request will be deemed to be made in writing
if made through a computer interface system.
Sec. 2.
Minnesota Statutes 2014, section 13.46, subdivision 7, is amended to read:
Subd. 7.
Mental health data.
(a) Mental health data are private data on individuals
and shall not be disclosed, except:
(1) pursuant to section 13.05, as determined by the responsible authority for the
community mental health center, mental health division, or provider;
(2) pursuant to court order;
(3) pursuant to a statute specifically authorizing access to or disclosure of mental
health data or as otherwise provided by this subdivision; deleted text begin or
deleted text end
(4) new text begin to personnel of the welfare system working in the same program or providing
services to the same individual or family to the extent necessary to coordinate services,
provided that a health record may be disclosed only as provided under section 144.293;
new text end
new text begin
(5) to a health care provider governed by sections 144.291 to 144.298, to the extent
necessary to coordinate services; or
new text end
new text begin (6) new text end with the consent of the client or patient.
(b) An agency of the welfare system may not require an individual to consent to the
release of mental health data as a condition for receiving services or for reimbursing a
community mental health center, mental health division of a county, or provider under
contract to deliver mental health services.
(c) Notwithstanding section 245.69, subdivision 2, paragraph (f), or any other law
to the contrary, the responsible authority for a community mental health center, mental
health division of a county, or a mental health provider must disclose mental health data to
a law enforcement agency if the law enforcement agency provides the name of a client or
patient and communicates that the:
(1) client or patient is currently involved in an emergency interaction with the law
enforcement agency; and
(2) data is necessary to protect the health or safety of the client or patient or of
another person.
The scope of disclosure under this paragraph is limited to the minimum necessary for
law enforcement to respond to the emergency. Disclosure under this paragraph may include,
but is not limited to, the name and telephone number of the psychiatrist, psychologist,
therapist, mental health professional, practitioner, or case manager of the client or patient.
A law enforcement agency that obtains mental health data under this paragraph shall
maintain a record of the requestor, the provider of the information, and the client or patient
name. Mental health data obtained by a law enforcement agency under this paragraph
are private data on individuals and must not be used by the law enforcement agency for
any other purpose. A law enforcement agency that obtains mental health data under this
paragraph shall inform the subject of the data that mental health data was obtained.
(d) In the event of a request under paragraph (a), clause (4), a community mental
health center, county mental health division, or provider must release mental health data to
Criminal Mental Health Court personnel in advance of receiving a copy of a consent if the
Criminal Mental Health Court personnel communicate that the:
(1) client or patient is a defendant in a criminal case pending in the district court;
(2) data being requested is limited to information that is necessary to assess whether
the defendant is eligible for participation in the Criminal Mental Health Court; and
(3) client or patient has consented to the release of the mental health data and a copy
of the consent will be provided to the community mental health center, county mental
health division, or provider within 72 hours of the release of the data.
For purposes of this paragraph, "Criminal Mental Health Court" refers to a specialty
criminal calendar of the Hennepin County District Court for defendants with mental illness
and brain injury where a primary goal of the calendar is to assess the treatment needs of
the defendants and to incorporate those treatment needs into voluntary case disposition
plans. The data released pursuant to this paragraph may be used for the sole purpose of
determining whether the person is eligible for participation in mental health court. This
paragraph does not in any way limit or otherwise extend the rights of the court to obtain the
release of mental health data pursuant to court order or any other means allowed by law.
Sec. 3.
Minnesota Statutes 2014, section 62Q.55, subdivision 3, is amended to read:
Subd. 3.
Emergency services.
As used in this section, "emergency services" means,
with respect to an emergency medical condition:
(1) a medical screening examination, as required under section 1867 of the Social
Security Act, that is within the capability of the emergency department of a hospital,
including ancillary services routinely available to the emergency department to evaluate
such emergency medical condition; deleted text begin and
deleted text end
(2) within the capabilities of the staff and facilities available at the hospital, such
further medical examination and treatment as are required under section 1867 of the Social
Security Act to stabilize the patientnew text begin ; and
new text end
new text begin (3) emergency services as defined in sections 245.462, subdivision 11, and 245.4871,
subdivision 14new text end .
Sec. 4.
Minnesota Statutes 2014, section 144.293, subdivision 6, is amended to read:
Subd. 6.
Consent does not expire.
Notwithstanding subdivision 4, if a patient
explicitly gives informed consent to the release of health records for the purposes and
restrictions in deleted text begin clausesdeleted text end new text begin clausenew text end (1) deleted text begin anddeleted text end new text begin ,new text end (2),new text begin or (3),new text end the consent does not expire after one
year for:
(1) the release of health records to a provider who is being advised or consulted with
in connection with the releasing provider's current treatment of the patient;
(2) the release of health records to an accident and health insurer, health service plan
corporation, health maintenance organization, or third-party administrator for purposes of
payment of claims, fraud investigation, or quality of care review and studies, provided that:
(i) the use or release of the records complies with sections 72A.49 to 72A.505;
(ii) further use or release of the records in individually identifiable form to a person
other than the patient without the patient's consent is prohibited; and
(iii) the recipient establishes adequate safeguards to protect the records from
unauthorized disclosure, including a procedure for removal or destruction of information
that identifies the patientnew text begin ; or
new text end
new text begin (3) the release of health records to a program in the welfare system, as defined in
section 13.46, to the extent necessary to coordinate services for the patientnew text end .
Sec. 5.
Minnesota Statutes 2014, section 144.551, subdivision 1, is amended to read:
Subdivision 1.
Restricted construction or modification.
(a) The following
construction or modification may not be commenced:
(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
to another, or otherwise results in an increase or redistribution of hospital beds within
the state; and
(2) the establishment of a new hospital.
(b) This section does not apply to:
(1) construction or relocation within a county by a hospital, clinic, or other health
care facility that is a national referral center engaged in substantial programs of patient
care, medical research, and medical education meeting state and national needs that
receives more than 40 percent of its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a health care facility held
an approved certificate of need on May 1, 1984, regardless of the date of expiration of
the certificate;
(3) a project for which a certificate of need was denied before July 1, 1990, if a
timely appeal results in an order reversing the denial;
(4) a project exempted from certificate of need requirements by Laws 1981, chapter
200, section 2;
(5) a project involving consolidation of pediatric specialty hospital services within
the Minneapolis-St. Paul metropolitan area that would not result in a net increase in the
number of pediatric specialty hospital beds among the hospitals being consolidated;
(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds
to an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
the number of hospital beds. Upon completion of the reconstruction, the licenses of both
hospitals must be reinstated at the capacity that existed on each site before the relocation;
(7) the relocation or redistribution of hospital beds within a hospital building or
identifiable complex of buildings provided the relocation or redistribution does not result
in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds
from one physical site or complex to another; or (iii) redistribution of hospital beds within
the state or a region of the state;
(8) relocation or redistribution of hospital beds within a hospital corporate system
that involves the transfer of beds from a closed facility site or complex to an existing site
or complex provided that: (i) no more than 50 percent of the capacity of the closed facility
is transferred; (ii) the capacity of the site or complex to which the beds are transferred
does not increase by more than 50 percent; (iii) the beds are not transferred outside of a
federal health systems agency boundary in place on July 1, 1983; and (iv) the relocation or
redistribution does not involve the construction of a new hospital building;
(9) a construction project involving up to 35 new beds in a psychiatric hospital in
Rice County that primarily serves adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;
(10) a project to replace a hospital or hospitals with a combined licensed capacity
of 130 beds or less if: (i) the new hospital site is located within five miles of the current
site; and (ii) the total licensed capacity of the replacement hospital, either at the time of
construction of the initial building or as the result of future expansion, will not exceed 70
licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
(11) the relocation of licensed hospital beds from an existing state facility operated
by the commissioner of human services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one regional treatment center
site to another; or from one building or site to a new or existing building or site on the
same campus;
(12) the construction or relocation of hospital beds operated by a hospital having a
statutory obligation to provide hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
beds, of which 12 serve mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;
(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;
(14) a construction project involving the addition of up to eight new beds in an
existing nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
(15) a construction project involving the addition of 20 new hospital beds
used for rehabilitation services in an existing hospital in Carver County serving the
southwest suburban metropolitan area. Beds constructed under this clause shall not be
eligible for reimbursement under medical assistance, general assistance medical care,
or MinnesotaCare;
(16) a project for the construction or relocation of up to 20 hospital beds for the
operation of up to two psychiatric facilities or units for children provided that the operation
of the facilities or units have received the approval of the commissioner of human services;
(17) a project involving the addition of 14 new hospital beds to be used for
rehabilitation services in an existing hospital in Itasca County;
(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin
County that closed 20 rehabilitation beds in 2002, provided that the beds are used only
for rehabilitation in the hospital's current rehabilitation building. If the beds are used for
another purpose or moved to another location, the hospital's licensed capacity is reduced
by 20 beds;
(19) a critical access hospital established under section 144.1483, clause (9), and
section 1820 of the federal Social Security Act, United States Code, title 42, section
1395i-4, that delicensed beds since enactment of the Balanced Budget Act of 1997, Public
Law 105-33, to the extent that the critical access hospital does not seek to exceed the
maximum number of beds permitted such hospital under federal law;
(20) notwithstanding section 144.552, a project for the construction of a new hospital
in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
(i) the project, including each hospital or health system that will own or control the
entity that will hold the new hospital license, is approved by a resolution of the Maple
Grove City Council as of March 1, 2006;
(ii) the entity that will hold the new hospital license will be owned or controlled by
one or more not-for-profit hospitals or health systems that have previously submitted a
plan or plans for a project in Maple Grove as required under section 144.552, and the
plan or plans have been found to be in the public interest by the commissioner of health
as of April 1, 2005;
(iii) the new hospital's initial inpatient services must include, but are not limited
to, medical and surgical services, obstetrical and gynecological services, intensive
care services, orthopedic services, pediatric services, noninvasive cardiac diagnostics,
behavioral health services, and emergency room services;
(iv) the new hospital:
(A) will have the ability to provide and staff sufficient new beds to meet the growing
needs of the Maple Grove service area and the surrounding communities currently being
served by the hospital or health system that will own or control the entity that will hold
the new hospital license;
(B) will provide uncompensated care;
(C) will provide mental health services, including inpatient beds;
(D) will be a site for workforce development for a broad spectrum of
health-care-related occupations and have a commitment to providing clinical training
programs for physicians and other health care providers;
(E) will demonstrate a commitment to quality care and patient safety;
(F) will have an electronic medical records system, including physician order entry;
(G) will provide a broad range of senior services;
(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to
enhance the continuity of care for emergency medical patients; and
(I) will be completed by December 31, 2009, unless delayed by circumstances
beyond the control of the entity holding the new hospital license; and
(v) as of 30 days following submission of a written plan, the commissioner of health
has not determined that the hospitals or health systems that will own or control the entity
that will hold the new hospital license are unable to meet the criteria of this clause;
(21) a project approved under section 144.553;
(22) a project for the construction of a hospital with up to 25 beds in Cass County
within a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's
license holder is approved by the Cass County Board;
(23) a project for an acute care hospital in Fergus Falls that will increase the bed
capacity from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16
and closing a separately licensed 13-bed skilled nursing facility;
(24) notwithstanding section 144.552, a project for the construction and expansion
of a specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for
patients who are under 21 years of age on the date of admission. The commissioner
conducted a public interest review of the mental health needs of Minnesota and the Twin
Cities metropolitan area in 2008. No further public interest review shall be conducted for
the construction or expansion project under this clause; deleted text begin or
deleted text end
(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if
the commissioner finds the project is in the public interest after the public interest review
conducted under section 144.552 is completenew text begin ; or
new text end
new text begin
(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the
city of Maple Grove, exclusively for patients who are under 21 years of age on the date of
admission, if the commissioner finds the project is in the public interest after the public
interest review conducted under section 144.552 is complete;
new text end
new text begin
(ii) this project shall serve patients in the continuing care benefit program under
section 256.9693. The project may also serve patients not in the continuing care benefit
program; and
new text end
new text begin (iii) if the project ceases to participate in the continuing care benefit program, the
commissioner must complete a subsequent public interest review under section 144.552.
If the project is found not to be in the public interest, the license must be terminated six
months from the date of that finding. If the commissioner of human services terminates the
contract without cause or reduces per diem payment rates for patients under the continuing
care benefit program below the rates in effect for services provided on December 31, 2015,
the project may cease to participate in the continuing care benefit program and continue to
operate without a subsequent public interest reviewnew text end .
Sec. 6.
Minnesota Statutes 2014, section 145.56, subdivision 2, is amended to read:
Subd. 2.
Community-based programs.
To the extent funds are appropriated for the
purposes of this subdivision, the commissioner shall establish a grant program to fund:
(1) community-based programs to provide education, outreach, and advocacy
services to populations who may be at risk for suicide;
(2) community-based programs that educate community helpers and gatekeepers,
such as family members, spiritual leaders, coaches, and business owners, employers, and
coworkers on how to prevent suicide by encouraging help-seeking behaviors;
(3) community-based programs that educate populations at risk for suicide and
community helpers and gatekeepers that must include information on the symptoms
of depression and other psychiatric illnesses, the warning signs of suicide, skills for
preventing suicides, and making or seeking effective referrals to intervention and
community resources; deleted text begin and
deleted text end
(4) community-based programs to provide evidence-based suicide prevention and
intervention education to school staff, parents, and students in grades kindergarten through
12, and for students attending Minnesota colleges and universitiesnew text begin ;
new text end
new text begin
(5) community-based programs to provide evidence-based suicide prevention and
intervention to public school nurses, teachers, administrators, coaches, school social
workers, peace officers, firefighters, emergency medical technicians, advanced emergency
medical technicians, paramedics, primary care providers, and others; and
new text end
new text begin (6) community-based, evidence-based postvention training to mental health
professionals and practitioners in order to provide technical assistance to communities
after a suicide and to prevent suicide clusters and contagionnew text end .
Sec. 7.
Minnesota Statutes 2014, section 145.56, subdivision 4, is amended to read:
Subd. 4.
Collection and reporting suicide data.
new text begin (a) new text end The commissioner shall
coordinate with federal, regional, local, and other state agencies to collect, analyze, and
annually issue a public report on Minnesota-specific data on suicide and suicidal behaviors.
new text begin
(b) The commissioner, in consultation with stakeholders, shall submit a detailed
plan identifying proposed methods to improve the timeliness, usefulness, and quality of
suicide-related data so that the data can help identify the scope of the suicide problem,
identify high-risk groups, set priority prevention activities, and monitor the effects of
suicide prevention programs. The report shall include how to improve external cause
of injury coding, progress on implementing the Minnesota Violent Death Reporting
System, how to obtain and release data in a timely manner, and how to support the use of
psychological autopsies.
new text end
new text begin
(c) The written report must be provided to the chairs and ranking minority members
of the house of representatives and senate finance and policy divisions and committees
with jurisdiction over health and human services by February 1, 2016.
new text end
Sec. 8.
Minnesota Statutes 2014, section 245.4661, subdivision 5, is amended to read:
Subd. 5.
Planning for pilot projects.
(a) Each local plan for a pilot project, with
the exception of the placement of a Minnesota specialty treatment facility as defined in
paragraph (c), must be developed under the direction of the county board, or multiple
county boards acting jointly, as the local mental health authority. The planning process
for each pilot shall include, but not be limited to, mental health consumers, families,
advocates, local mental health advisory councils, local and state providers, representatives
of state and local public employee bargaining units, and the department of human services.
As part of the planning process, the county board or boards shall designate a managing
entity responsible for receipt of funds and management of the pilot project.
(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
request for proposal for regions in which a need has been identified for services.
(c) For purposes of this section, "Minnesota specialty treatment facility" is defined
as an intensive deleted text begin rehabilitative mental healthdeleted text end new text begin residential treatment new text end service under section
256B.0622, subdivision 2, paragraph (b).
Sec. 9.
Minnesota Statutes 2014, section 245.4661, subdivision 6, is amended to read:
Subd. 6.
Duties of commissioner.
(a) For purposes of the pilot projects, the
commissioner shall facilitate integration of funds or other resources as needed and
requested by each project. These resources may include:
(1) community support services funds administered under Minnesota Rules, parts
9535.1700 to 9535.1760;
(2) other mental health special project funds;
(3) medical assistance, general assistance medical care, MinnesotaCare and group
residential housing if requested by the project's managing entity, and if the commissioner
determines this would be consistent with the state's overall health care reform efforts;new text begin and
new text end
(4) regional treatment center resources consistent with section 246.0136, subdivision
1deleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(5) funds transferred from section 246.18, subdivision 8, for grants to providers to
participate in mental health specialty treatment services, awarded to providers through
a request for proposal process.
deleted text end
(b) The commissioner shall consider the following criteria in awarding start-up and
implementation grants for the pilot projects:
(1) the ability of the proposed projects to accomplish the objectives described in
subdivision 2;
(2) the size of the target population to be served; and
(3) geographical distribution.
(c) The commissioner shall review overall status of the projects initiatives at least
every two years and recommend any legislative changes needed by January 15 of each
odd-numbered year.
(d) The commissioner may waive administrative rule requirements which are
incompatible with the implementation of the pilot project.
(e) The commissioner may exempt the participating counties from fiscal sanctions
for noncompliance with requirements in laws and rules which are incompatible with the
implementation of the pilot project.
(f) The commissioner may award grants to an entity designated by a county board or
group of county boards to pay for start-up and implementation costs of the pilot project.
Sec. 10.
Minnesota Statutes 2014, section 245.4661, is amended by adding a
subdivision to read:
new text begin Subd. 9. new text end
new text begin Services and programs. new text end
new text begin
(a) The following three distinct grant programs
are funded under this section:
new text end
new text begin
(1) mental health crisis services;
new text end
new text begin
(2) housing with supports for adults with serious mental illness; and
new text end
new text begin
(3) projects for assistance in transitioning from homelessness (PATH program).
new text end
new text begin
(b) In addition, the following are eligible for grant funds:
new text end
new text begin
(1) community education and prevention;
new text end
new text begin
(2) client outreach;
new text end
new text begin
(3) early identification and intervention;
new text end
new text begin
(4) adult outpatient diagnostic assessment and psychological testing;
new text end
new text begin
(5) peer support services;
new text end
new text begin
(6) community support program services (CSP);
new text end
new text begin
(7) adult residential crisis stabilization;
new text end
new text begin
(8) supported employment;
new text end
new text begin
(9) assertive community treatment (ACT);
new text end
new text begin
(10) housing subsidies;
new text end
new text begin
(11) basic living, social skills, and community intervention;
new text end
new text begin
(12) emergency response services;
new text end
new text begin
(13) adult outpatient psychotherapy;
new text end
new text begin
(14) adult outpatient medication management;
new text end
new text begin
(15) adult mobile crisis services;
new text end
new text begin
(16) adult day treatment;
new text end
new text begin
(17) partial hospitalization;
new text end
new text begin
(18) adult residential treatment;
new text end
new text begin
(19) adult mental health targeted case management;
new text end
new text begin
(20) intensive community residential services (IRCS); and
new text end
new text begin
(21) transportation.
new text end
Sec. 11.
Minnesota Statutes 2014, section 245.4661, is amended by adding a
subdivision to read:
new text begin Subd. 10. new text end
new text begin Commissioner duty to report on use of grant funds biennially. new text end
new text begin
By
November 1, 2016, and biennially thereafter, the commissioner of human services shall
provide sufficient information to the members of the legislative committees having
jurisdiction over mental health funding and policy issues to evaluate the use of funds
appropriated under this section of law. The commissioner shall provide, at a minimum,
the following information:
new text end
new text begin
(1) the amount of funding to mental health initiatives, what programs and services
were funded in the previous two years, gaps in services that each initiative brought to
the attention of the commissioner, and outcome data for the programs and services that
were funded; and
new text end
new text begin
(2) the amount of funding for other targeted services and the location of services.
new text end
Sec. 12.
Minnesota Statutes 2014, section 245.467, subdivision 6, is amended to read:
Subd. 6.
Restricted access to data.
The county board shall establish procedures
to ensure that the names and addresses of persons receiving mental health services are
disclosed only to:
(1) county employees who are specifically responsible for determining county of
financial responsibility or making payments to providers; deleted text begin and
deleted text end
(2) staff who provide treatment services or case management and their clinical
supervisorsdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) personnel of the welfare system or health care providers who have access to the
data under section 13.46, subdivision 7.
new text end
Release of mental health data on individuals submitted under subdivisions 4 and 5,
to persons other than those specified in this subdivision, or use of this data for purposes
other than those stated in subdivisions 4 and 5, results in civil or criminal liability under
the standards in section 13.08 or 13.09.
Sec. 13.
Minnesota Statutes 2014, section 245.4876, subdivision 7, is amended to read:
Subd. 7.
Restricted access to data.
The county board shall establish procedures
to ensure that the names and addresses of children receiving mental health services and
their families are disclosed only to:
(1) county employees who are specifically responsible for determining county of
financial responsibility or making payments to providers; deleted text begin and
deleted text end
(2) staff who provide treatment services or case management and their clinical
supervisorsdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) personnel of the welfare system or health care providers who have access to the
data under section 13.46, subdivision 7.
new text end
Release of mental health data on individuals submitted under subdivisions 5 and 6,
to persons other than those specified in this subdivision, or use of this data for purposes
other than those stated in subdivisions 5 and 6, results in civil or criminal liability under
section 13.08 or 13.09.
Sec. 14.
Minnesota Statutes 2014, section 245.4889, subdivision 1, is amended to read:
Subdivision 1.
Establishment and authority.
(a) The commissioner is authorized
to make grants from available appropriations to assist:
(1) counties;
(2) Indian tribes;
(3) children's collaboratives under section 124D.23 or 245.493; or
(4) mental health service providers
deleted text begin for providing services to children with emotional disturbances as defined in section
245.4871, subdivision 15, and their families. The commissioner may also authorize
grants to young adults meeting the criteria for transition services in section 245.4875,
subdivision 8, and their familiesdeleted text end .
(b) new text begin The following services are eligible for grants under this section:
new text end
new text begin
(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;
new text end
new text begin
(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;
new text end
new text begin
(3) respite care services for children with severe emotional disturbances who are at
risk of out-of-home placement;
new text end
new text begin
(4) children's mental health crisis services;
new text end
new text begin
(5) mental health services for people from cultural and ethnic minorities;
new text end
new text begin
(6) children's mental health screening and follow-up diagnostic assessment and
treatment;
new text end
new text begin
(7) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;
new text end
new text begin
(8) school-linked mental health services;
new text end
new text begin
(9) building evidence-based mental health intervention capacity for children birth to
age five;
new text end
new text begin
(10) suicide prevention and counseling services that use text messaging statewide;
new text end
new text begin
(11) mental health first aid training;
new text end
new text begin
(12) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
Web site to share information and strategies to promote resilience and prevent trauma;
new text end
new text begin
(13) transition age services to develop or expand mental health treatment and
supports for adolescents and young adults 26 years of age or younger;
new text end
new text begin
(14) early childhood mental health consultation;
new text end
new text begin
(15) evidence-based interventions for youth at risk of developing or experiencing a
first episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis; and
new text end
new text begin
(16) psychiatric consultation for primary care practitioners.
new text end
new text begin (c) new text end Services under paragraph deleted text begin (a)deleted text end new text begin (b) new text end must be designed to help each child to function
and remain with the child's family in the community and delivered consistent with the
child's treatment plan. Transition services to eligible young adults under paragraph deleted text begin (a)deleted text end new text begin (b)
new text end must be designed to foster independent living in the community.
Sec. 15.
Minnesota Statutes 2014, section 245.4889, is amended by adding a
subdivision to read:
new text begin Subd. 3. new text end
new text begin Commissioner duty to report on use of grant funds biennially. new text end
new text begin
By
November 1, 2016, and biennially thereafter, the commissioner of human services shall
provide sufficient information to the members of the legislative committees having
jurisdiction over mental health funding and policy issues to evaluate the use of funds
appropriated under this section. The commissioner shall provide, at a minimum, the
following information:
new text end
new text begin
(1) the amount of funding for children's mental health grants, what programs and
services were funded in the previous two years, and outcome data for the programs and
services that were funded; and
new text end
new text begin
(2) the amount of funding for other targeted services and the location of services.
new text end
Sec. 16.
new text begin
[245.735] EXCELLENCE IN MENTAL HEALTH DEMONSTRATION
PROJECT.
new text end
new text begin Subdivision 1. new text end
new text begin Excellence in Mental Health demonstration project. new text end
new text begin
The
commissioner shall develop and execute projects to reform the mental health system by
participating in the Excellence in Mental Health demonstration project.
new text end
new text begin Subd. 2. new text end
new text begin Federal proposal. new text end
new text begin
The commissioner shall develop and submit to the
United States Department of Health and Human Services a proposal for the Excellence
in Mental Health demonstration project. The proposal shall include any necessary state
plan amendments, waivers, requests for new funding, realignment of existing funding, and
other authority necessary to implement the projects specified in subdivision 3.
new text end
new text begin Subd. 3. new text end
new text begin Reform projects. new text end
new text begin
(a) The commissioner shall establish standards for state
certification of clinics as certified community behavioral health clinics, in accordance with
the criteria published on or before September 1, 2015, by the United States Department
of Health and Human Services. Certification standards established by the commissioner
shall require that:
new text end
new text begin
(1) clinic staff have backgrounds in diverse disciplines, include licensed mental
health professionals, and are culturally and linguistically trained to serve the needs of the
clinic's patient population;
new text end
new text begin
(2) clinic services are available and accessible and that crisis management services
are available 24 hours per day;
new text end
new text begin
(3) fees for clinic services are established using a sliding fee scale and services to
patients are not denied or limited due to a patient's inability to pay for services;
new text end
new text begin
(4) clinics provide coordination of care across settings and providers to ensure
seamless transitions for patients across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with federally qualified health centers, inpatient
psychiatric facilities, substance use and detoxification facilities, community-based mental
health providers, and other community services, supports, and providers including
schools, child welfare agencies, juvenile and criminal justice agencies, Indian Health
Services clinics, tribally licensed health care and mental health facilities, urban Indian
health clinics, Department of Veterans Affairs medical centers, outpatient clinics, drop-in
centers, acute care hospitals, and hospital outpatient clinics;
new text end
new text begin
(5) services provided by clinics include crisis mental health services, emergency
crisis intervention services, and stabilization services; screening, assessment, and diagnosis
services, including risk assessments and level of care determinations; patient-centered
treatment planning; outpatient mental health and substance use services; targeted case
management; psychiatric rehabilitation services; peer support and counselor services and
family support services; and intensive community-based mental health services, including
mental health services for members of the armed forces and veterans; and
new text end
new text begin
(6) clinics comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data.
new text end
new text begin
(b) The commissioner shall establish standards and methodologies for a prospective
payment system for medical assistance payments for mental health services delivered by
certified community behavioral health clinics, in accordance with guidance issued on or
before September 1, 2015, by the Centers for Medicare and Medicaid Services. During the
operation of the demonstration project, payments shall comply with federal requirements
for a 90 percent enhanced federal medical assistance percentage.
new text end
new text begin Subd. 4. new text end
new text begin Public participation. new text end
new text begin
In developing the projects under subdivision 3, the
commissioner shall consult with mental health providers, advocacy organizations, licensed
mental health professionals, and Minnesota public health care program enrollees who
receive mental health services and their families.
new text end
new text begin Subd. 5. new text end
new text begin Information systems support. new text end
new text begin
The commissioner and the state chief
information officer shall provide information systems support to the projects as necessary
to comply with federal requirements.
new text end
Sec. 17.
Minnesota Statutes 2014, section 246.18, subdivision 8, is amended to read:
Subd. 8.
State-operated services account.
(a) The state-operated services account is
established in the special revenue fund. Revenue generated by new state-operated services
listed under this section established after July 1, 2010, that are not enterprise activities must
be deposited into the state-operated services account, unless otherwise specified in law:
(1) intensive residential treatment services;
(2) foster care services; and
(3) psychiatric extensive recovery treatment services.
(b) Funds deposited in the state-operated services account are deleted text begin available deleted text end new text begin appropriated
new text end to the commissioner of human services for the purposes of:
(1) providing services needed to transition individuals from institutional settings
within state-operated services to the community when those services have no other
adequate funding source;new text begin and
new text end
(2) deleted text begin grants to providers participating in mental health specialty treatment services
under section 245.4661; and
deleted text end
deleted text begin (3)deleted text end to fund the operation of the intensive residential treatment service program in
Willmar.
Sec. 18.
Minnesota Statutes 2014, section 253B.18, subdivision 4c, is amended to read:
Subd. 4c.
Special review board.
(a) The commissioner shall establish one or more
panels of a special review board. The board shall consist of three members experienced
in the field of mental illness. One member of each special review board panel shall be a
psychiatrist or a doctoral level psychologist with forensic experience and one member
shall be an attorney. No member shall be affiliated with the Department of Human
Services. The special review board shall meet at least every six months and at the call of
the commissioner. It shall hear and consider all petitions for a reduction in custody or to
appeal a revocation of provisional discharge. A "reduction in custody" means transfer
from a secure treatment facility, discharge, and provisional discharge. Patients may be
transferred by the commissioner between secure treatment facilities without a special
review board hearing.
Members of the special review board shall receive compensation and reimbursement
for expenses as established by the commissioner.
(b) new text begin The special review board must review each denied petition under subdivision
5 for barriers and obstacles preventing the patient from progressing in treatment. Based
on the cases before the board in the previous year, the special review board shall provide
to the commissioner an annual summation of the barriers to treatment progress, and
recommendations to achieve the common goal of making progress in treatment.
new text end
new text begin (c) new text end A petition filed by a person committed as mentally ill and dangerous to the
public under this section must be heard as provided in subdivision 5 and, as applicable,
subdivision 13. A petition filed by a person committed as a sexual psychopathic personality
or as a sexually dangerous person under chapter 253D, or committed as both mentally ill
and dangerous to the public under this section and as a sexual psychopathic personality or
as a sexually dangerous person must be heard as provided in section 253D.27.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 19.
Minnesota Statutes 2014, section 253B.18, subdivision 5, is amended to read:
Subd. 5.
Petition; notice of hearing; attendance; order.
(a) A petition for
a reduction in custody or revocation of provisional discharge shall be filed with the
commissioner and may be filed by the patient or by the head of the treatment facility. A
patient may not petition the special review board for six months following commitment
under subdivision 3 or following the final disposition of any previous petition and
subsequent appeal by the patient. new text begin The head of the treatment facility must schedule a
hearing before the special review board for any patient who has not appeared before the
special review board in the previous three years, and schedule a hearing at least every
three years thereafter. new text end The medical director may petition at any time.
(b) Fourteen days prior to the hearing, the committing court, the county attorney of
the county of commitment, the designated agency, interested person, the petitioner, and
the petitioner's counsel shall be given written notice by the commissioner of the time and
place of the hearing before the special review board. Only those entitled to statutory notice
of the hearing or those administratively required to attend may be present at the hearing.
The patient may designate interested persons to receive notice by providing the names
and addresses to the commissioner at least 21 days before the hearing. The board shall
provide the commissioner with written findings of fact and recommendations within 21
days of the hearing. The commissioner shall issue an order no later than 14 days after
receiving the recommendation of the special review board. A copy of the order shall be
mailed to every person entitled to statutory notice of the hearing within five days after it
is signed. No order by the commissioner shall be effective sooner than 30 days after the
order is signed, unless the county attorney, the patient, and the commissioner agree that
it may become effective sooner.
(c) The special review board shall hold a hearing on each petition prior to making
its recommendation to the commissioner. The special review board proceedings are not
contested cases as defined in chapter 14. Any person or agency receiving notice that
submits documentary evidence to the special review board prior to the hearing shall also
provide copies to the patient, the patient's counsel, the county attorney of the county of
commitment, the case manager, and the commissioner.
(d) Prior to the final decision by the commissioner, the special review board may be
reconvened to consider events or circumstances that occurred subsequent to the hearing.
(e) In making their recommendations and order, the special review board and
commissioner must consider any statements received from victims under subdivision 5a.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016, with hearings
starting no later than February 1, 2016.
new text end
Sec. 20.
Minnesota Statutes 2014, section 254B.05, subdivision 5, as amended by
Laws 2015, chapter 21, article 1, section 52, is amended to read:
Subd. 5.
Rate requirements.
(a) The commissioner shall establish rates for
chemical dependency services and service enhancements funded under this chapter.
(b) Eligible chemical dependency treatment services include:
(1) outpatient treatment services that are licensed according to Minnesota Rules,
parts 9530.6405 to 9530.6480, or applicable tribal license;
(2) medication-assisted therapy services that are licensed according to Minnesota
Rules, parts 9530.6405 to 9530.6480 and 9530.6500, or applicable tribal license;
(3) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (2) and provide nine hours of clinical services each week;
(4) high, medium, and low intensity residential treatment services that are licensed
according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, or applicable
tribal license which provide, respectively, 30, 15, and five hours of clinical services each
week;
(5) hospital-based treatment services that are licensed according to Minnesota Rules,
parts 9530.6405 to 9530.6480, or applicable tribal license and licensed as a hospital under
sections 144.50 to 144.56;
(6) adolescent treatment programs that are licensed as outpatient treatment programs
according to Minnesota Rules, parts 9530.6405 to 9530.6485, or as residential treatment
programs according to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to
2960.0490, or applicable tribal license; deleted text begin and
deleted text end
(7) new text begin high-intensity residential treatment services that are licensed according to
Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, or applicable tribal
license, which provide 30 hours of clinical services each week provided by a state-operated
vendor or to clients who have been civilly committed to the commissioner, present the
most complex and difficult care needs, and are a potential threat to the community; and
new text end
new text begin (8) new text end room and board facilities that meet the requirements of subdivision 1a.
(c) The commissioner shall establish higher rates for programs that meet the
requirements of paragraph (b) and the following additional requirements:
(1) programs that serve parents with their children if the program:
(i) provides on-site child care during hours of treatment activity that meets the
requirements in Minnesota Rules, part 9530.6490, or section 245A.03, subdivision 2; or
(ii) arranges for off-site child care during hours of treatment activity at a facility that
is licensed under chapter 245A as:
(A) a child care center under Minnesota Rules, chapter 9503; or
(B) a family child care home under Minnesota Rules, chapter 9502;
(2) culturally specific programs as defined in section 254B.01, subdivision 4a, if the
program meets the requirements in Minnesota Rules, part 9530.6605, subpart 13;
(3) programs that offer medical services delivered by appropriately credentialed
health care staff in an amount equal to two hours per client per week if the medical
needs of the client and the nature and provision of any medical services provided are
documented in the client file; and
(4) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:
(i) the program meets the co-occurring requirements in Minnesota Rules, part
9530.6495;
(ii) 25 percent of the counseling staff are licensed mental health professionals, as
defined in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing
candidates under the supervision of a licensed alcohol and drug counselor supervisor and
licensed mental health professional, except that no more than 50 percent of the mental
health staff may be students or licensing candidates with time documented to be directly
related to provisions of co-occurring services;
(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;
(iv) the program has standards for multidisciplinary case review that include a
monthly review for each client that, at a minimum, includes a licensed mental health
professional and licensed alcohol and drug counselor, and their involvement in the review
is documented;
(v) family education is offered that addresses mental health and substance abuse
disorders and the interaction between the two; and
(vi) co-occurring counseling staff will receive eight hours of co-occurring disorder
training annually.
(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause
(1), must be deemed in compliance with the licensing requirements in Minnesota Rules,
part 9530.6490.
(e) Adolescent residential programs that meet the requirements of Minnesota
Rules, parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the
requirements in paragraph (c), clause (4), items (i) to (iv).
Sec. 21.
Minnesota Statutes 2014, section 254B.12, subdivision 2, is amended to read:
Subd. 2.
Payment methodology for highly specialized vendors.
deleted text begin (a)
deleted text end Notwithstanding subdivision 1, the commissioner shall seek federal authority to develop
separate payment methodologies for chemical dependency treatment services provided
under the consolidated chemical dependency treatment fund: (1) by a state-operated
vendor; or (2) for persons who have been civilly committed to the commissioner, present
the most complex and difficult care needs, and are a potential threat to the community. A
payment methodology under this subdivision is effective for services provided on or after
October 1, 2015, or on or after the receipt of federal approval, whichever is later.
deleted text begin
(b) Before implementing an approved payment methodology under paragraph
(a), the commissioner must also receive any necessary legislative approval of required
changes to state law or funding.
deleted text end
Sec. 22.
Minnesota Statutes 2014, section 256B.0615, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
Peer support services may be made available to consumers
of (1) intensive deleted text begin rehabilitative mental healthdeleted text end new text begin residential treatment new text end services under section
256B.0622; (2) adult rehabilitative mental health services under section 256B.0623; and
(3) crisis stabilization and mental health mobile crisis intervention services under section
256B.0624.
Sec. 23.
Minnesota Statutes 2014, section 256B.0622, subdivision 1, is amended to read:
Subdivision 1.
Scope.
Subject to federal approval, medical assistance covers
medically necessary, deleted text begin intensive nonresidentialdeleted text end new text begin assertive community treatmentnew text end and new text begin intensive
new text end residential deleted text begin rehabilitative mental healthdeleted text end new text begin treatmentnew text end services as defined in subdivision 2, for
recipients as defined in subdivision 3, when the services are provided by an entity meeting
the standards in this section.
Sec. 24.
Minnesota Statutes 2014, section 256B.0622, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the
meanings given them.
(a) deleted text begin "Intensive nonresidential rehabilitative mental health services" means adult
rehabilitative mental health services as defined in section 256B.0623, subdivision 2,
paragraph (a), except that these services are provided by a multidisciplinary staff using
a total team approach consistent with assertive community treatment, the Fairweather
Lodge treatment model, as defined by the standards established by the National Coalition
for Community Living, and other evidence-based practices, and directed to recipients with
a serious mental illness who require intensive services.deleted text end new text begin "Assertive community treatment"
means intensive nonresidential rehabilitative mental health services provided according
to the evidence-based practice of assertive community treatment. Core elements of this
service include, but are not limited to:
new text end
new text begin
(1) a multidisciplinary staff who utilize a total team approach and who serve as a
fixed point of responsibility for all service delivery;
new text end
new text begin
(2) providing services 24 hours per day and 7 days per week;
new text end
new text begin
(3) providing the majority of services in a community setting;
new text end
new text begin
(4) offering a low ratio of recipients to staff; and
new text end
new text begin
(5) providing service that is not time-limited.
new text end
(b) "Intensive residential deleted text begin rehabilitative mental healthdeleted text end new text begin treatmentnew text end services" means
short-term, time-limited services provided in a residential setting to recipients who are
in need of more restrictive settings and are at risk of significant functional deterioration
if they do not receive these services. Services are designed to develop and enhance
psychiatric stability, personal and emotional adjustment, self-sufficiency, and skills to live
in a more independent setting. Services must be directed toward a targeted discharge
date with specified client outcomes deleted text begin and must be consistent with the Fairweather Lodge
treatment model as defined in paragraph (a), and other evidence-based practicesdeleted text end .
(c) "Evidence-based practices" are nationally recognized mental health services that
are proven by substantial research to be effective in helping individuals with serious
mental illness obtain specific treatment goals.
(d) "Overnight staff" means a member of the intensive residential rehabilitative
mental health treatment team who is responsible during hours when recipients are
typically asleep.
(e) "Treatment team" means all staff who provide services under this section to
recipients. At a minimum, this includes the clinical supervisor, mental health professionals
as defined in section 245.462, subdivision 18, clauses (1) to (6); mental health practitioners
as defined in section 245.462, subdivision 17; mental health rehabilitation workers under
section 256B.0623, subdivision 5, clause (3); and certified peer specialists under section
256B.0615.
Sec. 25.
Minnesota Statutes 2014, section 256B.0622, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
An eligible recipient is an individual who:
(1) is age 18 or older;
(2) is eligible for medical assistance;
(3) is diagnosed with a mental illness;
(4) because of a mental illness, has substantial disability and functional impairment
in three or more of the areas listed in section 245.462, subdivision 11a, so that
self-sufficiency is markedly reduced;
(5) has one or more of the following: a history of deleted text begin two or moredeleted text end new text begin recurring or prolonged
new text end inpatient hospitalizations in the past year, significant independent living instability,
homelessness, or very frequent use of mental health and related services yielding poor
outcomes; and
(6) in the written opinion of a licensed mental health professional, has the need for
mental health services that cannot be met with other available community-based services,
or is likely to experience a mental health crisis or require a more restrictive setting if
intensive rehabilitative mental health services are not provided.
Sec. 26.
Minnesota Statutes 2014, section 256B.0622, subdivision 4, is amended to read:
Subd. 4.
Provider certification and contract requirements.
(a) The deleted text begin intensive
nonresidential rehabilitative mental health servicesdeleted text end new text begin assertive community treatment
new text end provider must:
(1) have a contract with the host county to provide intensive adult rehabilitative
mental health services; and
(2) be certified by the commissioner as being in compliance with this section and
section 256B.0623.
(b) The intensive residential deleted text begin rehabilitative mental healthdeleted text end new text begin treatmentnew text end services provider
must:
(1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;
(2) not exceed 16 beds per site;
(3) comply with the additional standards in this section; and
(4) have a contract with the host county to provide these services.
(c) The commissioner shall develop procedures for counties and providers to submit
contracts and other documentation as needed to allow the commissioner to determine
whether the standards in this section are met.
Sec. 27.
Minnesota Statutes 2014, section 256B.0622, subdivision 5, is amended to read:
Subd. 5.
Standards applicable to both deleted text begin nonresidentialdeleted text end new text begin assertive community
treatmentnew text end and residential providers.
(a) Services must be provided by qualified staff as
defined in section 256B.0623, subdivision 5, who are trained and supervised according to
section 256B.0623, subdivision 6, except that mental health rehabilitation workers acting
as overnight staff are not required to comply with section 256B.0623, subdivision 5,
clause deleted text begin (3)deleted text end new text begin (4), item new text end (iv).
(b) The clinical supervisor must be an active member of the treatment team. The
treatment team must meet with the clinical supervisor at least weekly to discuss recipients'
progress and make rapid adjustments to meet recipients' needs. The team meeting shall
include recipient-specific case reviews and general treatment discussions among team
members. Recipient-specific case reviews and planning must be documented in the
individual recipient's treatment record.
(c) Treatment staff must have prompt access in person or by telephone to a mental
health practitioner or mental health professional. The provider must have the capacity to
promptly and appropriately respond to emergent needs and make any necessary staffing
adjustments to assure the health and safety of recipients.
(d) The initial functional assessment must be completed within ten days of intake
and updated at least every deleted text begin three monthsdeleted text end new text begin 30 days for intensive residential treatment services
and every six months for assertive community treatment,new text end or prior to discharge from the
service, whichever comes first.
(e) The initial individual treatment plan must be completed within ten days of intake
deleted text begin anddeleted text end new text begin for assertive community treatment and within 24 hours of admission for intensive
residential treatment services. Within ten days of admission, the initial treatment plan
must be refined and further developed for intensive residential treatment services, except
for providers certified according to Minnesota Rules, parts 9533.0010 to 9533.0180.
The individual treatment plan must be new text end reviewednew text begin with the recipientnew text end and updated at least
monthly deleted text begin with the recipientdeleted text end new text begin for intensive residential treatment services and at least every
six months for assertive community treatmentnew text end .
Sec. 28.
Minnesota Statutes 2014, section 256B.0622, subdivision 7, is amended to read:
Subd. 7.
Additional standards for deleted text begin nonresidential servicesdeleted text end new text begin assertive community
treatmentnew text end .
The standards in this subdivision apply to deleted text begin intensive nonresidential
rehabilitative mental healthdeleted text end new text begin assertive community treatmentnew text end services.
(1) The treatment team must use team treatment, not an individual treatment model.
(2) The clinical supervisor must function as a practicing clinician at least on a
part-time basis.
(3) The staffing ratio must not exceed ten recipients to one full-time equivalent
treatment team position.
(4) Services must be available at times that meet client needs.
(5) The treatment team must actively and assertively engage and reach out to the
recipient's family members and significant others, after obtaining the recipient's permission.
(6) The treatment team must establish ongoing communication and collaboration
between the team, family, and significant others and educate the family and significant
others about mental illness, symptom management, and the family's role in treatment.
(7) The treatment team must provide interventions to promote positive interpersonal
relationships.
Sec. 29.
Minnesota Statutes 2014, section 256B.0622, subdivision 8, is amended to read:
Subd. 8.
Medical assistance payment for intensive rehabilitative mental health
services.
(a) Payment for new text begin intensive new text end residential deleted text begin and nonresidentialdeleted text end new text begin treatmentnew text end services
new text begin and assertive community treatment new text end in this section shall be based on one daily rate per
provider inclusive of the following services received by an eligible recipient in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.
(b) Except as indicated in paragraph (c), payment will not be made to more than one
entity for each recipient for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.
(c) The commissioner shall determine one rate for each provider that will bill
medical assistance for residential services under this section and one rate for each
deleted text begin nonresidentialdeleted text end new text begin assertive community treatmentnew text end provider. If a single entity provides both
services, one rate is established for the entity's residential services and another rate for the
entity's nonresidential services under this section. A provider is not eligible for payment
under this section without authorization from the commissioner. The commissioner shall
develop rates using the following criteria:
deleted text begin
(1) the cost for similar services in the local trade area;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end the provider's cost for services shall include direct services costs, other
program costs, and other costs determined as follows:
(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;
(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that
provide similar services;
(iii) deleted text begin in situations where a provider of intensive residential services can demonstrate
actual program-related physical plant costs in excess of the group residential housing
reimbursement, the commissioner may include these costs in the program rate, so long
as the additional reimbursement does not subsidize the room and board expenses of the
programdeleted text end new text begin physical plant costs calculated based on the percentage of space within the
program that is entirely devoted to treatment and programming. This does not include
administrative or residential spacenew text end ;
(iv) deleted text begin intensive nonresidential servicesdeleted text end new text begin assertive community treatmentnew text end physical plant
costs must be reimbursed as part of the costs described in item (ii); and
(v) new text begin subject to federal approval, new text end up to an additional five percent of the total rate deleted text begin must
deleted text end new text begin maynew text end be added to the program rate as a quality incentive based upon the entity meeting
performance criteria specified by the commissioner;
deleted text begin (3)deleted text end new text begin (2)new text end actual cost is defined as costs which are allowable, allocable, and reasonable,
and consistent with federal reimbursement requirements under Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and Office of
Management and Budget Circular Number A-122, relating to nonprofit entities;
deleted text begin (4)deleted text end new text begin (3)new text end the number of service units;
deleted text begin (5)deleted text end new text begin (4)new text end the degree to which recipients will receive services other than services under
this section;new text begin and
new text end
deleted text begin (6)deleted text end new text begin (5)new text end the costs of other services that will be separately reimburseddeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(7) input from the local planning process authorized by the adult mental health
initiative under section 245.4661, regarding recipients' service needs.
deleted text end
(d) The rate for intensive deleted text begin rehabilitative mental healthdeleted text end new text begin residential treatmentnew text end services
new text begin and assertive community treatmentnew text end must exclude room and board, as defined in section
256I.03, subdivision 6, and services not covered under this section, such as partial
hospitalization, home care, and inpatient services.
new text begin (e) new text end Physician services that are not separately billed may be included in the rate to the
extent that a psychiatristnew text begin , or other health care professional providing physician services
within their scope of practice, new text end is a member of the treatment team.new text begin Physician services,
whether billed separately or included in the rate, may be delivered by telemedicine. For
purposes of this paragraph, "telemedicine" has the meaning given to "mental health
telemedicine" in section 256B.0625, subdivision 46, when telemedicine is used to provide
intensive residential treatment services.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end When services under this section are provided by an deleted text begin intensive nonresidential
servicedeleted text end new text begin assertive community treatment new text end provider, case management functions must be an
integral part of the team.
deleted text begin (f)deleted text end new text begin (g)new text end The rate for a provider must not exceed the rate charged by that provider for
the same service to other payors.
deleted text begin (g)deleted text end new text begin (h)new text end The rates for existing programs must be established prospectively based upon
the expenditures and utilization over a prior 12-month period using the criteria established
in paragraph (c).new text begin The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (c).
new text end
deleted text begin (h)deleted text end new text begin (i)new text end Entities who discontinue providing services must be subject to a settle-up
process whereby actual costs and reimbursement for the previous 12 months are
compared. In the event that the entity was paid more than the entity's actual costs plus
any applicable performance-related funding due the provider, the excess payment must
be reimbursed to the department. If a provider's revenue is less than actual allowed costs
due to lower utilization than projected, the commissioner may reimburse the provider to
recover its actual allowable costs. The resulting adjustments by the commissioner must
be proportional to the percent of total units of service reimbursed by the commissioner
new text begin and must reflect a difference of greater than five percentnew text end .
deleted text begin (i)deleted text end new text begin (j)new text end A provider may request of the commissioner a review of any rate-setting
decision made under this subdivision.
Sec. 30.
Minnesota Statutes 2014, section 256B.0622, subdivision 9, is amended to read:
Subd. 9.
Provider enrollment; rate setting for county-operated entities.
Counties
that employ their own staff to provide services under this section shall apply directly to
the commissioner for enrollment and rate setting. In this case, a county contract is not
required deleted text begin and the commissioner shall perform the program review and rate setting duties
which would otherwise be required of counties under this sectiondeleted text end .
Sec. 31.
Minnesota Statutes 2014, section 256B.0622, subdivision 10, is amended to
read:
Subd. 10.
Provider enrollment; rate setting for specialized program.
A new text begin county
contract is not required for a new text end provider proposing to serve a subpopulation of eligible
recipients deleted text begin may bypass the county approval procedures in this section and receive approval
for provider enrollment and rate setting directly from the commissionerdeleted text end under the
following circumstances:
(1) the provider demonstrates that the subpopulation to be served requires a
specialized program which is not available from county-approved entities; and
(2) the subpopulation to be served is of such a low incidence that it is not feasible to
develop a program serving a single county or regional group of counties.
deleted text begin
For providers meeting the criteria in clauses (1) and (2), the commissioner shall
perform the program review and rate setting duties which would otherwise be required of
counties under this section.
deleted text end
Sec. 32.
Minnesota Statutes 2014, section 256B.0622, is amended by adding a
subdivision to read:
new text begin Subd. 11. new text end
new text begin Sustainability grants. new text end
new text begin
The commissioner may disburse grant funds
directly to intensive residential treatment services providers and assertive community
treatment providers to maintain access to these services.
new text end
Sec. 33.
Minnesota Statutes 2014, section 256B.0624, subdivision 7, is amended to read:
Subd. 7.
Crisis stabilization services.
(a) Crisis stabilization services must be
provided by qualified staff of a crisis stabilization services provider entity and must meet
the following standards:
(1) a crisis stabilization treatment plan must be developed which meets the criteria
in subdivision 11;
(2) staff must be qualified as defined in subdivision 8; and
(3) services must be delivered according to the treatment plan and include
face-to-face contact with the recipient by qualified staff for further assessment, help with
referrals, updating of the crisis stabilization treatment plan, supportive counseling, skills
training, and collaboration with other service providers in the community.
(b) If crisis stabilization services are provided in a supervised, licensed residential
setting, the recipient must be contacted face-to-face daily by a qualified mental health
practitioner or mental health professional. The program must have 24-hour-a-day
residential staffing which may include staff who do not meet the qualifications in
subdivision 8. The residential staff must have 24-hour-a-day immediate direct or telephone
access to a qualified mental health professional or practitioner.
(c) If crisis stabilization services are provided in a supervised, licensed residential
setting that serves no more than four adult residents, and deleted text begin no more than two are recipients
of crisis stabilization servicesdeleted text end new text begin one or more individuals are present at the setting to receive
residential crisis stabilization servicesnew text end , the residential staff must include, for at least eight
hours per day, at least one individual who meets the qualifications in subdivision 8new text begin ,
paragraph (a), clause (1) or (2)new text end .
(d) If crisis stabilization services are provided in a supervised, licensed residential
setting that serves more than four adult residents, and one or more are recipients of crisis
stabilization services, the residential staff must include, for 24 hours a day, at least one
individual who meets the qualifications in subdivision 8. During the first 48 hours that a
recipient is in the residential program, the residential program must have at least two staff
working 24 hours a day. Staffing levels may be adjusted thereafter according to the needs
of the recipient as specified in the crisis stabilization treatment plan.
Sec. 34.
Minnesota Statutes 2014, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 45a. new text end
new text begin
Psychiatric residential treatment facility services for persons under
21 years of age.
new text end
new text begin
(a) Medical assistance covers psychiatric residential treatment facility
services for persons under 21 years of age. Individuals who reach age 21 at the time they
are receiving services are eligible to continue receiving services until they no longer
require services or until they reach age 22, whichever occurs first.
new text end
new text begin
(b) For purposes of this subdivision, "psychiatric residential treatment facility"
means a facility other than a hospital that provides psychiatric services, as described in
Code of Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under
age 21 in an inpatient setting.
new text end
new text begin
(c) The commissioner shall develop admissions and discharge procedures and
establish rates consistent with guidelines from the federal Centers for Medicare and
Medicaid Services.
new text end
new text begin
(d) The commissioner shall enroll up to 150 certified psychiatric residential
treatment facility services beds at up to six sites. The commissioner shall select psychiatric
residential treatment facility services providers through a request for proposals process.
Providers of state-operated services may respond to the request for proposals.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2017, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end
Sec. 35.
Minnesota Statutes 2014, section 256B.0625, subdivision 48, is amended to
read:
Subd. 48.
Psychiatric consultation to primary care practitioners.
Medical
assistance covers consultation provided by a psychiatrist, a psychologist, deleted text begin ordeleted text end an advanced
practice registered nurse certified in psychiatric mental healthnew text begin , a licensed independent
clinical social worker, as defined in section 245.462, subdivision 18, clause (2), or a
licensed marriage and family therapist, as defined in section 245.462, subdivision 18,
clause (5),new text end via telephone, e-mail, facsimile, or other means of communication to primary
care practitioners, including pediatricians. The need for consultation and the receipt of the
consultation must be documented in the patient record maintained by the primary care
practitioner. If the patient consents, and subject to federal limitations and data privacy
provisions, the consultation may be provided without the patient present.
Sec. 36.
new text begin
[256B.7631] CHEMICAL DEPENDENCY PROVIDER RATE
INCREASE.
new text end
new text begin
For the chemical dependency services listed in section 254B.05, subdivision 5, and
provided on or after July 1, 2015, payment rates shall be increased by two percent over
the rates in effect on January 1, 2014, for vendors who meet the requirements of section
254B.05.
new text end
Sec. 37. new text begin CLUBHOUSE PROGRAM SERVICES.
new text end
new text begin
The commissioner of human services, in consultation with stakeholders, shall
develop service standards and a payment methodology for Clubhouse program services
to be covered under medical assistance when provided by a Clubhouse International
accredited provider or a provider meeting equivalent standards. The commissioner shall
seek federal approval for the service standards and payment methodology. Upon federal
approval, the commissioner must seek and obtain legislative approval of the services
standards and funding methodology allowing medical assistance coverage of the service.
new text end
Sec. 38. new text begin EXCELLENCE IN MENTAL HEALTH DEMONSTRATION PROJECT.
new text end
new text begin
By January 15, 2016, the commissioner of human services shall report to the
legislative committees in the house of representatives and senate with jurisdiction over
human services issues on the progress of the Excellence in Mental Health demonstration
project under Minnesota Statutes, section 245.735. The commissioner shall include in
the report any recommendations for legislative changes needed to implement the reform
projects specified in Minnesota Statutes, section 245.735, subdivision 3.
new text end
Sec. 39. new text begin RATE-SETTING METHODOLOGY FOR COMMUNITY-BASED
MENTAL HEALTH SERVICES.
new text end
new text begin
The commissioner of human services shall conduct a comprehensive analysis
of the current rate-setting methodology for all community-based mental health
services for children and adults. The report shall include an assessment of alternative
payment structures, consistent with the intent and direction of the federal Centers for
Medicare and Medicaid Services, that could provide adequate reimbursement to sustain
community-based mental health services regardless of geographic location. The report
shall also include recommendations for establishing pay-for-performance measures for
providers delivering services consistent with evidence-based practices. In developing the
report, the commissioner shall consult with stakeholders and with outside experts in
Medicaid financing. The commissioner shall provide a report on the analysis to the chairs
of the legislative committees with jurisdiction over health and human services finance
by January 1, 2017.
new text end
Sec. 40. new text begin REPORT ON HUMAN SERVICES DATA SHARING TO
COORDINATE SERVICES AND CARE OF A PATIENT.
new text end
new text begin
The commissioner of human services, in coordination with Hennepin County, shall
report to the legislative committees with jurisdiction over health care financing on the
fiscal impact, including the estimated savings, resulting from the modifications to the Data
Practices Act in the 2015 legislative session, permitting the sharing of public welfare data
and allowing the exchange of health records between providers to the extent necessary to
coordinate services and care for clients enrolled in public health care programs. Counties
shall provide information on the fiscal impact, including the estimated savings, resulting
from the modifications to the Data Practices Act in the 2015 legislative session, the
number of clients receiving care coordination, and improved outcomes achieved due
to data sharing, to the commissioner of human services to include in the report. The
commissioner may establish the form in which the information must be provided. The
report is due January 1, 2017.
new text end
Sec. 41. new text begin COMPREHENSIVE MENTAL HEALTH PROGRAM IN BELTRAMI
COUNTY.
new text end
new text begin
(a) The commissioner of human services shall award a grant to Beltrami County
to fund the planning and development of a comprehensive mental health program
contingent upon Beltrami County providing to the commissioner of human services a
formal commitment and plan to fund, operate, and sustain the program and services after
the onetime state grant is expended. The county must provide evidence of the funding
stream or mechanism, and a sufficient local funding commitment, that will ensure that
the onetime state investment in the program will result in a sustainable program without
future state grants. The funding stream may include state funding for programs and
services for which the individuals served under this section may be eligible. The grant
under this section cannot be used for any purpose that could be funded with state bond
proceeds. This is a onetime appropriation.
new text end
new text begin
(b) The planning and development of the program by the county must include an
integrated care model for the provision of mental health and substance use disorder
treatment for the individuals served under paragraph (c), in collaboration with existing
services. The model may include mobile crisis services, crisis residential services,
outpatient services, and community-based services. The model must be patient-centered,
culturally competent, and based on evidence-based practices.
new text end
new text begin
(c) The comprehensive mental health program will serve individuals who are:
new text end
new text begin
(1) under arrest or subject to arrest who are experiencing a mental health crisis;
new text end
new text begin
(2) under a transport hold under Minnesota Statutes, section 253B.05, subdivision
2; or
new text end
new text begin
(3) in immediate need of mental health crisis services.
new text end
new text begin
(d) The commissioner of human services may encourage the commissioners of
the Minnesota Housing Finance Agency, corrections, and health to provide technical
assistance and support in the planning and development of the mental health program
under paragraph (a). The commissioners of the Minnesota Housing Finance Agency and
human services may explore a plan to develop short-term and long-term housing for
individuals served by the program, and the possibility of using existing appropriations
available in the housing finance budget for low-income housing or homelessness.
new text end
new text begin
(e) The commissioner of human services, in consultation with Beltrami County,
shall report to the senate and house of representatives committees having jurisdiction over
mental health issues the status of the planning and development of the mental health
program, and the plan to financially support the program and services after the state grant
is expended, by November 1, 2017.
new text end
Sec. 42. new text begin MENTAL HEALTH CRISIS SERVICES.
new text end
new text begin
The commissioner of human services shall increase access to mental health crisis
services for children and adults. In order to increase access, the commissioner must:
new text end
new text begin
(1) develop a central phone number where calls can be routed to the appropriate
crisis services;
new text end
new text begin
(2) provide telephone consultation 24 hours a day to mobile crisis teams who are
serving people with traumatic brain injury or intellectual disabilities who are experiencing
a mental health crisis;
new text end
new text begin
(3) expand crisis services across the state, including rural areas of the state and
examining access per population;
new text end
new text begin
(4) establish and implement state standards for crisis services; and
new text end
new text begin
(5) provide grants to adult mental health initiatives, counties, tribes, or community
mental health providers to establish new mental health crisis residential service capacity.
new text end
new text begin
Priority will be given to regions that do not have a mental health crisis residential
services program, do not have an inpatient psychiatric unit within the region, do not have
an inpatient psychiatric unit within 90 miles, or have a demonstrated need based on the
number of crisis residential or intensive residential treatment beds available to meet the
needs of the residents in the region. At least 50 percent of the funds must be distributed to
programs in rural Minnesota. Grant funds may be used for start-up costs, including but not
limited to renovations, furnishings, and staff training. Grant applications shall provide
details on how the intended service will address identified needs and shall demonstrate
collaboration with crisis teams, other mental health providers, hospitals, and police.
new text end
Sec. 43. new text begin INSTRUCTIONS TO THE COMMISSIONER.
new text end
new text begin
The commissioner of human services shall, in consultation with stakeholders, develop
recommendations on funding for children's mental health crisis residential services that will
allow for timely access without requiring county authorization or child welfare placement.
new text end
ARTICLE 3
WITHDRAWAL MANAGEMENT PROGRAMS
Section 1.
new text begin
[245F.01] PURPOSE.
new text end
new text begin
It is hereby declared to be the public policy of this state that the public interest is best
served by providing efficient and effective withdrawal management services to persons
in need of appropriate detoxification, assessment, intervention, and referral services.
The services shall vary to address the unique medical needs of each patient and shall be
responsive to the language and cultural needs of each patient. Services shall not be denied
on the basis of a patient's inability to pay.
new text end
Sec. 2.
new text begin
[245F.02] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
The terms used in this chapter have the meanings given
them in this section.
new text end
new text begin Subd. 2. new text end
new text begin Administration of medications. new text end
new text begin
"Administration of medications" means
performing a task to provide medications to a patient, and includes the following tasks
performed in the following order:
new text end
new text begin
(1) checking the patient's medication record;
new text end
new text begin
(2) preparing the medication for administration;
new text end
new text begin
(3) administering the medication to the patient;
new text end
new text begin
(4) documenting administration of the medication or the reason for not administering
the medication as prescribed; and
new text end
new text begin
(5) reporting information to a licensed practitioner or a registered nurse regarding
problems with the administration of the medication or the patient's refusal to take the
medication.
new text end
new text begin Subd. 3. new text end
new text begin Alcohol and drug counselor. new text end
new text begin
"Alcohol and drug counselor" means an
individual qualified under Minnesota Rules, part 9530.6450, subpart 5.
new text end
new text begin Subd. 4. new text end
new text begin Applicant. new text end
new text begin
"Applicant" means an individual, partnership, voluntary
association, corporation, or other public or private organization that submits an application
for licensure under this chapter.
new text end
new text begin Subd. 5. new text end
new text begin Care coordination. new text end
new text begin
"Care coordination" means activities intended to bring
together health services, patient needs, and streams of information to facilitate the aims
of care. Care coordination includes an ongoing needs assessment, life skills advocacy,
treatment follow-up, disease management, education, and other services as needed.
new text end
new text begin Subd. 6. new text end
new text begin Chemical. new text end
new text begin
"Chemical" means alcohol, solvents, controlled substances as
defined in section 152.01, subdivision 4, and other mood-altering substances.
new text end
new text begin Subd. 7. new text end
new text begin Clinically managed program. new text end
new text begin
"Clinically managed program" means a
residential setting with staff comprised of a medical director and a licensed practical nurse.
A licensed practical nurse must be on site 24 hours a day, seven days a week. A qualified
medical professional must be available by telephone or in person for consultation 24 hours
a day. Patients admitted to this level of service receive medical observation, evaluation,
and stabilization services during the detoxification process; access to medications
administered by trained, licensed staff to manage withdrawal; and a comprehensive
assessment pursuant to Minnesota Rules, part 9530.6422.
new text end
new text begin Subd. 8. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of human
services or the commissioner's designated representative.
new text end
new text begin Subd. 9. new text end
new text begin Department. new text end
new text begin
"Department" means the Department of Human Services.
new text end
new text begin Subd. 10. new text end
new text begin Direct patient contact. new text end
new text begin
"Direct patient contact" has the meaning given
for "direct contact" in section 245C.02, subdivision 11.
new text end
new text begin Subd. 11. new text end
new text begin Discharge plan. new text end
new text begin
"Discharge plan" means a written plan that states with
specificity the services the program has arranged for the patient to transition back into
the community.
new text end
new text begin Subd. 12. new text end
new text begin Licensed practitioner. new text end
new text begin
"Licensed practitioner" means a practitioner as
defined in section 151.01, subdivision 23, who is authorized to prescribe.
new text end
new text begin Subd. 13. new text end
new text begin Medical director. new text end
new text begin
"Medical director" means an individual licensed in
Minnesota as a doctor of osteopathy or physician, or an individual licensed in Minnesota
as an advanced practice registered nurse by the Board of Nursing and certified to practice
as a clinical nurse specialist or nurse practitioner by a national nurse organization
acceptable to the board. The medical director must be employed by or under contract with
the license holder to direct and supervise health care for patients of a program licensed
under this chapter.
new text end
new text begin Subd. 14. new text end
new text begin Medically monitored program. new text end
new text begin
"Medically monitored program" means
a residential setting with staff that includes a registered nurse and a medical director. A
registered nurse must be on site 24 hours a day. A medical director must be on site seven
days a week, and patients must have the ability to be seen by a medical director within 24
hours. Patients admitted to this level of service receive medical observation, evaluation,
and stabilization services during the detoxification process; medications administered by
trained, licensed staff to manage withdrawal; and a comprehensive assessment pursuant to
Minnesota Rules, part 9530.6422.
new text end
new text begin Subd. 15. new text end
new text begin Nurse. new text end
new text begin
"Nurse" means a person licensed and currently registered to
practice practical or professional nursing as defined in section 148.171, subdivisions
14 and 15.
new text end
new text begin Subd. 16. new text end
new text begin Patient. new text end
new text begin
"Patient" means an individual who presents or is presented for
admission to a withdrawal management program that meets the criteria in section 245F.05.
new text end
new text begin Subd. 17. new text end
new text begin Peer recovery support services. new text end
new text begin
"Peer recovery support services"
means mentoring and education, advocacy, and nonclinical recovery support provided
by a recovery peer.
new text end
new text begin Subd. 18. new text end
new text begin Program director. new text end
new text begin
"Program director" means the individual who is
designated by the license holder to be responsible for all operations of a withdrawal
management program and who meets the qualifications specified in section 245F.15,
subdivision 3.
new text end
new text begin Subd. 19. new text end
new text begin Protective procedure. new text end
new text begin
"Protective procedure" means an action taken by a
staff member of a withdrawal management program to protect a patient from imminent
danger of harming self or others. Protective procedures include the following actions:
new text end
new text begin
(1) seclusion, which means the temporary placement of a patient, without the
patient's consent, in an environment to prevent social contact; and
new text end
new text begin
(2) physical restraint, which means the restraint of a patient by use of physical holds
intended to limit movement of the body.
new text end
new text begin Subd. 20. new text end
new text begin Qualified medical professional. new text end
new text begin
"Qualified medical professional"
means an individual licensed in Minnesota as a doctor of osteopathy or physician, or an
individual licensed in Minnesota as an advanced practice registered nurse by the Board of
Nursing and certified to practice as a clinical nurse specialist or nurse practitioner by a
national nurse organization acceptable to the board.
new text end
new text begin Subd. 21. new text end
new text begin Recovery peer. new text end
new text begin
"Recovery peer" means a person who has progressed in
the person's own recovery from substance use disorder and is willing to serve as a peer
to assist others in their recovery.
new text end
new text begin Subd. 22. new text end
new text begin Responsible staff person. new text end
new text begin
"Responsible staff person" means the program
director, the medical director, or a staff person with current licensure as a nurse in
Minnesota. The responsible staff person must be on the premises and is authorized to
make immediate decisions concerning patient care and safety.
new text end
new text begin Subd. 23. new text end
new text begin Substance. new text end
new text begin
"Substance" means "chemical" as defined in subdivision 6.
new text end
new text begin Subd. 24. new text end
new text begin Substance use disorder. new text end
new text begin
"Substance use disorder" means a pattern of
substance use as defined in the current edition of the Diagnostic and Statistical Manual of
Mental Disorders.
new text end
new text begin Subd. 25. new text end
new text begin Technician. new text end
new text begin
"Technician" means a person who meets the qualifications in
section 245F.15, subdivision 6.
new text end
new text begin Subd. 26. new text end
new text begin Withdrawal management program. new text end
new text begin
"Withdrawal management
program" means a licensed program that provides short-term medical services on
a 24-hour basis for the purpose of stabilizing intoxicated patients, managing their
withdrawal, and facilitating access to substance use disorder treatment as indicated by a
comprehensive assessment.
new text end
Sec. 3.
new text begin
[245F.03] APPLICATION.
new text end
new text begin
(a) This chapter establishes minimum standards for withdrawal management
programs licensed by the commissioner that serve one or more unrelated persons.
new text end
new text begin
(b) This chapter does not apply to a withdrawal management program licensed as a
hospital under sections 144.50 to 144.581. A withdrawal management program located in
a hospital licensed under sections 144.50 to 144.581 that chooses to be licensed under this
chapter is deemed to be in compliance with section 245F.13.
new text end
Sec. 4.
new text begin
[245F.04] PROGRAM LICENSURE.
new text end
new text begin Subdivision 1. new text end
new text begin General application and license requirements. new text end
new text begin
An applicant
for licensure as a clinically managed withdrawal management program or medically
monitored withdrawal management program must meet the following requirements,
except where otherwise noted. All programs must comply with federal requirements and
the general requirements in chapters 245A and 245C and sections 626.556, 626.557, and
626.5572. A withdrawal management program must be located in a hospital licensed under
sections 144.50 to 144.581, or must be a supervised living facility with a class B license
from the Department of Health under Minnesota Rules, parts 4665.0100 to 4665.9900.
new text end
new text begin Subd. 2. new text end
new text begin Contents of application. new text end
new text begin
Prior to the issuance of a license, an applicant
must submit, on forms provided by the commissioner, documentation demonstrating
the following:
new text end
new text begin
(1) compliance with this section;
new text end
new text begin
(2) compliance with applicable building, fire, and safety codes; health rules; zoning
ordinances; and other applicable rules and regulations or documentation that a waiver
has been granted. The granting of a waiver does not constitute modification of any
requirement of this section;
new text end
new text begin
(3) completion of an assessment of need for a new or expanded program as required
by Minnesota Rules, part 9530.6800; and
new text end
new text begin
(4) insurance coverage, including bonding, sufficient to cover all patient funds,
property, and interests.
new text end
new text begin Subd. 3. new text end
new text begin Changes in license terms. new text end
new text begin
(a) A license holder must notify the
commissioner before one of the following occurs and the commissioner must determine
the need for a new license:
new text end
new text begin
(1) a change in the Department of Health's licensure of the program;
new text end
new text begin
(2) a change in the medical services provided by the program that affects the
program's capacity to provide services required by the program's license designation as a
clinically managed program or medically monitored program;
new text end
new text begin
(3) a change in program capacity; or
new text end
new text begin
(4) a change in location.
new text end
new text begin
(b) A license holder must notify the commissioner and apply for a new license
when a change in program ownership occurs.
new text end
new text begin Subd. 4. new text end
new text begin Variances. new text end
new text begin
The commissioner may grant variances to the requirements of
this chapter under section 245A.04, subdivision 9.
new text end
Sec. 5.
new text begin
[245F.05] ADMISSION AND DISCHARGE POLICIES.
new text end
new text begin Subdivision 1. new text end
new text begin Admission policy. new text end
new text begin
A license holder must have a written admission
policy containing specific admission criteria. The policy must describe the admission
process and the point at which an individual who is eligible under subdivision 2 is
admitted to the program. A license holder must not admit individuals who do not meet the
admission criteria. The admission policy must be approved and signed by the medical
director of the facility and must designate which staff members are authorized to admit
and discharge patients. The admission policy must be posted in the area of the facility
where patients are admitted and given to all interested individuals upon request.
new text end
new text begin Subd. 2. new text end
new text begin Admission criteria. new text end
new text begin
For an individual to be admitted to a withdrawal
management program, the program must make a determination that the program services
are appropriate to the needs of the individual. A program may only admit individuals who
meet the admission criteria and who, at the time of admission:
new text end
new text begin
(1) are impaired as the result of intoxication;
new text end
new text begin
(2) are experiencing physical, mental, or emotional problems due to intoxication or
withdrawal from alcohol or other drugs;
new text end
new text begin
(3) are being held under apprehend and hold orders under section 253B.07,
subdivision 2b;
new text end
new text begin
(4) have been committed under chapter 253B, and need temporary placement;
new text end
new text begin
(5) are held under emergency holds or peace and health officer holds under section
253B.05, subdivision 1 or 2; or
new text end
new text begin
(6) need to stay temporarily in a protective environment because of a crisis related
to substance use disorder. Individuals satisfying this clause may be admitted only at the
request of the county of fiscal responsibility, as determined according to section 256G.02,
subdivision 4. Individuals admitted according to this clause must not be restricted to
the facility.
new text end
new text begin Subd. 3. new text end
new text begin Individuals denied admission by program. new text end
new text begin
(a) A license holder must
have a written policy and procedure for addressing the needs of individuals who are
denied admission to the program. These individuals include:
new text end
new text begin
(1) individuals whose pregnancy, in combination with their presenting problem,
requires services not provided by the program; and
new text end
new text begin
(2) individuals who are in imminent danger of harming self or others if their
behavior is beyond the behavior management capabilities of the program and staff.
new text end
new text begin
(b) Programs must document denied admissions, including the date and time of
the admission request, reason for the denial of admission, and where the individual was
referred. If the individual did not receive a referral, the program must document why a
referral was not made. This information must be documented on a form approved by the
commissioner and made available to the commissioner upon request.
new text end
new text begin Subd. 4. new text end
new text begin
License holder responsibilities; denying admission or terminating
services.
new text end
new text begin
(a) If a license holder denies an individual admission to the program or
terminates services to a patient and the denial or termination poses an immediate threat to
the patient's or individual's health or requires immediate medical intervention, the license
holder must refer the patient or individual to a medical facility capable of admitting the
patient or individual.
new text end
new text begin
(b) A license holder must report to a law enforcement agency with proper jurisdiction
all denials of admission and terminations of services that involve the commission of a crime
against a staff member of the license holder or on the license holder's property, as provided
in Code of Federal Regulations, title 42, section 2.12(c)(5), and title 45, parts 160 to 164.
new text end
new text begin Subd. 5. new text end
new text begin Discharge and transfer policies. new text end
new text begin
A license holder must have a written
policy and procedure, approved and signed by the medical director, that specifies
conditions under which patients may be discharged or transferred. The policy must
include the following:
new text end
new text begin
(1) guidelines for determining when a patient is medically stable and whether a
patient is able to be discharged or transferred to a lower level of care;
new text end
new text begin
(2) guidelines for determining when a patient needs a transfer to a higher level of care.
Clinically managed program guidelines must include guidelines for transfer to a medically
monitored program, hospital, or other acute care facility. Medically monitored program
guidelines must include guidelines for transfer to a hospital or other acute care facility;
new text end
new text begin
(3) procedures staff must follow when discharging a patient under each of the
following circumstances:
new text end
new text begin
(i) the patient is involved in the commission of a crime against program staff or
against a license holder's property. The procedures for a patient discharged under this
item must specify how reports must be made to law enforcement agencies with proper
jurisdiction as allowed under Code of Federal Regulations, title 42, section 2.12(c)(5), and
title 45, parts 160 to 164;
new text end
new text begin
(ii) the patient is in imminent danger of harming self or others and is beyond the
license holder's capacity to ensure safety;
new text end
new text begin
(iii) the patient was admitted under chapter 253B; or
new text end
new text begin
(iv) the patient is leaving against staff or medical advice; and
new text end
new text begin
(4) a requirement that staff must document where the patient was referred after
discharge or transfer, and if a referral was not made, the reason the patient was not
provided a referral.
new text end
Sec. 6.
new text begin
[245F.06] SCREENING AND COMPREHENSIVE ASSESSMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Screening for substance use disorder. new text end
new text begin
A nurse or an alcohol
and drug counselor must screen each patient upon admission to determine whether a
comprehensive assessment is indicated. The license holder must screen patients at
each admission, except that if the patient has already been determined to suffer from a
substance use disorder, subdivision 2 applies.
new text end
new text begin Subd. 2. new text end
new text begin Comprehensive assessment. new text end
new text begin
(a) Prior to a medically stable discharge,
but not later than 72 hours following admission, a license holder must provide a
comprehensive assessment according to section 245.4863, paragraph (a), and Minnesota
Rules, part 9530.6422, for each patient who has a positive screening for a substance use
disorder. If a patient's medical condition prevents a comprehensive assessment from
being completed within 72 hours, the license holder must document why the assessment
was not completed. The comprehensive assessment must include documentation of the
appropriateness of an involuntary referral through the civil commitment process.
new text end
new text begin
(b) If available to the program, a patient's previous comprehensive assessment may
be used in the patient record. If a previously completed comprehensive assessment is used,
its contents must be reviewed to ensure the assessment is accurate and current and complies
with the requirements of this chapter. The review must be completed by a staff person
qualified according to Minnesota Rules, part 9530.6450, subpart 5. The license holder must
document that the review was completed and that the previously completed assessment is
accurate and current, or the license holder must complete an updated or new assessment.
new text end
Sec. 7.
new text begin
[245F.07] STABILIZATION PLANNING.
new text end
new text begin Subdivision 1. new text end
new text begin Stabilization plan. new text end
new text begin
Within 12 hours of admission, a license
holder must develop an individualized stabilization plan for each patient accepted for
stabilization services. The plan must be based on the patient's initial health assessment
and continually updated based on new information gathered about the patient's condition
from the comprehensive assessment, medical evaluation and consultation, and ongoing
monitoring and observations of the patient. The patient must have an opportunity to have
direct involvement in the development of the plan. The stabilization plan must:
new text end
new text begin
(1) identify medical needs and goals to be achieved while the patient is receiving
services;
new text end
new text begin
(2) specify stabilization services to address the identified medical needs and goals,
including amount and frequency of services;
new text end
new text begin
(3) specify the participation of others in the stabilization planning process and
specific services where appropriate; and
new text end
new text begin
(4) document the patient's participation in developing the content of the stabilization
plan and any updates.
new text end
new text begin Subd. 2. new text end
new text begin Progress notes. new text end
new text begin
Progress notes must be entered in the patient's file at least
daily and immediately following any significant event, including any change that impacts
the medical, behavioral, or legal status of the patient. Progress notes must:
new text end
new text begin
(1) include documentation of the patient's involvement in the stabilization services,
including the type and amount of each stabilization service;
new text end
new text begin
(2) include the monitoring and observations of the patient's medical needs;
new text end
new text begin
(3) include documentation of referrals made to other services or agencies;
new text end
new text begin
(4) specify the participation of others; and
new text end
new text begin
(5) be legible, signed, and dated by the staff person completing the documentation.
new text end
new text begin Subd. 3. new text end
new text begin Discharge plan. new text end
new text begin
Before a patient leaves the facility, the license holder
must conduct discharge planning for the patient, document discharge planning in the
patient's record, and provide the patient with a copy of the discharge plan. The discharge
plan must include:
new text end
new text begin
(1) referrals made to other services or agencies at the time of transition;
new text end
new text begin
(2) the patient's plan for follow-up, aftercare, or other poststabilization services;
new text end
new text begin
(3) documentation of the patient's participation in the development of the transition
plan;
new text end
new text begin
(4) any service that will continue after discharge under the direction of the license
holder; and
new text end
new text begin
(5) a stabilization summary and final evaluation of the patient's progress toward
treatment objectives.
new text end
Sec. 8.
new text begin
[245F.08] STABILIZATION SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin General. new text end
new text begin
The license holder must encourage patients to remain in
care for an appropriate duration as determined by the patient's stabilization plan, and must
encourage all patients to enter programs for ongoing recovery as clinically indicated. In
addition, the license holder must offer services that are patient-centered, trauma-informed,
and culturally appropriate. Culturally appropriate services must include translation services
and dietary services that meet a patient's dietary needs. All services provided to the patient
must be documented in the patient's medical record. The following services must be
offered unless clinically inappropriate and the justifying clinical rationale is documented:
new text end
new text begin
(1) individual or group motivational counseling sessions;
new text end
new text begin
(2) individual advocacy and case management services;
new text end
new text begin
(3) medical services as required in section 245F.12;
new text end
new text begin
(4) care coordination provided according to subdivision 2;
new text end
new text begin
(5) peer recovery support services provided according to subdivision 3;
new text end
new text begin
(6) patient education provided according to subdivision 4; and
new text end
new text begin
(7) referrals to mutual aid, self-help, and support groups.
new text end
new text begin Subd. 2. new text end
new text begin Care coordination. new text end
new text begin
Care coordination services must be initiated for each
patient upon admission. The license holder must identify the staff person responsible for
the provision of each service. Care coordination services must include:
new text end
new text begin
(1) coordination with significant others to assist in the stabilization planning process
whenever possible;
new text end
new text begin
(2) coordination with and follow-up to appropriate medical services as identified by
the nurse or licensed practitioner;
new text end
new text begin
(3) referral to substance use disorder services as indicated by the comprehensive
assessment;
new text end
new text begin
(4) referral to mental health services as identified in the comprehensive assessment;
new text end
new text begin
(5) referrals to economic assistance, social services, and prenatal care in accordance
with the patient's needs;
new text end
new text begin
(6) review and approval of the transition plan prior to discharge, except in an
emergency, by a staff member able to provide direct patient contact;
new text end
new text begin
(7) documentation of the provision of care coordination services in the patient's
file; and
new text end
new text begin
(8) addressing cultural and socioeconomic factors affecting the patient's access to
services.
new text end
new text begin Subd. 3. new text end
new text begin Peer recovery support services. new text end
new text begin
(a) Peers in recovery serve as mentors or
recovery-support partners for individuals in recovery, and may provide encouragement,
self-disclosure of recovery experiences, transportation to appointments, assistance with
finding resources that will help locate housing, job search resources, and assistance finding
and participating in support groups.
new text end
new text begin
(b) Peer recovery support services are provided by a recovery peer and must be
supervised by the responsible staff person.
new text end
new text begin Subd. 4. new text end
new text begin Patient education. new text end
new text begin
A license holder must provide education to each
patient on the following:
new text end
new text begin
(1) substance use disorder, including the effects of alcohol and other drugs, specific
information about the effects of substance use on unborn children, and the signs and
symptoms of fetal alcohol spectrum disorders;
new text end
new text begin
(2) tuberculosis and reporting known cases of tuberculosis disease to health care
authorities according to section 144.4804;
new text end
new text begin
(3) Hepatitis C treatment and prevention;
new text end
new text begin
(4) HIV as required in section 245A.19, paragraphs (b) and (c);
new text end
new text begin
(5) nicotine cessation options, if applicable;
new text end
new text begin
(6) opioid tolerance and overdose risks, if applicable; and
new text end
new text begin
(7) long-term withdrawal issues related to use of barbiturates and benzodiazepines,
if applicable.
new text end
new text begin Subd. 5. new text end
new text begin Mutual aid, self-help, and support groups. new text end
new text begin
The license holder must
refer patients to mutual aid, self-help, and support groups when clinically indicated and
to the extent available in the community.
new text end
Sec. 9.
new text begin
[245F.09] PROTECTIVE PROCEDURES.
new text end
new text begin Subdivision 1. new text end
new text begin Use of protective procedures. new text end
new text begin
(a) Programs must incorporate
person-centered planning and trauma-informed care into its protective procedure policies.
Protective procedures may be used only in cases where a less restrictive alternative will
not protect the patient or others from harm and when the patient is in imminent danger
of harming self or others. When a program uses a protective procedure, the program
must continuously observe the patient until the patient may safely be left for 15-minute
intervals. Use of the procedure must end when the patient is no longer in imminent danger
of harming self or others.
new text end
new text begin
(b) Protective procedures may not be used:
new text end
new text begin
(1) for disciplinary purposes;
new text end
new text begin
(2) to enforce program rules;
new text end
new text begin
(3) for the convenience of staff;
new text end
new text begin
(4) as a part of any patient's health monitoring plan; or
new text end
new text begin
(5) for any reason except in response to specific, current behaviors which create an
imminent danger of harm to the patient or others.
new text end
new text begin Subd. 2. new text end
new text begin Protective procedures plan. new text end
new text begin
A license holder must have a written policy
and procedure that establishes the protective procedures that program staff must follow
when a patient is in imminent danger of harming self or others. The policy must be
appropriate to the type of facility and the level of staff training. The protective procedures
policy must include:
new text end
new text begin
(1) an approval signed and dated by the program director and medical director prior
to implementation. Any changes to the policy must also be approved, signed, and dated by
the current program director and the medical director prior to implementation;
new text end
new text begin
(2) which protective procedures the license holder will use to prevent patients from
imminent danger of harming self or others;
new text end
new text begin
(3) the emergency conditions under which the protective procedures are permitted
to be used, if any;
new text end
new text begin
(4) the patient's health conditions that limit the specific procedures that may be used
and alternative means of ensuring safety;
new text end
new text begin
(5) emergency resources the program staff must contact when a patient's behavior
cannot be controlled by the procedures established in the policy;
new text end
new text begin
(6) the training that staff must have before using any protective procedure;
new text end
new text begin
(7) documentation of approved therapeutic holds;
new text end
new text begin
(8) the use of law enforcement personnel as described in subdivision 4;
new text end
new text begin
(9) standards governing emergency use of seclusion. Seclusion must be used only
when less restrictive measures are ineffective or not feasible. The standards in items (i) to
(vii) must be met when seclusion is used with a patient:
new text end
new text begin
(i) seclusion must be employed solely for the purpose of preventing a patient from
imminent danger of harming self or others;
new text end
new text begin
(ii) seclusion rooms must be equipped in a manner that prevents patients from
self-harm using projections, windows, electrical fixtures, or hard objects, and must allow
the patient to be readily observed without being interrupted;
new text end
new text begin
(iii) seclusion must be authorized by the program director, a licensed physician, or
a registered nurse. If one of these individuals is not present in the facility, the program
director or a licensed physician or registered nurse must be contacted and authorization
must be obtained within 30 minutes of initiating seclusion, according to written policies;
new text end
new text begin
(iv) patients must not be placed in seclusion for more than 12 hours at any one time;
new text end
new text begin
(v) once the condition of a patient in seclusion has been determined to be safe
enough to end continuous observation, a patient in seclusion must be observed at a
minimum of every 15 minutes for the duration of seclusion and must always be within
hearing range of program staff;
new text end
new text begin
(vi) a process for program staff to use to remove a patient to other resources available
to the facility if seclusion does not sufficiently assure patient safety; and
new text end
new text begin
(vii) a seclusion area may be used for other purposes, such as intensive observation, if
the room meets normal standards of care for the purpose and if the room is not locked; and
new text end
new text begin
(10) physical holds may only be used when less restrictive measures are not feasible.
The standards in items (i) to (iv) must be met when physical holds are used with a patient:
new text end
new text begin
(i) physical holds must be employed solely for preventing a patient from imminent
danger of harming self or others;
new text end
new text begin
(ii) physical holds must be authorized by the program director, a licensed physician,
or a registered nurse. If one of these individuals is not present in the facility, the program
director or a licensed physician or a registered nurse must be contacted and authorization
must be obtained within 30 minutes of initiating a physical hold, according to written
policies;
new text end
new text begin
(iii) the patient's health concerns must be considered in deciding whether to use
physical holds and which holds are appropriate for the patient; and
new text end
new text begin
(iv) only approved holds may be utilized. Prone holds are not allowed and must
not be authorized.
new text end
new text begin Subd. 3. new text end
new text begin Records. new text end
new text begin
Each use of a protective procedure must be documented in the
patient record. The patient record must include:
new text end
new text begin
(1) a description of specific patient behavior precipitating a decision to use a
protective procedure, including date, time, and program staff present;
new text end
new text begin
(2) the specific means used to limit the patient's behavior;
new text end
new text begin
(3) the time the protective procedure began, the time the protective procedure ended,
and the time of each staff observation of the patient during the procedure;
new text end
new text begin
(4) the names of the program staff authorizing the use of the protective procedure,
the time of the authorization, and the program staff directly involved in the protective
procedure and the observation process;
new text end
new text begin
(5) a brief description of the purpose for using the protective procedure, including
less restrictive interventions used prior to the decision to use the protective procedure
and a description of the behavioral results obtained through the use of the procedure. If
a less restrictive intervention was not used, the reasons for not using a less restrictive
intervention must be documented;
new text end
new text begin
(6) documentation by the responsible staff person on duty of reassessment of the
patient at least every 15 minutes to determine if seclusion or the physical hold can be
terminated;
new text end
new text begin
(7) a description of the physical holds used in escorting a patient; and
new text end
new text begin
(8) any injury to the patient that occurred during the use of a protective procedure.
new text end
new text begin Subd. 4. new text end
new text begin Use of law enforcement. new text end
new text begin
The program must maintain a central log
documenting each incident involving use of law enforcement, including:
new text end
new text begin
(1) the date and time law enforcement arrived at and left the program;
new text end
new text begin
(2) the reason for the use of law enforcement;
new text end
new text begin
(3) if law enforcement used force or a protective procedure and which protective
procedure was used; and
new text end
new text begin
(4) whether any injuries occurred.
new text end
new text begin Subd. 5. new text end
new text begin Administrative review. new text end
new text begin
(a) The license holder must keep a record of all
patient incidents and protective procedures used. An administrative review of each use
of protective procedures must be completed within 72 hours by someone other than the
person who used the protective procedure. The record of the administrative review of the
use of protective procedures must state whether:
new text end
new text begin
(1) the required documentation was recorded for each use of a protective procedure;
new text end
new text begin
(2) the protective procedure was used according to the policy and procedures;
new text end
new text begin
(3) the staff who implemented the protective procedure was properly trained; and
new text end
new text begin
(4) the behavior met the standards for imminent danger of harming self or others.
new text end
new text begin
(b) The license holder must conduct and document a quarterly review of the use of
protective procedures with the goal of reducing the use of protective procedures. The
review must include:
new text end
new text begin
(1) any patterns or problems indicated by similarities in the time of day, day of the
week, duration of the use of a protective procedure, individuals involved, or other factors
associated with the use of protective procedures;
new text end
new text begin
(2) any injuries resulting from the use of protective procedures;
new text end
new text begin
(3) whether law enforcement was involved in the use of a protective procedure;
new text end
new text begin
(4) actions needed to correct deficiencies in the program's implementation of
protective procedures;
new text end
new text begin
(5) an assessment of opportunities missed to avoid the use of protective procedures;
and
new text end
new text begin
(6) proposed actions to be taken to minimize the use of protective procedures.
new text end
Sec. 10.
new text begin
[245F.10] PATIENT RIGHTS AND GRIEVANCE PROCEDURES.
new text end
new text begin Subdivision 1. new text end
new text begin Patient rights. new text end
new text begin
Patients have the rights in sections 144.651,
148F.165, and 253B.03, as applicable. The license holder must give each patient, upon
admission, a written statement of patient rights. Program staff must review the statement
with the patient.
new text end
new text begin Subd. 2. new text end
new text begin Grievance procedure. new text end
new text begin
Upon admission, the license holder must explain
the grievance procedure to the patient or patient's representative and give the patient a
written copy of the procedure. The grievance procedure must be posted in a place visible
to the patient and must be made available to current and former patients upon request. A
license holder's written grievance procedure must include:
new text end
new text begin
(1) staff assistance in developing and processing the grievance;
new text end
new text begin
(2) an initial response to the patient who filed the grievance within 24 hours of the
program's receipt of the grievance, and timelines for additional steps to be taken to resolve
the grievance, including access to the person with the highest level of authority in the
program if the grievance cannot be resolved by other staff members; and
new text end
new text begin
(3) the current addresses and telephone numbers of the Department of Human
Services Licensing Division, Department of Health Office of Health Facilities Complaints,
Board of Behavioral Health and Therapy, Board of Medical Practice, Board of Nursing,
and Office of the Ombudsman for Mental Health and Developmental Disabilities.
new text end
Sec. 11.
new text begin
[245F.11] PATIENT PROPERTY MANAGEMENT.
new text end
new text begin
A license holder must meet the requirements for handling patient funds and property
in section 245A.04, subdivision 13, except:
new text end
new text begin
(1) a license holder must establish policies regarding the use of personal property to
assure that program activities and the rights of other patients are not infringed, and may
take temporary custody of personal property if these policies are violated;
new text end
new text begin
(2) a license holder must retain the patient's property for a minimum of seven days
after discharge if the patient does not reclaim the property after discharge; and
new text end
new text begin
(3) the license holder must return to the patient all of the patient's property held in
trust at discharge, regardless of discharge status, except that:
new text end
new text begin
(i) drugs, drug paraphernalia, and drug containers that are subject to forfeiture under
section 609.5316 must be given over to the custody of a local law enforcement agency or,
if giving the property over to the custody of a local law enforcement agency would violate
Code of Federal Regulations, title 42, sections 2.1 to 2.67, and title 45, parts 160 to 164,
destroyed by a staff person designated by the program director; and
new text end
new text begin
(ii) weapons, explosives, and other property that may cause serious harm to self
or others must be transferred to a local law enforcement agency. The patient must be
notified of the transfer and the right to reclaim the property if the patient has a legal right
to possess the item.
new text end
Sec. 12.
new text begin
[245F.12] MEDICAL SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Services provided at all programs. new text end
new text begin
Withdrawal management
programs must have:
new text end
new text begin
(1) a standardized data collection tool for collecting health-related information about
each patient. The data collection tool must be developed in collaboration with a registered
nurse and approved and signed by the medical director; and
new text end
new text begin
(2) written procedures for a nurse to assess and monitor patient health within the
nurse's scope of practice. The procedures must:
new text end
new text begin
(i) be approved by the medical director;
new text end
new text begin
(ii) include a follow-up screening conducted between four and 12 hours after service
initiation to collect information relating to acute intoxication, other health complaints, and
behavioral risk factors that the patient may not have communicated at service initiation;
new text end
new text begin
(iii) specify the physical signs and symptoms that, when present, require consultation
with a registered nurse or a physician and that require transfer to an acute care facility or
a higher level of care than that provided by the program;
new text end
new text begin
(iv) specify those staff members responsible for monitoring patient health and
provide for hourly observation and for more frequent observation if the initial health
assessment or follow-up screening indicates a need for intensive physical or behavioral
health monitoring; and
new text end
new text begin
(v) specify the actions to be taken to address specific complicating conditions,
including pregnancy or the presence of physical signs or symptoms of any other medical
condition.
new text end
new text begin Subd. 2. new text end
new text begin Services provided at clinically managed programs. new text end
new text begin
In addition to the
services listed in subdivision 1, clinically managed programs must:
new text end
new text begin
(1) have a licensed practical nurse on site 24 hours a day and a medical director;
new text end
new text begin
(2) provide an initial health assessment conducted by a nurse upon admission;
new text end
new text begin
(3) provide daily on-site medical evaluation by a nurse;
new text end
new text begin
(4) have a registered nurse available by telephone or in person for consultation
24 hours a day;
new text end
new text begin
(5) have a qualified medical professional available by telephone or in person for
consultation 24 hours a day; and
new text end
new text begin
(6) have appropriately licensed staff available to administer medications according
to prescriber-approved orders.
new text end
new text begin Subd. 3. new text end
new text begin Services provided at medically monitored programs. new text end
new text begin
In addition to the
services listed in subdivision 1, medically monitored programs must have a registered
nurse on site 24 hours a day and a medical director. Medically monitored programs must
provide intensive inpatient withdrawal management services which must include:
new text end
new text begin
(1) an initial health assessment conducted by a registered nurse upon admission;
new text end
new text begin
(2) the availability of a medical evaluation and consultation with a registered nurse
24 hours a day;
new text end
new text begin
(3) the availability of a qualified medical professional by telephone or in person
for consultation 24 hours a day;
new text end
new text begin
(4) the ability to be seen within 24 hours or sooner by a qualified medical
professional if the initial health assessment indicates the need to be seen;
new text end
new text begin
(5) the availability of on-site monitoring of patient care seven days a week by a
qualified medical professional; and
new text end
new text begin
(6) appropriately licensed staff available to administer medications according to
prescriber-approved orders.
new text end
Sec. 13.
new text begin
[245F.13] MEDICATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Administration of medications. new text end
new text begin
A license holder must employ or
contract with a registered nurse to develop the policies and procedures for medication
administration. A registered nurse must provide supervision as defined in section 148.171,
subdivision 23, for the administration of medications. For clinically managed programs,
the registered nurse supervision must include on-site supervision at least monthly or more
often as warranted by the health needs of the patient. The medication administration
policies and procedures must include:
new text end
new text begin
(1) a provision that patients may carry emergency medication such as nitroglycerin
as instructed by their prescriber;
new text end
new text begin
(2) requirements for recording the patient's use of medication, including staff
signatures with date and time;
new text end
new text begin
(3) guidelines regarding when to inform a licensed practitioner or a registered nurse
of problems with medication administration, including failure to administer, patient
refusal of a medication, adverse reactions, or errors; and
new text end
new text begin
(4) procedures for acceptance, documentation, and implementation of prescriptions,
whether written, oral, telephonic, or electronic.
new text end
new text begin Subd. 2. new text end
new text begin Control of drugs. new text end
new text begin
A license holder must have in place and implement
written policies and procedures relating to control of drugs. The policies and procedures
must be developed by a registered nurse and must contain the following provisions:
new text end
new text begin
(1) a requirement that all drugs must be stored in a locked compartment. Schedule II
drugs, as defined in section 152.02, subdivision 3, must be stored in a separately locked
compartment that is permanently affixed to the physical plant or a medication cart;
new text end
new text begin
(2) a system for accounting for all scheduled drugs each shift;
new text end
new text begin
(3) a procedure for recording a patient's use of medication, including staff signatures
with time and date;
new text end
new text begin
(4) a procedure for destruction of discontinued, outdated, or deteriorated medications;
new text end
new text begin
(5) a statement that only authorized personnel are permitted to have access to the
keys to the locked drug compartments; and
new text end
new text begin
(6) a statement that no legend drug supply for one patient may be given to another
patient.
new text end
Sec. 14.
new text begin
[245F.14] STAFFING REQUIREMENTS AND DUTIES.
new text end
new text begin Subdivision 1. new text end
new text begin Program director. new text end
new text begin
A license holder must employ or contract with a
person, on a full-time basis, to serve as program director. The program director must be
responsible for all aspects of the facility and the services delivered to the license holder's
patients. An individual may serve as program director for more than one program owned
by the same license holder.
new text end
new text begin Subd. 2. new text end
new text begin Responsible staff person. new text end
new text begin
During all hours of operation, a license holder
must designate a staff member as the responsible staff person to be present and awake
in the facility and be responsible for the program. The responsible staff person must
have decision-making authority over the day-to-day operation of the program as well
as the authority to direct the activity of or terminate the shift of any staff member who
has direct patient contact.
new text end
new text begin Subd. 3. new text end
new text begin Technician required. new text end
new text begin
A license holder must have one technician awake
and on duty at all times for every ten patients in the program. A license holder may assign
technicians according to the need for care of the patients, except that the same technician
must not be responsible for more than 15 patients at one time. For purposes of establishing
this ratio, all staff whose qualifications meet or exceed those for technicians under section
245F.15, subdivision 6, and who are performing the duties of a technician may be counted
as technicians. The same individual may not be counted as both a technician and an
alcohol and drug counselor.
new text end
new text begin Subd. 4. new text end
new text begin Registered nurse required. new text end
new text begin
A license holder must employ or contract
with a registered nurse, who must be available 24 hours a day by telephone or in person
for consultation. The registered nurse is responsible for:
new text end
new text begin
(1) establishing and implementing procedures for the provision of nursing care and
delegated medical care, including:
new text end
new text begin
(i) a health monitoring plan;
new text end
new text begin
(ii) a medication control plan;
new text end
new text begin
(iii) training and competency evaluations for staff performing delegated medical and
nursing functions;
new text end
new text begin
(iv) handling serious illness, accident, or injury to patients;
new text end
new text begin
(v) an infection control program; and
new text end
new text begin
(vi) a first aid kit;
new text end
new text begin
(2) delegating nursing functions to other staff consistent with their education,
competence, and legal authorization;
new text end
new text begin
(3) assigning, supervising, and evaluating the performance of nursing tasks; and
new text end
new text begin
(4) implementing condition-specific protocols in compliance with section 151.37,
subdivision 2.
new text end
new text begin Subd. 5. new text end
new text begin Medical director required. new text end
new text begin
A license holder must have a medical director
available for medical supervision. The medical director is responsible for ensuring the
accurate and safe provision of all health-related services and procedures. A license
holder must obtain and document the medical director's annual approval of the following
procedures before the procedures may be used:
new text end
new text begin
(1) admission, discharge, and transfer criteria and procedures;
new text end
new text begin
(2) a health services plan;
new text end
new text begin
(3) physical indicators for a referral to a physician, registered nurse, or hospital, and
procedures for referral;
new text end
new text begin
(4) procedures to follow in case of accident, injury, or death of a patient;
new text end
new text begin
(5) formulation of condition-specific protocols regarding the medications that
require a withdrawal regimen that will be administered to patients;
new text end
new text begin
(6) an infection control program;
new text end
new text begin
(7) protective procedures; and
new text end
new text begin
(8) a medication control plan.
new text end
new text begin Subd. 6. new text end
new text begin Alcohol and drug counselor. new text end
new text begin
A withdrawal management program must
provide one full-time equivalent alcohol and drug counselor for every 16 patients served
by the program.
new text end
new text begin Subd. 7. new text end
new text begin Ensuring staff-to-patient ratio. new text end
new text begin
The responsible staff person under
subdivision 2 must ensure that the program does not exceed the staff-to-patient ratios in
subdivisions 3 and 6 and must inform admitting staff of the current staffed capacity of
the program for that shift. A license holder must have a written policy for documenting
staff-to-patient ratios for each shift and actions to take when staffed capacity is reached.
new text end
Sec. 15.
new text begin
[245F.15] STAFF QUALIFICATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Qualifications for all staff who have direct patient contact. new text end
new text begin
(a) All
staff who have direct patient contact must be at least 18 years of age and must, at the time
of hiring, document that they meet the requirements in paragraph (b), (c), or (d).
new text end
new text begin
(b) Program directors, supervisors, nurses, and alcohol and drug counselors must be
free of substance use problems for at least two years immediately preceding their hiring
and must sign a statement attesting to that fact.
new text end
new text begin
(c) Recovery peers must be free of substance use problems for at least one year
immediately preceding their hiring and must sign a statement attesting to that fact.
new text end
new text begin
(d) Technicians and other support staff must be free of substance use problems
for at least six months immediately preceding their hiring and must sign a statement
attesting to that fact.
new text end
new text begin Subd. 2. new text end
new text begin Continuing employment; no substance use problems. new text end
new text begin
License holders
must require staff to be free from substance use problems as a condition of continuing
employment. Staff are not required to sign statements attesting to their freedom from
substance use problems after the initial statement required by subdivision 1. Staff with
substance use problems must be immediately removed from any responsibilities that
include direct patient contact.
new text end
new text begin Subd. 3. new text end
new text begin Program director qualifications. new text end
new text begin
A program director must:
new text end
new text begin
(1) have at least one year of work experience in direct service to individuals
with substance use disorders or one year of work experience in the management or
administration of direct service to individuals with substance use disorders;
new text end
new text begin
(2) have a baccalaureate degree or three years of work experience in administration
or personnel supervision in human services; and
new text end
new text begin
(3) know and understand the requirements of this chapter and chapters 245A and
245C, and sections 253B.04, 253B.05, 626.556, 626.557, and 626.5572.
new text end
new text begin Subd. 4. new text end
new text begin Alcohol and drug counselor qualifications. new text end
new text begin
An alcohol and drug
counselor must meet the requirements in Minnesota Rules, part 9530.6450, subpart 5.
new text end
new text begin Subd. 5. new text end
new text begin Responsible staff person qualifications. new text end
new text begin
Each responsible staff person
must know and understand the requirements of this chapter and sections 245A.65,
253B.04, 253B.05, 626.556, 626.557, and 626.5572. In a clinically managed program, the
responsible staff person must be a licensed practical nurse employed by or under contract
with the license holder. In a medically monitored program, the responsible staff person
must be a registered nurse, program director, or physician.
new text end
new text begin Subd. 6. new text end
new text begin Technician qualifications. new text end
new text begin
A technician employed by a program must
demonstrate competency, prior to direct patient contact, in the following areas:
new text end
new text begin
(1) knowledge of the client bill of rights in section 148F.165, and staff responsibilities
in sections 144.651 and 253B.03;
new text end
new text begin
(2) knowledge of and the ability to perform basic health screening procedures with
intoxicated patients that consist of:
new text end
new text begin
(i) blood pressure, pulse, temperature, and respiration readings;
new text end
new text begin
(ii) interviewing to obtain relevant medical history and current health complaints; and
new text end
new text begin
(iii) visual observation of a patient's health status, including monitoring a patient's
behavior as it relates to health status;
new text end
new text begin
(3) a current first aid certificate from the American Red Cross or an equivalent
organization; a current cardiopulmonary resuscitation certificate from the American Red
Cross, the American Heart Association, a community organization, or an equivalent
organization; and knowledge of first aid for seizures, trauma, and loss of consciousness; and
new text end
new text begin
(4) knowledge of and ability to perform basic activities of daily living and personal
hygiene.
new text end
new text begin Subd. 7. new text end
new text begin Recovery peer qualifications. new text end
new text begin
Recovery peers must:
new text end
new text begin
(1) be at least 21 years of age and have a high school diploma or its equivalent;
new text end
new text begin
(2) have a minimum of one year in recovery from substance use disorder;
new text end
new text begin
(3) have completed a curriculum designated by the commissioner that teaches
specific skills and training in the domains of ethics and boundaries, advocacy, mentoring
and education, and recovery and wellness support; and
new text end
new text begin
(4) receive supervision in areas specific to the domains of their role by qualified
supervisory staff.
new text end
new text begin Subd. 8. new text end
new text begin Personal relationships. new text end
new text begin
A license holder must have a written policy
addressing personal relationships between patients and staff who have direct patient
contact. The policy must:
new text end
new text begin
(1) prohibit direct patient contact between a patient and a staff member if the staff
member has had a personal relationship with the patient within two years prior to the
patient's admission to the program;
new text end
new text begin
(2) prohibit access to a patient's clinical records by a staff member who has had a
personal relationship with the patient within two years prior to the patient's admission,
unless the patient consents in writing; and
new text end
new text begin
(3) prohibit a clinical relationship between a staff member and a patient if the staff
member has had a personal relationship with the patient within two years prior to the
patient's admission. If a personal relationship exists, the staff member must report the
relationship to the staff member's supervisor and recuse the staff member from a clinical
relationship with that patient.
new text end
Sec. 16.
new text begin
[245F.16] PERSONNEL POLICIES AND PROCEDURES.
new text end
new text begin Subdivision 1. new text end
new text begin Policy requirements. new text end
new text begin
A license holder must have written personnel
policies and must make them available to staff members at all times. The personnel
policies must:
new text end
new text begin
(1) ensure that staff member's retention, promotion, job assignment, or pay are not
affected by a good faith communication between the staff member and the Department
of Human Services, Department of Health, Ombudsman for Mental Health and
Developmental Disabilities, law enforcement, or local agencies that investigate complaints
regarding patient rights, health, or safety;
new text end
new text begin
(2) include a job description for each position that specifies job responsibilities,
degree of authority to execute job responsibilities, standards of job performance related to
specified job responsibilities, and qualifications;
new text end
new text begin
(3) provide for written job performance evaluations for staff members of the license
holder at least annually;
new text end
new text begin
(4) describe behavior that constitutes grounds for disciplinary action, suspension, or
dismissal, including policies that address substance use problems and meet the requirements
of section 245F.15, subdivisions 1 and 2. The policies and procedures must list behaviors
or incidents that are considered substance use problems. The list must include:
new text end
new text begin
(i) receiving treatment for substance use disorder within the period specified for the
position in the staff qualification requirements;
new text end
new text begin
(ii) substance use that has a negative impact on the staff member's job performance;
new text end
new text begin
(iii) substance use that affects the credibility of treatment services with patients,
referral sources, or other members of the community; and
new text end
new text begin
(iv) symptoms of intoxication or withdrawal on the job;
new text end
new text begin
(5) include policies prohibiting personal involvement with patients and policies
prohibiting patient maltreatment as specified under chapter 604 and sections 245A.65,
626.556, 626.557, and 626.5572;
new text end
new text begin
(6) include a chart or description of organizational structure indicating the lines
of authority and responsibilities;
new text end
new text begin
(7) include a written plan for new staff member orientation that, at a minimum,
includes training related to the specific job functions for which the staff member was hired,
program policies and procedures, patient needs, and the areas identified in subdivision 2,
paragraphs (b) to (e); and
new text end
new text begin
(8) include a policy on the confidentiality of patient information.
new text end
new text begin Subd. 2. new text end
new text begin Staff development. new text end
new text begin
(a) A license holder must ensure that each staff
member receives orientation training before providing direct patient care and at least
30 hours of continuing education every two years. A written record must be kept to
demonstrate completion of training requirements.
new text end
new text begin
(b) Within 72 hours of beginning employment, all staff having direct patient contact
must be provided orientation on the following:
new text end
new text begin
(1) specific license holder and staff responsibilities for patient confidentiality;
new text end
new text begin
(2) standards governing the use of protective procedures;
new text end
new text begin
(3) patient ethical boundaries and patient rights, including the rights of patients
admitted under chapter 253B;
new text end
new text begin
(4) infection control procedures;
new text end
new text begin
(5) mandatory reporting under sections 245A.65, 626.556, and 626.557, including
specific training covering the facility's policies concerning obtaining patient releases
of information;
new text end
new text begin
(6) HIV minimum standards as required in section 245A.19;
new text end
new text begin
(7) motivational counseling techniques and identifying stages of change; and
new text end
new text begin
(8) eight hours of training on the program's protective procedures policy required in
section 245F.09, including:
new text end
new text begin
(i) approved therapeutic holds;
new text end
new text begin
(ii) protective procedures used to prevent patients from imminent danger of harming
self or others;
new text end
new text begin
(iii) the emergency conditions under which the protective procedures may be used, if
any;
new text end
new text begin
(iv) documentation standards for using protective procedures;
new text end
new text begin
(v) how to monitor and respond to patient distress; and
new text end
new text begin
(vi) person-centered planning and trauma-informed care.
new text end
new text begin
(c) All staff having direct patient contact must be provided annual training on the
following:
new text end
new text begin
(1) infection control procedures;
new text end
new text begin
(2) mandatory reporting under sections 245A.65, 626.556, and 626.557, including
specific training covering the facility's policies concerning obtaining patient releases
of information;
new text end
new text begin
(3) HIV minimum standards as required in section 245A.19; and
new text end
new text begin
(4) motivational counseling techniques and identifying stages of change.
new text end
new text begin
(d) All staff having direct patient contact must be provided training every two
years on the following:
new text end
new text begin
(1) specific license holder and staff responsibilities for patient confidentiality;
new text end
new text begin
(2) standards governing use of protective procedures, including:
new text end
new text begin
(i) approved therapeutic holds;
new text end
new text begin
(ii) protective procedures used to prevent patients from imminent danger of harming
self or others;
new text end
new text begin
(iii) the emergency conditions under which the protective procedures may be used, if
any;
new text end
new text begin
(iv) documentation standards for using protective procedures;
new text end
new text begin
(v) how to monitor and respond to patient distress; and
new text end
new text begin
(vi) person-centered planning and trauma-informed care; and
new text end
new text begin
(3) patient ethical boundaries and patient rights, including the rights of patients
admitted under chapter 253B.
new text end
new text begin
(e) Continuing education that is completed in areas outside of the required topics
must provide information to the staff person that is useful to the performance of the
individual staff person's duties.
new text end
Sec. 17.
new text begin
[245F.17] PERSONNEL FILES.
new text end
new text begin
A license holder must maintain a separate personnel file for each staff member. At a
minimum, the file must contain:
new text end
new text begin
(1) a completed application for employment signed by the staff member that
contains the staff member's qualifications for employment and documentation related to
the applicant's background study data, as defined in chapter 245C;
new text end
new text begin
(2) documentation of the staff member's current professional license or registration,
if relevant;
new text end
new text begin
(3) documentation of orientation and subsequent training;
new text end
new text begin
(4) documentation of a statement of freedom from substance use problems; and
new text end
new text begin
(5) an annual job performance evaluation.
new text end
Sec. 18.
new text begin
[245F.18] POLICY AND PROCEDURES MANUAL.
new text end
new text begin
A license holder must develop a written policy and procedures manual that is
alphabetically indexed and has a table of contents, so that staff have immediate access
to all policies and procedures, and that consumers of the services, and other authorized
parties have access to all policies and procedures. The manual must contain the following
materials:
new text end
new text begin
(1) a description of patient education services as required in section 245F.06;
new text end
new text begin
(2) personnel policies that comply with section 245F.16;
new text end
new text begin
(3) admission information and referral and discharge policies that comply with
section 245F.05;
new text end
new text begin
(4) a health monitoring plan that complies with section 245F.12;
new text end
new text begin
(5) a protective procedures policy that complies with section 245F.09, if the program
elects to use protective procedures;
new text end
new text begin
(6) policies and procedures for assuring appropriate patient-to-staff ratios that
comply with section 245F.14;
new text end
new text begin
(7) policies and procedures for assessing and documenting the susceptibility for
risk of abuse to the patient as the basis for the individual abuse prevention plan required
by section 245A.65;
new text end
new text begin
(8) procedures for mandatory reporting as required by sections 245A.65, 626.556,
and 626.557;
new text end
new text begin
(9) a medication control plan that complies with section 245F.13; and
new text end
new text begin
(10) policies and procedures regarding HIV that meet the minimum standards
under section 245A.19.
new text end
Sec. 19.
new text begin
[245F.19] PATIENT RECORDS.
new text end
new text begin Subdivision 1. new text end
new text begin Patient records required. new text end
new text begin
A license holder must maintain a file of
current patient records on the program premises where the treatment is provided. Each
entry in each patient record must be signed and dated by the staff member making the
entry. Patient records must be protected against loss, tampering, or unauthorized disclosure
in compliance with chapter 13 and section 254A.09; Code of Federal Regulations, title 42,
sections 2.1 to 2.67; and title 45, parts 160 to 164.
new text end
new text begin Subd. 2. new text end
new text begin Records retention. new text end
new text begin
A license holder must retain and store records as
required by section 245A.041, subdivisions 3 and 4.
new text end
new text begin Subd. 3. new text end
new text begin Contents of records. new text end
new text begin
Patient records must include the following:
new text end
new text begin
(1) documentation of the patient's presenting problem, any substance use screening,
the most recent assessment, and any updates;
new text end
new text begin
(2) a stabilization plan and progress notes as required by section 245F.07,
subdivisions 1 and 2;
new text end
new text begin
(3) a discharge summary as required by section 245F.07, subdivision 3;
new text end
new text begin
(4) an individual abuse prevention plan that complies with section 245A.65, and
related rules;
new text end
new text begin
(5) documentation of referrals made; and
new text end
new text begin
(6) documentation of the monitoring and observations of the patient's medical needs.
new text end
Sec. 20.
new text begin
[245F.20] DATA COLLECTION REQUIRED.
new text end
new text begin
The license holder must participate in the drug and alcohol abuse normative
evaluation system (DAANES) by submitting, in a format provided by the commissioner,
information concerning each patient admitted to the program. Staff submitting data must
be trained by the license holder with the DAANES Web manual.
new text end
Sec. 21.
new text begin
[245F.21] PAYMENT METHODOLOGY.
new text end
new text begin
The commissioner shall develop a payment methodology for services provided
under this chapter or by an Indian Health Services facility or a facility owned and operated
by a tribe or tribal organization operating under Public Law 93-638 as a 638 facility. The
commissioner shall seek federal approval for the methodology. Upon federal approval, the
commissioner must seek and obtain legislative approval of the funding methodology to
support the service.
new text end
ARTICLE 4
DIRECT CARE AND TREATMENT
Section 1.
Minnesota Statutes 2014, section 43A.241, is amended to read:
43A.241 INSURANCE CONTRIBUTIONS; FORMER deleted text begin CORRECTIONS
deleted text end EMPLOYEES.
(a) This section applies to a person who:
(1) was employed by the commissioner of the Department of Corrections deleted text begin at a state
institution under control of the commissioner, and in that employment was a member
of the general plan of the Minnesota State Retirement System;deleted text end new text begin or by the Department
of Human Services;
new text end
(2) new text begin was covered by the correctional employee retirement plan under section 352.91
or the general state employees retirement plan of the Minnesota State Retirement System
as defined in section 352.021;
new text end
new text begin (3) while employed under clause (1), new text end was assaulted bynew text begin :
new text end
deleted text begin
an inmate at a state institution under control of the commissioner of the Department
of Corrections
deleted text end
new text begin
(i) a person under correctional supervision for a criminal offense; or
new text end
new text begin (ii) a client or patient at the Minnesota sex offender program, or at a state-operated
forensic services program as defined in section 352.91, subdivision 3j, under the control of
the commissioner of the Department of Human Servicesnew text end ; and
deleted text begin (3)deleted text end new text begin (4) as a direct result of the assault under clause (3), new text end was determined to be
totally and permanently new text begin physically new text end disabled under laws governing the Minnesota State
Retirement System.
(b) For a person to whom this section applies, the commissioner of the Department
of Corrections new text begin or the commissioner of the Department of Human Services new text end must continue
to make the employer contribution for deleted text begin hospital,deleted text end medicaldeleted text begin ,deleted text end and dental benefits under the
State Employee Group Insurance Program after the person terminates state service. If
the person had dependent coverage at the time of terminating state service, employer
contributions for dependent coverage also must continue under this section. The employer
contributions must be in the amount of the employer contribution for active state
employees at the time each payment is made. The employer contributions must continue
until the person reaches age 65, provided the person makes the required employee
contributions, in the amount required of an active state employee, at the time and in
the manner specified by the commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment
and applies to a person assaulted by an inmate, client, or patient on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2014, section 246.54, subdivision 1, is amended to read:
Subdivision 1.
County portion for cost of care.
(a) Except for chemical
dependency services provided under sections 254B.01 to 254B.09, the client's county
shall pay to the state of Minnesota a portion of the cost of care provided in a regional
treatment center or a state nursing facility to a client legally settled in that county. A
county's payment shall be made from the county's own sources of revenue and payments
shall equal a percentage of the cost of care, as determined by the commissioner, for each
day, or the portion thereof, that the client spends at a regional treatment center or a state
nursing facility according to the following schedule:
(1) zero percent for the first 30 days;
(2) 20 percent for days 31 deleted text begin to 60deleted text end new text begin and over if the stay is determined to be clinically
appropriate for the clientnew text end ; and
(3) deleted text begin 75 percent for any days over 60deleted text end new text begin 100 percent for each day during the stay,
including the day of admission, when the facility determines that it is clinically appropriate
for the client to be dischargednew text end .
deleted text begin
(b) The increase in the county portion for cost of care under paragraph (a), clause
(3), shall be imposed when the treatment facility has determined that it is clinically
appropriate for the client to be discharged.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end If payments received by the state under sections 246.50 to 246.53 exceed
80 percent of the cost of care for days new text begin over new text end 31 deleted text begin to 60, or 25 percent for days over 60deleted text end new text begin for
clients who meet the criteria in paragraph (a), clause (2)new text end , the county shall be responsible
for paying the state only the remaining amount. The county shall not be entitled to
reimbursement from the client, the client's estate, or from the client's relatives, except as
provided in section 246.53.
ARTICLE 5
SIMPLIFICATION OF PUBLIC ASSISTANCE PROGRAMS
Section 1.
Minnesota Statutes 2014, section 119B.011, subdivision 15, is amended to
read:
Subd. 15.
Income.
"Income" means earned deleted text begin or unearneddeleted text end income deleted text begin received by all
family members, includingdeleted text end new text begin as defined under section 256P.01, subdivision 3, unearned
income as defined under section 256P.01, subdivision 8, and new text end public assistance cash benefits
deleted text begin anddeleted text end new text begin , including the Minnesota family investment program, diversionary work program,
work benefit, Minnesota supplemental aid, general assistance, refugee cash assistance,
new text end at-home infant child care subsidy payments, deleted text begin unless specifically excludeddeleted text end and child support
and maintenance distributed to the family under section 256.741, subdivision 15. The
following are deleted text begin excludeddeleted text end new text begin deductednew text end from income: funds used to pay for health insurance
premiums for family members, deleted text begin Supplemental Security Income, scholarships, work-study
income, and grants that cover costs or reimbursement for tuition, fees, books, and
educational supplies; student loans for tuition, fees, books, supplies, and living expenses;
state and federal earned income tax credits; assistance specifically excluded as income by
law; in-kind income such as food support, energy assistance, foster care assistance, medical
assistance, child care assistance, and housing subsidies; earned income of full-time or
part-time students up to the age of 19, who have not earned a high school diploma or GED
high school equivalency diploma including earnings from summer employment; grant
awards under the family subsidy program; nonrecurring lump-sum income only to the
extent that it is earmarked and used for the purpose for which it is paid; and any income
assigned to the public authority according to section 256.741deleted text end new text begin and child or spousal support
paid to or on behalf of a person or persons who live outside of the household. Income
sources not included in this subdivision and section 256P.06, subdivision 3, are not countednew text end .
Sec. 2.
Minnesota Statutes 2014, section 119B.025, subdivision 1, is amended to read:
Subdivision 1.
Factors which must be verified.
(a) The county shall verify the
following at all initial child care applications using the universal application:
(1) identity of adults;
(2) presence of the minor child in the home, if questionable;
(3) relationship of minor child to the parent, stepparent, legal guardian, eligible
relative caretaker, or the spouses of any of the foregoing;
(4) age;
(5) immigration status, if related to eligibility;
(6) Social Security number, if given;
(7) income;
(8) spousal support and child support payments made to persons outside the
household;
(9) residence; and
(10) inconsistent information, if related to eligibility.
(b) If a family did not use the universal application or child care addendum to apply
for child care assistance, the family must complete the universal application or child care
addendum at its next eligibility redetermination and the county must verify the factors
listed in paragraph (a) as part of that redetermination. Once a family has completed a
universal application or child care addendum, the county shall use the redetermination
form described in paragraph (c) for that family's subsequent redeterminations. Eligibility
must be redetermined at least every six months. A family is considered to have met the
eligibility redetermination requirement if a complete redetermination form and all required
verifications are received within 30 days after the date the form was due. Assistance shall
be payable retroactively from the redetermination due date. For a family where at least
one parent is under the age of 21, does not have a high school or general equivalency
diploma, and is a student in a school district or another similar program that provides or
arranges for child care, as well as parenting, social services, career and employment
supports, and academic support to achieve high school graduation, the redetermination of
eligibility shall be deferred beyond six months, but not to exceed 12 months, to the end of
the student's school year. If a family reports a change in an eligibility factor before the
family's next regularly scheduled redetermination, the county must recalculate eligibility
without requiring verification of any eligibility factor that did not change.new text begin Changes must
be reported as required by section 256P.07. A change in income occurs on the day the
participant received the first payment reflecting the change in income.
new text end
(c) The commissioner shall develop a redetermination form to redetermine eligibility
and a change report form to report changes that minimize paperwork for the county and
the participant.
Sec. 3.
Minnesota Statutes 2014, section 119B.035, subdivision 4, is amended to read:
Subd. 4.
Assistance.
(a) A family is limited to a lifetime total of 12 months of
assistance under subdivision 2. The maximum rate of assistance is equal to 68 percent
of the rate established under section 119B.13 for care of infants in licensed family child
care in the applicant's county of residence.
(b) A participating family must report income and other family changes as specified in
new text begin sections 256P.06 and 256P.07, and new text end the county's plan under section 119B.08, subdivision 3.
(c) Persons who are admitted to the at-home infant child care program retain their
position in any basic sliding fee program. Persons leaving the at-home infant child care
program reenter the basic sliding fee program at the position they would have occupied.
(d) Assistance under this section does not establish an employer-employee
relationship between any member of the assisted family and the county or state.
Sec. 4.
Minnesota Statutes 2014, section 119B.09, subdivision 4, is amended to read:
Subd. 4.
Eligibility; annual income; calculation.
Annual income of the applicant
family is the current monthly income of the family multiplied by 12 or the income for
the 12-month period immediately preceding the date of application, or income calculated
by the method which provides the most accurate assessment of income available to the
family. Self-employment income must be calculated based on gross receipts less operating
expenses. Income must be recalculated when the family's income changes, but no less
often than every six months. For a family where at least one parent is under the age of
21, does not have a high school or general equivalency diploma, and is a student in a
school district or another similar program that provides or arranges for child care, as well
as parenting, social services, career and employment supports, and academic support to
achieve high school graduation, income must be recalculated when the family's income
changes, but otherwise shall be deferred beyond six months, but not to exceed 12 months,
to the end of the student's school year.new text begin Included lump sums counted as income under
section 256P.06, subdivision 3, must be annualized over 12 months.new text end Income must be
verified with documentary evidence. If the applicant does not have sufficient evidence of
income, verification must be obtained from the source of the income.
Sec. 5.
Minnesota Statutes 2014, section 256D.01, subdivision 1a, is amended to read:
Subd. 1a.
Standards.
(a) A principal objective in providing general assistance is
to provide for single adults, childless couples, or children as defined in section 256D.02,
subdivision 6, ineligible for federal programs who are unable to provide for themselves.
The minimum standard of assistance determines the total amount of the general assistance
grant without separate standards for shelter, utilities, or other needs.
(b) The commissioner shall set the standard of assistance for an assistance unit
consisting of an adult recipient who is childless and unmarried or living apart from
children and spouse and who does not live with a parent or parents or a legal custodian.
When the other standards specified in this subdivision increase, this standard must also be
increased by the same percentage.
(c) For an assistance unit consisting of a single adult who lives with a parent or
parents, the general assistance standard of assistance is the amount that the aid to families
with dependent children standard of assistance, in effect on July 16, 1996, would increase
if the recipient were added as an additional minor child to an assistance unit consisting
of the recipient's parent and all of that parent's family members, except that the standard
may not exceed the standard for a general assistance recipient living alone. Benefits
received by a responsible relative of the assistance unit under the Supplemental Security
Income program, a workers' compensation program, the Minnesota supplemental aid
program, or any other program based on the responsible relative's disability, and any
benefits received by a responsible relative of the assistance unit under the Social Security
retirement program, may not be counted in the determination of eligibility or benefit
level for the assistance unit. Except as provided below, the assistance unit is ineligible
for general assistance if the available resources or the countable income of the assistance
unit and the parent or parents with whom the assistance unit lives are such that a family
consisting of the assistance unit's parent or parents, the parent or parents' other family
members and the assistance unit as the only or additional minor child would be financially
ineligible for general assistance. For the purposes of calculating the countable income
of the assistance unit's parent or parents, the calculation methodsdeleted text begin , income deductions,
exclusions, and disregards used when calculating the countable income for a single adult
or childless coupledeleted text end must deleted text begin be useddeleted text end new text begin follow the provisions under section 256P.06new text end .
(d) For an assistance unit consisting of a childless couple, the standards of assistance
are the same as the first and second adult standards of the aid to families with dependent
children program in effect on July 16, 1996. If one member of the couple is not included
in the general assistance grant, the standard of assistance for the other is the second adult
standard of the aid to families with dependent children program as of July 16, 1996.
Sec. 6.
Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Assistance unit. new text end
new text begin
"Assistance unit" means an individual who is, or an
eligible married couple who live together who are, applying for or receiving benefits
under this chapter.
new text end
Sec. 7.
Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin Cash assistance benefit. new text end
new text begin
"Cash assistance benefit" means any payment
received as a disability benefit, including veterans or workers' compensation; old age,
survivors, and disability insurance; railroad retirement benefits; unemployment benefits;
and benefits under any federally aided categorical assistance program, Supplemental
Security Income, or other assistance program.
new text end
Sec. 8.
Minnesota Statutes 2014, section 256D.02, subdivision 8, is amended to read:
Subd. 8.
Income.
"Income" means deleted text begin any form of income, including remuneration
for services performed as an employee and earned income from rental income and
self-employment earnings as described under section 256P.05deleted text end new text begin earned income as defined
under section 256P.01, subdivision 3, and unearned income as defined under section
256P.01, subdivision 8new text end .
deleted text begin
Income includes any payments received as an annuity, retirement, or disability
benefit, including veteran's or workers' compensation; old age, survivors, and disability
insurance; railroad retirement benefits; unemployment benefits; and benefits under any
federally aided categorical assistance program, supplementary security income, or other
assistance program; rents, dividends, interest and royalties; and support and maintenance
payments. Such payments may not be considered as available to meet the needs of any
person other than the person for whose benefit they are received, unless that person is
a family member or a spouse and the income is not excluded under section 256D.01,
subdivision 1a. Goods and services provided in lieu of cash payment shall be excluded
from the definition of income, except that payments made for room, board, tuition or
fees by a parent, on behalf of a child enrolled as a full-time student in a postsecondary
institution, and payments made on behalf of an applicant or participant which the applicant
or participant could legally demand to receive personally in cash, must be included as
income. Benefits of an applicant or participant, such as those administered by the Social
Security Administration, that are paid to a representative payee, and are spent on behalf of
the applicant or participant, are considered available income of the applicant or participant.
deleted text end
Sec. 9.
Minnesota Statutes 2014, section 256D.06, subdivision 1, is amended to read:
Subdivision 1.
Eligibility; amount of assistance.
General assistance shall be
granted in an amount that when added to the deleted text begin nonexemptdeleted text end new text begin countable new text end income new text begin as determined
to be new text end actually available to the assistance unitnew text begin under section 256P.06new text end , the total amount
equals the applicable standard of assistance for general assistance. In determining
eligibility for and the amount of assistance for an individual or married couple, the agency
shall apply the earned income disregard as determined in section 256P.03.
Sec. 10.
Minnesota Statutes 2014, section 256D.405, subdivision 3, is amended to read:
Subd. 3.
Reports.
Participants must report changes in circumstances new text begin according to
section 256P.07 new text end that affect eligibility or assistance payment amounts within ten days of the
change. Participants who do not receive SSI because of excess income must complete a
monthly report form if they have earned income, if they have income deemed to them
from a financially responsible relative with whom the participant resides, or if they have
income deemed to them by a sponsor. If the report form is not received before the end of
the month in which it is due, the county agency must terminate assistance. The termination
shall be effective on the first day of the month following the month in which the report
was due. If a complete report is received within the month the assistance was terminated,
the assistance unit is considered to have continued its application for assistance, effective
the first day of the month the assistance was terminated.
Sec. 11.
Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin Assistance unit. new text end
new text begin
"Assistance unit" means an individual who is applying
for or receiving benefits under this chapter.
new text end
Sec. 12.
Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:
Subd. 7.
Countable income.
"Countable income" means all income received by an
applicant or recipient new text begin as described under section 256P.06, new text end less any applicable exclusions
or disregards. For a recipient of any cash benefit from the SSI program, countable income
means the SSI benefit limit in effect at the time the person is in a GRH, less the medical
assistance personal needs allowance. If the SSI limit has been reduced for a person due to
events occurring prior to the persons entering the GRH setting, countable income means
actual income less any applicable exclusions and disregards.
Sec. 13.
Minnesota Statutes 2014, section 256I.04, subdivision 1, is amended to read:
Subdivision 1.
Individual eligibility requirements.
An individual is eligible for
and entitled to a group residential housing payment to be made on the individual's behalf
if the agency has approved the individual's residence in a group residential housing setting
and the individual meets the requirements in paragraph (a) or (b).
(a) The individual is aged, blind, or is over 18 years of age and disabled as
determined under the criteria used by the title II program of the Social Security Act, and
meets the resource restrictions and standards of section 256P.02, and the individual's
countable income after deducting the (1) exclusions and disregards of the SSI program,
(2) the medical assistance personal needs allowance under section 256B.35, and (3) an
amount equal to the income actually made available to a community spouse by an elderly
waiver participant under the provisions of sections 256B.0575, paragraph (a), clause
(4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's
agreement with the provider of group residential housing in which the individual resides.
(b) The individual meets a category of eligibility under section 256D.05, subdivision
1, paragraph (a), and the individual's resources are less than the standards specified by
section 256P.02, and the individual's countable income as determined under deleted text begin sections
256D.01 to 256D.21deleted text end new text begin section 256P.06new text end , less the medical assistance personal needs allowance
under section 256B.35 is less than the monthly rate specified in the agency's agreement
with the provider of group residential housing in which the individual resides.
Sec. 14.
Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:
Subd. 6.
Reports.
Recipients must report changes in circumstances new text begin according
to section 256P.07 new text end that affect eligibility or group residential housing payment amounts
within ten days of the change. Recipients with countable earned income must complete
a monthly household report form. If the report form is not received before the end of
the month in which it is due, the county agency must terminate eligibility for group
residential housing payments. The termination shall be effective on the first day of the
month following the month in which the report was due. If a complete report is received
within the month eligibility was terminated, the individual is considered to have continued
an application for group residential housing payment effective the first day of the month
the eligibility was terminated.
Sec. 15.
Minnesota Statutes 2014, section 256J.08, subdivision 26, is amended to read:
Subd. 26.
Earned income.
"Earned income" deleted text begin means cash or in-kind income earned
through the receipt of wages, salary, commissions, profit from employment activities, net
profit from self-employment activities, payments made by an employer for regularly
accrued vacation or sick leave, and any other profit from activity earned through effort or
labor. The income must be in return for, or as a result of, legal activitydeleted text end new text begin has the meaning
given in section 256P.01, subdivision 3new text end .
Sec. 16.
Minnesota Statutes 2014, section 256J.08, subdivision 86, is amended to read:
Subd. 86.
Unearned income.
"Unearned income" deleted text begin means income received by
a person that does not meet the definition of earned income. Unearned income includes
income from a contract for deed, interest, dividends, unemployment benefits, disability
insurance payments, veterans benefits, pension payments, return on capital investment,
insurance payments or settlements, severance payments, child support and maintenance
payments, and payments for illness or disability whether the premium payments are
made in whole or in part by an employer or participantdeleted text end new text begin has the meaning given in section
256P.01, subdivision 8new text end .
Sec. 17.
Minnesota Statutes 2014, section 256J.30, subdivision 1, is amended to read:
Subdivision 1.
Applicant reporting requirements.
An applicant must provide
information on an application form and supplemental forms about the applicant's
circumstances deleted text begin which affect MFIP eligibility or the assistance payment. An applicant must
report changes identified in subdivision 9 while the application is pending. When an
applicant does not accurately report information on an application, both an overpayment
and a referral for a fraud investigation may result. When an applicant does not provide
information or documentation, the receipt of the assistance payment may be delayed or the
application may be denied depending on the type of information required and its effect on
eligibilitydeleted text end new text begin according to section 256P.07new text end .
Sec. 18.
Minnesota Statutes 2014, section 256J.30, subdivision 9, is amended to read:
Subd. 9.
Changes that must be reported.
A caregiver must report deleted text begin the changes or
anticipated changes specified in clauses (1) to (15) within ten days of the date they occur,
at the time of the periodic recertification of eligibility under section 256P.04, subdivisions
8 and 9, or within eight calendar days of a reporting period as in subdivision 5, whichever
occurs first. A caregiver must report other changes at the time of the periodic recertification
of eligibility under section 256P.04, subdivisions 8 and 9, or at the end of a reporting period
under subdivision 5, as applicable. A caregiver must make these reports in writing to the
agency. When an agency could have reduced or terminated assistance for one or more
payment months if a delay in reporting a change specified under clauses (1) to (14) had
not occurred, the agency must determine whether a timely notice under section 256J.31,
subdivision 4, could have been issued on the day that the change occurred. When a timely
notice could have been issued, each month's overpayment subsequent to that notice must be
considered a client error overpayment under section 256J.38. Calculation of overpayments
for late reporting under clause (15) is specified in section 256J.09, subdivision 9. Changes
in circumstances which must be reported within ten days must also be reported on the
MFIP household report form for the reporting period in which those changes occurred.
Within ten days, a caregiver must report:deleted text end new text begin changes as specified under section 256P.07.
new text end
deleted text begin
(1) a change in initial employment;
deleted text end
deleted text begin
(2) a change in initial receipt of unearned income;
deleted text end
deleted text begin
(3) a recurring change in unearned income;
deleted text end
deleted text begin
(4) a nonrecurring change of unearned income that exceeds $30;
deleted text end
deleted text begin
(5) the receipt of a lump sum;
deleted text end
deleted text begin
(6) an increase in assets that may cause the assistance unit to exceed asset limits;
deleted text end
deleted text begin
(7) a change in the physical or mental status of an incapacitated member of the
assistance unit if the physical or mental status is the basis for reducing the hourly
participation requirements under section 256J.55, subdivision 1, or the type of activities
included in an employment plan under section 256J.521, subdivision 2;
deleted text end
deleted text begin
(8) a change in employment status;
deleted text end
deleted text begin
(9) the marriage or divorce of an assistance unit member;
deleted text end
deleted text begin
(10) the death of a parent, minor child, or financially responsible person;
deleted text end
deleted text begin
(11) a change in address or living quarters of the assistance unit;
deleted text end
deleted text begin
(12) the sale, purchase, or other transfer of property;
deleted text end
deleted text begin
(13) a change in school attendance of a caregiver under age 20 or an employed child;
deleted text end
deleted text begin
(14) filing a lawsuit, a workers' compensation claim, or a monetary claim against a
third party; and
deleted text end
deleted text begin
(15) a change in household composition, including births, returns to and departures
from the home of assistance unit members and financially responsible persons, or a change
in the custody of a minor child.
deleted text end
Sec. 19.
Minnesota Statutes 2014, section 256J.35, is amended to read:
256J.35 AMOUNT OF ASSISTANCE PAYMENT.
Except as provided in paragraphs (a) to (d), the amount of an assistance payment is
equal to the difference between the MFIP standard of need or the Minnesota family wage
level in section 256J.24 and countable income.
(a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing
assistance grant of $110 per month, unless:
(1) the housing assistance unit is currently receiving public and assisted rental
subsidies provided through the Department of Housing and Urban Development (HUD)
and is subject to section 256J.37, subdivision 3a; or
(2) the assistance unit is a child-only case under section 256J.88.
(b) When MFIP eligibility exists for the month of application, the amount of the
assistance payment for the month of application must be prorated from the date of
application or the date all other eligibility factors are met for that applicant, whichever is
later. This provision applies when an applicant loses at least one day of MFIP eligibility.
(c) MFIP overpayments to an assistance unit must be recouped according to section
deleted text begin 256J.38, subdivision 4deleted text end new text begin 256P.08, subdivision 6new text end .
(d) An initial assistance payment must not be made to an applicant who is not
eligible on the date payment is made.
Sec. 20.
Minnesota Statutes 2014, section 256J.40, is amended to read:
256J.40 FAIR HEARINGS.
Caregivers receiving a notice of intent to sanction or a notice of adverse action that
includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or
termination of benefits may request a fair hearing. A request for a fair hearing must be
submitted in writing to the county agency or to the commissioner and must be mailed
within 30 days after a participant or former participant receives written notice of the
agency's action or within 90 days when a participant or former participant shows good
cause for not submitting the request within 30 days. A former participant who receives a
notice of adverse action due to an overpayment may appeal the adverse action according
to the requirements in this section. Issues that may be appealed are:
(1) the amount of the assistance payment;
(2) a suspension, reduction, denial, or termination of assistance;
(3) the basis for an overpayment, the calculated amount of an overpayment, and
the level of recoupment;
(4) the eligibility for an assistance payment; and
(5) the use of protective or vendor payments under section 256J.39, subdivision 2,
clauses (1) to (3).
Except for benefits issued under section 256J.95, a county agency must not reduce,
suspend, or terminate payment when an aggrieved participant requests a fair hearing
prior to the effective date of the adverse action or within ten days of the mailing of the
notice of adverse action, whichever is later, unless the participant requests in writing not
to receive continued assistance pending a hearing decision. An appeal request cannot
extend benefits for the diversionary work program under section 256J.95 beyond the
four-month time limit. Assistance issued pending a fair hearing is subject to recovery
under section deleted text begin 256J.38deleted text end new text begin 256P.08new text end when as a result of the fair hearing decision the participant
is determined ineligible for assistance or the amount of the assistance received. A county
agency may increase or reduce an assistance payment while an appeal is pending when the
circumstances of the participant change and are not related to the issue on appeal. The
commissioner's order is binding on a county agency. No additional notice is required to
enforce the commissioner's order.
A county agency shall reimburse appellants for reasonable and necessary expenses
of attendance at the hearing, such as child care and transportation costs and for the
transportation expenses of the appellant's witnesses and representatives to and from the
hearing. Reasonable and necessary expenses do not include legal fees. Fair hearings
must be conducted at a reasonable time and date by an impartial human services judge
employed by the department. The hearing may be conducted by telephone or at a site that
is readily accessible to persons with disabilities.
The appellant may introduce new or additional evidence relevant to the issues on
appeal. Recommendations of the human services judge and decisions of the commissioner
must be based on evidence in the hearing record and are not limited to a review of the
county agency action.
Sec. 21.
Minnesota Statutes 2014, section 256J.95, subdivision 19, is amended to read:
Subd. 19.
DWP overpayments and underpayments.
DWP benefits are subject
to overpayments and underpayments. Anytime an overpayment or an underpayment is
determined for DWP, the correction shall be calculated using prospective budgeting.
Corrections shall be determined based on the policy in section 256J.34, subdivision 1,
paragraphs (a), (b), and (c). ATM errors must be recovered as specified in section deleted text begin 256J.38,
subdivision 5deleted text end new text begin 256P.08, subdivision 7new text end . Cross program recoupment of overpayments cannot
be assigned to or from DWP.
Sec. 22.
Minnesota Statutes 2014, section 256P.001, is amended to read:
256P.001 APPLICABILITY.
General assistance and Minnesota supplemental aid under chapter 256Dnew text begin , child care
assistance programs under chapter 119B, new text end and programs governed by chapter 256I or 256J
are subject to the requirements of this chapter, unless otherwise specified or exempted.
Sec. 23.
Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Assistance unit. new text end
new text begin
"Assistance unit" is defined by program area under
sections 119B.011, subdivision 13; 256D.02, subdivision 1a; 256D.35, subdivision 3a;
256I.03, subdivision 1b; and 256J.08, subdivision 7.
new text end
Sec. 24.
Minnesota Statutes 2014, section 256P.01, subdivision 3, is amended to read:
Subd. 3.
Earned income.
"Earned income" means cash or in-kind income earned
through the receipt of wages, salary, commissions, new text begin bonuses, tips, gratuities, new text end profit from
employment activities, net profit from self-employment activities, payments made by
an employer for regularly accrued vacation or sick leave, deleted text begin and anydeleted text end new text begin severance pay based
on accrued leave time, payments from training programs at a rate at or greater than the
state's minimum wage, royalties, honoraria, or new text end other profit from activity deleted text begin earned through
effortdeleted text end new text begin that results from the client's work, service, effort, new text end or labor. The income must be in
return for, or as a result of, legal activity.
Sec. 25.
Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Unearned income. new text end
new text begin
"Unearned income" has the meaning given in section
256P.06, subdivision 3, clause (2).
new text end
Sec. 26.
Minnesota Statutes 2014, section 256P.02, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Exemption. new text end
new text begin
Participants who qualify for child care assistance programs
under chapter 119B are exempt from this section.
new text end
Sec. 27.
Minnesota Statutes 2014, section 256P.03, subdivision 1, is amended to read:
Subdivision 1.
Exempted programs.
Participants who qualify for new text begin child care
assistance programs under chapter 119B, new text end Minnesota supplemental aid under chapter
256Dnew text begin ,new text end and deleted text begin fordeleted text end group residential housing under chapter 256I on the basis of eligibility for
Supplemental Security Income are exempt from this section.
Sec. 28.
Minnesota Statutes 2014, section 256P.04, subdivision 1, is amended to read:
Subdivision 1.
Exemption.
Participants who receive Minnesota supplemental aid
and who maintain Supplemental Security Income eligibility under chapters 256D and 256I
are exempt from the reporting requirements of this section, except that the policies and
procedures for transfers of assets are those used by the medical assistance program under
section 256B.0595.new text begin Participants who receive child care assistance under chapter 119B are
exempt from the requirements of this section.
new text end
Sec. 29.
Minnesota Statutes 2014, section 256P.04, subdivision 4, is amended to read:
Subd. 4.
Factors to be verified.
(a) The agency shall verify the following at
application:
(1) identity of adults;
(2) age, if necessary to determine eligibility;
(3) immigration status;
(4) income;
(5) spousal support and child support payments made to persons outside the
household;
(6) vehicles;
(7) checking and savings accounts;
(8) inconsistent information, if related to eligibility;
(9) residence; deleted text begin and
deleted text end
(10) Social Security numberdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2),
item (ix), for the intended purpose for which it was given and received.
new text end
(b) Applicants who are qualified noncitizens and victims of domestic violence as
defined under section 256J.08, subdivision 73, clause (7), are not required to verify the
information in paragraph (a), clause (10). When a Social Security number is not provided
to the agency for verification, this requirement is satisfied when each member of the
assistance unit cooperates with the procedures for verification of Social Security numbers,
issuance of duplicate cards, and issuance of new numbers which have been established
jointly between the Social Security Administration and the commissioner.
Sec. 30.
Minnesota Statutes 2014, section 256P.05, subdivision 1, is amended to read:
Subdivision 1.
Exempted programs.
Participants who qualify fornew text begin child care
assistance programs under chapter 119B, new text end Minnesota supplemental aid under chapter
256Dnew text begin ,new text end and deleted text begin fordeleted text end group residential housing under chapter 256I on the basis of eligibility for
Supplemental Security Income are exempt from this section.
Sec. 31.
new text begin
[256P.06] INCOME CALCULATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Reporting of income. new text end
new text begin
To determine eligibility, the county agency
must evaluate income received by members of the assistance unit, or by other persons
whose income is considered available to the assistance unit, and only count income that
is available to the assistance unit. Income is available if the individual has legal access
to the income.
new text end
new text begin Subd. 2. new text end
new text begin Exempted individuals. new text end
new text begin
The following members of an assistance unit
under chapters 119B and 256J are exempt from having their earned income count towards
the income of an assistance unit:
new text end
new text begin
(1) children under six years old;
new text end
new text begin
(2) caregivers under 20 years of age enrolled at least half-time in school; and
new text end
new text begin
(3) minors enrolled in school full time.
new text end
new text begin Subd. 3. new text end
new text begin Income inclusions. new text end
new text begin
The following must be included in determining the
income of an assistance unit:
new text end
new text begin
(1) earned income; and
new text end
new text begin
(2) unearned income, which includes:
new text end
new text begin
(i) interest and dividends from investments and savings;
new text end
new text begin
(ii) capital gains as defined by the Internal Revenue Service from any sale of real
property;
new text end
new text begin
(iii) proceeds from rent and contract for deed payments in excess of the principal
and interest portion owed on property;
new text end
new text begin
(iv) income from trusts, excluding special needs and supplemental needs trusts;
new text end
new text begin
(v) interest income from loans made by the participant or household;
new text end
new text begin
(vi) cash prizes and winnings;
new text end
new text begin
(vii) unemployment insurance income;
new text end
new text begin
(viii) retirement, survivors, and disability insurance payments;
new text end
new text begin
(ix) nonrecurring income over $60 per quarter unless earmarked and used for the
purpose for which it is intended. Income and use of this income is subject to verification
requirements under section 256P.04;
new text end
new text begin
(x) retirement benefits;
new text end
new text begin
(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D,
256I, and 256J;
new text end
new text begin
(xii) tribal per capita payments unless excluded by federal and state law;
new text end
new text begin
(xiii) income and payments from service and rehabilitation programs that meet
or exceed the state's minimum wage rate;
new text end
new text begin
(xiv) income from members of the United States armed forces unless excluded from
income taxes according to federal or state law;
new text end
new text begin
(xv) all child support payments for programs under chapters 119B, 256D, and 256I;
new text end
new text begin
(xvi) the amount of current child support received that exceeds $100 for assistance
units with one child and $200 for assistance units with two or more children for programs
under chapter 256J; and
new text end
new text begin
(xvii) spousal support.
new text end
Sec. 32.
new text begin
[256P.07] REPORTING OF INCOME AND CHANGES.
new text end
new text begin Subdivision 1. new text end
new text begin Exempted programs. new text end
new text begin
Participants who qualify for Minnesota
supplemental aid under chapter 256D and for group residential housing under chapter 256I
on the basis of eligibility for Supplemental Security Income are exempt from this section.
new text end
new text begin Subd. 2. new text end
new text begin Reporting requirements. new text end
new text begin
An applicant or participant must provide
information on an application and any subsequent reporting forms about the assistance
unit's circumstances that affect eligibility or benefits. An applicant or assistance unit must
report changes identified in subdivision 3. When information is not accurately reported,
both an overpayment and a referral for a fraud investigation may result. When information
or documentation is not provided, the receipt of any benefit may be delayed or denied,
depending on the type of information required and its effect on eligibility.
new text end
new text begin Subd. 3. new text end
new text begin Changes that must be reported. new text end
new text begin
An assistance unit must report the
changes or anticipated changes specified in clauses (1) to (12) within ten days of the date
they occur, at the time of recertification of eligibility under section 256P.04, subdivisions
8 and 9, or within eight calendar days of a reporting period, whichever occurs first. An
assistance unit must report other changes at the time of recertification of eligibility under
section 256P.04, subdivisions 8 and 9, or at the end of a reporting period, as applicable.
When an agency could have reduced or terminated assistance for one or more payment
months if a delay in reporting a change specified under clauses (1) to (12) had not occurred,
the agency must determine whether a timely notice could have been issued on the day
that the change occurred. When a timely notice could have been issued, each month's
overpayment subsequent to that notice must be considered a client error overpayment
under section 119B.11, subdivision 2a, or 256P.08. Changes in circumstances that must
be reported within ten days must also be reported for the reporting period in which those
changes occurred. Within ten days, an assistance unit must report:
new text end
new text begin
(1) a change in earned income of $100 per month or greater;
new text end
new text begin
(2) a change in unearned income of $50 per month or greater;
new text end
new text begin
(3) a change in employment status and hours;
new text end
new text begin
(4) a change in address or residence;
new text end
new text begin
(5) a change in household composition with the exception of programs under
chapter 256I;
new text end
new text begin
(6) a receipt of a lump-sum payment;
new text end
new text begin
(7) an increase in assets if over $9,000 with the exception of programs under chapter
119B;
new text end
new text begin
(8) a change in citizenship or immigration status;
new text end
new text begin
(9) a change in family status with the exception of programs under chapter 256I;
new text end
new text begin
(10) a change in disability status of a unit member, with the exception of programs
under chapter 119B;
new text end
new text begin
(11) a new rent subsidy or a change in rent subsidy; and
new text end
new text begin
(12) a sale, purchase, or transfer of real property.
new text end
new text begin Subd. 4. new text end
new text begin MFIP-specific reporting. new text end
new text begin
In addition to subdivision 3, an assistance unit
under chapter 256J, within ten days of the change, must report:
new text end
new text begin
(1) a pregnancy not resulting in birth when there are no other minor children; and
new text end
new text begin
(2) a change in school attendance of a parent under 20 years of age or of an
employed child.
new text end
new text begin Subd. 5. new text end
new text begin DWP-specific reporting. new text end
new text begin
In addition to subdivisions 3 and 4, an assistance
unit participating in the diversionary work program under section 256J.95 must report
on an application:
new text end
new text begin
(1) shelter expenses; and
new text end
new text begin
(2) utility expenses.
new text end
new text begin Subd. 6. new text end
new text begin Child care assistance programs-specific reporting. new text end
new text begin
In addition to
subdivision 3, an assistance unit under chapter 119B, within ten days of the change, must
report:
new text end
new text begin
(1) a change in a parentally responsible individual's visitation schedule or custody
arrangement for any child receiving child care assistance program benefits; and
new text end
new text begin
(2) a change in authorized activity status.
new text end
new text begin Subd. 7. new text end
new text begin Minnesota supplemental aid-specific reporting. new text end
new text begin
In addition to
subdivision 3, an assistance unit participating in the Minnesota supplemental aid program
under section 256D.44, subdivision 5, paragraph (f), within ten days of the change, must
report shelter expenses.
new text end
Sec. 33.
new text begin
[256P.08] CORRECTION OF OVERPAYMENTS AND
UNDERPAYMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Exempted programs. new text end
new text begin
Participants who qualify for child care
assistance programs under chapter 119B or group residential housing under chapter 256I
are exempt from this section.
new text end
new text begin Subd. 2. new text end
new text begin Scope of overpayment. new text end
new text begin
(a) When a participant or former participant
receives an overpayment due to client or ATM error, or due to assistance received while
an appeal is pending and the participant or former participant is determined ineligible
for assistance or for less assistance than was received, except as provided for interim
assistance in section 256D.06, subdivision 5, the county agency must recoup or recover
the overpayment using the following methods:
new text end
new text begin
(1) reconstruct each affected budget month and corresponding payment month;
new text end
new text begin
(2) use the policies and procedures that were in effect for the payment month; and
new text end
new text begin
(3) do not allow employment disregards in the calculation of the overpayment when
the unit has not reported within two calendar months following the end of the month in
which the income was received.
new text end
new text begin
(b) Establishment of an overpayment is limited to six years prior to the month of
discovery due to client error or an intentional program violation determined under section
256.046.
new text end
new text begin
(c) A participant or former participant is not responsible for overpayments due to
agency error, unless the amount of the overpayment is large enough that a reasonable
person would know it is an error.
new text end
new text begin Subd. 3. new text end
new text begin Notice of overpayment. new text end
new text begin
When a county agency discovers that a participant
or former participant has received an overpayment for one or more months, the county
agency must notify the participant or former participant of the overpayment in writing.
A notice of overpayment must specify the reason for the overpayment, the authority for
citing the overpayment, the time period in which the overpayment occurred, the amount of
the overpayment, and the participant's or former participant's right to appeal. No limit
applies to the period in which the county agency is required to recoup or recover an
overpayment according to subdivisions 4, 5, and 6.
new text end
new text begin Subd. 4. new text end
new text begin
Recovering general assistance and Minnesota supplemental aid
overpayments.
new text end
new text begin
(a) If an amount of assistance is paid to an assistance unit in excess of the
payment due, it shall be recoverable by the agency. The agency shall give written notice to
the participant of its intention to recover the overpayment.
new text end
new text begin
(b) If the individual is no longer receiving assistance, the agency may request
voluntary repayment or pursue civil recovery.
new text end
new text begin
(c) If the individual is receiving assistance, except as provided for interim assistance
in section 256D.06, subdivision 5, when an overpayment occurs the agency shall recover
the overpayment by withholding an amount equal to:
new text end
new text begin
(1) three percent of the assistance unit's standard of need for all Minnesota
supplemental aid assistance units, and nonfraud cases for general assistance; and
new text end
new text begin
(2) ten percent where fraud has occurred in general assistance cases; or
new text end
new text begin
(3) the amount of the monthly general assistance or Minnesota supplemental aid
payment, whichever is less.
new text end
new text begin
(d) In cases when there is both an overpayment and underpayment, the county
agency shall offset one against the other in correcting the payment.
new text end
new text begin
(e) Overpayments may also be voluntarily repaid, in part or in full, by the individual,
in addition to the assistance reductions provided in this subdivision, to include further
voluntary reductions in the grant level agreed to in writing by the individual, until the
total amount of the overpayment is repaid.
new text end
new text begin
(f) The county agency shall make reasonable efforts to recover overpayments to
individuals no longer on assistance. The agency need not attempt to recover overpayments
of less than $35 paid to an individual no longer on assistance if the individual does not
receive assistance again within three years, unless the individual has been convicted of
violating section 256.98.
new text end
new text begin
(g) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to agency error and six years prior to the month of discovery due to client
error or an intentional program violation determined under section 256.046.
new text end
new text begin
(h) Residents of licensed residential facilities shall not have overpayments recovered
from their personal needs allowance.
new text end
new text begin
(i) Overpayments by another maintenance benefit program shall not be recovered
from the general assistance or Minnesota supplemental aid grant.
new text end
new text begin Subd. 5. new text end
new text begin Recovering MFIP overpayments. new text end
new text begin
A county agency must initiate efforts
to recover overpayments paid to a former participant or caregiver. Caregivers, both
parental and nonparental, and minor caregivers of an assistance unit at the time an
overpayment occurs, whether receiving assistance or not, are jointly and individually
liable for repayment of the overpayment. The county agency must request repayment
from the former participants and caregivers. When an agreement for repayment is
not completed within six months of the date of discovery or when there is a default on
an agreement for repayment after six months, the county agency must initiate recovery
consistent with chapter 270A or section 541.05. When a person has been disqualified
or convicted of fraud under section 256.98, recovery must be sought regardless of the
amount of overpayment. When an overpayment is less than $35, and is not the result of a
fraud conviction under section 256.98, the county agency must not seek recovery under
this subdivision. The county agency must retain information about all overpayments
regardless of the amount. When an adult, adult caregiver, or minor caregiver reapplies for
assistance, the overpayment must be recouped under subdivision 6.
new text end
new text begin Subd. 6. new text end
new text begin Recouping overpayments from MFIP participants. new text end
new text begin
A participant may
voluntarily repay, in part or in full, an overpayment even if assistance is reduced under this
subdivision, until the total amount of the overpayment is repaid. When an overpayment
occurs due to fraud, the county agency must recover from the overpaid assistance unit,
including child-only cases, ten percent of the applicable standard or the amount of the
monthly assistance payment, whichever is less. When a nonfraud overpayment occurs,
the county agency must recover from the overpaid assistance unit, including child-only
cases, three percent of the MFIP standard of need or the amount of the monthly assistance
payment, whichever is less.
new text end
new text begin Subd. 7. new text end
new text begin Recovering automatic teller machine errors. new text end
new text begin
For recipients receiving
benefits by electronic benefit transfer, if the overpayment is a result of an ATM dispensing
funds in error to the recipient, the agency may recover the ATM error by immediately
withdrawing funds from the recipient's electronic benefit transfer account, up to the
amount of the error.
new text end
new text begin Subd. 8. new text end
new text begin Scope of underpayments. new text end
new text begin
A county agency must issue a corrective
payment for underpayments made to a participant or to a person who would be a
participant if an agency or client error causing the underpayment had not occurred.
Corrective payments are limited to 12 months prior to the month of discovery. The county
agency must issue the corrective payment according to subdivision 10.
new text end
new text begin Subd. 9. new text end
new text begin Identifying the underpayment. new text end
new text begin
An underpayment may be identified by
a county agency, participant, former participant, or person who would be a participant
except for agency or client error.
new text end
new text begin Subd. 10. new text end
new text begin Issuing corrective payments. new text end
new text begin
A county agency must correct an
underpayment within seven calendar days after the underpayment has been identified,
by adding the corrective payment amount to the monthly assistance payment of the
participant, issuing a separate payment to a participant or former participant, or reducing
an existing overpayment balance. When an underpayment occurs in a payment month
and is not identified until the next payment month or later, the county agency must first
subtract the underpayment from any overpayment balance before issuing the corrective
payment. The county agency must not apply an underpayment in a current payment month
against an overpayment balance. When an underpayment in the current payment month
is identified, the corrective payment must be issued within seven calendar days after the
underpayment is identified. Corrective payments must be excluded when determining the
applicant's or participant's income and resources for the month of payment. The county
agency must correct underpayments using the following methods:
new text end
new text begin
(1) reconstruct each affected budget month and corresponding payment month; and
new text end
new text begin
(2) use the policies and procedures that were in effect for the payment month.
new text end
new text begin Subd. 11. new text end
new text begin Appeals. new text end
new text begin
A participant may appeal an underpayment, an overpayment,
and a reduction in an assistance payment made to recoup the overpayment under
subdivisions 4 and 6. The participant's appeal of each issue must be timely under section
256.045. When an appeal based on the notice issued under subdivision 3 is not timely, the
fact or the amount of that overpayment must not be considered as a part of a later appeal,
including an appeal of a reduction in an assistance payment to recoup that overpayment.
new text end
Sec. 34. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2014, sections 256D.0513; 256D.06, subdivision 8; 256D.09,
subdivision 6; 256D.49; and 256J.38,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, part 3400.0170, subparts 5, 6, 12, and 13,
new text end
new text begin
are repealed.
new text end
Sec. 35. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective August 1, 2016.
new text end
ARTICLE 6
NURSING FACILITY PAYMENT REFORM AND WORKFORCE
DEVELOPMENT
Section 1.
new text begin
[144.1503] HOME AND COMMUNITY-BASED SERVICES
EMPLOYEE SCHOLARSHIP PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Creation. new text end
new text begin
The home and community-based services employee
scholarship grant program is established for the purpose of assisting qualified provider
applicants to fund employee scholarships for education in nursing and other health care
fields.
new text end
new text begin Subd. 2. new text end
new text begin Provision of grants. new text end
new text begin
The commissioner shall make grants available
to qualified providers of older adult services. Grants must be used by home and
community-based service providers to recruit and train staff through the establishment of
an employee scholarship fund.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility. new text end
new text begin
(a) Eligible providers must primarily provide services to
individuals who are 65 years of age and older in home and community-based settings,
including housing with services establishments as defined in section 144D.01, subdivision
4; adult day care as defined in section 245A.02, subdivision 2a; and home care services as
defined in section 144A.43, subdivision 3.
new text end
new text begin
(b) Qualifying providers must establish a home and community-based services
employee scholarship program, as specified in subdivision 4. Providers that receive
funding under this section must use the funds to award scholarships to employees who
work an average of at least 16 hours per week for the provider.
new text end
new text begin Subd. 4. new text end
new text begin
Home and community-based services employee scholarship program.
new text end
new text begin
Each qualifying provider under this section must propose a home and community-based
services employee scholarship program. Providers must establish criteria by which
funds are to be distributed among employees. At a minimum, the scholarship program
must cover employee costs related to a course of study that is expected to lead to career
advancement with the provider or in the field of long-term care, including home care,
care of persons with disabilities, or nursing.
new text end
new text begin Subd. 5. new text end
new text begin Participating providers. new text end
new text begin
The commissioner shall publish a request for
proposals in the State Register, specifying provider eligibility requirements, criteria for
a qualifying employee scholarship program, provider selection criteria, documentation
required for program participation, maximum award amount, and methods of evaluation.
The commissioner must publish additional requests for proposals each year in which
funding is available for this purpose.
new text end
new text begin Subd. 6. new text end
new text begin Application requirements. new text end
new text begin
Eligible providers seeking a grant shall submit
an application to the commissioner. Applications must contain a complete description of
the employee scholarship program being proposed by the applicant, including the need for
the organization to enhance the education of its workforce, the process for determining
which employees will be eligible for scholarships, any other sources of funding for
scholarships, the expected degrees or credentials eligible for scholarships, the amount of
funding sought for the scholarship program, a proposed budget detailing how funds will
be spent, and plans for retaining eligible employees after completion of their scholarship.
new text end
new text begin Subd. 7. new text end
new text begin Selection process. new text end
new text begin
The commissioner shall determine a maximum
award for grants and make grant selections based on the information provided in the
grant application, including the demonstrated need for an applicant provider to enhance
the education of its workforce, the proposed employee scholarship selection process,
the applicant's proposed budget, and other criteria as determined by the commissioner.
Notwithstanding any law or rule to the contrary, funds awarded to grantees in a grant
agreement do not lapse until the grant agreement expires.
new text end
new text begin Subd. 8. new text end
new text begin Reporting requirements. new text end
new text begin
Participating providers shall submit an invoice
for reimbursement and a report to the commissioner on a schedule determined by the
commissioner and on a form supplied by the commissioner. The report shall include
the amount spent on scholarships; the number of employees who received scholarships;
and, for each scholarship recipient, the name of the recipient, the current position of
the recipient, the amount awarded, the educational institution attended, the nature of
the educational program, and the expected or actual program completion date. During
the grant period, the commissioner may require and collect from grant recipients other
information necessary to evaluate the program.
new text end
Sec. 2.
Minnesota Statutes 2014, section 144A.071, subdivision 4a, is amended to read:
Subd. 4a.
Exceptions for replacement beds.
It is in the best interest of the state
to ensure that nursing homes and boarding care homes continue to meet the physical
plant licensing and certification requirements by permitting certain construction projects.
Facilities should be maintained in condition to satisfy the physical and emotional needs
of residents while allowing the state to maintain control over nursing home expenditure
growth.
The commissioner of health in coordination with the commissioner of human
services, may approve the renovation, replacement, upgrading, or relocation of a nursing
home or boarding care home, under the following conditions:
(a) to license or certify beds in a new facility constructed to replace a facility or to
make repairs in an existing facility that was destroyed or damaged after June 30, 1987, by
fire, lightning, or other hazard provided:
(i) destruction was not caused by the intentional act of or at the direction of a
controlling person of the facility;
(ii) at the time the facility was destroyed or damaged the controlling persons of the
facility maintained insurance coverage for the type of hazard that occurred in an amount
that a reasonable person would conclude was adequate;
(iii) the net proceeds from an insurance settlement for the damages caused by the
hazard are applied to the cost of the new facility or repairs;
(iv) the number of licensed and certified beds in the new facility does not exceed the
number of licensed and certified beds in the destroyed facility; and
(v) the commissioner determines that the replacement beds are needed to prevent an
inadequate supply of beds.
Project construction costs incurred for repairs authorized under this clause shall not be
considered in the dollar threshold amount defined in subdivision 2;
(b) to license or certify beds that are moved from one location to another within a
nursing home facility, provided the total costs of remodeling performed in conjunction
with the relocation of beds does not exceed $1,000,000;
(c) to license or certify beds in a project recommended for approval under section
144A.073;
(d) to license or certify beds that are moved from an existing state nursing home to
a different state facility, provided there is no net increase in the number of state nursing
home beds;
(e) to certify and license as nursing home beds boarding care beds in a certified
boarding care facility if the beds meet the standards for nursing home licensure, or in a
facility that was granted an exception to the moratorium under section 144A.073, and if
the cost of any remodeling of the facility does not exceed $1,000,000. If boarding care
beds are licensed as nursing home beds, the number of boarding care beds in the facility
must not increase beyond the number remaining at the time of the upgrade in licensure.
The provisions contained in section 144A.073 regarding the upgrading of the facilities
do not apply to facilities that satisfy these requirements;
(f) to license and certify up to 40 beds transferred from an existing facility owned and
operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the
same location as the existing facility that will serve persons with Alzheimer's disease and
other related disorders. The transfer of beds may occur gradually or in stages, provided
the total number of beds transferred does not exceed 40. At the time of licensure and
certification of a bed or beds in the new unit, the commissioner of health shall delicense
and decertify the same number of beds in the existing facility. As a condition of receiving
a license or certification under this clause, the facility must make a written commitment
to the commissioner of human services that it will not seek to receive an increase in its
property-related payment rate as a result of the transfers allowed under this paragraph;
(g) to license and certify nursing home beds to replace currently licensed and certified
boarding care beds which may be located either in a remodeled or renovated boarding care
or nursing home facility or in a remodeled, renovated, newly constructed, or replacement
nursing home facility within the identifiable complex of health care facilities in which the
currently licensed boarding care beds are presently located, provided that the number of
boarding care beds in the facility or complex are decreased by the number to be licensed
as nursing home beds and further provided that, if the total costs of new construction,
replacement, remodeling, or renovation exceed ten percent of the appraised value of
the facility or $200,000, whichever is less, the facility makes a written commitment to
the commissioner of human services that it will not seek to receive an increase in its
property-related payment rate by reason of the new construction, replacement, remodeling,
or renovation. The provisions contained in section 144A.073 regarding the upgrading of
facilities do not apply to facilities that satisfy these requirements;
(h) to license as a nursing home and certify as a nursing facility a facility that is
licensed as a boarding care facility but not certified under the medical assistance program,
but only if the commissioner of human services certifies to the commissioner of health that
licensing the facility as a nursing home and certifying the facility as a nursing facility will
result in a net annual savings to the state general fund of $200,000 or more;
(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing
home beds in a facility that was licensed and in operation prior to January 1, 1992;
(j) to license and certify new nursing home beds to replace beds in a facility acquired
by the Minneapolis Community Development Agency as part of redevelopment activities
in a city of the first class, provided the new facility is located within three miles of the site
of the old facility. Operating and property costs for the new facility must be determined
and allowed under section 256B.431 or 256B.434;
(k) to license and certify up to 20 new nursing home beds in a community-operated
hospital and attached convalescent and nursing care facility with 40 beds on April 21,
1991, that suspended operation of the hospital in April 1986. The commissioner of human
services shall provide the facility with the same per diem property-related payment rate
for each additional licensed and certified bed as it will receive for its existing 40 beds;
(l) to license or certify beds in renovation, replacement, or upgrading projects as
defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the
facility's remodeling projects do not exceed $1,000,000;
(m) to license and certify beds that are moved from one location to another for the
purposes of converting up to five four-bed wards to single or double occupancy rooms
in a nursing home that, as of January 1, 1993, was county-owned and had a licensed
capacity of 115 beds;
(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified
nursing facility located in Minneapolis to layaway all of its licensed and certified nursing
home beds. These beds may be relicensed and recertified in a newly constructed teaching
nursing home facility affiliated with a teaching hospital upon approval by the legislature.
The proposal must be developed in consultation with the interagency committee on
long-term care planning. The beds on layaway status shall have the same status as
voluntarily delicensed and decertified beds, except that beds on layaway status remain
subject to the surcharge in section 256.9657. This layaway provision expires July 1, 1998;
(o) to allow a project which will be completed in conjunction with an approved
moratorium exception project for a nursing home in southern Cass County and which is
directly related to that portion of the facility that must be repaired, renovated, or replaced,
to correct an emergency plumbing problem for which a state correction order has been
issued and which must be corrected by August 31, 1993;
(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified
nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to
the commissioner, up to 30 of the facility's licensed and certified beds by converting
three-bed wards to single or double occupancy. Beds on layaway status shall have the
same status as voluntarily delicensed and decertified beds except that beds on layaway
status remain subject to the surcharge in section 256.9657, remain subject to the license
application and renewal fees under section 144A.07 and shall be subject to a $100 per bed
reactivation fee. In addition, at any time within three years of the effective date of the
layaway, the beds on layaway status may be:
(1) relicensed and recertified upon relocation and reactivation of some or all of
the beds to an existing licensed and certified facility or facilities located in Pine River,
Brainerd, or International Falls; provided that the total project construction costs related to
the relocation of beds from layaway status for any facility receiving relocated beds may
not exceed the dollar threshold provided in subdivision 2 unless the construction project
has been approved through the moratorium exception process under section 144A.073;
(2) relicensed and recertified, upon reactivation of some or all of the beds within the
facility which placed the beds in layaway status, if the commissioner has determined a
need for the reactivation of the beds on layaway status.
The property-related payment rate of a facility placing beds on layaway status
must be adjusted by the incremental change in its rental per diem after recalculating the
rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The
property-related payment rate for a facility relicensing and recertifying beds from layaway
status must be adjusted by the incremental change in its rental per diem after recalculating
its rental per diem using the number of beds after the relicensing to establish the facility's
capacity day divisor, which shall be effective the first day of the month following the
month in which the relicensing and recertification became effective. Any beds remaining
on layaway status more than three years after the date the layaway status became effective
must be removed from layaway status and immediately delicensed and decertified;
(q) to license and certify beds in a renovation and remodeling project to convert 12
four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing
home that, as of January 1, 1994, met the following conditions: the nursing home was
located in Ramsey County; had a licensed capacity of 154 beds; and had been ranked
among the top 15 applicants by the 1993 moratorium exceptions advisory review panel.
The total project construction cost estimate for this project must not exceed the cost
estimate submitted in connection with the 1993 moratorium exception process;
(r) to license and certify up to 117 beds that are relocated from a licensed and certified
138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds
located in South St. Paul, provided that the nursing facility and hospital are owned by the
same or a related organization and that prior to the date the relocation is completed the
hospital ceases operation of its inpatient hospital services at that hospital. After relocation,
the nursing facility's status shall be the same as it was prior to relocation. The nursing
facility's property-related payment rate resulting from the project authorized in this
paragraph shall become effective no earlier than April 1, 1996. For purposes of calculating
the incremental change in the facility's rental per diem resulting from this project, the
allowable appraised value of the nursing facility portion of the existing health care facility
physical plant prior to the renovation and relocation may not exceed $2,490,000;
(s) to license and certify two beds in a facility to replace beds that were voluntarily
delicensed and decertified on June 28, 1991;
(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed
nursing home and 21-bed boarding care home facility in Minneapolis, notwithstanding
the licensure and certification after July 1, 1995, of the Minneapolis facility as a 147-bed
nursing home facility after completion of a construction project approved in 1993 under
section 144A.073, to be laid away upon 30 days' prior written notice to the commissioner.
Beds on layaway status shall have the same status as voluntarily delicensed or decertified
beds except that they shall remain subject to the surcharge in section 256.9657. The
16 beds on layaway status may be relicensed as nursing home beds and recertified at
any time within five years of the effective date of the layaway upon relocation of some
or all of the beds to a licensed and certified facility located in Watertown, provided that
the total project construction costs related to the relocation of beds from layaway status
for the Watertown facility may not exceed the dollar threshold provided in subdivision
2 unless the construction project has been approved through the moratorium exception
process under section 144A.073.
The property-related payment rate of the facility placing beds on layaway status must
be adjusted by the incremental change in its rental per diem after recalculating the rental per
diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
payment rate for the facility relicensing and recertifying beds from layaway status must be
adjusted by the incremental change in its rental per diem after recalculating its rental per
diem using the number of beds after the relicensing to establish the facility's capacity day
divisor, which shall be effective the first day of the month following the month in which
the relicensing and recertification became effective. Any beds remaining on layaway
status more than five years after the date the layaway status became effective must be
removed from layaway status and immediately delicensed and decertified;
(u) to license and certify beds that are moved within an existing area of a facility or
to a newly constructed addition which is built for the purpose of eliminating three- and
four-bed rooms and adding space for dining, lounge areas, bathing rooms, and ancillary
service areas in a nursing home that, as of January 1, 1995, was located in Fridley and had
a licensed capacity of 129 beds;
(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County
to a 160-bed facility in Crow Wing County, provided all the affected beds are under
common ownership;
(w) to license and certify a total replacement project of up to 49 beds located in
Norman County that are relocated from a nursing home destroyed by flood and whose
residents were relocated to other nursing homes. The operating cost payment rates for
the new nursing facility shall be determined based on the interim and settle-up payment
provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of
section 256B.431. Property-related reimbursement rates shall be determined under section
256B.431, taking into account any federal or state flood-related loans or grants provided
to the facility;
(x) to license and certify deleted text begin a totaldeleted text end new text begin to the licensee of a nursing home in Polk County
that was destroyed by flood in 1997new text end replacement deleted text begin projectdeleted text end new text begin projects with a totalnew text end of up to 129
bedsnew text begin , with at least 25 beds to benew text end located in Polk County deleted text begin that are relocated from a nursing
home destroyed by flood and whose residents were relocated to other nursing homes.deleted text end new text begin and
up to 104 beds distributed among up to three other counties. These beds may only be
distributed to counties with fewer than the median number of age intensity adjusted beds
per thousand, as most recently published by the commissioner of human services. If the
licensee chooses to distribute beds outside of Polk County under this paragraph, prior to
distributing the beds, the commissioner of health must approve the location in which the
licensee plans to distribute the beds. The commissioner of health shall consult with the
commissioner of human services prior to approving the location of the proposed beds.
The licensee may combine these beds with beds relocated from other nursing facilities
as provided in section 144A.073, subdivision 3c.new text end The operating deleted text begin costdeleted text end payment rates for
the new nursing deleted text begin facilitydeleted text end new text begin facilitiesnew text end shall be determined based on the interim and settle-up
payment provisions ofnew text begin section 256B.431, 256B.434, or 256B.441 ornew text end Minnesota Rules, deleted text begin part
9549.0057, and the reimbursement provisions of section 256B.431, except that subdivision
26, paragraphs (a) and (b), shall not apply until the second rate year after the settle-up cost
report is filed. Property-related reimbursement rates shall be determined under section
256B.431, taking into account any federal or state flood-related loans or grants provided to
the facility;deleted text end new text begin parts 9549.0010 to 9549.0080. Property-related reimbursement rates shall
be determined under section 256B.431, 256B.434, or 256B.441. If the replacement beds
permitted under this paragraph are combined with beds from other nursing facilities, the
rates shall be calculated as the weighted average of rates determined as provided in this
paragraph and section 256B.441, subdivision 60;
new text end
(y) to license and certify beds in a renovation and remodeling project to convert 13
three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and
add improvements in a nursing home that, as of January 1, 1994, met the following
conditions: the nursing home was located in Ramsey County, was not owned by a hospital
corporation, had a licensed capacity of 64 beds, and had been ranked among the top 15
applicants by the 1993 moratorium exceptions advisory review panel. The total project
construction cost estimate for this project must not exceed the cost estimate submitted in
connection with the 1993 moratorium exception process;
(z) to license and certify up to 150 nursing home beds to replace an existing 285
bed nursing facility located in St. Paul. The replacement project shall include both the
renovation of existing buildings and the construction of new facilities at the existing
site. The reduction in the licensed capacity of the existing facility shall occur during the
construction project as beds are taken out of service due to the construction process. Prior
to the start of the construction process, the facility shall provide written information to the
commissioner of health describing the process for bed reduction, plans for the relocation
of residents, and the estimated construction schedule. The relocation of residents shall be
in accordance with the provisions of law and rule;
(aa) to allow the commissioner of human services to license an additional 36 beds
to provide residential services for the physically disabled under Minnesota Rules, parts
9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that
the total number of licensed and certified beds at the facility does not increase;
(bb) to license and certify a new facility in St. Louis County with 44 beds
constructed to replace an existing facility in St. Louis County with 31 beds, which has
resident rooms on two separate floors and an antiquated elevator that creates safety
concerns for residents and prevents nonambulatory residents from residing on the second
floor. The project shall include the elimination of three- and four-bed rooms;
(cc) to license and certify four beds in a 16-bed certified boarding care home in
Minneapolis to replace beds that were voluntarily delicensed and decertified on or
before March 31, 1992. The licensure and certification is conditional upon the facility
periodically assessing and adjusting its resident mix and other factors which may
contribute to a potential institution for mental disease declaration. The commissioner of
human services shall retain the authority to audit the facility at any time and shall require
the facility to comply with any requirements necessary to prevent an institution for mental
disease declaration, including delicensure and decertification of beds, if necessary;
(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with
80 beds as part of a renovation project. The renovation must include construction of
an addition to accommodate ten residents with beginning and midstage dementia in a
self-contained living unit; creation of three resident households where dining, activities,
and support spaces are located near resident living quarters; designation of four beds
for rehabilitation in a self-contained area; designation of 30 private rooms; and other
improvements;
(ee) to license and certify beds in a facility that has undergone replacement or
remodeling as part of a planned closure under section 256B.437;
(ff) to license and certify a total replacement project of up to 124 beds located
in Wilkin County that are in need of relocation from a nursing home significantly
damaged by flood. The operating cost payment rates for the new nursing facility shall be
determined based on the interim and settle-up payment provisions of Minnesota Rules,
part 9549.0057, and the reimbursement provisions of section 256B.431. Property-related
reimbursement rates shall be determined under section 256B.431, taking into account any
federal or state flood-related loans or grants provided to the facility;
(gg) to allow the commissioner of human services to license an additional nine beds
to provide residential services for the physically disabled under Minnesota Rules, parts
9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the
total number of licensed and certified beds at the facility does not increase;
(hh) to license and certify up to 120 new nursing facility beds to replace beds in a
facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the
new facility is located within four miles of the existing facility and is in Anoka County.
Operating and property rates shall be determined and allowed under section 256B.431 and
Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.441; or
(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County
that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit
nursing facility located in the city of Columbia Heights or its affiliate. The transfer is
effective when the receiving facility notifies the commissioner in writing of the number of
beds accepted. The commissioner shall place all transferred beds on layaway status held in
the name of the receiving facility. The layaway adjustment provisions of section 256B.431,
subdivision 30, do not apply to this layaway. The receiving facility may only remove the
beds from layaway for recertification and relicensure at the receiving facility's current
site, or at a newly constructed facility located in Anoka County. The receiving facility
must receive statutory authorization before removing these beds from layaway status, or
may remove these beds from layaway status if removal from layaway status is part of a
moratorium exception project approved by the commissioner under section 144A.073.
Sec. 3.
Minnesota Statutes 2014, section 256B.0913, subdivision 4, is amended to read:
Subd. 4.
Eligibility for funding for services for nonmedical assistance recipients.
(a) Funding for services under the alternative care program is available to persons who
meet the following criteria:
(1) the person has been determined by a community assessment under section
256B.0911 to be a person who would require the level of care provided in a nursing
facility, as determined under section 256B.0911, subdivision 4e, but for the provision of
services under the alternative care program;
(2) the person is age 65 or older;
(3) the person would be eligible for medical assistance within 135 days of admission
to a nursing facility;
(4) the person is not ineligible for the payment of long-term care services by the
medical assistance program due to an asset transfer penalty under section 256B.0595 or
equity interest in the home exceeding $500,000 as stated in section 256B.056;
(5) the person needs long-term care services that are not funded through other
state or federal funding, or other health insurance or other third-party insurance such as
long-term care insurance;
(6) except for individuals described in clause (7), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
does not prohibit the alternative care client from payment for additional services, but in no
case may the cost of additional services purchased under this section exceed the difference
between the client's monthly service limit defined under section 256B.0915, subdivision
3, and the alternative care program monthly service limit defined in this paragraph. If
care-related supplies and equipment or environmental modifications and adaptations are or
will be purchased for an alternative care services recipient, the costs may be prorated on a
monthly basis for up to 12 consecutive months beginning with the month of purchase.
If the monthly cost of a recipient's other alternative care services exceeds the monthly
limit established in this paragraph, the annual cost of the alternative care services shall be
determined. In this event, the annual cost of alternative care services shall not exceed 12
times the monthly limit described in this paragraph;
(7) for individuals assigned a case mix classification A as described under section
256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily
living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
when the dependency score in eating is three or greater as determined by an assessment
performed under section 256B.0911, the monthly cost of alternative care services funded
by the program cannot exceed $593 per month for all new participants enrolled in
the program on or after July 1, 2011. This monthly limit shall be applied to all other
participants who meet this criteria at reassessment. This monthly limit shall be increased
annually as described in section 256B.0915, subdivision 3a, deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (a)new text begin and
(e)new text end . This monthly limit does not prohibit the alternative care client from payment for
additional services, but in no case may the cost of additional services purchased exceed the
difference between the client's monthly service limit defined in this clause and the limit
described in clause (6) for case mix classification A; and
(8) the person is making timely payments of the assessed monthly fee.
A person is ineligible if payment of the fee is over 60 days past due, unless the person
agrees to:
(i) the appointment of a representative payee;
(ii) automatic payment from a financial account;
(iii) the establishment of greater family involvement in the financial management of
payments; or
(iv) another method acceptable to the lead agency to ensure prompt fee payments.
The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.
(b) Alternative care funding under this subdivision is not available for a person who
is a medical assistance recipient or who would be eligible for medical assistance without a
spenddown or waiver obligation. A person whose initial application for medical assistance
and the elderly waiver program is being processed may be served under the alternative care
program for a period up to 60 days. If the individual is found to be eligible for medical
assistance, medical assistance must be billed for services payable under the federally
approved elderly waiver plan and delivered from the date the individual was found eligible
for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
care funds may not be used to pay for any service the cost of which: (i) is payable by
medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
pay a medical assistance income spenddown for a person who is eligible to participate in the
federally approved elderly waiver program under the special income standard provision.
(c) Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.
(d) Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
year for which alternative care eligibility is determined, who would be eligible for the
elderly waiver with a waiver obligation.
Sec. 4.
Minnesota Statutes 2014, section 256B.0915, subdivision 3a, is amended to read:
Subd. 3a.
Elderly waiver cost limits.
(a) deleted text begin The monthly limit for the cost of
waivered services to an individual elderly waiver client except for individuals described
in paragraphs (b) and (d) shall be the weighted average monthly nursing facility rate of
the case mix resident class to which the elderly waiver client would be assigned under
Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs
allowance as described in subdivision 1d, paragraph (a), until the first day of the state
fiscal year in which the resident assessment system as described in section 256B.438 for
nursing home rate determination is implemented.deleted text end Effective on the first day of the state
fiscal year in which the resident assessment system as described in section 256B.438 for
nursing home rate determination is implemented and the first day of each subsequent state
fiscal year, the monthly limit for the cost of waivered services to an individual elderly
waiver client shall be the deleted text begin ratedeleted text end new text begin monthly limitnew text end of the case mix resident class to which the
waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in
effect on the last day of the previous state fiscal year, adjusted by any legislatively adopted
home and community-based services percentage rate adjustment.
(b) The monthly limit for the cost of waivered servicesnew text begin under paragraph (a)new text end to an
individual elderly waiver client assigned to a case mix classification A deleted text begin under paragraph
(a)deleted text end with:
(1) no dependencies in activities of daily living; or
(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
when the dependency score in eating is three or greater as determined by an assessment
performed under section 256B.0911 shall be $1,750 per month effective on July 1, 2011,
for all new participants enrolled in the program on or after July 1, 2011. This monthly
limit shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (a)new text begin and (e)new text end .
(c) If extended medical supplies and equipment or environmental modifications are
or will be purchased for an elderly waiver client, the costs may be prorated for up to
12 consecutive months beginning with the month of purchase. If the monthly cost of a
recipient's waivered services exceeds the monthly limit established in paragraph (a) deleted text begin ordeleted text end new text begin ,
new text end (b),new text begin (d), or (e),new text end the annual cost of all waivered services shall be determined. In this event,
the annual cost of all waivered services shall not exceed 12 times the monthly limit of
waivered services as described in paragraph (a) deleted text begin ordeleted text end new text begin , new text end (b)new text begin , (d), or (e)new text end .
(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
any necessary home care services described in section 256B.0651, subdivision 2, for
individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
amount established for home care services as described in section 256B.0652, subdivision
7, and the annual average contracted amount established by the commissioner for nursing
facility services for ventilator-dependent individuals. This monthly limit shall be increased
annually as described in deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (a)new text begin and (e)new text end .
new text begin
(e) Effective July 1, 2016, and each July 1 thereafter, the monthly cost limits for
elderly waiver services in effect on the previous June 30 shall be increased by the
difference between any legislatively adopted home and community-based provider rate
increases effective on July 1 or since the previous July 1 and the average statewide
percentage increase in nursing facility operating payment rates under sections 256B.431,
256B.434, and 256B.441, effective the previous January 1. This paragraph shall only
apply if the average statewide percentage increase in nursing facility operating payment
rates is greater than any legislatively adopted home and community-based provider rate
increases effective on July 1, or occurring since the previous July 1.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 5.
Minnesota Statutes 2014, section 256B.0915, subdivision 3e, is amended to read:
Subd. 3e.
Customized living service rate.
(a) Payment for customized living
services shall be a monthly rate authorized by the lead agency within the parameters
established by the commissioner. The payment agreement must delineate the amount of
each component service included in the recipient's customized living service plan. The
lead agency, with input from the provider of customized living services, shall ensure that
there is a documented need within the parameters established by the commissioner for all
component customized living services authorized.
(b) The payment rate must be based on the amount of component services to be
provided utilizing component rates established by the commissioner. Counties and tribes
shall use tools issued by the commissioner to develop and document customized living
service plans and rates.
(c) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale. Customized
living services must not include rent or raw food costs.
(d) With the exception of individuals described in subdivision 3a, paragraph (b), the
individualized monthly authorized payment for the customized living service plan shall not
exceed 50 percent of the greater of either the statewide or any of the geographic groups'
weighted average monthly nursing facility rate of the case mix resident class to which the
elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0050 to
9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph
(a)deleted text begin , until the July 1 of the state fiscal year in which the resident assessment system as
described in section 256B.438 for nursing home rate determination is implementeddeleted text end .
Effective on July 1 of the state fiscal year in which the resident assessment system as
described in section 256B.438 for nursing home rate determination is implemented and
July 1 of each subsequent state fiscal year, the individualized monthly authorized payment
for the services described in this clause shall not exceed the limit which was in effect on
June 30 of the previous state fiscal year updated annually based on legislatively adopted
changes to all service rate maximums for home and community-based service providers.
(e) Effective July 1, 2011, the individualized monthly payment for the customized
living service plan for individuals described in subdivision 3a, paragraph (b), must be the
monthly authorized payment limit for customized living for individuals classified as case
mix A, reduced by 25 percent. This rate limit must be applied to all new participants
enrolled in the program on or after July 1, 2011, who meet the criteria described in
subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
(f) Customized living services are delivered by a provider licensed by the
Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.
Licensed home care providers are subject to section 256B.0651, subdivision 14.
(g) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (d), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.
new text begin
(h) Effective July 1, 2016, and each July 1 thereafter, individualized service rate
limits for customized living services under this subdivision shall be increased by the
difference between any legislatively adopted home and community-based provider rate
increases effective on July 1 or since the previous July 1 and the average statewide
percentage increase in nursing facility operating payment rates under sections 256B.431,
256B.434, and 256B.441, effective the previous January 1. This paragraph shall only
apply if the average statewide percentage increase in nursing facility operating payment
rates is greater than any legislatively adopted home and community-based provider rate
increases effective on July 1, or occurring since the previous July 1.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 6.
Minnesota Statutes 2014, section 256B.0915, subdivision 3h, is amended to read:
Subd. 3h.
Service rate limits; 24-hour customized living services.
(a) The
payment rate for 24-hour customized living services is a monthly rate authorized by the
lead agency within the parameters established by the commissioner of human services.
The payment agreement must delineate the amount of each component service included
in each recipient's customized living service plan. The lead agency, with input from
the provider of customized living services, shall ensure that there is a documented need
within the parameters established by the commissioner for all component customized
living services authorized. The lead agency shall not authorize 24-hour customized living
services unless there is a documented need for 24-hour supervision.
(b) For purposes of this section, "24-hour supervision" means that the recipient
requires assistance due to needs related to one or more of the following:
(1) intermittent assistance with toileting, positioning, or transferring;
(2) cognitive or behavioral issues;
(3) a medical condition that requires clinical monitoring; or
(4) for all new participants enrolled in the program on or after July 1, 2011, and
all other participants at their first reassessment after July 1, 2011, dependency in at
least three of the following activities of daily living as determined by assessment under
section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency
score in eating is three or greater; and needs medication management and at least 50
hours of service per month. The lead agency shall ensure that the frequency and mode
of supervision of the recipient and the qualifications of staff providing supervision are
described and meet the needs of the recipient.
(c) The payment rate for 24-hour customized living services must be based on the
amount of component services to be provided utilizing component rates established by the
commissioner. Counties and tribes will use tools issued by the commissioner to develop
and document customized living plans and authorize rates.
(d) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale.
(e) The individually authorized 24-hour customized living payments, in combination
with the payment for other elderly waiver services, including case management, must not
exceed the recipient's community budget cap specified in subdivision 3a. Customized
living services must not include rent or raw food costs.
(f) The individually authorized 24-hour customized living payment rates shall not
exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
living services in effect and in the Medicaid management information systems on March
31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
to 9549.0059, to which elderly waiver service clients are assigned. When there are
fewer than 50 authorizations in effect in the case mix resident class, the commissioner
shall multiply the calculated service payment rate maximum for the A classification by
the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
9549.0059, to determine the applicable payment rate maximum. Service payment rate
maximums shall be updated annually based on legislatively adopted changes to all service
rates for home and community-based service providers.
(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
may establish alternative payment rate systems for 24-hour customized living services in
housing with services establishments which are freestanding buildings with a capacity of
16 or fewer, by applying a single hourly rate for covered component services provided
in either:
(1) licensed corporate adult foster homes; or
(2) specialized dementia care units which meet the requirements of section 144D.065
and in which:
(i) each resident is offered the option of having their own apartment; or
(ii) the units are licensed as board and lodge establishments with maximum capacity
of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
subparts 1, 2, 3, and 4, item A.
(h) Twenty-four-hour customized living services are delivered by a provider licensed
by the Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.
Licensed home care providers are subject to section 256B.0651, subdivision 14.
(i) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (e), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.
new text begin
(j) Effective July 1, 2016, and each July 1 thereafter, individualized service rate
limits for 24-hour customized living services under this subdivision shall be increased by
the difference between any legislatively adopted home and community-based provider
rate increases effective on July 1 or since the previous July 1 and the average statewide
percentage increase in nursing facility operating payment rates under sections 256B.431,
256B.434, and 256B.441, effective the previous January 1. This paragraph shall only
apply if the average statewide percentage increase in nursing facility operating payment
rates is greater than any legislatively adopted home and community-based provider rate
increases effective on July 1, or occurring since the previous July 1.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 7.
Minnesota Statutes 2014, section 256B.431, subdivision 2b, is amended to read:
Subd. 2b.
Operating costs after July 1, 1985.
(a) For rate years beginning on or
after July 1, 1985, the commissioner shall establish procedures for determining per diem
reimbursement for operating costs.
(b) The commissioner shall contract with an econometric firm with recognized
expertise in and access to national economic change indices that can be applied to the
appropriate cost categories when determining the operating cost payment rate.
(c) The commissioner shall analyze and evaluate each nursing facility's cost report
of allowable operating costs incurred by the nursing facility during the reporting year
immediately preceding the rate year for which the payment rate becomes effective.
(d) The commissioner shall establish limits on actual allowable historical operating
cost per diems based on cost reports of allowable operating costs for the reporting year
that begins October 1, 1983, taking into consideration relevant factors including resident
needs, geographic location, and size of the nursing facility. In developing the geographic
groups for purposes of reimbursement under this section, the commissioner shall ensure
that nursing facilities in any county contiguous to the Minneapolis-St. Paul seven-county
metropolitan area are included in the same geographic group. The limits established by
the commissioner shall not be less, in the aggregate, than the 60th percentile of total
actual allowable historical operating cost per diems for each group of nursing facilities
established under subdivision 1 based on cost reports of allowable operating costs in the
previous reporting year. For rate years beginning on or after July 1, 1989, facilities located
in geographic group I as described in Minnesota Rules, part 9549.0052, on January 1,
1989, may choose to have the commissioner apply either the care related limits or the
other operating cost limits calculated for facilities located in geographic group II, or
both, if either of the limits calculated for the group II facilities is higher. The efficiency
incentive for geographic group I nursing facilities must be calculated based on geographic
group I limits. The phase-in must be established utilizing the chosen limits. For purposes
of these exceptions to the geographic grouping requirements, the definitions in Minnesota
Rules, parts 9549.0050 to 9549.0059 (Emergency), and 9549.0010 to 9549.0080, apply.
The limits established under this paragraph remain in effect until the commissioner
establishes a new base period. Until the new base period is established, the commissioner
shall adjust the limits annually using the appropriate economic change indices established
in paragraph (e). In determining allowable historical operating cost per diems for purposes
of setting limits and nursing facility payment rates, the commissioner shall divide the
allowable historical operating costs by the actual number of resident days, except that
where a nursing facility is occupied at less than 90 percent of licensed capacity days, the
commissioner may establish procedures to adjust the computation of the per diem to
an imputed occupancy level at or below 90 percent. The commissioner shall establish
efficiency incentives as appropriate. The commissioner may establish efficiency incentives
for different operating cost categories. The commissioner shall consider establishing
efficiency incentives in care related cost categories. The commissioner may combine one
or more operating cost categories and may use different methods for calculating payment
rates for each operating cost category or combination of operating cost categories. For the
rate year beginning on July 1, 1985, the commissioner shall:
(1) allow nursing facilities that have an average length of stay of 180 days or less in
their skilled nursing level of care, 125 percent of the care related limit and 105 percent
of the other operating cost limit established by rule; and
(2) exempt nursing facilities licensed on July 1, 1983, by the commissioner to
provide residential services for the physically disabled under Minnesota Rules, parts
9570.2000 to 9570.3600, from the care related limits and allow 105 percent of the other
operating cost limit established by rule.
For the purpose of calculating the other operating cost efficiency incentive for
nursing facilities referred to in clause (1) or (2), the commissioner shall use the other
operating cost limit established by rule before application of the 105 percent.
(e) The commissioner shall establish a composite index or indices by determining
the appropriate economic change indicators to be applied to specific operating cost
categories or combination of operating cost categories.
(f) Each nursing facility shall receive an operating cost payment rate equal to the sum
of the nursing facility's operating cost payment rates for each operating cost category. The
operating cost payment rate for an operating cost category shall be the lesser of the nursing
facility's historical operating cost in the category increased by the appropriate index
established in paragraph (e) for the operating cost category plus an efficiency incentive
established pursuant to paragraph (d) or the limit for the operating cost category increased
by the same index. If a nursing facility's actual historic operating costs are greater than the
prospective payment rate for that rate year, there shall be no retroactive cost settle up. In
establishing payment rates for one or more operating cost categories, the commissioner may
establish separate rates for different classes of residents based on their relative care needs.
(g) The commissioner shall include the reported actual real estate tax liability or
payments in lieu of real estate tax of each nursing facility as an operating cost of that
nursing facility. Allowable costs under this subdivision for payments made by a nonprofit
nursing facility that are in lieu of real estate taxes shall not exceed the amount which the
nursing facility would have paid to a city or township and county for fire, police, sanitation
services, and road maintenance costs had real estate taxes been levied on that property
for those purposes. For rate years beginning on or after July 1, 1987, the reported actual
real estate tax liability or payments in lieu of real estate tax of nursing facilities shall be
adjusted to include an amount equal to one-half of the dollar change in real estate taxes
from the prior year. The commissioner shall include a reported actual special assessment,
and reported actual license fees required by the Minnesota Department of Health, for each
nursing facility as an operating cost of that nursing facility. For rate years beginning
on or after July 1, 1989, the commissioner shall include a nursing facility's reported
Public Employee Retirement Act contribution for the reporting year as apportioned to the
care-related operating cost categories and other operating cost categories multiplied by
the appropriate composite index or indices established pursuant to paragraph (e) as costs
under this paragraph. Total adjusted real estate tax liability, payments in lieu of real
estate tax, actual special assessments paid, the indexed Public Employee Retirement Act
contribution, and license fees paid as required by the Minnesota Department of Health,
for each nursing facility (1) shall be divided by actual resident days in order to compute
the operating cost payment rate for this operating cost category, (2) shall not be used to
compute the care-related operating cost limits or other operating cost limits established
by the commissioner, and (3) shall not be increased by the composite index or indices
established pursuant to paragraph (e), unless otherwise indicated in this paragraph.
deleted text begin
(h) For rate years beginning on or after July 1, 1987, the commissioner shall adjust
the rates of a nursing facility that meets the criteria for the special dietary needs of its
residents and the requirements in section 31.651. The adjustment for raw food cost shall
be the difference between the nursing facility's allowable historical raw food cost per
diem and 115 percent of the median historical allowable raw food cost per diem of the
corresponding geographic group.
deleted text end
deleted text begin
The rate adjustment shall be reduced by the applicable phase-in percentage as
provided under subdivision 2h.
deleted text end
Sec. 8.
Minnesota Statutes 2014, section 256B.431, subdivision 36, is amended to read:
Subd. 36.
Employee scholarship costs and training in English as a second
language.
(a) For the period between July 1, 2001, and June 30, 2003, the commissioner
shall provide to each nursing facility reimbursed under this section, section 256B.434,
or any other section, a scholarship per diem of 25 cents to the total operating payment
ratenew text begin . For the 27-month period beginning October 1, 2015, through December 31, 2017,
the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing
facility with no scholarship per diem that is requesting a scholarship per diem to be added
to the external fixed payment ratenew text end to be used:
(1) for employee scholarships that satisfy the following requirements:
(i) scholarships are available to all employees who work an average of at least deleted text begin 20
deleted text end new text begin tennew text end hours per week at the facility except the administrator, deleted text begin department supervisors, and
registered nursesdeleted text end new text begin and to reimburse student loan expenses for newly hired and recently
graduated registered nurses and licensed practical nurses, and training expenses for
nursing assistants as defined in section 144A.611, subdivision 2, who are newly hired and
have graduated within the last 12 monthsnew text end ; and
(ii) the course of study is expected to lead to career advancement with the facility or
in long-term care, including medical care interpreter services and social work; and
(2) to provide job-related training in English as a second language.
(b) deleted text begin A facility receivingdeleted text end new text begin All facilities may annually requestnew text end a rate adjustment under
this subdivision deleted text begin may submitdeleted text end new text begin by submitting informationnew text end to the commissioner on a schedule
deleted text begin determined by the commissionerdeleted text end and deleted text begin ondeleted text end new text begin innew text end a form supplied by the commissioner deleted text begin a
calculation of the scholarship per diem, including: the amount received from this rate
adjustment; the amount used for training in English as a second language; the number of
persons receiving the training; the name of the person or entity providing the training;
and for each scholarship recipient, the name of the recipient, the amount awarded, the
educational institution attended, the nature of the educational program, the program
completion date, and a determination of the per diem amount of these costs based on
actual resident daysdeleted text end .new text begin The commissioner shall allow a scholarship payment rate equal to
the reported and allowable costs divided by resident days.
new text end
(c) deleted text begin On July 1, 2003, the commissioner shall remove the 25 cent scholarship per diem
from the total operating payment rate of each facility.
deleted text end
deleted text begin (d) For rate years beginning after June 30, 2003, the commissioner shall provide to
each facility the scholarship per diem determined in paragraph (b).deleted text end In calculating the per
diem under paragraph (b), the commissioner shall allow deleted text begin onlydeleted text end costs related to tuition deleted text begin anddeleted text end new text begin ,
new text end direct educational expensesnew text begin , and reasonable costs as defined by the commissioner for child
care costs and transportation expenses related to direct educational expensesnew text end .
new text begin
(d) The rate increase under this subdivision is an optional rate add-on that the facility
must request from the commissioner in a manner prescribed by the commissioner. The
rate increase must be used for scholarships as specified in this subdivision.
new text end
new text begin
(e) For instances in which a rate adjustment will be 15 cents or greater, nursing
facilities that close beds during a rate year may request to have their scholarship
adjustment under paragraph (b) recalculated by the commissioner for the remainder of the
rate year to reflect the reduction in resident days compared to the cost report year.
new text end
Sec. 9.
Minnesota Statutes 2014, section 256B.434, subdivision 4, is amended to read:
Subd. 4.
Alternate rates for nursing facilities.
deleted text begin
(a) For nursing facilities which
have their payment rates determined under this section rather than section 256B.431, the
commissioner shall establish a rate under this subdivision. The nursing facility must enter
into a written contract with the commissioner.
deleted text end
deleted text begin
(b) A nursing facility's case mix payment rate for the first rate year of a facility's
contract under this section is the payment rate the facility would have received under
section 256B.431.
deleted text end
deleted text begin (c)deleted text end A nursing facility's case mix payment rates for the second and subsequent years
of a facility's contract under this section are the previous rate year's contract payment rates
plus an inflation adjustment and, for facilities reimbursed under this section or section
256B.431, an adjustment to include the cost of any increase in Health Department licensing
fees for the facility taking effect on or after July 1, 2001. The index for the inflation
adjustment must be based on the change in the Consumer Price Index-All Items (United
States City average) (CPI-U) forecasted by the commissioner of management and budget's
national economic consultant, as forecasted in the fourth quarter of the calendar year
preceding the rate year. The inflation adjustment must be based on the 12-month period
from the midpoint of the previous rate year to the midpoint of the rate year for which the
rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July
1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007,
July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the
property-related payment rate. For the rate years beginning on October 1, 2011, October 1,
2012, October 1, 2013, October 1, 2014, October 1, 2015, deleted text begin and Octoberdeleted text end new text begin Januarynew text end 1, 2016, new text begin and
January 1, 2017, new text end the rate adjustment under this paragraph shall be suspended. Beginning
in 2005, adjustment to the property payment rate under this section and section 256B.431
shall be effective on October 1. In determining the amount of the property-related payment
rate adjustment under this paragraph, the commissioner shall determine the proportion of
the facility's rates that are property-related based on the facility's most recent cost report.
deleted text begin
(d) The commissioner shall develop additional incentive-based payments of up to
five percent above a facility's operating payment rate for achieving outcomes specified
in a contract. The commissioner may solicit contract amendments and implement those
which, on a competitive basis, best meet the state's policy objectives. The commissioner
shall limit the amount of any incentive payment and the number of contract amendments
under this paragraph to operate the incentive payments within funds appropriated for this
purpose. The contract amendments may specify various levels of payment for various
levels of performance. Incentive payments to facilities under this paragraph may be in the
form of time-limited rate adjustments or onetime supplemental payments. In establishing
the specified outcomes and related criteria, the commissioner shall consider the following
state policy objectives:
deleted text end
deleted text begin
(1) successful diversion or discharge of residents to the residents' prior home or other
community-based alternatives;
deleted text end
deleted text begin
(2) adoption of new technology to improve quality or efficiency;
deleted text end
deleted text begin
(3) improved quality as measured in the Nursing Home Report Card;
deleted text end
deleted text begin
(4) reduced acute care costs; and
deleted text end
deleted text begin
(5) any additional outcomes proposed by a nursing facility that the commissioner
finds desirable.
deleted text end
deleted text begin
(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
take action to come into compliance with existing or pending requirements of the life
safety code provisions or federal regulations governing sprinkler systems must receive
reimbursement for the costs associated with compliance if all of the following conditions
are met:
deleted text end
deleted text begin
(1) the expenses associated with compliance occurred on or after January 1, 2005,
and before December 31, 2008;
deleted text end
deleted text begin
(2) the costs were not otherwise reimbursed under subdivision 4f or section
144A.071 or 144A.073; and
deleted text end
deleted text begin
(3) the total allowable costs reported under this paragraph are less than the minimum
threshold established under section 256B.431, subdivision 15, paragraph (e), and
subdivision 16.
deleted text end
deleted text begin
The commissioner shall use money appropriated for this purpose to provide to qualifying
nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
2008. Nursing facilities that have spent money or anticipate the need to spend money
to satisfy the most recent life safety code requirements by (1) installing a sprinkler
system or (2) replacing all or portions of an existing sprinkler system may submit to the
commissioner by June 30, 2007, on a form provided by the commissioner the actual
costs of a completed project or the estimated costs, based on a project bid, of a planned
project. The commissioner shall calculate a rate adjustment equal to the allowable
costs of the project divided by the resident days reported for the report year ending
September 30, 2006. If the costs from all projects exceed the appropriation for this
purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
qualifying facilities by reducing the rate adjustment determined for each facility by an
equal percentage. Facilities that used estimated costs when requesting the rate adjustment
shall report to the commissioner by January 31, 2009, on the use of this money on a
form provided by the commissioner. If the nursing facility fails to provide the report, the
commissioner shall recoup the money paid to the facility for this purpose. If the facility
reports expenditures allowable under this subdivision that are less than the amount received
in the facility's annualized rate adjustment, the commissioner shall recoup the difference.
deleted text end
Sec. 10.
Minnesota Statutes 2014, section 256B.434, is amended by adding a
subdivision to read:
new text begin Subd. 4i. new text end
new text begin
Construction project rate adjustments for certain nursing facilities.
new text end
new text begin
(a) This subdivision applies to nursing facilities with at least 120 active beds as of January
1, 2015, that have projects approved in 2015 under the nursing facility moratorium
exception process in section 144A.073. When each facility's moratorium exception
construction project is completed, the facility must receive the rate adjustment allowed
under subdivision 4f. In addition to that rate adjustment, facilities with at least 120
active beds, but not more than 149 active beds, as of January 1, 2015, must have their
construction project rate adjustment increased by an additional $4; and facilities with at
least 150 active beds, but not more than 160 active beds, as of January 1, 2015, must have
their construction project rate adjustment increased by an additional $12.50.
new text end
new text begin
(b) Notwithstanding any other law to the contrary, money available under section
144A.073, subdivision 11, after the completion of the moratorium exception approval
process in 2015 under section 144A.073, subdivision 3, shall be used to reduce the fiscal
impact to the medical assistance budget for the increases allowed in this subdivision.
new text end
Sec. 11.
Minnesota Statutes 2014, section 256B.441, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Rebasingdeleted text end new text begin Calculationnew text end of nursing facility operating payment
rates.
(a) The commissioner shall deleted text begin rebase nursing facility operating payment rates to align
payments to facilities with the cost of providing care. The rebaseddeleted text end new text begin calculatenew text end operating
payment rates deleted text begin shall be calculateddeleted text end using the statistical and cost report filed by each nursing
facility for the report period ending deleted text begin one yeardeleted text end new text begin 15 monthsnew text end prior to the rate year.
(b) The deleted text begin newdeleted text end operating payment rates based on this section shall take effect deleted text begin beginning
deleted text end with the rate year beginning deleted text begin October 1, 2008, and shall be phased in over eight rate years
through October 1, 2015. For each year of the phase-in, the operating payment rates shall
be calculated using the statistical and cost report filed by each nursing facility for the
report period ending one year prior to the rate yeardeleted text end new text begin January 1, 2016new text end .
deleted text begin
(c) Operating payment rates shall be rebased on October 1, 2016, and every two
years after that date.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end Each cost reporting year shall begin on October 1 and end on the following
September 30. deleted text begin Beginning in 2014,deleted text end A statistical and cost report shall be filed by each
nursing facility by February 1new text begin in a form and manner specified by the commissionernew text end .
Notice of rates shall be distributed by deleted text begin Augustdeleted text end new text begin Novembernew text end 15 and the rates shall go into
effect on deleted text begin Octoberdeleted text end new text begin Januarynew text end 1 for one year.
deleted text begin
(e) Effective October 1, 2014, property rates shall be rebased in accordance with
section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine
what the property payment rate for a nursing facility would be had the facility not had its
property rate determined under section 256B.434. The commissioner shall allow nursing
facilities to provide information affecting this rate determination that would have been
filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report
information necessary to determine allowable debt. The commissioner shall use this
information to determine the property payment rate.
deleted text end
Sec. 12.
Minnesota Statutes 2014, section 256B.441, subdivision 5, is amended to read:
Subd. 5.
Administrative costs.
"Administrative costs" means the direct costs for
administering the overall activities of the nursing home. These costs include salaries and
wages of the administrator, assistant administrator, business office employees, security
guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases
related to business office functions, licenses, and permits except as provided in the
external fixed costs category, employee recognition, travel including meals and lodging,
all training except as specified in subdivision 11, voice and data communication or
transmission, office supplies,new text begin property andnew text end liability insurance and other forms of insurance
not designated to other areas, personnel recruitment, legal services, accounting services,
management or business consultants, data processing, information technology, Web
site, central or home office costs, business meetings and seminars, postage, fees for
professional organizations, subscriptions, security services, advertising, board of director's
fees, working capital interest expense, and bad debts and bad debt collection fees.
Sec. 13.
Minnesota Statutes 2014, section 256B.441, subdivision 6, is amended to read:
Subd. 6.
Allowed costs.
new text begin (a) new text end "Allowed costs" means the amounts reported by the
facility which are necessary for the operation of the facility and the care of residents
and which are reviewed by the department for accuracy; reasonableness, in accordance
with the requirements set forth in title XVIII of the federal Social Security Act and the
interpretations in the provider reimbursement manual; and compliance with this section
and generally accepted accounting principles. All references to costs in this section shall
be assumed to refer to allowed costs.
new text begin
(b) For facilities where employees are represented by collective bargaining agents,
costs related to the salaries and wages, payroll taxes, and employer's share of fringe benefit
costs, except employer health insurance costs, for facility employees who are members of
the bargaining unit are allowed costs only if:
new text end
new text begin
(1) these costs are incurred pursuant to a collective bargaining agreement. The
commissioner shall allow until March 1 following the date on which the cost report was
required to be submitted for a collective bargaining agent to notify the commissioner if
a collective bargaining agreement, effective on the last day of the cost reporting year,
was not in effect; or
new text end
new text begin
(2) the collective bargaining agent notifies the commissioner by October 1 following
the date on which the cost report was required to be submitted that these costs are
incurred pursuant to an agreement or understanding between the facility and the collective
bargaining agent.
new text end
new text begin
(c) In any year when a portion of a facility's reported costs are not allowed costs
under paragraph (b), when calculating the operating payment rate for the facility, the
commissioner shall use the facility's allowed costs from the facility's second most recent
cost report in place of the nonallowed costs. For the purpose of setting the price for other
operating costs under subdivision 51, the price shall be reduced by the difference between
the nonallowed costs and the allowed costs from the facility's second most recent cost
report.
new text end
Sec. 14.
Minnesota Statutes 2014, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 11a. new text end
new text begin Employer health insurance costs. new text end
new text begin
"Employer health insurance costs"
means premium expenses for group coverage and reinsurance, actual expenses incurred
for self-insured plans, and employer contributions to employee health reimbursement and
health savings accounts. Premium and expense costs and contributions are allowable for
employees who meet the definition of full-time employees and their spouse and dependents
under the federal Affordable Care Act, Public Law 111-148, and part-time employees.
new text end
Sec. 15.
Minnesota Statutes 2014, section 256B.441, subdivision 13, is amended to read:
Subd. 13.
External fixed costs.
"External fixed costs" means costs related to the
nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
section 144.122; deleted text begin until September 30, 2013, long-term care consultation fees under
section 256B.0911, subdivision 6;deleted text end family advisory council fee under section 144A.33;
scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
under section 256B.437; deleted text begin ordeleted text end single bed room incentives under section 256B.431,
subdivision 42; property taxes deleted text begin and property insurancedeleted text end new text begin , assessments, and payments in
lieu of taxes; employer health insurance costs; quality improvement incentive payment
rate adjustments under subdivision 46c; performance-based incentive payments under
subdivision 46d; special dietary needs under subdivision 51bnew text end ; and PERA.
Sec. 16.
Minnesota Statutes 2014, section 256B.441, subdivision 14, is amended to read:
Subd. 14.
Facility average case mix index.
"Facility average case mix index"
or "CMI" means a numerical deleted text begin valuedeleted text end score that describes the relative resource use for
all residents within the groups under the resource utilization group deleted text begin (RUG-III)deleted text end new text begin (RUG)
new text end classification system prescribed by the commissioner based on an assessment of each
resident. The facility average CMI shall be computed as the standardized days divided by
total days for all residents in the facility. The RUG's weights used deleted text begin in this section shall be
as follows for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC
1.259; RAB 1.109; RAA 0.957; SSC 1.453; SSB 1.224; SSA 1.047; CC2 1.292; CC1
1.200; CB2 1.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720;
IA1 0.676; BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2
1.023; PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651;
BC1 0.651; and DDF 1.000deleted text end new text begin shall be based on the system prescribed in section 256B.438new text end .
Sec. 17.
Minnesota Statutes 2014, section 256B.441, subdivision 17, is amended to read:
Subd. 17.
Fringe benefit costs.
"Fringe benefit costs" means the costs for group life,
deleted text begin health,deleted text end dental, workers' compensation, and other employee insurances and pension, new text begin except
for the Public Employees Retirement Association and employer health insurance costs;
new text end profit sharingdeleted text begin ,deleted text end new text begin ;new text end and retirement plans for which the employer pays all or a portion of the costs.
Sec. 18.
Minnesota Statutes 2014, section 256B.441, subdivision 30, is amended to read:
Subd. 30.
deleted text begin Peer groupsdeleted text end new text begin Median total care-related cost per diem and other
operating per diem determinednew text end .
deleted text begin
Facilities shall be classified into three groups by county.
The groups shall consist of:
deleted text end
deleted text begin
(1) group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota,
Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott,
Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;
deleted text end
deleted text begin
(2) group two: facilities in Aitkin, Beltrami, Blue Earth, Brown, Cass, Clay,
Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, Itasca, Kanabec,
Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, Meeker, Mower,
Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, Watonwan, or Wilkin
County; and
deleted text end
deleted text begin (3) group three: facilities in all other countiesdeleted text end new text begin (a) The commissioner shall determine
the median total care-related per diem to be used in subdivision 50 and the median other
operating per diem to be used in subdivision 51 using the cost reports from nursing
facilities in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Countiesnew text end .
new text begin
(b) The median total care-related per diem shall be equal to the median direct care
cost for a RUG's weight of 1.00 for facilities located in the counties listed in paragraph (a).
new text end
new text begin
(c) The median other operating per diem shall be equal to the median other
operating per diem for facilities located in the counties listed in paragraph (a). The other
operating per diem shall be the sum of each facility's administrative costs, dietary costs,
housekeeping costs, laundry costs, and maintenance and plant operations costs divided
by each facility's resident days.
new text end
Sec. 19.
Minnesota Statutes 2014, section 256B.441, subdivision 31, is amended to read:
Subd. 31.
Prior system operating cost payment rate.
"Prior system operating cost
payment rate" means the operating cost payment rate in effect on deleted text begin September 30, 2008
deleted text end new text begin December 31, 2015new text end , under Minnesota Rules and Minnesota Statutes, deleted text begin not including planned
closure rate adjustments under section 256B.437 or single bed room incentives under
section 256B.431, subdivision 42deleted text end new text begin inclusive of health insurance plus property insurance
costs from external fixed, but not including rate increases allowed under subdivision 55anew text end .
Sec. 20.
Minnesota Statutes 2014, section 256B.441, subdivision 33, is amended to read:
Subd. 33.
Rate year.
"Rate year" means the 12-month period beginning on deleted text begin October
deleted text end new text begin Januarynew text end 1 deleted text begin following the second most recent reporting yeardeleted text end .
Sec. 21.
Minnesota Statutes 2014, section 256B.441, subdivision 35, is amended to read:
Subd. 35.
Reporting period.
"Reporting period" means the one-year period
beginning on October 1 and ending on the following September 30 during which incurred
costs are accumulated and then reported on the statistical and cost report.new text begin If a facility is
reporting for an interim or settle-up period, the reporting period beginning date may be a
date other than October 1. An interim or settle-up report must cover at least five months,
but no more than 17 months, and must always end on September 30.
new text end
Sec. 22.
Minnesota Statutes 2014, section 256B.441, subdivision 40, is amended to read:
Subd. 40.
Standardized days.
"Standardized days" means the sum of resident days
by case mix category multiplied by the RUG index for each category.new text begin When a facility has
resident days at a penalty classification, these days shall be reported as resident days at the
RUG class established immediately after the penalty period, if available, and otherwise, at
the RUG class in effect before the penalty began.
new text end
Sec. 23.
Minnesota Statutes 2014, section 256B.441, subdivision 44, is amended to read:
Subd. 44.
Calculation of a quality score.
(a) The commissioner shall determine
a quality score for each nursing facility using quality measures established in section
256B.439, according to methods determined by the commissioner in consultation with
stakeholders and expertsnew text begin , and using the most recently available data as provided in
the Minnesota Nursing Home Report Cardnew text end . These methods shall be exempt from the
rulemaking requirements under chapter 14.
(b) For each quality measure, a score shall be determined with deleted text begin a maximumdeleted text end new text begin the new text end number
of points deleted text begin available and number of pointsdeleted text end assigned as determined by the commissioner
using the methodology established according to this subdivision. deleted text begin The scores determined
for all quality measures shall be totaled.deleted text end The determination of the quality measures to be
used and the methods of calculating scores may be revised annually by the commissioner.
(c) deleted text begin For the initial rate year under the new payment system, the quality measures
shall include:
deleted text end
deleted text begin
(1) staff turnover;
deleted text end
deleted text begin
(2) staff retention;
deleted text end
deleted text begin
(3) use of pool staff;
deleted text end
deleted text begin
(4) quality indicators from the minimum data set; and
deleted text end
deleted text begin
(5) survey deficiencies.
deleted text end
deleted text begin (d)deleted text end Beginning deleted text begin July 1, 2013deleted text end new text begin January 1, 2016new text end , the quality score shall deleted text begin be a value
between zero and 100, using data as provided in the Minnesota nursing home report
card, withdeleted text end new text begin include up to new text end 50 deleted text begin percent derived fromdeleted text end new text begin points related to new text end the Minnesota quality
indicators score, new text begin up to new text end 40 deleted text begin percent derived fromdeleted text end new text begin points related to new text end the resident quality of life
score, andnew text begin up to new text end ten deleted text begin percent derived fromdeleted text end new text begin points related to new text end the state inspection results score.
deleted text begin (e)deleted text end new text begin (d) new text end The commissioner, in cooperation with the commissioner of health, may
adjust the formula in paragraph deleted text begin (d)deleted text end new text begin (c)new text end , or the methodology for computing the total quality
score, effective July 1 of any year beginning in deleted text begin 2014deleted text end new text begin 2017new text end , with five months advance
public notice. In changing the formula, the commissioner shall consider quality measure
priorities registered by report card users, advice of stakeholders, and available research.
Sec. 24.
Minnesota Statutes 2014, section 256B.441, subdivision 46c, is amended to
read:
Subd. 46c.
Quality improvement incentive system beginning October 1, 2015.
The commissioner shall develop a quality improvement incentive program in consultation
with stakeholders. The annual funding pool available for quality improvement incentive
payments shall be equal to 0.8 percent of all operating payments, not including any rate
components resulting from equitable cost-sharing for publicly owned nursing facility
program participation under subdivision 55a, critical access nursing facility program
participation under subdivision 63, or performance-based incentive payment program
participation under section 256B.434, subdivision 4, paragraph (d). new text begin For the period from
October 1, 2015, to December 31, 2016, rate adjustments provided under this subdivision
shall be effective for 15 months. new text end Beginning deleted text begin October 1, 2015deleted text end new text begin January 1, 2017new text end , annual
rate adjustments provided under this subdivision shall be effective for one year, starting
deleted text begin Octoberdeleted text end new text begin January new text end 1 and ending the following deleted text begin September 30deleted text end new text begin December 31. The increase in
this subdivision shall be included in the external fixed payment rate under subdivisions
13 and 53new text end .
Sec. 25.
Minnesota Statutes 2014, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 46d. new text end
new text begin Performance-based incentive payments. new text end
new text begin
The commissioner shall
develop additional incentive-based payments of up to five percent above a facility's
operating payment rate for achieving outcomes specified in a contract. The commissioner
may solicit proposals and select those which, on a competitive basis, best meet the state's
policy objectives. The commissioner shall limit the amount of any incentive payment
and the number of contract amendments under this subdivision to operate the incentive
payments within funds appropriated for this purpose. The commissioner shall approve
proposals through a memorandum of understanding which shall specify various levels of
payment for various levels of performance. Incentive payments to facilities under this
subdivision shall be in the form of time-limited rate adjustments which shall be included
in the external fixed payment rate under subdivisions 13 and 53. In establishing the
specified outcomes and related criteria, the commissioner shall consider the following
state policy objectives:
new text end
new text begin
(1) successful diversion or discharge of residents to the residents' prior home or other
community-based alternatives;
new text end
new text begin
(2) adoption of new technology to improve quality or efficiency;
new text end
new text begin
(3) improved quality as measured in the Minnesota Nursing Home Report Card;
new text end
new text begin
(4) reduced acute care costs; and
new text end
new text begin
(5) any additional outcomes proposed by a nursing facility that the commissioner
finds desirable.
new text end
Sec. 26.
Minnesota Statutes 2014, section 256B.441, subdivision 48, is amended to read:
Subd. 48.
Calculation of deleted text begin operatingdeleted text end new text begin care-relatednew text end per diems.
The direct care per
diem for each facility shall be the facility's direct care costs divided by its standardized
days. The other care-related per diem shall be the sum of the facility's activities costs,
other direct care costs, raw food costs, therapy costs, and social services costs, divided by
the facility's resident days. deleted text begin The other operating per diem shall be the sum of the facility's
administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance
and plant operations costs divided by the facility's resident days.
deleted text end
Sec. 27.
Minnesota Statutes 2014, section 256B.441, subdivision 50, is amended to read:
Subd. 50.
Determination of total care-related limit.
(a) The deleted text begin limit on thedeleted text end new text begin median
new text end total care-related per diem shall be determined deleted text begin for each peer group and facility type group
combination. A facility's total care-related per diems shall be limited to 120 percent of the
median for the facility's peer and facility type group. The facility-specific direct care costs
used in making this comparison and in the calculation of the median shall be based on a
RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per
diem reduced to the limit. If a reduction of the total care-related per diem is necessary
because of this limit, the reduction shall be made proportionally to both the direct care per
diem and the other care-related per diemdeleted text end new text begin according to subdivision 30new text end .
(b) deleted text begin Beginning with rates determined for October 1, 2016, thedeleted text end new text begin A facility'snew text end total
care-related limit shall be a variable amount based on each facility's quality score, as
determined under subdivision 44, in accordance with clauses (1) to deleted text begin (4)deleted text end new text begin (3)new text end :
(1) deleted text begin for each facility, the commissioner shall determine the quality score, subtract 40,
divide by 40, and convert to a percentagedeleted text end new text begin the quality score shall be multiplied by 0.5625new text end ;
(2) deleted text begin if the value determined in clause (1) is less than zero, the total care-related limit
shall be 105 percent of the median for the facility's peer and facility type groupdeleted text end new text begin add 89.375
to the amount determined in clause (1), and divide the total by 100new text end ;new text begin and
new text end
(3) deleted text begin if the value determined in clause (1) is greater than 100 percent, the total
care-related limit shall be 125 percent of the median for the facility's peer and facility type
group; anddeleted text end new text begin multiply the amount determined in clause (2) by the median total care-related
per diem determined in subdivision 30, paragraph (b).
new text end
deleted text begin
(4) if the value determined in clause (1) is greater than zero and less than 100
percent, the total care-related limit shall be 105 percent of the median for the facility's peer
and facility type group plus one-fifth of the percentage determined in clause (1).
deleted text end
new text begin
(c) A RUG's weight of 1.00 shall be used in the calculation of the median total
care-related per diem, and in comparisons of facility-specific direct care costs to the median.
new text end
new text begin
(d) A facility that is above its total care-related limit as determined according to
paragraph (b) shall have its total care-related per diem reduced to its limit. If a reduction
of the total care-related per diem is necessary due to this limit, the reduction shall be made
proportionally to both the direct care per diem and the other care-related per diem.
new text end
Sec. 28.
Minnesota Statutes 2014, section 256B.441, subdivision 51, is amended to read:
Subd. 51.
Determination of other operating deleted text begin limitdeleted text end new text begin pricenew text end .
deleted text begin The limit on thedeleted text end new text begin A price
fornew text end other operating deleted text begin per diemdeleted text end new text begin costsnew text end shall be determined deleted text begin for each peer groupdeleted text end . deleted text begin A facility's
other operating per diem shall be limited todeleted text end new text begin The price shall be calculated asnew text end 105 percent
of the median deleted text begin for its peer groupdeleted text end new text begin other operating per diem described in subdivision 30,
paragraph (c)new text end . deleted text begin A facility that is above that limit shall have its other operating per diem
reduced to the limit.
deleted text end
Sec. 29.
Minnesota Statutes 2014, section 256B.441, subdivision 51a, is amended to
read:
Subd. 51a.
Exception deleted text begin allowing contractingdeleted text end for specialized carenew text begin facilitiesnew text end .
(a)
For rate years beginning on or after deleted text begin Octoberdeleted text end new text begin Januarynew text end 1, 2016, deleted text begin the commissioner may
negotiate increases to the care-related limit for nursing facilities that provide specialized
care, at a cost to the general fund not to exceed $600,000 per year. The commissioner
shall publish a request for proposals annually, and may negotiate increases to the limits
that shall apply for either one or two years before the increase shall be subject to a new
proposal and negotiation.deleted text end the care-related limit deleted text begin maydeleted text end new text begin for specialized care facilities shall
new text end be increased by deleted text begin up todeleted text end 50 percent.
(b) deleted text begin In selecting facilities with which to negotiate, the commissioner shall consider:
deleted text end new text begin "Specialized care facilities" are defined as a facility having a program licensed under
chapter 245A and Minnesota Rules, chapter 9570, or a facility with 96 beds on January 1,
2015, located in Robbinsdale that specializes in the treatment of Huntington's Disease.
new text end
deleted text begin
(1) the diagnoses or other circumstances of residents in the specialized program that
require care that costs substantially more than the RUG's rates associated with those
residents;
deleted text end
deleted text begin
(2) the nature of the specialized program or programs offered to meet the needs
of these individuals; and
deleted text end
deleted text begin
(3) outcomes achieved by the specialized program.
deleted text end
Sec. 30.
Minnesota Statutes 2014, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 51b. new text end
new text begin Special dietary needs. new text end
new text begin
The commissioner shall adjust the rates of
a nursing facility that meets the criteria for the special dietary needs of its residents and
the requirements in section 31.651 or 31.658. The adjustment for raw food cost shall be
the difference between the nursing facility's most recently reported allowable raw food
cost per diem and 115 percent of the median allowable raw food cost per diem. For rate
years beginning on or after January 1, 2016, this amount shall be removed from allowable
raw food per diem costs under operating costs and included in the external fixed per
diem rate under subdivisions 13 and 53.
new text end
Sec. 31.
Minnesota Statutes 2014, section 256B.441, subdivision 53, is amended to read:
Subd. 53.
Calculation of payment rate for external fixed costs.
The commissioner
shall calculate a payment rate for external fixed costs.
(a) For a facility licensed as a nursing home, the portion related to section 256.9657
shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
result of its number of nursing home beds divided by its total number of licensed beds.
(b) The portion related to the licensure fee under section 144.122, paragraph (d),
shall be the amount of the fee divided by actual resident days.
(c) new text begin The portion related to development and education of resident and family advisory
councils under section 144A.33 shall be $5 divided by 365.
new text end
new text begin (d) new text end The portion related to scholarships shall be determined under section 256B.431,
subdivision 36.
deleted text begin
(d) Until September 30, 2013, the portion related to long-term care consultation shall
be determined according to section 256B.0911, subdivision 6.
deleted text end
deleted text begin
(e) The portion related to development and education of resident and family advisory
councils under section 144A.33 shall be $5 divided by 365.
deleted text end
deleted text begin (f)deleted text end new text begin (e)new text end The portion related to planned closure rate adjustments shall be as determined
under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
deleted text begin Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
be included in the payment rate for external fixed costs beginning October 1, 2016.
Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
longer be included in the payment rate for external fixed costs beginning on October 1 of
the first year not less than two years after their effective date.
deleted text end
new text begin
(f) The single bed room incentives shall be as determined under section 256B.431,
subdivision 42.
new text end
(g) The portions related to deleted text begin property insurance,deleted text end real estate taxes, special assessments,
and payments made in lieu of real estate taxes directly identified or allocated to the nursing
facility shall be the actual amounts divided by actual resident days.
(h) new text begin The portion related to employer health insurance costs shall be the allowable
costs divided by resident days.
new text end
new text begin (i) new text end The portion related to the Public Employees Retirement Association shall be
actual costs divided by resident days.
deleted text begin
(i) The single bed room incentives shall be as determined under section 256B.431,
subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
no longer be included in the payment rate for external fixed costs beginning October 1,
2016. Single bed room incentives that take effect on or after October 1, 2014, shall no
longer be included in the payment rate for external fixed costs beginning on October 1 of
the first year not less than two years after their effective date.
deleted text end
new text begin
(j) The portion related to quality improvement incentive payment rate adjustments
shall be as determined under subdivision 46c.
new text end
new text begin
(k) The portion related to performance-based incentive payments shall be as
determined under subdivision 46d.
new text end
new text begin
(l) The portion related to special dietary needs shall be the per diem amount
determined under subdivision 51b.
new text end
deleted text begin (j)deleted text end new text begin (m)new text end The payment rate for external fixed costs shall be the sum of the amounts in
paragraphs (a) to deleted text begin (i)deleted text end new text begin (l)new text end .
Sec. 32.
Minnesota Statutes 2014, section 256B.441, subdivision 54, is amended to read:
Subd. 54.
Determination of total payment rates.
deleted text begin In rate years when rates are
rebased,deleted text end new text begin The total care-related per diem, other operating price, and external fixed per
diem for each facility shall be converted to payment rates.new text end The total payment rate for
a RUG's weight of 1.00 shall be the sum of the total care-related payment rate, other
operating payment rate, deleted text begin efficiency incentive,deleted text end external fixed cost rate, and the property rate
determined under section 256B.434. To determine a total payment rate for each RUG's
level, the total care-related payment rate shall be divided into the direct care payment rate
and the other care-related payment rate, and the direct care payment rate multiplied by the
RUG's weight for each RUG's level deleted text begin using the weights in subdivision 14deleted text end .
Sec. 33.
Minnesota Statutes 2014, section 256B.441, subdivision 55a, is amended to
read:
Subd. 55a.
Alternative to phase-in for publicly owned nursing facilities.
(a) For
operating payment rates implemented between October 1, 2011, and the day before deleted text begin the
phase-in under subdivision 55 is completedeleted text end new text begin operating payment rates are determined under
this sectionnew text end , the commissioner shall allow nursing facilities whose physical plant is owned
or whose license is held by a city, county, or hospital district to apply for a higher payment
rate under this section if the local governmental entity agrees to pay a specified portion
of the nonfederal share of medical assistance costs. Nursing facilities that apply shall be
eligible to select an operating payment rate, with a weight of 1.00, up to the rate calculated
in subdivision 54, without application of the phase-in under subdivision 55. The rates for
the other RUGs shall be computed as provided under subdivision 54.
(b) For operating payment rates implemented beginning the day when the deleted text begin phase-in
under subdivision 55 is completedeleted text end new text begin operating payment rates are determined under this
sectionnew text end , the commissioner shall allow nursing facilities whose physical plant is owned or
whose license is held by a city, county, or hospital district to apply for a higher payment
rate under this section if the local governmental entity agrees to pay a specified portion of
the nonfederal share of medical assistance costs. Nursing facilities that apply are eligible
to select an operating payment rate with a weight of 1.00, up to an amount determined by
the commissioner to be allowable under the Medicare upper payment limit test. The rates
for the other RUGs shall be computed under subdivision 54. The rate increase allowed in
this paragraph shall take effect only upon federal approval.
(c) Rates determined under this subdivision shall take effect deleted text begin beginning October 1,
2011, based on cost reports for the reporting year ending September 30, 2010, and in
future rate years, rates determined for nursing facilities participating under this subdivision
shall take effect on October 1 of each yeardeleted text end new text begin in accordance with the rate year in subdivision
33new text end , based on the most recent available cost report.
(d) Eligible nursing facilities that wish to participate under this subdivision shall
make an application to the commissioner by August 31, 2011, or by deleted text begin Junedeleted text end new text begin Septembernew text end 30
of any subsequent year.
(e) For each participating nursing facility, the public entity that owns the physical
plant or is the license holder of the nursing facility shall pay to the state the entire
nonfederal share of medical assistance payments received as a result of the difference
between the nursing facility's payment rate under paragraph (a) or (b), and the rates that
the nursing facility would otherwise be paid without application of this subdivision under
subdivision 54 deleted text begin or 55deleted text end as determined by the commissioner.
(f) The commissioner may, at any time, reduce the payments under this subdivision
based on the commissioner's determination that the payments shall cause nursing facility
rates to exceed the state's Medicare upper payment limit or any other federal limitation. If
the commissioner determines a reduction is necessary, the commissioner shall reduce all
payment rates for participating nursing facilities by a percentage applied to the amount of
increase they would otherwise receive under this subdivision and shall notify participating
facilities of the reductions. If payments to a nursing facility are reduced, payments under
section 256B.19, subdivision 1e, shall be reduced accordingly.
Sec. 34.
Minnesota Statutes 2014, section 256B.441, subdivision 56, is amended to read:
Subd. 56.
Hold harmless.
new text begin (a) new text end For the rate years beginning deleted text begin October 1, 2008, to
Octoberdeleted text end new text begin on or after Januarynew text end 1, 2016, no nursing facility shall receive deleted text begin an operatingdeleted text end new text begin anew text end cost
payment ratenew text begin , including the property insurance portion of operating costs plus the health
insurance component of external fixed,new text end less than its deleted text begin operatingdeleted text end new text begin prior systemnew text end cost payment
rate deleted text begin under section 256B.434. For rate years beginning between October 1, 2009, and
October 1, 2015, no nursing facility shall receive an operating payment rate less than its
operating payment rate in effect on September 30, 2009deleted text end new text begin , which included operating costs
inclusive of health insurance costs plus the property insurance component of external
fixednew text end . The comparison of operating payment rates under this section shall be made for a
RUG's rate with a weight of 1.00.
new text begin
(b) For rate years beginning on or after January 1, 2016, no facility shall be subject
to a care-related payment rate limit reduction greater than five percent of the median
determined in subdivision 30.
new text end
Sec. 35.
Minnesota Statutes 2014, section 256B.441, subdivision 63, is amended to read:
Subd. 63.
Critical access nursing facilities.
(a) The commissioner, in consultation
with the commissioner of health, may designate certain nursing facilities as critical access
nursing facilities. The designation shall be granted on a competitive basis, within the
limits of funds appropriated for this purpose.
(b) The commissioner shall request proposals from nursing facilities every
two years. Proposals must be submitted in the form and according to the timelines
established by the commissioner. In selecting applicants to designate, the commissioner,
in consultation with the commissioner of health, and with input from stakeholders, shall
develop criteria designed to preserve access to nursing facility services in isolated areas,
rebalance long-term care, and improve quality. Beginning in fiscal year 2015, to the
extent practicable, the commissioner shall ensure an even distribution of designations
across the state.
(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing
facilities designated as critical access nursing facilities:
(1) partial rebasing, with the commissioner allowing a designated facility operating
payment rates being the sum of up to 60 percent of the operating payment rate determined
in accordance with subdivision 54 and at least 40 percent, with the sum of the two portions
being equal to 100 percent, of the operating payment rate that would have been allowed
had the facility not been designated. The commissioner may adjust these percentages by
up to 20 percent and may approve a request for less than the amount allowed;
(2) enhanced payments for leave days. Notwithstanding section 256B.431,
subdivision 2r, upon designation as a critical access nursing facility, the commissioner
shall limit payment for leave days to 60 percent of that nursing facility's total payment rate
for the involved resident, and shall allow this payment only when the occupancy of the
nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;
(3) two designated critical access nursing facilities, with up to 100 beds in active
service, may jointly apply to the commissioner of health for a waiver of Minnesota
Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The
commissioner of health will consider each waiver request independently based on the
criteria under Minnesota Rules, part 4658.0040;
(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e),
shall be 40 percent of the amount that would otherwise apply; and
(5) deleted text begin notwithstanding subdivision 58, beginning October 1, 2014,deleted text end the quality-based
rate limits under subdivision 50 shall apply to designated critical access nursing facilities.
(d) Designation of a critical access nursing facility shall be for a period of two
years, after which the benefits allowed under paragraph (c) shall be removed. Designated
facilities may apply for continued designation.
new text begin
(e) This subdivision is suspended and no state or federal funding shall be
appropriated or allocated for the purposes of this subdivision from January 1, 2016, to
December 31, 2017.
new text end
Sec. 36.
Minnesota Statutes 2014, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 65. new text end
new text begin Nursing facility in Golden Valley. new text end
new text begin
Effective for the rate year beginning
January 1, 2016, and all subsequent rate years, the operating payment rate for a facility
located in the city of Golden Valley at 3915 Golden Valley Road with 44 licensed
rehabilitation beds as of January 7, 2015, must be calculated without the application of
subdivisions 50 and 51.
new text end
Sec. 37.
Minnesota Statutes 2014, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 66. new text end
new text begin Nursing facilities in border cities. new text end
new text begin
Effective for the rate year beginning
January 1, 2016, and annually thereafter, operating payment rates of a nonprofit nursing
facility that exists on January 1, 2015, is located anywhere within the boundaries of the
city of Breckenridge, and is reimbursed under this section, section 256B.431, or section
256B.434, shall be adjusted to be equal to the median RUG's rates, including comparable
rate components as determined by the commissioner, for the equivalent RUG's weight of
the nonprofit nursing facility or facilities located in an adjacent city in another state and
in cities contiguous to the adjacent city. The Minnesota facility's operating payment rate
with a weight of 1.0 shall be computed by dividing the adjacent city's nursing facilities
median operating payment rate with a weight of 1.02 by 1.02. If the adjustments under
this subdivision result in a rate that exceeds the limits in subdivisions 50 and 51 in a given
rate year, the facility's rate shall not be subject to those limits for that rate year. This
subdivision shall apply only if it results in a higher operating payment rate than would
otherwise be determined under this section, section 256B.431, or section 256B.434.
new text end
Sec. 38.
Minnesota Statutes 2014, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 67. new text end
new text begin Nursing facility; contract with insurance provider. new text end
new text begin
Within the projected
cost of nursing facility payment reform under this section, for a facility that did not provide
employee health insurance coverage as of May 1, 2015, if the facility has a signed contract
with a health insurance provider to begin providing employee health insurance coverage
by January 1, 2016, the facility shall be paid for the employer health insurance costs
portion of external fixed costs under subdivisions 13 and 53 beginning January 1, 2016.
new text end
Sec. 39.
Minnesota Statutes 2014, section 256B.50, subdivision 1, is amended to read:
Subdivision 1.
Scope.
A provider may appeal from a determination of a payment
rate established pursuant to this chapternew text begin or allowed costs under section 256B.441new text end and
reimbursement rules of the commissioner if the appeal, if successful, would result in
a change to the provider's payment rate or to the calculation of maximum charges to
therapy vendors as provided by section 256B.433, subdivision 3. Appeals must be filed
in accordance with procedures in this section. This section does not apply to a request
from a resident or long-term care facility for reconsideration of the classification of a
resident under section 144.0722.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2015, and applies to appeals
filed on or after that date.
new text end
Sec. 40.
Minnesota Statutes 2014, section 256I.05, subdivision 2, is amended to read:
Subd. 2.
Monthly rates; exemptions.
This subdivision applies to a residence
that on August 1, 1984, was licensed by the commissioner of health only as a boarding
care home, certified by the commissioner of health as an intermediate care facility, and
licensed by the commissioner of human services under Minnesota Rules, parts 9520.0500
to 9520.0690. Notwithstanding the provisions of subdivision 1c, the rate paid to a
facility reimbursed under this subdivision shall be determined under section 256B.431,
deleted text begin or under sectiondeleted text end 256B.434new text begin , or 256B.441,new text end if the facility is accepted by the commissioner
for participation in the alternative payment demonstration project. The rate paid to this
facility shall also include adjustments to the group residential housing rate according to
subdivision 1, and any adjustments applicable to supplemental service rates statewide.
Sec. 41. new text begin DIRECTION TO COMMISSIONER; NURSING FACILITY PAYMENT
REFORM REPORT.
new text end
new text begin
By January 1, 2017, the commissioner of human services shall evaluate and report to
the house of representatives and senate committees and divisions with jurisdiction over
nursing facility payment rates on:
new text end
new text begin
(1) the impact of using cost report data to set rates without accounting for cost
report to rate year inflation;
new text end
new text begin
(2) the impact of the quality adjusted care limits;
new text end
new text begin
(3) the ability of nursing facilities to attract and retain employees, including how rate
increases are being passed through to employees, under the new payment system;
new text end
new text begin
(4) the efficacy of the critical access nursing facility program under Minnesota
Statutes, section 256B.441, subdivision 63, given the new nursing facility payment system;
new text end
new text begin
(5) creating a process for the commissioner to designate certain facilities as
specialized care facilities for difficult-to-serve populations; and
new text end
new text begin
(6) limiting the hold harmless in Minnesota Statutes, section 256B.441, subdivision
56.
new text end
Sec. 42. new text begin PROPERTY RATE SETTING.
new text end
new text begin
The commissioner shall conduct a study, in consultation with stakeholders and
experts, of property rate setting, based on a rental value or other approach for Minnesota
nursing facilities, and shall report the findings to the house of representatives and senate
committees and divisions with jurisdiction over nursing facility payment rates by March 1,
2016, for a system implementation date of January 1, 2017. The commissioner shall:
new text end
new text begin
(1) contract with at least two firms to conduct appraisals of all nursing facilities in
the medical assistance program. Each firm shall conduct appraisals of approximately
equal portions of all nursing facilities assigned to them at random. The appraisals shall
determine the value of the land, building, and equipment of each nursing facility, taking
into account the quality of construction and current condition of the building;
new text end
new text begin
(2) use the information from the appraisals to complete the design of a rental value
or other system and calculate a replacement value and an effective age for each nursing
facility. Nursing facilities may request an appraisal by a second firm which shall be
assigned randomly by the commissioner. The commissioner shall use the findings of
the second appraisal. If the second firm increases the appraisal value by more than five
percent, the state shall pay for the second appraisal. Otherwise, the nursing facility shall
pay the cost of the appraisal. Results of appraisals are not otherwise subject to appeal
under section 256B.50; and
new text end
new text begin
(3) include in the report required under this section the following items:
new text end
new text begin
(i) a description of the proposed rental value or other system;
new text end
new text begin
(ii) options for adjusting the system parameters that vary the cost of implementing
the new property rate system and an analysis of individual nursing facilities under the
current property payment rate and the rates under various approaches to calculating rates
under the rental value or other system;
new text end
new text begin
(iii) recommended steps for transition to the rental value or other system;
new text end
new text begin
(iv) an analysis of the expected long-term incentives of the rental value or other
system for nursing facilities to maintain and replace buildings, including how the current
exceptions to the moratorium process under Minnesota Statutes, section 144A.073, may
be adapted; and
new text end
new text begin
(v) bill language for implementation of the rental value or other system.
new text end
Sec. 43. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
The revisor of statutes, in consultation with the House Research Department, Office
of Senate Counsel, Research, and Fiscal Analysis, Department of Human Services, and
stakeholders, shall prepare legislation for the 2016 legislative session to recodify laws
governing nursing home payments and rates in Minnesota Statutes, chapter 256B, and in
Minnesota Rules, chapter 9549.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 44. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2014, sections 256B.434, subdivision 19b; and 256B.441,
subdivisions 14a, 19, 50a, 52, 55, 58, and 62,
new text end
new text begin
are repealed.
new text end
ARTICLE 7
CONTINUING CARE
Section 1.
Minnesota Statutes 2014, section 13.461, is amended by adding a
subdivision to read:
new text begin Subd. 32. new text end
new text begin ABLE accounts and designated beneficiaries. new text end
new text begin
Data on ABLE accounts
and designated beneficiaries of ABLE accounts are classified under section 256Q.05,
subdivision 7.
new text end
Sec. 2.
Minnesota Statutes 2014, section 144.057, subdivision 1, is amended to read:
Subdivision 1.
Background studies required.
The commissioner of health shall
contract with the commissioner of human services to conduct background studies of:
(1) individuals providing services which have direct contact, as defined under
section 245C.02, subdivision 11, with patients and residents in hospitals, boarding care
homes, outpatient surgical centers licensed under sections 144.50 to 144.58; nursing
homes and home care agencies licensed under chapter 144A; residential care homes
licensed under chapter 144B, and board and lodging establishments that are registered to
provide supportive or health supervision services under section 157.17;
(2) individuals specified in section 245C.03, subdivision 1, who perform direct
contact services in a nursing home or a home care agency licensed under chapter 144A
or a boarding care home licensed under sections 144.50 to 144.58deleted text begin , anddeleted text end new text begin .new text end If the individual
under study resides outside Minnesota, the study must deleted text begin be at least as comprehensive as
that of a Minnesota resident and include a search of information from the criminal justice
data communications network in the state where the subject of the study residesdeleted text end new text begin include a
check for substantiated findings of maltreatment of adults and children in the individual's
state of residence when the information is made available by that state, and must include a
check of the National Crime Information Center databasenew text end ;
(3) beginning July 1, 1999, all other employees in nursing homes licensed under
chapter 144A, and boarding care homes licensed under sections 144.50 to 144.58. A
disqualification of an individual in this section shall disqualify the individual from
positions allowing direct contact or access to patients or residents receiving services.
"Access" means physical access to a client or the client's personal property without
continuous, direct supervision as defined in section 245C.02, subdivision 8, when the
employee's employment responsibilities do not include providing direct contact services;
(4) individuals employed by a supplemental nursing services agency, as defined
under section 144A.70, who are providing services in health care facilities; and
(5) controlling persons of a supplemental nursing services agency, as defined under
section 144A.70.
If a facility or program is licensed by the Department of Human Services and
subject to the background study provisions of chapter 245C and is also licensed by the
Department of Health, the Department of Human Services is solely responsible for the
background studies of individuals in the jointly licensed programs.
Sec. 3.
Minnesota Statutes 2014, section 245A.06, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin
Correction orders and conditional licenses for programs licensed as
home and community-based services.
new text end
new text begin
(a) For programs licensed under both this chapter
and chapter 245D, if the license holder operates more than one service site under a single
license governed by chapter 245D, the order issued under this section shall be specific to
the service site or sites at which the violations of applicable law or rules occurred. The
order shall not apply to other service sites governed by chapter 245D and operated by the
same license holder unless the commissioner has included in the order the articulable basis
for applying the order to another service site.
new text end
new text begin
(b) If the commissioner has issued more than one license to the license holder under
this chapter, the conditions imposed under this section shall be specific to the license for
the program at which the violations of applicable law or rules occurred and shall not apply
to other licenses held by the same license holder if those programs are being operated in
substantial compliance with applicable law and rules.
new text end
Sec. 4.
new text begin
[245A.081] SETTLEMENT AGREEMENT.
new text end
new text begin
(a) A license holder who has made a timely appeal pursuant to section 245A.06,
subdivision 4, or 245A.07, subdivision 3, or the commissioner may initiate a discussion
about a possible settlement agreement related to the licensing sanction. For the purposes
of this section, the following conditions apply to a settlement agreement reached by the
parties:
new text end
new text begin
(1) if the parties enter into a settlement agreement, the effect of the agreement shall
be that the appeal is withdrawn and the agreement shall constitute the full agreement
between the commissioner and the party who filed the appeal; and
new text end
new text begin
(2) the settlement agreement must identify the agreed upon actions the license holder
has taken and will take in order to achieve and maintain compliance with the licensing
requirements that the commissioner determined the license holder had violated.
new text end
new text begin
(b) Neither the license holder nor the commissioner is required to initiate a
settlement discussion under this section.
new text end
new text begin
(c) If a settlement discussion is initiated by the license holder, the commissioner
shall respond to the license holder within 14 calendar days of receipt of the license
holder's submission.
new text end
new text begin
(d) If the commissioner agrees to engage in settlement discussions, the commissioner
may decide at any time not to continue settlement discussions with a license holder.
new text end
Sec. 5.
Minnesota Statutes 2014, section 245A.155, subdivision 1, is amended to read:
Subdivision 1.
Licensed foster care and respite care.
This section applies to
foster care agencies and licensed foster care providers who place, supervise, or care for
individuals who rely on medical monitoring equipment to sustain life or monitor a medical
conditionnew text begin that could become life-threatening without proper use of the medical equipment
new text end in respite care or foster care.
Sec. 6.
Minnesota Statutes 2014, section 245A.155, subdivision 2, is amended to read:
Subd. 2.
Foster care agency requirements.
In order for an agency to place an
individual who relies on medical equipment to sustain life or monitor a medical condition
new text begin that could become life-threatening without proper use of the medical equipmentnew text end with a
foster care provider, the agency must ensure that the foster care provider has received the
training to operate such equipment as observed and confirmed by a qualified source,
and that the provider:
(1) is currently caring for an individual who is using the same equipment in the
foster home; or
(2) has written documentation that the foster care provider has cared for an
individual who relied on such equipment within the past six months; or
(3) has successfully completed training with the individual being placed with the
provider.
Sec. 7.
Minnesota Statutes 2014, section 245A.65, subdivision 2, is amended to read:
Subd. 2.
Abuse prevention plans.
All license holders shall establish and enforce
ongoing written program abuse prevention plans and individual abuse prevention plans as
required under section 626.557, subdivision 14.
(a) The scope of the program abuse prevention plan is limited to the population,
physical plant, and environment within the control of the license holder and the location
where licensed services are provided. In addition to the requirements in section 626.557,
subdivision 14, the program abuse prevention plan shall meet the requirements in clauses
(1) to (5).
(1) The assessment of the population shall include an evaluation of the following
factors: age, gender, mental functioning, physical and emotional health or behavior of the
client; the need for specialized programs of care for clients; the need for training of staff to
meet identified individual needs; and the knowledge a license holder may have regarding
previous abuse that is relevant to minimizing risk of abuse for clients.
(2) The assessment of the physical plant where the licensed services are provided
shall include an evaluation of the following factors: the condition and design of the
building as it relates to the safety of the clients; and the existence of areas in the building
which are difficult to supervise.
(3) The assessment of the environment for each facility and for each site when living
arrangements are provided by the agency shall include an evaluation of the following
factors: the location of the program in a particular neighborhood or community; the type
of grounds and terrain surrounding the building; the type of internal programming; and
the program's staffing patterns.
(4) The license holder shall provide an orientation to the program abuse prevention
plan for clients receiving services. If applicable, the client's legal representative must be
notified of the orientation. The license holder shall provide this orientation for each new
person within 24 hours of admission, or for persons who would benefit more from a later
orientation, the orientation may take place within 72 hours.
(5) The license holder's governing bodynew text begin or the governing body's delegated
representativenew text end shall review the plan at least annually using the assessment factors in the
plan and any substantiated maltreatment findings that occurred since the last review. The
governing bodynew text begin or the governing body's delegated representativenew text end shall revise the plan,
if necessary, to reflect the review results.
(6) A copy of the program abuse prevention plan shall be posted in a prominent
location in the program and be available upon request to mandated reporters, persons
receiving services, and legal representatives.
(b) In addition to the requirements in section 626.557, subdivision 14, the individual
abuse prevention plan shall meet the requirements in clauses (1) and (2).
(1) The plan shall include a statement of measures that will be taken to minimize the
risk of abuse to the vulnerable adult when the individual assessment required in section
626.557, subdivision 14, paragraph (b), indicates the need for measures in addition to the
specific measures identified in the program abuse prevention plan. The measures shall
include the specific actions the program will take to minimize the risk of abuse within
the scope of the licensed services, and will identify referrals made when the vulnerable
adult is susceptible to abuse outside the scope or control of the licensed services. When
the assessment indicates that the vulnerable adult does not need specific risk reduction
measures in addition to those identified in the program abuse prevention plan, the
individual abuse prevention plan shall document this determination.
(2) An individual abuse prevention plan shall be developed for each new person as
part of the initial individual program plan or service plan required under the applicable
licensing rule. The review and evaluation of the individual abuse prevention plan shall
be done as part of the review of the program plan or service plan. The person receiving
services shall participate in the development of the individual abuse prevention plan to the
full extent of the person's abilities. If applicable, the person's legal representative shall be
given the opportunity to participate with or for the person in the development of the plan.
The interdisciplinary team shall document the review of all abuse prevention plans at least
annually, using the individual assessment and any reports of abuse relating to the person.
The plan shall be revised to reflect the results of this review.
Sec. 8.
Minnesota Statutes 2014, section 245C.08, subdivision 1, is amended to read:
Subdivision 1.
Background studies conducted by Department of Human
Services.
(a) For a background study conducted by the Department of Human Services,
the commissioner shall review:
(1) information related to names of substantiated perpetrators of maltreatment of
vulnerable adults that has been received by the commissioner as required under section
626.557, subdivision 9c, paragraph (j);
(2) the commissioner's records relating to the maltreatment of minors in licensed
programs, and from findings of maltreatment of minors as indicated through the social
service information system;
(3) information from juvenile courts as required in subdivision 4 for individuals
listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
(4) information from the Bureau of Criminal Apprehension, including information
regarding a background study subject's registration in Minnesota as a predatory offender
under section 243.166;
(5) except as provided in clause (6), information from the national crime information
system when the commissioner has reasonable cause as defined under section 245C.05,
subdivision 5new text begin , or as required under section 144.057, subdivision 1, clause (2)new text end ; and
(6) for a background study related to a child foster care application for licensure, a
transfer of permanent legal and physical custody of a child under sections 260C.503 to
260C.515, or adoptions, the commissioner shall also review:
(i) information from the child abuse and neglect registry for any state in which the
background study subject has resided for the past five years; and
(ii) information from national crime information databases, when the background
study subject is 18 years of age or older.
(b) Notwithstanding expungement by a court, the commissioner may consider
information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
received notice of the petition for expungement and the court order for expungement is
directed specifically to the commissioner.
(c) The commissioner shall also review criminal case information received according
to section 245C.04, subdivision 4a, from the Minnesota court information system that
relates to individuals who have already been studied under this chapter and who remain
affiliated with the agency that initiated the background study.
(d) When the commissioner has reasonable cause to believe that the identity of
a background study subject is uncertain, the commissioner may require the subject to
provide a set of classifiable fingerprints for purposes of completing a fingerprint-based
record check with the Bureau of Criminal Apprehension. Fingerprints collected under this
paragraph shall not be saved by the commissioner after they have been used to verify the
identity of the background study subject against the particular criminal record in question.
new text begin
(e) The commissioner may inform the entity that initiated a background study under
NETStudy 2.0 of the status of processing of the subject's fingerprints.
new text end
Sec. 9.
Minnesota Statutes 2014, section 245C.12, is amended to read:
245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.
(a) For the purposes of background studies completed by tribal organizations
performing licensing activities otherwise required of the commissioner under this chapter,
after obtaining consent from the background study subject, tribal licensing agencies shall
have access to criminal history data in the same manner as county licensing agencies and
private licensing agencies under this chapter.
(b) Tribal organizations may contract with the commissioner to obtain background
study data on individuals under tribal jurisdiction related to adoptions according to
section 245C.34. Tribal organizations may also contract with the commissioner to obtain
background study data on individuals under tribal jurisdiction related to child foster care
according to section 245C.34.
new text begin
(c) For the purposes of background studies completed to comply with a tribal
organization's licensing requirements for individuals affiliated with a tribally licensed
nursing facility, the commissioner shall obtain criminal history data from the National
Criminal Records Repository in accordance with section 245C.32.
new text end
Sec. 10.
Minnesota Statutes 2014, section 245D.02, is amended by adding a
subdivision to read:
new text begin Subd. 37. new text end
new text begin Working day. new text end
new text begin
"Working day" means Monday, Tuesday, Wednesday,
Thursday, or Friday, excluding any legal holiday.
new text end
Sec. 11.
Minnesota Statutes 2014, section 245D.05, subdivision 1, is amended to read:
Subdivision 1.
Health needs.
(a) The license holder is responsible for meeting
health service needs assigned in the coordinated service and support plan or the
coordinated service and support plan addendum, consistent with the person's health needs.
new text begin Unless directed otherwise in the coordinated service and support plan or the coordinated
service and support plan addendum,new text end the license holder is responsible for promptly
notifying the person's legal representative, if any, and the case manager of changes in a
person's physical and mental health needs affecting health service needs assigned to the
license holder in the coordinated service and support plan or the coordinated service
and support plan addendum, when discovered by the license holder, unless the license
holder has reason to know the change has already been reported. The license holder
must document when the notice is provided.
(b) If responsibility for meeting the person's health service needs has been assigned
to the license holder in the coordinated service and support plan or the coordinated service
and support plan addendum, the license holder must maintain documentation on how the
person's health needs will be met, including a description of the procedures the license
holder will follow in order to:
(1) provide medication setup, assistance, or administration according to this chapter.
Unlicensed staff responsible for medication setup or medication administration under this
section must complete training according to section 245D.09, subdivision 4a, paragraph (d);
(2) monitor health conditions according to written instructions from a licensed
health professional;
(3) assist with or coordinate medical, dental, and other health service appointments; or
(4) use medical equipment, devices, or adaptive aides or technology safely and
correctly according to written instructions from a licensed health professional.
Sec. 12.
Minnesota Statutes 2014, section 245D.05, subdivision 2, is amended to read:
Subd. 2.
Medication administration.
(a) For purposes of this subdivision,
"medication administration" means:
(1) checking the person's medication record;
(2) preparing the medication as necessary;
(3) administering the medication or treatment to the person;
(4) documenting the administration of the medication or treatment or the reason for
not administering the medication or treatment; and
(5) reporting to the prescriber or a nurse any concerns about the medication or
treatment, including side effects, effectiveness, or a pattern of the person refusing to
take the medication or treatment as prescribed. Adverse reactions must be immediately
reported to the prescriber or a nurse.
(b)(1) If responsibility for medication administration is assigned to the license holder
in the coordinated service and support plan or the coordinated service and support plan
addendum, the license holder must implement medication administration procedures to
ensure a person takes medications and treatments as prescribed. The license holder must
ensure that the requirements in clauses (2) and (3) have been met before administering
medication or treatment.
(2) The license holder must obtain written authorization from the person or the
person's legal representative to administer medication or treatment deleted text begin and must obtain
reauthorization annually as neededdeleted text end . This authorization shall remain in effect unless it is
withdrawn in writing and may be withdrawn at any time. If the person or the person's
legal representative refuses to authorize the license holder to administer medication, the
medication must not be administered. The refusal to authorize medication administration
must be reported to the prescriber as expediently as possible.
(3) For a license holder providing intensive support services, the medication or
treatment must be administered according to the license holder's medication administration
policy and procedures as required under section 245D.11, subdivision 2, clause (3).
(c) The license holder must ensure the following information is documented in the
person's medication administration record:
(1) the information on the current prescription label or the prescriber's current
written or electronically recorded order or prescription that includes the person's name,
description of the medication or treatment to be provided, and the frequency and other
information needed to safely and correctly administer the medication or treatment to
ensure effectiveness;
(2) information on any risks or other side effects that are reasonable to expect, and
any contraindications to its use. This information must be readily available to all staff
administering the medication;
(3) the possible consequences if the medication or treatment is not taken or
administered as directed;
(4) instruction on when and to whom to report the following:
(i) if a dose of medication is not administered or treatment is not performed as
prescribed, whether by error by the staff or the person or by refusal by the person; and
(ii) the occurrence of possible adverse reactions to the medication or treatment;
(5) notation of any occurrence of a dose of medication not being administered or
treatment not performed as prescribed, whether by error by the staff or the person or by
refusal by the person, or of adverse reactions, and when and to whom the report was
made; and
(6) notation of when a medication or treatment is started, administered, changed, or
discontinued.
Sec. 13.
Minnesota Statutes 2014, section 245D.06, subdivision 1, is amended to read:
Subdivision 1.
Incident response and reporting.
(a) The license holder must
respond to incidents under section 245D.02, subdivision 11, that occur while providing
services to protect the health and safety of and minimize risk of harm to the person.
(b) The license holder must maintain information about and report incidents to the
person's legal representative or designated emergency contact and case manager within
24 hours of an incident occurring while services are being provided, within 24 hours of
discovery or receipt of information that an incident occurred, unless the license holder
has reason to know that the incident has already been reported, or as otherwise directed
in a person's coordinated service and support plan or coordinated service and support
plan addendum. An incident of suspected or alleged maltreatment must be reported as
required under paragraph (d), and an incident of serious injury or death must be reported
as required under paragraph (e).
(c) When the incident involves more than one person, the license holder must not
disclose personally identifiable information about any other person when making the report
to each person and case manager unless the license holder has the consent of the person.
(d) Within 24 hours of reporting maltreatment as required under section 626.556
or 626.557, the license holder must inform the case manager of the report unless there is
reason to believe that the case manager is involved in the suspected maltreatment. The
license holder must disclose the nature of the activity or occurrence reported and the
agency that received the report.
(e) The license holder must report the death or serious injury of the person as
required in paragraph (b) and to the Department of Human Services Licensing Division,
and the Office of Ombudsman for Mental Health and Developmental Disabilities as
required under section 245.94, subdivision 2a, within 24 hours of the deathnew text begin or serious
injurynew text end , or receipt of information that the deathnew text begin or serious injurynew text end occurred, unless the license
holder has reason to know that the deathnew text begin or serious injurynew text end has already been reported.
(f) When a death or serious injury occurs in a facility certified as an intermediate
care facility for persons with developmental disabilities, the death or serious injury must
be reported to the Department of Health, Office of Health Facility Complaints, and the
Office of Ombudsman for Mental Health and Developmental Disabilities, as required
under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
know that the deathnew text begin or serious injurynew text end has already been reported.
(g) The license holder must conduct an internal review of incident reports of deaths
and serious injuries that occurred while services were being provided and that were not
reported by the program as alleged or suspected maltreatment, for identification of incident
patterns, and implementation of corrective action as necessary to reduce occurrences.
The review must include an evaluation of whether related policies and procedures were
followed, whether the policies and procedures were adequate, whether there is a need for
additional staff training, whether the reported event is similar to past events with the
persons or the services involved, and whether there is a need for corrective action by the
license holder to protect the health and safety of persons receiving services. Based on
the results of this review, the license holder must develop, document, and implement a
corrective action plan designed to correct current lapses and prevent future lapses in
performance by staff or the license holder, if any.
(h) The license holder must verbally report the emergency use of manual restraint
of a person as required in paragraph (b) within 24 hours of the occurrence. The license
holder must ensure the written report and internal review of all incident reports of the
emergency use of manual restraints are completed according to the requirements in section
245D.061 or successor provisions.
Sec. 14.
Minnesota Statutes 2014, section 245D.06, subdivision 2, is amended to read:
Subd. 2.
Environment and safety.
The license holder must:
(1) ensure the following when the license holder is the owner, lessor, or tenant
of the service site:
(i) the service site is a safe and hazard-free environment;
(ii) that toxic substances or dangerous items are inaccessible to persons served by
the program only to protect the safety of a person receiving services when a known safety
threat exists and not as a substitute for staff supervision or interactions with a person who
is receiving services. If toxic substances or dangerous items are made inaccessible, the
license holder must document an assessment of the physical plant, its environment, and its
population identifying the risk factors which require toxic substances or dangerous items
to be inaccessible and a statement of specific measures to be taken to minimize the safety
risk to persons receiving services and to restore accessibility to all persons receiving
services at the service site;
(iii) doors are locked from the inside to prevent a person from exiting only when
necessary to protect the safety of a person receiving services and not as a substitute for
staff supervision or interactions with the person. If doors are locked from the inside, the
license holder must document an assessment of the physical plant, the environment and
the population served, identifying the risk factors which require the use of locked doors,
and a statement of specific measures to be taken to minimize the safety risk to persons
receiving services at the service site; and
(iv) a staff person is available at the service site who is trained in basic first aid and,
when required in a person's coordinated service and support plan or coordinated service
and support plan addendum, cardiopulmonary resuscitation (CPR) whenever persons are
present and staff are required to be at the site to provide direct support service. The CPR
training must include deleted text begin in-persondeleted text end instruction, hands-on practice, and an observed skills
assessment under the direct supervision of a CPR instructor;
(2) maintain equipment, vehicles, supplies, and materials owned or leased by the
license holder in good condition when used to provide services;
(3) follow procedures to ensure safe transportation, handling, and transfers of the
person and any equipment used by the person, when the license holder is responsible for
transportation of a person or a person's equipment;
(4) be prepared for emergencies and follow emergency response procedures to
ensure the person's safety in an emergency; and
(5) follow universal precautions and sanitary practices, including hand washing, for
infection prevention and control, and to prevent communicable diseases.
Sec. 15.
Minnesota Statutes 2014, section 245D.06, subdivision 7, is amended to read:
Subd. 7.
Permitted actions and procedures.
(a) Use of the instructional techniques
and intervention procedures as identified in paragraphs (b) and (c) is permitted when used
on an intermittent or continuous basis. When used on a continuous basis, it must be
addressed in a person's coordinated service and support plan addendum as identified in
sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this
subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720.
(b) Physical contact or instructional techniques must use the least restrictive
alternative possible to meet the needs of the person and may be used:
(1) to calm or comfort a person by holding that person with no resistance from
that person;
(2) to protect a person known to be at risk of injury due to frequent falls as a result
of a medical condition;
(3) to facilitate the person's completion of a task or response when the person does
not resist or the person's resistance is minimal in intensity and duration;
(4) to block or redirect a person's limbs or body without holding the person or
limiting the person's movement to interrupt the person's behavior that may result in injury
to self or others with less than 60 seconds of physical contact by staff; or
(5) to redirect a person's behavior when the behavior does not pose a serious threat
to the person or others and the behavior is effectively redirected with less than 60 seconds
of physical contact by staff.
(c) Restraint may be used as an intervention procedure to:
(1) allow a licensed health care professional to safely conduct a medical examination
or to provide medical treatment ordered by a licensed health care professional deleted text begin to a person
necessary to promote healing or recovery from an acute, meaning short-term, medical
conditiondeleted text end ;
(2) assist in the safe evacuation or redirection of a person in the event of an
emergency and the person is at imminent risk of harm; or
(3) position a person with physical disabilities in a manner specified in the person's
coordinated service and support plan addendum.
Any use of manual restraint as allowed in this paragraph must comply with the restrictions
identified in subdivision 6, paragraph (b).
(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment
ordered by a licensed health professional to treat a diagnosed medical condition do not in
and of themselves constitute the use of mechanical restraint.
Sec. 16.
Minnesota Statutes 2014, section 245D.07, subdivision 2, is amended to read:
Subd. 2.
Service planning requirements for basic support services.
(a) License
holders providing basic support services must meet the requirements of this subdivision.
(b) Within 15new text begin calendarnew text end days of service initiation the license holder must complete
a preliminary coordinated service and support plan addendum based on the coordinated
service and support plan.
(c) Within 60new text begin calendarnew text end days of service initiation the license holder must review
and revise as needed the preliminary coordinated service and support plan addendum to
document the services that will be provided including how, when, and by whom services
will be provided, and the person responsible for overseeing the delivery and coordination
of services.
(d) The license holder must participate in service planning and support team
meetings for the person following stated timelines established in the person's coordinated
service and support plan or as requested by the person or the person's legal representative,
the support team or the expanded support team.
Sec. 17.
Minnesota Statutes 2014, section 245D.071, subdivision 5, is amended to read:
Subd. 5.
Service plan review and evaluation.
(a) The license holder must give the
person or the person's legal representative and case manager an opportunity to participate
in the ongoing review and development of the service plan and the methods used to support
the person and accomplish outcomes identified in subdivisions 3 and 4. The license holder,
in coordination with the person's support team or expanded support team, must meet
with the person, the person's legal representative, and the case manager, and participate
in service plan review meetings following stated timelines established in the person's
coordinated service and support plan or coordinated service and support plan addendum or
within 30 days of a written request by the person, the person's legal representative, or the
case manager, at a minimum of once per year. The purpose of the service plan review
is to determine whether changes are needed to the service plan based on the assessment
information, the license holder's evaluation of progress towards accomplishing outcomes,
or other information provided by the support team or expanded support team.
(b) The license holder must summarize the person's status and progress toward
achieving the identified outcomes and make recommendations and identify the rationale
for changing, continuing, or discontinuing implementation of supports and methods
identified in subdivision 4 in a deleted text begin writtendeleted text end report deleted text begin sent to the person or the person's legal
representative and case manager five working days prior to the review meeting, unless the
person, the person's legal representative, or the case manager requests to receive the report
deleted text end new text begin availablenew text end at the time of thenew text begin progress reviewnew text end meeting.new text begin The report must be sent at least
five working days prior to the progress review meeting if requested by the team in the
coordinated service and support plan or coordinated service and support plan addendum.
new text end
(c) new text begin The license holder must send the coordinated service and support plan addendum
to the person, the person's legal representative, and the case manager by mail within ten
working days of the progress review meeting.new text end Within ten working days of the deleted text begin progress
review meetingdeleted text end new text begin mailing of the coordinated service and support plan addendumnew text end , the license
holder must obtain dated signatures from the person or the person's legal representative
and the case manager to document approval of any changes to the coordinated service and
support plan addendum.
new text begin
(d) If, within ten working days of submitting changes to the coordinated service
and support plan and coordinated service and support plan addendum, the person or the
person's legal representative or case manager has not signed and returned to the license
holder the coordinated service and support plan or coordinated service and support plan
addendum or has not proposed written modifications to the license holder's submission, the
submission is deemed approved and the coordinated service and support plan addendum
becomes effective and remains in effect until the legal representative or case manager
submits a written request to revise the coordinated service and support plan addendum.
new text end
Sec. 18.
Minnesota Statutes 2014, section 245D.09, subdivision 3, is amended to read:
Subd. 3.
Staff qualifications.
(a) The license holder must ensure that staff providing
direct support, or staff who have responsibilities related to supervising or managing the
provision of direct support service, are competent as demonstrated through skills and
knowledge training, experience, and education relevant to the primary disability of the
person and to meet the person's needs and additional requirements as written in the
coordinated service and support plan or coordinated service and support plan addendum,
or when otherwise required by the case manager or the federal waiver plan. The license
holder must verify and maintain evidence of staff competency, including documentation of:
(1) education and experience qualifications relevant to the job responsibilities
assigned to the staff and to the primary disability of persons served by the program,
including a valid degree and transcript, or a current license, registration, or certification,
when a degree or licensure, registration, or certification is required by this chapter or in the
coordinated service and support plan or coordinated service and support plan addendum;
(2) demonstrated competency in the orientation and training areas required under
this chapter, and when applicable, completion of continuing education required to
maintain professional licensure, registration, or certification requirements. Competency in
these areas is determined by the license holder through knowledge testing or observed
skill assessment conducted by the trainer or instructornew text begin or by an individual who has been
previously deemed competent by the trainer or instructor in the area being assessednew text end ; and
(3) except for a license holder who is the sole direct support staff, periodic
performance evaluations completed by the license holder of the direct support staff
person's ability to perform the job functions based on direct observation.
(b) Staff under 18 years of age may not perform overnight duties or administer
medication.
Sec. 19.
Minnesota Statutes 2014, section 245D.09, subdivision 5, is amended to read:
Subd. 5.
Annual training.
A license holder must provide annual training to direct
support staff on the topics identified in subdivision 4, clauses (3) to (10). new text begin If the direct
support staff has a first aid certification, annual training under subdivision 4, clause (9), is
not required as long as the certification remains current. new text end A license holder must provide a
minimum of 24 hours of annual training to direct service staff providing intensive services
and having fewer than five years of documented experience and 12 hours of annual
training to direct service staff providing intensive services and having five or more years
of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a) to
(f). Training on relevant topics received from sources other than the license holder may
count toward training requirements. A license holder must provide a minimum of 12 hours
of annual training to direct service staff providing basic services and having fewer than
five years of documented experience and six hours of annual training to direct service staff
providing basic services and having five or more years of documented experience.
Sec. 20.
Minnesota Statutes 2014, section 245D.22, subdivision 4, is amended to read:
Subd. 4.
First aid must be available on site.
(a) A staff person trained in first
aid must be available on site and, when required in a person's coordinated service and
support plan or coordinated service and support plan addendum, be able to provide
cardiopulmonary resuscitation, whenever persons are present and staff are required to be
at the site to provide direct service. The CPR training must include deleted text begin in-persondeleted text end instruction,
hands-on practice, and an observed skills assessment under the direct supervision of a
CPR instructor.
(b) A facility must have first aid kits readily available for use by, and that meet
the needs of, persons receiving services and staff. At a minimum, the first aid kit must
be equipped with accessible first aid supplies including bandages, sterile compresses,
scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap,
adhesive tape, and first aid manual.
Sec. 21.
Minnesota Statutes 2014, section 245D.31, subdivision 3, is amended to read:
Subd. 3.
Staff ratio requirement for each person receiving services.
The case
manager, in consultation with the interdisciplinary team, must determine at least once each
year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving
services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio
assigned each person and the documentation of how the ratio was arrived at must be kept
in each person's individual service plan. Documentation must include an assessment of the
person with respect to the characteristics in subdivisions 4, 5, and 6 deleted text begin recorded on a standard
assessment form required by the commissionerdeleted text end .
Sec. 22.
Minnesota Statutes 2014, section 245D.31, subdivision 4, is amended to read:
Subd. 4.
Person requiring staff ratio of one to four.
A person must be assigned a
staff ratio requirement of one to four if:
(1) on a daily basis the person requires total care and monitoring or constant
hand-over-hand physical guidance to successfully complete at least three of the following
activities: toileting, communicating basic needs, eating,new text begin ornew text end ambulating; deleted text begin or is not capable
of taking appropriate action for self-preservation under emergency conditions;deleted text end or
(2) the person engages in conduct that poses an imminent risk of physical harm to
self or others at a documented level of frequency, intensity, or duration requiring frequent
daily ongoing intervention and monitoring as established in the person's coordinated
service and support plan or coordinated service and support plan addendum.
Sec. 23.
Minnesota Statutes 2014, section 245D.31, subdivision 5, is amended to read:
Subd. 5.
Person requiring staff ratio of one to eight.
A person must be assigned a
staff ratio requirement of one to eight if:
(1) the person does not meet the requirements in subdivision 4; and
(2) on a daily basis the person requires verbal prompts or spot checks and minimal
or no physical assistance to successfully complete at least deleted text begin fourdeleted text end new text begin threenew text end of the following
activities: toileting, communicating basic needs, eating, new text begin or new text end ambulatingdeleted text begin , or taking
appropriate action for self-preservation under emergency conditionsdeleted text end .
Sec. 24.
Minnesota Statutes 2014, section 252.27, subdivision 2a, is amended to read:
Subd. 2a.
Contribution amount.
(a) The natural or adoptive parents of a minor
child, including a child determined eligible for medical assistance without consideration of
parental income, must contribute to the cost of services used by making monthly payments
on a sliding scale based on income, unless the child is married or has been married, parental
rights have been terminated, or the child's adoption is subsidized according to chapter
259A or through title IV-E of the Social Security Act. The parental contribution is a partial
or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
mitigating, rehabilitation, maintenance, and personal care services as defined in United
States Code, title 26, section 213, needed by the child with a chronic illness or disability.
(b) For households with adjusted gross income equal to or greater than 275 percent
of federal poverty guidelines, the parental contribution shall be computed by applying the
following schedule of rates to the adjusted gross income of the natural or adoptive parents:
(1) if the adjusted gross income is equal to or greater than 275 percent of federal
poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
the parental contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at deleted text begin 2.48deleted text end new text begin 2.23new text end percent of adjusted gross
income at 275 percent of federal poverty guidelines and increases to deleted text begin 6.75deleted text end new text begin 6.08new text end percent of
adjusted gross income for those with adjusted gross income up to 545 percent of federal
poverty guidelines;
(2) if the adjusted gross income is greater than 545 percent of federal poverty
guidelines and less than 675 percent of federal poverty guidelines, the parental
contribution shall be deleted text begin 6.75deleted text end new text begin 6.08new text end percent of adjusted gross income;
(3) if the adjusted gross income is equal to or greater than 675 percent of federal
poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at deleted text begin 6.75deleted text end new text begin 6.08new text end percent of adjusted gross income at 675 percent
of federal poverty guidelines and increases to deleted text begin ninedeleted text end new text begin 8.1new text end percent of adjusted gross income
for those with adjusted gross income up to 975 percent of federal poverty guidelines; and
(4) if the adjusted gross income is equal to or greater than 975 percent of federal
poverty guidelines, the parental contribution shall be deleted text begin 11.25deleted text end new text begin 10.13new text end percent of adjusted
gross income.
If the child lives with the parent, the annual adjusted gross income is reduced by
$2,400 prior to calculating the parental contribution. If the child resides in an institution
specified in section 256B.35, the parent is responsible for the personal needs allowance
specified under that section in addition to the parental contribution determined under this
section. The parental contribution is reduced by any amount required to be paid directly to
the child pursuant to a court order, but only if actually paid.
(c) The household size to be used in determining the amount of contribution under
paragraph (b) includes natural and adoptive parents and their dependents, including the
child receiving services. Adjustments in the contribution amount due to annual changes
in the federal poverty guidelines shall be implemented on the first day of July following
publication of the changes.
(d) For purposes of paragraph (b), "income" means the adjusted gross income of the
natural or adoptive parents determined according to the previous year's federal tax form,
except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
have been used to purchase a home shall not be counted as income.
(e) The contribution shall be explained in writing to the parents at the time eligibility
for services is being determined. The contribution shall be made on a monthly basis
effective with the first month in which the child receives services. Annually upon
redetermination or at termination of eligibility, if the contribution exceeded the cost of
services provided, the local agency or the state shall reimburse that excess amount to
the parents, either by direct reimbursement if the parent is no longer required to pay a
contribution, or by a reduction in or waiver of parental fees until the excess amount is
exhausted. All reimbursements must include a notice that the amount reimbursed may be
taxable income if the parent paid for the parent's fees through an employer's health care
flexible spending account under the Internal Revenue Code, section 125, and that the
parent is responsible for paying the taxes owed on the amount reimbursed.
(f) The monthly contribution amount must be reviewed at least every 12 months;
when there is a change in household size; and when there is a loss of or gain in income
from one month to another in excess of ten percent. The local agency shall mail a written
notice 30 days in advance of the effective date of a change in the contribution amount.
A decrease in the contribution amount is effective in the month that the parent verifies a
reduction in income or change in household size.
(g) Parents of a minor child who do not live with each other shall each pay the
contribution required under paragraph (a). An amount equal to the annual court-ordered
child support payment actually paid on behalf of the child receiving services shall be
deducted from the adjusted gross income of the parent making the payment prior to
calculating the parental contribution under paragraph (b).
(h) The contribution under paragraph (b) shall be increased by an additional five
percent if the local agency determines that insurance coverage is available but not
obtained for the child. For purposes of this section, "available" means the insurance is a
benefit of employment for a family member at an annual cost of no more than five percent
of the family's annual income. For purposes of this section, "insurance" means health
and accident insurance coverage, enrollment in a nonprofit health service plan, health
maintenance organization, self-insured plan, or preferred provider organization.
Parents who have more than one child receiving services shall not be required
to pay more than the amount for the child with the highest expenditures. There shall
be no resource contribution from the parents. The parent shall not be required to pay
a contribution in excess of the cost of the services provided to the child, not counting
payments made to school districts for education-related services. Notice of an increase in
fee payment must be given at least 30 days before the increased fee is due.
(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
in the 12 months prior to July 1:
(1) the parent applied for insurance for the child;
(2) the insurer denied insurance;
(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
a complaint or appeal, in writing, to the commissioner of health or the commissioner of
commerce, or litigated the complaint or appeal; and
(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
For purposes of this section, "insurance" has the meaning given in paragraph (h).
A parent who has requested a reduction in the contribution amount under this
paragraph shall submit proof in the form and manner prescribed by the commissioner or
county agency, including, but not limited to, the insurer's denial of insurance, the written
letter or complaint of the parents, court documents, and the written response of the insurer
approving insurance. The determinations of the commissioner or county agency under this
paragraph are not rules subject to chapter 14.
Sec. 25.
Minnesota Statutes 2014, section 256.478, is amended to read:
256.478 HOME AND COMMUNITY-BASED SERVICES TRANSITIONS
GRANTS.
deleted text begin (a)deleted text end The commissioner shall make available home and community-based services
transition grants to serve individuals who do not meet eligibility criteria for the medical
assistance program under section 256B.056 or 256B.057, but who otherwise meet the
criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24.
deleted text begin
(b) For the purposes of this section, the commissioner has the authority to transfer
funds between the medical assistance account and the home and community-based
services transitions grants account.
deleted text end
Sec. 26.
Minnesota Statutes 2014, section 256.975, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Regional and local dementia grants. new text end
new text begin
(a) The Minnesota Board on
Aging shall award competitive grants to eligible applicants for regional and local projects
and initiatives targeted to a designated community, which may consist of a specific
geographic area or population, to increase awareness of Alzheimer's disease and other
dementias, increase the rate of cognitive testing in the population at risk for dementias,
promote the benefits of early diagnosis of dementias, or connect caregivers of persons
with dementia to education and resources.
new text end
new text begin
(b) The project areas for grants include:
new text end
new text begin
(1) local or community-based initiatives to promote the benefits of physician
consultations for all individuals who suspect a memory or cognitive problem;
new text end
new text begin
(2) local or community-based initiatives to promote the benefits of early diagnosis of
Alzheimer's disease and other dementias; and
new text end
new text begin
(3) local or community-based initiatives to provide informational materials and
other resources to caregivers of persons with dementia.
new text end
new text begin
(c) Eligible applicants for local and regional grants may include, but are not limited
to, community health boards, school districts, colleges and universities, community
clinics, tribal communities, nonprofit organizations, and other health care organizations.
new text end
new text begin
(d) Applicants must:
new text end
new text begin
(1) describe the proposed initiative, including the targeted community and how the
initiative meets the requirements of this subdivision; and
new text end
new text begin
(2) identify the proposed outcomes of the initiative and the evaluation process to be
used to measure these outcomes.
new text end
new text begin
(e) In awarding the regional and local dementia grants, the Minnesota Board on
Aging must give priority to applicants who demonstrate that the proposed project:
new text end
new text begin
(1) is supported by and appropriately targeted to the community the applicant serves;
new text end
new text begin
(2) is designed to coordinate with other community activities related to other health
initiatives, particularly those initiatives targeted at the elderly;
new text end
new text begin
(3) is conducted by an applicant able to demonstrate expertise in the project areas;
new text end
new text begin
(4) utilizes and enhances existing activities and resources or involves innovative
approaches to achieve success in the project areas; and
new text end
new text begin
(5) strengthens community relationships and partnerships in order to achieve the
project areas.
new text end
new text begin
(f) The board shall divide the state into specific geographic regions and allocate a
percentage of the money available for the local and regional dementia grants to projects or
initiatives aimed at each geographic region.
new text end
new text begin
(g) The board shall award any available grants by January 1, 2016, and each July 1
thereafter.
new text end
new text begin
(h) Each grant recipient shall report to the board on the progress of the initiative at
least once during the grant period, and within two months of the end of the grant period
shall submit a final report to the board that includes the outcome results.
new text end
new text begin
(i) The Minnesota Board on Aging shall:
new text end
new text begin
(1) develop the criteria and procedures to allocate the grants under this subdivision,
evaluate all applicants on a competitive basis and award the grants, and select qualified
providers to offer technical assistance to grant applicants and grantees. The selected
provider shall provide applicants and grantees assistance with project design, evaluation
methods, materials, and training; and
new text end
new text begin
(2) submit by January 15, 2017, and on each January 15 thereafter, a progress
report on the dementia grants programs under this subdivision to the chairs and ranking
minority members of the senate and house of representatives committees and divisions
with jurisdiction over health finance and policy. The report shall include:
new text end
new text begin
(i) information on each grant recipient;
new text end
new text begin
(ii) a summary of all projects or initiatives undertaken with each grant;
new text end
new text begin
(iii) the measurable outcomes established by each grantee, an explanation of the
evaluation process used to determine whether the outcomes were met, and the results of
the evaluation; and
new text end
new text begin
(iv) an accounting of how the grant funds were spent.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2015.
new text end
Sec. 27.
Minnesota Statutes 2014, section 256B.056, subdivision 5c, is amended to read:
Subd. 5c.
Excess income standard.
(a) The excess income standard for parents
and caretaker relatives, pregnant women, infants, and children ages two through 20 is the
standard specified in subdivision 4, paragraph (b).
(b) The excess income standard for a person whose eligibility is based on blindness,
disability, or age of 65 or more years shall equal deleted text begin 75deleted text end new text begin 80new text end percent of the federal poverty
guidelines.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 28.
Minnesota Statutes 2014, section 256B.057, subdivision 9, is amended to read:
Subd. 9.
Employed persons with disabilities.
(a) Medical assistance may be paid
for a person who is employed and who:
(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;
(2) meets the asset limits in paragraph (d); and
(3) pays a premium and other obligations under paragraph (e).
(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. Any
spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.
(c) After the month of enrollment, a person enrolled in medical assistance under
this subdivision who:
(1) is temporarily unable to work and without receipt of earned income due to a
medical condition, as verified by a physician; or
(2) loses employment for reasons not attributable to the enrollee, and is without
receipt of earned income may retain eligibility for up to four consecutive months after the
month of job loss. To receive a four-month extension, enrollees must verify the medical
condition or provide notification of job loss. All other eligibility requirements must be met
and the enrollee must pay all calculated premium costs for continued eligibility.
(d) For purposes of determining eligibility under this subdivision, a person's assets
must not exceed $20,000, excluding:
(1) all assets excluded under section 256B.056;
(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
Keogh plans, and pension plans;
(3) medical expense accounts set up through the person's employer; and
(4) spousal assets, including spouse's share of jointly held assets.
(e) All enrollees must pay a premium to be eligible for medical assistance under this
subdivision, except as provided under clause (5).
(1) An enrollee must pay the greater of a deleted text begin $65deleted text end new text begin $35new text end premium or the premium calculated
based on the person's gross earned and unearned income and the applicable family size
using a sliding fee scale established by the commissioner, which begins at one percent of
income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of
income for those with incomes at or above 300 percent of the federal poverty guidelines.
(2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.
(3) All enrollees who receive unearned income must pay deleted text begin fivedeleted text end new text begin one-half of one new text end percent
of unearned income in addition to the premium amount, except as provided under clause (5).
(4) Increases in benefits under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each year.
(5) Effective July 1, 2009, American Indians are exempt from paying premiums as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
(f) A person's eligibility and premium shall be determined by the local county
agency. Premiums must be paid to the commissioner. All premiums are dedicated to
the commissioner.
(g) Any required premium shall be determined at application and redetermined at
the enrollee's six-month income review or when a change in income or household size is
reported. Enrollees must report any change in income or household size within ten days
of when the change occurs. A decreased premium resulting from a reported change in
income or household size shall be effective the first day of the next available billing month
after the change is reported. Except for changes occurring from annual cost-of-living
increases, a change resulting in an increased premium shall not affect the premium amount
until the next six-month review.
(h) Premium payment is due upon notification from the commissioner of the
premium amount required. Premiums may be paid in installments at the discretion of
the commissioner.
(i) Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. Good cause exists
if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
D, are met. Except when an installment agreement is accepted by the commissioner, all
persons disenrolled for nonpayment of a premium must pay any past due premiums as well
as current premiums due prior to being reenrolled. Nonpayment shall include payment with
a returned, refused, or dishonored instrument. The commissioner may require a guaranteed
form of payment as the only means to replace a returned, refused, or dishonored instrument.
(j) For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
paragraph (a).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2015.
new text end
Sec. 29.
Minnesota Statutes 2014, section 256B.059, subdivision 5, is amended to read:
Subd. 5.
Asset availability.
(a) At the time of initial determination of eligibility for
medical assistance benefits following the first continuous period of institutionalization on
or after October 1, 1989, assets considered available to the institutionalized spouse shall
be the total value of all assets in which either spouse has an ownership interest, reduced by
the following amount for the community spouse:
(1) prior to July 1, 1994, the greater of:
(i) $14,148;
(ii) the lesser of the spousal share or $70,740; or
(iii) the amount required by court order to be paid to the community spouse;
(2) for persons whose date of initial determination of eligibility for medical
assistance following their first continuous period of institutionalization occurs on or after
July 1, 1994, the greater of:
(i) $20,000;
(ii) the lesser of the spousal share or $70,740; or
(iii) the amount required by court order to be paid to the community spouse.
The value of assets transferred for the sole benefit of the community spouse under section
256B.0595, subdivision 4, in combination with other assets available to the community
spouse under this section, cannot exceed the limit for the community spouse asset
allowance determined under subdivision 3 or 4. Assets that exceed this allowance shall be
considered available to the institutionalized spouse deleted text begin whether or notdeleted text end deleted text begin converted todeleted text end deleted text begin incomedeleted text end . If
the community spouse asset allowance has been increased under subdivision 4, then the
assets considered available to the institutionalized spouse under this subdivision shall be
further reduced by the value of additional amounts allowed under subdivision 4.
(b) An institutionalized spouse may be found eligible for medical assistance even
though assets in excess of the allowable amount are found to be available under paragraph
(a) if the assets are owned jointly or individually by the community spouse, and the
institutionalized spouse cannot use those assets to pay for the cost of care without the
consent of the community spouse, and if: (i) the institutionalized spouse assigns to the
commissioner the right to support from the community spouse under section 256B.14,
subdivision 3; (ii) the institutionalized spouse lacks the ability to execute an assignment
due to a physical or mental impairment; or (iii) the denial of eligibility would cause an
imminent threat to the institutionalized spouse's health and well-being.
(c) After the month in which the institutionalized spouse is determined eligible for
medical assistance, during the continuous period of institutionalization, no assets of the
community spouse are considered available to the institutionalized spouse, unless the
institutionalized spouse has been found eligible under paragraph (b).
(d) Assets determined to be available to the institutionalized spouse under this
section must be used for the health care or personal needs of the institutionalized spouse.
(e) For purposes of this section, assets do not include assets excluded under the
Supplemental Security Income program.
Sec. 30.
Minnesota Statutes 2014, section 256B.0916, subdivision 2, is amended to read:
Subd. 2.
Distribution of funds; partnerships.
(a) Beginning with fiscal year 2000,
the commissioner shall distribute all funding available for home and community-based
waiver services for persons with developmental disabilities to individual counties or to
groups of counties that form partnerships to jointly plan, administer, and authorize funding
for eligible individuals. The commissioner shall encourage counties to form partnerships
that have a sufficient number of recipients and funding to adequately manage the risk
and maximize use of available resources.
(b) Counties must submit a request for funds and a plan for administering the
program as required by the commissioner. The plan must identify the number of clients to
be served, their ages, and their priority listing based on:
(1) requirements in Minnesota Rules, part 9525.1880; and
(2) statewide priorities identified in section 256B.092, subdivision 12.
The plan must also identify changes made to improve services to eligible persons and to
improve program management.
(c) In allocating resources to counties, priority must be given to groups of counties
that form partnerships to jointly plan, administer, and authorize funding for eligible
individuals and to counties determined by the commissioner to have sufficient waiver
capacity to maximize resource use.
(d) Within 30 days after receiving the county request for funds and plans, the
commissioner shall provide a written response to the plan that includes the level of
resources available to serve additional persons.
(e) Counties are eligible to receive medical assistance administrative reimbursement
for administrative costs under criteria established by the commissioner.
new text begin
(f) The commissioner shall manage waiver allocations in such a manner as to fully
use available state and federal waiver appropriations.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 31.
Minnesota Statutes 2014, section 256B.0916, subdivision 11, is amended to
read:
Subd. 11.
Excess spending.
County and tribal agencies are responsible for spending
in excess of the allocation made by the commissioner. In the event a county or tribal agency
spends in excess of the allocation made by the commissioner for a given allocation period,
they must submit a corrective action plan to the commissionernew text begin for approvalnew text end . The plan must
state the actions the agency will take to correct their overspending for the deleted text begin yeardeleted text end new text begin two years
new text end following the period when the overspending occurred. deleted text begin Failure to correct overspending
shall result in recoupment of spending in excess of the allocationdeleted text end new text begin . The commissioner
shall recoup spending in excess of the allocation only in cases where statewide spending
exceeds the appropriation designated for the home and community-based services waiversnew text end .
Nothing in this subdivision shall be construed as reducing the county's responsibility to
offer and make available feasible home and community-based options to eligible waiver
recipients within the resources allocated to them for that purpose.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 32.
Minnesota Statutes 2014, section 256B.0916, is amended by adding a
subdivision to read:
new text begin Subd. 12. new text end
new text begin Use of waiver allocations. new text end
new text begin
County and tribal agencies are responsible
for spending the annual allocation made by the commissioner. In the event a county or
tribal agency spends less than 97 percent of the allocation, while maintaining a list of
persons waiting for waiver services, the county or tribal agency must submit a corrective
action plan to the commissioner for approval. The commissioner may determine a plan
is unnecessary given the size of the allocation and capacity for new enrollment. The
plan must state the actions the agency will take to assure reasonable and timely access
to home and community-based waiver services for persons waiting for services. If a
county or tribe does not submit a plan when required or implement the changes required,
the commissioner shall assure access to waiver services within the county's or tribe's
available allocation and take other actions needed to assure that all waiver participants in
that county or tribe are receiving appropriate waiver services to meet their needs.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 33.
Minnesota Statutes 2014, section 256B.49, subdivision 26, is amended to read:
Subd. 26.
Excess allocations.
new text begin (a) Effective through June 30, 2018, new text end county and
tribal agencies will be responsible for authorizations in excess of the new text begin annual new text end allocation
made by the commissioner. In the event a county or tribal agency authorizes in excess
of the allocation made by the commissioner for a given allocation period, the county or
tribal agency must submit a corrective action plan to the commissionernew text begin for approvalnew text end .
The plan must state the actions the agency will take to correct their overspending for
the deleted text begin yeardeleted text end new text begin two years new text end following the period when the overspending occurred. deleted text begin Failure to
correct overauthorizations shall result in recoupment of authorizations in excess of the
allocation.deleted text end new text begin The commissioner shall recoup funds spent in excess of the allocation only
in cases where statewide spending exceeds the appropriation designated for the home
and community-based services waivers. new text end Nothing in this subdivision shall be construed
as reducing the county's responsibility to offer and make available feasible home and
community-based options to eligible waiver recipients within the resources allocated
to them for that purpose.
new text begin
(b) Effective July 1, 2018, county and tribal agencies will be responsible for
spending in excess of the annual allocation made by the commissioner. In the event a
county or tribal agency spends in excess of the allocation made by the commissioner for a
given allocation period, the county or tribal agency must submit a corrective action plan to
the commissioner for approval. The plan must state the actions the agency will take to
correct its overspending for the two years following the period when the overspending
occurred. The commissioner shall recoup funds spent in excess of the allocation only in
cases when statewide spending exceeds the appropriation designated for the home and
community-based services waivers. Nothing in this subdivision shall be construed as
reducing the county or tribe's responsibility to offer and make available feasible home and
community-based options to eligible waiver recipients within the resources allocated to
it for that purpose.
new text end
Sec. 34.
Minnesota Statutes 2014, section 256B.49, is amended by adding a
subdivision to read:
new text begin Subd. 27. new text end
new text begin Use of waiver allocations. new text end
new text begin
(a) Effective until June 30, 2018, county
and tribal agencies are responsible for authorizing the annual allocation made by the
commissioner. In the event a county or tribal agency authorizes less than 97 percent of
the allocation, while maintaining a list of persons waiting for waiver services, the county
or tribal agency must submit a corrective action plan to the commissioner for approval.
The commissioner may determine a plan is unnecessary given the size of the allocation
and capacity for new enrollment. The plan must state the actions the agency will take
to assure reasonable and timely access to home and community-based waiver services
for persons waiting for services.
new text end
new text begin
(b) Effective July 1, 2018, county and tribal agencies are responsible for spending
the annual allocation made by the commissioner. In the event a county or tribal agency
spends less than 97 percent of the allocation, while maintaining a list of persons waiting
for waiver services, the county or tribal agency must submit a corrective action plan to the
commissioner for approval. The commissioner may determine a plan is unnecessary given
the size of the allocation and capacity for new enrollment. The plan must state the actions
the agency will take to assure reasonable and timely access to home and community-based
waiver services for persons waiting for services.
new text end
new text begin
(c) If a county or tribe does not submit a plan when required or implement the
changes required, the commissioner shall assure access to waiver services within the
county or tribe's available allocation, and take other actions needed to assure that all
waiver participants in that county or tribe are receiving appropriate waiver services
to meet their needs.
new text end
Sec. 35.
Minnesota Statutes 2014, section 256B.4913, subdivision 4a, is amended to
read:
Subd. 4a.
Rate stabilization adjustment.
(a) For purposes of this subdivision,
"implementation period" means the period beginning January 1, 2014, and ending on
the last day of the month in which the rate management system is populated with the
data necessary to calculate rates for substantially all individuals receiving home and
community-based waiver services under sections 256B.092 and 256B.49. "Banding
period" means the time period beginning on January 1, 2014, and ending upon the
expiration of the 12-month period defined in paragraph (c), clause (5).
(b) For purposes of this subdivision, the historical rate for all service recipients means
the individual reimbursement rate for a recipient in effect on December 1, 2013, except that:
(1) for a day service recipient who was not authorized to receive these waiver
services prior to January 1, 2014; added a new service or services on or after January 1,
2014; or changed providers on or after January 1, 2014, the historical rate must be the
authorized rate for the provider in the county of service, effective December 1, 2013; or
(2) for a unit-based service with programming or a unit-based service without
programming recipient who was not authorized to receive these waiver services prior to
January 1, 2014; added a new service or services on or after January 1, 2014; or changed
providers on or after January 1, 2014, the historical rate must be the weighted average
authorized rate for each provider number in the county of service, effective December 1,
2013; or
(3) for residential service recipients who change providers on or after January 1,
2014, the historical rate must be set by each lead agency within their county aggregate
budget using their respective methodology for residential services effective December 1,
2013, for determining the provider rate for a similarly situated recipient being served by
that provider.
(c) The commissioner shall adjust individual reimbursement rates determined under
this section so that the unit rate is no higher or lower than:
(1) 0.5 percent from the historical rate for the implementation period;
(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period
immediately following the time period of clause (1);
(3) deleted text begin 1.0deleted text end new text begin 0.5 new text end percent from the rate in effect in clause (2), for the 12-month period
immediately following the time period of clause (2);
(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period
immediately following the time period of clause (3); deleted text begin and
deleted text end
(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period
immediately following the time period of clause (4)new text begin ; and
new text end
new text begin (6) no adjustment to the rate in effect in clause (5) for the 12-month period
immediately following the time period of clause (5). During this banding rate period, the
commissioner shall not enforce any rate decrease or increase that would otherwise result
from the end of the banding period. The commissioner shall, upon enactment, seek federal
approval for the addition of this banding periodnew text end .
(d) The commissioner shall review all changes to rates that were in effect on
December 1, 2013, to verify that the rates in effect produce the equivalent level of spending
and service unit utilization on an annual basis as those in effect on October 31, 2013.
(e) By December 31, 2014, the commissioner shall complete the review in paragraph
(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
(f) During the banding period, the Medicaid Management Information System
(MMIS) service agreement rate must be adjusted to account for change in an individual's
need. The commissioner shall adjust the Medicaid Management Information System
(MMIS) service agreement rate by:
(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for
the individual with variables reflecting the level of service in effect on December 1, 2013;
(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or
9, for the individual with variables reflecting the updated level of service at the time
of application; and
(3) adding to or subtracting from the Medicaid Management Information System
(MMIS) service agreement rate, the difference between the values in clauses (1) and (2).
(g) This subdivision must not apply to rates for recipients served by providers new
to a given county after January 1, 2014. Providers of personal supports services who also
acted as fiscal support entities must be treated as new providers as of January 1, 2014.
Sec. 36.
Minnesota Statutes 2014, section 256B.4913, subdivision 5, is amended to read:
Subd. 5.
Stakeholder consultationnew text begin and county trainingnew text end .
new text begin (a) new text end The commissioner
shall continue consultation on regular intervals with the existing stakeholder group
established as part of the rate-setting methodology process and others, to gather input,
concerns, and data, to assist in the full implementation of the new rate payment system and
to make pertinent information available to the public through the department's Web site.
new text begin
(b) The commissioner shall offer training at least annually for county personnel
responsible for administering the rate-setting framework in a manner consistent with this
section and section 256B.4914.
new text end
new text begin
(c) The commissioner shall maintain an online instruction manual explaining the
rate-setting framework. The manual shall be consistent with this section and section
256B.4914, and shall be accessible to all stakeholders including recipients, representatives
of recipients, county or tribal agencies, and license holders.
new text end
new text begin
(d) The commissioner shall not defer to the county or tribal agency on matters of
technical application of the rate-setting framework, and a county or tribal agency shall not
set rates in a manner that conflicts with this section or section 256B.4914.
new text end
Sec. 37.
Minnesota Statutes 2014, section 256B.4914, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For purposes of this section, the following terms have the
meanings given them, unless the context clearly indicates otherwise.
(b) "Commissioner" means the commissioner of human services.
(c) "Component value" means underlying factors that are part of the cost of providing
services that are built into the waiver rates methodology to calculate service rates.
(d) "Customized living tool" means a methodology for setting service rates that
delineates and documents the amount of each component service included in a recipient's
customized living service plan.
(e) "Disability waiver rates system" means a statewide system that establishes rates
that are based on uniform processes and captures the individualized nature of waiver
services and recipient needs.
(f) "Individual staffing" means the time spent as a one-to-one interaction specific to
an individual recipient by staff deleted text begin brought in solelydeleted text end to provide direct support and assistance
with activities of daily living, instrumental activities of daily living, and training to
participants, and is based on the requirements in each individual's coordinated service and
support plan under section 245D.02, subdivision 4b; any coordinated service and support
plan addendum under section 245D.02, subdivision 4c; new text begin and new text end an assessment tooldeleted text begin ; anddeleted text end new text begin .
new text end Provider observation of an individual's needsnew text begin must also be considerednew text end .
(g) "Lead agency" means a county, partnership of counties, or tribal agency charged
with administering waivered services under sections 256B.092 and 256B.49.
(h) "Median" means the amount that divides distribution into two equal groups,
one-half above the median and one-half below the median.
(i) "Payment or rate" means reimbursement to an eligible provider for services
provided to a qualified individual based on an approved service authorization.
(j) "Rates management system" means a Web-based software application that uses
a framework and component values, as determined by the commissioner, to establish
service rates.
(k) "Recipient" means a person receiving home and community-based services
funded under any of the disability waivers.
(l) "Shared staffing" means time spent by employees, not defined under paragraph
(f), providing or available to provide more than one individual with direct support and
assistance with activities of daily living as defined under section 256B.0659, subdivision 1,
paragraph (b); instrumental activities of daily living as defined under section 256B.0659,
subdivision 1, paragraph (i); ancillary activities needed to support individual services; and
training to participants, and is based on the requirements in each individual's coordinated
service and support plan under section 245D.02, subdivision 4b; any coordinated service
and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and
provider observation of an individual's service need. Total shared staffing hours are divided
proportionally by the number of individuals who receive the shared service provisions.
(m) "Staffing ratio" means the number of recipients a service provider employee
supports during a unit of service based on a uniform assessment tool, provider observation,
case history, and the recipient's services of choice, and not based on the staffing ratios
under section 245D.31.
(n) "Unit of service" means the following:
(1) for residential support services under subdivision 6, a unit of service is a day.
Any portion of any calendar day, within allowable Medicaid rules, where an individual
spends time in a residential setting is billable as a day;
(2) for day services under subdivision 7:
(i) for day training and habilitation services, a unit of service is either:
(A) a day unit of service is defined as six or more hours of time spent providing
direct services and transportation; or
(B) a partial day unit of service is defined as fewer than six hours of time spent
providing direct services and transportation; and
(C) for new day service recipients after January 1, 2014, 15 minute units of
service must be used for fewer than six hours of time spent providing direct services
and transportation;
(ii) for adult day and structured day services, a unit of service is a day or 15 minutes.
A day unit of service is six or more hours of time spent providing direct services;
(iii) for prevocational services, a unit of service is a day or an hour. A day unit of
service is six or more hours of time spent providing direct service;
(3) for unit-based services with programming under subdivision 8:
(i) for supported living services, a unit of service is a day or 15 minutes. When a
day rate is authorized, any portion of a calendar day where an individual receives services
is billable as a day; and
(ii) for all other services, a unit of service is 15 minutes; and
(4) for unit-based services without programming under subdivision 9:
(i) for respite services, a unit of service is a day or 15 minutes. When a day rate is
authorized, any portion of a calendar day when an individual receives services is billable
as a day; and
(ii) for all other services, a unit of service is 15 minutes.
Sec. 38.
Minnesota Statutes 2014, section 256B.4914, subdivision 6, is amended to read:
Subd. 6.
Payments for residential support services.
(a) Payments for residential
support services, as defined in sections 256B.092, subdivision 11, and 256B.49,
subdivision 22, must be calculated as follows:
(1) determine the number of shared staffing and individual direct staff hours to meet
a recipient's needs provided on site or through monitoring technology;
(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
5. This is defined as the direct-care rate;
(3) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (2). This is defined as the customized direct-care rate;
(4) multiply the number of shared and individual direct staff hours provided on site
or through monitoring technology and nursing hours by the appropriate staff wages in
subdivision 5, paragraph (a), or the customized direct-care rate;
(5) multiply the number of shared and individual direct staff hours provided on site
or through monitoring technology and nursing hours by the product of the supervision
span of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate
supervision wage in subdivision 5, paragraph (a), clause (16);
(6) combine the results of clauses (4) and (5), excluding any shared and individual
direct staff hours provided through monitoring technology, and multiply the result by one
plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph
(b), clause (2). This is defined as the direct staffing cost;
(7) for employee-related expenses, multiply the direct staffing cost, excluding any
shared and individual direct staff hours provided through monitoring technology, by one
plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
(8) for client programming and supports, the commissioner shall add $2,179; and
(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
customized for adapted transport, based on the resident with the highest assessed need.
(b) The total rate must be calculated using the following steps:
(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any
shared and individual direct staff hours provided through monitoring technology that
was excluded in clause (7);
(2) sum the standard general and administrative rate, the program-related expense
ratio, and the absence and utilization ratio;
(3) divide the result of clause (1) by one minus the result of clause (2). This is
the total payment amount; and
(4) adjust the result of clause (3) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
(c) The payment methodology for customized living, 24-hour customized living, and
residential care services must be the customized living tool. Revisions to the customized
living tool must be made to reflect the services and activities unique to disability-related
recipient needs.
deleted text begin
(d) The commissioner shall establish a Monitoring Technology Review Panel to
annually review and approve the plans, safeguards, and rates that include residential
direct care provided remotely through monitoring technology. Lead agencies shall submit
individual service plans that include supervision using monitoring technology to the
Monitoring Technology Review Panel for approval. Individual service plans that include
supervision using monitoring technology as of December 31, 2013, shall be submitted to
the Monitoring Technology Review Panel, but the plans are not subject to approval.
deleted text end
deleted text begin (e)deleted text end new text begin (d)new text end For individuals enrolled prior to January 1, 2014, the days of service
authorized must meet or exceed the days of service used to convert service agreements
in effect on December 1, 2013, and must not result in a reduction in spending or service
utilization due to conversion during the implementation period under section 256B.4913,
subdivision 4a. If during the implementation period, an individual's historical rate,
including adjustments required under section 256B.4913, subdivision 4a, paragraph (c),
is equal to or greater than the rate determined in this subdivision, the number of days
authorized for the individual is 365.
deleted text begin (f)deleted text end new text begin (e)new text end The number of days authorized for all individuals enrolling after January 1,
2014, in residential services must include every day that services start and end.
Sec. 39.
Minnesota Statutes 2014, section 256B.4914, subdivision 8, is amended to read:
Subd. 8.
Payments for unit-based services with programming.
Payments for
unit-based deleted text begin with programdeleted text end servicesnew text begin with programmingnew text end , including behavior programming,
housing access coordination, in-home family support, independent living skills training,
hourly supported living services, and supported employment provided to an individual
outside of any day or residential service plan must be calculated as follows, unless the
services are authorized separately under subdivision 6 or 7:
(1) determine the number of units of service to meet a recipient's needs;
(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
(3) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (2). This is defined as the customized direct-care rate;
(4) multiply the number of direct staff hours by the appropriate staff wage in
subdivision 5, paragraph (a), or the customized direct-care rate;
(5) multiply the number of direct staff hours by the product of the supervision span
of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (16);
(6) combine the results of clauses (4) and (5), and multiply the result by one plus
the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e),
clause (2). This is defined as the direct staffing rate;
(7) for program plan support, multiply the result of clause (6) by one plus the
program plan supports ratio in subdivision 5, paragraph (e), clause (4);
(8) for employee-related expenses, multiply the result of clause (7) by one plus the
employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
(9) for client programming and supports, multiply the result of clause (8) by one plus
the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
(10) this is the subtotal rate;
(11) sum the standard general and administrative rate, the program-related expense
ratio, and the absence and utilization factor ratio;
(12) divide the result of clause (10) by one minus the result of clause (11). This is
the total payment amount;
(13) for supported employment provided in a shared manner, divide the total
payment amount in clause (12) by the number of service recipients, not to exceed three.
For independent living skills training provided in a shared manner, divide the total
payment amount in clause (12) by the number of service recipients, not to exceed two; and
(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
Sec. 40.
Minnesota Statutes 2014, section 256B.4914, subdivision 10, is amended to
read:
Subd. 10.
Updating payment values and additional information.
(a) From
January 1, 2014, through December 31, 2017, the commissioner shall develop and
implement uniform procedures to refine terms and adjust values used to calculate payment
rates in this section.
(b) No later than July 1, 2014, the commissioner shall, within available resources,
begin to conduct research and gather data and information from existing state systems or
other outside sources on the following items:
(1) differences in the underlying cost to provide services and care across the state; and
(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides,
and units of transportation for all day services, which must be collected from providers
using the rate management worksheet and entered into the rates management system; and
(3) the distinct underlying costs for services provided by a license holder new text begin under
sections 245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services
provided by a license holder new text end certified under section 245D.33.
(c) Using a statistically valid set of rates management system data, the commissioner,
in consultation with stakeholders, shall analyze for each service the average difference
in the rate on December 31, 2013, and the framework rate at the individual, provider,
lead agency, and state levels. The commissioner shall issue semiannual reports to the
stakeholders on the difference in rates by service and by county during the banding period
under section 256B.4913, subdivision 4a. The commissioner shall issue the first report
by October 1, 2014.
(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders,
shall begin the review and evaluation of the following values already in subdivisions 6 to
9, or issues that impact all services, including, but not limited to:
(1) values for transportation rates for day services;
(2) values for transportation rates in residential services;
(3) values for services where monitoring technology replaces staff time;
(4) values for indirect services;
(5) values for nursing;
(6) component values for independent living skills;
(7) component values for family foster care that reflect licensing requirements;
(8) adjustments to other components to replace the budget neutrality factor;
(9) remote monitoring technology for nonresidential services;
(10) values for basic and intensive services in residential services;
(11) values for the facility use rate in day servicesnew text begin , and the weightings used in the
day service ratios and adjustments to those weightingsnew text end ;
(12) values for workers' compensation as part of employee-related expenses;
(13) values for unemployment insurance as part of employee-related expenses;
(14) a component value to reflect costs for individuals with rates previously adjusted
for the inclusion of group residential housing rate 3 costs, only for any individual enrolled
as of December 31, 2013; and
(15) any changes in state or federal law with an impact on the underlying cost of
providing home and community-based services.
(e) The commissioner shall report to the chairs and the ranking minority members of
the legislative committees and divisions with jurisdiction over health and human services
policy and finance with the information and data gathered under paragraphs (b) to (d)
on the following dates:
(1) January 15, 2015, with preliminary results and data;
(2) January 15, 2016, with a status implementation update, and additional data
and summary information;
(3) January 15, 2017, with the full report; and
(4) January 15, 2019, with another full report, and a full report once every four
years thereafter.
(f) Based on the commissioner's evaluation of the information and data collected in
paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by
January 15, 2015, to address any issues identified during the first year of implementation.
After January 15, 2015, the commissioner may make recommendations to the legislature
to address potential issues.
(g) The commissioner shall implement a regional adjustment factor to all rate
calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Prior to
implementation, the commissioner shall consult with stakeholders on the methodology to
calculate the adjustment.
(h) The commissioner shall provide a public notice via LISTSERV in October of
each year beginning October 1, 2014, containing information detailing legislatively
approved changes in:
(1) calculation values including derived wage rates and related employee and
administrative factors;
(2) service utilization;
(3) county and tribal allocation changes; and
(4) information on adjustments made to calculation values and the timing of those
adjustments.
The information in this notice must be effective January 1 of the following year.
new text begin
(i) No later than July 1, 2016, the commissioner shall develop and implement, in
consultation with stakeholders, a methodology sufficient to determine the shared staffing
levels necessary to meet, at a minimum, health and welfare needs of individuals who
will be living together in shared residential settings, and the required shared staffing
activities described in subdivision 2, paragraph (l). This determination methodology must
ensure staffing levels are adaptable to meet the needs and desired outcomes for current and
prospective residents in shared residential settings.
new text end
new text begin
(j) When the available shared staffing hours in a residential setting are insufficient to
meet the needs of an individual who enrolled in residential services after January 1, 2014,
or insufficient to meet the needs of an individual with a service agreement adjustment
described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing
hours shall be used.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 41.
Minnesota Statutes 2014, section 256B.4914, subdivision 14, is amended to
read:
Subd. 14.
Exceptions.
(a) In a format prescribed by the commissioner, lead
agencies must identify individuals with exceptional needs that cannot be met under the
disability waiver rate system. The commissioner shall use that information to evaluate
and, if necessary, approve an alternative payment rate for those individuals.new text begin Whether
granted, denied, or modified, the commissioner shall respond to all exception requests in
writing. The commissioner shall include in the written response the basis for the action
and provide notification of the right to appeal under paragraph (h).
new text end
(b) Lead agencies must new text begin act on an exception request within 30 days and notify the
initiator of the request of their recommendation in writing. A lead agency shall new text end submit new text begin all
new text end exception requests new text begin along with its recommendation new text end to the deleted text begin statedeleted text end new text begin commissionernew text end .
(c) An application for a rate exception may be submitted for the following criteria:
(1) an individual has service needs that cannot be met through additional units
of service; deleted text begin or
deleted text end
(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 deleted text begin resultsdeleted text end new text begin is so
insufficient that it has resulted new text end in an individual deleted text begin being dischargeddeleted text end new text begin receiving a notice of
discharge from the individual's provider; or
new text end
new text begin (3) an individual's service needs, including behavioral changes, require a level of
service which necessitates a change in provider or which requires the current provider to
propose service changes beyond those currently authorizednew text end .
(d) Exception requests must include the following information:
(1) the service needs required by each individual that are not accounted for in
subdivisions 6, 7, 8, and 9;
(2) the service rate requested and the difference from the rate determined in
subdivisions 6, 7, 8, and 9;
(3) a basis for the underlying costs used for the rate exception and any accompanying
documentation;new text begin and
new text end
(4) deleted text begin the duration of the rate exception; and
deleted text end
deleted text begin (5)deleted text end any contingencies for approval.
(e) Approved rate exceptions shall be managed within lead agency allocations under
sections 256B.092 and 256B.49.
(f) Individual disability waiver recipientsnew text begin , an interested party, or the license holder
that would receive the rate exception increasenew text end may request that a lead agency submit an
exception request. A lead agency that denies such a request shall notify the individual
waiver recipientnew text begin , interested party, or license holder new text end of its decision and the reasons for
denying the request in writing no later than 30 days after the deleted text begin individual'sdeleted text end request has been
madenew text begin and shall submit its denial to the commissioner in accordance with paragraph (b).
The reasons for the denial must be based on the failure to meet the criteria in paragraph (c)new text end .
(g) The commissioner shall determine whether to approve or deny an exception
request no more than 30 days after receiving the request. If the commissioner denies the
request, the commissioner shall notify the lead agency and the individual disability waiver
recipientnew text begin , the interested party, and the license holdernew text end in writing of the reasons for the denial.
(h) The individual disability waiver recipient may appeal any denial of an exception
request by either the lead agency or the commissioner, pursuant to sections 256.045 and
256.0451. When the denial of an exception request results in the proposed demission of a
waiver recipient from a residential or day habilitation program, the commissioner shall
issue a temporary stay of demission, when requested by the disability waiver recipient,
consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c).
The temporary stay shall remain in effect until the lead agency can provide an informed
choice of appropriate, alternative services to the disability waiver.
(i) Providers may petition lead agencies to update values that were entered
incorrectly or erroneously into the rate management system, based on past service level
discussions and determination in subdivision 4, without applying for a rate exception.
new text begin
(j) The starting date for the rate exception will be the later of the date of the
recipient's change in support or the date of the request to the lead agency for an exception.
new text end
new text begin
(k) The commissioner shall track all exception requests received and their
dispositions. The commissioner shall issue quarterly public exceptions statistical reports,
including the number of exception requests received and the numbers granted, denied,
withdrawn, and pending. The report shall include the average amount of time required to
process exceptions.
new text end
new text begin
(l) No later than January 15, 2016, the commissioner shall provide research
findings on the estimated fiscal impact, the primary cost drivers, and common population
characteristics of recipients with needs that cannot be met by the framework rates.
new text end
new text begin
(m) No later than July 1, 2016, the commissioner shall develop and implement,
in consultation with stakeholders, a process to determine eligibility for rate exceptions
for individuals with rates determined under the methodology in section 256B.4913,
subdivision 4a. Determination of eligibility for an exception will occur as annual service
renewals are completed.
new text end
new text begin
(n) Approved rate exceptions will be implemented at such time that the individual's
rate is no longer banded and remain in effect in all cases until an individual's needs change
as defined in paragraph (c).
new text end
Sec. 42.
Minnesota Statutes 2014, section 256B.4914, subdivision 15, is amended to
read:
Subd. 15.
County or tribal allocations.
(a) Upon implementation of the disability
waiver rates management system on January 1, 2014, the commissioner shall establish
a method of tracking and reporting the fiscal impact of the disability waiver rates
management system on individual lead agencies.
(b) Beginning January 1, 2014, the commissioner shall make annual adjustments to
lead agencies' home and community-based waivered service budget allocations to adjust
for rate differences and the resulting impact on county allocations upon implementation of
the disability waiver rates system.
(c) deleted text begin During the first two years of implementation under section 256B.4913, deleted text end Lead
agencies exceeding their allocations new text begin shall be subject to the provisions new text end under sections
deleted text begin 256B.092deleted text end new text begin 256B.0916, subdivision 11,new text end and deleted text begin shall only be held liable for spending
in excess of their allocations after a reallocation of resources by the commissioner under
paragraph (b). The commissioner shall reallocate resources under sections 256B.092,
subdivision 12, and 256B.49, subdivision 11a. The commissioner shall notify lead
agencies of this process by July 1, 2014deleted text end new text begin 256B.49, subdivision 26new text end .
Sec. 43.
Minnesota Statutes 2014, section 256B.492, is amended to read:
256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
WITH DISABILITIES.
(a) Individuals receiving services under a home and community-based waiver under
section 256B.092 or 256B.49 may receive services in the following settings:
(1) deleted text begin an individual's own home or familydeleted text end homenew text begin and community-based settings that
comply with all requirements identified by the federal Centers for Medicare and Medicaid
Services in the Code of Federal Regulations, title 42, section 441.301(c), and with the
requirements of the federally approved transition plan and waiver plans for each home
and community-based services waivernew text end ;new text begin and
new text end
(2) deleted text begin a licensed adult foster care or child foster care setting of up to five people or
community residential setting of up to five people; anddeleted text end new text begin settings required by the Housing
Opportunities for Persons with AIDS Program.
new text end
deleted text begin
(3) community living settings as defined in section 256B.49, subdivision 23, where
individuals with disabilities may reside in all of the units in a building of four or fewer units,
and who receive services under a home and community-based waiver occupy no more
than the greater of four or 25 percent of the units in a multifamily building of more than
four units, unless required by the Housing Opportunities for Persons with AIDS Program.
deleted text end
(b) The settings in paragraph (a) must notdeleted text begin :
deleted text end
deleted text begin
(1) be located in a building that is a publicly or privately operated facility that
provides institutional treatment or custodial care;
deleted text end
deleted text begin
(2) be located in a building on the grounds of or adjacent to a public or private
institution;
deleted text end
deleted text begin
(3) be a housing complex designed expressly around an individual's diagnosis or
disability, unless required by the Housing Opportunities for Persons with AIDS Program;
deleted text end
deleted text begin
(4) be segregated based on a disability, either physically or because of setting
characteristics, from the larger community; and
deleted text end
deleted text begin (5)deleted text end have the qualities of an institution which include, but are not limited to:
regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
agreed to and documented in the person's individual service plan shall not result in a
residence having the qualities of an institution as long as the restrictions for the person are
not imposed upon others in the same residence and are the least restrictive alternative,
imposed for the shortest possible time to meet the person's needs.
deleted text begin
(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
individuals receive services under a home and community-based waiver as of July 1,
2012, and the setting does not meet the criteria of this section.
deleted text end
deleted text begin
(d) Notwithstanding paragraph (c), a program in Hennepin County established as
part of a Hennepin County demonstration project is qualified for the exception allowed
under paragraph (c).
deleted text end
deleted text begin
(e) Notwithstanding paragraphs (a) and (b), a program in Hennepin County, located
in the city of Golden Valley, within the city of Golden Valley's Highway 55 West
redevelopment area, that is not a provider-owned or controlled home and community-based
setting, and is scheduled to open by July 1, 2016, is exempt from the restrictions in
paragraphs (a) and (b). If the program fails to comply with the Centers for Medicare and
Medicaid Services rules for home and community-based settings, the exemption is void.
deleted text end
deleted text begin
(f) The commissioner shall submit an amendment to the waiver plan no later than
December 31, 2012.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 44.
new text begin
[256Q.01] PLAN ESTABLISHED.
new text end
new text begin
A savings plan known as the Minnesota ABLE plan is established. In establishing
this plan, the legislature seeks to encourage and assist individuals and families in saving
private funds for the purpose of supporting individuals with disabilities to maintain health,
independence, and quality of life, and to provide secure funding for disability-related
expenses on behalf of designated beneficiaries with disabilities that will supplement, but
not supplant, benefits provided through private insurance, the Medicaid program under
title XIX of the Social Security Act, the Supplemental Security Income program under
title XVI of the Social Security Act, the beneficiary's employment, and other sources.
new text end
Sec. 45.
new text begin
[256Q.02] CITATION.
new text end
new text begin
This chapter may be cited as the "Minnesota Achieving a Better Life Experience
Act" or "Minnesota ABLE Act."
new text end
Sec. 46.
new text begin
[256Q.03] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
For the purposes of this chapter, the terms defined in this
section have the meanings given them.
new text end
new text begin Subd. 2. new text end
new text begin ABLE account. new text end
new text begin
"ABLE account" has the meaning given in section
529A(e)(6) of the Internal Revenue Code.
new text end
new text begin Subd. 3. new text end
new text begin ABLE plan or plan. new text end
new text begin
"ABLE plan" or "plan" means the qualified ABLE
program, as defined in section 529A(b) of the Internal Revenue Code, provided for
in this chapter.
new text end
new text begin Subd. 4. new text end
new text begin Account. new text end
new text begin
"Account" means the formal record of transactions relating to an
ABLE plan beneficiary.
new text end
new text begin Subd. 5. new text end
new text begin Account owner. new text end
new text begin
"Account owner" means the designated beneficiary
of the account.
new text end
new text begin Subd. 6. new text end
new text begin Annual contribution limit. new text end
new text begin
"Annual contribution limit" has the meaning
given in section 529A(b)(2) of the Internal Revenue Code.
new text end
new text begin Subd. 7. new text end
new text begin Application. new text end
new text begin
"Application" means the form executed by a prospective
account owner to enter into a participation agreement and open an account in the plan.
The application incorporates by reference the participation agreement.
new text end
new text begin Subd. 8. new text end
new text begin Board. new text end
new text begin
"Board" means the State Board of Investment.
new text end
new text begin Subd. 9. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of human
services.
new text end
new text begin Subd. 10. new text end
new text begin Contribution. new text end
new text begin
"Contribution" means a payment directly allocated to
an account for the benefit of a beneficiary.
new text end
new text begin Subd. 11. new text end
new text begin Department. new text end
new text begin
"Department" means the Department of Human Services.
new text end
new text begin Subd. 12. new text end
new text begin Designated beneficiary or beneficiary. new text end
new text begin
"Designated beneficiary" or
"beneficiary" has the meaning given in section 529A(e)(3) of the Internal Revenue Code
and further defined through regulations issued under that section.
new text end
new text begin Subd. 13. new text end
new text begin Earnings. new text end
new text begin
"Earnings" means the total account balance minus the
investment in the account.
new text end
new text begin Subd. 14. new text end
new text begin Eligible individual. new text end
new text begin
"Eligible individual" has the meaning given in
section 529A(e)(1) of the Internal Revenue Code and further defined through regulations
issued under that section.
new text end
new text begin Subd. 15. new text end
new text begin Executive director. new text end
new text begin
"Executive director" means the executive director of
the State Board of Investment.
new text end
new text begin Subd. 16. new text end
new text begin Internal Revenue Code. new text end
new text begin
"Internal Revenue Code" means the Internal
Revenue Code of 1986, as amended.
new text end
new text begin Subd. 17. new text end
new text begin Investment in the account. new text end
new text begin
"Investment in the account" means the sum
of all contributions made to an account by a particular date minus the aggregate amount
of contributions included in distributions or rollover distributions, if any, made from the
account as of that date.
new text end
new text begin Subd. 18. new text end
new text begin Member of the family. new text end
new text begin
"Member of the family" has the meaning given in
section 529A(e)(4) of the Internal Revenue Code.
new text end
new text begin Subd. 19. new text end
new text begin Participation agreement. new text end
new text begin
"Participation agreement" means an agreement
to participate in the Minnesota ABLE plan between an account owner and the state
through its agencies, the commissioner, and the board.
new text end
new text begin Subd. 20. new text end
new text begin Person. new text end
new text begin
"Person" means an individual, trust, estate, partnership,
association, company, corporation, or the state.
new text end
new text begin Subd. 21. new text end
new text begin Plan administrator. new text end
new text begin
"Plan administrator" means the person selected by
the commissioner and the board to administer the daily operations of the ABLE plan and
provide record keeping, investment management, and other services for the plan.
new text end
new text begin Subd. 22. new text end
new text begin Qualified disability expense. new text end
new text begin
"Qualified disability expense" has the
meaning given in section 529A(e)(5) of the Internal Revenue Code and further defined
through regulations issued under that section.
new text end
new text begin Subd. 23. new text end
new text begin Qualified distribution. new text end
new text begin
"Qualified distribution" means a withdrawal from
an ABLE account to pay the qualified disability expenses of the beneficiary of the account.
A qualified withdrawal may be made by the beneficiary, by an agent of the beneficiary
who has the power of attorney, or by the beneficiary's legal guardian.
new text end
new text begin Subd. 24. new text end
new text begin Rollover distribution. new text end
new text begin
"Rollover distribution" means a transfer of funds
made:
new text end
new text begin
(1) from one account in another state's qualified ABLE program to an account for
the benefit of the same designated beneficiary or an eligible individual who is a family
member of the former designated beneficiary; or
new text end
new text begin
(2) from one account to another account for the benefit of an eligible individual who
is a family member of the former designated beneficiary.
new text end
new text begin Subd. 25. new text end
new text begin Total account balance. new text end
new text begin
"Total account balance" means the amount in an
account on a particular date or the fair market value of an account on a particular date.
new text end
Sec. 47.
new text begin
[256Q.04] ABLE PLAN REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin State residency requirement. new text end
new text begin
The designated beneficiary of an
ABLE account must be a resident of Minnesota, or the resident of a state that has entered
into a contract with Minnesota to provide its residents access to the Minnesota ABLE plan.
new text end
new text begin Subd. 2. new text end
new text begin Single account requirement. new text end
new text begin
No more than one ABLE account shall be
established per beneficiary, except as permitted under section 529A(c)(4) of the Internal
Revenue Code.
new text end
new text begin Subd. 3. new text end
new text begin Accounts-type plan. new text end
new text begin
The plan must be operated as an accounts-type
plan. A separate account must be maintained for each designated beneficiary for whom
contributions are made.
new text end
new text begin Subd. 4. new text end
new text begin Contribution and account requirements. new text end
new text begin
Contributions to an ABLE
account are subject to the requirements of section 529A(b)(2) of the Internal Revenue
Code prohibiting noncash contributions and contributions in excess of the annual
contribution limit. The total account balance may not exceed the maximum account
balance limit imposed under section 136G.09, subdivision 8.
new text end
new text begin Subd. 5. new text end
new text begin Limited investment direction. new text end
new text begin
Designated beneficiaries may not direct
the investment of assets in their accounts more than twice in any calendar year.
new text end
new text begin Subd. 6. new text end
new text begin Security for loans. new text end
new text begin
An interest in an account must not be used as security
for a loan.
new text end
Sec. 48.
new text begin
[256Q.05] ABLE PLAN ADMINISTRATION.
new text end
new text begin Subdivision 1. new text end
new text begin Plan to comply with federal law. new text end
new text begin
The commissioner shall ensure
that the plan meets the requirements for an ABLE account under section 529A of the
Internal Revenue Code, including any regulations released after the effective date of this
section. The commissioner may request a private letter ruling or rulings from the Internal
Revenue Service or Secretary of Health and Human Services and must take any necessary
steps to ensure that the plan qualifies under relevant provisions of federal law.
new text end
new text begin Subd. 2. new text end
new text begin Plan rules and procedures. new text end
new text begin
(a) The commissioner shall establish the
rules, terms, and conditions for the plan, subject to the requirements of this chapter and
section 529A of the Internal Revenue Code.
new text end
new text begin
(b) The commissioner shall prescribe the application forms, procedures, and other
requirements that apply to the plan.
new text end
new text begin Subd. 3. new text end
new text begin Consultation with other state agencies; annual fee. new text end
new text begin
In designing and
establishing the plan's requirements and in negotiating or entering into contracts with third
parties under subdivision 4, the commissioner shall consult with the executive director of
the board and the commissioner of the Office of Higher Education. The commissioner and
the executive director shall establish an annual fee, equal to a percentage of the average
daily net assets of the plan, to be imposed on account owners to recover the costs of
administration, record keeping, and investment management as provided in subdivision 5.
new text end
new text begin Subd. 4. new text end
new text begin Administration. new text end
new text begin
The commissioner shall administer the plan, including
accepting and processing applications, verifying state residency, verifying eligibility,
maintaining account records, making payments, and undertaking any other necessary
tasks to administer the plan. Notwithstanding other requirements of this chapter, the
commissioner shall adopt rules for purposes of implementing and administering the plan.
The commissioner may contract with one or more third parties to carry out some or all of
these administrative duties, including providing incentives. The commissioner and the
board may jointly contract with third-party providers, if the commissioner and board
determine that it is desirable to contract with the same entity or entities for administration
and investment management.
new text end
new text begin Subd. 5. new text end
new text begin Authority to impose fees. new text end
new text begin
The commissioner, or the commissioner's
designee, may impose annual fees, as provided in subdivision 3, on account owners to
recover the costs of administration. The commissioner must keep the fees as low as
possible, consistent with efficient administration, so that the returns on savings invested in
the plan are as high as possible.
new text end
new text begin Subd. 6. new text end
new text begin Federally mandated reporting. new text end
new text begin
(a) As required under section 529A(d) of
the Internal Revenue Code, the commissioner or the commissioner's designee shall submit
a notice to the Secretary of the Treasury upon the establishment of each ABLE account.
The notice must contain the name and state of residence of the designated beneficiary and
other information as the secretary may require.
new text end
new text begin
(b) As required under section 529A(d) of the Internal Revenue Code, the
commissioner or the commissioner's designee shall submit electronically on a monthly
basis to the Commissioner of Social Security, in a manner specified by the Commissioner
of Social Security, statements on relevant distributions and account balances from all
ABLE accounts.
new text end
new text begin Subd. 7. new text end
new text begin Data. new text end
new text begin
(a) Data on ABLE accounts and designated beneficiaries of ABLE
accounts are private data on individuals or nonpublic data as defined in section 13.02.
new text end
new text begin
(b) The commissioner may share or disseminate data classified as private or
nonpublic in this subdivision as follows:
new text end
new text begin
(1) with other state or federal agencies, only to the extent necessary to verify
identity of, determine the eligibility of, or process applications for an eligible individual
participating in the Minnesota ABLE plan; and
new text end
new text begin
(2) with a nongovernmental person, only to the extent necessary to carry out the
functions of the Minnesota ABLE plan, provided the commissioner has entered into
a data-sharing agreement with the person, as provided in section 13.05, subdivision 6,
prior to sharing data under this clause or a contract with that person that complies with
section 13.05, subdivision 11, as applicable.
new text end
Sec. 49.
new text begin
[256Q.06] PLAN ACCOUNTS.
new text end
new text begin Subdivision 1. new text end
new text begin Contributions to an account. new text end
new text begin
Any person may make contributions
to an ABLE account on behalf of a designated beneficiary. Contributions to an account
made by persons other than the account owner become the property of the account owner.
A person does not acquire an interest in an ABLE account by making contributions to
an account. Contributions to an account must be made in cash, by check, or by other
commercially acceptable means, as permitted by the Internal Revenue Service and
approved by the plan administrator in cooperation with the commissioner and the board.
new text end
new text begin Subd. 2. new text end
new text begin Contribution and account limitations. new text end
new text begin
Contributions to an ABLE
account are subject to the requirements of section 529A(b) of the Internal Revenue Code.
The total account balance of an ABLE account may not exceed the maximum account
balance limit imposed under section 136G.09, subdivision 8. The plan administrator must
reject any portion of a contribution to an account that exceeds the annual contribution limit
or that would cause the total account balance to exceed the maximum account balance
limit imposed under section 136G.09, subdivision 8.
new text end
new text begin Subd. 3. new text end
new text begin Authority of account owner. new text end
new text begin
An account owner is the only person
entitled to:
new text end
new text begin
(1) request distributions;
new text end
new text begin
(2) request rollover distributions; or
new text end
new text begin
(3) change the beneficiary of an ABLE account to a member of the family of the
current beneficiary, but only if the beneficiary to whom the ABLE account is transferred
is an eligible individual.
new text end
new text begin Subd. 4. new text end
new text begin Effect of plan changes on participation agreement. new text end
new text begin
Amendments to
this chapter automatically amend the participation agreement. Any amendments to the
operating procedures and policies of the plan automatically amend the participation
agreement after adoption by the commissioner or the board.
new text end
new text begin Subd. 5. new text end
new text begin Special account to hold plan assets in trust. new text end
new text begin
All assets of the plan,
including contributions to accounts, are held in trust for the exclusive benefit of account
owners. Assets must be held in a separate account in the state treasury to be known as
the Minnesota ABLE plan account or in accounts with the third-party provider selected
pursuant to section 256Q.05, subdivision 4. Plan assets are not subject to claims by creditors
of the state, are not part of the general fund, and are not subject to appropriation by the
state. Payments from the Minnesota ABLE plan account shall be made under this chapter.
new text end
Sec. 50.
new text begin
[256Q.07] INVESTMENT OF ABLE ACCOUNTS.
new text end
new text begin Subdivision 1. new text end
new text begin State Board of Investment to invest. new text end
new text begin
The State Board of Investment
shall invest the money deposited in accounts in the plan.
new text end
new text begin Subd. 2. new text end
new text begin Permitted investments. new text end
new text begin
The board may invest the accounts in any
permitted investment under section 11A.24, except that the accounts may be invested
without limit in investment options from open-ended investment companies registered
under the federal Investment Company Act of 1940, United States Code, title 15, sections
80a-1 to 80a-64.
new text end
new text begin Subd. 3. new text end
new text begin Contracting authority. new text end
new text begin
The board may contract with one or more third
parties for investment management, record keeping, or other services in connection with
investing the accounts. The board and commissioner may jointly contract with third-party
providers, if the commissioner and board determine that it is desirable to contract with the
same entity or entities for administration and investment management.
new text end
Sec. 51.
new text begin
[256Q.08] ACCOUNT DISTRIBUTIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Qualified distribution methods. new text end
new text begin
(a) Qualified distributions may
be made:
new text end
new text begin
(1) directly to participating providers of goods and services that are qualified
disability expenses, if purchased for a beneficiary;
new text end
new text begin
(2) in the form of a check payable to both the beneficiary and provider of goods or
services that are qualified disability expenses; or
new text end
new text begin
(3) directly to the beneficiary, if the beneficiary has already paid qualified disability
expenses.
new text end
new text begin
(b) Qualified distributions must be withdrawn proportionally from contributions and
earnings in an account owner's account on the date of distribution as provided in section
529A of the Internal Revenue Code.
new text end
new text begin Subd. 2. new text end
new text begin Distributions upon death of a beneficiary. new text end
new text begin
Upon the death of a
beneficiary, the amount remaining in the beneficiary's account must be distributed pursuant
to section 529A(f) of the Internal Revenue Code.
new text end
new text begin Subd. 3. new text end
new text begin Nonqualified distribution. new text end
new text begin
An account owner may request a nonqualified
distribution from an account at any time. Nonqualified distributions are based on the total
account balances in an account owner's account and must be withdrawn proportionally
from contributions and earnings as provided in section 529A of the Internal Revenue
Code. The earnings portion of a nonqualified distribution is subject to a federal additional
tax pursuant to section 529A of the Internal Revenue Code. For purposes of this
subdivision, "earnings portion" means the ratio of the earnings in the account to the total
account balance, immediately prior to the distribution, multiplied by the distribution.
new text end
Sec. 52. new text begin INDIVIDUAL PROVIDERS OF DIRECT SUPPORT SERVICES.
new text end
new text begin
The labor agreement between the state of Minnesota and the Service Employees
International Union Healthcare Minnesota, submitted to the Legislative Coordinating
Commission on March 2, 2015, is ratified.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2015.
new text end
Sec. 53. new text begin RATE INCREASE FOR DIRECT SUPPORT SERVICES PROVIDERS
WORKFORCE NEGOTIATIONS.
new text end
new text begin
(a) If the labor agreement between the state of Minnesota and the Service Employees
International Union Healthcare Minnesota under Minnesota Statutes, section 179A.54, is
approved pursuant to Minnesota Statutes, sections 3.855 and 179A.22, the commissioner
of human services shall increase reimbursement rates, individual budgets, grants, or
allocations by 1.53 percent for services provided on or after July 1, 2015, and by an
additional 0.2 percent for services provided on or after July 1, 2016, to implement the
minimum hourly wage and paid time off provisions of that agreement.
new text end
new text begin
(b) The rate changes described in this section apply to direct support services
provided through a covered program, as defined in Minnesota Statutes, section 256B.0711,
subdivision 1.
new text end
Sec. 54. new text begin CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
METHODOLOGY EXCEPTION.
new text end
new text begin
(a) No later than September 30, 2015, if necessary, the commissioner of human
services shall submit an amendment to the Centers for Medicare and Medicaid Services
for the home and community-based services waivers authorized under Minnesota Statutes,
sections 256B.092 and 256B.49, to establish an exception to the consumer-directed
community supports budget methodology to provide up to 20 percent more funds for:
new text end
new text begin
(1) consumer-directed community supports participants who have graduated
from high school and have a coordinated service and support plan which identifies the
need for more services under consumer-directed community supports, either prior to
graduation or in order to increase the amount of time a person works or to improve their
employment opportunities, than the amount they are eligible to receive under the current
consumer-directed community supports budget methodology; and
new text end
new text begin
(2) home and community-based waiver participants who are currently using licensed
services for employment supports or services during the day which cost more annually
than the person would spend under a consumer-directed community supports plan for
individualized employment supports or services during the day.
new text end
new text begin
(b) The exception under paragraph (a) is limited to those persons who can
demonstrate either that they will have to leave consumer-directed community supports and
use other waiver services because their need for day or employment supports cannot be
met within the consumer-directed community supports budget limits or they will move
to consumer-directed community supports and their services will cost less than services
currently being used.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
The exception under this section is effective October 1, 2015,
or upon federal approval, whichever is later. The commissioner of human services shall
notify the revisor of statutes when this occurs.
new text end
Sec. 55. new text begin HOME AND COMMUNITY-BASED SERVICES INCENTIVE POOL.
new text end
new text begin
The commissioner of human services shall develop an initiative to provide
incentives for innovation in achieving integrated competitive employment, living in
the most integrated setting, and other outcomes determined by the commissioner. The
commissioner shall seek requests for proposals and shall contract with one or more entities
to provide incentive payments for meeting identified outcomes. The initial requests for
proposals must be issued by October 1, 2016.
new text end
Sec. 56. new text begin DIRECTION TO COMMISSIONER; REPORTS REQUIRED.
new text end
new text begin
The commissioner of human services shall develop and submit reports to the chairs
and ranking minority members of the house of representatives and senate committees and
divisions with jurisdiction over health and human services policy and finance on the
implementation of Minnesota Statutes, sections 256B.0916, subdivisions 2, 11, and 12,
and 256B.49, subdivisions 26 and 27. The commissioner shall submit two reports, one by
February 15, 2018, and the second by February 15, 2019.
new text end
Sec. 57. new text begin INSTRUCTIONS TO THE COMMISSIONER.
new text end
new text begin
The commissioner shall determine the number of individuals who were determined
to be ineligible to receive community first services and supports because they did not
require constant supervision and cuing in order to accomplish activities of daily living.
The commissioner shall issue a report with these findings to the chairs and ranking
minority members of the house and senate committees with jurisdiction over human
services programs.
new text end
Sec. 58. new text begin REPEALER.
new text end
new text begin
Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter
312, article 27, section 72,
new text end
new text begin
is repealed upon the effective date of section 54.
new text end
ARTICLE 8
HEALTH DEPARTMENT AND PUBLIC HEALTH
Section 1.
Minnesota Statutes 2014, section 16A.724, subdivision 2, is amended to read:
Subd. 2.
Transfers.
(a) Notwithstanding section 295.581, to the extent available
resources in the health care access fund exceed expenditures in that fund, effective for
the biennium beginning July 1, 2007, the commissioner of management and budget shall
transfer the excess funds from the health care access fund to the general fund on June 30
of each year, provided that the amount transferred in any fiscal biennium shall not exceed
$96,000,000. The purpose of this transfer is to meet the rate increase required under Laws
2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and,
if necessary, the commissioner shall reduce these transfers from the health care access
fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
transfer sufficient funds from the general fund to the health care access fund to meet
annual MinnesotaCare expenditures.
deleted text begin
(c) Notwithstanding section 295.581, to the extent available resources in the health
care access fund exceed expenditures in that fund after the transfer required in paragraph
(a), effective for the biennium beginning July 1, 2013, the commissioner of management
and budget shall transfer $1,000,000 each fiscal year from the health access fund to
the medical education and research costs fund established under section 62J.692, for
distribution under section 62J.692, subdivision 4, paragraph (c).
deleted text end
Sec. 2.
Minnesota Statutes 2014, section 62J.498, is amended to read:
62J.498 HEALTH INFORMATION EXCHANGE.
Subdivision 1.
Definitions.
The following definitions apply to sections 62J.498 to
62J.4982:
new text begin
(a) "Clinical data repository" means a real time database that consolidates data from
a variety of clinical sources to present a unified view of a single patient and is used by a
state-certified health information exchange service provider to enable health information
exchange among health care providers that are not related health care entities as defined in
section 144.291, subdivision 2, paragraph (j). This does not include clinical data that are
submitted to the commissioner for public health purposes required or permitted by law,
including any rules adopted by the commissioner.
new text end
deleted text begin (a)deleted text end new text begin (b)new text end "Clinical transaction" means any meaningful use transactionnew text begin or other health
information exchange transactionnew text end that is not covered by section 62J.536.
deleted text begin (b)deleted text end new text begin (c)new text end "Commissioner" means the commissioner of health.
deleted text begin
(c) "Direct health information exchange" means the electronic transmission of
health-related information through a direct connection between the electronic health
record systems of health care providers without the use of a health data intermediary.
deleted text end
(d) "Health care provider" or "provider" means a health care provider or provider as
defined in section 62J.03, subdivision 8.
(e) "Health data intermediary" means an entity that provides the deleted text begin infrastructure
deleted text end new text begin technical capabilities or related products and servicesnew text end to deleted text begin connect computer systems or
other electronic devices used by health care providers, laboratories, pharmacies, health
plans, third-party administrators, or pharmacy benefit managers to facilitate the secure
transmission of health information, includingdeleted text end new text begin enable health information exchange among
health care providers that are not related health care entities as defined in section 144.291,
subdivision 2, paragraph (j). This includes but is not limited to: health information service
providers (HISP), electronic health record vendors, andnew text end pharmaceutical electronic data
intermediaries as defined in section 62J.495. deleted text begin This does not include health care providers
engaged in direct health information exchange.
deleted text end
(f) "Health information exchange" means the electronic transmission of health-related
information between organizations according to nationally recognized standards.
(g) "Health information exchange service provider" means a health data intermediary
or health information organization deleted text begin that has been issued a certificate of authority by the
commissioner under section 62J.4981deleted text end .
(h) "Health information organization" means an organization that oversees, governs,
and facilitates deleted text begin thedeleted text end new text begin health informationnew text end exchange deleted text begin of health-related informationdeleted text end among
deleted text begin organizations according to nationally recognized standardsdeleted text end new text begin health care providers that are
not related health care entities as defined in section 144.291, subdivision 2, paragraph (j),
to improve coordination of patient care and the efficiency of health care deliverynew text end .
(i) "HITECH Act" means the Health Information Technology for Economic and
Clinical Health Act as defined in section 62J.495.
(j) "Major participating entity" means:
(1) a participating entity that receives compensation for services that is greater
than 30 percent of the health information organization's gross annual revenues from the
health information exchange service provider;
(2) a participating entity providing administrative, financial, or management services
to the health information organization, if the total payment for all services provided by the
participating entity exceeds three percent of the gross revenue of the health information
organization; and
(3) a participating entity that nominates or appoints 30 percent or more of the board
of directors new text begin or equivalent governing body new text end of the health information organization.
new text begin
(k) "Master patient index" means an electronic database that holds unique identifiers
of patients registered at a care facility and is used by a state-certified health information
exchange service provider to enable health information exchange among health care
providers that are not related health care entities as defined in section 144.291, subdivision
2, paragraph (j). This does not include data that are submitted to the commissioner for
public health purposes required or permitted by law, including any rules adopted by the
commissioner.
new text end
deleted text begin (k)deleted text end new text begin (l)new text end "Meaningful use" means use of certified electronic health record technology
deleted text begin that includes e-prescribing, and is connected in a manner that provides for the electronic
exchange of health information and used for the submission of clinical quality measures
deleted text end new text begin to improve quality, safety, and efficiency and reduce health disparities; engage patients
and families; improve care coordination and population and public health; and maintain
privacy and security of patient health information new text end as established by the Center for
Medicare and Medicaid Services and the Minnesota Department of Human Services
pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
deleted text begin (l)deleted text end new text begin (m)new text end "Meaningful use transaction" means an electronic transaction that a health
care provider must exchange to receive Medicare or Medicaid incentives or avoid
Medicare penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
deleted text begin (m)deleted text end new text begin (n)new text end "Participating entity" means any of the following persons, health care
providers, companies, or other organizations with which a health information organization
or health data intermediary has contracts or other agreements for the provision of health
information exchange deleted text begin service providersdeleted text end new text begin servicesnew text end :
(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
licensed under the laws of this state or registered with the commissioner;
(2) a health care provider, and any other health care professional otherwise licensed
under the laws of this state or registered with the commissioner;
(3) a group, professional corporation, or other organization that provides the
services of individuals or entities identified in clause (2), including but not limited to a
medical clinic, a medical group, a home health care agency, an urgent care center, and
an emergent care center;
(4) a health plan as defined in section 62A.011, subdivision 3; and
(5) a state agency as defined in section 13.02, subdivision 17.
deleted text begin (n)deleted text end new text begin (o)new text end "Reciprocal agreement" means an arrangement in which two or more health
information exchange service providers agree to share in-kind services and resources to
allow for the pass-through of deleted text begin meaningful usedeleted text end new text begin clinicalnew text end transactions.
deleted text begin (o)deleted text end new text begin (p)new text end "State-certified health data intermediary" means a health data intermediary
thatdeleted text begin : deleted text end new text begin has been issued a certificate of authority to operate in Minnesota.
new text end
deleted text begin
(1) provides a subset of the meaningful use transaction capabilities necessary for
hospitals and providers to achieve meaningful use of electronic health records;
deleted text end
deleted text begin
(2) is not exclusively engaged in the exchange of meaningful use transactions
covered by section 62J.536; and
deleted text end
deleted text begin
(3) has been issued a certificate of authority to operate in Minnesota.
deleted text end
deleted text begin (p)deleted text end new text begin (q)new text end "State-certified health information organization" means a deleted text begin nonprofitdeleted text end health
information organization that deleted text begin provides transaction capabilities necessary to fully support
clinical transactions required for meaningful use of electronic health records thatdeleted text end has been
issued a certificate of authority to operate in Minnesota.
Subd. 2.
Health information exchange oversight.
(a) The commissioner shall
protect the public interest on matters pertaining to health information exchange. The
commissioner shall:
(1) review and act on applications from health data intermediaries and health
information organizations for certificates of authority to operate in Minnesota;
(2) provide ongoing monitoring to ensure compliance with criteria established under
sections 62J.498 to 62J.4982;
(3) respond to public complaints related to health information exchange services;
(4) take enforcement actions as necessary, including the imposition of fines,
suspension, or revocation of certificates of authority as outlined in section 62J.4982;
(5) provide a biennial report on the status of health information exchange services
that includes but is not limited to:
(i) recommendations on actions necessary to ensure that health information exchange
services are adequate to meet the needs of Minnesota citizens and providers statewide;
(ii) recommendations on enforcement actions to ensure that health information
exchange service providers act in the public interest without causing disruption in health
information exchange services;
(iii) recommendations on updates to criteria for obtaining certificates of authority
under this section; and
(iv) recommendations on standard operating procedures for health information
exchange, including but not limited to the management of consumer preferences; and
(6) other duties necessary to protect the public interest.
(b) As part of the application review process for certification under paragraph (a),
prior to issuing a certificate of authority, the commissioner shall:
(1) deleted text begin hold public hearings that provide an adequate opportunity for participating
entities and consumers to provide feedback and recommendations on the application under
consideration. The commissioner shalldeleted text end make all portions of the application classified as
public data available to the publicnew text begin fornew text end at least ten days deleted text begin in advance of the hearingdeleted text end new text begin while
an application is under considerationnew text end . new text begin At the request of the commissioner, new text end the applicant
shall participate in deleted text begin thedeleted text end new text begin a publicnew text end hearing by presenting an overview of their application and
responding to questions from interested parties;new text begin and
new text end
(2) deleted text begin make available all feedback and recommendations gathered at the hearing
available to the public prior to issuing a certificate of authority; and
deleted text end
deleted text begin (3)deleted text end consult with hospitals, physicians, and other deleted text begin professionals eligible to receive
meaningful use incentive payments or subject to penalties as established in the HITECH
Act, and their respective statewide associations,deleted text end new text begin providersnew text end prior to issuing a certificate of
authority.
(c) When the commissioner is actively considering a suspension or revocation of a
certificate of authority as described in section 62J.4982, subdivision 3, all investigatory
data that are collected, created, or maintained related to the suspension or revocation
are classified as confidential data on individuals and as protected nonpublic data in the
case of data not on individuals.
(d) The commissioner may disclose data classified as protected nonpublic or
confidential under paragraph (c) if disclosing the data will protect the health or safety of
patients.
(e) After the commissioner makes a final determination regarding a suspension or
revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
conclusions of law, and the specification of the final disciplinary action, are classified
as public data.
Sec. 3.
Minnesota Statutes 2014, section 62J.4981, is amended to read:
62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
INFORMATION EXCHANGE SERVICES.
Subdivision 1.
Authority to require organizations to apply.
The commissioner
shall require deleted text begin an entity providing health information exchange servicesdeleted text end new text begin a health data
intermediary or a health information organizationnew text end to apply for a certificate of authority
under this section. An applicant may continue to operate until the commissioner acts
on the application. If the application is denied, the applicant is considered a health
information deleted text begin organizationdeleted text end new text begin exchange service providernew text end whose certificate of authority has
been revoked under section 62J.4982, subdivision 2, paragraph (d).
Subd. 2.
Certificate of authority for health data intermediaries.
(a) A health
data intermediary deleted text begin that provides health information exchange services for the transmission
of one or more clinical transactions necessary for hospitals, providers, or eligible
professionals to achieve meaningful usedeleted text end must be deleted text begin registered withdeleted text end new text begin certified bynew text end the state and
comply with requirements established in this section.
(b) Notwithstanding any law to the contrary, any corporation organized to do so
may apply to the commissioner for a certificate of authority to establish and operate as
a health data intermediary in compliance with this section. No person shall establish or
operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers
to purchase or receive advance or periodic consideration in conjunction with a health
data intermediary contract unless the organization has a certificate of authority or has an
application under active consideration under this section.
(c) In issuing the certificate of authority, the commissioner shall determine whether
the applicant for the certificate of authority has demonstrated that the applicant meets
the following minimum criteria:
deleted text begin
(1) interoperate with at least one state-certified health information organization;
deleted text end
deleted text begin
(2) provide an option for Minnesota entities to connect to their services through at
least one state-certified health information organization;
deleted text end
deleted text begin
(3) have a record locator service as defined in section 144.291, subdivision 2,
paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8,
when conducting meaningful use transactions; and
deleted text end
deleted text begin (4)deleted text end new text begin (1)new text end hold reciprocal agreements with at least one state-certified health information
organization to deleted text begin enabledeleted text end access deleted text begin to record locator services to finddeleted text end patient data, and for the
transmission and receipt of deleted text begin meaningful usedeleted text end new text begin clinicalnew text end transactions deleted text begin consistent with the
format and content required by national standards established by Centers for Medicare
and Medicaid Servicesdeleted text end . Reciprocal agreements must meet the requirements established in
subdivision 5deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(2) participate in statewide shared health information exchange services as defined
by the commissioner to support interoperability between state-certified health information
organizations and state-certified health data intermediaries.
new text end
Subd. 3.
Certificate of authority for health information organizations.
(a) A health information organization deleted text begin that provides all electronic capabilities for the
transmission of clinical transactions necessary for meaningful use of electronic health
recordsdeleted text end must obtain a certificate of authority from the commissioner and demonstrate
compliance with the criteria in paragraph (c).
(b) Notwithstanding any law to the contrary,deleted text begin a nonprofit corporation organized to
do sodeleted text end new text begin an organizationnew text end may apply for a certificate of authority to establish and operate a
health information organization under this section. No person shall establish or operate a
health information organization in this state, nor sell or offer to sell, or solicit offers
to purchase or receive advance or periodic consideration in conjunction with a health
information organization or health information contract unless the organization has a
certificate of authority under this section.
(c) In issuing the certificate of authority, the commissioner shall determine whether
the applicant for the certificate of authority has demonstrated that the applicant meets
the following minimum criteria:
(1) the entity is a legally establisheddeleted text begin , nonprofitdeleted text end organization;
(2) appropriate insurance, including liability insurance, for the operation of the
health information organization is in place and sufficient to protect the interest of the
public and participating entities;
(3) strategic and operational plans deleted text begin clearlydeleted text end address new text begin governance, technical
infrastructure, legal and policy issues, finance, and business operations in regard to new text end how
the organization will expand deleted text begin technical capacity of the health information organization
deleted text end to support providers in achieving deleted text begin meaningful use of electronic health recordsdeleted text end new text begin health
information exchange goalsnew text end over time;
(4) the entity addresses the parameters to be used with participating entities and
other health information deleted text begin organizationsdeleted text end new text begin exchange service providersnew text end for deleted text begin meaningful use
deleted text end new text begin clinicalnew text end transactions, compliance with Minnesota law, and interstate health information
exchange deleted text begin indeleted text end trust agreements;
(5) the entity's board of directors new text begin or equivalent governing body new text end is composed of
members that broadly represent the health information organization's participating entities
and consumers;
(6) the entity maintains a professional staff responsible to the board of directorsnew text begin or
equivalent governing body new text end with the capacity to ensure accountability to the organization's
mission;
(7) the organization is compliant with deleted text begin criteria established under the Health
Information Exchange Accreditation Program of the Electronic Healthcare Network
Accreditation Commission (EHNAC) or equivalent criteria establisheddeleted text end new text begin national
certification and accreditation programs designatednew text end by the commissioner;
(8) the entity maintains deleted text begin adeleted text end new text begin the capability to query for patient information based on
national standards. The query capability may utilize a master patient index, clinical
data repository, ornew text end record locator service as defined in section 144.291, subdivision 2,
paragraph (i)deleted text begin , that isdeleted text end new text begin . The entity must benew text end compliant with the requirements of section
144.293, subdivision 8, when conducting deleted text begin meaningful usedeleted text end new text begin clinicalnew text end transactions;
(9) the organization demonstrates interoperability with all other state-certified health
information organizations using nationally recognized standards;
(10) the organization demonstrates compliance with all privacy and security
requirements required by state and federal law; and
(11) the organization uses financial policies and procedures consistent with generally
accepted accounting principles and has an independent audit of the organization's
financials on an annual basis.
(d) Health information organizations that have obtained a certificate of authority must:
(1) meet the requirements established for connecting to the deleted text begin Nationwide Health
Information Network (NHIN) within the federally mandated timeline or within a time
frame established by the commissioner and published in the State Register. If the state
timeline for implementation varies from the federal timeline, the State Register notice
shall include an explanation for the variationdeleted text end new text begin National eHealth Exchangenew text end ;
(2) annually submit strategic and operational plans for review by the commissioner
that address:
deleted text begin
(i) increasing adoption rates to include a sufficient number of participating entities to
achieve financial sustainability; and
deleted text end
deleted text begin (ii)deleted text end new text begin (i)new text end progress in achieving objectives included in previously submitted strategic
and operational plans across the following domains: business and technical operations,
technical infrastructure, legal and policy issues, finance, and organizational governance;
deleted text begin
(3) develop and maintain a business plan that addresses:
deleted text end
deleted text begin (i)deleted text end new text begin (ii)new text end plans for ensuring the necessary capacity to support deleted text begin meaningful usedeleted text end new text begin clinical
new text end transactions;
deleted text begin (ii)deleted text end new text begin (iii)new text end approach for attaining financial sustainability, including public and private
financing strategies, and rate structures;
deleted text begin (iii)deleted text end new text begin (iv)new text end rates of adoption, utilization, and transaction volume, and mechanisms to
support health information exchange; and
deleted text begin (iv)deleted text end new text begin (v)new text end an explanation of methods employed to address the needs of community
clinics, critical access hospitals, and free clinics in accessing health information exchange
services;
deleted text begin
(4) annually submit a rate plan to the commissioner outlining fee structures for health
information exchange services for approval by the commissioner. The commissioner
shall approve the rate plan if it:
deleted text end
deleted text begin
(i) distributes costs equitably among users of health information services;
deleted text end
deleted text begin
(ii) provides predictable costs for participating entities;
deleted text end
deleted text begin
(iii) covers all costs associated with conducting the full range of meaningful use
clinical transactions, including access to health information retrieved through other
state-certified health information exchange service providers; and
deleted text end
deleted text begin
(iv) provides for a predictable revenue stream for the health information organization
and generates sufficient resources to maintain operating costs and develop technical
infrastructure necessary to serve the public interest;
deleted text end
deleted text begin (5)deleted text end new text begin (3)new text end enter into reciprocal agreements with all other state-certified health
information organizations new text begin and state-certified health data intermediaries new text end to enable access
to deleted text begin record locator services to finddeleted text end patient data, and new text begin for the new text end transmission and receipt of
deleted text begin meaningful usedeleted text end new text begin clinical new text end transactions deleted text begin consistent with the format and content required by
national standards established by Centers for Medicare and Medicaid Servicesdeleted text end . Reciprocal
agreements must meet the requirements in subdivision 5; deleted text begin and
deleted text end
new text begin
(4) participate in statewide shared health information exchange services as defined
by the commissioner to support interoperability between state-certified health information
organizations and state-certified health data intermediaries; and
new text end
deleted text begin (6)deleted text end new text begin (5)new text end comply with additional requirements for the certification or recertification of
health information organizations that may be established by the commissioner.
Subd. 4.
Application for certificate of authority for health information exchange
service providers.
(a) Each application for a certificate of authority shall be in a form
prescribed by the commissioner and verified by an officer or authorized representative
of the applicant. Each application shall include the followingnew text begin in addition to information
described in the criteria in subdivisions 2 and 3new text end :
(1) new text begin for health information organizations only, new text end a copy of the basic organizational
document, if any, of the applicant and of each major participating entity, such as the
articles of incorporation, or other applicable documents, and all amendments to it;
(2) new text begin for health information organizations only, new text end a list of the names, addresses, and
official positions of the following:
(i) all members of the board of directorsnew text begin or equivalent governing bodynew text end , and the
principal officers and, if applicable, shareholders of the applicant organization; and
(ii) all members of the board of directorsnew text begin or equivalent governing bodynew text end , and the
principal officers of each major participating entity and, if applicable, each shareholder
beneficially owning more than ten percent of any voting stock of the major participating
entity;
(3) new text begin for health information organizations only, new text end the name and address of each
participating entity and the agreed-upon duration of each contract or agreement if
applicable;
(4) a copy of each standard agreement or contract intended to bind the participating
entities and the health information deleted text begin organizationdeleted text end new text begin exchange service providernew text end . Contractual
provisions shall be consistent with the purposes of this section, in regard to the services to
be performed under the standard agreement or contract, the manner in which payment for
services is determined, the nature and extent of responsibilities to be retained by the health
information organization, and contractual termination provisions;
deleted text begin
(5) a copy of each contract intended to bind major participating entities and the
health information organization. Contract information filed with the commissioner under
this section shall be nonpublic as defined in section 13.02, subdivision 9;
deleted text end
deleted text begin (6)deleted text end new text begin (5)new text end a statement generally describing the health information deleted text begin organizationdeleted text end new text begin exchange
service providernew text end , its health information exchange contracts, facilities, and personnel,
including a statement describing the manner in which the applicant proposes to provide
participants with comprehensive health information exchange services;
deleted text begin
(7) financial statements showing the applicant's assets, liabilities, and sources
of financial support, including a copy of the applicant's most recent certified financial
statement;
deleted text end
deleted text begin
(8) strategic and operational plans that specifically address how the organization
will expand technical capacity of the health information organization to support providers
in achieving meaningful use of electronic health records over time, a description of
the proposed method of marketing the services, a schedule of proposed charges, and a
financial plan that includes a three-year projection of the expenses and income and other
sources of future capital;
deleted text end
deleted text begin (9)deleted text end new text begin (6)new text end a statement reasonably describing the geographic area or areas to be served
and the type or types of participants to be served;
deleted text begin (10)deleted text end new text begin (7)new text end a description of the complaint procedures to be used as required under
this section;
deleted text begin (11)deleted text end new text begin (8)new text end a description of the mechanism by which participating entities will have an
opportunity to participate in matters of policy and operation;
deleted text begin (12)deleted text end new text begin (9)new text end a copy of any pertinent agreements between the health information
organization and insurers, including liability insurers, demonstrating coverage is in place;
deleted text begin (13)deleted text end new text begin (10)new text end a copy of the conflict of interest policy that applies to all members of the
board of directorsnew text begin or equivalent governing bodynew text end and the principal officers of the health
information organization; and
deleted text begin (14)deleted text end new text begin (11)new text end other information as the commissioner may reasonably require to be
provided.
(b) Within deleted text begin 30deleted text end new text begin 45new text end days after the receipt of the application for a certificate of authority,
the commissioner shall determine whether or not the application submitted meets the
requirements for completion in paragraph (a), and notify the applicant of any further
information required for the application to be processed.
(c) Within 90 days after the receipt of a complete application for a certificate of
authority, the commissioner shall issue a certificate of authority to the applicant if the
commissioner determines that the applicant meets the minimum criteria requirements
of subdivision 2 for health data intermediaries or subdivision 3 for health information
organizations. If the commissioner determines that the applicant is not qualified, the
commissioner shall notify the applicant and specify the reasons for disqualification.
(d) Upon being granted a certificate of authority to operate as a new text begin state-certified new text end health
information organizationnew text begin or state-certified health data intermediarynew text end , the organization must
operate in compliance with the provisions of this section. Noncompliance may result in
the imposition of a fine or the suspension or revocation of the certificate of authority
according to section 62J.4982.
Subd. 5.
Reciprocal agreements between health information exchange entities.
(a) Reciprocal agreements between two health information organizations or between a
health information organization and a health data intermediary must include a fair and
equitable model for charges between the entities that:
(1) does not impede the secure transmission of new text begin clinical new text end transactions deleted text begin necessary to
achieve meaningful usedeleted text end ;
(2) does not charge a fee for the exchange of meaningful use transactions transmitted
according to nationally recognized standards where no additional value-added service
is rendered to the sending or receiving health information organization or health data
intermediary either directly or on behalf of the client;
(3) is consistent with fair market value and proportionately reflects the value-added
services accessed as a result of the agreement; and
(4) prevents health care stakeholders from being charged multiple times for the
same service.
(b) Reciprocal agreements must include comparable quality of service standards that
ensure equitable levels of services.
(c) Reciprocal agreements are subject to review and approval by the commissioner.
(d) Nothing in this section precludes a state-certified health information organization
or state-certified health data intermediary from entering into contractual agreements for
the provision of value-added services beyond meaningful usenew text begin transactionsnew text end .
deleted text begin
(e) The commissioner of human services or health, when providing access to data or
services through a certified health information organization, must offer the same data or
services directly through any certified health information organization at the same pricing,
if the health information organization pays for all connection costs to the state data or
service. For all external connectivity to the respective agencies through existing or future
information exchange implementations, the respective agency shall establish the required
connectivity methods as well as protocol standards to be utilized.
deleted text end
deleted text begin Subd. 6. deleted text end
deleted text begin State participation in health information exchange. deleted text end
deleted text begin
A state agency that
connects to a health information exchange service provider for the purpose of exchanging
meaningful use transactions must ensure that the contracted health information exchange
service provider has reciprocal agreements in place as required by this section. The
reciprocal agreements must provide equal access to information supplied by the agency as
necessary for meaningful use by the participating entities of the other health information
service providers.
deleted text end
Sec. 4.
Minnesota Statutes 2014, section 62J.4982, subdivision 4, is amended to read:
Subd. 4.
Coordination.
deleted text begin (a)deleted text end The commissioner shall, to the extent possible, seek
the advice of the Minnesota e-Health Advisory Committee, in the review and update of
criteria for the certification and recertification of health information exchange service
providers when implementing sections 62J.498 to 62J.4982.
deleted text begin
(b) By January 1, 2011, the commissioner shall report to the governor and the chairs
of the senate and house of representatives committees having jurisdiction over health
information policy issues on the status of health information exchange in Minnesota, and
provide recommendations on further action necessary to facilitate the secure electronic
movement of health information among health providers that will enable Minnesota
providers and hospitals to meet meaningful use exchange requirements.
deleted text end
Sec. 5.
Minnesota Statutes 2014, section 62J.4982, subdivision 5, is amended to read:
Subd. 5.
Fees and monetary penalties.
(a) The commissioner shall assess fees
on every health information exchange service provider subject to sections 62J.4981 and
62J.4982 as follows:
(1) filing an application for certificate of authority to operate as a health information
organization, deleted text begin $10,500deleted text end new text begin $7,000new text end ;
(2) filing an application for certificate of authority to operate as a health data
intermediary, $7,000;
(3) annual health information organization certificate fee, deleted text begin $14,000deleted text end new text begin $7,000new text end ;new text begin and
new text end
(4) annual health data intermediary certificate fee, $7,000deleted text begin ; and
deleted text end
deleted text begin (5) fees for other filings, as specified by ruledeleted text end .
new text begin
(b) Fees collected under this section shall be deposited in the state treasury and
credited to the state government special revenue fund.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end Administrative monetary penalties imposed under this subdivision shall
be credited to an account in the special revenue fund and are appropriated to the
commissioner for the purposes of sections 62J.498 to 62J.4982.
Sec. 6.
Minnesota Statutes 2014, section 62J.692, subdivision 4, is amended to read:
Subd. 4.
Distribution of funds.
(a) The commissioner shall annually distribute the
available medical education funds to all qualifying applicants based on a public program
volume factor, which is determined by the total volume of public program revenue
received by each training site as a percentage of all public program revenue received by
all training sites in the fund pool.
Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue
are ineligible for funds available under this subdivision. For purposes of determining
training-site level grants to be distributed under this paragraph, total statewide average
costs per trainee for medical residents is based on audited clinical training costs per trainee
in primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs
per trainee in clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical training
costs per trainee in clinical medical education programs for pharmacy students. Training
sites whose training site level grant is less than $5,000, based on the formula described
in this paragraph, or that train fewer than 0.1 FTE eligible trainees, are ineligible for
funds available under this subdivision. No training sites shall receive a grant per FTE
trainee that is in excess of the 95th percentile grant per FTE across all eligible training
sites; grants in excess of this amount will be redistributed to other eligible sites based on
the formula described in this paragraph.
(b) For funds distributed in fiscal years 2014 and 2015, the distribution formula shall
include a supplemental public program volume factor, which is determined by providing
a supplemental payment to training sites whose public program revenue accounted for
at least 0.98 percent of the total public program revenue received by all eligible training
sites. The supplemental public program volume factor shall be equal to ten percent of each
training site's grant for funds distributed in fiscal year 2014 and for funds distributed in
fiscal year 2015. Grants to training sites whose public program revenue accounted for less
than 0.98 percent of the total public program revenue received by all eligible training sites
shall be reduced by an amount equal to the total value of the supplemental payment. For
fiscal year 2016 and beyond, the distribution of funds shall be based solely on the public
program volume factor as described in paragraph (a).
(c) deleted text begin Of available medical education funds, $1,000,000 shall be distributed each
year for grants to family medicine residency programs located outside the seven-county
metropolitan area, as defined in section 473.121, subdivision 4, focused on eduction and
training of family medicine physicians to serve communities outside the metropolitan area.
To be eligible for a grant under this paragraph, a family medicine residency program must
demonstrate that over the most recent three calendar years, at least 25 percent of its residents
practice in Minnesota communities outside the metropolitan area. Grant funds must be
allocated proportionally based on the number of residents per eligible residency program.
deleted text end
deleted text begin (d)deleted text end Funds distributed shall not be used to displace current funding appropriations
from federal or state sources.
deleted text begin (e)deleted text end new text begin (d) new text end Funds shall be distributed to the sponsoring institutions indicating the amount
to be distributed to each of the sponsor's clinical medical education programs based on the
criteria in this subdivision and in accordance with the commissioner's approval letter. Each
clinical medical education program must distribute funds allocated under paragraphs (a)
and (b) to the training sites as specified in the commissioner's approval letter. Sponsoring
institutions, which are accredited through an organization recognized by the Department
of Education or the Centers for Medicare and Medicaid Services, may contract directly
with training sites to provide clinical training. To ensure the quality of clinical training,
those accredited sponsoring institutions must:
(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and
(2) take necessary action if the contract requirements are not met. Action may include
the withholding of payments under this section or the removal of students from the site.
deleted text begin (f)deleted text end new text begin (e) new text end Use of funds is limited to expenses related to clinical training program costs
for eligible programs.
deleted text begin (g)deleted text end new text begin (f) new text end Any funds not distributed in accordance with the commissioner's approval
letter must be returned to the medical education and research fund within 30 days of
receiving notice from the commissioner. The commissioner shall distribute returned funds
to the appropriate training sites in accordance with the commissioner's approval letter.
deleted text begin (h)deleted text end new text begin (g) new text end A maximum of $150,000 of the funds dedicated to the commissioner
under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
administrative expenses associated with implementing this section.
Sec. 7.
Minnesota Statutes 2014, section 62Q.37, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the
meanings given them.
(a) "Commissioner" means the commissioner of health for purposes of regulating
health maintenance organizations and community integrated service networks, the
commissioner of commerce for purposes of regulating nonprofit health service plan
corporations, or the commissioner of human services for the purpose of contracting with
managed care organizations serving persons enrolled in programs under chapter 256B,
256D, or 256L.
(b) "Health plan company" means (i) a nonprofit health service plan corporation
operating under chapter 62C; (ii) a health maintenance organization operating under
chapter 62D; (iii) a community integrated service network operating under chapter 62N;
or (iv) a managed care organization operating under chapter 256B, 256D, or 256L.
(c) "Nationally recognized independent organization" means (i) an organization
that sets specific national standards governing health care quality assurance processes,
utilization review, provider credentialing, marketing, and other topics covered by
this chapter and other chapters and audits and provides accreditation to those health
plan companies that meet those standards. The American Accreditation Health Care
Commission (URAC), the National Committee for Quality Assurance (NCQA), deleted text begin and
deleted text end the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)new text begin , and the
Accreditation Association for Ambulatory Health Care (AAAHC)new text end are, at a minimum,
defined as nationally recognized independent organizations; and (ii) the Centers for
Medicare and Medicaid Services for purposes of reviews or audits conducted of health
plan companies under Part C of Title XVIII of the Social Security Act or under section
1876 of the Social Security Act.
(d) "Performance standard" means those standards relating to quality management
and improvement, access and availability of service, utilization review, provider selection,
provider credentialing, marketing, member rights and responsibilities, complaints, appeals,
grievance systems, enrollee information and materials, enrollment and disenrollment,
subcontractual relationships and delegation, confidentiality, continuity and coordination of
care, assurance of adequate capacity and services, coverage and authorization of services,
practice guidelines, health information systems, and financial solvency.
Sec. 8.
Minnesota Statutes 2014, section 62U.04, subdivision 11, is amended to read:
Subd. 11.
Restricted uses of the all-payer claims data.
(a) Notwithstanding
subdivision 4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the
commissioner's designee shall only use the data submitted under subdivisions 4 and 5 for
the following purposes:
(1) to evaluate the performance of the health care home program as authorized under
sections 256B.0751, subdivision 6, and 256B.0752, subdivision 2;
(2) to study, in collaboration with the reducing avoidable readmissions effectively
(RARE) campaign, hospital readmission trends and rates;
(3) to analyze variations in health care costs, quality, utilization, and illness burden
based on geographical areas or populations; deleted text begin and
deleted text end
(4) to evaluate the state innovation model (SIM) testing grant received by the
Departments of Health and Human Services, including the analysis of health care cost,
quality, and utilization baseline and trend information for targeted populations and
communitiesdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(5) to compile one or more public use files of summary data or tables that must:
new text end
new text begin
(i) be available to the public for no or minimal cost by March 1, 2016, and available
by Web-based electronic data download by June 30, 2019;
new text end
new text begin
(ii) not identify individual patients, payers, or providers;
new text end
new text begin
(iii) be updated by the commissioner, at least annually, with the most current data
available;
new text end
new text begin
(iv) contain clear and conspicuous explanations of the characteristics of the data,
such as the dates of the data contained in the files, the absence of costs of care for uninsured
patients or nonresidents, and other disclaimers that provide appropriate context; and
new text end
new text begin
(v) not lead to the collection of additional data elements beyond what is authorized
under this section as of June 30, 2015.
new text end
(b) The commissioner may publish the results of the authorized uses identified
in paragraph (a) so long as the data released publicly do not contain information or
descriptions in which the identity of individual hospitals, clinics, or other providers may
be discerned.
(c) Nothing in this subdivision shall be construed to prohibit the commissioner from
using the data collected under subdivision 4 to complete the state-based risk adjustment
system assessment due to the legislature on October 1, 2015.
(d) The commissioner or the commissioner's designee may use the data submitted
under subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until
July 1, 2016.
new text begin
(e) The commissioner shall consult with the all-payer claims database work group
established under subdivision 12 regarding the technical considerations necessary to create
the public use files of summary data described in paragraph (a), clause (5).
new text end
Sec. 9.
Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Projected spending baseline. new text end
new text begin
Beginning February 15, 2016, and each
February 15 thereafter, the commissioner of health shall report the projected impact on
spending from specified health indicators related to various preventable illnesses and
death. The impacts shall be reported over a ten-year time frame using a baseline forecast
of private and public health care and long-term care spending for residents of this state,
beginning with calendar year 2009 projected estimates of costs, and updated annually
for each of the following health indicators:
new text end
new text begin
(1) costs related to rates of obesity, including obesity-related cancers, coronary
heart disease, stroke, and arthritis;
new text end
new text begin
(2) costs related to the utilization of tobacco products;
new text end
new text begin
(3) costs related to hypertension;
new text end
new text begin
(4) costs related to diabetes or prediabetes; and
new text end
new text begin
(5) costs related to dementia and chronic disease among an elderly population over
60, including additional long-term care costs.
new text end
Sec. 10.
Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Outcomes reporting; savings determination. new text end
new text begin
(a) Beginning November 1,
2016, and each November 1 thereafter, the commissioner of health shall determine the
actual total private and public health care and long-term care spending for Minnesota
residents related to each health indicator projected in subdivision 6 for the most recent
calendar year available. The commissioner shall determine the difference between the
projected and actual spending for each health indicator and for each year, and determine
the savings attributable to changes in these health indicators. The assumptions and
research methods used to calculate actual spending must be determined to be appropriate
by an independent actuarial consultant. If the actual spending is less than the projected
spending, the commissioner, in consultation with the commissioners of human services
and management and budget, shall use the proportion of spending for state-administered
health care programs to total private and public health care spending for each health
indicator for the calendar year two years before the current calendar year to determine
the percentage of the calculated aggregate savings amount accruing to state-administered
health care programs.
new text end
new text begin
(b) The commissioner may use the data submitted under section 62U.04, subdivisions
4 and 5, to complete the activities required under this section, but may only report publicly
on regional data aggregated to granularity of 25,000 lives or greater for this purpose.
new text end
Sec. 11.
Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Transfers. new text end
new text begin
When accumulated annual savings accruing to
state-administered health care programs, as calculated under subdivision 7, meet or
exceed $50,000,000 for all health indicators in aggregate statewide, the commissioner of
health shall certify that event to the commissioner of management and budget, no later
than December 15 of each year. In the next fiscal year following the certification, the
commissioner of management and budget shall transfer $50,000,000 from the general
fund to the health care access fund. This transfer shall repeat in each fiscal year following
subsequent certifications of additional cumulative savings, up to $50,000,000 per year.
The amount necessary to make the transfer is appropriated from the general fund to the
commissioner of management and budget.
new text end
Sec. 12.
Minnesota Statutes 2014, section 144.1501, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following definitions
apply.
new text begin
(b) "Advanced dental therapist" means an individual who is licensed as a dental
therapist under section 150A.06, and who is certified as an advanced dental therapist
under section 150A.106.
new text end
new text begin
(c) "Dental therapist" means an individual who is licensed as a dental therapist
under section 150A.06.
new text end
deleted text begin (b)deleted text end new text begin (d)new text end "Dentist" means an individual who is licensed to practice dentistry.
deleted text begin (c)deleted text end new text begin (e)new text end "Designated rural area" means a new text begin statutory and home rule charternew text end city or
township that isdeleted text begin :
deleted text end
deleted text begin (1)deleted text end outside the seven-county metropolitan area as defined in section 473.121,
subdivision 2deleted text begin ; anddeleted text end new text begin , excluding the cities of Duluth, Mankato, Moorhead, Rochester, and
St. Cloud.
new text end
deleted text begin
(2) has a population under 15,000.
deleted text end
deleted text begin (d)deleted text end new text begin (f)new text end "Emergency circumstances" means those conditions that make it impossible
for the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.
new text begin
(g) "Mental health professional" means an individual providing clinical services in
the treatment of mental illness who is qualified in at least one of the ways specified in
section 245.462, subdivision 18.
new text end
deleted text begin (e)deleted text end new text begin (h)new text end "Medical resident" means an individual participating in a medical residency
in family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
deleted text begin (f)deleted text end new text begin (i)new text end "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.
deleted text begin (g)deleted text end new text begin (j)new text end "Nurse" means an individual who has completed training and received
all licensing or certification necessary to perform duties as a licensed practical nurse
or registered nurse.
deleted text begin (h)deleted text end new text begin (k)new text end "Nurse-midwife" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse-midwives.
deleted text begin (i)deleted text end new text begin (l)new text end "Nurse practitioner" means a registered nurse who has graduated from a
program of study designed to prepare registered nurses for advanced practice as nurse
practitioners.
deleted text begin (j)deleted text end new text begin (m)new text end "Pharmacist" means an individual with a valid license issued under chapter
151.
deleted text begin (k)deleted text end new text begin (n)new text end "Physician" means an individual who is licensed to practice medicine in
the areas of family practice, internal medicine, obstetrics and gynecology, pediatrics,
or psychiatry.
deleted text begin (l)deleted text end new text begin (o)new text end "Physician assistant" means a person licensed under chapter 147A.
new text begin
(p) "Public health nurse" means a registered nurse licensed in Minnesota who has
obtained a registration certificate as a public health nurse from the Board of Nursing in
accordance with Minnesota Rules, chapter 6316.
new text end
deleted text begin (m)deleted text end new text begin (q)new text end "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.
deleted text begin (n)deleted text end new text begin (r)new text end "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.
Sec. 13.
Minnesota Statutes 2014, section 144.1501, subdivision 2, is amended to read:
Subd. 2.
Creation of account.
(a) A health professional education loan forgiveness
program account is established. The commissioner of health shall use money from the
account to establish a loan forgiveness program:
(1) for medical residents new text begin and mental health professionalsnew text end agreeing to practice
in designated rural areas or underserved urban communities or specializing in the area
of pediatric psychiatry;
(2) for midlevel practitioners agreeing to practice in designated rural areas or to
teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary
program at the undergraduate level or the equivalent at the graduate level;
(3) for nurses who agree to practice in a Minnesota nursing home deleted text begin ordeleted text end new text begin ; annew text end intermediate
care facility for persons with developmental disabilitynew text begin ;new text end ornew text begin a hospital if the hospital owns
and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked
by the nurse is in the nursing home; or agreenew text end to teach at least 12 credit hours, or 720 hours
per year in the nursing field in a postsecondary program at the undergraduate level or the
equivalent at the graduate level;
(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with
the Healthcare Education-Industry Partnership, shall determine the health care fields
where the need is the greatest, including, but not limited to, respiratory therapy, clinical
laboratory technology, radiologic technology, and surgical technology;
(5) for pharmacistsnew text begin , advanced dental therapists, dental therapists, and public health
nurses new text end who agree to practice in designated rural areas; and
(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by
the United States Department of Health and Human Services under Code of Federal
Regulations, title 42, section 51, chapter 303.
(b) Appropriations made to the account do not cancel and are available until
expended, except that at the end of each biennium, any remaining balance in the account
that is not committed by contract and not needed to fulfill existing commitments shall
cancel to the fund.
Sec. 14.
Minnesota Statutes 2014, section 144.1501, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
(a) To be eligible to participate in the loan forgiveness program,
an individual must:
(1) be a medical or dental residentdeleted text begin ,deleted text end new text begin ;new text end a licensed pharmacistnew text begin ;new text end or be enrolled in new text begin a training
or education program to become new text end a dentist, new text begin dental therapist, advanced dental therapist,
mental health professional, pharmacist, public health nurse, new text end midlevel practitioner,
registered nurse, or a licensed practical nurse deleted text begin training program deleted text end new text begin . The commissioner may
also consider applications submitted by graduates in eligible professions who are licensed
and in practicenew text end ; and
(2) submit an application to the commissioner of health.deleted text begin If fewer applications are
deleted text end deleted text begin submitted by dental students or residents than there are dentist participant slots available,
deleted text end deleted text begin the commissioner may consider applications submitted by dental program graduates
deleted text end deleted text begin who are licensed dentists.
deleted text end
(b) An applicant selected to participate must sign a contract to agree to serve a
minimum three-year full-time service obligation according to subdivision 2, which
shall begin no later than March 31 following completion of required trainingnew text begin , with the
exception of a nurse, who must agree to serve a minimum two-year full-time service
obligation according to subdivision 2, which shall begin no later than March 31 following
completion of required trainingnew text end .
Sec. 15.
Minnesota Statutes 2014, section 144.1501, subdivision 4, is amended to read:
Subd. 4.
Loan forgiveness.
The commissioner of health may select applicants
each year for participation in the loan forgiveness program, within the limits of available
funding. new text begin In considering applications, the commissioner shall give preference to applicants
who document diverse cultural competencies. new text end The commissioner shall distribute available
funds for loan forgiveness proportionally among the eligible professions according to the
vacancy rate for each profession in the required geographic area, facility type, teaching
area, patient group, or specialty type specified in subdivision 2. The commissioner shall
allocate funds for physician loan forgiveness so that 75 percent of the funds available are
used for rural physician loan forgiveness and 25 percent of the funds available are used
for underserved urban communities and pediatric psychiatry loan forgiveness. If the
commissioner does not receive enough qualified applicants each year to use the entire
allocation of funds for any eligible profession, the remaining funds may be allocated
proportionally among the other eligible professions according to the vacancy rate for
each profession in the required geographic area, patient group, or facility type specified
in subdivision 2. Applicants are responsible for securing their own qualified educational
loans. The commissioner shall select participants based on their suitability for practice
serving the required geographic area or facility type specified in subdivision 2, as indicated
by experience or training. The commissioner shall give preference to applicants closest to
completing their training. For each year that a participant meets the service obligation
required under subdivision 3, up to a maximum of four years, the commissioner shall make
annual disbursements directly to the participant equivalent to 15 percent of the average
educational debt for indebted graduates in their profession in the year closest to the
applicant's selection for which information is available, not to exceed the balance of the
participant's qualifying educational loans. Before receiving loan repayment disbursements
and as requested, the participant must complete and return to the commissioner a
confirmation of practice form provided by the commissioner verifying that the participant
is practicing as required under subdivisions 2 and 3. The participant must provide the
commissioner with verification that the full amount of loan repayment disbursement
received by the participant has been applied toward the designated loans. After each
disbursement, verification must be received by the commissioner and approved before the
next loan repayment disbursement is made. Participants who move their practice remain
eligible for loan repayment as long as they practice as required under subdivision 2.
Sec. 16.
new text begin
[144.1506] PRIMARY CARE RESIDENCY EXPANSION GRANT
PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
For purposes of this section, the following definitions
apply:
new text end
new text begin
(1) "eligible primary care residency program" means a program that meets the
following criteria:
new text end
new text begin
(i) is located in Minnesota;
new text end
new text begin
(ii) trains medical residents in the specialties of family medicine, general internal
medicine, general pediatrics, psychiatry, geriatrics, or general surgery; and
new text end
new text begin
(iii) is accredited by the Accreditation Council for Graduate Medical Education or
presents a credible plan to obtain accreditation;
new text end
new text begin
(2) "eligible project" means a project to establish a new eligible primary care
residency program or create at least one new residency slot in an existing eligible primary
care residency program; and
new text end
new text begin
(3) "new residency slot" means the creation of a new residency position and the
execution of a contract with a new resident in a residency program.
new text end
new text begin Subd. 2. new text end
new text begin Expansion grant program. new text end
new text begin
(a) The commissioner of health shall award
primary care residency expansion grants to eligible primary care residency programs to
plan and implement new residency slots. A planning grant shall not exceed $75,000, and a
training grant shall not exceed $150,000 per new residency slot for the first year, $100,000
for the second year, and $50,000 for the third year of the new residency slot.
new text end
new text begin
(b) Funds may be spent to cover the costs of:
new text end
new text begin
(1) planning related to establishing an accredited primary care residency program;
new text end
new text begin
(2) obtaining accreditation by the Accreditation Council for Graduate Medical
Education or another national body that accredits residency programs;
new text end
new text begin
(3) establishing new residency programs or new resident training slots;
new text end
new text begin
(4) recruitment, training, and retention of new residents and faculty;
new text end
new text begin
(5) travel and lodging for new residents;
new text end
new text begin
(6) faculty, new resident, and preceptor salaries related to new residency slots;
new text end
new text begin
(7) training site improvements, fees, equipment, and supplies required for new
primary care resident training slots; and
new text end
new text begin
(8) supporting clinical education in which trainees are part of a primary care team
model.
new text end
new text begin Subd. 3. new text end
new text begin Applications for expansion grants. new text end
new text begin
Eligible primary care residency
programs seeking a grant shall apply to the commissioner. Applications must include the
number of new primary care residency slots planned or under contract; attestation that
funding will be used to support an increase in the number of available residency slots;
a description of the training to be received by the new residents, including the location
of training; a description of the project, including all costs associated with the project;
all sources of funds for the project; detailed uses of all funds for the project; the results
expected; and a plan to maintain the new residency slot after the grant period. The
applicant must describe achievable objectives, a timetable, and roles and capabilities of
responsible individuals in the organization.
new text end
new text begin Subd. 4. new text end
new text begin Consideration of expansion grant applications. new text end
new text begin
The commissioner shall
review each application to determine whether or not the residency program application
is complete and whether the proposed new residency program and any new residency
slots are eligible for a grant. The commissioner shall award grants to support up to six
family medicine, general internal medicine, or general pediatrics residents; four psychiatry
residents; two geriatrics residents; and two general surgery residents. If insufficient
applications are received from any eligible specialty, funds may be redistributed to
applications from other eligible specialties.
new text end
new text begin Subd. 5. new text end
new text begin Program oversight. new text end
new text begin
During the grant period, the commissioner may
require and collect from grantees any information necessary to evaluate the program.
Appropriations made to the program do not cancel and are available until expended.
new text end
Sec. 17.
new text begin
[144.1911] INTERNATIONAL MEDICAL GRADUATES ASSISTANCE
PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The international medical graduates assistance
program is established to address barriers to practice and facilitate pathways to assist
immigrant international medical graduates to integrate into the Minnesota health
care delivery system, with the goal of increasing access to primary care in rural and
underserved areas of the state.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the following terms
have the meanings given.
new text end
new text begin
(b) "Commissioner" means the commissioner of health.
new text end
new text begin
(c) "Immigrant international medical graduate" means an international medical
graduate who was born outside the United States, now resides permanently in the United
States, and who did not enter the United States on a J1 or similar nonimmigrant visa
following acceptance into a United States medical residency or fellowship program.
new text end
new text begin
(d) "International medical graduate" means a physician who received a basic medical
degree or qualification from a medical school located outside the United States and Canada.
new text end
new text begin
(e) "Minnesota immigrant international medical graduate" means an immigrant
international medical graduate who has lived in Minnesota for at least two years.
new text end
new text begin
(f) "Rural community" means a statutory and home rule charter city or township that
is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2,
excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
new text end
new text begin
(g) "Underserved community" means a Minnesota area or population included in
the list of designated primary medical care health professional shortage areas, medically
underserved areas, or medically underserved populations (MUPs) maintained and updated
by the United States Department of Health and Human Services.
new text end
new text begin Subd. 3. new text end
new text begin Program administration. new text end
new text begin
(a) In administering the international medical
graduates assistance program, the commissioner shall:
new text end
new text begin
(1) provide overall coordination for the planning, development, and implementation
of a comprehensive system for integrating qualified immigrant international medical
graduates into the Minnesota health care delivery system, particularly those willing to
serve in rural or underserved communities of the state;
new text end
new text begin
(2) develop and maintain, in partnership with community organizations working
with international medical graduates, a voluntary roster of immigrant international medical
graduates interested in entering the Minnesota health workforce to assist in planning
and program administration, including making available summary reports that show the
aggregate number and distribution, by geography and specialty, of immigrant international
medical graduates in Minnesota;
new text end
new text begin
(3) work with graduate clinical medical training programs to address barriers
faced by immigrant international medical graduates in securing residency positions in
Minnesota, including the requirement that applicants for residency positions be recent
graduates of medical school. The annual report required in subdivision 10 shall include
any progress in addressing these barriers;
new text end
new text begin
(4) develop a system to assess and certify the clinical readiness of eligible immigrant
international medical graduates to serve in a residency program. The system shall
include assessment methods, an operating plan, and a budget. Initially, the commissioner
may develop assessments for clinical readiness for practice of one or more primary
care specialties, and shall add additional assessments as resources are available. The
commissioner may contract with an independent entity or another state agency to conduct
the assessments. In order to be assessed for clinical readiness for residency, an eligible
international medical graduate must have obtained a certification from the Educational
Commission of Foreign Medical Graduates. The commissioner shall issue a Minnesota
certificate of clinical readiness for residency to those who pass the assessment;
new text end
new text begin
(5) explore and facilitate more streamlined pathways for immigrant international
medical graduates to serve in nonphysician professions in the Minnesota workforce; and
new text end
new text begin
(6) study, in consultation with the Board of Medical Practice and other stakeholders,
changes necessary in health professional licensure and regulation to ensure full utilization
of immigrant international medical graduates in the Minnesota health care delivery
system. The commissioner shall include recommendations in the annual report required
under subdivision 10, due January 15, 2017.
new text end
new text begin Subd. 4. new text end
new text begin Career guidance and support services. new text end
new text begin
(a) The commissioner shall
award grants to eligible nonprofit organizations to provide career guidance and support
services to immigrant international medical graduates seeking to enter the Minnesota
health workforce. Eligible grant activities include the following:
new text end
new text begin
(1) educational and career navigation, including information on training and
licensing requirements for physician and nonphysician health care professions, and
guidance in determining which pathway is best suited for an individual international
medical graduate based on the graduate's skills, experience, resources, and interests;
new text end
new text begin
(2) support in becoming proficient in medical English;
new text end
new text begin
(3) support in becoming proficient in the use of information technology, including
computer skills and use of electronic health record technology;
new text end
new text begin
(4) support for increasing knowledge of and familiarity with the United States
health care system;
new text end
new text begin
(5) support for other foundational skills identified by the commissioner;
new text end
new text begin
(6) support for immigrant international medical graduates in becoming certified
by the Educational Commission on Foreign Medical Graduates, including help with
preparation for required licensing examinations and financial assistance for fees; and
new text end
new text begin
(7) assistance to international medical graduates in registering with the program's
Minnesota international medical graduate roster.
new text end
new text begin
(b) The commissioner shall award the initial grants under this subdivision by
December 31, 2015.
new text end
new text begin Subd. 5. new text end
new text begin Clinical preparation. new text end
new text begin
(a) The commissioner shall award grants to support
clinical preparation for Minnesota international medical graduates needing additional
clinical preparation or experience to qualify for residency. The grant program shall include:
new text end
new text begin
(1) proposed training curricula;
new text end
new text begin
(2) associated policies and procedures for clinical training sites, which must be part
of existing clinical medical education programs in Minnesota; and
new text end
new text begin
(3) monthly stipends for international medical graduate participants. Priority shall
be given to primary care sites in rural or underserved areas of the state, and international
medical graduate participants must commit to serving at least five years in a rural or
underserved community of the state.
new text end
new text begin
(b) The policies and procedures for the clinical preparation grants must be developed
by December 31, 2015, including an implementation schedule that begins awarding grants
to clinical preparation programs beginning in June of 2016.
new text end
new text begin Subd. 6. new text end
new text begin
International medical graduate primary care residency grant program
and revolving account.
new text end
new text begin
(a) The commissioner shall award grants to support primary
care residency positions designated for Minnesota immigrant physicians who are willing
to serve in rural or underserved areas of the state. No grant shall exceed $150,000 per
residency position per year. Eligible primary care residency grant recipients include
accredited family medicine, internal medicine, obstetrics and gynecology, psychiatry, and
pediatric residency programs. Eligible primary care residency programs shall apply to the
commissioner. Applications must include the number of anticipated residents to be funded
using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded
to grantees in a grant agreement do not lapse until the grant agreement expires. Before any
funds are distributed, a grant recipient shall provide the commissioner with the following:
new text end
new text begin
(1) a copy of the signed contract between the primary care residency program and
the participating international medical graduate;
new text end
new text begin
(2) certification that the participating international medical graduate has lived in
Minnesota for at least two years and is certified by the Educational Commission on
Foreign Medical Graduates. Residency programs may also require that participating
international medical graduates hold a Minnesota certificate of clinical readiness for
residency, once the certificates become available; and
new text end
new text begin
(3) verification that the participating international medical graduate has executed a
participant agreement pursuant to paragraph (b).
new text end
new text begin
(b) Upon acceptance by a participating residency program, international medical
graduates shall enter into an agreement with the commissioner to provide primary
care for at least five years in a rural or underserved area of Minnesota after graduating
from the residency program and make payments to the revolving international medical
graduate residency account for five years beginning in their second year of postresidency
employment. Participants shall pay $15,000 or ten percent of their annual compensation
each year, whichever is less.
new text end
new text begin
(c) A revolving international medical graduate residency account is established
as an account in the special revenue fund in the state treasury. The commissioner of
management and budget shall credit to the account appropriations, payments, and
transfers to the account. Earnings, such as interest, dividends, and any other earnings
arising from fund assets, must be credited to the account. Funds in the account are
appropriated annually to the commissioner to award grants and administer the grant
program established in paragraph (a). Notwithstanding any law to the contrary, any funds
deposited in the account do not expire. The commissioner may accept contributions to the
account from private sector entities subject to the following provisions:
new text end
new text begin
(1) the contributing entity may not specify the recipient or recipients of any grant
issued under this subdivision;
new text end
new text begin
(2) the commissioner shall make public the identity of any private contributor to the
account, as well as the amount of the contribution provided; and
new text end
new text begin
(3) a contributing entity may not specify that the recipient or recipients of any funds
use specific products or services, nor may the contributing entity imply that a contribution
is an endorsement of any specific product or service.
new text end
new text begin Subd. 7. new text end
new text begin Voluntary hospital programs. new text end
new text begin
A hospital may establish residency
programs for foreign-trained physicians to become candidates for licensure to practice
medicine in the state of Minnesota. A hospital may partner with organizations, such as
the New Americans Alliance for Development, to screen for and identify foreign-trained
physicians eligible for a hospital's particular residency program.
new text end
new text begin Subd. 8. new text end
new text begin Board of Medical Practice. new text end
new text begin
Nothing in this section alters the authority of
the Board of Medical Practice to regulate the practice of medicine.
new text end
new text begin Subd. 9. new text end
new text begin Consultation with stakeholders. new text end
new text begin
The commissioner shall administer the
international medical graduates assistance program, including the grant programs described
under subdivisions 4, 5, and 6, in consultation with representatives of the following sectors:
new text end
new text begin
(1) state agencies:
new text end
new text begin
(i) Board of Medical Practice;
new text end
new text begin
(ii) Office of Higher Education; and
new text end
new text begin
(iii) Department of Employment and Economic Development;
new text end
new text begin
(2) health care industry:
new text end
new text begin
(i) a health care employer in a rural or underserved area of Minnesota;
new text end
new text begin
(ii) a health plan company;
new text end
new text begin
(iii) the Minnesota Medical Association;
new text end
new text begin
(iv) licensed physicians experienced in working with international medical
graduates; and
new text end
new text begin
(v) the Minnesota Academy of Physician Assistants;
new text end
new text begin
(3) community-based organizations:
new text end
new text begin
(i) organizations serving immigrant and refugee communities of Minnesota;
new text end
new text begin
(ii) organizations serving the international medical graduate community, such as the
New Americans Alliance for Development and Women's Initiative for Self Empowerment;
and
new text end
new text begin
(iii) the Minnesota Association of Community Health Centers;
new text end
new text begin
(4) higher education:
new text end
new text begin
(i) University of Minnesota;
new text end
new text begin
(ii) Mayo Clinic School of Health Professions;
new text end
new text begin
(iii) graduate medical education programs not located at the University of Minnesota
or Mayo Clinic School of Health Professions; and
new text end
new text begin
(iv) Minnesota physician assistant education program; and
new text end
new text begin
(5) two international medical graduates.
new text end
new text begin Subd. 10. new text end
new text begin Report. new text end
new text begin
The commissioner shall submit an annual report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health care
and higher education on the progress of the integration of international medical graduates
into the Minnesota health care delivery system. The report shall include recommendations
on actions needed for continued progress integrating international medical graduates. The
report shall be submitted by January 15 each year, beginning January 15, 2016.
new text end
Sec. 18.
Minnesota Statutes 2014, section 144.291, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For the purposes of sections 144.291 to 144.298, the following
terms have the meanings given.
(a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
(b) "Health information exchange" means a legal arrangement between health care
providers and group purchasers to enable and oversee the business and legal issues
involved in the electronic exchange of health records between the entities for the delivery
of patient care.
(c) "Health record" means any information, whether oral or recorded in any form or
medium, that relates to the past, present, or future physical or mental health or condition of
a patient; the provision of health care to a patient; or the past, present, or future payment
for the provision of health care to a patient.
(d) "Identifying information" means the patient's name, address, date of birth,
gender, parent's or guardian's name regardless of the age of the patient, and other
nonclinical data which can be used to uniquely identify a patient.
(e) "Individually identifiable form" means a form in which the patient is or can be
identified as the subject of the health records.
(f) "Medical emergency" means medically necessary care which is immediately
needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
or prevent placing the physical or mental health of the patient in serious jeopardy.
(g) "Patient" means a natural person who has received health care services from a
provider for treatment or examination of a medical, psychiatric, or mental condition, the
surviving spouse and parents of a deceased patient, or a person the patient appoints in
writing as a representative, including a health care agent acting according to chapter 145C,
unless the authority of the agent has been limited by the principal in the principal's health
care directive. Except for minors who have received health care services under sections
144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a
person acting as a parent or guardian in the absence of a parent or guardian.
new text begin
(h) "Patient information service" means a service providing the following query
options: a record locator service as defined in section 144.291, subdivision 2, paragraph
(i), or a master patient index or clinical data repository as defined in section 62J.498,
subdivision 1.
new text end
deleted text begin (h)deleted text end new text begin (i)new text end "Provider" means:
(1) any person who furnishes health care services and is regulated to furnish the
services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148D, 148F, 150A,
151, 153, or 153A;
(2) a home care provider licensed under section deleted text begin 144A.46deleted text end new text begin 144A.471new text end ;
(3) a health care facility licensed under this chapter or chapter 144A; and
(4) a physician assistant registered under chapter 147A.
deleted text begin (i)deleted text end new text begin (j)new text end "Record locator service" means an electronic index of patient identifying
information that directs providers in a health information exchange to the location of
patient health records held by providers and group purchasers.
deleted text begin (j)deleted text end new text begin (k)new text end "Related health care entity" means an affiliate, as defined in section 144.6521,
subdivision 3, paragraph (b), of the provider releasing the health records.
Sec. 19.
Minnesota Statutes 2014, section 144.293, subdivision 5, is amended to read:
Subd. 5.
Exceptions to consent requirement.
new text begin (a) new text end This section does not prohibit the
release of health records:
(1) for a medical emergency when the provider is unable to obtain the patient's
consent due to the patient's condition or the nature of the medical emergency;
(2) to other providers within related health care entities when necessary for the
current treatment of the patient; or
(3) to a health care facility licensed by this chapter, chapter 144A, or to the same
types of health care facilities licensed by this chapter and chapter 144A that are licensed
in another state when a patient:
(i) is returning to the health care facility and unable to provide consent; or
(ii) who resides in the health care facility, has services provided by an outside
resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
to provide consent.
new text begin
(b) A provider may release a deceased patient's health care records to another provider
for the purposes of diagnosing or treating the deceased patient's surviving adult child.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 20.
Minnesota Statutes 2014, section 144.293, subdivision 8, is amended to read:
Subd. 8.
Record locator new text begin or patient information new text end service.
(a) A provider or group
purchaser may release patient identifying information and information about the location
of the patient's health records to a record locator new text begin or patient information new text end service without
consent from the patient, unless the patient has elected to be excluded from the service
under paragraph (d). The Department of Health may not access the record locator new text begin or
patient information new text end service or receive data from the deleted text begin record locatordeleted text end service. Only a
provider may have access to patient identifying information in a record locator new text begin or patient
information new text end service. Except in the case of a medical emergency, a provider participating in
a health information exchange using a record locator new text begin or patient information new text end service does
not have access to patient identifying information and information about the location of
the patient's health records unless the patient specifically consents to the access. A consent
does not expire but may be revoked by the patient at any time by providing written notice
of the revocation to the provider.
(b) A health information exchange maintaining a record locator new text begin or patient
information new text end service must maintain an audit log of providers accessing information in deleted text begin a
record locatordeleted text end new text begin thenew text end service that at least contains information on:
(1) the identity of the provider accessing the information;
(2) the identity of the patient whose information was accessed by the provider; and
(3) the date the information was accessed.
(c) No group purchaser may in any way require a provider to participate in a record
locator new text begin or patient information new text end service as a condition of payment or participation.
(d) A provider or an entity operating a record locator new text begin or patient information new text end service
must provide a mechanism under which patients may exclude their identifying information
and information about the location of their health records from a record locator new text begin or patient
information new text end service. At a minimum, a consent form that permits a provider to access
a record locator new text begin or patient information new text end service must include a conspicuous check-box
option that allows a patient to exclude all of the patient's information from the deleted text begin record
locatordeleted text end service. A provider participating in a health information exchange with a record
locator new text begin or patient information new text end service who receives a patient's request to exclude all of the
patient's information from the deleted text begin record locatordeleted text end service or to have a specific provider contact
excluded from the deleted text begin record locatordeleted text end service is responsible for removing that information
from the deleted text begin record locatordeleted text end service.
Sec. 21.
Minnesota Statutes 2014, section 144.298, subdivision 2, is amended to read:
Subd. 2.
Liability of provider or other person.
A person who does any of the
following is liable to the patient for compensatory damages caused by an unauthorized
release or an intentional, unauthorized access, plus costs and reasonable attorney fees:
(1) negligently or intentionally requests or releases a health record in violation
of sections 144.291 to 144.297;
(2) forges a signature on a consent form or materially alters the consent form of
another person without the person's consent;
(3) obtains a consent form or the health records of another person under false
pretenses; or
(4) intentionally violates sections 144.291 to 144.297 by intentionally accessing a
record locator new text begin or patient information new text end service without authorization.
Sec. 22.
Minnesota Statutes 2014, section 144.298, subdivision 3, is amended to read:
Subd. 3.
Liability for record locator new text begin or patient information new text end service.
A patient
is entitled to receive compensatory damages plus costs and reasonable attorney fees
if a health information exchange maintaining a record locator new text begin or patient information
new text end service, or an entity maintaining a record locator new text begin or patient information new text end service for a
health information exchange, negligently or intentionally violates the provisions of section
144.293, subdivision 8.
Sec. 23.
new text begin
[144.3875] EARLY DENTAL PREVENTION INITIATIVE.
new text end
new text begin
(a) The commissioner of health, in collaboration with the commissioner of human
services, shall implement a statewide initiative to increase awareness among communities
of color and recent immigrants on the importance of early preventive dental intervention
for infants and toddlers before and after primary teeth appear.
new text end
new text begin
(b) The commissioner shall develop educational materials and information for
expectant and new parents within the targeted communities that include the importance
of early dental care to prevent early cavities, including proper cleaning techniques and
feeding habits, before and after primary teeth appear.
new text end
new text begin
(c) The commissioner shall develop a distribution plan to ensure that the materials
are distributed to expectant and new parents within the targeted communities, including,
but not limited to, making the materials available to health care providers, community
clinics, WIC sites, and other relevant sites within the targeted communities.
new text end
new text begin
(d) In developing these materials and distribution plan, the commissioner shall work
collaboratively with members of the targeted communities, dental providers, pediatricians,
child care providers, and home visiting nurses.
new text end
new text begin
(e) The commissioner shall, with input from stakeholders listed in paragraph (d),
develop and pilot incentives to encourage early dental care within one year of an infant's
teeth erupting.
new text end
Sec. 24.
new text begin
[144.4961] MINNESOTA RADON LICENSING ACT.
new text end
new text begin Subdivision 1. new text end
new text begin Citation. new text end
new text begin
This section may be cited as the "Minnesota Radon
Licensing Act."
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) As used in this section, the following terms have the
meanings given them.
new text end
new text begin
(b) "Mitigation" means the act of repairing or altering a building or building design
for the purpose in whole or in part of reducing the concentration of radon in the indoor
atmosphere.
new text end
new text begin
(c) "Radon" means both the radioactive, gaseous element produced by the
disintegration of radium, and the short-lived radionuclides that are decay products of radon.
new text end
new text begin Subd. 3. new text end
new text begin Rulemaking. new text end
new text begin
The commissioner of health shall adopt rules for licensure
and enforcement of applicable laws and rules relating to indoor radon in dwellings and
other buildings, with the exception of newly constructed Minnesota homes according
to section 326B.106, subdivision 6. The commissioner shall coordinate, oversee, and
implement all state functions in matters concerning the presence, effects, measurement,
and mitigation of risks of radon in dwellings and other buildings.
new text end
new text begin Subd. 4. new text end
new text begin System tag. new text end
new text begin
All radon mitigation systems installed in Minnesota on or after
October 1, 2017, must have a radon mitigation system tag provided by the commissioner.
A radon mitigation professional must attach the tag to the radon mitigation system in
a visible location.
new text end
new text begin Subd. 5. new text end
new text begin License required annually. new text end
new text begin
A license is required annually for every
person, firm, or corporation that sells a device or performs a service for compensation
to detect the presence of radon in the indoor atmosphere, performs laboratory analysis,
or performs a service to mitigate radon in the indoor atmosphere. This section does not
apply to retail stores that only sell or distribute radon sampling but are not engaged in the
manufacture of radon sampling devices.
new text end
new text begin Subd. 6. new text end
new text begin Exemptions. new text end
new text begin
Radon systems installed in newly constructed Minnesota
homes according to section 326B.106, subdivision 6, prior to the issuance of a certificate
of occupancy are not required to follow the requirements of this section.
new text end
new text begin Subd. 7. new text end
new text begin License applications and other reports. new text end
new text begin
The professionals, companies,
and laboratories listed in subdivision 8 must submit applications for licenses, system
tags, and any other reporting required under this section and Minnesota Rules on forms
prescribed by the commissioner.
new text end
new text begin Subd. 8. new text end
new text begin Licensing fees. new text end
new text begin
(a) All radon license applications submitted to the
commissioner of health must be accompanied by the required fees. If the commissioner
determines that insufficient fees were paid, the necessary additional fees must be paid
before the commissioner approves the application. The commissioner shall charge the
following fees for each radon license:
new text end
new text begin
(1) Each measurement professional license, $300 per year. "Measurement
professional" means any person who performs a test to determine the presence and
concentration of radon in a building they do not own or lease; provides professional or
expert advice on radon testing, radon exposure, or health risks related to radon exposure;
or makes representations of doing any of these activities.
new text end
new text begin
(2) Each mitigation professional license, $500 per year. "Mitigation professional"
means an individual who performs radon mitigation in a building they do not own or
lease; provides professional or expert advice on radon mitigation or radon entry routes;
or provides on-site supervision of radon mitigation and mitigation technicians; or makes
representations of doing any of these activities. This license also permits the licensee to
perform the activities of a measurement professional described in clause (1).
new text end
new text begin
(3) Each mitigation company license, $500 per year. "Mitigation company" means
any business or government entity that performs or authorizes employees to perform radon
mitigation. This fee is waived if the company is a sole proprietorship.
new text end
new text begin
(4) Each radon analysis laboratory license, $500 per year. "Radon analysis
laboratory" means a business entity or government entity that analyzes passive radon
detection devices to determine the presence and concentration of radon in the devices.
This fee is waived if the laboratory is a government entity and is only distributing test kits
for the general public to use in Minnesota.
new text end
new text begin
(5) Each Minnesota Department of Health radon mitigation system tag, $75 per tag.
"Minnesota Department of Health radon mitigation system tag" or "system tag" means a
unique identifiable radon system label provided by the commissioner of health.
new text end
new text begin
(b) Fees collected under this section shall be deposited in the state treasury and
credited to the state government special revenue fund.
new text end
new text begin Subd. 9. new text end
new text begin Enforcement. new text end
new text begin
The commissioner shall enforce this section under the
provisions of sections 144.989 to 144.993.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2015, except subdivisions 4
and 5, which are effective October 1, 2017.
new text end
Sec. 25.
new text begin
[144.566] VIOLENCE AGAINST HEALTH CARE WORKERS.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) The following definitions apply to this section and
have the meanings given.
new text end
new text begin
(b) "Act of violence" means an act by a patient or visitor against a health care
worker that includes kicking, scratching, urinating, sexually harassing, or any act defined
in sections 609.221 to 609.2241.
new text end
new text begin
(c) "Commissioner" means the commissioner of health.
new text end
new text begin
(d) "Health care worker" means any person, whether licensed or unlicensed,
employed by, volunteering in, or under contract with a hospital, who has direct contact
with a patient of the hospital for purposes of either medical care or emergency response to
situations potentially involving violence.
new text end
new text begin
(e) "Hospital" means any facility licensed as a hospital under section 144.55.
new text end
new text begin
(f) "Incident response" means the actions taken by hospital administration and health
care workers during and following an act of violence.
new text end
new text begin
(g) "Interfere" means to prevent, impede, discourage, or delay a health care worker's
ability to report acts of violence, including by retaliating or threatening to retaliate against
a health care worker.
new text end
new text begin
(h) "Preparedness" means the actions taken by hospital administration and health
care workers to prevent a single act of violence or acts of violence generally.
new text end
new text begin
(i) "Retaliate" means to discharge, discipline, threaten, otherwise discriminate
against, or penalize a health care worker regarding the health care worker's compensation,
terms, conditions, location, or privileges of employment.
new text end
new text begin Subd. 2. new text end
new text begin Hospital duties. new text end
new text begin
(a) All hospitals must design and implement preparedness
and incident response action plans to acts of violence by January 15, 2016, and review the
plan at least annually thereafter.
new text end
new text begin
(b) A hospital shall designate a committee of representatives of health care workers
employed by the hospital, including nonmanagerial health care workers, nonclinical
staff, administrators, patient safety experts, and other appropriate personnel to develop
preparedness and incident response action plans to acts of violence. The hospital shall, in
consultation with the designated committee, implement the plans under paragraph (a).
Nothing in this paragraph shall require the establishment of a separate committee solely
for the purpose required by this subdivision.
new text end
new text begin
(c) A hospital shall provide training to all health care workers employed or
contracted with the hospital on safety during acts of violence. Each health care worker
must receive safety training annually and upon hire. Training must, at a minimum, include:
new text end
new text begin
(1) safety guidelines for response to and de-escalation of an act of violence;
new text end
new text begin
(2) ways to identify potentially violent or abusive situations; and
new text end
new text begin
(3) the hospital's incident response reaction plan and violence prevention plan.
new text end
new text begin
(d) As part of its annual review required under paragraph (a), the hospital must
review with the designated committee:
new text end
new text begin
(1) the effectiveness of its preparedness and incident response action plans;
new text end
new text begin
(2) the most recent gap analysis as provided by the commissioner; and
new text end
new text begin
(3) the number of acts of violence that occurred in the hospital during the previous
year, including injuries sustained, if any, and the unit in which the incident occurred.
new text end
new text begin
(e) A hospital shall make its action plans and the information listed in paragraph
(d) available to local law enforcement and, if any of its workers are represented by a
collective bargaining unit, to the exclusive bargaining representatives of those collective
bargaining units.
new text end
new text begin
(f) A hospital, including any individual, partner, association, or any person or group
of persons acting directly or indirectly in the interest of the hospital, shall not interfere
with or discourage a health care worker if the health care worker wishes to contact law
enforcement or the commissioner regarding an act of violence.
new text end
new text begin
(g) The commissioner may impose an administrative fine of up to $250 for failure to
comply with the requirements of subdivision 2.
new text end
Sec. 26.
new text begin
[144.586] REQUIREMENTS FOR CERTAIN NOTICES AND
DISCHARGE PLANNING.
new text end
new text begin Subdivision 1. new text end
new text begin Observation stay notice. new text end
new text begin
(a) Each hospital, as defined under
section 144.50, subdivision 2, shall provide oral and written notice to each patient that
the hospital places in observation status of such placement not later than 24 hours after
such placement. The oral and written notices must include:
new text end
new text begin
(1) a statement that the patient is not admitted to the hospital but is under observation
status;
new text end
new text begin
(2) a statement that observation status may affect the patient's Medicare coverage for:
new text end
new text begin
(i) hospital services, including medications and pharmaceutical supplies; or
new text end
new text begin
(ii) home or community-based care or care at a skilled nursing facility upon the
patient's discharge; and
new text end
new text begin
(3) a recommendation that the patient contact the patient's health insurance provider
or the Office of the Ombudsman for Long-Term Care or Office of the Ombudsman for
State Managed Health Care Programs or the Beneficiary and Family Centered Care
Quality Improvement Organization to better understand the implications of placement in
observation status.
new text end
new text begin
(b) The hospital shall document the date in the patient's record that the notice
required in paragraph (a) was provided to the patient, the patient's designated
representative such as the patient's health care agent, legal guardian, conservator, or
another person acting as the patient's representative.
new text end
new text begin Subd. 2. new text end
new text begin Postacute care discharge planning. new text end
new text begin
Each hospital, including hospitals
designated as critical access hospitals, must comply with the federal hospital requirements
for discharge planning which include:
new text end
new text begin
(1) conducting a discharge planning evaluation that includes an evaluation of:
new text end
new text begin
(i) the likelihood of the patient needing posthospital services and of the availability
of those services; and
new text end
new text begin
(ii) the patient's capacity for self-care or the possibility of the patient being cared for
in the environment from which the patient entered the hospital;
new text end
new text begin
(2) timely completion of the discharge planning evaluation under clause (1) by
hospital personnel so that appropriate arrangements for posthospital care are made before
discharge, and to avoid unnecessary delays in discharge;
new text end
new text begin
(3) including the discharge planning evaluation under clause (1) in the patient's
medical record for use in establishing an appropriate discharge plan. The hospital must
discuss the results of the evaluation with the patient or individual acting on behalf of the
patient. The hospital must reassess the patient's discharge plan if the hospital determines
that there are factors that may affect continuing care needs or the appropriateness of
the discharge plan; and
new text end
new text begin
(4) providing counseling, as needed, for the patient and family members or interested
persons to prepare them for posthospital care. The hospital must provide a list of available
Medicare-eligible home care agencies or skilled nursing facilities that serve the patient's
geographic area, or other area requested by the patient if such care or placement is
indicated and appropriate. Once the patient has designated their preferred providers, the
hospital will assist the patient in securing care covered by their health plan or within the
care network. The hospital must not specify or otherwise limit the qualified providers that
are available to the patient. The hospital must document in the patient's record that the list
was presented to the patient or to the individual acting on the patient's behalf.
new text end
Sec. 27.
Minnesota Statutes 2014, section 144.9501, subdivision 6d, is amended to read:
Subd. 6d.
Certified lead firm.
"Certified lead firm" means a person that employs
individuals to perform regulated lead worknew text begin , with the exception of renovation,new text end and deleted text begin that
deleted text end is certified by the commissioner under section 144.9505.
Sec. 28.
Minnesota Statutes 2014, section 144.9501, is amended by adding a
subdivision to read:
new text begin Subd. 6e. new text end
new text begin Certified renovation firm. new text end
new text begin
"Certified renovation firm" means a person
that employs individuals to perform renovation and is certified by the commissioner
under section 144.9505.
new text end
Sec. 29.
Minnesota Statutes 2014, section 144.9501, subdivision 22b, is amended to
read:
Subd. 22b.
Lead sampling technician.
"Lead sampling technician" means an
individual who performs clearance inspections for renovation sites and lead dust sampling
for nonabatement sitesdeleted text begin , and who is registered with the commissioner under section
144.9505deleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 30.
Minnesota Statutes 2014, section 144.9501, subdivision 26b, is amended to
read:
Subd. 26b.
Renovation.
"Renovation" means the modification of any new text begin pre-1978
new text end affected property that results in the disturbance of new text begin known or presumed lead-containing
new text end painted surfacesnew text begin defined under section 144.9508new text end , unless that activity is performed as deleted text begin an
abatementdeleted text end new text begin lead hazard reductionnew text end . A renovation performed for the purpose of converting a
building or part of a building into an affected property is a renovation under this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 31.
Minnesota Statutes 2014, section 144.9501, is amended by adding a
subdivision to read:
new text begin Subd. 26c. new text end
new text begin Lead renovator. new text end
new text begin
"Lead renovator" means an individual who directs
individuals who perform renovations. A lead renovator also performs renovation, surface
coating testing, and cleaning verification.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 32.
Minnesota Statutes 2014, section 144.9505, is amended to read:
144.9505 deleted text begin LICENSINGdeleted text end new text begin CREDENTIALINGnew text end OF LEAD FIRMS AND
PROFESSIONALS.
Subdivision 1.
Licensing deleted text begin anddeleted text end new text begin ,new text end certificationdeleted text begin ; generallydeleted text end new text begin , and permittingnew text end .
(a) deleted text begin All
deleted text end Fees deleted text begin received shall be paiddeleted text end new text begin collected under this section shall be depositednew text end into the state
treasury and credited to the deleted text begin lead abatement licensing and certification account and are
appropriated to the commissioner to cover costs incurred under this section and section
144.9508deleted text end new text begin state government special revenue fundnew text end .
(b) Persons shall not advertise or otherwise present themselves as lead supervisors,
lead workers, lead inspectors, lead risk assessors, lead sampling technicians, lead project
designers, deleted text begin ordeleted text end new text begin renovation firms, or new text end lead firms unless they have licenses or certificates issued
by deleted text begin or are registered withdeleted text end the commissioner under this section.
(c) The fees required in this section for inspectors, risk assessors, and certified lead
firms are waived for state or local government employees performing services for or
as an assessing agency.
(d) An individual who is the owner of property on which regulated lead work is to be
performed or an adult individual who is related to the property owner, as defined under
section 245A.02, subdivision 13, is exempt from the requirements to obtain a license and
pay a fee according to this section.
(e) A person that employs individuals to perform regulated lead work outside of the
person's property must obtain certification as a certified lead firm. An individual who
performs deleted text begin regulated lead workdeleted text end new text begin lead hazard reduction, lead hazard screens, lead inspections,
lead risk assessments, clearance inspections, lead project designer services, lead sampling
technician services, swab team services, and activities performed to comply with lead
ordersnew text end must be employed by a certified lead firm, unless the individual is a sole proprietor
and does not employ any other deleted text begin individual who performs regulated lead workdeleted text end new text begin individualsnew text end ,
the individual is employed by a person that does not perform regulated lead work outside
of the person's property, or the individual is employed by an assessing agency.
Subd. 1a.
Lead worker license.
Before an individual performs regulated lead work
as a worker, the individual shall first obtain a license from the commissioner. No license
shall be issued unless the individual shows evidence of successfully completing a training
course in lead hazard control. The commissioner shall specify the course of training and
testing requirements and shall charge a $50 fee new text begin annually new text end for the license. License fees are
nonrefundable and must be submitted with each application. The license must be carried
by the individual and be readily available for review by the commissioner and other public
health officials charged with the health, safety, and welfare of the state's citizens.
Subd. 1b.
Lead supervisor license.
Before an individual performs regulated lead
work as a supervisor, the individual shall first obtain a license from the commissioner. No
license shall be issued unless the individual shows evidence of experience and successful
completion of a training course in lead hazard control. The commissioner shall specify
the course of training, experience, and testing requirements and shall charge a $50 fee
new text begin annually new text end for the license. License fees are nonrefundable and must be submitted with
each application. The license must be carried by the individual and be readily available
for review by the commissioner and other public health officials charged with the health,
safety, and welfare of the state's citizens.
Subd. 1c.
Lead inspector license.
Before an individual performs lead inspection
services, the individual shall first obtain a license from the commissioner. No license shall
be issued unless the individual shows evidence of successfully completing a training
course in lead inspection. The commissioner shall specify the course of training and
testing requirements and shall charge a $50 fee new text begin annually new text end for the license. License fees are
nonrefundable and must be submitted with each application. The license must be carried
by the individual and be readily available for review by the commissioner and other public
health officials charged with the health, safety, and welfare of the state's citizens.
Subd. 1d.
Lead risk assessor license.
Before an individual performs lead risk
assessor services, the individual shall first obtain a license from the commissioner. No
license shall be issued unless the individual shows evidence of experience and successful
completion of a training course in lead risk assessment. The commissioner shall specify
the course of training, experience, and testing requirements and shall charge a $100 fee
new text begin annually new text end for the license. License fees are nonrefundable and must be submitted with
each application. The license must be carried by the individual and be readily available
for review by the commissioner and other public health officials charged with the health,
safety, and welfare of the state's citizens.
Subd. 1e.
Lead project designer license.
Before an individual performs lead
project designer services, the individual shall first obtain a license from the commissioner.
No license shall be issued unless the individual shows evidence of experience and
successful completion of a training course in lead project design. The commissioner shall
specify the course of training, experience, and testing requirements and shall charge a
$100 fee new text begin annually new text end for the license. License fees are nonrefundable and must be submitted
with each application. The license must be carried by the individual and be readily
available for review by the commissioner and other public health officials charged with
the health, safety, and welfare of the state's citizens.
deleted text begin Subd. 1f. deleted text end
deleted text begin Lead sampling technician. deleted text end
deleted text begin
An individual performing lead sampling
technician services shall first register with the commissioner. The commissioner shall not
register an individual unless the individual shows evidence of successfully completing a
training course in lead sampling. The commissioner shall specify the course of training
and testing requirements. Proof of registration must be carried by the individual and be
readily available for review by the commissioner and other public health officials charged
with the health, safety, and welfare of the state's citizens.
deleted text end
Subd. 1g.
Certified lead firm.
A person who employs individuals to perform
regulated lead worknew text begin , with the exception of renovation,new text end outside of the person's property
must obtain certification as a lead firm. The certificate must be in writing, contain an
expiration date, be signed by the commissioner, and give the name and address of the
person to whom it is issued. new text begin A lead firm certificate is valid for one year. new text end The certification
fee is $100, is nonrefundable, and must be submitted with each application. The new text begin lead firm
new text end certificate or a copy of the certificate must be readily available at the worksite for review
by the contracting entity, the commissioner, and other public health officials charged with
the health, safety, and welfare of the state's citizens.
new text begin Subd. 1h. new text end
new text begin Certified renovation firm. new text end
new text begin
A person who employs individuals to
perform renovation activities outside of the person's property must obtain certification
as a renovation firm. The certificate must be in writing, contain an expiration date, be
signed by the commissioner, and give the name and address of the person to whom it is
issued. A renovation firm certificate is valid for two years. The certification fee is $100,
is nonrefundable, and must be submitted with each application. The renovation firm
certificate or a copy of the certificate must be readily available at the worksite for review
by the contracting entity, the commissioner, and other public health officials charged with
the health, safety, and welfare of the state's citizens.
new text end
new text begin Subd. 1i. new text end
new text begin Lead training course. new text end
new text begin
Before a person provides training to lead
workers, lead supervisors, lead inspectors, lead risk assessors, lead project designers, lead
sampling technicians, and lead renovators, the person shall first obtain a permit from the
commissioner. The permit must be in writing, contain an expiration date, be signed by
the commissioner, and give the name and address of the person to whom it is issued.
A training course permit is valid for two years. Training course permit fees shall be
nonrefundable and must be submitted with each application in the amount of $500 for an
initial training course, $250 for renewal of a permit for an initial training course, $250 for
a refresher training course, and $125 for renewal of a permit of a refresher training course.
new text end
Subd. 3.
Licensed building contractor; information.
The commissioner shall
provide health and safety information on lead abatement and lead hazard reduction to all
residential building contractors licensed under section 326B.805. The information must
include the lead-safe practices and any other materials describing ways to protect the
health and safety of both employees and residents.
Subd. 4.
Notice of regulated lead work.
(a) At least five working days before
starting work at each regulated lead worksite, the person performing the regulated lead
work shall give written notice to the commissioner and the appropriate board of health.
(b) This provision does not apply to lead hazard screen, lead inspection, lead risk
assessment, lead sampling technician, renovation, or lead project design activities.
Subd. 6.
Duties of contracting entity.
A contracting entity intending to have
regulated lead work performed for its benefit shall include in the specifications and
contracts for the work a requirement that the work be performed by contractors and
subcontractors licensed by the commissioner under sections 144.9501 to 144.9512 and
according to rules adopted by the commissioner related to regulated lead work. No
contracting entity shall allow regulated lead work to be performed for its benefit unless the
contracting entity has seen that the person has a valid license or certificate. A contracting
entity's failure to comply with this subdivision does not relieve a person from any
responsibility under sections 144.9501 to 144.9512.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 33.
Minnesota Statutes 2014, section 144.9508, is amended to read:
144.9508 RULES.
Subdivision 1.
Sampling and analysis.
The commissioner shall adopt, by rule,
methods for:
(1) lead inspections, lead hazard screens, lead risk assessments, and clearance
inspections;
(2) environmental surveys of lead in paint, soil, dust, and drinking water to determine
areas at high risk for toxic lead exposure;
(3) soil sampling for soil used as replacement soil;
(4) drinking water sampling, which shall be done in accordance with lab certification
requirements and analytical techniques specified by Code of Federal Regulations, title
40, section 141.89; and
(5) sampling to determine whether at least 25 percent of the soil samples collected
from a census tract within a standard metropolitan statistical area contain lead in
concentrations that exceed 100 parts per million.
Subd. 2.
Regulated lead work standards and methods.
(a) The commissioner shall
adopt rules establishing regulated lead work standards and methods in accordance with the
provisions of this section, for lead in paint, dust, drinking water, and soil in a manner that
protects public health and the environment for all residences, including residences also
used for a commercial purpose, child care facilities, playgrounds, and schools.
(b) In the rules required by this section, the commissioner shall require lead hazard
reduction of intact paint only if the commissioner finds that the intact paint is on a
chewable or lead-dust producing surface that is a known source of actual lead exposure to
a specific individual. The commissioner shall prohibit methods that disperse lead dust into
the air that could accumulate to a level that would exceed the lead dust standard specified
under this section. The commissioner shall work cooperatively with the commissioner
of administration to determine which lead hazard reduction methods adopted under this
section may be used for lead-safe practices including prohibited practices, preparation,
disposal, and cleanup. The commissioner shall work cooperatively with the commissioner
of the Pollution Control Agency to develop disposal procedures. In adopting rules under
this section, the commissioner shall require the best available technology for regulated
lead work methods, paint stabilization, and repainting.
(c) The commissioner of health shall adopt regulated lead work standards and
methods for lead in bare soil in a manner to protect public health and the environment.
The commissioner shall adopt a maximum standard of 100 parts of lead per million in
bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts
of lead per million. Soil lead hazard reduction methods shall focus on erosion control
and covering of bare soil.
(d) The commissioner shall adopt regulated lead work standards and methods for lead
in dust in a manner to protect the public health and environment. Dust standards shall use
a weight of lead per area measure and include dust on the floor, on the window sills, and
on window wells. Lead hazard reduction methods for dust shall focus on dust removal and
other practices which minimize the formation of lead dust from paint, soil, or other sources.
(e) The commissioner shall adopt lead hazard reduction standards and methods for
lead in drinking water both at the tap and public water supply system or private well
in a manner to protect the public health and the environment. The commissioner may
adopt the rules for controlling lead in drinking water as contained in Code of Federal
Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include
an educational approach of minimizing lead exposure from lead in drinking water.
(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
removal of exterior lead-based coatings from residences and steel structures by abrasive
blasting methods is conducted in a manner that protects health and the environment.
(g) All regulated lead work standards shall provide reasonable margins of safety that
are consistent with more than a summary review of scientific evidence and an emphasis on
overprotection rather than underprotection when the scientific evidence is ambiguous.
(h) No unit of local government shall have an ordinance or regulation governing
regulated lead work standards or methods for lead in paint, dust, drinking water, or soil
that require a different regulated lead work standard or method than the standards or
methods established under this section.
(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit
of local government of an innovative lead hazard reduction method which is consistent
in approach with methods established under this section.
(j) The commissioner shall adopt rules for issuing lead orders required under section
144.9504, rules for notification of abatement or interim control activities requirements,
and other rules necessary to implement sections 144.9501 to 144.9512.
(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the
Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property
where a child or pregnant female resides is conducted in a manner that protects health
and the environment.new text begin Notwithstanding sections 14.125 and 14.128, the authority to adopt
these rules does not expire.
new text end
(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b)
of the Toxic Substances Control Act.new text begin Notwithstanding sections 14.125 and 14.128, the
authority to adopt these rules does not expire.
new text end
Subd. 2a.
Lead standards for exterior surfaces and street dust.
The
commissioner may, by rule, establish lead standards for exterior horizontal surfaces,
concrete or other impervious surfaces, and street dust on residential property to protect the
public health and the environment.
Subd. 3.
Licensure and certification.
The commissioner shall adopt rules to license
lead supervisors, lead workers, lead project designers, lead inspectors, lead risk assessors,
and lead sampling technicians. The commissioner shall also adopt rules requiring
certification of firms that perform regulated lead work. The commissioner shall require
periodic renewal of licenses and certificates and shall establish the renewal periods.
Subd. 4.
Lead training course.
The commissioner shall establish by rule
requirements for training course providers and the renewal period for each lead-related
training course required for certification or licensure. The commissioner shall establish
criteria in rules for the content and presentation of training courses intended to qualify
trainees for licensure under subdivision 3. The commissioner shall establish criteria in
rules for the content and presentation of training courses for lead renovation and lead
sampling technicians. deleted text begin Training course permit fees shall be nonrefundable and must be
submitted with each application in the amount of $500 for an initial training course, $250
for renewal of a permit for an initial training course, $250 for a refresher training course,
and $125 for renewal of a permit of a refresher training course.
deleted text end
Subd. 5.
Variances.
In adopting the rules required under this section, the
commissioner shall provide variance procedures for any provision in rules adopted under
this section, except for the numerical standards for the concentrations of lead in paint,
dust, bare soil, and drinking water. A variance shall be considered only according to the
procedures and criteria in Minnesota Rules, parts 4717.7000 to 4717.7050.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 34.
new text begin
[144.999] LIFE-SAVING ALLERGY MEDICATION.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms
have the meanings given.
new text end
new text begin
(b) "Administer" means the direct application of an epinephrine auto-injector to
the body of an individual.
new text end
new text begin
(c) "Authorized entity" means entities that fall in the categories of recreation camps,
colleges and universities, preschools and daycares, and any other category of entities or
organizations that the commissioner authorizes to obtain and administer epinephrine
auto-injectors without a prescription. This definition does not include a school covered
under section 121A.2207.
new text end
new text begin
(d) "Commissioner" means the commissioner of health.
new text end
new text begin
(e) "Epinephrine auto-injector" means a single-use device used for the automatic
injection of a premeasured dose of epinephrine into the human body.
new text end
new text begin
(f) "Provide" means to supply one or more epinephrine auto-injectors to an
individual or the individual's parent, legal guardian, or caretaker.
new text end
new text begin Subd. 2. new text end
new text begin Commissioner duties. new text end
new text begin
The commissioner may identify additional
categories of entities or organizations to be authorized entities if the commissioner
determines that individuals may come in contact with allergens capable of causing
anaphylaxis. Beginning July 1, 2016, the commissioner may annually review the
categories of authorized entities and may authorize additional categories of authorized
entities as the commissioner deems appropriate. The commissioner may contract with a
vendor to perform the review and identification of authorized entities.
new text end
new text begin Subd. 3. new text end
new text begin Obtaining and storing epinephrine auto-injectors. new text end
new text begin
(a) Notwithstanding
section 151.37, an authorized entity may obtain and possess epinephrine auto-injectors
to be provided or administered to an individual if, in good faith, an owner, manager,
employee, or agent of an authorized entity believes that the individual is experiencing
anaphylaxis regardless of whether the individual has a prescription for an epinephrine
auto-injector. The administration of an epinephrine auto-injector in accordance with
this section is not the practice of medicine.
new text end
new text begin
(b) An authorized entity may obtain epinephrine auto-injectors from pharmacies
licensed as wholesale drug distributors pursuant to section 151.47. Prior to obtaining an
epinephrine auto-injector, an owner, manager, or authorized agent of the entity must
present to the pharmacy a valid certificate of training obtained pursuant to subdivision 5.
new text end
new text begin
(c) An authorized entity shall store epinephrine auto-injectors in a location readily
accessible in an emergency and in accordance with the epinephrine auto-injector's
instructions for use and any additional requirements that may be established by the
commissioner. An authorized entity shall designate employees or agents who have
completed the training program required under subdivision 5 to be responsible for the
storage, maintenance, and control of epinephrine auto-injectors obtained and possessed
by the authorized entity.
new text end
new text begin Subd. 4. new text end
new text begin Use of epinephrine auto-injectors. new text end
new text begin
(a) An owner, manager, employee, or
agent of an authorized entity who has completed the training required under subdivision 5
may:
new text end
new text begin
(1) provide an epinephrine auto-injector for immediate administration to an
individual or the individual's parent, legal guardian, or caregiver if the owner, manager,
employee, or agent believes, in good faith, the individual is experiencing anaphylaxis,
regardless of whether the individual has a prescription for an epinephrine auto-injector or
has previously been diagnosed with an allergy; or
new text end
new text begin
(2) administer an epinephrine auto-injector to an individual who the owner, manager,
employee, or agent believes, in good faith, is experiencing anaphylaxis, regardless of
whether the individual has a prescription for an epinephrine auto-injector or has previously
been diagnosed with an allergy.
new text end
new text begin
(b) Nothing in this section shall be construed to require any authorized entity to
maintain a stock of epinephrine auto-injectors.
new text end
new text begin Subd. 5. new text end
new text begin Training. new text end
new text begin
(a) In order to use an epinephrine auto-injector as authorized
under subdivision 4, an individual must complete, every two years, an anaphylaxis training
program conducted by a nationally recognized organization experienced in training
laypersons in emergency health treatment, a statewide organization with experience
providing training on allergies and anaphylaxis under the supervision of board-certified
allergy medical advisors, or an entity or individual approved by the commissioner to
provide an anaphylaxis training program. The commissioner may approve specific entities
or individuals to conduct the training program or may approve categories of entities or
individuals to conduct the training program. Training may be conducted online or in
person and, at a minimum, must cover:
new text end
new text begin
(1) how to recognize signs and symptoms of severe allergic reactions, including
anaphylaxis;
new text end
new text begin
(2) standards and procedures for the storage and administration of an epinephrine
auto-injector; and
new text end
new text begin
(3) emergency follow-up procedures.
new text end
new text begin
(b) The entity or individual conducting the training shall issue a certificate to each
person who successfully completes the anaphylaxis training program. The commissioner
may develop, approve, and disseminate a standard certificate of completion. The
certificate of completion shall be valid for two years from the date issued.
new text end
new text begin Subd. 6. new text end
new text begin Good samaritan protections. new text end
new text begin
Any act or omission taken pursuant to
this section by an authorized entity that possesses and makes available epinephrine
auto-injectors and its employees or agents, a pharmacy or manufacturer that dispenses
epinephrine auto-injectors to an authorized entity, or an individual or entity that conducts
the training described in subdivision 5 is considered "emergency care, advice, or
assistance" under section 604A.01.
new text end
Sec. 35.
Minnesota Statutes 2014, section 144A.70, subdivision 6, is amended to read:
Subd. 6.
Supplemental nursing services agency.
"Supplemental nursing services
agency" means a person, firm, corporation, partnership, or association engaged for hire
in the business of providing or procuring temporary employment in health care facilities
for nurses, nursing assistants, nurse aides, deleted text begin anddeleted text end orderliesnew text begin , and other licensed health
professionalsnew text end . Supplemental nursing services agency does not include an individual who
only engages in providing the individual's services on a temporary basis to health care
facilities. Supplemental nursing services agency does not include a professional home
care agency licensed deleted text begin as a Class A providerdeleted text end under section deleted text begin and rules adopted
thereunderdeleted text end new text begin 144A.471new text end that only provides staff to other home care providers.
Sec. 36.
Minnesota Statutes 2014, section 144A.70, is amended by adding a
subdivision to read:
new text begin Subd. 7. new text end
new text begin Oversight. new text end
new text begin
The commissioner is responsible for the oversight of
supplemental nursing services agencies through annual unannounced surveys, complaint
investigations under sections 144A.51 to 144A.53, and other actions necessary to ensure
compliance with sections 144A.70 to 144A.74.
new text end
Sec. 37.
Minnesota Statutes 2014, section 144A.71, is amended to read:
144A.71 SUPPLEMENTAL NURSING SERVICES AGENCY
REGISTRATION.
Subdivision 1.
Duty to register.
A person who operates a supplemental nursing
services agency shall register deleted text begin the agencydeleted text end new text begin annuallynew text end with the commissioner. Each separate
location of the business of a supplemental nursing services agency shall register the agency
with the commissioner. Each separate location of the business of a supplemental nursing
services agency shall have a separate registration.new text begin Fees collected under this section shall be
deposited in the state treasury and credited to the state government special revenue fund.
new text end
Subd. 2.
Application information and fee.
The commissioner shall establish forms
and procedures for processing each supplemental nursing services agency registration
application. An application for a supplemental nursing services agency registration must
include at least the following:
(1) the names and addresses of the owner or owners of the supplemental nursing
services agency;
(2) if the owner is a corporation, copies of its articles of incorporation and current
bylaws, together with the names and addresses of its officers and directors;
(3) satisfactory proof of compliance with section 144A.72, subdivision 1, clauses
(5) to (7);
(4) any other relevant information that the commissioner determines is necessary
to properly evaluate an application for registration; deleted text begin and
deleted text end
(5) deleted text begin the annual registration fee for a supplemental nursing services agency, which
is $891.deleted text end new text begin a policy and procedure that describes how the supplemental nursing services
agency's records will be immediately available at all times to the commissioner; and
new text end
new text begin
(6) a registration fee of $2,035.
new text end
new text begin
If a supplemental nursing services agency fails to provide the items in this
subdivision to the department, the commissioner shall immediately suspend or refuse to
issue the supplemental nursing services agency registration. The supplemental nursing
services agency may appeal the commissioner's findings according to section 144A.475,
subdivisions 3a and 7, except that the hearing must be conducted by an administrative law
judge within 60 calendar days of the request for hearing assignment.
new text end
Subd. 3.
Registration not transferable.
A registration issued by the commissioner
according to this section is effective for a period of one year from the date of its issuance
unless the registration is revoked or suspended under section 144A.72, subdivision 2, or
unless the supplemental nursing services agency is sold or ownership or management
is transferred. When a supplemental nursing services agency is sold or ownership or
management is transferred, the registration of the agency must be voided and the new
owner or operator may apply for a new registration.
Sec. 38.
Minnesota Statutes 2014, section 144A.72, is amended to read:
144A.72 REGISTRATION REQUIREMENTS; PENALTIES.
Subdivision 1.
Minimum criteria.
new text begin (a) new text end The commissioner shall require that, as a
condition of registration:
(1) the supplemental nursing services agency shall document that each temporary
employee provided to health care facilities currently meets the minimum licensing, training,
and continuing education standards for the position in which the employee will be working;
(2) the supplemental nursing services agency shall comply with all pertinent
requirements relating to the health and other qualifications of personnel employed in
health care facilities;
(3) the supplemental nursing services agency must not restrict in any manner the
employment opportunities of its employees;
(4) the supplemental nursing services agency shall carry medical malpractice
insurance to insure against the loss, damage, or expense incident to a claim arising out
of the death or injury of any person as the result of negligence or malpractice in the
provision of health care services by the supplemental nursing services agency or by any
employee of the agency;
(5) the supplemental nursing services agency shall carry an employee dishonesty
bond in the amount of $10,000;
(6) the supplemental nursing services agency shall maintain insurance coverage
for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies
provided or procured by the agency;
(7) the supplemental nursing services agency shall file with the commissioner of
revenue: (i) the name and address of the bank, savings bank, or savings association
in which the supplemental nursing services agency deposits all employee income tax
withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide, or
orderly whose income is derived from placement by the agency, if the agency purports
the income is not subject to withholding;
(8) the supplemental nursing services agency must not, in any contract with any
employee or health care facility, require the payment of liquidated damages, employment
fees, or other compensation should the employee be hired as a permanent employee of a
health care facility; deleted text begin and
deleted text end
(9) the supplemental nursing services agency shall document that each temporary
employee provided to health care facilities is an employee of the agency and is not
an independent contractordeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(10) the supplemental nursing services agency shall retain all records for five
calendar years. All records of the supplemental nursing services agency must be
immediately available to the department.
new text end
new text begin
(b) In order to retain registration, the supplemental nursing services agency must
provide services to a health care facility during the year preceding the supplemental
nursing services agency's registration renewal date.
new text end
Subd. 2.
Penalties.
deleted text begin A pattern ofdeleted text end Failure to comply with this section shall subject
the supplemental nursing services agency to revocation or nonrenewal of its registration.
Violations of section 144A.74 are subject to a fine equal to 200 percent of the amount
billed or received in excess of the maximum permitted under that section.
Subd. 3.
Revocation.
Notwithstanding subdivision 2, the registration of a
supplemental nursing services agency that knowingly supplies to a health care facility a
person with an illegally or fraudulently obtained or issued diploma, registration, license,
certificate, or background study shall be revoked by the commissioner. The commissioner
shall notify the supplemental nursing services agency 15 days in advance of the date
of revocation.
Subd. 4.
Hearing.
(a) No supplemental nursing services agency's registration
may be revoked without a hearing held as a contested case in accordance with deleted text begin chapter
14. The hearing must commence within 60 days after the proceedings are initiated
deleted text end new text begin section 144A.475, subdivisions 3a and 7, except the hearing must be conducted by an
administrative law judge within 60 calendar days of the request for assignmentnew text end .
(b) If a controlling person has been notified by the commissioner of health that the
supplemental nursing services agency will not receive an initial registration or that a
renewal of the registration has been denied, the controlling person or a legal representative
on behalf of the supplemental nursing services agency may request and receive a hearing
on the denial. deleted text begin Thisdeleted text end new text begin Thenew text end hearing shall be deleted text begin held as a contested case in accordance with
chapter 14deleted text end new text begin a contested case in accordance with section 144A.475, subdivisions 3a and 7,
except the hearing must be conducted by an administrative law judge within 60 calendar
days of the request for assignmentnew text end .
Subd. 5.
Period of ineligibility.
(a) The controlling person of a supplemental
nursing services agency whose registration has not been renewed or has been revoked
because of noncompliance with the provisions of sections 144A.70 to 144A.74 shall not
be eligible to apply for nor will be granted a registration for five years following the
effective date of the nonrenewal or revocation.
(b) The commissioner shall not issue or renew a registration to a supplemental
nursing services agency if a controlling person includes any individual or entity who was
a controlling person of a supplemental nursing services agency whose registration was
not renewed or was revoked as described in paragraph (a) for five years following the
effective date of nonrenewal or revocation.
Sec. 39.
Minnesota Statutes 2014, section 144A.73, is amended to read:
144A.73 COMPLAINT SYSTEM.
The commissioner shall establish a system for reporting complaints against a
supplemental nursing services agency or its employees. Complaints may be made by
any member of the public. deleted text begin Written complaints must be forwarded to the employer of
each person against whom a complaint is made. The employer shall promptly report to
the commissioner any corrective action takendeleted text end new text begin Complaints against a supplemental nursing
services agency shall be investigated by the Office of Health Facility Complaints under
Minnesota Statutes, sections 144A.51 to 144A.53new text end .
Sec. 40.
Minnesota Statutes 2014, section 144A.75, subdivision 13, is amended to read:
Subd. 13.
Residential hospice facility.
new text begin (a) new text end "Residential hospice facility" means
a facility that resembles a single-family home located in a residential area that directly
provides 24-hour residential and support services in a home-like setting for hospice patients
as an integral part of the continuum of home care provided by a hospice and that houses:
(1) no more than eight hospice patients; or
(2) at least nine and no more than 12 hospice patients with the approval of the local
governing authority, notwithstanding section 462.357, subdivision 8.
new text begin
(b) Residential hospice facility also means a facility that directly provides 24-hour
residential and support services for hospice patients and that:
new text end
new text begin
(1) houses no more than 21 hospice patients;
new text end
new text begin
(2) meets hospice certification regulations adopted pursuant to title XVIII of the
federal Social Security Act, United States Code, title 42, section 1395, et seq.; and
new text end
new text begin
(3) is located on St. Anthony Avenue in St. Paul, Minnesota, and was licensed as a
40-bed non-Medicare certified nursing home as of January 1, 2015.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 41.
Minnesota Statutes 2014, section 144D.01, is amended by adding a
subdivision to read:
new text begin Subd. 3a. new text end
new text begin Direct-care staff. new text end
new text begin
"Direct-care staff" means staff and employees who
provide home care services listed in section 144A.471, subdivisions 6 and 7.
new text end
Sec. 42.
new text begin
[144D.066] ENFORCEMENT OF DEMENTIA CARE TRAINING
REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Enforcement. new text end
new text begin
(a) The commissioner shall enforce the dementia care
training standards for staff working in housing with services settings and for housing
managers according to clauses (1) to (3):
new text end
new text begin
(1) for dementia care training requirements in section 144D.065, the commissioner
shall review training records as part of the home care provider survey process for direct
care staff and supervisors of direct care staff, in accordance with section 144A.474. The
commissioner may also request and review training records at any time during the year;
new text end
new text begin
(2) for dementia care training standards in section 144D.065, the commissioner
shall review training records for maintenance, housekeeping, and food service staff and
other staff not providing direct care working in housing with services settings as part of
the housing with services registration application and renewal application process in
accordance with section 144D.03. The commissioner may also request and review training
records at any time during the year; and
new text end
new text begin
(3) for housing managers, the commissioner shall review the statement verifying
compliance with the required training described in section 144D.10, paragraph (d),
through the housing with services registration application and renewal application process
in accordance with section 144D.03. The commissioner may also request and review
training records at any time during the year.
new text end
new text begin
(b) The commissioner shall specify the required forms and what constitutes sufficient
training records for the items listed in paragraph (a), clauses (1) to (3).
new text end
new text begin Subd. 2. new text end
new text begin Fines for noncompliance. new text end
new text begin
(a) Beginning January 1, 2017, the
commissioner may impose a $200 fine for every staff person required to obtain dementia
care training who does not have training records to show compliance. For violations of
subdivision 1, paragraph (a), clause (1), the fine will be imposed upon the home care
provider, and may be appealed under the contested case procedure in section 144A.475,
subdivisions 3a, 4, and 7. For violations of subdivision 1, paragraph (a), clauses (2) and
(3), the fine will be imposed on the housing with services registrant and may be appealed
under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. Prior
to imposing the fine, the commissioner must allow two weeks for staff to complete the
required training. Fines collected under this section shall be deposited in the state treasury
and credited to the state government special revenue fund.
new text end
new text begin
(b) The housing with services registrant and home care provider must allow
for the required training as part of employee and staff duties. Imposition of a fine
by the commissioner does not negate the need for the required training. Continued
noncompliance with the requirements of sections 144D.065 and 144D.10 may result in
revocation or nonrenewal of the housing with services registration or home care license.
The commissioner shall make public the list of all housing with services establishments
that have complied with the training requirements.
new text end
new text begin Subd. 3. new text end
new text begin Technical assistance. new text end
new text begin
From January 1, 2016, to December 31, 2016,
the commissioner shall provide technical assistance instead of imposing fines for
noncompliance with the training requirements. During the year of technical assistance,
the commissioner shall review the training records to determine if the records meet the
requirements and inform the home care provider. The commissioner shall also provide
information about available training resources.
new text end
Sec. 43.
Minnesota Statutes 2014, section 145.4131, subdivision 1, is amended to read:
Subdivision 1.
Forms.
(a) Within 90 days of July 1, 1998, the commissioner shall
prepare a reporting form for use by physicians or facilities performing abortions. A copy
of this section shall be attached to the form. A physician or facility performing an abortion
shall obtain a form from the commissioner.
(b) The form shall require the following information:
(1) the number of abortions performed by the physician in the previous calendar
year, reported by month;
(2) the method used for each abortion;
(3) the approximate gestational age expressed in one of the following increments:
(i) less than nine weeks;
(ii) nine to ten weeks;
(iii) 11 to 12 weeks;
(iv) 13 to 15 weeks;
(v) 16 to 20 weeks;
(vi) 21 to 24 weeks;
(vii) 25 to 30 weeks;
(viii) 31 to 36 weeks; or
(ix) 37 weeks to term;
(4) the age of the woman at the time the abortion was performed;
(5) the specific reason for the abortion, including, but not limited to, the following:
(i) the pregnancy was a result of rape;
(ii) the pregnancy was a result of incest;
(iii) economic reasons;
(iv) the woman does not want children at this time;
(v) the woman's emotional health is at stake;
(vi) the woman's physical health is at stake;
(vii) the woman will suffer substantial and irreversible impairment of a major bodily
function if the pregnancy continues;
(viii) the pregnancy resulted in fetal anomalies; or
(ix) unknown or the woman refused to answer;
(6) the number of prior induced abortions;
(7) the number of prior spontaneous abortions;
(8) whether the abortion was paid for by:
(i) private coverage;
(ii) public assistance health coverage; or
(iii) self-pay;
(9) whether coverage was under:
(i) a fee-for-service plan;
(ii) a capitated private plan; or
(iii) other;
(10) complications, if any, for each abortion and for the aftermath of each abortion.
Space for a description of any complications shall be available on the form; deleted text begin and
deleted text end
(11) the medical specialty of the physician performing the abortionnew text begin ;
new text end
new text begin
(12) whether the abortion resulted in a born alive infant, as defined in section
145.423, subdivision 4, and:
new text end
new text begin
(i) any medical actions taken to preserve the life of the born alive infant;
new text end
new text begin
(ii) whether the born alive infant survived; and
new text end
new text begin (iii) the status of the born alive infant, should the infant survive, if knownnew text end .
Sec. 44.
Minnesota Statutes 2014, section 145.423, is amended to read:
145.423 ABORTION; LIVE BIRTHS.
Subdivision 1.
Recognition; medical care.
A deleted text begin live child borndeleted text end new text begin born alive infantnew text end as a
result of an abortion shall be fully recognized as a human person, and accorded immediate
protection under the law. All reasonable measures consistent with good medical practice,
including the compilation of appropriate medical records, shall be takennew text begin by the responsible
medical personnelnew text end to preserve the life and health of the deleted text begin childdeleted text end new text begin born alive infantnew text end .
Subd. 2.
Physician required.
When an abortion is performed after the twentieth
week of pregnancy, a physician, other than the physician performing the abortion, shall
be immediately accessible to take all reasonable measures consistent with good medical
practice, including the compilation of appropriate medical records, to preserve the life and
health of any deleted text begin live birthdeleted text end new text begin born alive infantnew text end that is the result of the abortion.
Subd. 3.
Death.
If a deleted text begin childdeleted text end new text begin born alive infantnew text end described in subdivision 1 dies after
birth, the body shall be disposed of in accordance with the provisions of section 145.1621.
new text begin Subd. 4. new text end
new text begin Definition of born alive infant. new text end
new text begin
(a) In determining the meaning of
any Minnesota statute, or of any ruling, regulation, or interpretation of the various
administrative bureaus and agencies of Minnesota, the words "person," "human being,"
"child," and "individual" shall include every infant member of the species Homo sapiens
who is born alive at any stage of development.
new text end
new text begin
(b) As used in this section, the term "born alive," with respect to a member of the
species Homo sapiens, means the complete expulsion or extraction from his or her mother
of that member, at any stage of development, who, after such expulsion or extraction,
breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of
voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless
of whether the expulsion or extraction occurs as a result of a natural or induced labor,
cesarean section, or induced abortion.
new text end
new text begin
(c) Nothing in this section shall be construed to affirm, deny, expand, or contract any
legal status or legal right applicable to any member of the species Homo sapiens at any
point prior to being born alive, as defined in this section.
new text end
new text begin Subd. 5. new text end
new text begin Civil and disciplinary actions. new text end
new text begin
(a) Any person upon whom an abortion
has been performed, or the parent or guardian of the mother if the mother is a minor,
and the abortion results in the infant having been born alive, may maintain an action for
death of or injury to the born alive infant against the person who performed the abortion
if the death or injury was a result of simple negligence, gross negligence, wantonness,
willfulness, intentional conduct, or another violation of the legal standard of care.
new text end
new text begin
(b) Any responsible medical personnel that does not take all reasonable measures
consistent with good medical practice to preserve the life and health of the born alive
infant, as required by subdivision 1, may be subject to the suspension or revocation of that
person's professional license by the professional board with authority over that person.
Any person who has performed an abortion and against whom judgment has been rendered
pursuant to paragraph (a) shall be subject to an automatic suspension of the person's
professional license for at least one year and said license shall be reinstated only after the
person's professional board requires compliance with this section by all board licensees.
new text end
new text begin
(c) Nothing in this subdivision shall be construed to hold the mother of the born alive
infant criminally or civilly liable for the actions of a physician, nurse, or other licensed
health care provider in violation of this section to which the mother did not give her consent.
new text end
new text begin Subd. 6. new text end
new text begin Protection of privacy in court proceedings. new text end
new text begin
In every civil action
brought under this section, the court shall rule whether the anonymity of any female
upon whom an abortion has been performed or attempted shall be preserved from public
disclosure if she does not give her consent to such disclosure. The court, upon motion or
sua sponte, shall make such a ruling and, upon determining that her anonymity should
be preserved, shall issue orders to the parties, witnesses, and counsel and shall direct the
sealing of the record and exclusion of individuals from courtrooms or hearing rooms to
the extent necessary to safeguard her identity from public disclosure. Each order must be
accompanied by specific written findings explaining why the anonymity of the female
should be preserved from public disclosure, why the order is essential to that end, how the
order is narrowly tailored to serve that interest, and why no reasonable, less restrictive
alternative exists. This section may not be construed to conceal the identity of the plaintiff
or of witnesses from the defendant.
new text end
new text begin Subd. 7. new text end
new text begin Status of born alive infant. new text end
new text begin
Unless the abortion is performed to save the
life of the woman or fetus, or, unless one or both of the parents of the born alive infant
agree within 30 days of the birth to accept the parental rights and responsibilities for the
child, the child shall be an abandoned ward of the state and the parents shall have no
parental rights or obligations as if the parental rights had been terminated pursuant to
section 260C.301. The child shall be provided for pursuant to chapter 256J.
new text end
new text begin Subd. 8. new text end
new text begin Severability. new text end
new text begin
If any one or more provision, section, subdivision, sentence,
clause, phrase, or word of this section or the application of it to any person or circumstance
is found to be unconstitutional, it is declared to be severable and the balance of this section
shall remain effective notwithstanding such unconstitutionality. The legislature intends
that it would have passed this section, and each provision, section, subdivision, sentence,
clause, phrase, or word, regardless of the fact that any one provision, section, subdivision,
sentence, clause, phrase, or word is declared unconstitutional.
new text end
new text begin Subd. 9. new text end
new text begin Short title. new text end
new text begin
This act may be cited as the "Born Alive Infants Protection Act."
new text end
Sec. 45.
Minnesota Statutes 2014, section 145.928, subdivision 13, is amended to read:
Subd. 13.
deleted text begin Reportdeleted text end new text begin Reportsnew text end .
new text begin (a) new text end The commissioner shall submit a biennial report
to the legislature on the local community projects, tribal government, and community
health board prevention activities funded under this section. These reports must include
information on grant recipients, activities that were conducted using grant funds,
evaluation data, and outcome measures, if available. These reports are due by January 15
of every other year, beginning in the year 2003.
new text begin
(b) The commissioner shall submit an annual report to the chairs and ranking
minority members of the house of representatives and senate committees with jurisdiction
over public health on grants made under subdivision 7 to decrease racial and ethnic
disparities in infant mortality rates. The report must provide specific information on the
amount of each grant awarded to each agency or organization, the population served
by each agency or organization, outcomes of the programs funded by each grant, and
the amount of the appropriation retained by the commissioner for administrative and
associated expenses. The commissioner shall issue a report each January 15 for the
previous fiscal year beginning January 15, 2016.
new text end
Sec. 46.
Minnesota Statutes 2014, section 145.928, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Promising strategies. new text end
new text begin
For all grants awarded under this section, the
commissioner shall consider applicants that present evidence of a promising strategy to
accomplish the applicant's objective. A promising strategy shall be given the same weight
as a research or evidence-based strategy based on potential value and measurable outcomes.
new text end
Sec. 47.
Minnesota Statutes 2014, section 145.986, subdivision 1a, is amended to read:
Subd. 1a.
Grants to local communities.
(a) Beginning July 1, 2009, the
commissioner of health shall award competitive grants to community health boards and
tribal governments to convene, coordinate, and implement evidence-based strategies
targeted at reducing the percentage of Minnesotans who are obese or overweight and
to reduce the use of tobacco. Grants shall be awarded to all community health boards
and tribal governments whose proposals demonstrate the ability to implement programs
designed to achieve the purposes in subdivision 1 and other requirements of this section.
(b) Grantee activities shall:
(1) be based on scientific evidence;
(2) be based on community input;
(3) address behavior change at the individual, community, and systems levels;
(4) occur in community, school, work site, and health care settings;
(5) be focused on policy, systems, and environmental changes that support healthy
behaviors; and
(6) address the health disparities and inequities that exist in the grantee's community.
(c) To receive a grant under this section, community health boards and tribal
governments must submit proposals to the commissioner. A local match of ten percent
of the total funding allocation is required. This local match may include funds donated
by community partners.
(d) In order to receive a grant, community health boards and tribal governments
must submit a health improvement plan to the commissioner of health for approval. The
commissioner may require the plan to identify a community leadership team, community
partners, and a community action plan that includes an assessment of area strengths and
needs, proposed action strategies, technical assistance needs, and a staffing plan.
(e) The grant recipient must implement the health improvement plan, evaluate the
effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.
(f) Grant recipients shall report their activities and their progress toward the
outcomes established under subdivision 2 to the commissioner in a format and at a time
specified by the commissioner.
(g) All grant recipients shall be held accountable for making progress toward the
measurable outcomes established in subdivision 2. The commissioner shall require a
corrective action plan and may reduce the funding level of grant recipients that do not
make adequate progress toward the measurable outcomes.
new text begin
(h) Beginning November 1, 2015, the commissioner shall offer grant recipients the
option of using a grant awarded under this subdivision to implement health improvement
strategies that improve the health status, delay the expression of dementia, or slow the
progression of dementia, for a targeted population at risk for dementia and shall award
at least two of the grants awarded on November 1, 2015, for these purposes. The grants
must meet all other requirements of this section. The commissioner shall coordinate grant
planning activities with the commissioner of human services, the Minnesota Board on
Aging, and community-based organizations with a focus on dementia. Each grant must
include selected outcomes and evaluation measures related to the incidence or progression
of dementia among the targeted population using the procedure described in subdivision 2.
new text end
Sec. 48.
Minnesota Statutes 2014, section 145.986, subdivision 2, is amended to read:
Subd. 2.
Outcomes.
(a) The commissioner shall set measurable outcomes to meet
the goals specified in subdivision 1, and annually review the progress of grant recipients
in meeting the outcomes.
(b) The commissioner shall measure current public health status, using existing
measures and data collection systems when available, to determine baseline data against
which progress shall be monitored.
new text begin
(c) For grants awarded on or after July 1, 2016, the commissioner, in coordination
with each grant recipient under section 145.986, must identify:
new text end
new text begin
(1) each geographic area or population to be targeted;
new text end
new text begin
(2) the policy, systems, or environmental strategy to be used to address one or more
of the health indicators listed in section 62U.10, subdivision 6; and
new text end
new text begin
(3) the selected outcomes and evaluation measures for the grant, related to one or
more of the health indicators listed in section 62U.10, subdivision 6, within the geographic
area or among the population targeted.
new text end
Sec. 49.
Minnesota Statutes 2014, section 145.986, subdivision 4, is amended to read:
Subd. 4.
Evaluation.
(a) Using the outcome measures established in subdivision 3,
the commissioner shall conduct a biennial evaluation of the statewide health improvement
program funded under this section. Grant recipients shall cooperate with the commissioner
in the evaluation and provide the commissioner with the information necessary to conduct
the evaluationnew text begin , including information on any impact on the health indicators listed in
section 62U.10, subdivision 6, within the geographic area or among the population targetednew text end .
(b) Grant recipients will collect, monitor, and submit to the Department of Health
baseline and annual data and provide information to improve the quality and impact of
community health improvement strategies.
(c) For the purposes of carrying out the grant program under this section, including
for administrative purposes, the commissioner shall award contracts to appropriate entities
to assist in designing and implementing evaluation systems.
(d) Contracts awarded under paragraph (c) may be used to:
(1) develop grantee monitoring and reporting systems to track grantee progress,
including aggregated and disaggregated data;
(2) manage, analyze, and report program evaluation data results; and
(3) utilize innovative support tools to analyze and predict the impact of prevention
strategies on health outcomes and state health care costs over time.
Sec. 50.
Minnesota Statutes 2014, section 145A.131, subdivision 1, is amended to read:
Subdivision 1.
Funding formula for community health boards.
(a) Base funding
for each community health board eligible for a local public health grant under section
145A.03, subdivision 7, shall be determined by each community health board's fiscal year
2003 allocations, prior to unallotment, for the following grant programs: community
health services subsidy; state and federal maternal and child health special projects grants;
family home visiting grants; TANF MN ENABL grants; TANF youth risk behavior grants;
and available women, infants, and children grant funds in fiscal year 2003, prior to
unallotment, distributed based on the proportion of WIC participants served in fiscal year
2003 within the CHS service area.
(b) Base funding for a community health board eligible for a local public health
grant under section 145A.03, subdivision 7, as determined in paragraph (a), shall be
adjusted by the percentage difference between the base, as calculated in paragraph (a),
and the funding available for the local public health grant.
(c) Multicounty or multicity community health boards shall receive a local
partnership base of up to $5,000 per year for each county or city in the case of a multicity
community health board included in the community health board.
(d) The State Community Health Advisory Committee may recommend a formula
to the commissioner to use in distributing deleted text begin state and federaldeleted text end funds to community health
boards deleted text begin organized and operating under sections 145A.03 to 145A.131 to achieve locally
identified priorities under section 145A.04, subdivision 1a, for use in distributing funds to
community health boards beginning January 1, 2006, and thereafterdeleted text end .
new text begin
(e) Notwithstanding any adjustment in paragraph (b), community health boards, all
or a portion of which are located outside of the counties of Anoka, Chisago, Carver,
Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright, are eligible
to receive an increase equal to ten percent of the grant award to the community health
board under paragraph (a) starting July 1, 2015. The increase in calendar year 2015 shall
be prorated for the last six months of the year. For calendar years beginning on or after
January 1, 2016, the amount distributed under this paragraph shall be adjusted each year
based on available funding and the number of eligible community health boards.
new text end
Sec. 51.
Minnesota Statutes 2014, section 149A.20, subdivision 5, is amended to read:
Subd. 5.
Examinations.
After having met the educational requirements of
subdivision 4, a person must attain a passing score on the National Board Examination
administered by the Conference of Funeral Service Examining Boards of the United
States, Inc. or any other examination that, in the determination of the commissioner,
adequately and accurately assesses the knowledge and skills required to practice
mortuary science. In addition, a person must attain a passing score on the state licensing
examination administered by or on behalf of the commissioner. The state examination
shall encompass the laws and rules of Minnesota that pertain to the practice of mortuary
science. The commissioner shall make available copies of all pertinent laws and rules
prior to administration of the state licensing examination.new text begin If a passing score is not attained
on the state examination, the individual must wait two weeks before they can retake
the examination.
new text end
Sec. 52.
Minnesota Statutes 2014, section 149A.20, subdivision 6, is amended to read:
Subd. 6.
Internship.
(a) A person who attains a passing score on both examinations
in subdivision 5 must complete a registered internship under the direct supervision of an
individual currently licensed to practice mortuary science in Minnesota. Interns must file
with the commissioner:
(1) the appropriate fee; and
(2) a registration form indicating the name and home address of the intern, the
date the internship begins, and the name, license number, and business address of the
supervising mortuary science licensee.
(b) Any changes in information provided in the registration must be immediately
reported to the commissioner. The internship shall be a minimum of deleted text begin one calendar year
and a maximum of three calendar years in duration;deleted text end new text begin 2,080 hours to be completed within a
three-year period,new text end however, the commissioner may waive up to deleted text begin three monthsdeleted text end new text begin 520 hoursnew text end of
the internship time requirement upon satisfactory completion of a clinical or practicum
in mortuary science administered through the program of mortuary science of the
University of Minnesota or a substantially similar programnew text begin approved by the commissionernew text end .
Registrations must be renewed on an annual basis if they exceed one calendar year. During
the internship period, the intern must be under the direct supervision of a person holding a
current license to practice mortuary science in Minnesota. An intern may be registered
under only one licensee at any given time and may be directed and supervised only by
the registered licensee. The registered licensee shall have only one intern registered at
any given time. The commissioner shall issue to each registered intern a registration
permit that must be displayed with the other establishment and practice licenses. While
under the direct supervision of the licensee, the intern must deleted text begin actively participate in the
embalming of at least 25 dead human bodies and in the arrangements for and direction of
at least 25 funeralsdeleted text end new text begin complete 25 case reports in each of the following areas: embalming,
funeral arrangements, and servicesnew text end . Case reports, on forms provided by the commissioner,
shall be completed by the interndeleted text begin , signed by the supervising licensee,deleted text end and filed with the
commissioner deleted text begin for at least 25 embalmings and funerals in which the intern participatesdeleted text end new text begin prior
to the completion of the internshipnew text end . Information contained in these reports that identifies
the subject or the family of the subject embalmed or the subject or the family of the subject
of the funeral shall be classified as licensing data under section 13.41, subdivision 2.
Sec. 53.
Minnesota Statutes 2014, section 149A.40, subdivision 11, is amended to read:
Subd. 11.
Continuing education.
The commissioner deleted text begin maydeleted text end new text begin shallnew text end require new text begin 15
new text end continuing education hours for renewal of a license to practice mortuary science.new text begin Nine
of the hours must be in the following areas: body preparation, care, or handling, 3 CE
hours; professional practices, 3 CE hours; regulation and ethics, 3 CE hours. Continuing
education hours shall be reported to the commissioner every other year based on the
licensee's license number. Licensees whose license ends in an odd number must report CE
hours at renewal time every odd year. If a licensee's license ends in an even number, the
licensee must report the licensee's CE hours at renewal time every even year.
new text end
Sec. 54.
Minnesota Statutes 2014, section 149A.65, is amended to read:
149A.65 FEES.
Subdivision 1.
Generally.
This section establishes the fees for registrations,
examinations, initial and renewal licenses, and late fees authorized under the provisions
of this chapter.
Subd. 2.
Mortuary science fees.
Fees for mortuary science are:
(1) deleted text begin $50deleted text end new text begin $75new text end for the initial and renewal registration of a mortuary science intern;
(2) deleted text begin $100deleted text end new text begin $125 new text end for the mortuary science examination;
(3) deleted text begin $125deleted text end new text begin $200new text end for issuance of initial and renewal mortuary science licenses;
(4) deleted text begin $25deleted text end new text begin $100new text end late fee charge for a license renewal; and
(5) deleted text begin $200deleted text end new text begin $250new text end for issuing a mortuary science license by endorsement.
Subd. 3.
Funeral directors.
The license renewal fee for funeral directors is deleted text begin $125
deleted text end new text begin $200new text end . The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .
Subd. 4.
Funeral establishments.
The initial and renewal fee for funeral
establishments is deleted text begin $300deleted text end new text begin $425new text end . The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .
Subd. 5.
Crematories.
The initial and renewal fee for a crematory is deleted text begin $300deleted text end new text begin $425new text end .
The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .
Subd. 6.
Alkaline hydrolysis facilities.
The initial and renewal fee for an alkaline
hydrolysis facility is deleted text begin $300deleted text end new text begin $425new text end . The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .
Subd. 7.
State government special revenue fund.
Fees collected by the
commissioner under this section must be deposited in the state treasury and credited to
the state government special revenue fund.
Sec. 55.
Minnesota Statutes 2014, section 149A.92, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Exemptiondeleted text end new text begin Establishment updatenew text end .
deleted text begin All funeral establishments
having a preparation and embalming room that has not been used for the preparation
or embalming of a dead human body in the 12 calendar months prior to July 1, 1997,
are exempt from the minimum requirements in subdivisions 2 to 6, except as provided
in this section.deleted text end new text begin (a) Notwithstanding subdivision 11, a funeral establishment with other
establishment locations that uses one preparation and embalming room for all establishment
locations has until July 1, 2017, to bring the other establishment locations that are not used
for preparation or embalming into compliance with this section so long as the preparation
and embalming room that is used complies with the minimum standards in this section.
new text end
new text begin (b) new text end At the time that ownership of a funeral establishment changes, the physical
location of the establishment changes, or the building housing the funeral establishment or
business space of the establishment is remodeled the existing preparation and embalming
room must be brought into compliance with the minimum standards in this sectionnew text begin and in
accordance with subdivision 11new text end .
Sec. 56.
Minnesota Statutes 2014, section 149A.97, subdivision 7, is amended to read:
Subd. 7.
Reports to commissioner.
Every funeral provider lawfully doing business
in Minnesota that accepts funds under subdivision 2 must make a complete annual report
to the commissioner. The reports may be on forms provided by the commissioner or
substantially similar forms containing, at least, identification and the state of each trust
account, including all transactions involving principal and accrued interest, and must be
filed by March 31 of the calendar year following the reporting year along with a filing fee
of $25 for each report. Fees shall be paid to the commissioner of management and budget,
state of Minnesota, for deposit in the state government special revenue fund in the state
treasury. Reports must be signed by an authorized representative of the funeral provider
and notarized under oath. All reports to the commissioner shall be reviewed for account
inaccuracies or possible violations of this section. If the commissioner has a reasonable
belief to suspect that there are account irregularities or possible violations of this section,
the commissioner shall report that belief, in a timely manner, to the state auditornew text begin or other
state agencies as determined by the commissionernew text end . new text begin The commissioner may require a
funeral provider reporting preneed trust accounts under this section to arrange for and
pay an independent third-party auditing firm to complete an audit of the preneed trust
accounts every other year. The funeral provider shall report the findings of the audit to the
commissioner by March 31 of the calendar year following the reporting year. This report is
in addition to the annual report.new text end The commissioner shall also file an annual letter with the
state auditor disclosing whether or not any irregularities or possible violations were detected
in review of the annual trust fund reports filed by the funeral providers. This letter shall be
filed with the state auditor by May 31 of the calendar year following the reporting year.
Sec. 57.
Minnesota Statutes 2014, section 157.15, subdivision 8, is amended to read:
Subd. 8.
Lodging establishment.
"Lodging establishment" meansnew text begin : (1)new text end a building,
structure, enclosure, or any part thereof used as, maintained as, advertised as, or held out to
be a place where sleeping accommodations are furnished to the public as regular roomers,
for periods of one week or more, and having five or more beds to let to the publicdeleted text begin .deleted text end new text begin ; or (2) a
building, structure, or enclosure or any part thereof located within ten miles distance from
a hospital or medical center and maintained as, advertised as, or held out to be a place
where sleeping accommodations are furnished exclusively to patients, their families, and
caregivers while the patient is receiving or waiting to receive health care treatments or
procedures for periods of one week or more, and where no supportive services, as defined
under section 157.17, subdivision 1, paragraph (a), or health supervision services, as
defined under section 157.17, subdivision 1, paragraph (b), or home care services, as
defined under section 144A.471, subdivisions 6 and 7, are provided.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 58. new text begin WORKING GROUP ON VIOLENCE AGAINST ASIAN WOMEN
AND CHILDREN.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of health, in collaboration with
the commissioners of human services and public safety, and the Council on Asian-Pacific
Minnesotans, shall create a multidisciplinary working group to address violence against
Asian women and children by July 1, 2015.
new text end
new text begin Subd. 2. new text end
new text begin The working group. new text end
new text begin
The commissioner of health, in collaboration with
the commissioners of human services and public safety, and the Council on Asian-Pacific
Minnesotans, shall appoint 15 members representing the following groups to participate in
the working group:
new text end
new text begin
(1) advocates;
new text end
new text begin
(2) survivors;
new text end
new text begin
(3) service providers;
new text end
new text begin
(4) community leaders;
new text end
new text begin
(5) city and county attorneys;
new text end
new text begin
(6) city officials;
new text end
new text begin
(7) law enforcement; and
new text end
new text begin
(8) health professionals.
new text end
new text begin
At least eight of the members of the working group must be from the Asian-Pacific
Islander community.
new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin
(a) The working group must study the nature, scope, and prevalence
of violence against Asian women and children in Minnesota, including domestic violence,
trafficking, international abusive marriage, stalking, sexual assault, and other violence.
new text end
new text begin
(b) The working group may:
new text end
new text begin
(1) evaluate the adequacy and effectiveness of existing support programs;
new text end
new text begin
(2) conduct a needs assessment of culturally and linguistically appropriate programs
and interventions;
new text end
new text begin
(3) identify barriers in delivering services to Asian women and children;
new text end
new text begin
(4) identify promising prevention and intervention strategies in addressing violence
against Asian women and children; and
new text end
new text begin
(5) propose mechanisms to collect and monitor data on violence against Asian
women and children.
new text end
new text begin Subd. 4. new text end
new text begin Chair. new text end
new text begin
The commissioner of health shall designate one member to serve as
chair of the working group.
new text end
new text begin Subd. 5. new text end
new text begin First meeting. new text end
new text begin
The chair shall convene the first meeting by September
10, 2015.
new text end
new text begin Subd. 6. new text end
new text begin Compensation; expense reimbursement. new text end
new text begin
Members of the working group
shall be compensated and reimbursed for expenses under Minnesota Statutes, section
15.059, subdivision 3.
new text end
new text begin Subd. 7. new text end
new text begin Report. new text end
new text begin
By January 1, 2017, the working group must submit its
recommendations and any draft legislation necessary to implement those recommendations
to the commissioners of health, human services, and public safety, and the Council on
Asian-Pacific Minnesotans. The Council on Asian-Pacific Minnesotans shall submit a
report of findings and recommendations to the chair and ranking minority members of the
committees in the house of representatives and senate having jurisdiction over health and
human services and public safety by February 15, 2017.
new text end
new text begin Subd. 8. new text end
new text begin Sunset. new text end
new text begin
The working group on violence against Asian women and children
sunsets the day after the Council on Asian-Pacific Minnesotans submits the report under
subdivision 7.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 59. new text begin HEALTH EQUITY GRANTS.
new text end
new text begin
For the competitive grants awarded under Laws 2014, chapter 312, article 30,
section 3, subdivision 2, the commissioner of health shall consider applicants who present
evidence of a promising strategy to accomplish the applicant's objective. A promising
strategy shall be given the same weight as a research or evidence-based strategy based on
potential value and measurable outcomes.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
ARTICLE 9
HEALTH CARE DELIVERY
Section 1.
new text begin
[62A.67] SHORT TITLE.
new text end
new text begin
Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act."
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 2.
new text begin
[62A.671] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
For purposes of sections 62A.67 to 62A.672, the
terms defined in this section have the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Distant site. new text end
new text begin
"Distant site" means a site at which a licensed health care
provider is located while providing health care services or consultations by means of
telemedicine.
new text end
new text begin Subd. 3. new text end
new text begin Health care provider. new text end
new text begin
"Health care provider" has the meaning provided
in section 62A.63, subdivision 2.
new text end
new text begin Subd. 4. new text end
new text begin Health carrier. new text end
new text begin
"Health carrier" has the meaning provided in section
62A.011, subdivision 2.
new text end
new text begin Subd. 5. new text end
new text begin Health plan. new text end
new text begin
"Health plan" means a health plan as defined in section
62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision
3, but does not include dental plans that provide indemnity-based benefits, regardless of
expenses incurred and are designed to pay benefits directly to the policyholder.
new text end
new text begin Subd. 6. new text end
new text begin Licensed health care provider. new text end
new text begin
"Licensed health care provider" means a
health care provider who is:
new text end
new text begin
(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a
mental health professional as defined under section 245.462, subdivision 18, or 245.4871,
subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and
new text end
new text begin
(2) authorized within their respective scope of practice to provide the particular
service with no supervision or under general supervision.
new text end
new text begin Subd. 7. new text end
new text begin Originating site. new text end
new text begin
"Originating site" means a site including, but not limited
to, a health care facility at which a patient is located at the time health care services are
provided to the patient by means of telemedicine.
new text end
new text begin Subd. 8. new text end
new text begin Store-and-forward technology. new text end
new text begin
"Store-and-forward technology" means
the transmission of a patient's medical information from an originating site to a health care
provider at a distant site without the patient being present, or the delivery of telemedicine
that does not occur in real time via synchronous transmissions.
new text end
new text begin Subd. 9. new text end
new text begin Telemedicine. new text end
new text begin
"Telemedicine" means the delivery of health care services
or consultations while the patient is at an originating site and the licensed health care
provider is at a distant site. A communication between licensed health care providers
that consists solely of a telephone conversation, e-mail, or facsimile transmission does
not constitute telemedicine consultations or services. A communication between a
licensed health care provider and a patient that consists solely of an e-mail or facsimile
transmission does not constitute telemedicine consultations or services. Telemedicine may
be provided by means of real-time two-way, interactive audio and visual communications,
including the application of secure video conferencing or store-and-forward technology
to provide or support health care delivery, which facilitate the assessment, diagnosis,
consultation, treatment, education, and care management of a patient's health care.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 3.
new text begin
[62A.672] COVERAGE OF TELEMEDICINE SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Coverage of telemedicine. new text end
new text begin
(a) A health plan sold, issued, or renewed
by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall
include coverage for telemedicine benefits in the same manner as any other benefits covered
under the policy, plan, or contract, and shall comply with the regulations of this section.
new text end
new text begin
(b) Nothing in this section shall be construed to:
new text end
new text begin
(1) require a health carrier to provide coverage for services that are not medically
necessary;
new text end
new text begin
(2) prohibit a health carrier from establishing criteria that a health care provider
must meet to demonstrate the safety or efficacy of delivering a particular service via
telemedicine for which the health carrier does not already reimburse other health
care providers for delivering via telemedicine, so long as the criteria are not unduly
burdensome or unreasonable for the particular service; or
new text end
new text begin
(3) prevent a health carrier from requiring a health care provider to agree to certain
documentation or billing practices designed to protect the health carrier or patients from
fraudulent claims so long as the practices are not unduly burdensome or unreasonable
for the particular service.
new text end
new text begin Subd. 2. new text end
new text begin Parity between telemedicine and in-person services. new text end
new text begin
A health carrier
shall not exclude a service for coverage solely because the service is provided via
telemedicine and is not provided through in-person consultation or contact between a
licensed health care provider and a patient.
new text end
new text begin Subd. 3. new text end
new text begin Reimbursement for telemedicine services. new text end
new text begin
(a) A health carrier shall
reimburse the distant site licensed health care provider for covered services delivered via
telemedicine on the same basis and at the same rate as the health carrier would apply to
those services if the services had been delivered in person by the distant site licensed
health care provider.
new text end
new text begin
(b) It is not a violation of this subdivision for a health carrier to include a
deductible, co-payment, or coinsurance requirement for a health care service provided via
telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition
to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same
services were provided through in-person contact.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 4.
Minnesota Statutes 2014, section 62U.02, subdivision 1, is amended to read:
Subdivision 1.
Development.
(a) The commissioner of health shall develop a
standardized set of measures by which to assess the quality of health care services offered
by health care providers, including health care providers certified as health care homes
under section 256B.0751. Quality measures must be based on medical evidence and be
developed through a process in which providers participate. The measures shall be used
for the quality incentive payment system developed in subdivision 2 and must:
(1) include uniform definitions, measures, and forms for submission of data, to the
greatest extent possible;
(2) seek to avoid increasing the administrative burden on health care providers;
(3) be initially based on existing quality indicators for physician and hospital
services, which are measured and reported publicly by quality measurement organizations,
including, but not limited to, Minnesota Community Measurement and specialty societies;
(4) place a priority on measures of health care outcomes, rather than process
measures, wherever possible; and
(5) incorporate measures for primary care, including preventive services, coronary
artery and heart disease, diabetes, asthma, depression, and other measures as determined
by the commissioner.
new text begin
(b) Effective July 1, 2016, the commissioner shall stratify quality measures by race,
ethnicity, preferred language, and country of origin beginning with five measures, and
stratifying additional measures to the extent resources are available. On or after January 1,
2018, the commissioner may require measures to be stratified by other sociodemographic
factors that according to reliable data are correlated with health disparities and have an
impact on performance on quality or cost indicators. New methods of stratifying data
under this paragraph must be tested and evaluated through pilot projects prior to adding
them to the statewide system. In determining whether to add additional sociodemographic
factors and developing the methodology to be used, the commissioner shall consider the
reporting burden on providers and determine whether there are alternative sources of data
that could be used. The commissioner shall ensure that categories and data collection
methods are developed in consultation with those communities impacted by health
disparities using culturally appropriate community engagement principles and methods.
The commissioner shall implement this paragraph in coordination with the contracting
entity retained under section 62U.02, subdivision 4, in order to build upon the data
stratification methodology that has been developed and tested by the entity. Nothing in
this paragraph expands or changes the commissioner's authority to collect, analyze, or
report health care data. Any data collected to implement this paragraph must be data that
is available or is authorized to be collected under other laws. Nothing in this paragraph
grants authority to the commissioner to collect or analyze patient-level or patient-specific
data of the patient characteristics identified under this paragraph.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end The measures shall be reviewed at least annually by the commissioner.
Sec. 5.
Minnesota Statutes 2014, section 62U.02, subdivision 2, is amended to read:
Subd. 2.
Quality incentive payments.
(a) By July 1, 2009, the commissioner
shall develop a system of quality incentive payments under which providers are eligible
for quality-based payments that are in addition to existing payment levels, based upon
a comparison of provider performance against specified targets, and improvement over
time. The targets must be based upon and consistent with the quality measures established
under subdivision 1.
(b) To the extent possible, the payment system must adjust for variations in patient
population in order to reduce incentives to health care providers to avoid high-risk patients
or populationsnew text begin , including those with risk factors related to race, ethnicity, language,
country of origin, and sociodemographic factorsnew text end .
(c) The requirements of section 62Q.101 do not apply under this incentive payment
system.
Sec. 6.
Minnesota Statutes 2014, section 62U.02, subdivision 3, is amended to read:
Subd. 3.
Quality transparency.
new text begin (a) new text end The commissioner shall establish standards for
measuring health outcomes, establish a system for risk adjusting quality measures, and
issue annual public reports on provider quality beginning July 1, 2010.
new text begin
(b) Effective July 1, 2017, the risk adjustment system established under this
subdivision shall adjust for patient characteristics identified under subdivision 1, paragraph
(b), that are correlated with health disparities and have an impact on performance on cost
and quality measures. The risk adjustment method may consist of reporting based on an
actual-to-expected comparison that reflects the characteristics of the patient population
served by the clinic or hospital. The commissioner shall implement this paragraph in
coordination with any contracting entity retained under section 62U.02, subdivision 4.
new text end
new text begin (c)new text end By January 1, 2010, physician clinics and hospitals shall submit standardized
electronic information on the outcomes and processes associated with patient care to
the commissioner or the commissioner's designee. In addition to measures of care
processes and outcomes, the report may include other measures designated by the
commissioner, including, but not limited to, care infrastructure and patient satisfaction.
The commissioner shall ensure that any quality data reporting requirements established
under this subdivision are not duplicative of publicly reported, communitywide quality
reporting activities currently under way in Minnesota. Nothing in this subdivision is
intended to replace or duplicate current privately supported activities related to quality
measurement and reporting in Minnesota.
Sec. 7.
Minnesota Statutes 2014, section 62U.02, subdivision 4, is amended to read:
Subd. 4.
Contracting.
The commissioner may contract with a private entity or
consortium of private entities to complete the tasks in subdivisions 1 to 3. The private
entity or consortium must be nonprofit and have governance that includes representatives
from the following stakeholder groups: health care providersnew text begin , including providers serving
high concentrations of patients and communities impacted by health disparities;new text end deleted text begin ,deleted text end health
plan companiesdeleted text begin ,deleted text end new text begin ;new text end consumersnew text begin , including consumers representing groups who experience
health disparities;new text end deleted text begin ,deleted text end employers or other health care purchasersdeleted text begin ,deleted text end new text begin ;new text end and state government. No
one stakeholder group shall have a majority of the votes on any issue or hold extraordinary
powers not granted to any other governance stakeholder.
Sec. 8.
Minnesota Statutes 2014, section 144E.001, is amended by adding a subdivision
to read:
new text begin Subd. 5h. new text end
new text begin
Community medical response emergency medical technician.
new text end
new text begin
"Community medical response emergency medical technician" or "CEMT" means
a person who is certified as an emergency medical technician, who is a member of a
registered medical response unit under section 144E.275, and who meets the requirements
for additional certification as a CEMT as specified in section 144E.275, subdivision 7.
new text end
Sec. 9.
Minnesota Statutes 2014, section 144E.275, subdivision 1, is amended to read:
Subdivision 1.
Definition.
For purposes of this section, the following definitions
apply:
(a) "Medical response unit" means an organized service recognized by a local
political subdivision whose primary responsibility is to respond to medical emergencies to
provide initial medical care before the arrival of a licensed ambulance service.new text begin Medical
response units may also provide CEMT services as permitted under subdivision 7.
new text end
(b) "Specialized medical response unit" means an organized service recognized by a
board-approved authority other than a local political subdivision that responds to medical
emergencies as needed or as required by local procedure or protocol.
Sec. 10.
Minnesota Statutes 2014, section 144E.275, is amended by adding a
subdivision to read:
new text begin Subd. 7. new text end
new text begin Community medical response emergency medical technician. new text end
new text begin
(a) To be
eligible for certification by the board as a CEMT, an individual shall:
new text end
new text begin
(1) be currently certified as an EMT or AEMT;
new text end
new text begin
(2) have two years of service as an EMT or AEMT;
new text end
new text begin
(3) be a member of a registered medical response unit as defined under this section;
new text end
new text begin
(4) successfully complete a CEMT training program from a college or university that
has been approved by the board or accredited by a board-approved national accrediting
organization. The training must include clinical experience under the supervision of the
medical response unit medical director, an advanced practice registered nurse, a physician
assistant, or a public health nurse operating under the direct authority of a local unit
of government;
new text end
new text begin
(5) successfully complete a training program that includes training in providing
culturally appropriate care; and
new text end
new text begin
(6) complete a board-approved application form.
new text end
new text begin
(b) A CEMT must practice in accordance with protocols and supervisory standards
established by the medical response unit medical director in accordance with section
144E.265.
new text end
new text begin
(c) A CEMT may provide services within the CEMT skill set as approved by the
medical response unit medical director.
new text end
new text begin
(d) A CEMT may provide episodic individual patient education and prevention
education but only as directed by a patient care plan developed by the patient's primary
physician, an advanced practice registered nurse, or a physician assistant, in conjunction
with the medical response unit medical director and relevant local health care providers.
The patient care plan must ensure that the services provided by the CEMT are consistent
with services offered by the patient's health care home, if one exists, that the patient
receives the necessary services, and that there is no duplication of services to the patient.
new text end
new text begin
(e) A CEMT is subject to all certification, disciplinary, complaint, and other
regulatory requirements that apply to EMTs under this chapter.
new text end
new text begin
(f) A CEMT may not provide services as defined in section 144A.471, subdivisions
6 and 7, except a CEMT may provide verbal or visual reminders to the patient to:
new text end
new text begin
(1) take a regularly scheduled medication, but not to provide or bring the patient
medication; and
new text end
new text begin
(2) follow regularly scheduled treatment or exercise plans.
new text end
Sec. 11.
Minnesota Statutes 2014, section 151.58, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section only, the terms defined in this
subdivision have the meanings given.
(a) "Automated drug distribution system" or "system" means a mechanical system
approved by the board that performs operations or activities, other than compounding or
administration, related to the storage, packaging, or dispensing of drugs, and collects,
controls, and maintains all required transaction information and records.
(b) "Health care facility" means a nursing home licensed under section 144A.02;
a housing with services establishment registered under section 144D.01, subdivision 4,
in which a home provider licensed under chapter 144A is providing centralized storage
of medications; new text begin a boarding care home licensed under sections 144.50 to 144.58 that is
providing centralized storage of medications; new text end or a Minnesota sex offender program facility
operated by the Department of Human Services.
(c) "Managing pharmacy" means a pharmacy licensed by the board that controls and
is responsible for the operation of an automated drug distribution system.
Sec. 12.
Minnesota Statutes 2014, section 151.58, subdivision 5, is amended to read:
Subd. 5.
Operation of automated drug distribution systems.
(a) The managing
pharmacy and the pharmacist in charge are responsible for the operation of an automated
drug distribution system.
(b) Access to an automated drug distribution system must be limited to pharmacy
and nonpharmacy personnel authorized to procure drugs from the system, except that field
service technicians may access a system located in a health care facility for the purposes of
servicing and maintaining it while being monitored either by the managing pharmacy, or a
licensed nurse within the health care facility. In the case of an automated drug distribution
system that is not physically located within a licensed pharmacy, access for the purpose
of procuring drugs shall be limited to licensed nurses. Each person authorized to access
the system must be assigned an individual specific access code. Alternatively, access to
the system may be controlled through the use of biometric identification procedures. A
policy specifying time access parameters, including time-outs, logoffs, and lockouts,
must be in place.
(c) For the purposes of this section only, the requirements of section 151.215 are met
if the following clauses are met:
(1) a pharmacist employed by and working at the managing pharmacy, or at a
pharmacy that is acting as a central services pharmacy for the managing pharmacy,
pursuant to Minnesota Rules, part 6800.4075, must review, interpret, and approve all
prescription drug orders before any drug is distributed from the system to be administered
to a patient. A pharmacy technician may perform data entry of prescription drug orders
provided that a pharmacist certifies the accuracy of the data entry before the drug can
be released from the automated drug distribution system. A pharmacist employed by
and working at the managing pharmacy must certify the accuracy of the filling of any
cassettes, canisters, or other containers that contain drugs that will be loaded into the
automated drug distribution systemnew text begin , unless the filled cassettes, canisters, or containers
have been provided by a repackager registered with the United States Food and Drug
Administration and licensed by the board as a manufacturernew text end ; and
(2) when the automated drug dispensing system is located and used within the
managing pharmacy, a pharmacist must personally supervise and take responsibility for all
packaging and labeling associated with the use of an automated drug distribution system.
(d) Access to drugs when a pharmacist has not reviewed and approved the
prescription drug order is permitted only when a formal and written decision to allow such
access is issued by the pharmacy and the therapeutics committee or its equivalent. The
committee must specify the patient care circumstances in which such access is allowed,
the drugs that can be accessed, and the staff that are allowed to access the drugs.
(e) In the case of an automated drug distribution system that does not utilize bar
coding in the loading process, the loading of a system located in a health care facility may
be performed by a pharmacy technician, so long as the activity is continuously supervised,
through a two-way audiovisual system by a pharmacist on duty within the managing
pharmacy. In the case of an automated drug distribution system that utilizes bar coding
in the loading process, the loading of a system located in a health care facility may be
performed by a pharmacy technician or a licensed nurse, provided that the managing
pharmacy retains an electronic record of loading activities.
(f) The automated drug distribution system must be under the supervision of a
pharmacist. The pharmacist is not required to be physically present at the site of the
automated drug distribution system if the system is continuously monitored electronically
by the managing pharmacy. A pharmacist on duty within a pharmacy licensed by the
board must be continuously available to address any problems detected by the monitoring
or to answer questions from the staff of the health care facility. The licensed pharmacy
may be the managing pharmacy or a pharmacy which is acting as a central services
pharmacy, pursuant to Minnesota Rules, part 6800.4075, for the managing pharmacy.
Sec. 13.
Minnesota Statutes 2014, section 256B.0625, subdivision 3b, is amended to
read:
Subd. 3b.
Telemedicine deleted text begin consultationsdeleted text end new text begin servicesnew text end .
new text begin (a) new text end Medical assistance covers
new text begin medically necessary services and consultations delivered by a licensed health care provider
vianew text end telemedicine deleted text begin consultations. Telemedicine consultations must be made via two-way,
interactive video or store-and-forward technology. Store-and-forward technology includes
telemedicine consultations that do not occur in real time via synchronous transmissions,
and that do not require a face-to-face encounter with the patient for all or any part of any
such telemedicine consultation. The patient record must include a written opinion from the
consulting physician providing the telemedicine consultation. A communication between
two physicians that consists solely of a telephone conversation is not a telemedicine
consultationdeleted text end new text begin in the same manner as if the service or consultation was delivered in personnew text end .
Coverage is limited to three telemedicine deleted text begin consultationsdeleted text end new text begin servicesnew text end per deleted text begin recipientdeleted text end new text begin enrolleenew text end per
calendar week. Telemedicine deleted text begin consultationsdeleted text end new text begin servicesnew text end shall be paid at the full allowable rate.
new text begin
(b) The commissioner shall establish criteria that a health care provider must attest
to in order to demonstrate the safety or efficacy of delivering a particular service via
telemedicine. The attestation may include that the health care provider:
new text end
new text begin
(1) has identified the categories or types of services the health care provider will
provide via telemedicine;
new text end
new text begin
(2) has written policies and procedures specific to telemedicine services that are
regularly reviewed and updated;
new text end
new text begin
(3) has policies and procedures that adequately address patient safety before, during,
and after the telemedicine service is rendered;
new text end
new text begin
(4) has established protocols addressing how and when to discontinue telemedicine
services; and
new text end
new text begin
(5) has an established quality assurance process related to telemedicine services.
new text end
new text begin
(c) As a condition of payment, a licensed health care provider must document
each occurrence of a health service provided by telemedicine to a medical assistance
enrollee. Health care service records for services provided by telemedicine must meet
the requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and
must document:
new text end
new text begin
(1) the type of service provided by telemedicine;
new text end
new text begin
(2) the time the service began and the time the service ended, including an a.m. and
p.m. designation;
new text end
new text begin
(3) the licensed health care provider's basis for determining that telemedicine is an
appropriate and effective means for delivering the service to the enrollee;
new text end
new text begin
(4) the mode of transmission of the telemedicine service and records evidencing that
a particular mode of transmission was utilized;
new text end
new text begin
(5) the location of the originating site and the distant site;
new text end
new text begin
(6) if the claim for payment is based on a physician's telemedicine consultation
with another physician, the written opinion from the consulting physician providing the
telemedicine consultation; and
new text end
new text begin
(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).
new text end
new text begin
(d) For purposes of this subdivision, unless otherwise covered under this chapter,
"telemedicine" is defined as the delivery of health care services or consultations while
the patient is at an originating site and the licensed health care provider is at a distant
site. A communication between licensed health care providers, or a licensed health care
provider and a patient that consists solely of a telephone conversation, e-mail, or facsimile
transmission does not constitute telemedicine consultations or services. Telemedicine may
be provided by means of real-time two-way, interactive audio and visual communications,
including the application of secure video conferencing or store-and-forward technology
to provide or support health care delivery, which facilitate the assessment, diagnosis,
consultation, treatment, education, and care management of a patient's health care.
new text end
new text begin
(e) For purposes of this section, "licensed health care provider" is defined under
section 62A.671, subdivision 6; "health care provider" is defined under section 62A.671,
subdivision 3; and "originating site" is defined under section 62A.671, subdivision 7.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 14.
Minnesota Statutes 2014, section 256B.0625, subdivision 13, is amended to
read:
Subd. 13.
Drugs.
(a) Medical assistance covers drugs, except for fertility drugs
when specifically used to enhance fertility, if prescribed by a licensed practitioner and
dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance
program as a dispensing physician, or by a physician, physician assistant, or a nurse
practitioner employed by or under contract with a community health board as defined in
section 145A.02, subdivision 5, for the purposes of communicable disease control.
(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissioner.
(c) For the purpose of this subdivision and subdivision 13d, an "active
pharmaceutical ingredient" is defined as a substance that is represented for use in a drug
and when used in the manufacturing, processing, or packaging of a drug becomes an
active ingredient of the drug product. An "excipient" is defined as an inert substance
used as a diluent or vehicle for a drug. The commissioner shall establish a list of active
pharmaceutical ingredients and excipients which are included in the medical assistance
formulary. Medical assistance covers selected active pharmaceutical ingredients and
excipients used in compounded prescriptions when the compounded combination is
specifically approved by the commissioner or when a commercially available product:
(1) is not a therapeutic option for the patient;
(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and
(3) cannot be used in place of the active pharmaceutical ingredient in the
compounded prescription.
(d) Medical assistance covers the following over-the-counter drugs when prescribed
by a licensed practitioner or by a licensed pharmacist who meets standards established by
the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen,
family planning products, aspirin, insulin, products for the treatment of lice, vitamins for
adults with documented vitamin deficiencies, vitamins for children under the age of seven
and pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the formulary committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions,
or disorders, and this determination shall not be subject to the requirements of chapter
14. A pharmacist may prescribe over-the-counter medications as provided under this
paragraph for purposes of receiving reimbursement under Medicaid. When prescribing
over-the-counter drugs under this paragraph, licensed pharmacists must consult with
the recipient to determine necessity, provide drug counseling, review drug therapy
for potential adverse interactions, and make referrals as needed to other health care
professionals. Over-the-counter medications must be dispensed in a quantity that is the
deleted text begin lowerdeleted text end new text begin lowestnew text end of: (1) the number of dosage units contained in the manufacturer's original
package; deleted text begin anddeleted text end (2) the number of dosage units required to complete the patient's course of
therapynew text begin ; or (3) if applicable, the number of dosage units dispensed from a system using
retrospective billing, as provided under subdivision 13e, paragraph (b)new text end .
(e) Effective January 1, 2006, medical assistance shall not cover drugs that
are coverable under Medicare Part D as defined in the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e),
for individuals eligible for drug coverage as defined in the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section
1860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the
drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this
subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code,
title 42, section 1396r-8(d)(2)(E), shall not be covered.
(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under
common ownership of the 340B covered entity. Medical assistance does not cover drugs
acquired through the federal 340B Drug Pricing Program and dispensed by 340B contract
pharmacies.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016, or upon federal
approval, whichever is later.
new text end
Sec. 15.
Minnesota Statutes 2014, section 256B.0625, subdivision 13e, is amended to
read:
Subd. 13e.
Payment rates.
(a) The basis for determining the amount of payment
shall be the lower of the actual acquisition costs of the drugs or the maximum allowable
cost by the commissioner plus the fixed dispensing fee; or the usual and customary price
charged to the public. The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any provider/insurer agreement or contract for submitted
charges to medical assistance programs. The net submitted charge may not be greater
than the patient liability for the service. The pharmacy dispensing fee shall be $3.65
new text begin for legend prescription drugsnew text end , except that the dispensing fee for intravenous solutions
which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer
chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed
in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in
quantities greater than one liter. new text begin The pharmacy dispensing fee for over the counter drugs
shall be $3.65, except that the fee shall be $1.31 for retrospectively billing pharmacies
when billing for quantities less than the number of units contained in the manufacturer's
original package. new text end Actual acquisition cost includes quantity and other special discounts
except time and cash discounts. The actual acquisition cost of a drug shall be estimated
by the commissioner at wholesale acquisition cost plus four percent for independently
owned pharmacies located in a designated rural area within Minnesota, and at wholesale
acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently
owned" if it is one of four or fewer pharmacies under the same ownership nationally. A
"designated rural area" means an area defined as a small rural area or isolated rural area
according to the four-category classification of the Rural Urban Commuting Area system
developed for the United States Health Resources and Services Administration. Effective
January 1, 2014, the actual acquisition cost of a drug acquired through the federal 340B
Drug Pricing Program shall be estimated by the commissioner at wholesale acquisition
cost minus 40 percent. Wholesale acquisition cost is defined as the manufacturer's list
price for a drug or biological to wholesalers or direct purchasers in the United States, not
including prompt pay or other discounts, rebates, or reductions in price, for the most
recent month for which information is available, as reported in wholesale price guides or
other publications of drug or biological pricing data. The maximum allowable cost of a
multisource drug may be set by the commissioner and it shall be comparable to, but no
higher than, the maximum amount paid by other third-party payors in this state who have
maximum allowable cost programs. Establishment of the amount of payment for drugs
shall not be subject to the requirements of the Administrative Procedure Act.
(b) new text begin Pharmacies dispensing prescriptions to residents of long-term care facilities
using an automated drug distribution system meeting the requirements of section 151.58,
or a packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents.
A retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.
new text end
new text begin (c) new text end An additional dispensing fee of $.30 may be added to the dispensing fee paid to
pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities
when a unit dose blister card system, approved by the department, is used. Under this type
of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National
Drug Code (NDC) from the drug container used to fill the blister card must be identified on
the claim to the department. The unit dose blister card containing the drug must meet the
packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of
unused drugs to the pharmacy for reuse. deleted text begin Thedeleted text end new text begin Anew text end pharmacy provider deleted text begin will bedeleted text end new text begin using packaging
that meets the standards set forth in Minnesota Rules, part 6800.2700, is new text end required to credit
the department for the actual acquisition cost of all unused drugs that are eligible for reusenew text begin ,
unless the pharmacy is using retrospective billingnew text end . The commissioner may permit the drug
clozapine to be dispensed in a quantity that is less than a 30-day supply.
deleted text begin (c)deleted text end new text begin (d)new text end Whenever a maximum allowable cost has been set for a multisource drug,
payment shall be the lower of the usual and customary price charged to the public or the
maximum allowable cost established by the commissioner unless prior authorization
for the brand name product has been granted according to the criteria established by
the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the
prescriber has indicated "dispense as written" on the prescription in a manner consistent
with section 151.21, subdivision 2.
deleted text begin (d)deleted text end new text begin (e)new text end The basis for determining the amount of payment for drugs administered in
an outpatient setting shall be the lower of the usual and customary cost submitted by
the provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment
must be lower of the usual and customary cost submitted by the provider, the wholesale
acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the
commissioner. Effective January 1, 2014, the commissioner shall discount the payment
rate for drugs obtained through the federal 340B Drug Pricing Program by 20 percent. The
payment for drugs administered in an outpatient setting shall be made to the administering
facility or practitioner. A retail or specialty pharmacy dispensing a drug for administration
in an outpatient setting is not eligible for direct reimbursement.
deleted text begin (e)deleted text end new text begin (f)new text end The commissioner may negotiate lower reimbursement rates for specialty
pharmacy products than the rates specified in paragraph (a). The commissioner may
require individuals enrolled in the health care programs administered by the department
to obtain specialty pharmacy products from providers with whom the commissioner has
negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
used by a small number of recipients or recipients with complex and chronic diseases
that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
that require complex care. The commissioner shall consult with the formulary committee
to develop a list of specialty pharmacy products subject to this paragraph. In consulting
with the formulary committee in developing this list, the commissioner shall take into
consideration the population served by specialty pharmacy products, the current delivery
system and standard of care in the state, and access to care issues. The commissioner shall
have the discretion to adjust the reimbursement rate to prevent access to care issues.
deleted text begin (f)deleted text end new text begin (g)new text end Home infusion therapy services provided by home infusion therapy
pharmacies must be paid at rates according to subdivision 8d.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016, or upon federal
approval, whichever is later.
new text end
Sec. 16.
Minnesota Statutes 2014, section 256B.072, is amended to read:
256B.072 PERFORMANCE REPORTING AND QUALITY IMPROVEMENT
SYSTEM.
(a) The commissioner of human services shall establish a performance reporting
system for health care providers who provide health care services to public program
recipients covered under chapters 256B, 256D, and 256L, reporting separately for
managed care and fee-for-service recipients.
(b) The measures used for the performance reporting system for medical groups
shall include measures of care for asthma, diabetes, hypertension, and coronary artery
disease and measures of preventive care services. The measures used for the performance
reporting system for inpatient hospitals shall include measures of care for acute myocardial
infarction, heart failure, and pneumonia, and measures of care and prevention of surgical
infections. In the case of a medical group, the measures used shall be consistent with
measures published by nonprofit Minnesota or national organizations that produce and
disseminate health care quality measures or evidence-based health care guidelines. In
the case of inpatient hospital measures, the commissioner shall appoint the Minnesota
Hospital Association and Stratis Health to advise on the development of the performance
measures to be used for hospital reporting. To enable a consistent measurement process
across the community, the commissioner may use measures of care provided for patients in
addition to those identified in paragraph (a). The commissioner shall ensure collaboration
with other health care reporting organizations so that the measures described in this
section are consistent with those reported by those organizations and used by other
purchasers in Minnesota.
(c) The commissioner may require providers to submit information in a required
format to a health care reporting organization or to cooperate with the information collection
procedures of that organization. The commissioner may collaborate with a reporting
organization to collect information reported and to prevent duplication of reporting.
(d) By October 1, 2007, and annually thereafter, the commissioner shall report
through a public Web site the results by medical groups and hospitals, where possible,
of the measures under this section, and shall compare the results by medical groups and
hospitals for patients enrolled in public programs to patients enrolled in private health
plans. To achieve this reporting, the commissioner may collaborate with a health care
reporting organization that operates a Web site suitable for this purpose.
new text begin
(e) Performance measures must be stratified as provided under section 62U.02,
subdivision 1, paragraph (b), and risk-adjusted as specified in section 62U.02, subdivision
3, paragraph (b).
new text end
Sec. 17. new text begin PROPOSAL FOR CHILD PROTECTION FOCUSED "COMMUNITY
MEDICAL RESPONSE EMERGENCY MEDICAL TECHNICIAN" (CEMT)
MODEL.
new text end
new text begin
The commissioner shall develop a proposal for a pilot project to create a
community-based support system that coordinates services between child protection
services and community emergency medical technicians. This pilot project model shall
be developed with the input of stakeholders that represent both child protection services
and community emergency medical technicians. The model must be designed so that the
collaborative effort results in increased safety for children and increased support for
families. The pilot project model must be reviewed by the Task Force on the Protection of
Children, and the commissioner shall make recommendations for the pilot project to the
members of the legislative committees with primary jurisdiction over CEMT and child
protection issues no later than January 15, 2016.
new text end
Sec. 18. new text begin COMMUNITY MEDICAL RESPONSE EMERGENCY MEDICAL
TECHNICIAN SERVICES COVERED UNDER THE MEDICAL ASSISTANCE
PROGRAM.
new text end
new text begin
(a) The commissioner of human services, in consultation with representatives of
emergency medical service providers, public health nurses, community health workers,
the Minnesota State Fire Chiefs Association, the Minnesota Professional Firefighters
Association, the Minnesota State Firefighters Department Association, Minnesota
Academy of Family Physicians, Minnesota Licensed Practical Nurses Association,
Minnesota Nurses Association, and local public health agencies, shall determine specified
services and payment rates for these services to be performed by community medical
response emergency medical technicians certified under Minnesota Statutes, section
144E.275, subdivision 7, and covered by medical assistance under Minnesota Statutes,
section 256B.0625. Services must be in the CEMT skill set and may include interventions
intended to prevent avoidable ambulance transportation or hospital emergency department
use.
new text end
new text begin
(b) In order to be eligible for payment, services provided by a community medical
response emergency medical technician must be:
new text end
new text begin
(1) ordered by a medical response unit medical director;
new text end
new text begin
(2) part of a patient care plan that has been developed in coordination with the
patient's primary physician, advanced practice registered nurse, and relevant local health
care providers; and
new text end
new text begin
(3) billed by an eligible medical assistance enrolled provider that employs or
contracts with the community medical response emergency medical technician.
new text end
new text begin
In determining the community medical response emergency medical technician services
to include under medical assistance coverage, the commissioner of human services shall
consider the potential of hospital admittance and emergency room utilization reductions as
well as increased access to quality care in rural communities.
new text end
new text begin
(c) The commissioner of human services shall submit the list of services to be
covered by medical assistance to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and
spending by February 15, 2016. These services shall not be covered by medical assistance
until legislation providing coverage for the services is enacted in law.
new text end
Sec. 19. new text begin EVALUATION OF COMMUNITY MEDICAL RESPONSE
EMERGENCY MEDICAL TECHNICIAN SERVICES.
new text end
new text begin
If legislation is enacted to cover community medical response emergency medical
technician services with medical assistance, the commissioner of human services shall
evaluate the effect of medical assistance and MinnesotaCare coverage for those services
on the cost and quality of care under those programs and the coordination of those services
with the health care home services. The commissioner shall present findings to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
and human services policy and spending by December 1, 2017. The commissioner shall
require medical assistance and MinnesotaCare enrolled providers that employ or contract
with community medical response emergency medical technicians to provide to the
commissioner, in the form and manner specified by the commissioner, the utilization, cost,
and quality data necessary to conduct this evaluation.
new text end
ARTICLE 10
HEALTH LICENSING BOARDS
Section 1.
Minnesota Statutes 2014, section 148.52, is amended to read:
148.52 BOARD OF OPTOMETRY.
The Board of Optometry shall consist of two public members as defined by section
214.02 and five deleted text begin qualifieddeleted text end new text begin Minnesota licensednew text end optometrists appointed by the governor.
Membership terms, compensation of members, removal of members, the filling of
membership vacancies, and fiscal year and reporting requirements shall be as provided in
sections 214.07 to 214.09.
The provision of staff, administrative services and office space; the review and
processing of complaints; the setting of board fees; and other provisions relating to board
operations shall be as provided in chapter 214.
Sec. 2.
Minnesota Statutes 2014, section 148.54, is amended to read:
148.54 BOARD; SEAL.
The Board of Optometry shall elect from among its members a presidentnew text begin , vice
president, and secretarynew text end and may adopt a seal.
Sec. 3.
Minnesota Statutes 2014, section 148.57, subdivision 1, is amended to read:
Subdivision 1.
Examination.
(a) A person not authorized to practice optometry in
the state and desiring to do so shall apply to the state Board of Optometry by filling out
and swearing to an application for a license granted by the board and accompanied by a
fee deleted text begin in an amount of $87deleted text end new text begin established by the board, not to exceed the amount specified in
section 148.59new text end . With the submission of the application form, the candidate shall prove
that the candidate:
(1) is of good moral character;
(2) has obtained a clinical doctorate degree from a board-approved school or college
of optometry, or is currently enrolled in the final year of study at such an institution; and
(3) has passed all parts of an examination.
(b) The examination shall include both a written portion and a clinical practical
portion and shall thoroughly test the fitness of the candidate to practice in this state. In
regard to the written and clinical practical examinations, the board may:
(1) prepare, administer, and grade the examination itself;
(2) recognize and approve in whole or in part an examination prepared, administered
and graded by a national board of examiners in optometry; or
(3) administer a recognized and approved examination prepared and graded by or
under the direction of a national board of examiners in optometry.
(c) The board shall issue a license to each applicant who satisfactorily passes the
examinations and fulfills the other requirements stated in this section deleted text begin and section 148.575
for board certification for the use of legend drugs. Applicants for initial licensure do not
need to apply for or possess a certificate as referred to in sections 148.571 to 148.574. The
fees mentioned in this section are for the use of the board and in no case shall be refundeddeleted text end .
Sec. 4.
Minnesota Statutes 2014, section 148.57, subdivision 2, is amended to read:
Subd. 2.
Endorsement.
new text begin (a) new text end An optometrist who holds a current license from
another state, and who has practiced in that state not less than three years immediately
preceding application, may apply for licensure in Minnesota by filling out and swearing
to an application for license by endorsement furnished by the board. The completed
application with all required documentation shall be filed at the board office along with a
fee deleted text begin of $87deleted text end new text begin established by the board, not to exceed the amount specified in section 148.59new text end .
The application fee shall be for the use of the board and in no case shall be refunded.
new text begin (b)new text end To verify that the applicant possesses the knowledge and ability essential to the
practice of optometry in this state, the applicant must provide evidence of:
(1) having obtained a clinical doctorate degree from a board-approved school
or college of optometry;
(2) successful completion of both written and practical examinations for licensure in
the applicant's original state of licensure that thoroughly tested the fitness of the applicant
to practice;
(3) successful completion of an examination of Minnesota state optometry laws;
(4) compliance with the requirements deleted text begin for board certificationdeleted text end in section 148.575;
(5) compliance with all continuing education required for license renewal in every
state in which the applicant currently holds an active license to practice; and
(6) being in good standing with every state board from which a license has been
issued.
new text begin (c) new text end Documentation from a national certification system or program, approved by
the board, which supports any of the listed requirements, may be used as evidence. The
applicant may then be issued a license if the requirements for licensure in the other state
are deemed by the board to be equivalent to those of sections 148.52 to 148.62.
Sec. 5.
Minnesota Statutes 2014, section 148.57, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Change of address. new text end
new text begin
A person regulated by the board shall maintain a
current name and address with the board and shall notify the board in writing within 30
days of any change in name or address. If a name change only is requested, the regulated
person must request revised credentials and return the current credentials to the board.
The board may require the regulated person to substantiate the name change by submitting
official documentation from a court of law or agency authorized under law to receive and
officially record a name change. If an address change only is requested, no request for
revised credentials is required. If the regulated person's current credentials have been lost,
stolen, or destroyed, the person shall provide a written explanation to the board.
new text end
Sec. 6.
Minnesota Statutes 2014, section 148.574, is amended to read:
148.574 PROHIBITIONS RELATING TO LEGEND DRUGSdeleted text begin ;
AUTHORIZING SALES BY PHARMACISTS UNDER CERTAIN CONDITIONSdeleted text end .
deleted text begin An optometrist shall not purchase, possess, administer, prescribe or give any legend
drug as defined in section 151.01 or 152.02 to any person except as is expressly authorized
by sections 148.571 to 148.577. Nothing in chapter 151 shall prevent a pharmacist from
selling topical ocular drugs to an optometrist authorized to use such drugs according to
sections 148.571 to 148.577.deleted text end Notwithstanding sections 151.37 and 152.12, an optometrist
is prohibited from dispensing legend drugs at retail, unless the legend drug is within the
scope designated in section 148.56, subdivision 1, and is administered to the eye through
an ophthalmic good as defined in section 145.711, subdivision 4.
Sec. 7.
Minnesota Statutes 2014, section 148.575, subdivision 2, is amended to read:
Subd. 2.
deleted text begin Board certifieddeleted text end new text begin Requirementsnew text end defined.
deleted text begin "Board certified" means thatdeleted text end A
licensed optometrist deleted text begin has been issued a certificate by the Board of Optometry certifying
that the optometrist has complieddeleted text end new text begin shall complynew text end with the following requirements for the use
of legend drugs deleted text begin described in section 148.576deleted text end :
deleted text begin
(1) successful completion of at least 60 hours of study in general and ocular
pharmacology emphasizing drugs used for examination or treatment purposes, their
systemic effects and management or referral of adverse reactions;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end successful completion of at least 100 hours of study in the examination,
diagnosis, and treatment of conditions of the human eye with legend drugs;
deleted text begin (3)deleted text end new text begin (2)new text end successful completion of two years of supervised clinical experience in
differential diagnosis of eye disease or disorders as part of optometric training or one year
of that experience and ten years of actual clinical experience as a licensed optometrist; and
deleted text begin (4)deleted text end new text begin (3)new text end successful completion of a nationally standardized examination approved or
administered by the board on the subject of treatment and management of ocular disease.
Sec. 8.
Minnesota Statutes 2014, section 148.577, is amended to read:
148.577 STANDARD OF CARE.
A licensed optometrist deleted text begin who is board certified under section 148.575deleted text end is held to the
same standard of care in the use of those legend drugs as physicians licensed by the state
of Minnesota.
Sec. 9.
Minnesota Statutes 2014, section 148.59, is amended to read:
148.59 LICENSE RENEWAL; deleted text begin FEEdeleted text end new text begin LICENSE AND REGISTRATION FEESnew text end .
A licensed optometrist shall pay to the state Board of Optometry a fee as set by the
board in order to renew a license as provided by board rule.new text begin No fees shall be refunded.
Fees may not exceed the following amounts but may be adjusted lower by board direction
and are for the exclusive use of the board:
new text end
new text begin
(1) optometry licensure application, $160;
new text end
new text begin
(2) optometry annual licensure renewal, $135;
new text end
new text begin
(3) optometry late penalty fee, $75;
new text end
new text begin
(4) annual license renewal card, $10;
new text end
new text begin
(5) continuing education provider application, $45;
new text end
new text begin
(6) emeritus registration, $10;
new text end
new text begin
(7) endorsement/reciprocity application, $160;
new text end
new text begin
(8) replacement of initial license, $12; and
new text end
new text begin
(9) license verification, $50.
new text end
Sec. 10.
Minnesota Statutes 2014, section 148.603, is amended to read:
148.603 deleted text begin FORMS OFdeleted text end new text begin GROUNDS FORnew text end DISCIPLINARY deleted text begin ACTIONSdeleted text end new text begin ACTIONnew text end .
deleted text begin
When grounds exist under section 148.57, subdivision 3, or other statute or rule
which the board is authorized to enforce, the board may take one or more of the following
disciplinary actions, provided that disciplinary or corrective action may not be imposed
by the board on any regulated person except after a contested case hearing conducted
pursuant to chapter 14 or by consent of the parties:
deleted text end
deleted text begin
(1) deny an application for a credential;
deleted text end
deleted text begin
(2) revoke the regulated person's credential;
deleted text end
deleted text begin
(3) suspend the regulated person's credential;
deleted text end
deleted text begin
(4) impose limitations on the regulated person's credential;
deleted text end
deleted text begin
(5) impose conditions on the regulated person's credential;
deleted text end
deleted text begin
(6) censure or reprimand the regulated person;
deleted text end
deleted text begin
(7) impose a civil penalty not exceeding $10,000 for each separate violation, the
amount of the civil penalty to be fixed so as to deprive the person of any economic
advantage gained by reason of the violation or to discourage similar violations or to
reimburse the board for the cost of the investigation and proceeding. For purposes of
this section, the cost of the investigation and proceeding may include, but is not limited
to, fees paid for services provided by the Office of Administrative Hearings, legal and
investigative services provided by the Office of the Attorney General, court reporters,
witnesses, reproduction of records, board members' per diem compensation, board staff
time, and travel costs and expenses incurred by board staff and board members; or
deleted text end
deleted text begin
(8) when grounds exist under section 148.57, subdivision 3, or a board rule, enter
into an agreement with the regulated person for corrective action which may include
requiring the regulated person:
deleted text end
deleted text begin
(i) to complete an educational course or activity;
deleted text end
deleted text begin
(ii) to submit to the executive director or designated board member a written
protocol or reports designed to prevent future violations of the same kind;
deleted text end
deleted text begin
(iii) to meet with a board member or board designee to discuss prevention of future
violations of the same kind; or
deleted text end
deleted text begin
(iv) to perform other action justified by the facts.
deleted text end
deleted text begin
Listing the measures in clause (8) does not preclude the board from including
them in an order for disciplinary action.
deleted text end
new text begin
The board may refuse to grant a license or
may impose disciplinary action as described in section 148.607 against any optometrist
for the following:
new text end
new text begin
(1) failure to demonstrate the qualifications or satisfy the requirements for a license
contained in this chapter or in rules of the board. The burden of proof shall be on the
applicant to demonstrate the qualifications or the satisfaction of the requirements;
new text end
new text begin
(2) obtaining a license by fraud or cheating, or attempting to subvert the licensing
examination process. Conduct which subverts or attempts to subvert the licensing
examination process includes, but is not limited to: (i) conduct which violates the
security of the examination materials, such as removing examination materials from the
examination room or having unauthorized possession of any portion of a future, current, or
previously administered licensing examination; (ii) conduct which violates the standard of
test administration, such as communicating with another examinee during administration
of the examination, copying another examinee's answers, permitting another examinee
to copy one's answers, or possessing unauthorized materials; or (iii) impersonating an
examinee or permitting an impersonator to take the examination on one's own behalf;
new text end
new text begin
(3) conviction, during the previous five years, of a felony or gross misdemeanor,
reasonably related to the practice of optometry. Conviction as used in this section shall
include a conviction of an offense which if committed in this state would be deemed a
felony or gross misdemeanor without regard to its designation elsewhere, or a criminal
proceeding where a finding or verdict of guilt is made or returned but the adjudication of
guilt is either withheld or not entered thereon;
new text end
new text begin
(4) revocation, suspension, restriction, limitation, or other disciplinary action against
the person's optometry license in another state or jurisdiction, failure to report to the
board that charges regarding the person's license have been brought in another state or
jurisdiction, or having been refused a license by any other state or jurisdiction;
new text end
new text begin
(5) advertising which is false or misleading, which violates any rule of the board, or
which claims without substantiation the positive cure of any disease;
new text end
new text begin
(6) violating a rule adopted by the board or an order of the board, a state or federal
law, which relates to the practice of optometry, or a state or federal narcotics or controlled
substance law;
new text end
new text begin
(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm
the public, or demonstrating a willful or careless disregard for the health, welfare, or
safety of a patient; or practice of optometry which is professionally incompetent, in that
it may create unnecessary danger to any patient's life, health, or safety, which in any of
the cases, proof of actual injury need not be established;
new text end
new text begin
(8) failure to supervise an optometrist's assistant or failure to supervise an
optometrist under any agreement with the board;
new text end
new text begin
(9) aiding or abetting an unlicensed person in the practice of optometry, except that
it is not a violation of this section for an optometrist to employ, supervise, or delegate
functions to a qualified person who may or may not be required to obtain a license or
registration to provide health services if that person is practicing within the scope of that
person's license or registration or delegated authority;
new text end
new text begin
(10) adjudication as mentally incompetent, mentally ill, or developmentally
disabled, or as a chemically dependent person, a person dangerous to the public, a sexually
dangerous person, or a person who has a sexual psychopathic personality by a court of
competent jurisdiction, within or without this state. Such adjudication shall automatically
suspend a license for the duration of the license unless the board orders otherwise;
new text end
new text begin
(11) engaging in unprofessional conduct which includes any departure from or the
failure to conform to the minimal standards of acceptable and prevailing practice in which
case actual injury to a patient need not be established;
new text end
new text begin
(12) inability to practice optometry with reasonable skill and safety to patients
by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type of
material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills;
new text end
new text begin
(13) revealing a privileged communication from or relating to a patient except when
otherwise required or permitted by law;
new text end
new text begin
(14) improper management of medical records, including failure to maintain
adequate medical records, to comply with a patient's request made pursuant to sections
144.291 to 144.298 or to furnish a medical record or report required by law;
new text end
new text begin
(15) fee splitting, including without limitation:
new text end
new text begin
(i) paying, offering to pay, receiving, or agreeing to receive a commission, rebate, or
remuneration, directly or indirectly, primarily for the referral of patients or the prescription
of drugs or devices; and
new text end
new text begin
(ii) dividing fees with another optometrist, other health care provider, or a
professional corporation, unless the division is in proportion to the services provided
and the responsibility assumed by each professional and the optometrist has disclosed
the terms of the division;
new text end
new text begin
(16) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws;
new text end
new text begin
(17) becoming addicted or habituated to a drug or intoxicant;
new text end
new text begin
(18) prescribing a drug or device for other than accepted therapeutic or experimental
or investigative purposes authorized by the state or a federal agency;
new text end
new text begin
(19) engaging in conduct with a patient which is sexual or may reasonably be
interpreted by the patient as sexual, or in any verbal behavior which is seductive or
sexually demeaning to a patient;
new text end
new text begin
(20) failure to make reports as required by section 148.604 or to cooperate with an
investigation of the board as required by section 148.606;
new text end
new text begin
(21) knowingly providing false or misleading information that is directly related to
the care of a patient; and
new text end
new text begin
(22) practice of a board-regulated profession under lapsed or nonrenewed credentials.
new text end
Sec. 11.
new text begin
[148.604] REPORTING OBLIGATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Permission to report. new text end
new text begin
A person who has knowledge of any conduct
constituting grounds for discipline under sections 148.52 to 148.62 may report the
violation to the board.
new text end
new text begin Subd. 2. new text end
new text begin Institutions. new text end
new text begin
Any hospital, clinic, prepaid medical plan, or other health
care institution or organization located in this state shall report to the board any action
taken by the institution or organization or any of its administrators or medical or other
committees to revoke, suspend, restrict, or condition an optometrist's privilege to practice
or treat patients in the institution, or as part of the organization, any denial of privileges,
or any other disciplinary action. The institution or organization shall also report the
resignation of any optometrist prior to the conclusion of any disciplinary proceeding, or
prior to the commencement of formal charges but after the optometrist had knowledge
that formal charges were contemplated or in preparation. Each report made under this
subdivision must state the nature of the action taken, state in detail the reasons for
the action, and identify the specific patient medical records upon which the action was
based. No report shall be required of an optometrist voluntarily limiting the practice of
the optometrist at a hospital provided that the optometrist notifies all hospitals where the
optometrist has privileges of the voluntary limitation and the reasons for it.
new text end
new text begin Subd. 3. new text end
new text begin Licensed professionals. new text end
new text begin
A licensed optometrist shall report to the board
personal knowledge of any conduct by any optometrist which the person reasonably
believes constitutes grounds for disciplinary action under sections 148.52 to 148.62,
including any conduct indicating that the person may be incompetent, may have engaged
in unprofessional conduct, or may be physically unable to safely engage in the practice
of optometry.
new text end
new text begin Subd. 4. new text end
new text begin Self-reporting. new text end
new text begin
An optometrist shall report to the board any personal
action which would require that a report be filed with the board by any person, health care
facility, business, or organization pursuant to subdivisions 2 and 3.
new text end
new text begin Subd. 5. new text end
new text begin Deadlines; forms; rulemaking. new text end
new text begin
Reports required by subdivisions 2 to
4 must be submitted not later than 30 days after the occurrence of the reportable event
or transaction. The board may provide forms for the submission of reports required by
this section, may require that reports be submitted on the forms provided, and may adopt
rules necessary to ensure prompt and accurate reporting.
new text end
new text begin Subd. 6. new text end
new text begin Subpoenas. new text end
new text begin
The board may issue subpoenas for the production of any
reports required by subdivisions 2 to 4 or any related documents.
new text end
Sec. 12.
new text begin
[148.605] IMMUNITY.
new text end
new text begin Subdivision 1. new text end
new text begin Reporting. new text end
new text begin
Any person, health care facility, business, or organization
is immune from civil liability or criminal prosecution for submitting a report to the
board pursuant to section 148.604 or for otherwise reporting to the board violations or
alleged violations of section 148.603, if they are acting in good faith and in the exercise
of reasonable care.
new text end
new text begin Subd. 2. new text end
new text begin Investigation; indemnification. new text end
new text begin
(a) Members of the board, persons
employed by the board, and consultants retained by the board for the purpose of
investigation of violations, the preparation of charges, and management of board orders on
behalf of the board are immune from civil liability and criminal prosecution for any actions,
transactions, or publications in the execution of, or relating to, their duties under sections
148.52 to 148.62, if they are acting in good faith and in the exercise of reasonable care.
new text end
new text begin
(b) Members of the board and persons employed by the board or engaged in
maintaining records and making reports regarding adverse health care events are immune
from civil liability and criminal prosecution for any actions, transactions, or publications
in the execution of, or relating to, their duties under sections 148.52 to 148.62, if they are
acting in good faith and in the exercise of reasonable care.
new text end
new text begin
(c) For purposes of this section, a member of the board or a consultant described in
paragraph (a) is considered a state employee under section 3.736, subdivision 9.
new text end
Sec. 13.
new text begin
[148.606] OPTOMETRIST COOPERATION.
new text end
new text begin
An optometrist who is the subject of an investigation by or on behalf of the board
shall cooperate fully with the investigation. Cooperation includes responding fully and
promptly to any question raised by or on behalf of the board relating to the subject of the
investigation and providing copies of patient medical records, as reasonably requested
by the board, to assist the board in its investigation. If the board does not have written
consent from a patient permitting access to the patient's records, the optometrist shall
delete any data in the record which identifies the patient before providing it to the board.
The board shall maintain any records obtained pursuant to this section as investigative
data pursuant to chapter 13.
new text end
Sec. 14.
new text begin
[148.607] DISCIPLINARY ACTIONS.
new text end
new text begin
When the board finds that a licensed optometrist under section 148.57 has violated a
provision or provisions of sections 148.52 to 148.62, it may do one or more of the following:
new text end
new text begin
(1) revoke the license;
new text end
new text begin
(2) suspend the license;
new text end
new text begin
(3) impose limitations or conditions on the optometrist's practice of optometry,
including the limitation of scope of practice to designated field specialties; the imposition
of retraining or rehabilitation requirements; the requirement of practice under supervision;
or the conditioning of continued practice on demonstration of knowledge or skills by
appropriate examination or other review of skill and competence;
new text end
new text begin
(4) impose a civil penalty not exceeding $10,000 for each separate violation, the
amount of the civil penalty to be fixed so as to deprive the optometrist of any economic
advantage gained by reason of the violation charged or to reimburse the board for the cost
of the investigation and proceeding; and
new text end
new text begin
(5) censure or reprimand the licensed optometrist.
new text end
Sec. 15.
Minnesota Statutes 2014, section 148E.075, is amended to read:
148E.075 deleted text begin INACTIVE LICENSESdeleted text end new text begin ALTERNATE LICENSESnew text end .
Subdivision 1.
deleted text begin Inactive statusdeleted text end new text begin Temporary leave licensenew text end .
(a) deleted text begin A licensee qualifies
for inactive status under either of the circumstances described in paragraph (b) or (c).
deleted text end
deleted text begin (b) A licensee qualifies for inactive status when the licensee is granted temporary
leave from active practice.deleted text end A licensee qualifies for temporary leave from active practice if
the licensee demonstrates to the satisfaction of the board that the licensee is not engaged
in the practice of social work in any setting, including settings in which social workers are
exempt from licensure according to section 148E.065. A licensee who is granted temporary
leave from active practice may reactivate the license according to section 148E.080.
new text begin
(b) A licensee may maintain a temporary leave license for no more than four
consecutive years.
new text end
deleted text begin
(c) A licensee qualifies for inactive status when a licensee is granted an emeritus
license. A licensee qualifies for an emeritus license if the licensee demonstrates to the
satisfaction of the board that:
deleted text end
deleted text begin
(1) the licensee is retired from social work practice; and
deleted text end
deleted text begin
(2) the licensee is not engaged in the practice of social work in any setting, including
settings in which social workers are exempt from licensure according to section 148E.065.
deleted text end
deleted text begin
A licensee who possesses an emeritus license may reactivate the license according to
section 148E.080.
deleted text end
new text begin
(c) A licensee who is granted temporary leave from active practice may reactivate
the license according to section 148E.080. If a licensee does not apply for reactivation
within 60 days following the end of the consecutive four-year period, the license
automatically expires. An individual with an expired license may apply for new licensure
according to section 148E.055.
new text end
new text begin
(d) Except as provided in paragraph (e), a licensee who holds a temporary leave
license must not practice, attempt to practice, offer to practice, or advertise or hold out as
authorized to practice social work.
new text end
new text begin
(e) The board may grant a variance to the requirements of paragraph (d) if a licensee
on temporary leave license provides emergency social work services. A variance is
granted only if the board provides the variance in writing to the licensee. The board may
impose conditions or restrictions on the variance.
new text end
new text begin
(f) In making representations of professional status to the public, when holding a
temporary leave license, a licensee must state that the license is not active and that the
licensee cannot practice social work.
new text end
new text begin Subd. 1a. new text end
new text begin Emeritus inactive license. new text end
new text begin
(a) A licensee qualifies for an emeritus inactive
license if the licensee demonstrates to the satisfaction of the board that the licensee is:
new text end
new text begin
(1) retired from social work practice; and
new text end
new text begin
(2) not engaged in the practice of social work in any setting, including settings in
which social workers are exempt from licensure according to section 148E.065.
new text end
new text begin
(b) A licensee with an emeritus inactive license may apply for reactivation according
to section 148E.080 only during the four years following the granting of the emeritus
inactive license. However, after four years following the granting of the emeritus inactive
license, an individual may apply for new licensure according to section 148E.055.
new text end
new text begin
(c) Except as provided in paragraph (d), a licensee who holds an emeritus inactive
license must not practice, attempt to practice, offer to practice, or advertise or hold out as
authorized to practice social work.
new text end
new text begin
(d) The board may grant a variance to the requirements of paragraph (c) if a licensee
on emeritus inactive license provides emergency social work services. A variance is
granted only if the board provides the variance in writing to the licensee. The board may
impose conditions or restrictions on the variance.
new text end
new text begin
(e) In making representations of professional status to the public, when holding
an emeritus inactive license, a licensee must state that the license is not active and that
the licensee cannot practice social work.
new text end
new text begin Subd. 1b. new text end
new text begin Emeritus active license. new text end
new text begin
(a) A licensee qualifies for an emeritus active
license if the applicant demonstrates to the satisfaction of the board that the licensee is:
new text end
new text begin
(1) retired from social work practice; and
new text end
new text begin
(2) in compliance with the supervised practice requirements, as applicable, under
sections 148E.100 to 148E.125.
new text end
new text begin
(b) A licensee who is issued an emeritus active license is only authorized to engage in:
new text end
new text begin
(1) pro bono or unpaid social work practice as specified in section 148E.010,
subdivisions 6 and 11; or
new text end
new text begin
(2) paid social work practice not to exceed 240 clock hours per calendar year, for the
exclusive purpose to provide licensing supervision as specified in sections 148E.100 to
148E.125; and
new text end
new text begin
(3) the authorized scope of practice specified in section 148E.050.
new text end
new text begin
(c) An emeritus active license must be renewed according to the requirements
specified in section 148E.070, subdivisions 1, 2, 3, 4, and 5.
new text end
new text begin
(d) At the time of license renewal a licensee must provide evidence satisfactory to the
board that the licensee has, during the renewal term, completed 20 clock hours of continuing
education, including at least two clock hours in ethics, as specified in section 148E.130:
new text end
new text begin
(1) for licensed independent clinical social workers, at least 12 clock hours must be
in the clinical content areas specified in section 148E.055, subdivision 5; and
new text end
new text begin
(2) for social workers providing supervision according to sections 148E.100 to
148E.125, at least three clock hours must be in the practice of supervision.
new text end
new text begin
(e) Independent study hours must not consist of more than eight clock hours of
continuing education per renewal term.
new text end
new text begin
(f) Failure to renew an active emeritus license on the expiration date will result in an
expired license as specified in section 148E.070, subdivision 5.
new text end
new text begin
(g) The board may grant a variance to the requirements of paragraph (b) if a licensee
holding an emeritus active license provides emergency social work services. A variance is
granted only if the board provides the variance in writing to the licensee. The board may
impose conditions or restrictions on the variance.
new text end
new text begin
(h) In making representations of professional status to the public, when holding an
emeritus active license, a licensee must state that an emeritus active license authorizes only
pro bono or unpaid social work practice, or paid social work practice not to exceed 240
clock hours per calendar year, for the exclusive purpose to provide licensing supervision
as specified in sections 148E.100 to 148E.125.
new text end
new text begin
(i) Notwithstanding the time limit and emeritus active license renewal requirements
specified in this section, a licensee who possesses an emeritus active license may
reactivate the license according to section 148E.080 or apply for new licensure according
to section 148E.055.
new text end
Subd. 2.
Application.
A licensee may apply for deleted text begin inactive statusdeleted text end new text begin temporary leave
license, emeritus inactive license, or emeritus active licensenew text end :
(1) at any time new text begin when currently licensed under section 148E.055, 148E.0555,
148E.0556, or 148E.0557, or when licensed as specified in section 148E.075, new text end by
submitting an application deleted text begin for a temporary leave from active practice or for an emeritus
licensedeleted text end new text begin form required by the boardnew text end ; or
(2) as an alternative to applying for the renewal of a license by so recording on the
application deleted text begin for license renewaldeleted text end new text begin form required by the boardnew text end and submitting the completed,
signed application to the board.
An application that is not completed or signed, or that is not accompanied by the
correct fee, must be returned to the applicant, along with any fee submitted, and is void.
For applications submitted electronically, a "signed application" means providing an
attestation as specified by the board.
Subd. 3.
Fee.
(a) Regardless of when the application for deleted text begin inactive statusdeleted text end new text begin temporary
leave license or emeritus inactive licensenew text end is submitted, the temporary leave new text begin license new text end or
emeritus new text begin inactive new text end license fee specified in section 148E.180, whichever is applicable, must
accompany the application. A licensee who is approved for deleted text begin inactive statusdeleted text end new text begin temporary
leave license or emeritus inactive licensenew text end before the license expiration date is not entitled
to receive a refund for any portion of the license or renewal fee.
(b) If an application for temporary leavenew text begin or emeritus active licensenew text end is received after
the license expiration date, the licensee must pay a renewal late fee as specified in section
148E.180 in addition to the temporary leave fee.
new text begin
(c) Regardless of when the application for emeritus active license is submitted,
the emeritus active license fee is one-half of the renewal fee for the applicable license
specified in section 148E.180, subdivision 3, and must accompany the application. A
licensee who is approved for emeritus active license before the license expiration date is
not entitled to receive a refund for any portion of the license or renewal fee.
new text end
deleted text begin Subd. 4. deleted text end
deleted text begin Time limits for temporary leaves. deleted text end
deleted text begin
A licensee may maintain an inactive
license on temporary leave for no more than five consecutive years. If a licensee does
not apply for reactivation within 60 days following the end of the consecutive five-year
period, the license automatically expires.
deleted text end
deleted text begin Subd. 5. deleted text end
deleted text begin Time limits for emeritus license. deleted text end
deleted text begin
A licensee with an emeritus license may
not apply for reactivation according to section 148E.080 after five years following the
granting of the emeritus license. However, after five years following the granting of the
emeritus license, an individual may apply for new licensure according to section 148E.055.
deleted text end
deleted text begin Subd. 6. deleted text end
deleted text begin Prohibition on practice. deleted text end
deleted text begin
(a) Except as provided in paragraph (b), a
licensee whose license is inactive must not practice, attempt to practice, offer to practice,
or advertise or hold out as authorized to practice social work.
deleted text end
deleted text begin
(b) The board may grant a variance to the requirements of paragraph (a) if a licensee
on inactive status provides emergency social work services. A variance is granted only
if the board provides the variance in writing to the licensee. The board may impose
conditions or restrictions on the variance.
deleted text end
deleted text begin Subd. 7. deleted text end
deleted text begin Representations of professional status. deleted text end
deleted text begin
In making representations of
professional status to the public, a licensee whose license is inactive must state that the
license is inactive and that the licensee cannot practice social work.
deleted text end
Subd. 8.
Disciplinary or other action.
The board may resolve any pending
complaints against a licensee before approving an application for deleted text begin inactive statusdeleted text end new text begin an
alternate license specified in this sectionnew text end . The board may take action according to sections
148E.255 to 148E.270 against a licensee deleted text begin whose license is inactivedeleted text end new text begin who is issued an
alternate license specified in this sectionnew text end based on conduct occurring before the license is
inactive or conduct occurring while the license is deleted text begin inactivedeleted text end new text begin effectivenew text end .
Sec. 16.
Minnesota Statutes 2014, section 148E.080, subdivision 1, is amended to read:
Subdivision 1.
Mailing notices to licensees on temporary leave.
The board must
mail a notice for reactivation to a licensee on temporary leave at least 45 days before the
expiration date of the license according to section 148E.075, subdivision deleted text begin 4deleted text end new text begin 1new text end . Mailing
the notice by United States mail to the licensee's last known mailing address constitutes
valid mailing. Failure to receive the reactivation notice does not relieve a licensee of the
obligation to comply with the provisions of this section to reactivate a license.
Sec. 17.
Minnesota Statutes 2014, section 148E.080, subdivision 2, is amended to read:
Subd. 2.
Reactivation from a temporary leave or emeritus status.
To reactivate a
license from a temporary leave or emeritus status, a licensee must do the following within
the time period specified in section 148E.075, subdivisions deleted text begin 4 and 5deleted text end new text begin 1, 1a, and 1bnew text end :
(1) complete an application form specified by the board;
(2) document compliance with the continuing education requirements specified in
subdivision 4;
(3) submit a supervision plan, if required;
(4) pay the reactivation of deleted text begin an inactive licenseedeleted text end new text begin a licensenew text end fee specified in section
148E.180; and
(5) pay the wall certificate fee according to section 148E.095, subdivision 1,
paragraph (b) or (c), if the licensee needs a duplicate license.
Sec. 18.
Minnesota Statutes 2014, section 148E.180, subdivision 2, is amended to read:
Subd. 2.
License fees.
License fees are as follows:
(1) for a licensed social worker, $81;
(2) for a licensed graduate social worker, $144;
(3) for a licensed independent social worker, $216;
(4) for a licensed independent clinical social worker, $238.50;
(5) for an emeritus new text begin inactive new text end license, $43.20; deleted text begin and
deleted text end
(6) new text begin for an emeritus active license, one-half of the renewal fee specified in subdivision
3; and
new text end
new text begin (7) new text end for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
If the licensee's initial license term is less or more than 24 months, the required
license fees must be prorated proportionately.
Sec. 19.
Minnesota Statutes 2014, section 148E.180, subdivision 5, is amended to read:
Subd. 5.
Late fees.
Late fees are as follows:
(1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3; deleted text begin and
deleted text end
(2) supervision plan late fee, $40deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) license late fee, $100 plus the prorated share of the license fee specified in
subdivision 2 for the number of months during which the individual practiced social
work without a license.
new text end
Sec. 20.
Minnesota Statutes 2014, section 150A.091, subdivision 4, is amended to read:
Subd. 4.
Annual license fees.
Each limited faculty or resident dentist shall submit
with an annual license renewal application a fee established by the board not to exceed
the following amounts:
(1) limited faculty dentist, $168; and
(2) resident dentist or dental provider, deleted text begin $59deleted text end new text begin $85new text end .
Sec. 21.
Minnesota Statutes 2014, section 150A.091, subdivision 5, is amended to read:
Subd. 5.
Biennial license or permit fees.
Each of the following applicants shall
submit with a biennial license or permit renewal application a fee as established by the
board, not to exceed the following amounts:
(1) dentist or full faculty dentist, deleted text begin $336deleted text end new text begin $475new text end ;
(2) dental therapist, deleted text begin $180deleted text end new text begin $300new text end ;
(3) dental hygienist, deleted text begin $118deleted text end new text begin $200new text end ;
(4) licensed dental assistant, deleted text begin $80deleted text end new text begin $150new text end ; and
(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
subpart 3, $24.
Sec. 22.
Minnesota Statutes 2014, section 150A.091, subdivision 11, is amended to read:
Subd. 11.
Certificate application fee for anesthesia/sedation.
Each dentist
shall submit with a general anesthesia or moderate sedation application deleted text begin ordeleted text end new text begin ,new text end a contracted
sedation provider applicationnew text begin , or biennial renewal, new text end a fee as established by the board not to
exceed the following amounts:
(1) for both a general anesthesia and moderate sedation application, deleted text begin $250deleted text end new text begin $400new text end ;
(2) for a general anesthesia application only, deleted text begin $250deleted text end new text begin $400new text end ;
(3) for a moderate sedation application only, deleted text begin $250deleted text end new text begin $400new text end ; and
(4) for a contracted sedation provider application, deleted text begin $250deleted text end new text begin $400new text end .
Sec. 23.
Minnesota Statutes 2014, section 150A.091, is amended by adding a
subdivision to read:
new text begin Subd. 17. new text end
new text begin Advanced dental therapy examination fee. new text end
new text begin
Any dental therapist eligible
to sit for the advanced dental therapy certification examination must submit with the
application a fee as established by the board, not to exceed $250.
new text end
Sec. 24.
Minnesota Statutes 2014, section 150A.091, is amended by adding a
subdivision to read:
new text begin Subd. 18. new text end
new text begin Corporation or professional firm late fee. new text end
new text begin
Any corporation or
professional firm whose annual fee is not postmarked or otherwise received by the board
by the due date of December 31 shall, in addition to the fee, submit a late fee as established
by the board, not to exceed $15.
new text end
Sec. 25.
Minnesota Statutes 2014, section 150A.31, is amended to read:
150A.31 FEES.
(a) The initial biennial registration fee is $50.
(b) The biennial renewal registration fee is deleted text begin $25deleted text end new text begin not to exceed $80new text end .
(c) The fees specified in this section are nonrefundable and shall be deposited in
the state government special revenue fund.
Sec. 26.
Minnesota Statutes 2014, section 151.01, subdivision 15a, is amended to read:
Subd. 15a.
Pharmacy technician.
"Pharmacy technician" means a person not
licensed as a pharmacist or new text begin registered as new text end a pharmacist intern, who deleted text begin assists the pharmacist
in the preparation and dispensing of medications by performing computer entry of
prescription data and other manipulative tasks. A pharmacy technician shall not perform
tasks specifically reserved to a licensed pharmacist or requiringdeleted text end new text begin has been trained in
pharmacy tasks that do not require thenew text end professional judgmentnew text begin of a licensed pharmacist. A
pharmacy technician may not perform tasks specifically reserved to a licensed pharmacistnew text end .
Sec. 27.
Minnesota Statutes 2014, section 151.01, subdivision 27, is amended to read:
Subd. 27.
Practice of pharmacy.
"Practice of pharmacy" means:
(1) interpretation and evaluation of prescription drug orders;
(2) compounding, labeling, and dispensing drugs and devices (except labeling by
a manufacturer or packager of nonprescription drugs or commercially packaged legend
drugs and devices);
(3) participation in clinical interpretations and monitoring of drug therapy for
assurance of safe and effective use of drugs, including the performance of laboratory tests
that are waived under the federal Clinical Laboratory Improvement Act of 1988, United
States Code, title 42, section 263a et seq., provided that a pharmacist may interpret the
results of laboratory tests but may modify drug therapy only pursuant to a protocol or
collaborative practice agreement;
(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;
(5) participation in administration of influenza vaccines to all eligible individuals deleted text begin ten
deleted text end new text begin sixnew text end years of age and older and all other vaccines to patients deleted text begin 18deleted text end new text begin 13new text end years of age and older
by written protocol with a physician licensed under chapter 147, a physician assistant
authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that:
(i) the protocol includes, at a minimum:
(A) the name, dose, and route of each vaccine that may be given;
(B) the patient population for whom the vaccine may be given;
(C) contraindications and precautions to the vaccine;
(D) the procedure for handling an adverse reaction;
(E) the name, signature, and address of the physician, physician assistant, or
advanced practice registered nurse;
(F) a telephone number at which the physician, physician assistant, or advanced
practice registered nurse can be contacted; and
(G) the date and time period for which the protocol is valid;
(ii) the pharmacist has successfully completed a program approved by the
Accreditation Council for Pharmacy Education specifically for the administration of
immunizations or a program approved by the board;
(iii) new text begin the pharmacist utilizes the Minnesota Immunization Information Connection
to assess the immunization status of individuals prior to the administration of vaccines,
except when administering influenza vaccines to individuals age nine and older;
new text end
new text begin (iv) new text end the pharmacist reports the administration of the immunization deleted text begin to the patient's
primary physician or clinic ordeleted text end to the Minnesota Immunization Information Connection; and
deleted text begin (iv)deleted text end new text begin (v)new text end the pharmacist complies with guidelines for vaccines and immunizations
established by the federal Advisory Committee on Immunization Practices, except that a
pharmacist does not need to comply with those portions of the guidelines that establish
immunization schedules when administering a vaccine pursuant to a valid, patient-specific
order issued by a physician licensed under chapter 147, a physician assistant authorized to
prescribe drugs under chapter 147A, or an advanced practice nurse authorized to prescribe
drugs under section 148.235, provided that the order is consistent with the United States
Food and Drug Administration approved labeling of the vaccine;
(6) participation in the initiation, management, modification, and discontinuation
of drug therapy according to a written protocol or collaborative practice agreement
between: (i) one or more pharmacists and one or more dentists, optometrists, physicians,
podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more physician
assistants authorized to prescribe, dispense, and administer under chapter 147A, or
advanced practice nurses authorized to prescribe, dispense, and administer under section
148.235. Any changes in drug therapy made pursuant to a protocol or collaborative
practice agreement must be documented by the pharmacist in the patient's medical record
or reported by the pharmacist to a practitioner responsible for the patient's care;
(7) participation in the storage of drugs and the maintenance of records;
(8) patient counseling on therapeutic values, content, hazards, and uses of drugs
and devices; and
(9) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy.
Sec. 28.
Minnesota Statutes 2014, section 151.02, is amended to read:
151.02 STATE BOARD OF PHARMACY.
The Minnesota State Board of Pharmacy shall consist of deleted text begin twodeleted text end new text begin threenew text end public members
as defined by section 214.02 and deleted text begin fivedeleted text end new text begin sixnew text end pharmacists actively engaged in the practice of
pharmacy in this state. Each of said pharmacists shall have had at least five consecutive
years of practical experience as a pharmacist immediately preceding appointment.
Sec. 29.
Minnesota Statutes 2014, section 151.065, subdivision 1, is amended to read:
Subdivision 1.
Application fees.
Application fees for licensure and registration
are as follows:
(1) pharmacist licensed by examination, deleted text begin $130deleted text end new text begin $145new text end ;
(2) pharmacist licensed by reciprocity, deleted text begin $225deleted text end new text begin $240new text end ;
(3) pharmacy intern, deleted text begin $30deleted text end new text begin $37.50new text end ;
(4) pharmacy technician, deleted text begin $30deleted text end new text begin $37.50new text end ;
(5) pharmacy, deleted text begin $190deleted text end new text begin $225new text end ;
(6) drug wholesaler, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;
(7) drug wholesaler, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;
(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, deleted text begin $175deleted text end new text begin $210new text end ;
(9) drug wholesaler, medical gases, deleted text begin $150deleted text end new text begin $175new text end ;
(10) drug wholesaler, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;
(11) drug manufacturer, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;
(12) drug manufacturer, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;
(13) drug manufacturer, nonlegend or veterinary legend drugs, deleted text begin $175deleted text end new text begin $210new text end ;
(14) drug manufacturer, medical gases, deleted text begin $150deleted text end new text begin $185new text end ;
(15) drug manufacturer, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;
(16) medical gas distributor, deleted text begin $75deleted text end new text begin $110new text end ;
(17) controlled substance researcher, deleted text begin $50deleted text end new text begin $75new text end ; and
(18) pharmacy professional corporation, deleted text begin $100deleted text end new text begin $125new text end .
Sec. 30.
Minnesota Statutes 2014, section 151.065, subdivision 2, is amended to read:
Subd. 2.
Original license fee.
The pharmacist original licensure fee, deleted text begin $130deleted text end new text begin $145new text end .
Sec. 31.
Minnesota Statutes 2014, section 151.065, subdivision 3, is amended to read:
Subd. 3.
Annual renewal fees.
Annual licensure and registration renewal fees
are as follows:
(1) pharmacist, deleted text begin $130deleted text end new text begin $145new text end ;
(2) pharmacy technician, deleted text begin $30deleted text end new text begin $37.50new text end ;
(3) pharmacy, deleted text begin $190deleted text end new text begin $225new text end ;
(4) drug wholesaler, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;
(5) drug wholesaler, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;
(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, deleted text begin $175deleted text end new text begin $210new text end ;
(7) drug wholesaler, medical gases, deleted text begin $150deleted text end new text begin $185new text end ;
(8) drug wholesaler, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;
(9) drug manufacturer, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;
(10) drug manufacturer, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;
(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, deleted text begin $175deleted text end new text begin $210new text end ;
(12) drug manufacturer, medical gases, deleted text begin $150deleted text end new text begin $185new text end ;
(13) drug manufacturer, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;
(14) medical gas distributor, deleted text begin $75deleted text end new text begin $110new text end ;
(15) controlled substance researcher, deleted text begin $50deleted text end new text begin $75new text end ; and
(16) pharmacy professional corporation, deleted text begin $45deleted text end new text begin $75new text end .
Sec. 32.
Minnesota Statutes 2014, section 151.065, subdivision 4, is amended to read:
Subd. 4.
Miscellaneous fees.
Fees for issuance of affidavits and duplicate licenses
and certificates are as follows:
(1) intern affidavit, deleted text begin $15deleted text end new text begin $20new text end ;
(2) duplicate small license, deleted text begin $15deleted text end new text begin $20new text end ; and
(3) duplicate large certificate, deleted text begin $25deleted text end new text begin $30new text end .
Sec. 33.
Minnesota Statutes 2014, section 151.102, is amended to read:
151.102 PHARMACY TECHNICIAN.
Subdivision 1.
General.
A pharmacy technician may assist a pharmacist in the
practice of pharmacy by performing deleted text begin nonjudgmentaldeleted text end tasks deleted text begin anddeleted text end new text begin that are not reserved to, and
do not require the professional judgment of, a licensed pharmacist. A pharmacy technician
new text end works under the personal and direct supervision of the pharmacist. A pharmacist may
supervise deleted text begin twodeleted text end new text begin up to threenew text end techniciansdeleted text begin , as long as thedeleted text end new text begin . Anew text end pharmacist deleted text begin assumes responsibility
deleted text end new text begin is responsiblenew text end for all the deleted text begin functionsdeleted text end new text begin worknew text end performed by the techniciansnew text begin who are under the
supervision of the pharmacistnew text end . A pharmacy may exceed the ratio of pharmacy technicians
to pharmacists permitted in this subdivision or in rule by a total of one technician at
any given time in the pharmacy, provided at least one technician in the pharmacy
holds a valid certification from the Pharmacy Technician Certification Board or from
another national certification body for pharmacy technicians that requires passage of a
nationally recognized, psychometrically valid certification examination for certification as
determined by the Board of Pharmacy. The Board of Pharmacy may, by rule, set ratios of
technicians to pharmacists greater than deleted text begin twodeleted text end new text begin threenew text end to one for the functions specified in rule.
deleted text begin The delegation of any duties, tasks, or functions by a pharmacist to a pharmacy technician
is subject to continuing review and becomes the professional and personal responsibility of
the pharmacist who directed the pharmacy technician to perform the duty, task, or function.
deleted text end
Subd. 2.
Waivers by board permitted.
A pharmacist in charge in a pharmacy may
petition the board for authorization to allow a pharmacist to supervise more than deleted text begin twodeleted text end new text begin three
new text end pharmacy technicians. The pharmacist's petition must include provisions addressing deleted text begin the
maintenance ofdeleted text end new text begin hownew text end patient care and safetynew text begin will be maintainednew text end . A petition filed with the
board under this subdivision shall be deemed approved 90 days after the board receives
the petition, unless the board denies the petition within 90 days of receipt and notifies the
petitioning pharmacist of the petition's denial and the board's reasons for denial.
Subd. 3.
Registration fee.
The board shall not register an individual as a pharmacy
technician unless all applicable fees specified in section 151.065 have been paid.
Sec. 34. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2014, sections 148.57, subdivisions 3 and 4; 148.571; 148.572;
148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, and 6; 148.576; 148E.060,
subdivision 12; and 148E.075, subdivisions 4, 5, 6, and 7,
new text end
new text begin
are repealed.
new text end
ARTICLE 11
HEALTH CARE
Section 1.
Minnesota Statutes 2014, section 62A.045, is amended to read:
62A.045 PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT
HEALTH PROGRAMS.
(a) As a condition of doing business in Minnesota or providing coverage to
residents of Minnesota covered by this section, each health insurer shall comply with the
requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171, including
any federal regulations adopted under that act, to the extent that it imposes a requirement
that applies in this state and that is not also required by the laws of this state. This section
does not require compliance with any provision of the federal act prior to the effective date
provided for that provision in the federal act. The commissioner shall enforce this section.
For the purpose of this section, "health insurer" includes self-insured plans, group
health plans (as defined in section 607(1) of the Employee Retirement Income Security
Act of 1974), service benefit plans, managed care organizations, pharmacy benefit
managers, or other parties that are by contract legally responsible to pay a claim for a
health-care item or service for an individual receiving benefits under paragraph (b).
(b) No plan offered by a health insurer issued or renewed to provide coverage to
a Minnesota resident shall contain any provision denying or reducing benefits because
services are rendered to a person who is eligible for or receiving medical benefits pursuant
to title XIX of the Social Security Act (Medicaid) in this or any other state; chapter 256;
256B; or 256D or services pursuant to section 252.27; 256L.01 to 256L.10; 260B.331,
subdivision 2; 260C.331, subdivision 2; or 393.07, subdivision 1 or 2. No health insurer
providing benefits under plans covered by this section shall use eligibility for medical
programs named in this section as an underwriting guideline or reason for nonacceptance
of the risk.
(c) If payment for covered expenses has been made under state medical programs for
health care items or services provided to an individual, and a third party has a legal liability
to make payments, the rights of payment and appeal of an adverse coverage decision for the
individual, or in the case of a child their responsible relative or caretaker, will be subrogated
to the state agency. The state agency may assert its rights under this section within three
years of the date the service was rendered. For purposes of this section, "state agency"
includes prepaid health plans under contract with the commissioner according to sections
256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; children's mental health
collaboratives under section 245.493; demonstration projects for persons with disabilities
under section 256B.77; nursing homes under the alternative payment demonstration project
under section 256B.434; and county-based purchasing entities under section 256B.692.
(d) Notwithstanding any law to the contrary, when a person covered by a plan
offered by a health insurer receives medical benefits according to any statute listed in this
section, payment for covered services or notice of denial for services billed by the provider
must be issued directly to the provider. If a person was receiving medical benefits through
the Department of Human Services at the time a service was provided, the provider must
indicate this benefit coverage on any claim forms submitted by the provider to the health
insurer for those services. If the commissioner of human services notifies the health
insurer that the commissioner has made payments to the provider, payment for benefits or
notices of denials issued by the health insurer must be issued directly to the commissioner.
Submission by the department to the health insurer of the claim on a Department of
Human Services claim form is proper notice and shall be considered proof of payment of
the claim to the provider and supersedes any contract requirements of the health insurer
relating to the form of submission. Liability to the insured for coverage is satisfied to the
extent that payments for those benefits are made by the health insurer to the provider or
the commissioner as required by this section.
(e) When a state agency has acquired the rights of an individual eligible for medical
programs named in this section and has health benefits coverage through a health insurer,
the health insurer shall not impose requirements that are different from requirements
applicable to an agent or assignee of any other individual covered.
new text begin
(f) A health insurer must process a clean claim made by a state agency for covered
expenses paid under state medical programs within 90 business days of the claim's
submission. A health insurer must process all other claims made by a state agency for
covered expenses paid under a state medical program within the timeline set forth in Code
of Federal Regulations, title 42, section 447.45(d)(4).
new text end
new text begin
(g) A health insurer may request a refund of a claim paid in error to the Department
of Human Services within two years of the date the payment was made to the department.
A request for a refund shall not be honored by the department if the health insurer makes
the request after the time period has lapsed.
new text end
Sec. 2.
Minnesota Statutes 2014, section 150A.06, subdivision 1b, is amended to read:
Subd. 1b.
Resident dentists.
A person who is a graduate of a dental school and
is an enrolled graduate student or student of an accredited advanced dental education
program and who is not licensed to practice dentistry in the state shall obtain from the
board a license to practice dentistry as a resident dentist. The license must be designated
"resident dentist license" and authorizes the licensee to practice dentistry only under the
supervision of a licensed dentist. new text begin A University of Minnesota School of Dentistry dental
resident holding a resident dentist license is eligible for enrollment in medical assistance,
as provided under section 256B.0625, subdivision 9b. new text end A resident dentist license must be
renewed annually pursuant to the board's rules. An applicant for a resident dentist license
shall pay a nonrefundable fee set by the board for issuing and renewing the license. The
requirements of sections 150A.01 to 150A.21 apply to resident dentists except as specified
in rules adopted by the board. A resident dentist license does not qualify a person for
licensure under subdivision 1.
Sec. 3.
Minnesota Statutes 2014, section 174.29, subdivision 1, is amended to read:
Subdivision 1.
Definition.
For the purpose of sections 174.29 and 174.30 "special
transportation service" means motor vehicle transportation provided on a regular basis
by a public or private entity or person that is designed exclusively or primarily to serve
individuals who are elderly or disabled and who are unable to use regular means of
transportation but do not require ambulance service, as defined in section 144E.001,
subdivision 3. Special transportation service includes but is not limited to service provided
by specially equipped buses, vans, taxis, and volunteers driving private automobiles.
new text begin Special transportation service also means those nonemergency medical transportation
services under section 256B.0625, subdivision 17, that are subject to the operating
standards for special transportation service under sections 174.29 to 174.30 and Minnesota
Rules, chapter 8840.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 4.
Minnesota Statutes 2014, section 174.30, subdivision 3, is amended to read:
Subd. 3.
Other standards; wheelchair securementnew text begin ; protected transportnew text end .
(a) A
special transportation service that transports individuals occupying wheelchairs is subject
to the provisions of sections 299A.11 to 299A.18 concerning wheelchair securement
devices. The commissioners of transportation and public safety shall cooperate in the
enforcement of this section and sections 299A.11 to 299A.18 so that a single inspection
is sufficient to ascertain compliance with sections 299A.11 to 299A.18 and with the
standards adopted under this section. Representatives of the Department of Transportation
may inspect wheelchair securement devices in vehicles operated by special transportation
service providers to determine compliance with sections 299A.11 to 299A.18 and to issue
certificates under section 299A.14, subdivision 4.
(b) In place of a certificate issued under section 299A.14, the commissioner may
issue a decal under subdivision 4 for a vehicle equipped with a wheelchair securement
device if the device complies with sections 299A.11 to 299A.18 and the decal displays the
information in section 299A.14, subdivision 4.
new text begin
(c) For vehicles designated as protected transport under section 256B.0625,
subdivision 17, paragraph (h), the commissioner of transportation, during the
commissioner's inspection, shall check to ensure the safety provisions contained in that
paragraph are in working order.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 5.
Minnesota Statutes 2014, section 174.30, subdivision 4, is amended to read:
Subd. 4.
Vehicle and equipment inspection; rules; decal; complaint contact
informationnew text begin ; restrictions on name of servicenew text end .
(a) The commissioner shall inspect or
provide for the inspection of vehicles at least annually. In addition to scheduled annual
inspections and reinspections scheduled for the purpose of verifying that deficiencies have
been corrected, unannounced inspections of any vehicle may be conducted.
(b) On determining that a vehicle or vehicle equipment is in a condition that is likely
to cause an accident or breakdown, the commissioner shall require the vehicle to be taken
out of service immediately. The commissioner shall require that vehicles and equipment
not meeting standards be repaired and brought into conformance with the standards
and shall require written evidence of compliance from the operator before allowing the
operator to return the vehicle to service.
(c) The commissioner shall provide in the rules procedures for inspecting vehicles,
removing unsafe vehicles from service, determining and requiring compliance, and
reviewing driver qualifications.
(d) The commissioner shall design a distinctive decal to be issued to special
transportation service providers with a current certificate of compliance under this section.
A decal is valid for one year from the last day of the month in which it is issued. A person
who is subject to the operating standards adopted under this section may not provide
special transportation service in a vehicle that does not conspicuously display a decal
issued by the commissioner.
(e) new text begin All special transportation service providers shall pay an annual fee of $45
to obtain a decal. Providers of ambulance service, as defined in section 144E.001,
subdivision 3, are exempt from the annual fee. Fees collected under this paragraph must
be deposited in the trunk highway fund, and are appropriated to the commissioner to pay
for costs related to administering the special transportation service program.
new text end
new text begin (f) new text end Special transportation service providers shall prominently display in each vehicle
all contact information for the submission of complaints regarding the transportation
services provided to that individual. All vehicles providing service under section
473.386 shall display contact information for the Metropolitan Council. All other special
transportation service vehicles shall display contact information for the commissioner of
transportation.
new text begin
(g) Nonemergency medical transportation providers must comply with Minnesota
Rules, part 8840.5450, except that a provider may use the phrase "nonemergency medical
transportation" in its name or in advertisements or information describing the service.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 6.
Minnesota Statutes 2014, section 174.30, is amended by adding a subdivision
to read:
new text begin Subd. 4b. new text end
new text begin Variance from the standards. new text end
new text begin
A nonemergency medical transportation
provider who was not subject to the standards in this section prior to July 1, 2014, must
apply for a variance from the commissioner if the provider cannot meet the standards
by January 1, 2017. The commissioner may grant or deny the variance application.
Variances, if granted, shall not exceed 60 days unless extended by the commissioner.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 7.
Minnesota Statutes 2014, section 174.30, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Background studies. new text end
new text begin
(a) Providers of special transportation service
regulated under this section must initiate background studies in accordance with chapter
245C on the following individuals:
new text end
new text begin
(1) each person with a direct or indirect ownership interest of five percent or higher
in the transportation service provider;
new text end
new text begin
(2) each controlling individual as defined under section 245A.02;
new text end
new text begin
(3) managerial officials as defined in section 245A.02;
new text end
new text begin
(4) each driver employed by the transportation service provider;
new text end
new text begin
(5) each individual employed by the transportation service provider to assist a
passenger during transport; and
new text end
new text begin
(6) all employees of the transportation service agency who provide administrative
support, including those who:
new text end
new text begin
(i) may have face-to-face contact with or access to passengers, their personal
property, or their private data;
new text end
new text begin
(ii) perform any scheduling or dispatching tasks; or
new text end
new text begin
(iii) perform any billing activities.
new text end
new text begin
(b) The transportation service provider must initiate the background studies required
under paragraph (a) using the online NETStudy system operated by the commissioner
of human services.
new text end
new text begin
(c) The transportation service provider shall not permit any individual to provide
any service listed in paragraph (a) until the transportation service provider has received
notification from the commissioner of human services indicating that the individual:
new text end
new text begin
(1) is not disqualified under chapter 245C; or
new text end
new text begin
(2) is disqualified, but has received a set-aside of that disqualification according to
section 245C.23 related to that transportation service provider.
new text end
new text begin
(d) When a local or contracted agency is authorizing a ride under section 256B.0625,
subdivision 17, by a volunteer driver, and the agency authorizing the ride has reason
to believe the volunteer driver has a history that would disqualify the individual or
that may pose a risk to the health or safety of passengers, the agency may initiate a
background study to be completed according to chapter 245C using the commissioner
of human services' online NETStudy system, or through contacting the Department of
Human Services background study division for assistance. The agency that initiates the
background study under this paragraph shall be responsible for providing the volunteer
driver with the privacy notice required under section 245C.05, subdivision 2c, and
payment for the background study required under section 245C.10, subdivision 11, before
the background study is completed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 8.
Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Providers of special transportation service. new text end
new text begin
The commissioner shall
conduct background studies on any individual required under section 174.30 to have a
background study completed under this chapter.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 9.
Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Providers of special transportation service. new text end
new text begin
The commissioner shall
recover the cost of background studies initiated by providers of special transportation
service under section 174.30 through a fee of no more than $20 per study. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 10.
Minnesota Statutes 2014, section 256.015, subdivision 7, is amended to read:
Subd. 7.
Cooperation with information requests required.
(a) Upon the request
of the commissioner of human services:
(1) any state agency or third-party payer shall cooperate by furnishing information to
help establish a third-party liability, as required by the federal Deficit Reduction Act of
2005, Public Law 109-171;
(2) any employer or third-party payer shall cooperate by furnishing a data file
containing information about group health insurance plan or medical benefit plan coverage
of its employees or insureds within 60 days of the request.new text begin The information in the data file
must include at least the following: full name, date of birth, Social Security number if
collected and stored in a system routinely used for producing data files by the employer
or third-party payer, employer name, policy identification number, group identification
number, and plan or coverage type.
new text end
(b) For purposes of section 176.191, subdivision 4, the commissioner of labor and
industry may allow the commissioner of human services and county agencies direct access
and data matching on information relating to workers' compensation claims in order to
determine whether the claimant has reported the fact of a pending claim and the amount
paid to or on behalf of the claimant to the commissioner of human services.
(c) For the purpose of compliance with section 169.09, subdivision 13, and
federal requirements under Code of Federal Regulations, title 42, section 433.138
(d)(4), the commissioner of public safety shall provide accident data as requested by
the commissioner of human services. The disclosure shall not violate section 169.09,
subdivision 13, paragraph (d).
(d) The commissioner of human services and county agencies shall limit its use of
information gained from agencies, third-party payers, and employers to purposes directly
connected with the administration of its public assistance and child support programs. The
provision of information by agencies, third-party payers, and employers to the department
under this subdivision is not a violation of any right of confidentiality or data privacy.
Sec. 11.
Minnesota Statutes 2014, section 256.969, subdivision 1, is amended to read:
Subdivision 1.
Hospital cost index.
(a) The hospital cost index shall be the change
in the deleted text begin Consumer Price Index-All Items (United States city average) (CPI-U) forecasted
by Data Resources, Inc.deleted text end new text begin Centers for Medicare and Medicaid Services Inpatient Hospital
Market Basket. new text end The commissioner shall use the indices as forecasted deleted text begin in the third quarter
of the calendar year prior to the rate year. The hospital cost index may be used to adjust
the base year operating payment rate through the rate year on an annually compounded
basisdeleted text end new text begin for the midpoint of the prior rate year to the midpoint of the current rate yearnew text end .
(b) For fiscal years beginning on or after July 1, 1993, the commissioner of human
services shall not provide automatic annual inflation adjustments for hospital payment
rates under medical assistance. deleted text begin The commissioner of management and budget shall
deleted text end deleted text begin include as a budget change request in each biennial detailed expenditure budget submitted
deleted text end deleted text begin to the legislature under section deleted text end deleted text begin 16A.11deleted text end deleted text begin annual adjustments in hospital payment rates under
deleted text end deleted text begin medical assistance based upon the hospital cost index.
deleted text end
Sec. 12.
Minnesota Statutes 2014, section 256.969, subdivision 2b, is amended to read:
Subd. 2b.
Hospital payment rates.
(a) For discharges occurring on or after
November 1, 2014, hospital inpatient services for hospitals located in Minnesota shall be
paid according to the following:
(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;
(2) long-term hospitals as defined by Medicare shall be paid on a per diem
methodology under subdivision 25;
(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and
(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall
not be rebased, except that a Minnesota long-term hospital shall be rebased effective
January 1, 2011, based on its most recent Medicare cost report ending on or before
September 1, 2008, with the provisions under subdivisions 9 and 23, based on the rates
in effect on December 31, 2010. For rate setting periods after November 1, 2014, in
which the base years are updated, a Minnesota long-term hospital's base year shall remain
within the same period as other hospitals.
(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base year for the rates effective November 1, 2014, shall
be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring
that the total aggregate payments under the rebased system are equal to the total aggregate
payments that were made for the same number and types of services in the base year.
Separate budget neutrality calculations shall be determined for payments made to critical
access hospitals and payments made to hospitals paid under the DRG system. Only the rate
increases or decreases under subdivision 3a or 3c that applied to the hospitals being rebased
during the entire base period shall be incorporated into the budget neutrality calculation.
(d) For discharges occurring on or after November 1, 2014, through deleted text begin June 30, 2016
deleted text end new text begin the next rebasing that occursnew text end , the rebased rates under paragraph (c) new text begin that apply to hospitals
under paragraph (a), clause (4),new text end shall include adjustments to the projected rates that result
in no greater than a five percent increase or decrease from the base year payments for any
hospital. Any adjustments to the rates made by the commissioner under this paragraph and
paragraph (e) shall maintain budget neutrality as described in paragraph (c).
(e) For discharges occurring on or after November 1, 2014, through deleted text begin June 30, 2016,
deleted text end new text begin the next rebasing that occursnew text end the commissioner may make additional adjustments to the
rebased rates, and when evaluating whether additional adjustments should be made, the
commissioner shall consider the impact of the rates on the following:
(1) pediatric services;
(2) behavioral health services;
(3) trauma services as defined by the National Uniform Billing Committee;
(4) transplant services;
(5) obstetric services, newborn services, and behavioral health services provided
by hospitals outside the seven-county metropolitan area;
(6) outlier admissions;
(7) low-volume providers; and
(8) services provided by small rural hospitals that are not critical access hospitals.
(f) Hospital payment rates established under paragraph (c) must incorporate the
following:
(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;
(2) for critical access hospitals, deleted text begin interim per diemdeleted text end payment rates new text begin for discharges
between November 1, 2014, and June 30, 2015, new text end shall be deleted text begin based on the ratio of cost
and charges reported on the base year Medicare cost report or reports and applied to
medical assistance utilization data. Final settlement payments for a state fiscal year must
be determined based on a review of the medical assistance cost report required under
subdivision 4b for the applicable state fiscal yeardeleted text end new text begin set to the same rate of payment that
applied for discharges on October 31, 2014new text end ;
(3) the cost and charge data used to establish hospital payment rates must only
reflect inpatient services covered by medical assistance; and
(4) in determining hospital payment rates for discharges occurring on or after the
rate year beginning January 1, 2011, through December 31, 2012, the hospital payment
rate per discharge shall be based on the cost-finding methods and allowable costs of the
Medicare program in effect during the base year or years.
(g) The commissioner shall validate the rates effective November 1, 2014, by
applying the rates established under paragraph (c), and any adjustments made to the rates
under paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine
whether the total aggregate payments for the same number and types of services under the
rebased rates are equal to the total aggregate payments made during calendar year 2013.
(h) Effective for discharges occurring on or after July 1, 2017, and every two
years thereafter, payment rates under this section shall be rebased to reflect only those
changes in hospital costs between the existing base year and the next base year. The
commissioner shall establish the base year for each rebasing period considering the most
recent year for which filed Medicare cost reports are available. The estimated change in
the average payment per hospital discharge resulting from a scheduled rebasing must be
calculated and made available to the legislature by January 15 of each year in which
rebasing is scheduled to occur, and must include by hospital the differential in payment
rates compared to the individual hospital's costs.
new text begin
(i) Effective for discharges occurring on or after July 1, 2015, payment rates for
critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five
percent decrease from the base year payments for any hospital, except a hospital that
had payments that were greater than 100 percent of the hospital's costs in the base year
shall have their rate set equal to 100 percent of costs in the base year. The rates paid for
discharges on and after July 1, 2016, covered under this paragraph shall be increased by
the inflation factor in subdivision 1, paragraph (a). The new cost-based rate shall be the
final rate and shall not be settled to actual incurred costs. Hospitals shall be assigned a
payment tier based on the following criteria:
new text end
new text begin
(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;
new text end
new text begin
(2) hospitals that had payments that were above 80 percent, up to and including
90 percent of their costs in the base year shall have a rate set that equals 95 percent of
their base year costs; and
new text end
new text begin
(3) hospitals that had payments that were above 90 percent of their costs in the base
year shall have a rate set that equals 100 percent of their base year costs.
new text end
new text begin
(j) The commissioner may refine the payment tiers and criteria for critical access
hospitals to coincide with the next rebasing under paragraph (h). The factors used to
develop the new methodology may include, but are not limited to:
new text end
new text begin
(1) the ratio between the hospital's costs for treating medical assistance patients and
the hospital's charges to the medical assistance program;
new text end
new text begin
(2) the ratio between the hospital's costs for treating medical assistance patients and
the hospital's payments received from the medical assistance program for the care of
medical assistance patients;
new text end
new text begin
(3) the ratio between the hospital's charges to the medical assistance program and
the hospital's payments received from the medical assistance program for the care of
medical assistance patients;
new text end
new text begin
(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
new text end
new text begin
(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and
new text end
new text begin
(6) geographic location.
new text end
Sec. 13.
Minnesota Statutes 2014, section 256.969, subdivision 2d, is amended to read:
Subd. 2d.
Interim payments.
Notwithstanding subdivision 2b, paragraph (c), for
discharges occurring on or after November 1, 2014, through deleted text begin June 30, 2015deleted text end new text begin March 1, 2016new text end ,
the commissioner may implement an interim payment process to pay hospitals, including
payments based on each hospital's average payments per claim for state fiscal years 2011
and 2012. These interim payments may be used to pay hospitals if the rebasing under
subdivision 2b, paragraph (c), is not implemented by November 1, 2014new text begin , or if electronic
systems changes necessary to support the conversion to the International Classification of
Diseases, 10th revision (ICD-10) coding system are not completednew text end . Claims paid at interim
payment rates shall be reprocessed and paid at the rates established under subdivision 2b,
paragraphs (c) and (d), upon implementation of the rebased rates.
Sec. 14.
Minnesota Statutes 2014, section 256.969, subdivision 3a, is amended to read:
Subd. 3a.
Payments.
(a) Acute care hospital billings under the medical assistance
program must not be submitted until the recipient is discharged. However, the
commissioner shall establish monthly interim payments for inpatient hospitals that have
individual patient lengths of stay over 30 days regardless of diagnostic category. Except
as provided in section 256.9693, medical assistance reimbursement for treatment of
mental illness shall be reimbursed based on diagnostic classifications. Individual hospital
payments established under this section and sections 256.9685, 256.9686, and 256.9695, in
addition to third-party and recipient liability, for discharges occurring during the rate year
shall not exceed, in aggregate, the charges for the medical assistance covered inpatient
services paid for the same period of time to the hospital. Services that have rates established
under subdivision 11 or 12, must be limited separately from other services. After
consulting with the affected hospitals, the commissioner may consider related hospitals
one entity and may merge the payment rates while maintaining separate provider numbers.
The operating and property base rates per admission or per day shall be derived from the
best Medicare and claims data available when rates are established. The commissioner
shall determine the best Medicare and claims data, taking into consideration variables of
recency of the data, audit disposition, settlement status, and the ability to set rates in a
timely manner. The commissioner shall notify hospitals of payment rates 30 days prior to
implementation. The rate setting data must reflect the admissions data used to establish
relative values. The commissioner may adjust base year cost, relative value, and case mix
index data to exclude the costs of services that have been discontinued by the October
1 of the year preceding the rate year or that are paid separately from inpatient services.
Inpatient stays that encompass portions of two or more rate years shall have payments
established based on payment rates in effect at the time of admission unless the date of
admission preceded the rate year in effect by six months or more. In this case, operating
payment rates for services rendered during the rate year in effect and established based on
the date of admission shall be adjusted to the rate year in effect by the hospital cost index.
(b) For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.
(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before
third-party liability and spenddown, is reduced five percent from the current statutory
rates. Mental health services within diagnosis related groups 424 to 432 or corresponding
APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph.
(d) In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 6.0 percent from
the current statutory rates. Mental health services within diagnosis related groups 424
to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after January 1, 2006, to reflect this reduction.
(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
3.46 percent from the current statutory rates. Mental health services with diagnosis
related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under
subdivision 16 are excluded from this paragraph. Payments made to managed care plans
shall be reduced for services provided on or after January 1, 2009, through June 30, 2009,
to reflect this reduction.
(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011,
made to hospitals for inpatient services before third-party liability and spenddown, is
reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis
related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under
subdivision 16 are excluded from this paragraph. Payments made to managed care plans
shall be reduced for services provided on or after July 1, 2009, through June 30, 2011,
to reflect this reduction.
(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 1.79 percent from
the current statutory rates. Mental health services with diagnosis related groups 424 to 432
or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded
from this paragraph. Payments made to managed care plans shall be reduced for services
provided on or after July 1, 2011, to reflect this reduction.
(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
payment for fee-for-service admissions occurring on or after July 1, 2009, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
one percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.
(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
payment for fee-for-service admissions occurring on or after July 1, 2011, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after January 1, 2011, to reflect this reduction.
(j) Effective for discharges on and after November 1, 2014, from hospitals paid
under subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this
subdivision must be incorporated into the rebased rates established under subdivision 2b,
paragraph (c), and must not be applied to each claim.
new text begin
(k) Effective for discharges on and after July 1, 2015, from hospitals paid under
subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision
must be incorporated into the rates and must not be applied to each claim.
new text end
Sec. 15.
Minnesota Statutes 2014, section 256.969, subdivision 3c, is amended to read:
Subd. 3c.
Rateable reduction and readmissions reduction.
(a) The total payment
for fee for service admissions occurring on or after September 1, 2011, to October 31,
2014, made to hospitals for inpatient services before third-party liability and spenddown,
is reduced ten percent from the current statutory rates. Facilities defined under subdivision
16, long-term hospitals as determined under the Medicare program, children's hospitals
whose inpatients are predominantly under 18 years of age, and payments under managed
care are excluded from this paragraph.
(b) Effective for admissions occurring during calendar year 2010 and each year
after, the commissioner shall calculate a readmission rate for admissions to all hospitals
occurring within 30 days of a previous discharge using data from the Reducing Avoidable
Readmissions Effectively (RARE) campaign. The commissioner may adjust the
readmission rate taking into account factors such as the medical relationship, complicating
conditions, and sequencing of treatment between the initial admission and subsequent
readmissions.
(c) Effective for payments to all hospitals on or after July 1, 2013, through October
31, 2014, the reduction in paragraph (a) is reduced one percentage point for every
percentage point reduction in the overall readmissions rate between the two previous
calendar years to a maximum of five percent.
(d) The exclusion from the rate reduction in paragraph (a) shall apply to a hospital
located in Hennepin County with a licensed capacity of 1,700 beds as of September 1,
2011, for admissions of children under 18 years of age occurring on or after September 1,
2011, through August 31, 2013, but shall not apply to payments for admissions occurring
on or after September 1, 2013, through October 31, 2014.
(e) Effective for discharges on or after November 1, 2014, from hospitals paid under
subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision
must be incorporated into the rebased rates established under subdivision 2b, paragraph
(c), and must not be applied to each claim.
new text begin
(f) Effective for discharges on and after July 1, 2015, from hospitals paid under
subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision
must be incorporated into the rates and must not be applied to each claim.
new text end
Sec. 16.
Minnesota Statutes 2014, section 256.969, subdivision 9, is amended to read:
Subd. 9.
Disproportionate numbers of low-income patients served.
(a) For
admissions occurring on or after July 1, 1993, the medical assistance disproportionate
population adjustment shall comply with federal law and shall be paid to a hospital,
excluding regional treatment centers and facilities of the federal Indian Health Service,
with a medical assistance inpatient utilization rate in excess of the arithmetic mean. The
adjustment must be determined as follows:
(1) for a hospital with a medical assistance inpatient utilization rate above the
arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
federal Indian Health Service but less than or equal to one standard deviation above the
mean, the adjustment must be determined by multiplying the total of the operating and
property payment rates by the difference between the hospital's actual medical assistance
inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
treatment centers and facilities of the federal Indian Health Service; and
(2) for a hospital with a medical assistance inpatient utilization rate above one
standard deviation above the mean, the adjustment must be determined by multiplying
the adjustment that would be determined under clause (1) for that hospital by 1.1.
deleted text begin The commissioner may establish a separate disproportionate population payment rate
deleted text end deleted text begin adjustment for critical access hospitals. deleted text end The commissioner shall report annually on the
number of hospitals likely to receive the adjustment authorized by this paragraph. The
commissioner shall specifically report on the adjustments received by public hospitals and
public hospital corporations located in cities of the first class.
(b) Certified public expenditures made by Hennepin County Medical Center shall
be considered Medicaid disproportionate share hospital payments. Hennepin County
and Hennepin County Medical Center shall report by June 15, 2007, on payments made
beginning July 1, 2005, or another date specified by the commissioner, that may qualify
for reimbursement under federal law. Based on these reports, the commissioner shall
apply for federal matching funds.
(c) Upon federal approval of the related state plan amendment, paragraph (b) is
effective retroactively from July 1, 2005, or the earliest effective date approved by the
Centers for Medicare and Medicaid Services.
new text begin
(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall
be paid in accordance with a new methodology using 2012 as the base year. Annual
payments made under this paragraph shall equal the total amount of payments made for
2012. A licensed children's hospital shall receive only a single DSH factor for children's
hospitals. Other DSH factors may be combined to arrive at a single factor for each hospital
that is eligible for DSH payments. The new methodology shall make payments only to
hospitals located in Minnesota and include the following factors:
new text end
new text begin
(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in
the base year shall receive a factor of 0.868. A licensed children's hospital with less than
1,000 fee-for-service discharges in the base year shall receive a factor of 0.7880;
new text end
new text begin
(2) a hospital that has in effect for the initial rate year a contract with the
commissioner to provide extended psychiatric inpatient services under section 256.9693
shall receive a factor of 0.0160;
new text end
new text begin
(3) a hospital that has received payment from the fee-for-service program for at least
20 transplant services in the base year shall receive a factor of 0.0435;
new text end
new text begin
(4) a hospital that has a medical assistance utilization rate in the base year between
20 percent up to one standard deviation above the statewide mean utilization rate shall
receive a factor of 0.0468;
new text end
new text begin
(5) a hospital that has a medical assistance utilization rate in the base year that is at
least one standard deviation above the statewide mean utilization rate but is less than three
standard deviations above the mean shall receive a factor of 0.2300; and
new text end
new text begin
(6) a hospital that has a medical assistance utilization rate in the base year that is
at least three standard deviations above the statewide mean utilization rate shall receive
a factor of 0.3711.
new text end
new text begin
(e) Any payments or portion of payments made to a hospital under this subdivision
that are subsequently returned to the commissioner because the payments are found to
exceed the hospital-specific DSH limit for that hospital shall be redistributed, proportionate
to the number of fee-for-service discharges, to other DSH-eligible nonchildren's hospitals
that have a medical assistance utilization rate that is at least one standard deviation above
the mean.
new text end
Sec. 17.
new text begin
[256B.0561] PERIODIC DATA MATCHING TO EVALUATE
CONTINUED ELIGIBILITY.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
For the purposes of this section, "periodic data
matching" means obtaining updated electronic information about medical assistance and
MinnesotaCare recipients on the MNsure information system from federal and state data
sources accessible to the MNsure information system and using that data to evaluate
continued eligibility between regularly scheduled renewals.
new text end
new text begin Subd. 2. new text end
new text begin Periodic data matching. new text end
new text begin
(a) Beginning March 1, 2016, the commissioner
shall conduct periodic data matching to identify recipients who, based on available
electronic data, may not meet eligibility criteria for the public health care program in
which the recipient is enrolled. The commissioner shall conduct data matching for
medical assistance or MinnesotaCare recipients at least once during a recipient's 12-month
period of eligibility.
new text end
new text begin
(b) If data matching indicates a recipient may no longer qualify for medical
assistance or MinnesotaCare, the commissioner must notify the recipient and allow the
recipient no more than 30 days to confirm the information obtained through the periodic
data matching or provide a reasonable explanation for the discrepancy to the state or
county agency directly responsible for the recipient's case. If a recipient does not respond
within the advance notice period or does not respond with information that demonstrates
eligibility or provides a reasonable explanation for the discrepancy within the 30-day time
period, the commissioner shall terminate the recipient's eligibility in the manner provided
for by the laws and regulations governing the health care program for which the recipient
has been identified as being ineligible.
new text end
new text begin
(c) The commissioner shall not terminate eligibility for a recipient who is
cooperating with the requirements of paragraph (b) and needs additional time to provide
information in response to the notification.
new text end
new text begin
(d) Any termination of eligibility for benefits under this section may be appealed
as provided for in sections 256.045 to 256.0451, and the laws governing the health care
programs for which eligibility is terminated.
new text end
new text begin Subd. 3. new text end
new text begin Recipient communication requirements. new text end
new text begin
The commissioner shall
include in all communications with recipients affected by the periodic data matching the
following contact information for: (1) the state or county agency directly responsible for
the recipient's case; and (2) consumer assistance partners who may be able to assist the
recipient in the periodic data matching process.
new text end
new text begin Subd. 4. new text end
new text begin Report. new text end
new text begin
By September 1, 2017, and each September 1 thereafter, the
commissioner shall submit a report to the chairs and ranking minority members of the
house and senate committees with jurisdiction over human services finance that includes
the number of cases affected by periodic data matching under this section, the number
of recipients identified as possibly ineligible as a result of a periodic data match, and the
number of recipients whose eligibility was terminated as a result of a periodic data match.
The report must also specify, for recipients whose eligibility was terminated, how many
cases were closed due to failure to cooperate.
new text end
new text begin Subd. 5. new text end
new text begin Federal compliance. new text end
new text begin
The commissioner shall ensure that the
implementation of this section complies with the Affordable Care Act, including the state's
maintenance of effort requirements. The commissioner shall not terminate eligibility
under this section if eligibility terminations would not conform with federal requirements,
including requirements not yet codified in Minnesota Statutes.
new text end
Sec. 18.
Minnesota Statutes 2014, section 256B.06, is amended by adding a
subdivision to read:
new text begin Subd. 6. new text end
new text begin Legal referral and assistance grants. new text end
new text begin
(a) The commissioner shall award
grants to one or more nonprofit programs that provide legal services based on indigency to
provide legal services to individuals with emergency medical conditions or chronic health
conditions who are not currently eligible for medical assistance or other public health
care programs based on their legal status, but who may meet eligibility requirements
with legal assistance.
new text end
new text begin
(b) The grantees, in collaboration with hospitals and safety net providers, shall
provide referral assistance to connect individuals identified in paragraph (a) with
alternative resources and services to assist in meeting their health care needs.
new text end
Sec. 19.
Minnesota Statutes 2014, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 9b. new text end
new text begin
Dental services provided by faculty members and resident dentists
at a dental school.
new text end
new text begin
(a) A dentist who is not enrolled as a medical assistance provider,
is a faculty or adjunct member at the University of Minnesota or a resident dentist
licensed under section 150A.06, subdivision 1b, and is providing dental services at a
dental clinic owned or operated by the University of Minnesota, may be enrolled as a
medical assistance provider if the provider completes and submits to the commissioner an
agreement form developed by the commissioner. The agreement must specify that the
faculty or adjunct member or resident dentist:
new text end
new text begin
(1) will not receive payment for the services provided to medical assistance or
MinnesotaCare enrollees performed at the dental clinics owned or operated by the
University of Minnesota;
new text end
new text begin
(2) will not be listed in the medical assistance or MinnesotaCare provider directory;
and
new text end
new text begin
(3) is not required to serve medical assistance and MinnesotaCare enrollees when
providing nonvolunteer services in a private practice.
new text end
new text begin
(b) A dentist or resident dentist enrolled under this subdivision as a fee-for-service
provider shall not otherwise be enrolled in or receive payments from medical assistance or
MinnesotaCare as a fee-for-service provider.
new text end
Sec. 20.
Minnesota Statutes 2014, section 256B.0625, subdivision 13h, is amended to
read:
Subd. 13h.
Medication therapy management services.
(a) Medical assistance deleted text begin and
deleted text end deleted text begin general assistance medical care coverdeleted text end new text begin coversnew text end medication therapy management services
for a recipient taking deleted text begin three or moredeleted text end prescriptions to treat or prevent one or more chronic
medical conditionsdeleted text begin ; a recipient with a drug therapy problem that is identified by the
commissioner or identified by a pharmacist and approved by the commissioner; or prior
authorized by the commissioner that has resulted or is likely to result in significant
nondrug program costs. The commissioner may cover medical therapy management
services under MinnesotaCare if the commissioner determines this is cost-effectivedeleted text end . For
purposes of this subdivision, "medication therapy management" means the provision
of the following pharmaceutical care services by a licensed pharmacist to optimize the
therapeutic outcomes of the patient's medications:
(1) performing or obtaining necessary assessments of the patient's health status;
(2) formulating a medication treatment plan;
(3) monitoring and evaluating the patient's response to therapy, including safety
and effectiveness;
(4) performing a comprehensive medication review to identify, resolve, and prevent
medication-related problems, including adverse drug events;
(5) documenting the care delivered and communicating essential information to
the patient's other primary care providers;
(6) providing verbal education and training designed to enhance patient
understanding and appropriate use of the patient's medications;
(7) providing information, support services, and resources designed to enhance
patient adherence with the patient's therapeutic regimens; and
(8) coordinating and integrating medication therapy management services within the
broader health care management services being provided to the patient.
Nothing in this subdivision shall be construed to expand or modify the scope of practice of
the pharmacist as defined in section 151.01, subdivision 27.
(b) To be eligible for reimbursement for services under this subdivision, a pharmacist
must meet the following requirements:
(1) have a valid license issued by the Board of Pharmacy of the state in which the
medication therapy management service is being performed;
(2) have graduated from an accredited college of pharmacy on or after May 1996, or
completed a structured and comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education for the provision and
documentation of pharmaceutical care management services that has both clinical and
didactic elements;
(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
have developed a structured patient care process that is offered in a private or semiprivate
patient care area that is separate from the commercial business that also occurs in the
setting, or in home settings, including long-term care settings, group homes, and facilities
providing assisted living services, but excluding skilled nursing facilities; and
(4) make use of an electronic patient record system that meets state standards.
(c) For purposes of reimbursement for medication therapy management services,
the commissioner may enroll individual pharmacists as medical assistance deleted text begin and general
assistance medical caredeleted text end providers. The commissioner may also establish contact
requirements between the pharmacist and recipient, including limiting the number of
reimbursable consultations per recipient.
(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
within a reasonable geographic distance of the patient, a pharmacist who meets the
requirements may provide the services via two-way interactive video. Reimbursement
shall be at the same rates and under the same conditions that would otherwise apply to
the services provided. To qualify for reimbursement under this paragraph, the pharmacist
providing the services must meet the requirements of paragraph (b), and must be
located within an ambulatory care setting deleted text begin approved by the commissionerdeleted text end new text begin that meets the
requirements of paragraph (b), clause (3)new text end . The patient must also be located within an
ambulatory care setting deleted text begin approved by the commissionerdeleted text end new text begin that meets the requirements of
paragraph (b), clause (3)new text end . Services provided under this paragraph may not be transmitted
into the patient's residence.
deleted text begin
(e) The commissioner shall establish a pilot project for an intensive medication
therapy management program for patients identified by the commissioner with multiple
chronic conditions and a high number of medications who are at high risk of preventable
hospitalizations, emergency room use, medication complications, and suboptimal
treatment outcomes due to medication-related problems. For purposes of the pilot
project, medication therapy management services may be provided in a patient's home
or community setting, in addition to other authorized settings. The commissioner may
waive existing payment policies and establish special payment rates for the pilot project.
The pilot project must be designed to produce a net savings to the state compared to the
estimated costs that would otherwise be incurred for similar patients without the program.
The pilot project must begin by January 1, 2010, and end June 30, 2012.
deleted text end
new text begin
(e) Medication therapy management services may be delivered into a patient's
residence via secure interactive video if the medication therapy management services
are performed electronically during a covered home care visit by an enrolled provider.
Reimbursement shall be at the same rates and under the same conditions that would
otherwise apply to the services provided. To qualify for reimbursement under this
paragraph, the pharmacist providing the services must meet the requirements of paragraph
(b) and must be located within an ambulatory care setting that meets the requirements of
paragraph (b), clause (3).
new text end
Sec. 21.
Minnesota Statutes 2014, section 256B.0625, subdivision 17, is amended to
read:
Subd. 17.
Transportation costs.
(a) "Nonemergency medical transportation
service" means motor vehicle transportation provided by a public or private person
that serves Minnesota health care program beneficiaries who do not require emergency
ambulance service, as defined in section 144E.001, subdivision 3, to obtain covered
medical services. deleted text begin Nonemergency medical transportation service includes, but is not
deleted text end deleted text begin limited to, special transportation service, defined in section deleted text end deleted text begin 174.29, subdivision 1deleted text end deleted text begin .
deleted text end
(b) Medical assistance covers medical transportation costs incurred solely for
obtaining emergency medical care or transportation costs incurred by eligible persons in
obtaining emergency or nonemergency medical care when paid directly to an ambulance
company, common carrier, or other recognized providers of transportation services.
Medical transportation must be provided by:
(1) nonemergency medical transportation providers who meet the requirements
of this subdivision;
(2) ambulances, as defined in section 144E.001, subdivision 2;
(3) taxicabs deleted text begin anddeleted text end new text begin ;
new text end
new text begin (4) new text end public transit, as defined in section 174.22, subdivision 7; or
deleted text begin (4)deleted text end new text begin (5)new text end not-for-hire vehicles, including volunteer drivers.
(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to
174.30 and Minnesota Rules, chapter 8840, and in consultation with the Minnesota
Department of Transportation. All nonemergency medical transportation providers shall
bill for nonemergency medical transportation services in accordance with Minnesota
health care programs criteria. Publicly operated transit systems, volunteers, and
not-for-hire vehicles are exempt from the requirements outlined in this paragraph.
(d) The administrative agency of nonemergency medical transportation must:
(1) adhere to the policies defined by the commissioner in consultation with the
Nonemergency Medical Transportation Advisory Committee;
(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;
(3) provide data monthly to the commissioner on appeals, complaints, no-shows,
canceled trips, and number of trips by mode; and
(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by
providers, and ensures prompt payment for nonemergency medical transportation services.
(e) Until the commissioner implements the single administrative structure and
delivery system under subdivision 18e, clients shall obtain their level-of-service certificate
from the commissioner or an entity approved by the commissioner that does not dispatch
rides for clients using modes new text begin of transportation new text end under paragraph (h), clauses (4), (5), (6),
and (7).
(f) The commissioner may use an order by the recipient's attending physician or a
medical or mental health professional to certify that the recipient requires nonemergency
medical transportation services. Nonemergency medical transportation providers shall
perform driver-assisted services for eligible individuals, when appropriate. Driver-assisted
service includes passenger pickup at and return to the individual's residence or place of
business, assistance with admittance of the individual to the medical facility, and assistance
in passenger securement or in securing of wheelchairs or stretchers in the vehicle.
deleted text begin Nonemergency medical transportation providers must have trip logs, which include pickup
and drop-off times, signed by the medical provider or client attesting mileage traveled to
obtain covered medical services, whichever is deemed most appropriate. Nonemergency
medical transportation providers may not bill for separate base rates for the continuation
of a trip beyond the original destination. Nonemergency medical transportation providers
must take clients to the health care provider, using the most direct route, and must not
exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty
care provider, unless the client receives authorization from the local agency. The minimum
medical assistance reimbursement rates for special transportation services are:
deleted text end
deleted text begin
(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to
eligible persons who need a wheelchair-accessible van;
deleted text end
deleted text begin
(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
eligible persons who do not need a wheelchair-accessible van; and
deleted text end
deleted text begin
(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip,
for special transportation services to eligible persons who need a stretcher-accessible
vehicle; and
deleted text end
deleted text begin (2)deleted text end new text begin Nonemergency medical transportation providers must take clients to the health
care provider using the most direct route, and must not exceed 30 miles for a trip to a
primary care provider or 60 miles for a trip to a specialty care provider, unless the client
receives authorization from the local agency.
new text end
new text begin Nonemergency medical transportation providers may not bill for separate base rates
for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. new text end Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.
deleted text begin
(g) The covered modes of nonemergency medical transportation include
transportation provided directly by clients or family members of clients with their own
transportation, volunteers using their own vehicles, taxicabs, and public transit, or
provided to a client who needs a stretcher-accessible vehicle, a lift/ramp equipped vehicle,
or a vehicle that is not stretcher-accessible or lift/ramp equipped designed to transport ten
or fewer persons. Upon implementation of a new rate structure, a new covered mode of
nonemergency medical transportation shall include transportation provided to a client who
needs a protected vehicle that is not an ambulance or police car and has safety locks, a
video recorder, and a transparent thermoplastic partition between the passenger and the
vehicle driver.
deleted text end
deleted text begin (h)deleted text end new text begin (g)new text end The administrative agency shall use the level of service process established
by the commissioner in consultation with the Nonemergency Medical Transportation
Advisory Committee to determine the client's most appropriate mode of transportation.
If public transit or a certified transportation provider is not available to provide the
appropriate service mode for the client, the client may receive a onetime service upgrade.
new text begin (h) new text end The deleted text begin newdeleted text end new text begin covered new text end modes of transportation, which may not be implemented
without a new rate structure, are:
(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportationnew text begin , new text end ornew text begin tonew text end family new text begin or an acquaintance new text end who provides
transportation to the client;
(2) volunteer transport, which includes transportation by volunteers using their
own vehicle;
(3) unassisted transport, which includes transportation provided to a client by a
taxicab or public transit. If a taxicab or deleted text begin publicly operateddeleted text end new text begin publicnew text end transit deleted text begin systemdeleted text end is not
available, the client can receive transportation from another nonemergency medical
transportation provider;
(4) assisted transport, which includes transport provided to clients who require
assistance by a nonemergency medical transportation provider;
(5) lift-equipped/ramp transport, which includes transport provided to a client who
is dependent on a device and requires a nonemergency medical transportation provider
with a vehicle containing a lift or ramp;
(6) protected transport, which includes transport new text begin provided new text end to a client who has
received a prescreening that has deemed other forms of transportation inappropriate and
who requires a providernew text begin : (i) with a protected vehicle that is not an ambulance or police car
and has safety locks, a video recorder, and a transparent thermoplastic partition between
the passenger and the vehicle driver; and (ii) who isnew text end certified as a protected transport
provider; and
(7) stretcher transport, which includes transport for a client in a prone or supine
position and requires a nonemergency medical transportation provider with a vehicle that
can transport a client in a prone or supine position.
(i) deleted text begin In accordance with subdivision 18e, by July 1, 2016,deleted text end The local agency shall be
the single administrative agency and shall administer and reimburse for modes defined in
paragraph (h) according to deleted text begin a new rate structure, once this is adopteddeleted text end new text begin paragraphs (l) and
(m) when the commissioner has developed, made available, and funded the Web-based
single administrative structure, assessment tool, and level of need assessment under
subdivision 18e. The local agency's financial obligation is limited to funds provided by
the state or federal governmentnew text end .
(j) The commissioner shall:
(1) in consultation with the Nonemergency Medical Transportation Advisory
Committee, verify that the mode and use of nonemergency medical transportation is
appropriate;
(2) verify that the client is going to an approved medical appointment; and
(3) investigate all complaints and appeals.
(k) The administrative agency shall pay for the services provided in this subdivision
and seek reimbursement from the commissioner, if appropriate. As vendors of medical
care, local agencies are subject to the provisions in section 256B.041, the sanctions and
monetary recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160
to 9505.2245.
(l) new text begin Payments for nonemergency medical transportation must be paid based on
the client's assessed mode under paragraph (g), not the type of vehicle used to provide
the service. The medical assistance reimbursement rates for nonemergency medical
transportation services that are payable by or on behalf of the commissioner for
nonemergency medical transportation services are:
new text end
new text begin
(1) $0.22 per mile for client reimbursement;
new text end
new text begin
(2) up to 100 percent of the Internal Revenue Service business deduction rate for
volunteer transport;
new text end
new text begin
(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;
new text end
new text begin
(4) $13 for the base rate and $1.30 per mile for assisted transport;
new text end
new text begin
(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
new text end
new text begin
(6) $75 for the base rate and $2.40 per mile for protected transport; and
new text end
new text begin
(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip
for an additional attendant if deemed medically necessary.
new text end
deleted text begin
The base rates for special transportation services in areas defined under RUCA to be
super rural shall be equal to the reimbursement rate established in paragraph (f), clause
(1), plus 11.3 percent, and for special
deleted text end
new text begin (m) The base rate for nonemergency medical transportation services in areas
defined under RUCA to be super rural is equal to 111.3 percent of the respective base
rate in paragraph (l), clauses (1) to (7). The mileage rate for nonemergency medical
new text end transportation services in areas defined under RUCA to be rural or super rural areasnew text begin isnew text end :
(1) for a trip equal to 17 miles or less, deleted text begin mileage reimbursement shall bedeleted text end equal to 125
percent of the respective mileage rate in paragraph deleted text begin (f)deleted text end new text begin (l)new text end , deleted text begin clausedeleted text end new text begin clauses new text end (1)new text begin to (7)new text end ; and
(2) for a trip between 18 and 50 miles, deleted text begin mileage reimbursement shall bedeleted text end equal to
112.5 percent of the respective mileage rate in paragraph deleted text begin (f)deleted text end new text begin (l)new text end , deleted text begin clausedeleted text end new text begin clauses new text end (1)new text begin to (7)new text end .
deleted text begin (m)deleted text end new text begin (n) new text end For purposes of reimbursement rates for deleted text begin specialdeleted text end new text begin nonemergency medical
new text end transportation services under deleted text begin paragraph (c)deleted text end new text begin paragraphs (l) and (m)new text end , the zip code of the
recipient's place of residence shall determine whether the urban, rural, or super rural
reimbursement rate applies.
deleted text begin (n)deleted text end new text begin (o) new text end For purposes of this subdivision, "rural urban commuting area" or "RUCA"
means a census-tract based classification system under which a geographical area is
determined to be urban, rural, or super rural.
deleted text begin
(o) Effective for services provided on or after September 1, 2011, nonemergency
transportation rates, including special transportation, taxi, and other commercial carriers,
are reduced 4.5 percent. Payments made to managed care plans and county-based
purchasing plans must be reduced for services provided on or after January 1, 2012,
to reflect this reduction.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 22.
Minnesota Statutes 2014, section 256B.0625, subdivision 17a, is amended to
read:
Subd. 17a.
Payment for ambulance services.
deleted text begin (a)deleted text end Medical assistance covers
ambulance services. Providers shall bill ambulance services according to Medicare
criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
for services rendered on or after July 1, 2001, medical assistance payments for ambulance
services shall be paid at the Medicare reimbursement rate or at the medical assistance
payment rate in effect on July 1, 2000, whichever is greater.
deleted text begin
(b) Effective for services provided on or after September 1, 2011, ambulance
services payment rates are reduced 4.5 percent. Payments made to managed care plans
and county-based purchasing plans must be reduced for services provided on or after
January 1, 2012, to reflect this reduction.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 23.
Minnesota Statutes 2014, section 256B.0625, subdivision 18a, is amended to
read:
Subd. 18a.
Access to medical services.
(a) Medical assistance reimbursement for
meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
$6.50 for lunch, or $8 for dinner.
(b) Medical assistance reimbursement for lodging for persons traveling to receive
medical care may not exceed $50 per day unless prior authorized by the local agency.
(c) deleted text begin Medical assistance direct mileage reimbursement to the eligible person or the
eligible person's driver may not exceed 20 cents per mile.
deleted text end
deleted text begin (d)deleted text end Regardless of the number of employees that an enrolled health care provider
may have, medical assistance covers sign and oral language interpreter services when
provided by an enrolled health care provider during the course of providing a direct,
person-to-person covered health care service to an enrolled recipient with limited English
proficiency or who has a hearing loss and uses interpreting services. Coverage for
face-to-face oral language interpreter services shall be provided only if the oral language
interpreter used by the enrolled health care provider is listed in the registry or roster
established under section 144.058.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 24.
Minnesota Statutes 2014, section 256B.0625, subdivision 18e, is amended to
read:
Subd. 18e.
Single administrative structure and delivery system.
The
commissionernew text begin , in coordination with the commissioner of transportation, new text end shall implement
a single administrative structure and delivery system for nonemergency medical
transportation, beginning the latter of the date the single administrative assessment tool
required in this subdivision is available for use, as determined by the commissioner or by
July 1, 2016.
In coordination with the Department of Transportation, the commissioner shall
develop and authorize a Web-based single administrative structure and assessment
tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee
assessment process for nonemergency medical transportation services. The Web-based
tool shall facilitate the transportation eligibility determination process initiated by clients
and client advocates; shall include an accessible automated intake and assessment
process and real-time identification of level of service eligibility; and shall authorize an
appropriate and auditable mode of transportation authorization. The tool shall provide a
single framework for reconciling trip information with claiming and collecting complaints
regarding inappropriate level of need determinations, inappropriate transportation modes
utilized, and interference with accessing nonemergency medical transportation. The
Web-based single administrative structure shall operate on a trial basis for one year from
implementation and, if approved by the commissioner, shall be permanent thereafter.
The commissioner shall seek input from the Nonemergency Medical Transportation
Advisory Committee to ensure the software is effective and user-friendly and make
recommendations regarding funding of the single administrative system.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2015.
new text end
Sec. 25.
Minnesota Statutes 2014, section 256B.0625, subdivision 28a, is amended to
read:
Subd. 28a.
Licensed physician assistant services.
(a) Medical assistance covers
services performed by a licensed physician assistant if the service is otherwise covered
under this chapter as a physician service and if the service is within the scope of practice
of a licensed physician assistant as defined in section 147A.09.
(b) Licensed physician assistants, who are supervised by a physician certified by
the American Board of Psychiatry and Neurology or eligible for board certification in
psychiatry, may bill for medication management and evaluation and management services
provided to medical assistance enrollees in inpatient hospital settingsnew text begin , and in outpatient
settings after the licensed physician assistant completes 2,000 hours of clinical experience
in the evaluation and treatment of mental healthnew text end , consistent with their authorized scope of
practice, as defined in section 147A.09, with the exception of performing psychotherapy
or diagnostic assessments or providing clinical supervision.
Sec. 26.
Minnesota Statutes 2014, section 256B.0625, subdivision 31, is amended to
read:
Subd. 31.
Medical supplies and equipment.
(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall
be made for wheelchairs and wheelchair accessories for recipients who are residents
of intermediate care facilities for the developmentally disabled. Reimbursement for
wheelchairs and wheelchair accessories for ICF/DD recipients shall be subject to the same
conditions and limitations as coverage for recipients who do not reside in institutions. A
wheelchair purchased outside of the facility's payment rate is the property of the recipient.
deleted text begin The commissioner may set reimbursement rates for specified categories of medical
supplies at levels below the Medicare payment rate.
deleted text end
(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.
(c) When necessary to ensure access to durable medical equipment, prosthetics,
orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
enrollment requirement if:
(1) the vendor supplies only one type of durable medical equipment, prosthetic,
orthotic, or medical supply;
(2) the vendor serves ten or fewer medical assistance recipients per year;
(3) the commissioner finds that other vendors are not available to provide same or
similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with
the Medicare program's supplier and quality standards and the vendor serves primarily
pediatric patients.
(d) Durable medical equipment means a device or equipment that:
(1) can withstand repeated use;
(2) is generally not useful in the absence of an illness, injury, or disability; and
(3) is provided to correct or accommodate a physiological disorder or physical
condition or is generally used primarily for a medical purpose.
(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
must be locked in order to prevent use not related to communication.
Sec. 27.
Minnesota Statutes 2014, section 256B.0625, subdivision 57, is amended to
read:
Subd. 57.
Payment for Part B Medicare crossover claims.
new text begin (a) new text end Effective for
services provided on or after January 1, 2012, medical assistance payment for an enrollee's
cost-sharing associated with Medicare Part B is limited to an amount up to the medical
assistance total allowed, when the medical assistance rate exceeds the amount paid by
Medicare.
new text begin (b) new text end Excluded from this limitation are payments for mental health services and
payments for dialysis services provided to end-stage renal disease patients. The exclusion
for mental health services does not apply to payments for physician services provided by
psychiatrists and advanced practice nurses with a specialty in mental health.
new text begin
(c) Excluded from this limitation are payments to federally qualified health centers
and rural health clinics.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2016.
new text end
Sec. 28.
Minnesota Statutes 2014, section 256B.0625, subdivision 58, is amended to
read:
Subd. 58.
Early and periodic screening, diagnosis, and treatment services.
Medical assistance covers early and periodic screening, diagnosis, and treatment services
(EPSDT). The payment amount for a complete EPSDT screening shall not include charges
for deleted text begin vaccinesdeleted text end new text begin health care services and productsnew text end that are available at no cost to the provider
and shall not exceed the rate established per Minnesota Rules, part 9505.0445, item M,
effective October 1, 2010.
Sec. 29.
Minnesota Statutes 2014, section 256B.0631, is amended to read:
256B.0631 MEDICAL ASSISTANCE CO-PAYMENTS.
Subdivision 1.
Cost-sharing.
(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following cost-sharing for all recipients, effective
for services provided on or after September 1, 2011:
(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
of this subdivision, a visit means an episode of service which is required because of
a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
midwife, advanced practice nurse, audiologist, optician, or optometrist;
(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that
this co-payment shall be increased to $20 upon federal approval;
(3) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness;
(4) deleted text begin effective January 1, 2012,deleted text end a family deductible equal to deleted text begin the maximum amount
allowed under Code of Federal Regulations, title 42, part 447.54deleted text end new text begin $2.75 per month per
family and adjusted annually by the percentage increase in the medical care component
of the CPI-U for the period of September to September of the preceding calendar year,
rounded to the next higher five-cent incrementnew text end ; and
(5) deleted text begin for individuals identified by the commissioner with income at or below 100
percent of the federal poverty guidelines,deleted text end total monthly cost-sharing must not exceed five
percent of family income. For purposes of this paragraph, family income is the total
earned and unearned income of the individual and the individual's spouse, if the spouse is
enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
new text begin This paragraph does not apply to premiums charged to individuals described under section
256B.057, subdivision 9.
new text end
(b) Recipients of medical assistance are responsible for all co-payments and
deductibles in this subdivision.
(c) Notwithstanding paragraph (b), the commissioner, through the contracting
process under sections 256B.69 and 256B.692, may allow managed care plans and
county-based purchasing plans to waive the family deductible under paragraph (a),
clause (4). The value of the family deductible shall not be included in the capitation
payment to managed care plans and county-based purchasing plans. Managed care plans
and county-based purchasing plans shall certify annually to the commissioner the dollar
value of the family deductible.
(d) Notwithstanding paragraph (b), the commissioner may waive the collection of
the family deductible described under paragraph (a), clause (4), from individuals and
allow long-term care and waivered service providers to assume responsibility for payment.
(e) Notwithstanding paragraph (b), the commissioner, through the contracting
process under section 256B.0756 shall allow the pilot program in Hennepin County to
waive co-payments. The value of the co-payments shall not be included in the capitation
payment amount to the integrated health care delivery networks under the pilot program.
Subd. 2.
Exceptions.
Co-payments and deductibles shall be subject to the following
exceptions:
(1) children under the age of 21;
(2) pregnant women for services that relate to the pregnancy or any other medical
condition that may complicate the pregnancy;
(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
intermediate care facility for the developmentally disabled;
(4) recipients receiving hospice care;
(5) 100 percent federally funded services provided by an Indian health service;
(6) emergency services;
(7) family planning services;
(8) services that are paid by Medicare, resulting in the medical assistance program
paying for the coinsurance and deductible;
(9) co-payments that exceed one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency room; deleted text begin and
deleted text end
(10) services, fee-for-service payments subject to volume purchase through
competitive biddingdeleted text begin .deleted text end new text begin ;
new text end
new text begin
(11) American Indians who meet the requirements in Code of Federal Regulations,
title 42, sections 447.51 and 447.56;
new text end
new text begin
(12) persons needing treatment for breast or cervical cancer as described under
section 256B.057, subdivision 10; and
new text end
new text begin
(13) services that currently have a rating of A or B from the United States Preventive
Services Task Force (USPSTF), immunizations recommended by the Advisory Committee
on Immunization Practices of the Centers for Disease Control and Prevention, and
preventive services and screenings provided to women as described in Code of Federal
Regulations, title 45, section 147.130.
new text end
Subd. 3.
Collection.
(a) The medical assistance reimbursement to the provider shall
be reduced by the amount of the co-payment or deductible, except that reimbursements
shall not be reduced:
(1) once a recipient has reached the $12 per month maximum for prescription drug
co-payments; or
(2) for a recipient deleted text begin identified by the commissioner under 100 percent of the federal
poverty guidelinesdeleted text end who has met their monthly five percent cost-sharing limit.
(b) The provider collects the co-payment or deductible from the recipient. Providers
may not deny services to recipients who are unable to pay the co-payment or deductible.
(c) Medical assistance reimbursement to fee-for-service providers and payments to
managed care plans shall not be increased as a result of the removal of co-payments or
deductibles effective on or after January 1, 2009.
new text begin EFFECTIVE DATE. new text end
new text begin
The amendment to subdivision 1, paragraph (a), clause (4), is
effective retroactively from January 1, 2014.
new text end
Sec. 30.
new text begin
[256B.0638] OPIOID PRESCRIBING IMPROVEMENT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Program established. new text end
new text begin
The commissioner of human services, in
conjunction with the commissioner of health, shall coordinate and implement an opioid
prescribing improvement program to reduce opioid dependency and substance use by
Minnesotans due to the prescribing of opioid analgesics by health care providers.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the terms defined in this
subdivision have the meanings given them.
new text end
new text begin
(b) "Commissioner" means the commissioner of human services.
new text end
new text begin
(c) "Commissioners" means the commissioner of human services and the
commissioner of health.
new text end
new text begin
(d) "DEA" means the United States Drug Enforcement Administration.
new text end
new text begin
(e) "Minnesota health care program" means a public health care program
administered by the commissioner of human services under chapters 256B and 256L, and
the Minnesota restricted recipient program.
new text end
new text begin
(f) "Opioid disenrollment standards" means parameters of opioid prescribing
practices that fall outside community standard thresholds for prescribing to such a degree
that a provider must be disenrolled as a medical assistance provider.
new text end
new text begin
(g) "Opioid prescriber" means a licensed health care provider who prescribes opioids
to medical assistance and MinnesotaCare enrollees under the fee-for-service system or
under a managed care or county-based purchasing plan.
new text end
new text begin
(h) "Opioid quality improvement standard thresholds" means parameters of opioid
prescribing practices that fall outside community standards for prescribing to such a
degree that quality improvement is required.
new text end
new text begin
(i) "Program" means the statewide opioid prescribing improvement program
established under this section.
new text end
new text begin
(j) "Provider group" means a clinic, hospital, or primary or specialty practice group
that employs, contracts with, or is affiliated with an opioid prescriber. Provider group does
not include a professional association supported by dues-paying members.
new text end
new text begin
(k) "Sentinel measures" means measures of opioid use that identify variations in
prescribing practices during the prescribing intervals.
new text end
new text begin Subd. 3. new text end
new text begin Opioid prescribing work group. new text end
new text begin
(a) The commissioner of human
services, in consultation with the commissioner of health, shall appoint the following
voting members to an opioid prescribing work group:
new text end
new text begin
(1) two consumer members who have been impacted by an opioid abuse disorder or
opioid dependence disorder, either personally or with family members;
new text end
new text begin
(2) one member who is a licensed physician actively practicing in Minnesota and
registered as a practitioner with the DEA;
new text end
new text begin
(3) one member who is a licensed pharmacist actively practicing in Minnesota and
registered as a practitioner with the DEA;
new text end
new text begin
(4) one member who is a licensed nurse practitioner actively practicing in Minnesota
and registered as a practitioner with the DEA;
new text end
new text begin
(5) one member who is a licensed dentist actively practicing in Minnesota and
registered as a practitioner with the DEA;
new text end
new text begin
(6) two members who are nonphysician licensed health care professionals actively
engaged in the practice of their profession in Minnesota, and their practice includes
treating pain;
new text end
new text begin
(7) one member who is a mental health professional who is licensed or registered
in a mental health profession, who is actively engaged in the practice of that profession
in Minnesota, and whose practice includes treating patients with chemical dependency
or substance abuse;
new text end
new text begin
(8) one member who is a medical examiner for a Minnesota county;
new text end
new text begin
(9) one member of the Health Services Policy Committee established under section
256B.0625, subdivisions 3c to 3e;
new text end
new text begin
(10) one member who is a medical director of a health plan company doing business
in Minnesota;
new text end
new text begin
(11) one member who is a pharmacy director of a health plan company doing
business in Minnesota; and
new text end
new text begin
(12) one member representing Minnesota law enforcement.
new text end
new text begin
(b) In addition, the work group shall include the following nonvoting members:
new text end
new text begin
(1) the medical director for the medical assistance program;
new text end
new text begin
(2) a member representing the Department of Human Services pharmacy unit; and
new text end
new text begin
(3) the medical director for the Department of Labor and Industry.
new text end
new text begin
(c) An honorarium of $200 per meeting and reimbursement for mileage and parking
shall be paid to each voting member in attendance.
new text end
new text begin Subd. 4. new text end
new text begin Program components. new text end
new text begin
(a) The working group shall recommend to the
commissioners the components of the statewide opioid prescribing improvement program,
including, but not limited to, the following:
new text end
new text begin
(1) developing criteria for opioid prescribing protocols, including:
new text end
new text begin
(i) prescribing for the interval of up to four days immediately after an acute painful
event;
new text end
new text begin
(ii) prescribing for the interval of up to 45 days after an acute painful event; and
new text end
new text begin
(iii) prescribing for chronic pain, which for purposes of this program means pain
lasting longer than 45 days after an acute painful event;
new text end
new text begin
(2) developing sentinel measures;
new text end
new text begin
(3) developing educational resources for opioid prescribers about communicating
with patients about pain management and the use of opioids to treat pain;
new text end
new text begin
(4) developing opioid quality improvement standard thresholds and opioid
disenrollment standards for opioid prescribers and provider groups. In developing opioid
disenrollment standards, the standards may be described in terms of the length of time in
which prescribing practices fall outside community standards and the nature and amount
of opioid prescribing that fall outside community standards; and
new text end
new text begin
(5) addressing other program issues as determined by the commissioners.
new text end
new text begin
(b) The opioid prescribing protocols shall not apply to opioids prescribed for patients
who are experiencing pain caused by a malignant condition or who are receiving hospice
care, or to opioids prescribed as medication-assisted therapy to treat opioid dependency.
new text end
new text begin
(c) All opioid prescribers who prescribe opioids to Minnesota health care program
enrollees must participate in the program in accordance with subdivision 5. Any other
prescriber who prescribes opioids may comply with the components of this program
described in paragraph (a) on a voluntary basis.
new text end
new text begin Subd. 5. new text end
new text begin Program implementation. new text end
new text begin
(a) The commissioner shall implement the
programs within the Minnesota health care program to improve the health of and quality
of care provided to Minnesota health care program enrollees. The commissioner shall
annually collect and report to opioid prescribers data showing the sentinel measures of
their opioid prescribing patterns compared to their anonymized peers.
new text end
new text begin
(b) The commissioner shall notify an opioid prescriber and all provider groups
with which the opioid prescriber is employed or affiliated when the opioid prescriber's
prescribing pattern exceeds the opioid quality improvement standard thresholds. An
opioid prescriber and any provider group that receives a notice under this paragraph shall
submit to the commissioner a quality improvement plan for review and approval by the
commissioner with the goal of bringing the opioid prescriber's prescribing practices into
alignment with community standards. A quality improvement plan must include:
new text end
new text begin
(1) components of the program described in subdivision 4, paragraph (a);
new text end
new text begin
(2) internal practice-based measures to review the prescribing practice of the
opioid prescriber and, where appropriate, any other opioid prescribers employed by or
affiliated with any of the provider groups with which the opioid prescriber is employed or
affiliated; and
new text end
new text begin
(3) appropriate use of the prescription monitoring program under section 152.126.
new text end
new text begin
(c) If, after a year from the commissioner's notice under paragraph (b), the opioid
prescriber's prescribing practices do not improve so that they are consistent with
community standards, the commissioner shall take one or more of the following steps:
new text end
new text begin
(1) monitor prescribing practices more frequently than annually;
new text end
new text begin
(2) monitor more aspects of the opioid prescriber's prescribing practices than the
sentinel measures; or
new text end
new text begin
(3) require the opioid prescriber to participate in additional quality improvement
efforts, including but not limited to mandatory use of the prescription monitoring program
established under section 152.126.
new text end
new text begin
(d) The commissioner shall terminate from Minnesota health care programs all
opioid prescribers and provider groups whose prescribing practices fall within the
applicable opioid disenrollment standards.
new text end
new text begin Subd. 6. new text end
new text begin Data practices. new text end
new text begin
(a) Reports and data identifying an opioid prescriber
are private data on individuals as defined under section 13.02, subdivision 12, until an
opioid prescriber is subject to termination as a medical assistance provider under this
section. Notwithstanding this data classification, the commissioner shall share with all of
the provider groups with which an opioid prescriber is employed or affiliated, a report
identifying an opioid prescriber who is subject to quality improvement activities under
subdivision 5, paragraph (b) or (c).
new text end
new text begin
(b) Reports and data identifying a provider group are nonpublic data as defined
under section 13.02, subdivision 9, until the provider group is subject to termination as a
medical assistance provider under this section.
new text end
new text begin
(c) Upon termination under this section, reports and data identifying an opioid
prescriber or provider group are public, except that any identifying information of
Minnesota health care program enrollees must be redacted by the commissioner.
new text end
new text begin Subd. 7. new text end
new text begin Annual report to legislature. new text end
new text begin
By September 15, 2016, and annually
thereafter, the commissioner of human services shall report to the legislature on the
implementation of the opioid prescribing improvement program in the Minnesota health
care programs. The report must include data on the utilization of opioids within the
Minnesota health care programs.
new text end
Sec. 31.
Minnesota Statutes 2014, section 256B.0757, is amended to read:
256B.0757 COORDINATED CARE THROUGH A HEALTH HOME.
Subdivision 1.
Provision of coverage.
(a) The commissioner shall provide
medical assistance coverage of health home services for eligible individuals with chronic
conditions who select a designated providerdeleted text begin , a team of health care professionals, or a
health teamdeleted text end as the individual's health home.
(b) The commissioner shall implement this section in compliance with the
requirements of the state option to provide health homes for enrollees with chronic
conditions, as provided under the Patient Protection and Affordable Care Act, Public
Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning
provided in that act.
new text begin
(c) The commissioner shall establish health homes to serve populations with serious
mental illness who meet the eligibility requirements described under subdivision 2, clause
(4). The health home services provided by health homes shall focus on both the behavioral
and the physical health of these populations.
new text end
Subd. 2.
Eligible individual.
An individual is eligible for health home services
under this section if the individual is eligible for medical assistance under this chapter
and has at least:
(1) two chronic conditions;
(2) one chronic condition and is at risk of having a second chronic condition; deleted text begin or
deleted text end
(3) one serious and persistent mental health conditiondeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(4) a condition that meets the definition in section 245.462, subdivision 20,
paragraph (a), or 245.4871, subdivision 15, clause (2); and has a current diagnostic
assessment as defined in Minnesota Rules, part 9505.0372, subpart 1, item B or C, as
performed or reviewed by a mental health professional employed by or under contract
with the behavioral health home. The commissioner shall establish criteria for determining
continued eligibility.
new text end
Subd. 3.
Health home services.
(a) Health home services means comprehensive and
timely high-quality services that are provided by a health home. These services include:
(1) comprehensive care management;
(2) care coordination and health promotion;
(3) comprehensive transitional care, including appropriate follow-up, from inpatient
to other settings;
(4) patient and family support, including authorized representatives;
(5) referral to community and social support services, if relevant; and
(6) use of health information technology to link services, as feasible and appropriate.
(b) The commissioner shall maximize the number and type of services included
in this subdivision to the extent permissible under federal law, including physician,
outpatient, mental health treatment, and rehabilitation services necessary for
comprehensive transitional care following hospitalization.
Subd. 4.
deleted text begin Health teamsdeleted text end new text begin Designated providernew text end .
new text begin (a) Health home services
are voluntary and an eligible individual may choose any designated provider. new text end The
commissioner shall establish deleted text begin health teams to support the patient-centereddeleted text end new text begin designated
providers to serve as new text end health deleted text begin homedeleted text end new text begin homesnew text end and provide the services described in subdivision
3 to individuals eligible under subdivision 2. The commissioner shall apply for grants deleted text begin or
contractsdeleted text end as provided under section 3502 of the Patient Protection and Affordable Care Act
to establish health deleted text begin teamsdeleted text end new text begin homesnew text end and provide capitated payments to deleted text begin primary caredeleted text end new text begin designated
new text end providers. For purposes of this section, deleted text begin "health teams"deleted text end new text begin "designated provider"new text end means
deleted text begin community-based, interdisciplinary, interprofessional teams of health care providers that
support primary care practices. These providers may include medical specialists, nurses,
advanced practice registered nurses, pharmacists, nutritionists, social workers, behavioral
and mental health providers, doctors of chiropractic, licensed complementary and
alternative medicine practitioners, and physician assistants.deleted text end new text begin a provider, clinical practice or
clinical group practice, rural clinic, community health center, community mental health
center, or any other entity that is determined by the commissioner to be qualified to be a
health home for eligible individuals. This determination must be based on documentation
evidencing that the designated provider has the systems and infrastructure in place to
provide health home services and satisfies the qualification standards established by the
commissioner in consultation with stakeholders and approved by the Centers for Medicare
and Medicaid Services.
new text end
new text begin
(b) The commissioner shall develop and implement certification standards for
designated providers under this subdivision.
new text end
Subd. 5.
Payments.
The commissioner shall make payments to each deleted text begin health home
and each health teamdeleted text end new text begin designated providernew text end for the provision of health home services
new text begin described in subdivision 3 new text end to each eligible individual deleted text begin with chronic conditionsdeleted text end new text begin under
subdivision 2new text end that selects the health home as a provider.
Subd. 6.
Coordination.
The commissioner, to the extent feasible, shall ensure that
the requirements and payment methods for deleted text begin health homes and health teamsdeleted text end new text begin designated
providersnew text end developed under this section are consistent with the requirements and payment
methods for health care homes established under sections 256B.0751 and 256B.0753. The
commissioner may modify requirements and payment methods under sections 256B.0751
and 256B.0753 in order to be consistent with federal health home requirements and
payment methods.
new text begin Subd. 8. new text end
new text begin Evaluation and continued development. new text end
new text begin
(a) For continued certification
under this section, health homes must meet process, outcome, and quality standards
developed and specified by the commissioner. The commissioner shall collect data from
health homes as necessary to monitor compliance with certification standards.
new text end
new text begin
(b) The commissioner may contract with a private entity to evaluate patient and
family experiences, health care utilization, and costs.
new text end
new text begin
(c) The commissioner shall utilize findings from the implementation of behavioral
health homes to determine populations to serve under subsequent health home models
for individuals with chronic conditions.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end
Sec. 32.
new text begin
[256B.0758] HEALTH CARE DELIVERY PILOT PROGRAM.
new text end
new text begin
(a) The commissioner may establish a health care delivery pilot program to test
alternative and innovative integrated health care delivery networks, including accountable
care organizations or a community-based collaborative care network created by or
including North Memorial Health Care. If required, the commissioner shall seek federal
approval of a new waiver request or amend an existing demonstration pilot project waiver.
new text end
new text begin
(b) Individuals eligible for the pilot program shall be individuals who are eligible for
medical assistance under section 256B.055. The commissioner may identify individuals
to be enrolled in the pilot program based on zip code or whether the individuals would
benefit from an integrated health care delivery network.
new text end
new text begin
(c) In developing a payment system for the pilot programs, the commissioner shall
establish a total cost of care for the individuals enrolled in the pilot program that equals
the cost of care that would otherwise be spent for these enrollees in the prepaid medical
assistance program.
new text end
Sec. 33.
Minnesota Statutes 2014, section 256B.69, subdivision 5a, is amended to read:
Subd. 5a.
Managed care contracts.
(a) Managed care contracts under this section
and section 256L.12 shall be entered into or renewed on a calendar year basis. The
commissioner may issue separate contracts with requirements specific to services to
medical assistance recipients age 65 and older.
(b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B and 256L is responsible for complying with the terms of its
contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B and 256L established after the effective date of a contract with the
commissioner take effect when the contract is next issued or renewed.
(c) The commissioner shall withhold five percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program pending completion of performance targets.
Each performance target must be quantifiable, objective, measurable, and reasonably
attainable, except in the case of a performance target based on a federal or state law
or rule. Criteria for assessment of each performance target must be outlined in writing
prior to the contract effective date. Clinical or utilization performance targets and their
related criteria must consider evidence-based research and reasonable interventions when
available or applicable to the populations served, and must be developed with input from
external clinical experts and stakeholders, including managed care plans, county-based
purchasing plans, and providers. The managed care or county-based purchasing plan
must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
attainment of the performance target is accurate. The commissioner shall periodically
change the administrative measures used as performance targets in order to improve plan
performance across a broader range of administrative services. The performance targets
must include measurement of plan efforts to contain spending on health care services and
administrative activities. The commissioner may adopt plan-specific performance targets
that take into account factors affecting only one plan, including characteristics of the
plan's enrollee population. The withheld funds must be returned no sooner than July of the
following year if performance targets in the contract are achieved. The commissioner may
exclude special demonstration projects under subdivision 23.
(d) The commissioner shall require that managed care plans use the assessment and
authorization processes, forms, timelines, standards, documentation, and data reporting
requirements, protocols, billing processes, and policies consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements consistent
with medical assistance fee-for-service or the Department of Human Services contract
requirements for all personal care assistance services under section 256B.0659.
(e) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction
in the health plan's emergency department utilization rate for medical assistance and
MinnesotaCare enrollees, as determined by the commissioner. For 2012, the reduction
shall be based on the health plan's utilization in 2009. To earn the return of the withhold
each subsequent year, the managed care plan or county-based purchasing plan must
achieve a qualifying reduction of no less than ten percent of the plan's emergency
department utilization rate for medical assistance and MinnesotaCare enrollees, excluding
enrollees in programs described in subdivisions 23 and 28, compared to the previous
measurement year until the final performance target is reached. When measuring
performance, the commissioner must consider the difference in health risk in a managed
care or county-based purchasing plan's membership in the baseline year compared to the
measurement year, and work with the managed care or county-based purchasing plan to
account for differences that they agree are significant.
The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program
enrollees is reduced by 25 percent of the plan's emergency room utilization rate for medical
assistance and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate
with the health plans in meeting this performance target and shall accept payment
withholds that may be returned to the hospitals if the performance target is achieved.
(f) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction
in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than five percent of the plan's hospital admission rate for medical
assistance and MinnesotaCare enrollees, excluding enrollees in programs described in
subdivisions 23 and 28, compared to the previous calendar year until the final performance
target is reached. When measuring performance, the commissioner must consider the
difference in health risk in a managed care or county-based purchasing plan's membership
in the baseline year compared to the measurement year, and work with the managed care
or county-based purchasing plan to account for differences that they agree are significant.
The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved. The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in
calendar year 2011, as determined by the commissioner. The hospital admissions in this
performance target do not include the admissions applicable to the subsequent hospital
admission performance target under paragraph (g). Hospitals shall cooperate with the
plans in meeting this performance target and shall accept payment withholds that may be
returned to the hospitals if the performance target is achieved.
(g) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the plan's hospitalization admission rates for subsequent hospitalizations within 30 days of
a previous hospitalization of a patient regardless of the reason, for medical assistance and
MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
withhold each year, the managed care plan or county-based purchasing plan must achieve
a qualifying reduction of the subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23
and 28, of no less than five percent compared to the previous calendar year until the
final performance target is reached.
The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
the subsequent hospitalization rate was achieved. The commissioner shall structure the
withhold so that the commissioner returns a portion of the withheld funds in amounts
commensurate with achieved reductions in utilization less than the targeted amount.
The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23
and 28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar
year 2011. Hospitals shall cooperate with the plans in meeting this performance target and
shall accept payment withholds that must be returned to the hospitals if the performance
target is achieved.
(h) Effective for services rendered on or after January 1, 2013, through December
31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(i) Effective for services rendered on or after January 1, 2014, the commissioner
shall withhold three percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. The withheld funds must be returned no sooner than July 1 and
no later than July 31 of the following year. The commissioner may exclude special
demonstration projects under subdivision 23.
(j) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
section that is reasonably expected to be returned.
(k) Contracts between the commissioner and a prepaid health plan are exempt from
the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
(a), and 7.
(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).
new text begin
(m) Managed care plans and county-based purchasing plans shall maintain current
and fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data
pursuant to section 13.02.
new text end
Sec. 34.
Minnesota Statutes 2014, section 256B.69, subdivision 5i, is amended to read:
Subd. 5i.
Administrative expenses.
(a) deleted text begin Managed care plan and county-based
purchasing plandeleted text end Administrative costs deleted text begin for a prepaid health plan provideddeleted text end new text begin paid to managed
care plans and county-based purchasing plansnew text end under this section deleted text begin ordeleted text end new text begin ,new text end section 256B.692new text begin ,
and section 256L.12new text end must not exceed deleted text begin by more than fivedeleted text end new text begin 6.6new text end percent deleted text begin that prepaid health
plan's or county-based purchasing plan's actual calculated administrative spending for the
previous calendar year as a percentage of total revenuedeleted text end new text begin of total payments made to all
managed care plans and county-based purchasing plans in aggregate across all state public
health care programs, based on payments expected to be made at the beginning of each
calendar yearnew text end . deleted text begin The penalty for exceeding this limit must be the amount of administrative
spending in excess of 105 percent of the actual calculated amount. The commissioner may
waive this penalty if the excess administrative spending is the result of unexpected shifts
in enrollment or member needs or new program requirements.deleted text end new text begin The commissioner may
reduce or eliminate administrative requirements to meet the administrative cost limit.
For purposes of this paragraph, administrative costs do not include premium taxes paid
under section 297I.05, subdivision 5, provider surcharges paid under section 256.9657,
subdivision 3, and health insurance fees under section 9010 of the Affordable Care Act.
new text end
(b) The following expenses are not allowable administrative expenses for rate-setting
purposes under this section:
(1) charitable contributions made by the managed care plan or the county-based
purchasing plan;
(2) deleted text begin any portion of an individual's compensation in excess of $200,000 paid by the
managed care plan or county-based purchasing plandeleted text end new text begin compensation of individuals within
the organization in excess of $200,000 such that the allocation of compensation for an
individual across all state public health care programs in total cannot exceed $200,000new text end ;
(3) any penalties or fines assessed against the managed care plan or county-based
purchasing plan; deleted text begin and
deleted text end
(4) any indirect marketing or advertising expenses of the managed care plan or
county-based purchasing plannew text begin , including but not limited to costs to promote the managed
care or county-based purchasing plan, costs of facilities used for special events, and costs
of displays, demonstrations, donations, and promotional items such as memorabilia,
models, gifts, and souvenirs. The commissioner may classify an item listed in this clause
as an allowable administrative expense for rate-setting purposes, if the commissioner
determines that the expense is incidental to an activity related to state pubic health care
programs that is an allowable cost for purposes of rate setting;
new text end
new text begin
(5) any lobbying and political activities, events, or contributions;
new text end
new text begin
(6) administrative expenses related to the provision of services not covered under
the state plan or waiver;
new text end
new text begin
(7) alcoholic beverages and related costs;
new text end
new text begin
(8) membership in any social, dining, or country club or organization; and
new text end
new text begin (9) entertainment, including amusement, diversion, and social activities, and any
costs directly associated with these costs, including but not limited to tickets to shows or
sporting events, meals, lodging, rentals, transportation, and gratuitiesnew text end .
For the purposes of this subdivision, compensation includes salaries, bonuses and
incentives, other reportable compensation on an IRS 990 form, retirement and other
deferred compensation, and nontaxable benefits.new text begin Charitable contributions under clause
(1) include payments for or to any organization or entity selected by the managed care
plan or county-based purchasing plan that is operated for charitable, educational, political,
religious, or scientific purposes, that are not related to medical and administrative services
covered under state public health care programs.
new text end
new text begin
(c) Payments to a quality improvement organization are an allowable administrative
expense for rate-setting purposes under this section, to the extent they are allocated to a
state public health care program and approved by the commissioner.
new text end
new text begin
(d) Where reasonably possible, expenses for an administrative item shall be directly
allocated so as to assign costs for an item to an individual state public health care program
when the cost can be specifically identified with and benefits the individual state public
health care program. For administrative services expensed to the state's public health care
programs, managed care plans and county-based purchasing plans must clearly identify
and separately record expense items listed under paragraph (b) in their accounting systems
in a manner that allows for independent verification of unallowable expenses for purposes
of determining payment rates for state public health care programs.
new text end
new text begin
(e) Notwithstanding paragraph (a), the commissioner shall reduce administrative
expenses paid to managed care plans and county-based purchasing plans by .50 of a
percentage point for contracts beginning January 1, 2016, and ending December 31,
2017. To meet the administrative reductions under this paragraph, the commissioner
may reduce or eliminate administrative requirements, exclude additional unallowable
administrative expenses identified under this section and resulting from the financial
audits conducted under subdivision 9d, and utilize competitive bidding to gain efficiencies
through economies of scale from increased enrollment. If the total reduction cannot be
achieved through administrative reduction, the commissioner may limit total rate increases
on payments to managed care plans and county-based purchasing plans.
new text end
Sec. 35.
Minnesota Statutes 2014, section 256B.69, subdivision 9c, is amended to read:
Subd. 9c.
Managed care financial reporting.
(a) The commissioner shall collect
detailed data regarding financials, provider payments, provider rate methodologies, and
other data as determined by the commissioner. The commissioner, in consultation with the
commissioners of health and commerce, and in consultation with managed care plans and
county-based purchasing plans, shall set uniform criteria, definitions, and standards for the
data to be submitted, and shall require managed care and county-based purchasing plans
to comply with these criteria, definitions, and standards when submitting data under this
section. In carrying out the responsibilities of this subdivision, the commissioner shall
ensure that the data collection is implemented in an integrated and coordinated manner
that avoids unnecessary duplication of effort. To the extent possible, the commissioner
shall use existing data sources and streamline data collection in order to reduce public
and private sector administrative costs. Nothing in this subdivision shall allow release of
information that is nonpublic data pursuant to section 13.02.
(b) Effective January 1, 2014, each managed care and county-based purchasing plan
must quarterly provide to the commissioner the following information on state public
programs, in the form and manner specified by the commissioner, according to guidelines
developed by the commissioner in consultation with managed care plans and county-based
purchasing plans under contract:
(1) an income statement by program;
(2) financial statement footnotes;
(3) quarterly profitability by program and population group;
(4) a medical liability summary by program and population group;
(5) received but unpaid claims report by program;
(6) services versus payment lags by program for hospital services, outpatient
services, physician services, other medical services, and pharmaceutical benefits;
(7) utilization reports that summarize utilization and unit cost information by
program for hospitalization services, outpatient services, physician services, and other
medical services;
(8) pharmaceutical statistics by program and population group for measures of price
and utilization of pharmaceutical services;
(9) subcapitation expenses by population group;
(10) third-party payments by program;
(11) all new, active, and closed subrogation cases by program;
(12) all new, active, and closed fraud and abuse cases by program;
(13) medical loss ratios by program;
(14) administrative expenses by category and subcategory by program that reconcile
to other state and federal regulatory agenciesnew text begin , including Minnesota Supplement Report
#1Anew text end ;
(15) revenues by program, including investment income;
(16) nonadministrative service payments, provider payments, and reimbursement
rates by provider type or service category, by program, paid by the managed care plan
under this section or the county-based purchasing plan under section 256B.692 to
providers and vendors for administrative services under contract with the plan, including
but not limited to:
(i) individual-level provider payment and reimbursement rate data;
(ii) provider reimbursement rate methodologies by provider type, by program,
including a description of alternative payment arrangements and payments outside the
claims process;
(iii) data on implementation of legislatively mandated provider rate changes; and
(iv) individual-level provider payment and reimbursement rate data and plan-specific
provider reimbursement rate methodologies by provider type, by program, including
alternative payment arrangements and payments outside the claims process, provided to
the commissioner under this subdivision are nonpublic data as defined in section 13.02;
(17) data on the amount of reinsurance or transfer of risk by program; and
(18) contribution to reserve, by program.
(c) In the event a report is published or released based on data provided under
this subdivision, the commissioner shall provide the report to managed care plans and
county-based purchasing plans 15 days prior to the publication or release of the report.
Managed care plans and county-based purchasing plans shall have 15 days to review the
report and provide comment to the commissioner.
The quarterly reports shall be submitted to the commissioner no later than 60 days after the
end of the previous quarter, except the fourth-quarter report, which shall be submitted by
April 1 of each year. The fourth-quarter report shall include audited financial statements,
parent company audited financial statements, an income statement reconciliation report,
and any other documentation necessary to reconcile the detailed reports to the audited
financial statements.
new text begin
(d) Managed care plans and county-based purchasing plans shall certify to the
commissioner for the purpose of financial reporting for state public health care programs
under this subdivision that costs reported for state public health care programs include:
new text end
new text begin
(1) only services covered under the state plan and waivers, and related allowable
administrative expenses; and
new text end
new text begin
(2) the dollar value of unallowable and nonstate plan services, including both
medical and administrative expenditures, that have been excluded.
new text end
Sec. 36.
Minnesota Statutes 2014, section 256B.69, subdivision 9d, is amended to read:
Subd. 9d.
Financial deleted text begin auditdeleted text end new text begin and quality assurance auditsnew text end .
deleted text begin
(a) The legislative
auditor shall contract with an audit firm to conduct a biennial independent third-party
financial audit of the information required to be provided by managed care plans and
county-based purchasing plans under subdivision 9c, paragraph (b). The audit shall be
conducted in accordance with generally accepted government auditing standards issued
by the United States Government Accountability Office. The contract with the audit
firm shall be designed and administered so as to render the independent third-party audit
eligible for a federal subsidy, if available. The contract shall require the audit to include
a determination of compliance with the federal Medicaid rate certification process. The
contract shall require the audit to determine if the administrative expenses and investment
income reported by the managed care plans and county-based purchasing plans are
compliant with state and federal law.
deleted text end
deleted text begin
(b) For purposes of this subdivision, "independent third party" means an audit firm
that is independent in accordance with government auditing standards issued by the United
States Government Accountability Office and licensed in accordance with chapter 326A.
An audit firm under contract to provide services in accordance with this subdivision must
not have provided services to a managed care plan or county-based purchasing plan during
the period for which the audit is being conducted.
deleted text end
deleted text begin (c)deleted text end new text begin (a) new text end The commissioner shall require, in the request for bids and resulting contracts
with managed care plans and county-based purchasing plans under this section and section
256B.692, that each managed care plan and county-based purchasing plan submit to and
fully cooperate with the independent third-party financial deleted text begin auditdeleted text end new text begin audits by the legislative
auditor under subdivision 9enew text end of the information required under subdivision 9c, paragraph
(b). Each contract with a managed care plan or county-based purchasing plan under this
section or section 256B.692 must provide the commissioner deleted text begin anddeleted text end new text begin ,new text end the deleted text begin audit firmdeleted text end new text begin legislative
auditor, and vendors new text end contracting with the legislative auditornew text begin ,new text end access to all data required to
complete deleted text begin the audit. For purposes of this subdivision, the contracting audit firm shall have
the same investigative power as the legislative auditor under section 3.978, subdivision 2
deleted text end new text begin audits under subdivision 9enew text end .
deleted text begin (d)deleted text end new text begin (b) new text end Each managed care plan and county-based purchasing plan providing services
under this section shall provide to the commissioner biweekly encounter data and claims
data for state public health care programs and shall participate in a quality assurance
program that verifies the timeliness, completeness, accuracy, and consistency of the data
provided. The commissioner shall develop written protocols for the quality assurance
program and shall make the protocols publicly available. The commissioner shall contract
for an independent third-party audit to evaluate the quality assurance protocols as to
the capacity of the protocols to ensure complete and accurate data and to evaluate the
commissioner's implementation of the protocols. deleted text begin The audit firm under contract to provide
this evaluation must meet the requirements in paragraph (b).
deleted text end
deleted text begin (e) Upon completion of the audit under paragraph (a) and receipt by the legislative
auditor, the legislative auditor shall provide copies of the audit report to the commissioner,
the state auditor, the attorney general, and the chairs and ranking minority members of the
health and human services finance committees of the legislature.deleted text end new text begin (c)new text end Upon completion
of the evaluation under paragraph deleted text begin (d)deleted text end new text begin (b)new text end , the commissioner shall provide copies of the
report to the legislative auditor and the chairs and ranking minority members of the deleted text begin health
finance committees of the legislaturedeleted text end new text begin legislative committees with jurisdiction over health
care policy and financingnew text end .
deleted text begin (f)deleted text end new text begin (d) new text end Any actuary under contract with the commissioner to provide actuarial
services must meet the independence requirements under the professional code for fellows
in the Society of Actuaries and must not have provided actuarial services to a managed
care plan or county-based purchasing plan that is under contract with the commissioner
pursuant to this section and section 256B.692 during the period in which the actuarial
services are being provided. An actuary or actuarial firm meeting the requirements
of this paragraph must certify and attest to the rates paid to the managed care plans
and county-based purchasing plans under this section and section 256B.692, and the
certification and attestation must be auditable.
new text begin
(e) The commissioner, to the extent of available funding, shall conduct ad hoc audits
of state public health care program administrative and medical expenses reported by
managed care plans and county-based purchasing plans. This includes: financial and
encounter data reported to the commissioner under subdivision 9c, including payments to
providers and subcontractors; supporting documentation for expenditures; categorization
of administrative and medical expenses; and allocation methods used to attribute
administrative expenses to state public health care programs. These audits also must
monitor compliance with data and financial report certification requirements established
by the commissioner for the purposes of managed care capitation payment rate-setting.
The managed care plans and county-based purchasing plans shall fully cooperate with
the audits in this subdivision. The commissioner shall report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance by February 1, 2016, and each February 1 thereafter, the
number of ad hoc audits conducted in the past calendar year and the results of these audits.
new text end
deleted text begin (g)deleted text end new text begin (f) new text end Nothing in this subdivision shall allow the release of information that is
nonpublic data pursuant to section 13.02.
Sec. 37.
Minnesota Statutes 2014, section 256B.69, is amended by adding a
subdivision to read:
new text begin Subd. 9e. new text end
new text begin Financial audits. new text end
new text begin
(a) The legislative auditor shall conduct or contract with
vendors to conduct independent third-party financial audits of the information required to
be provided by managed care plans and county-based purchasing plans under subdivision
9c, paragraph (b). The audits by the vendors shall be conducted as vendor resources
permit and in accordance with generally accepted government auditing standards issued
by the United States Government Accountability Office. The contract with the vendors
shall be designed and administered so as to render the independent third-party audits
eligible for a federal subsidy, if available. The contract shall require the audits to include a
determination of compliance with the federal Medicaid rate certification process.
new text end
new text begin
(b) For purposes of this subdivision, "independent third-party" means a vendor that
is independent in accordance with government auditing standards issued by the United
States Government Accountability Office.
new text end
Sec. 38.
Minnesota Statutes 2014, section 256B.75, is amended to read:
256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
(a) For outpatient hospital facility fee payments for services rendered on or after
October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
services for which there is a federal maximum allowable payment. Effective for services
rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
facility fees and emergency room facility fees shall be increased by eight percent over the
rates in effect on December 31, 1999, except for those services for which there is a federal
maximum allowable payment. Services for which there is a federal maximum allowable
payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
allowable payment. Total aggregate payment for outpatient hospital facility fee services
shall not exceed the Medicare upper limit. If it is determined that a provision of this
section conflicts with existing or future requirements of the United States government with
respect to federal financial participation in medical assistance, the federal requirements
prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
avoid reduced federal financial participation resulting from rates that are in excess of
the Medicare upper limitations.
(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
ambulatory surgery hospital facility fee services for critical access hospitals designated
under section 144.1483, clause (9), shall be paid on a cost-based payment system that is
based on the cost-finding methods and allowable costs of the Medicare program.new text begin Effective
for services provided on or after July 1, 2015, rates established for critical access hospitals
under this paragraph for the applicable payment year shall be the final payment and shall
not be settled to actual costs.
new text end
(c) Effective for services provided on or after July 1, 2003, rates that are based
on the Medicare outpatient prospective payment system shall be replaced by a budget
neutral prospective payment system that is derived using medical assistance data. The
commissioner shall provide a proposal to the 2003 legislature to define and implement
this provision.
(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital
facility services is reduced by .5 percent from the current statutory rate.
(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital
facility services before third-party liability and spenddown, is reduced five percent from
the current statutory rates. Facilities defined under section 256.969, subdivision 16, are
excluded from this paragraph.
(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three
percent from the current statutory rates. Mental health services and facilities defined under
section 256.969, subdivision 16, are excluded from this paragraph.
Sec. 39.
Minnesota Statutes 2014, section 256B.76, subdivision 1, is amended to read:
Subdivision 1.
Physician reimbursement.
(a) Effective for services rendered on
or after October 1, 1992, the commissioner shall make payments for physician services
as follows:
(1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care,"
"critical care," cesarean delivery and pharmacologic management provided to psychiatric
patients, and level three codes for enhanced services for prenatal high risk, shall be paid
at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
30, 1992. If the rate on any procedure code within these categories is different than the
rate that would have been paid under the methodology in section 256B.74, subdivision 2,
then the larger rate shall be paid;
(2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect
on September 30, 1992.
(b) Effective for services rendered on or after January 1, 2000, payment rates for
physician and professional services shall be increased by three percent over the rates
in effect on December 31, 1999, except for home health agency and family planning
agency services. The increases in this paragraph shall be implemented January 1, 2000,
for managed care.
(c) Effective for services rendered on or after July 1, 2009, payment rates for
physician and professional services shall be reduced by five percent, except that for the
period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
for the medical assistance and general assistance medical care programs, over the rates in
effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
to office or other outpatient visits, preventive medicine visits and family planning visits
billed by physicians, advanced practice nurses, or physician assistants in a family planning
agency or in one of the following primary care practices: general practice, general internal
medicine, general pediatrics, general geriatrics, and family medicine. This reduction
and the reductions in paragraph (d) do not apply to federally qualified health centers,
rural health centers, and Indian health services. Effective October 1, 2009, payments
made to managed care plans and county-based purchasing plans under sections 256B.69,
256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.
(d) Effective for services rendered on or after July 1, 2010, payment rates for
physician and professional services shall be reduced an additional seven percent over
the five percent reduction in rates described in paragraph (c). This additional reduction
does not apply to physical therapy services, occupational therapy services, and speech
pathology and related services provided on or after July 1, 2010. This additional reduction
does not apply to physician services billed by a psychiatrist or an advanced practice nurse
with a specialty in mental health. Effective October 1, 2010, payments made to managed
care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
256L.12 shall reflect the payment reduction described in this paragraph.
(e) Effective for services rendered on or after September 1, 2011, through June 30,
2013, payment rates for physician and professional services shall be reduced three percent
from the rates in effect on August 31, 2011. This reduction does not apply to physical
therapy services, occupational therapy services, and speech pathology and related services.
(f) Effective for services rendered on or after September 1, 2014, payment rates for
physician and professional services, including physical therapy, occupational therapy,
speech pathology, and mental health services shall be increased by five percent from the
rates in effect on August 31, 2014. In calculating this rate increase, the commissioner
shall not include in the base rate for August 31, 2014, the rate increase provided under
section 256B.76, subdivision 7. This increase does not apply to federally qualified health
centers, rural health centers, and Indian health services. Payments made to managed
care plans and county-based purchasing plans shall not be adjusted to reflect payments
under this paragraph.
new text begin
(g) Effective for services rendered on or after July 1, 2015, payment rates for
physical therapy, occupational therapy, and speech pathology and related services provided
by a hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph
(a), clause (4), shall be increased by 90 percent from the rates in effect on June 30, 2015.
Payments made to managed care plans and county-based purchasing plans shall not be
adjusted to reflect payments under this paragraph.
new text end
Sec. 40.
Minnesota Statutes 2014, section 256B.76, subdivision 2, is amended to read:
Subd. 2.
Dental reimbursement.
(a) Effective for services rendered on or after
October 1, 1992, the commissioner shall make payments for dental services as follows:
(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
percent above the rate in effect on June 30, 1992; and
(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases.
(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
(c) Effective for services rendered on or after January 1, 2000, payment rates for
dental services shall be increased by three percent over the rates in effect on December
31, 1999.
(d) Effective for services provided on or after January 1, 2002, payment for
diagnostic examinations and dental x-rays provided to children under age 21 shall be the
lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
2000, for managed care.
(f) Effective for dental services rendered on or after October 1, 2010, by a
state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
on the Medicare principles of reimbursement. This payment shall be effective for services
rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
county-based purchasing plans.
(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
year, a supplemental state payment equal to the difference between the total payments
in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
services for the operation of the dental clinics.
(h) If the cost-based payment system for state-operated dental clinics described in
paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
designated as critical access dental providers under subdivision 4, paragraph (b), and shall
receive the critical access dental reimbursement rate as described under subdivision 4,
paragraph (a).
(i) Effective for services rendered on or after September 1, 2011, through June 30,
2013, payment rates for dental services shall be reduced by three percent. This reduction
does not apply to state-operated dental clinics in paragraph (f).
(j) Effective for services rendered on or after January 1, 2014, payment rates for
dental services shall be increased by five percent from the rates in effect on December
31, 2013. This increase does not apply to state-operated dental clinics in paragraph (f),
federally qualified health centers, rural health centers, and Indian health services. Effective
January 1, 2014, payments made to managed care plans and county-based purchasing
plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase
described in this paragraph.
new text begin
(k) Effective for services rendered on or after July 1, 2015, the commissioner shall
increase payment rates for services furnished by dental providers located outside of the
seven-county metropolitan area by the maximum percentage possible above the rates in
effect on June 30, 2015, while remaining within the limits of funding appropriated for this
purpose. This increase does not apply to state-operated dental clinics in paragraph (f),
federally qualified health centers, rural health centers, and Indian health services. Effective
January 1, 2016, payments to managed care plans and county-based purchasing plans
under sections 256B.69 and 256B.692 shall reflect the payment increase described in this
paragraph. The commissioner shall require managed care and county-based purchasing
plans to pass on the full amount of the increase, in the form of higher payment rates to
dental providers located outside of the seven-county metropolitan area.
new text end
Sec. 41.
Minnesota Statutes 2014, section 256B.76, subdivision 4, as amended by
Laws 2015, chapter 21, article 1, section 58, is amended to read:
Subd. 4.
Critical access dental providers.
(a) Effective for dental services
rendered on or after January 1, 2002, the commissioner shall increase reimbursements
to dentists and dental clinics deemed by the commissioner to be critical access dental
providers. For dental services rendered on or after July 1, 2007, the commissioner shall
increase reimbursement by 35 percent above the reimbursement rate that would otherwise
be paid to the critical access dental provider. The commissioner shall pay the managed
care plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.
(b) The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:
(1) nonprofit community clinics that:
(i) have nonprofit status in accordance with chapter 317A;
(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);
(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;
(iv) have professional staff familiar with the cultural background of the clinic's
patients;
(v) charge for services on a sliding fee scale designed to provide assistance to
low-income patients based on current poverty income guidelines and family size;
(vi) do not restrict access or services because of a patient's financial limitations
or public assistance status; and
(vii) have free care available as needed;
(2) federally qualified health centers, rural health clinics, and public health clinics;
(3) city or county owned and operated hospital-based dental clinics;
(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance or MinnesotaCare;
(5) a dental clinic owned and operated by the University of Minnesota or the
Minnesota State Colleges and Universities system; and
(6) private practicing dentists if:
(i) the dentist's office is located within a health professional shortage area as defined
under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
section 254E;
(ii) more than 50 percent of the dentist's patient encounters per year are with patients
who are uninsured or covered by medical assistance or MinnesotaCare;new text begin and
new text end
deleted text begin
(iii) the dentist does not restrict access or services because of a patient's financial
limitations or public assistance status; and
deleted text end
deleted text begin (iv)deleted text end new text begin (iii)new text end the level of service provided by the dentist is critical to maintaining
adequate levels of patient access within the service area in which the dentist operates.
Sec. 42.
Minnesota Statutes 2014, section 256B.762, is amended to read:
256B.762 REIMBURSEMENT FOR HEALTH CARE SERVICES.
new text begin (a) new text end Effective for services provided on or after October 1, 2005, payment rates
for the following services shall be increased by five percent over the rates in effect on
September 30, 2005, when these services are provided as home health services under
section 256B.0625, subdivision 6a:
(1) skilled nursing visit;
(2) physical therapy visit;
(3) occupational therapy visit;
(4) speech therapy visit; and
(5) home health aide visit.
new text begin
(b) Effective for services provided on or after July 1, 2015, payment rates for
managed care and fee-for-service visits for the following services shall be increased by
ten percent over the rates in effect on June 30, 2015, when these services are provided as
home health services under section 256B.0625, subdivision 6a:
new text end
new text begin
(1) physical therapy;
new text end
new text begin
(2) occupational therapy; and
new text end
new text begin
(3) speech therapy.
new text end
new text begin
The commissioner shall adjust managed care and county-based purchasing plan capitation
rates to reflect the payment rates under this paragraph.
new text end
Sec. 43.
Minnesota Statutes 2014, section 256B.766, is amended to read:
256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
(a) Effective for services provided on or after July 1, 2009, total payments for basic
care services, shall be reduced by three percent, except that for the period July 1, 2009,
through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
assistance and general assistance medical care programs, prior to third-party liability and
spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
therapy services, occupational therapy services, and speech-language pathology and
related services as basic care services. The reduction in this paragraph shall apply to
physical therapy services, occupational therapy services, and speech-language pathology
and related services provided on or after July 1, 2010.
(b) Payments made to managed care plans and county-based purchasing plans shall
be reduced for services provided on or after October 1, 2009, to reflect the reduction
effective July 1, 2009, and payments made to the plans shall be reduced effective October
1, 2010, to reflect the reduction effective July 1, 2010.
(c) Effective for services provided on or after September 1, 2011, through June 30,
2013, total payments for outpatient hospital facility fees shall be reduced by five percent
from the rates in effect on August 31, 2011.
(d) Effective for services provided on or after September 1, 2011, through June
30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
and durable medical equipment not subject to a volume purchase contract, prosthetics
and orthotics, renal dialysis services, laboratory services, public health nursing services,
physical therapy services, occupational therapy services, speech therapy services,
eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
purchase contract, and anesthesia services shall be reduced by three percent from the
rates in effect on August 31, 2011.
(e) Effective for services provided on or after September 1, 2014, payments
for ambulatory surgery centers facility fees, hospice services, renal dialysis services,
laboratory services, public health nursing services, eyeglasses not subject to a volume
purchase contract, and hearing aids not subject to a volume purchase contract shall be
increased by three percent and payments for outpatient hospital facility fees shall be
increased by three percent. Payments made to managed care plans and county-based
purchasing plans shall not be adjusted to reflect payments under this paragraph.
(f) Payments for medical supplies and durable medical equipment not subject to a
volume purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014,
through June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies
and durable medical equipment not subject to a volume purchase contract, and prosthetics
and orthotics, provided on or after July 1, 2015, shall be increased by three percent from
the rates deleted text begin in effect on June 30, 2014deleted text end new text begin as determined under paragraph (i)new text end .
(g)new text begin Effective for services provided on or after July 1, 2015, payments for outpatient
hospital facility fees, medical supplies and durable medical equipment not subject to a
volume purchase contract, prosthetics and orthotics, and laboratory services to a hospital
meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4),
shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made
to managed care plans and county-based purchasing plans shall not be adjusted to reflect
payments under this paragraph.
new text end
new text begin (h)new text end This section does not apply to physician and professional services, inpatient
hospital services, family planning services, mental health services, dental services,
prescription drugs, medical transportation, federally qualified health centers, rural health
centers, Indian health services, and Medicare cost-sharing.
new text begin
(i) Effective July 1, 2015, the medical assistance payment rate for durable medical
equipment, prosthetics, orthotics, or supplies shall be restored to the January 1, 2008,
medical assistance fee schedule, updated to include subsequent rate increases in the
Medicare and medical assistance fee schedules, and including individually priced
items for the following categories: enteral nutrition and supplies, customized and other
specialized tracheostomy tubes and supplies, electric patient lifts, and durable medical
equipment repair and service. This paragraph does not apply to medical supplies and
durable medical equipment subject to a volume purchase contract, products subject to the
preferred diabetic testing supply program, and items provided to dually eligible recipients
when Medicare is the primary payer for the item.
new text end
Sec. 44.
Minnesota Statutes 2014, section 256B.767, is amended to read:
256B.767 MEDICARE PAYMENT LIMIT.
(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment
rates for physician and professional services under section 256B.76, subdivision 1, and
basic care services subject to the rate reduction specified in section 256B.766, shall not
exceed the Medicare payment rate for the applicable service, as adjusted for any changes
in Medicare payment rates after July 1, 2010. The commissioner shall implement this
section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates
under this section by first reducing or eliminating provider rate add-ons.
(b) This section does not apply to services provided by advanced practice certified
nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter
147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates
for advanced practice certified nurse midwives and licensed traditional midwives shall
equal and shall not exceed the medical assistance payment rate to physicians for the
applicable service.
(c) This section does not apply to mental health services or physician services billed
by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.
deleted text begin
(d) Effective for durable medical equipment, prosthetics, orthotics, or supplies
provided on or after July 1, 2013, through June 30, 2015, the payment rate for items
that are subject to the rates established under Medicare's National Competitive Bidding
Program shall be equal to the rate that applies to the same item when not subject to the
rate established under Medicare's National Competitive Bidding Program. This paragraph
does not apply to mail-order diabetic supplies and does not apply to items provided to
dually eligible recipients when Medicare is the primary payer of the item.
deleted text end
new text begin
(d) Effective July 1, 2015, this section shall not apply to durable medical equipment,
prosthetics, orthotics, or supplies.
new text end
new text begin
(e) This section does not apply to physical therapy, occupational therapy, speech
pathology and related services, and basic care services provided by a hospital meeting the
criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4).
new text end
Sec. 45.
new text begin
[256B.79] INTEGRATED CARE FOR HIGH-RISK PREGNANT
WOMEN.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms
have the meanings given them.
new text end
new text begin
(b) "Adverse outcomes" means maternal opiate addiction, other reportable prenatal
substance abuse, low birth weight, or preterm birth.
new text end
new text begin
(c) "Qualified integrated perinatal care collaborative" or "collaborative" means
a combination of (1) members of community-based organizations that represent
communities within the identified targeted populations, and (2) local or tribally based
service entities, including health care, public health, social services, mental health,
chemical dependency treatment, and community-based providers, determined by the
commissioner to meet the criteria for the provision of integrated care and enhanced
services for enrollees within targeted populations.
new text end
new text begin
(d) "Targeted populations" means pregnant medical assistance enrollees residing
in geographic areas identified by the commissioner as being at above-average risk for
adverse outcomes.
new text end
new text begin Subd. 2. new text end
new text begin Pilot program established. new text end
new text begin
The commissioner shall implement a pilot
program to improve birth outcomes and strengthen early parental resilience for pregnant
women who are medical assistance enrollees, are at significantly elevated risk for adverse
outcomes of pregnancy, and are in targeted populations. The program must promote the
provision of integrated care and enhanced services to these pregnant women, including
postpartum coordination to ensure ongoing continuity of care, by qualified integrated
perinatal care collaboratives.
new text end
new text begin Subd. 3. new text end
new text begin Grant awards. new text end
new text begin
The commissioner shall award grants to qualifying
applicants to support interdisciplinary, integrated perinatal care. Grants must be awarded
beginning July 1, 2016. Grant funds must be distributed through a request for proposals
process to a designated lead agency within an entity that has been determined to be a
qualified integrated perinatal care collaborative or within an entity in the process of
meeting the qualifications to become a qualified integrated perinatal care collaborative.
Grant awards must be used to support interdisciplinary, team-based needs assessments,
planning, and implementation of integrated care and enhanced services for targeted
populations. In determining grant award amounts, the commissioner shall consider the
identified health and social risks linked to adverse outcomes and attributed to enrollees
within the identified targeted population.
new text end
new text begin Subd. 4. new text end
new text begin Eligibility for grants. new text end
new text begin
To be eligible for a grant under this section, an
entity must show that the entity meets or is in the process of meeting qualifications
established by the commissioner to be a qualified integrated perinatal care collaborative.
These qualifications must include evidence that the entity has or is in the process of
developing policies, services, and partnerships to support interdisciplinary, integrated care.
The policies, services, and partnerships must meet specific criteria and be approved by the
commissioner. The commissioner shall establish a process to review the collaborative's
capacity for interdisciplinary, integrated care, to be reviewed at the commissioner's
discretion. In determining whether the entity meets the qualifications for a qualified
integrated perinatal care collaborative, the commissioner shall verify and review whether
the entity's policies, services, and partnerships:
new text end
new text begin
(1) optimize early identification of drug and alcohol dependency and abuse during
pregnancy, effectively coordinate referrals and follow-up of identified patients to
evidence-based or evidence-informed treatment, and integrate perinatal care services with
behavioral health and substance abuse services;
new text end
new text begin
(2) enhance access to, and effective use of, needed health care or tribal health care
services, public health or tribal public health services, social services, mental health
services, chemical dependency services, or services provided by community-based
providers by bridging cultural gaps within systems of care and by integrating
community-based paraprofessionals such as doulas and community health workers as
routinely available service components;
new text end
new text begin
(3) encourage patient education about prenatal care, birthing, and postpartum
care, and document how patient education is provided. Patient education may include
information on nutrition, reproductive life planning, breastfeeding, and parenting;
new text end
new text begin
(4) integrate child welfare case planning with substance abuse treatment planning
and monitoring, as appropriate;
new text end
new text begin
(5) effectively systematize screening, collaborative care planning, referrals, and
follow up for behavioral and social risks known to be associated with adverse outcomes
and known to be prevalent within the targeted populations;
new text end
new text begin
(6) facilitate ongoing continuity of care to include postpartum coordination and
referrals for interconception care, continued treatment for substance abuse, identification
and referrals for maternal depression and other chronic mental health conditions,
continued medication management for chronic diseases, and appropriate referrals to tribal
or county-based social services agencies and tribal or county-based public health nursing
services; and
new text end
new text begin
(7) implement ongoing quality improvement activities as determined by the
commissioner, including collection and use of data from qualified providers on metrics
of quality such as health outcomes and processes of care, and the use of other data that
has been collected by the commissioner.
new text end
new text begin Subd. 5. new text end
new text begin Gaps in communication, support, and care. new text end
new text begin
A collaborative receiving
a grant under this section must develop means of identifying and reporting gaps in the
collaborative's communication, administrative support, and direct care that must be
remedied for the collaborative to effectively provide integrated care and enhanced services
to targeted populations.
new text end
new text begin Subd. 6. new text end
new text begin Report. new text end
new text begin
By January 31, 2019, the commissioner shall report to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
and human services policy and finance on the status and progress of the pilot program.
The report must:
new text end
new text begin
(1) describe the capacity of collaboratives receiving grants under this section;
new text end
new text begin
(2) contain aggregate information about enrollees served within targeted populations;
new text end
new text begin
(3) describe the utilization of enhanced prenatal services;
new text end
new text begin
(4) for enrollees identified with maternal substance use disorders, describe the
utilization of substance use treatment and dispositions of any child protection cases;
new text end
new text begin
(5) contain data on outcomes within targeted populations and compare these
outcomes to outcomes statewide, using standard categories of race and ethnicity; and
new text end
new text begin
(6) include recommendations for continuing the program or sustaining improvements
through other means beyond June 30, 2019.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
This section expires June 30, 2019.
new text end
Sec. 46.
Minnesota Statutes 2014, section 256L.01, subdivision 3a, is amended to read:
Subd. 3a.
Family.
(a) new text begin Except as provided in paragraphs (c) and (d), new text end "family" has
the meaning given for family and family size as defined in Code of Federal Regulations,
title 26, section 1.36B-1.
(b) The term includes children who are temporarily absent from the household in
settings such as schools, camps, or parenting time with noncustodial parents.
new text begin
(c) For an individual who does not expect to file a federal tax return and does not
expect to be claimed as a dependent for the applicable tax year, "family" has the meaning
given in Code of Federal Regulations, title 42, section 435.603(f)(3).
new text end
new text begin
(d) For a married couple, "family" has the meaning given in Code of Federal
Regulations, title 42, section 435.603(f)(4).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 47.
Minnesota Statutes 2014, section 256L.01, subdivision 5, is amended to read:
Subd. 5.
Income.
"Income" has the meaning given for modified adjusted gross
income, as defined in Code of Federal Regulations, title 26, section 1.36B-1deleted text begin .deleted text end new text begin , and means a
household's projected annual income for the applicable tax year
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 48.
Minnesota Statutes 2014, section 256L.03, subdivision 5, is amended to read:
Subd. 5.
Cost-sharing.
(a) Except as otherwise provided in this subdivision, the
MinnesotaCare benefit plan shall include the following cost-sharing requirements for all
enrollees:
(1) $3 per prescription for adult enrollees;
(2) $25 for eyeglasses for adult enrollees;
(3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist;
(4) $6 for nonemergency visits to a hospital-based emergency room for services
provided through December 31, 2010, and $3.50 effective January 1, 2011; and
(5) a family deductible equal to deleted text begin the maximum amount allowed under Code of
Federal Regulations, title 42, part 447.54deleted text end deleted text begin .deleted text end new text begin $2.75 per month per family and adjusted
annually by the percentage increase in the medical care component of the CPI-U for
the period of September to September of the preceding calendar year, rounded to the
next-higher five cent increment.
new text end
(b) Paragraph (a) does not apply to children under the age of 21new text begin and to American
Indians as defined in Code of Federal Regulations, title 42, section 447.51new text end .
(c) Paragraph (a), clause (3), does not apply to mental health services.
(d) MinnesotaCare reimbursements to fee-for-service providers and payments to
managed care plans or county-based purchasing plans shall not be increased as a result of
the reduction of the co-payments in paragraph (a), clause (4), effective January 1, 2011.
(e) The commissioner, through the contracting process under section 256L.12,
may allow managed care plans and county-based purchasing plans to waive the family
deductible under paragraph (a), clause (5). The value of the family deductible shall not be
included in the capitation payment to managed care plans and county-based purchasing
plans. Managed care plans and county-based purchasing plans shall certify annually to the
commissioner the dollar value of the family deductible.
new text begin
(f) The commissioner shall increase co-payments for covered services in a manner
sufficient to reduce the actuarial value of the benefit to 94 percent. The cost-sharing
changes described in this paragraph do not apply to eligible recipients or services exempt
from cost-sharing under state law. The cost-sharing changes described in this paragraph
shall not be implemented prior to January 1, 2016.
new text end
new text begin
(g) The cost-sharing changes authorized under paragraph (f) must satisfy the
requirements for cost-sharing under the Basic Health Program as set forth in Code of
Federal Regulations, title 42, sections 600.510 and 600.520.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
The amendment to paragraph (a), clause (5), is effective
retroactively from January 1, 2014. The amendment to paragraph (b) is effective the
day following final enactment.
new text end
Sec. 49.
Minnesota Statutes 2014, section 256L.04, subdivision 1c, is amended to read:
Subd. 1c.
General requirements.
To be eligible for deleted text begin coverage underdeleted text end MinnesotaCare,
a person must meet the eligibility requirements of this section. A person eligible for
MinnesotaCare shall not be considered a qualified individual under section 1312 of the
Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
through MNsure under chapter 62V.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 50.
Minnesota Statutes 2014, section 256L.04, subdivision 7b, is amended to read:
Subd. 7b.
Annual income limits adjustment.
The commissioner shall adjust the
income limits under this section deleted text begin each July 1 by the annual update of the federal poverty
guidelines following publication by the United States Department of Health and Human
Services except that the income standards shall not go below those in effect on July 1,
2009deleted text end new text begin annually on January 1 as provided in Code of Federal Regulations, title 26, section
1.36B-1(h)new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 51.
Minnesota Statutes 2014, section 256L.05, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Eligibility and coverage. new text end
new text begin
For purposes of this chapter, an individual
is eligible for MinnesotaCare following a determination by the commissioner that the
individual meets the eligibility criteria for the applicable period of eligibility. For an
individual required to pay a premium, coverage is only available in each month of the
applicable period of eligibility for which a premium is paid.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 52.
Minnesota Statutes 2014, section 256L.05, subdivision 3, is amended to read:
Subd. 3.
Effective date of coverage.
(a) The effective date of coverage is the first
day of the month following the month in which eligibility is approved and the first premium
payment has been received. The effective date of coverage for new members added to the
family is the first day of the month following the month in which the change is reported. All
eligibility criteria must be met by the family at the time the new family member is added.
The income of the new family member is included with the family's modified adjusted gross
income and the adjusted premium begins in the month the new family member is added.
(b) The initial premium must be received by the last working day of the month for
coverage to begin the first day of the following month.
(c) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to
256L.18 are secondary to a plan of insurance or benefit program under which an eligible
person may have coverage and the commissioner shall use cost avoidance techniques to
ensure coordination of any other health coverage for eligible persons. The commissioner
shall identify eligible persons who may have coverage or benefits under other plans of
insurance or who become eligible for medical assistance.
(d) The effective date of coverage for individuals or families who are exempt from
paying premiums under section 256L.15, subdivision 1, paragraph (c), is the first day of
the month following the month in which deleted text begin verification of American Indian status is received
ordeleted text end eligibility is approveddeleted text begin , whichever is laterdeleted text end .
Sec. 53.
Minnesota Statutes 2014, section 256L.05, subdivision 3a, is amended to read:
Subd. 3a.
deleted text begin Renewaldeleted text end new text begin Redeterminationnew text end of eligibility.
(a) deleted text begin Beginning July 1, 2007,deleted text end An
enrollee's eligibility must be deleted text begin renewed every 12 monthsdeleted text end new text begin redetermined on an annual basisnew text end .
deleted text begin The 12-month period begins in the month after the month the application is approved.deleted text end new text begin The
period of eligibility is the entire calendar year following the year in which eligibility is
redetermined. Beginning in calendar year 2015, eligibility redeterminations shall occur
during the open enrollment period for qualified health plans as specified in Code of
Federal Regulations, title 45, section 155.410.
new text end
(b) Each new period of eligibility must take into account any changes in
circumstances that impact eligibility and premium amount. deleted text begin An enrollee must provide all
the information needed to redetermine eligibility by the first day of the month that ends
the eligibility period. The premium for the new period of eligibility must be received
deleted text end new text begin Coverage beginsnew text end as provided in section 256L.06 deleted text begin in order for eligibility to continuedeleted text end .
deleted text begin
(c) For children enrolled in MinnesotaCare, the first period of renewal begins the
month the enrollee turns 21 years of age.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 54.
Minnesota Statutes 2014, section 256L.05, subdivision 4, is amended to read:
Subd. 4.
Application processing.
The commissioner of human services shall
determine an applicant's eligibility for MinnesotaCare no more than deleted text begin 30deleted text end new text begin 45new text end days from the
date that the application is received by the Department of Human Servicesnew text begin as set forth in
Code of Federal Regulations, title 42, section 435.912new text end . deleted text begin Beginning January 1, 2000, this
requirement also applies to local county human services agencies that determine eligibility
for MinnesotaCare.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 55.
Minnesota Statutes 2014, section 256L.06, subdivision 3, is amended to read:
Subd. 3.
Commissioner's duties and payment.
(a) Premiums are dedicated to the
commissioner for MinnesotaCare.
(b) The commissioner shall develop and implement procedures to: (1) require
enrollees to report changes in income; (2) adjust sliding scale premium payments, based
upon both increases and decreases in enrollee income, at the time the change in income
is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
premiums. Failure to pay includes payment with a dishonored check, a returned automatic
bank withdrawal, or a refused credit card or debit card payment. The commissioner may
demand a guaranteed form of payment, including a cashier's check or a money order, as
the only means to replace a dishonored, returned, or refused payment.
(c) Premiums are calculated on a calendar month basis and may be paid on a
monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
commissioner of the premium amount required. The commissioner shall inform applicants
and enrollees of these premium payment options. Premium payment is required before
enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
received before noon are credited the same day. Premium payments received after noon
are credited on the next working day.
(d) Nonpayment of the premium will result in disenrollment from the plan
effective for the calendar month new text begin following the month new text end for which the premium was due.
Persons disenrolled for nonpayment deleted text begin who pay all past due premiums as well as current
premiums due, including premiums due for the period of disenrollment, within 20 days of
disenrollment, shall be reenrolled retroactively to the first day of disenrollmentdeleted text end new text begin may not
reenroll prior to the first day of the month following the payment of an amount equal to
two months' premiumsnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 56.
Minnesota Statutes 2014, section 256L.121, subdivision 1, is amended to read:
Subdivision 1.
Competitive process.
The commissioner of human services shall
establish a competitive process for entering into contracts with participating entities for
the offering of standard health plans through MinnesotaCare. Coverage through standard
health plans must be available to enrollees beginning January 1, 2015. Each standard
health plan must cover the health services listed in and meet the requirements of section
256L.03. The competitive process must meet the requirements of section 1331 of the
Affordable Care Act and be designed to ensure enrollee access to high-quality health care
coverage options. The commissioner, to the extent feasible, shall seek to ensure that
enrollees have a choice of coverage from more than one participating entity within a
geographic area. In counties that were part of a county-based purchasing plan on January
1, 2013, the commissioner shall use the medical assistance competitive procurement
process under section 256B.69, deleted text begin subdivisions 1deleted text end deleted text begin to 32,deleted text end under which selection of entities is
based on criteria related to provider network access, coordination of health care with other
local services, alignment with local public health goals, and other factors.
Sec. 57.
Minnesota Statutes 2014, section 256L.15, subdivision 1, is amended to read:
Subdivision 1.
Premium determinationnew text begin for MinnesotaCarenew text end .
(a) Families with
children and individuals shall pay a premium determined according to subdivision 2.
(b) Members of the military and their families who meet the eligibility criteria
for MinnesotaCare upon eligibility approval made within 24 months following the end
of the member's tour of active duty shall have their premiums paid by the commissioner.
The effective date of coverage for an individual or family who meets the criteria of this
paragraph shall be the first day of the month following the month in which eligibility is
approved. This exemption applies for 12 months.
(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their
families shall have their premiums waived by the commissioner in accordance with
section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
An individual must document status as an American Indian, as defined under Code of
Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
new text begin
(d) For premiums effective August 1, 2015, and after, the commissioner, after
consulting with the chairs and ranking minority members of the legislative committees
with jurisdiction over human services, shall increase premiums under subdivision 2
for recipients based on June 2015 program enrollment. Premium increases shall be
sufficient to increase projected revenue to the fund described in section 16A.724 by at
least $27,800,000 for the biennium ending June 30, 2017. The commissioner shall publish
the revised premium scale on the Department of Human Services Web site and in the State
Register no later than June 15, 2015. The revised premium scale applies to all premiums
on or after August 1, 2015, in place of the scale under subdivision 2.
new text end
new text begin
(e) By July 1, 2015, the commissioner shall provide the chairs and ranking minority
members of the legislative committees with jurisdiction over human services the revised
premium scale effective August 1, 2015, and statutory language to codify the revised
premium schedule.
new text end
new text begin
(f) Premium changes authorized under paragraph (d) must only apply to enrollees not
otherwise excluded from paying premiums under state or federal law. Premium changes
authorized under paragraph (d) must satisfy the requirements for premiums for the Basic
Health Program under title 42 of the Code of Federal Regulations, section 600.505.
new text end
Sec. 58.
Minnesota Statutes 2014, section 256L.15, subdivision 2, is amended to read:
Subd. 2.
Sliding fee scale; monthly individual or family income.
(a) The
commissioner shall establish a sliding fee scale to determine the percentage of monthly
individual or family income that households at different income levels must pay to obtain
coverage through the MinnesotaCare program. The sliding fee scale must be based on the
enrollee's monthly individual or family income.
(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums
according to the premium scale specified in paragraph deleted text begin (c) with the exception that children
20 years of age and younger in families with income at or below 200 percent of the federal
poverty guidelines shall pay no premiumsdeleted text end new text begin (d)new text end .
new text begin
(c) Paragraph (b) does not apply to:
new text end
new text begin
(1) children 20 years of age or younger; and
new text end
new text begin
(2) individuals with household incomes below 35 percent of the federal poverty
guidelines.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end The following premium scale is established for each individual in the
household who is 21 years of age or older and enrolled in MinnesotaCare:
|
Federal Poverty Guideline Greater than or Equal to |
Less than |
Individual Premium Amount |
|
deleted text begin
0%
deleted text end
new text begin
35% new text end |
55% |
$4 |
| 55% |
80% |
$6 |
| 80% |
90% |
$8 |
| 90% |
100% |
$10 |
| 100% |
110% |
$12 |
| 110% |
120% |
deleted text begin
$15
deleted text end
new text begin
$14 new text end |
| 120% |
130% |
deleted text begin
$18
deleted text end
new text begin
$15 new text end |
| 130% |
140% |
deleted text begin
$21
deleted text end
new text begin
$16 new text end |
| 140% |
150% |
$25 |
| 150% |
160% |
$29 |
| 160% |
170% |
$33 |
| 170% |
180% |
$38 |
| 180% |
190% |
$43 |
| 190% |
$50 |
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 59.
Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to read:
Subd. 5.Basic Health Care Grants
|
||||||
| (a) MinnesotaCare Grants |
||||||
|
Health Care Access |
-0- |
(770,000) |
||||
Incentive Program and Outreach Grants.
Of the appropriation for the Minnesota health
care outreach program in Laws 2007, chapter
147, article 19, section 3, subdivision 7,
paragraph (b):
(1) $400,000 in fiscal year 2009 from the
general fund and $200,000 in fiscal year 2009
from the health care access fund are for the
incentive program under Minnesota Statutes,
section 256.962, subdivision 5. For the
biennium beginning July 1, 2009, base level
funding for this activity shall be $360,000
from the general fund and $160,000 from the
health care access fund; and
(2) $100,000 in fiscal year 2009 from the
general fund and $50,000 in fiscal year 2009
from the health care access fund are for the
outreach grants under Minnesota Statutes,
section 256.962, subdivision 2. For the
biennium beginning July 1, 2009, base level
funding for this activity shall be $90,000
from the general fund and $40,000 from the
health care access fund.
| (b) MA Basic Health Care Grants - Families and Children |
-0- |
(17,280,000) |
||||
Third-Party Liability. (a) During
fiscal year 2009, the commissioner shall
employ a contractor paid on a percentage
basis to improve third-party collections.
Improvement initiatives may include, but not
be limited to, efforts to improve postpayment
collection from nonresponsive claims and
efforts to uncover third-party payers the
commissioner has been unable to identify.
(b) In fiscal year 2009, the first $1,098,000
of recoveries, after contract payments and
federal repayments, is appropriated to
the commissioner for technology-related
expenses.
deleted text begin
Administrative Costs. (a) For contracts
effective on or after January 1, 2009,
the commissioner shall limit aggregate
administrative costs paid to managed care
plans under Minnesota Statutes, section
256B.69, and to county-based purchasing
plans under Minnesota Statutes, section
256B.692, to an overall average of 6.6 percent
of total contract payments under Minnesota
Statutes, sections 256B.69 and 256B.692,
for each calendar year. For purposes of
this paragraph, administrative costs do not
include premium taxes paid under Minnesota
Statutes, section 297I.05, subdivision 5, and
provider surcharges paid under Minnesota
Statutes, section 256.9657, subdivision 3.
deleted text end
deleted text begin
(b) Notwithstanding any law to the contrary,
the commissioner may reduce or eliminate
administrative requirements to meet the
administrative target under paragraph (a).
deleted text end
deleted text begin
(c) Notwithstanding any contrary provision
of this article, this rider shall not expire.
deleted text end
Hospital Payment Delay. Notwithstanding
Laws 2005, First Special Session chapter 4,
article 9, section 2, subdivision 6, payments
from the Medicaid Management Information
System that would otherwise have been made
for inpatient hospital services for medical
assistance enrollees are delayed as follows:
(1) for fiscal year 2008, June payments must
be included in the first payments in fiscal
year 2009; and (2) for fiscal year 2009,
June payments must be included in the first
payment of fiscal year 2010. The provisions
of Minnesota Statutes, section 16A.124,
do not apply to these delayed payments.
Notwithstanding any contrary provision in
this article, this paragraph expires on June
30, 2010.
| (c) MA Basic Health Care Grants - Elderly and Disabled |
(14,028,000) |
(9,368,000) |
||||
Minnesota Disability Health Options Rate
Setting Methodology. The commissioner
shall develop and implement a methodology
for risk adjusting payments for community
alternatives for disabled individuals (CADI)
and traumatic brain injury (TBI) home
and community-based waiver services
delivered under the Minnesota disability
health options program (MnDHO) effective
January 1, 2009. The commissioner shall
take into account the weighting system used
to determine county waiver allocations in
developing the new payment methodology.
Growth in the number of enrollees receiving
CADI or TBI waiver payments through
MnDHO is limited to an increase of 200
enrollees in each calendar year from January
2009 through December 2011. If those limits
are reached, additional members may be
enrolled in MnDHO for basic care services
only as defined under Minnesota Statutes,
section 256B.69, subdivision 28, and the
commissioner may establish a waiting list for
future access of MnDHO members to those
waiver services.
MA Basic Elderly and Disabled
Adjustments. For the fiscal year ending June
30, 2009, the commissioner may adjust the
rates for each service affected by rate changes
under this section in such a manner across
the fiscal year to achieve the necessary cost
savings and minimize disruption to service
providers, notwithstanding the requirements
of Laws 2007, chapter 147, article 7, section
71.
| (d) General Assistance Medical Care Grants |
-0- |
(6,971,000) |
||||
| (e) Other Health Care Grants |
-0- |
(17,000) |
||||
MinnesotaCare Outreach Grants Special
Revenue Account. The balance in the
MinnesotaCare outreach grants special
revenue account on July 1, 2009, estimated
to be $900,000, must be transferred to the
general fund.
Grants Reduction. Effective July 1, 2008,
base level funding for nonforecast, general
fund health care grants issued under this
paragraph shall be reduced by 1.8 percent at
the allotment level.
Sec. 60.
Laws 2014, chapter 312, article 24, section 45, subdivision 2, is amended to
read:
Subd. 2.
Application for and terms of variance.
A new provider may apply to the
commissioner, on a form supplied by the commissioner for this purpose, for a variance
from special transportation service operating standards. The commissioner may grant or
deny the variance application. Variances expire on the earlier of February 1, deleted text begin 2016deleted text end new text begin 2017new text end , or
deleted text begin the date that the commissioner of transportation begins certifying new providers under the
terms of this act and successor legislationdeleted text end new text begin one year after the date the variance was issued.
The commissioner must not grant variances under this subdivision after June 30, 2016new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2016.
new text end
Sec. 61. new text begin STATEWIDE OPIOID PRESCRIBING IMPROVEMENT PROGRAM.
new text end
new text begin
The commissioner of human services, in collaboration with the commissioner of
health, shall report to the legislature by December 1, 2015, on recommendations made
by the opioid prescribing work group under Minnesota Statutes, section 256B.0638,
subdivision 4, and steps taken by the commissioner of human services to implement the
opioid prescribing improvement program under Minnesota Statutes, section 256B.0638,
subdivision 5.
new text end
Sec. 62. new text begin TASK FORCE ON HEALTH CARE FINANCING.
new text end
new text begin Subdivision 1. new text end
new text begin Task force. new text end
new text begin
(a) The governor shall convene a task force on health
care financing to advise the governor and legislature on strategies that will increase access
to and improve the quality of health care for Minnesotans. These strategies shall include
options for sustainable health care financing, coverage, purchasing, and delivery for all
insurance affordability programs, including MNsure, medical assistance, MinnesotaCare,
and individuals eligible to purchase coverage with federal advanced premium tax credits
and cost-sharing subsidies.
new text end
new text begin
(b) The task force shall consist of:
new text end
new text begin
(1) seven members appointed by the senate, four members appointed by the majority
leader of the senate, one of whom must be a legislator; and three members appointed by
the minority leader of the senate, one of whom must be a legislator;
new text end
new text begin
(2) seven members of the house of representatives, four members appointed by the
speaker of the house, one of whom must be a legislator; and three members appointed by
the minority leader of the house of representatives, one of whom must be a legislator;
new text end
new text begin
(3) 11 members appointed by the governor, including public and private health care
experts and consumer representatives. The consumer representatives must include one
member from a nonprofit organization with legal expertise representing low-income
consumers, at least one member from a broad-based nonprofit consumer advocacy
organization, and at least one member from an organization representing consumers of
color; and
new text end
new text begin
(4) the commissioners of human services, commerce, and health, and the executive
director of MNsure, or their designees.
new text end
new text begin
(c) The commissioner of human services and a member of the task force voted
by the task force shall serve as cochairs of the task force. The commissioner of human
services shall convene the first meeting and the members shall vote on the cochair position
at the first meeting.
new text end
new text begin Subd. 2. new text end
new text begin Duties. new text end
new text begin
(a) The task force shall consider opportunities, including
alternatives to MNsure, options under section 1332 of the Patient Protection and Affordable
Care Act, and options under a section 1115 waiver of the Social Security Act, including:
new text end
new text begin
(1) options for providing and financing seamless coverage for persons
otherwise eligible for insurance affordability programs, including medical assistance,
MinnesotaCare, and advanced premium tax credits used to purchase commercial
insurance. This includes, but is not limited to: alignment of eligibility and enrollment
requirements; smoothing consumer cost-sharing across programs; alignment and
alternatives to benefit sets; alternatives to the individual mandate; the employer mandate
and penalties; advanced premium tax credits; and qualified health plans;
new text end
new text begin
(2) options for transforming health care purchasing and delivery, including, but not
limited to: expansion of value-based direct contracting with providers and other entities
to reward improved health outcomes and reduced costs, including selective contracting;
contracting to provide services to public programs and commercial products; and payment
models that support and reward coordination of care across the continuum of services
and programs;
new text end
new text begin
(3) options for alignment, consolidation, and governance of certain operational
components, including, but not limited to: MNsure; program eligibility, enrollment, call
centers, and contracting; and the shared eligibility IT platform; and
new text end
new text begin
(4) examining the impact of options on the health care workforce and delivery
system, including, but not limited to, rural and safety net providers, clinics, and hospitals.
new text end
new text begin
(b) In development of the options in paragraph (a), the task force options and
recommendations shall include the following goals:
new text end
new text begin
(1) seamless consumer experience across all programs;
new text end
new text begin
(2) reducing barriers to accessibility and affordability of coverage;
new text end
new text begin
(3) improving sustainable financing of health programs, including impact on the
state budget;
new text end
new text begin
(4) assessing the impact of options for innovation on their potential to reduce
health disparities;
new text end
new text begin
(5) expanding innovative health care purchasing and delivery systems strategies that
reduce cost and improve health;
new text end
new text begin
(6) promoting effectively and efficiently aligning program resources and operations;
and
new text end
new text begin
(7) increasing transparency and accountability of program operations.
new text end
new text begin Subd. 3. new text end
new text begin Staff. new text end
new text begin
(a) The commissioner of human services shall provide staff and
administrative services for the task force. The commissioner may accept outside resources
to help support its efforts and shall leverage its existing vendor contracts to provide
technical expertise to develop options under subdivision 2. The commissioner of human
services shall receive expedited review and publication of competitive procurements for
additional vendor support needed to support the task force.
new text end
new text begin
(b) Technical assistance shall be provided by the Departments of Health, Commerce,
Human Services, and Management and Budget.
new text end
new text begin Subd. 4. new text end
new text begin Report. new text end
new text begin
The commissioner of human services shall submit
recommendations by January 15, 2016, to the governor and the chairs and ranking
minority members of the legislative committees with jurisdiction over health, human
services, and commerce policy and finance.
new text end
new text begin Subd. 5. new text end
new text begin Expiration. new text end
new text begin
The task force expires the day after submitting the report
required under subdivision 4.
new text end
Sec. 63. new text begin HEALTH DISPARITIES PAYMENT ENHANCEMENT.
new text end
new text begin
(a) The commissioner of human services shall develop a methodology to pay a
higher payment rate for health care providers and services that takes into consideration
the higher cost, complexity, and resources needed to serve patients and populations
who experience the greatest health disparities in order to achieve the same health and
quality outcomes that are achieved for other patients and populations. In developing
the methodology, the commissioner shall take into consideration all existing payment
methods and rates, including add-on or enhanced rates paid to providers serving high
concentrations of low-income patients or populations or providing access in underserved
regions or populations. The new methodology must not result in a net decrease in total
payment from all sources for those providers who qualify for additional add-on payments
or enhanced payments, including, but not limited to, critical access dental, community
clinic add-ons, federally qualified health centers payment rates, and disproportionate share
payments. The commissioner shall develop the methodology in consultation with affected
stakeholders, including communities impacted by health disparities, using culturally
appropriate methods of community engagement. The proposed methodology must include
recommendations for how the methodology could be incorporated into payment methods
used in both fee-for-service and managed care plans.
new text end
new text begin
(b) The commissioner shall submit a report on the analysis and provide options
for new payment methodologies that incorporate health disparities to the chairs and
ranking minority members of the legislative committees with jurisdiction over health care
policy and finance by February 1, 2016. The scope of the report and the development
work described in paragraph (a) is limited to data currently available to the Department
of Human Services; analyses of the data for reliability and completeness; analyses of
how these data relate to health disparities, outcomes, and expenditures; and options for
incorporating these data or measures into a payment methodology.
new text end
Sec. 64. new text begin CAPITATION PAYMENT DELAY.
new text end
new text begin
The commissioner of human services shall delay $135,000,000 of the medical
assistance capitation payment to managed care plans and county-based purchasing plans
due in May 2017 and the payment due in April 2017 for special needs basic care until
July 1, 2017. The payment shall be made no earlier than July 1, 2017, and no later than
July 31, 2017.
new text end
Sec. 65. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2014, sections 256.01, subdivision 35; 256.969, subdivisions
23 and 30; and 256B.69, subdivision 32,
new text end
new text begin
are repealed effective July 1, 2015.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2014, sections 256L.02, subdivision 3; and 256L.05,
subdivisions 1b, 1c, 3c, and 5,
new text end
new text begin
are repealed effective the day following final enactment.
new text end
new text begin
(c)
new text end
new text begin
Minnesota Rules, part 8840.5900, subparts 12 and 14,
new text end
new text begin
are repealed effective
January 1, 2016.
new text end
ARTICLE 12
MNSURE
Section 1.
Minnesota Statutes 2014, section 62A.02, subdivision 2, is amended to read:
Subd. 2.
Approval.
(a) The health plan form shall not be issued, nor shall any
application, rider, endorsement, or rate be used in connection with it, until the expiration
of 60 days after it has been filed unless the commissioner approves it before that time.
(b) Notwithstanding paragraph (a), a rate filed with respect to a policy of accident and
sickness insurance as defined in section 62A.01 by an insurer licensed under chapter 60A,
may be used on or after the date of filing with the commissioner. Rates that are not approved
or disapproved within the 60-day time period are deemed approved. This paragraph does
not apply to Medicare-related coverage as defined in section 62A.3099, subdivision 17.
new text begin
(c) For coverage to begin on or after January 1, 2016, and each January 1 thereafter,
health plans in the individual and small group markets that are not grandfathered plans to
be offered outside MNsure and qualified health plans to be offered inside MNsure must
receive rate approval from the commissioner no later than 30 days prior to the beginning
of the annual open enrollment period for MNsure. Premium rates for all carriers in the
applicable market for the next calendar year must be made available to the public by the
commissioner only after all rates for the applicable market are final and approved. Final
and approved rates must be publicly released at a uniform time for all individual and small
group health plans that are not grandfathered plans to be offered outside MNsure and
qualified health plans to be offered inside MNsure, and no later than 30 days prior to the
beginning of the annual open enrollment period for MNsure.
new text end
Sec. 2.
Minnesota Statutes 2014, section 62V.03, subdivision 2, is amended to read:
Subd. 2.
Application of other law.
(a) MNsure must be reviewed by the legislative
auditor under section 3.971. The legislative auditor shall audit the books, accounts, and
affairs of MNsure once each year or less frequently as the legislative auditor's funds and
personnel permit. Upon the audit of the financial accounts and affairs of MNsure, MNsure
is liable to the state for the total cost and expenses of the audit, including the salaries paid
to the examiners while actually engaged in making the examination. The legislative
auditor may bill MNsure either monthly or at the completion of the audit. All collections
received for the audits must be deposited in the general fund and are appropriated to
the legislative auditor. Pursuant to section 3.97, subdivision 3a, the Legislative Audit
Commission is requested to direct the legislative auditor to report by March 1, 2014, to
the legislature on any duplication of services that occurs within state government as a
result of the creation of MNsure. The legislative auditor may make recommendations on
consolidating or eliminating any services deemed duplicative. The board shall reimburse
the legislative auditor for any costs incurred in the creation of this report.
(b) Board members of MNsure are subject to sections 10A.07 and 10A.09. Board
members and the personnel of MNsure are subject to section 10A.071.
(c) All meetings of the board shall comply with the open meeting law in chapter
13Ddeleted text begin , except that:deleted text end new text begin .
new text end
deleted text begin
(1) meetings, or portions of meetings, regarding compensation negotiations with the
director or managerial staff may be closed in the same manner and according to the same
procedures identified in section 13D.03;
deleted text end
deleted text begin
(2) meetings regarding contract negotiation strategy may be closed in the same
manner and according to the same procedures identified in section 13D.05, subdivision 3,
paragraph (c); and
deleted text end
deleted text begin
(3) meetings, or portions of meetings, regarding not public data described in section
62V.06, subdivision 3, and regarding trade secret information as defined in section 13.37,
subdivision 1, paragraph (b), are closed to the public, but must otherwise comply with
the procedures identified in chapter 13D.
deleted text end
deleted text begin
(d) MNsure and provisions specified under this chapter are exempt from:
deleted text end
deleted text begin
(1) chapter 14, including section 14.386, except as specified in section 62V.05; and
deleted text end
deleted text begin
(2) chapters 16B and 16C, with the exception of sections 16C.08, subdivision 2,
paragraph (b), clauses (1) to (8); 16C.086; 16C.09, paragraph (a), clauses (1) and (3),
paragraph (b), and paragraph (c); and section 16C.16. However, MNsure, in consultation
with the commissioner of administration, shall implement policies and procedures to
establish an open and competitive procurement process for MNsure that, to the extent
practicable, conforms to the principles and procedures contained in chapters 16B and 16C.
In addition, MNsure may enter into an agreement with the commissioner of administration
for other services.
deleted text end
deleted text begin (e)deleted text end new text begin (d) new text end The board and the Web site are exempt from chapter 60K. Any employee of
MNsure who sells, solicits, or negotiates insurance to individuals or small employers must
be licensed as an insurance producer under chapter 60K.
deleted text begin (f)deleted text end new text begin (e) new text end Section 3.3005 applies to any federal funds received by MNsure.
deleted text begin
(g) MNsure is exempt from the following sections in chapter 16E: 16E.01,
subdivision 3, paragraph (b); 16E.03, subdivisions 3 and 4; 16E.04, subdivision 1,
subdivision 2, paragraph (c), and subdivision 3, paragraph (b); 16E.0465; 16E.055;
16E.145; 16E.15; 16E.16; 16E.17; 16E.18; and 16E.22.
deleted text end
deleted text begin (h)deleted text end new text begin (f)new text end A MNsure decision that requires a vote of the board, other than a decision
that applies only to hiring of employees or other internal management of MNsure, is an
"administrative action" under section 10A.01, subdivision 2.
Sec. 3.
Minnesota Statutes 2014, section 62V.05, subdivision 6, is amended to read:
Subd. 6.
Appeals.
(a) The board may conduct hearings, appoint hearing officers,
and recommend final orders related to appeals of any MNsure determinations, except for
those determinations identified in paragraph (d). An appeal by a health carrier regarding
a specific certification or selection determination made by MNsure under subdivision 5
must be conducted as a contested case proceeding under chapter 14, with the report or
order of the administrative law judge constituting the final decision in the case, subject to
judicial review under sections 14.63 to 14.69. For other appeals, the board shall establish
hearing processes which provide for a reasonable opportunity to be heard and timely
resolution of the appeal and which are consistent with the requirements of federal law and
guidance. An appealing party may be represented by legal counsel at these hearings, but
this is not a requirement.
(b) MNsure may establish service-level agreements with state agencies to conduct
hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is
authorized to enter into service-level agreements for this purpose with MNsure.
(c) For proceedings under this subdivision, MNsure may be represented by an
attorney who is an employee of MNsure.
(d) This subdivision does not apply to appeals of determinations where a state
agency hearing is available under section 256.045.
new text begin
(e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as
defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of
the appellant's county of residence by serving a written copy of a notice of appeal upon
MNsure and any other adverse party of record within 30 days after the date MNsure
issued the order, the amended order, or order affirming the original order, and by filing
the original notice and proof of service with the court administrator of the district court.
Service may be made personally or by mail; service by mail is complete upon mailing;
no filing fee shall be required by the court administrator in appeals taken pursuant to this
subdivision. MNsure shall furnish all parties to the proceedings with a copy of the decision
and a transcript of any testimony, evidence, or other supporting papers from the hearing
held before the appeals examiner within 45 days after service of the notice of appeal.
new text end
new text begin
(f) Any party aggrieved by the failure of an adverse party to obey an order issued
by MNsure may compel performance according to the order in the manner prescribed in
sections 586.01 to 586.12.
new text end
new text begin
(g) Any party may obtain a hearing at a special term of the district court by serving a
written notice of the time and place of the hearing at least ten days prior to the date of
the hearing. The court may consider the matter in or out of chambers, and shall take no
new or additional evidence unless it determines that such evidence is necessary for a
more equitable disposition of the appeal.
new text end
new text begin
(h) Any party aggrieved by the order of the district court may appeal the order as in
other civil cases. No costs or disbursements shall be taxed against any party nor shall any
filing fee or bond be required of any party.
new text end
new text begin
(i) If MNsure or district court orders eligibility for qualified health plan coverage
through MNsure, or eligibility for federal advance payment of premium tax credits
or cost-sharing reductions contingent upon full payment of respective premiums, the
premiums must be paid or provided pending appeal to the district court, Court of Appeals,
or Supreme Court. Provision of eligibility by MNsure pending appeal does not render
moot MNsure's position in a court of law.
new text end
Sec. 4.
Minnesota Statutes 2014, section 62V.05, subdivision 7, is amended to read:
Subd. 7.
Agreements; consultation.
(a) The board shall:
deleted text begin
(1) establish and maintain an agreement with the chief information officer of the
Office of MN.IT Services for information technology services that ensures coordination
with public health care programs. The board may establish and maintain agreements
with the chief information officer of the Office of MN.IT Services for other information
technology services, including an agreement that would permit MNsure to administer
eligibility for additional health care and public assistance programs under the authority
of the commissioner of human services;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end establish and maintain an agreement with the commissioner of human
services for cost allocation and services regarding eligibility determinations and
enrollment for public health care programs that use a modified adjusted gross income
standard to determine program eligibility. The board may establish and maintain an
agreement with the commissioner of human services for other services;
deleted text begin (3)deleted text end new text begin (2)new text end establish and maintain an agreement with the commissioners of commerce and
health for services regarding enforcement of MNsure certification requirements for health
plans and dental plans offered through MNsure. The board may establish and maintain
agreements with the commissioners of commerce and health for other services; and
deleted text begin (4)deleted text end new text begin (3)new text end establish interagency agreements to transfer funds to other state agencies for
their costs related to implementing and operating MNsure, excluding medical assistance
allocatable costs.
(b) The board shall consult with the commissioners of commerce and health
regarding the operations of MNsure.
(c) The board shall consult with Indian tribes and organizations regarding the
operation of MNsure.
(d) Beginning March 15, deleted text begin 2014deleted text end new text begin 2016new text end , and each March 15 thereafter, the board shall
submit a report to the chairs and ranking minority members of the committees in the
senate and house of representatives with primary jurisdiction over commerce, health, and
human services on all the agreements entered into with the chief information officer of the
Office of MN.IT Services, or the commissioners of human services, health, or commerce
in accordance with this subdivision. The report shall include the agency in which the
agreement is with; the time period of the agreement; the purpose of the agreement; and
a summary of the terms of the agreement. A copy of the agreement must be submitted
to the extent practicable.
Sec. 5.
Minnesota Statutes 2014, section 62V.05, subdivision 8, is amended to read:
Subd. 8.
Rulemaking.
deleted text begin
(a) If the board's policies, procedures, or other statements are
rules, as defined in section 14.02, subdivision 4, the requirements in either paragraph (b)
or (c) apply, as applicable.
deleted text end
deleted text begin
(b) Effective upon enactment until January 1, 2015:
deleted text end
deleted text begin
(1) the board shall publish notice of proposed rules in the State Register after
complying with section 14.07, subdivision 2;
deleted text end
deleted text begin
(2) interested parties have 21 days to comment on the proposed rules. The board
must consider comments it receives. After the board has considered all comments and
has complied with section 14.07, subdivision 2, the board shall publish notice of the
final rule in the State Register;
deleted text end
deleted text begin
(3) if the adopted rules are the same as the proposed rules, the notice shall state that
the rules have been adopted as proposed and shall cite the prior publication. If the adopted
rules differ from the proposed rules, the portions of the adopted rules that differ from the
proposed rules shall be included in the notice of adoption, together with a citation to the
prior State Register that contained the notice of the proposed rules; and
deleted text end
deleted text begin
(4) rules published in the State Register before January 1, 2014, take effect upon
publication of the notice. Rules published in the State Register on and after January 1,
2014, take effect 30 days after publication of the notice.
deleted text end
deleted text begin (c) Beginning January 1, 2015,deleted text end The board may adopt rules to implement any
provisions in this chapter using the expedited rulemaking process in section 14.389.
deleted text begin
(d) The notice of proposed rules required in paragraph (b) must provide information
as to where the public may obtain a copy of the rules. The board shall post the proposed
rules on the MNsure Web site at the same time the notice is published in the State Register.
deleted text end
Sec. 6.
Minnesota Statutes 2014, section 62V.05, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Prohibition on other product lines. new text end
new text begin
MNsure is prohibited from
certifying, selecting, or offering products and policies of coverage that do not meet the
definition of health plan or dental plan as provided in section 62V.02.
new text end
Sec. 7. new text begin EXPANDED ACCESS TO THE SMALL BUSINESS HEALTH CARE
TAX CREDIT.
new text end
new text begin
(a) The commissioner of human services, in consultation with the Board of Directors
of MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal
to allow small employers the ability to receive the small business health care tax credit
when the small employer pays the premiums on behalf of employees enrolled in either a
qualified health plan offered through a small business health options program (SHOP)
marketplace or a small group health plan offered outside of the SHOP marketplace within
MNsure. To be eligible for the tax credit, the small employer must meet the requirements
under the Affordable Care Act, except that employees may be enrolled in a small group
health plan product offered outside of MNsure.
new text end
new text begin
(b) The commissioner shall seek all federal waivers and approvals necessary to
implement the proposal in paragraph (a). The commissioner shall submit a draft proposal
to the MNsure board and the MNsure Legislative Oversight Committee at least 30 days
before submitting a final proposal to the federal government, and shall notify the board
and Legislative Oversight Committee of any federal decision or action received regarding
the proposal and submitted waiver.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 8. new text begin EXPANDED ACCESS TO QUALIFIED HEALTH PLANS AND
SUBSIDIES.
new text end
new text begin
The commissioner of commerce, in consultation with the Board of Directors of
MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal to
allow individuals to purchase qualified health plans outside of MNsure directly from
health plan companies and to allow eligible individuals to receive advanced premium tax
credits and cost-sharing reductions when purchasing these health plans. The commissioner
shall seek all federal waivers and approvals necessary to implement this proposal.
The commissioner shall submit a draft proposal to the MNsure board and the MNsure
Legislative Oversight Committee at least 30 days before submitting a final proposal to the
federal government and shall notify the board and legislative oversight committee of any
federal decision or action related to the proposal.
new text end
Sec. 9. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2014, section 62V.11, subdivision 3,
new text end
new text begin
is repealed.
new text end
ARTICLE 13
HUMAN SERVICES FORECAST ADJUSTMENTS
Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.new text end
|
new text begin
The dollar amounts shown are added to or, if shown in parentheses, are subtracted
from the appropriations in Laws 2013, chapter 108, article 14, as amended by Laws 2014,
chapter 312, article 30, from the general fund, or any other fund named, to the Department
of Human Services for the purposes specified in this article, to be available for the fiscal
years indicated for each purpose. The figure "2015" used in this article means that the
appropriations listed are available for the fiscal year ending June 30, 2015.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2015 new text end |
||||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
(255,104,000) new text end |
||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2015 new text end |
||
|
new text begin
General Fund new text end |
new text begin
(125,910,000) new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
(123,113,000) new text end |
|
|
new text begin
TANF new text end |
new text begin
(6,081,000) new text end |
|
new text begin Subd. 2. new text end
new text begin
Forecasted Programs
|
|||||
|
new text begin
(a) MFIP/DWP Grants new text end |
|||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General Fund new text end |
new text begin
(1,977,000) new text end |
|
|
new text begin
TANF new text end |
new text begin
(7,079,000) new text end |
|
|
new text begin
(b) MFIP Child Care Assistance Grants new text end |
new text begin
9,733,000 new text end |
|||||
|
new text begin
(c) General Assistance Grants new text end |
new text begin
(1,423,000) new text end |
|||||
|
new text begin
(d) Minnesota Supplemental Aid Grants new text end |
new text begin
(1,121,000) new text end |
|||||
|
new text begin
(e) Group Residential Housing Grants new text end |
new text begin
(6,314,000) new text end |
|||||
|
new text begin
(f) MinnesotaCare Grants new text end |
new text begin
(75,675,000) new text end |
|||||
new text begin
This appropriation is from the health care
access fund.
new text end
|
new text begin
(g) Medical Assistance Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General Fund new text end |
new text begin
(124,557,000) new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
(47,438,000) new text end |
|
|
new text begin
(h) Alternative Care Grants new text end |
new text begin
0 new text end |
|||||
|
new text begin
(i) CD Entitlement Grants new text end |
new text begin
(251,000) new text end |
|||||
new text begin Subd. 3. new text end
new text begin
Technical Activities
|
new text begin
998,000 new text end |
|||||
new text begin
This appropriation is from the TANF fund.
new text end
Sec. 3. new text begin EFFECTIVE DATE.
new text end
new text begin
Sections 1 and 2 are effective the day following final enactment.
new text end
ARTICLE 14
HEALTH AND HUMAN SERVICES APPROPRIATIONS
Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.new text end
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the
agencies and for the purposes specified in this article. The appropriations are from the
general fund, or another named fund, and are available for the fiscal years indicated
for each purpose. The figures "2016" and "2017" used in this article mean that the
appropriations listed under them are available for the fiscal year ending June 30, 2016, or
June 30, 2017, respectively. "The first year" is fiscal year 2016. "The second year" is fiscal
year 2017. "The biennium" is fiscal years 2016 and 2017.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2016 new text end |
new text begin
2017 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
7,236,563,000 new text end |
new text begin
$ new text end |
new text begin
7,443,496,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2016 new text end |
new text begin
2017 new text end |
|
|
new text begin
General new text end |
new text begin
5,903,939,000 new text end |
new text begin
6,448,469,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,514,000 new text end |
new text begin
4,274,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
1,059,147,000 new text end |
new text begin
725,326,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
267,070,000 new text end |
new text begin
263,531,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
1,893,000 new text end |
new text begin
1,896,000 new text end |
new text begin
Receipts for Systems Projects.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, ISDS, and SSIS must
be deposited in the state systems account
authorized in Minnesota Statutes, section
256.014. Money appropriated for computer
projects approved by the commissioner
of the Office of MN.IT Services, funded
by the legislature, and approved by the
commissioner of management and budget
may be transferred from one project to
another and from development to operations
as the commissioner of human services
considers necessary. Any unexpended
balance in the appropriation for these
projects does not cancel but is available for
ongoing development and operations.
new text end
new text begin
new text begin TANF Maintenance of Effort.new text end (a) In order
to meet the basic maintenance of effort
(MOE) requirements of the TANF block grant
specified under Code of Federal Regulations,
title 45, section 263.1, the commissioner may
only report nonfederal money expended for
allowable activities listed in the following
clauses as TANF/MOE expenditures:
new text end
new text begin
(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
new text end
new text begin
(2) the child care assistance programs
under Minnesota Statutes, sections 119B.03
and 119B.05, and county child care
administrative costs under Minnesota
Statutes, section 119B.15;
new text end
new text begin
(3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;
new text end
new text begin
(4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;
new text end
new text begin
(5) expenditures made on behalf of legal
noncitizen MFIP recipients who qualify for
the MinnesotaCare program under Minnesota
Statutes, chapter 256L;
new text end
new text begin
(6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671; and
new text end
new text begin
(7) qualifying Minnesota education credit
expenditures under Minnesota Statutes,
section 290.0674.
new text end
new text begin
(b) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
TANF/MOE requirements. For the activities
listed in paragraph (a), clauses (2) to
(7), the commissioner may only report
expenditures that are excluded from the
definition of assistance under Code of
Federal Regulations, title 45, section 260.31.
new text end
new text begin
(c) For fiscal years beginning with state fiscal
year 2003, the commissioner shall ensure
that the maintenance of effort used by the
commissioner of management and budget
for the February and November forecasts
required under Minnesota Statutes, section
16A.103, contains expenditures under
paragraph (a), clause (1), equal to at least 16
percent of the total required under Code of
Federal Regulations, title 45, section 263.1.
new text end
new text begin
(d) The requirement in Minnesota Statutes,
section 256.011, subdivision 3, that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, does not
apply if the grants or aids are federal TANF
funds.
new text end
new text begin
(e) For the federal fiscal years beginning on
or after October 1, 2007, the commissioner
may not claim an amount of TANF/MOE in
excess of the 75 percent standard in Code
of Federal Regulations, title 45, section
263.1(a)(2), except:
new text end
new text begin
(1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1),
if it is determined by the commissioner
that the state will not meet the TANF work
participation target rate for the current year;
new text end
new text begin
(2) to provide any additional amounts
under Code of Federal Regulations, title 45,
section 264.5, that relate to replacement of
TANF funds due to the operation of TANF
penalties; and
new text end
new text begin
(3) to provide any additional amounts that
may contribute to avoiding or reducing
TANF work participation penalties through
the operation of the excess MOE provisions
of Code of Federal Regulations, title 45,
section 261.43(a)(2).
new text end
new text begin
(f) For the purposes of paragraph (e), clauses
(1) to (3), the commissioner may supplement
the MOE claim with working family credit
expenditures or other qualified expenditures
to the extent such expenditures are otherwise
available after considering the expenditures
allowed in this subdivision and subdivision 2.
new text end
new text begin
(g) Notwithstanding any contrary provision
in this article, paragraphs (a) to (f) expire
June 30, 2019.
new text end
new text begin
Working Family Credit Expenditure
as TANF/MOE. The commissioner may
claim as TANF maintenance of effort up to
$6,707,000 per year of working family credit
expenditures in each fiscal year.
new text end
new text begin Subd. 2. new text end
new text begin
Working Family Credit to be Claimed
|
||||||
new text begin
The commissioner may count the following
additional amounts of working family credit
expenditures as TANF maintenance of effort:
new text end
new text begin
(1) fiscal year 2016, $0;
new text end
new text begin
(2) fiscal year 2017, $1,283,000;
new text end
new text begin
(3) fiscal year 2018, $0; and
new text end
new text begin
(4) fiscal year 2019, $0.
new text end
new text begin
Notwithstanding any contrary provision in
this article, this subdivision expires June 30,
2019.
new text end
new text begin Subd. 3. new text end
new text begin
Central Office
|
||||||
new text begin
The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) Operations new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
115,577,000 new text end |
new text begin
113,733,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,389,000 new text end |
new text begin
4,149,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
9,793,000 new text end |
new text begin
10,076,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
100,000 new text end |
new text begin
100,000 new text end |
new text begin
Administrative Recovery; Set-Aside. The
commissioner may invoice local entities
through the SWIFT accounting system as an
alternative means to recover the actual cost
of administering the following provisions:
new text end
new text begin
(1) Minnesota Statutes, section 125A.744,
subdivision 3;
new text end
new text begin
(2) Minnesota Statutes, section 245.495,
paragraph (b);
new text end
new text begin
(3) Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end
new text begin
(4) Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end
new text begin
(5) Minnesota Statutes, section 256B.0945,
subdivision 4, paragraph (d); and
new text end
new text begin
(6) Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end
new text begin
IT Appropriations Generally. This
appropriation includes funds for information
technology projects, services, and support.
Notwithstanding Minnesota Statutes,
section 16E.0466, funding for information
technology project costs shall be incorporated
into the service level agreement and paid
to the Office of MN.IT Services by the
Department of Human Services under
the rates and mechanism specified in that
agreement.
new text end
new text begin
new text begin Periodic Data Matching for Medical
Assistance and MinnesotaCare.new text end $1,598,000
in fiscal year 2016 and $2,017,000 in fiscal
year 2017 from the general fund are for
periodic data matching for medical assistance
and MinnesotaCare recipients under
Minnesota Statutes, section 256B.0561, and
related administrative services.
new text end
new text begin
new text begin Base Level Adjustment.new text end The general fund
base is increased by $1,240,000 in fiscal
year 2018 and by $1,291,000 in fiscal year
2019. The health care access fund base is
decreased by $455,000 in fiscal year 2018
and by $455,000 in fiscal year 2019.
new text end
|
new text begin
(b) Children and Families new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
9,974,000 new text end |
new text begin
9,829,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
2,582,000 new text end |
new text begin
2,582,000 new text end |
new text begin
Financial Institution Data Match and
Payment of Fees. The commissioner is
authorized to allocate up to $310,000 each
year in fiscal year 2016 and fiscal year
2017 from the PRISM special revenue
account to make payments to financial
institutions in exchange for performing
data matches between account information
held by financial institutions and the public
authority's database of child support obligors
as authorized by Minnesota Statutes, section
13B.06, subdivision 7.
new text end
new text begin
new text begin Child Support Work Group.new text end $12,000 in
fiscal year 2016 is from the general fund for
facilitation of the duties of the child support
work group.
new text end
new text begin
new text begin Base Level Adjustment.new text end The general fund
base is increased by $31,000 in fiscal year
2018 and by $31,000 in fiscal year 2019.
new text end
|
new text begin
(c) Health Care new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
16,667,000 new text end |
new text begin
16,309,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
33,185,000 new text end |
new text begin
34,007,000 new text end |
new text begin
Periodic Data Matching for Medical
Assistance and MinnesotaCare. $116,000
in fiscal year 2017 from the health care
access fund is for periodic data matching
for medical assistance and MinnesotaCare
recipients under Minnesota Statutes, section
256B.0561, and related administrative
services.
new text end
new text begin
Task Force. Of the general fund
appropriation, $770,000 in fiscal year 2016 is
for administrative services and support to the
Task Force on Health Care Financing. This
is a onetime appropriation.
new text end
new text begin
Base Level Adjustment. The general fund
base is decreased by $98,000 in fiscal year
2019. The health care access fund base is
increased by $43,000 in fiscal year 2018 and
by $150,000 in fiscal year 2019.
new text end
|
new text begin
(d) Continuing Care new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
32,950,000 new text end |
new text begin
29,924,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
125,000 new text end |
new text begin
125,000 new text end |
new text begin
Training of Direct Support Services
Providers. $250,000 in fiscal year 2017 is
for training of individual providers of direct
support services as defined in Minnesota
Statutes, section 256B.0711, subdivision
1. This appropriation is only available
if the labor agreement between the state
of Minnesota and the Service Employees
International Union Healthcare Minnesota
under Minnesota Statutes, section 179A.54,
is approved under Minnesota Statutes,
sections 3.855 and 179A.22.
new text end
new text begin
new text begin Deaf and Hard-of-Hearing Services
Division. new text end $650,000 in fiscal year 2016
and $500,000 in fiscal year 2017 are
from the general fund for the Deaf and
Hard-of-Hearing Services Division under
Minnesota Statutes, section 256C.233. This
is a onetime appropriation. The funds must
be used:
new text end
new text begin
(1) to provide linguistically and culturally
appropriate mental health services;
new text end
new text begin
(2) to ensure that each regional advisory
committee meets at least quarterly;
new text end
new text begin
(3) to increase the number of deafblind
Minnesotans receiving services;
new text end
new text begin
(4) to conduct an analysis of how the regional
offices and staff are operated, in consultation
with the Commission of Deaf, DeafBlind,
and Hard of Hearing Minnesotans;
new text end
new text begin
(5) during fiscal year 2016, to provide direct
services to clients and purchase additional
technology for the technology labs; and
new text end
new text begin
(6) to conduct an analysis of whether
deafblind services are being provided in the
best and most efficient way possible, with
input from deafblind Minnesotans receiving
services.
new text end
new text begin
new text begin Nursing Facilities.new text end $890,000 in fiscal year
2016 is from the general fund for the nursing
facility property rate setting appraisals and
study. This is a onetime appropriation.
new text end
new text begin
Base Level Adjustment. The general fund
base is decreased by $174,000 in fiscal year
2018 and by $234,000 in fiscal year 2019.
new text end
|
new text begin
(e) Chemical and Mental Health new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
7,058,000 new text end |
new text begin
7,240,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
160,000 new text end |
new text begin
163,000 new text end |
new text begin
Base Level Adjustment. The general fund
base is decreased by $301,000 in fiscal year
2018 and is decreased by $354,000 in fiscal
year 2019.
new text end
new text begin Subd. 4. new text end
new text begin
Forecasted Programs
|
||||||
new text begin
The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) MFIP/DWP new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
93,620,000 new text end |
new text begin
98,452,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
85,266,000 new text end |
new text begin
80,971,000 new text end |
|
new text begin
(b) MFIP Child Care Assistance new text end |
new text begin
101,315,000 new text end |
new text begin
108,521,000 new text end |
||||
|
new text begin
(c) General Assistance new text end |
new text begin
55,117,000 new text end |
new text begin
57,847,000 new text end |
||||
new text begin
General Assistance Standard. The
commissioner shall set the monthly standard
of assistance for general assistance units
consisting of an adult recipient who is
childless and unmarried or living apart
from parents or a legal guardian at $203.
The commissioner may reduce this amount
according to Laws 1997, chapter 85, article
3, section 54.
new text end
new text begin
Emergency General Assistance. The
amount appropriated for emergency
general assistance is limited to no more
than $6,729,812 in fiscal year 2016 and
$6,729,812 in fiscal year 2017. Funds
to counties shall be allocated by the
commissioner using the allocation method
under Minnesota Statutes, section 256D.06.
new text end
|
new text begin
(d) Minnesota Supplemental Aid new text end |
new text begin
39,668,000 new text end |
new text begin
41,169,000 new text end |
||||
|
new text begin
(e) Group Residential Housing new text end |
new text begin
155,753,000 new text end |
new text begin
167,194,000 new text end |
||||
|
new text begin
(f) Northstar Care for Children new text end |
new text begin
41,096,000 new text end |
new text begin
46,337,000 new text end |
||||
|
new text begin
(g) MinnesotaCare new text end |
new text begin
361,114,000 new text end |
new text begin
387,081,000 new text end |
||||
new text begin
This appropriation is from the health care
access fund.
new text end
|
new text begin
(h) Medical Assistance new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
4,468,089,000 new text end |
new text begin
4,977,237,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
650,139,000 new text end |
new text begin
288,224,000 new text end |
new text begin
Behavioral Health Services.
new text end
new text begin
$1,000,000
each fiscal year is for behavioral health
services provided by hospitals identified
under Minnesota Statutes, section 256.969,
subdivision 2b, paragraph (a), clause (4).
The increase in payments shall be made by
increasing the adjustment under Minnesota
Statutes, section 256.969, subdivision 2b,
paragraph (e), clause (2).
new text end
new text begin
Base Adjustment. The health care access
fund base for medical assistance is decreased
by $30,917,000 in fiscal year 2018 and by
$16,108,000 in fiscal year 2019.
new text end
|
new text begin
(i) Alternative Care new text end |
new text begin
43,997,000 new text end |
new text begin
43,590,000 new text end |
||||
new text begin
Alternative Care Transfer. Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but must be transferred to the
medical assistance account.
new text end
|
new text begin
(j) Chemical Dependency Treatment Fund new text end |
new text begin
83,868,000 new text end |
new text begin
86,962,000 new text end |
||||
new text begin Subd. 5. new text end
new text begin
Grant Programs
|
||||||
new text begin
The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) Support Services Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
13,133,000 new text end |
new text begin
8,715,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
96,311,000 new text end |
new text begin
96,311,000 new text end |
|
new text begin
(b) Basic Sliding Fee Child Care Assistance Grants new text end |
new text begin
48,439,000 new text end |
new text begin
51,559,000 new text end |
||||
new text begin
Basic Sliding Fee Waiting List Allocation.
Notwithstanding Minnesota Statutes, section
119B.03, $5,413,000 in fiscal year 2016 is to
reduce the basic sliding fee program waiting
list as follows:
new text end
new text begin
(1) The calendar year 2016 allocation shall
be increased to serve families on the waiting
list. To receive funds appropriated for this
purpose, a county must have:
new text end
new text begin
(i) a waiting list in the most recent published
waiting list month;
new text end
new text begin
(ii) an average of at least ten families on the
most recent six months of published waiting
list; and
new text end
new text begin
(iii) total expenditures in calendar year
2014 that met or exceeded 80 percent of the
county's available final allocation.
new text end
new text begin
(2) Funds shall be distributed proportionately
based on the average of the most recent six
months of published waiting lists to counties
that meet the criteria in clause (1).
new text end
new text begin
(3) Allocations in calendar years 2017
and beyond shall be calculated using the
allocation formula in Minnesota Statutes,
section 119B.03.
new text end
new text begin
(4) The guaranteed floor for calendar year
2017 shall be based on the revised calendar
year 2016 allocation.
new text end
new text begin
Base Level Adjustment. The general fund
base is increased by $810,000 in fiscal year
2018 and increased by $821,000 in fiscal
year 2019.
new text end
|
new text begin
(c) Child Care Development Grants new text end |
new text begin
1,737,000 new text end |
new text begin
1,737,000 new text end |
||||
|
new text begin
(d) Child Support Enforcement Grants new text end |
new text begin
50,000 new text end |
new text begin
50,000 new text end |
||||
|
new text begin
(e) Children's Services Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
39,015,000 new text end |
new text begin
38,665,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
140,000 new text end |
new text begin
140,000 new text end |
new text begin
Safe Place for Newborns.
new text end
new text begin
$350,000 from
the general fund in fiscal year 2016 is to
distribute information on the Safe Place
for Newborns law in Minnesota to increase
public awareness of the law. This is a
onetime appropriation.
new text end
new text begin
Child Protection.
new text end
new text begin
$23,350,000 in fiscal year
2016 and $23,350,000 in fiscal year 2017
are to address child protection staffing and
services under Minnesota Statutes, section
256M.41. $1,650,000 in fiscal year 2016 and
$1,650,000 in fiscal year 2017 are for child
protection grants to address child welfare
disparities under Minnesota Statutes, section
256E.28.
new text end
new text begin
Title IV-E Adoption Assistance. Additional
federal reimbursement to the state as a result
of the Fostering Connections to Success
and Increasing Adoptions Act's expanded
eligibility for title IV-E adoption assistance
is appropriated to the commissioner
for postadoption services, including a
parent-to-parent support network.
new text end
new text begin
Adoption Assistance Incentive Grants.
Federal funds available during fiscal years
2016 and 2017 for adoption incentive
grants are appropriated to the commissioner
for postadoption services, including a
parent-to-parent support network.
new text end
|
new text begin
(f) Children and Community Service Grants new text end |
new text begin
56,301,000 new text end |
new text begin
56,301,000 new text end |
||||
|
new text begin
(g) Children and Economic Support Grants new text end |
new text begin
26,778,000 new text end |
new text begin
26,966,000 new text end |
||||
new text begin
new text begin Mobile Food Shelf Grants.new text end (a) $1,000,000
in fiscal year 2016 and $1,000,000 in
fiscal year 2017 are for a grant to Hunger
Solutions. This is a onetime appropriation
and is available until June 30, 2017.
new text end
new text begin
(b) Hunger Solutions shall award grants of
up to $75,000 on a competitive basis. Grant
applications must include:
new text end
new text begin
(1) the location of the project;
new text end
new text begin
(2) a description of the mobile program,
including size and scope;
new text end
new text begin
(3) evidence regarding the unserved or
underserved nature of the community in
which the project is to be located;
new text end
new text begin
(4) evidence of community support for the
project;
new text end
new text begin
(5) the total cost of the project;
new text end
new text begin
(6) the amount of the grant request and how
funds will be used;
new text end
new text begin
(7) sources of funding or in-kind
contributions for the project that will
supplement any grant award;
new text end
new text begin
(8) a commitment to mobile programs by the
applicant and an ongoing commitment to
maintain the mobile program; and
new text end
new text begin
(9) any additional information requested by
Hunger Solutions.
new text end
new text begin
(c) Priority may be given to applicants who:
new text end
new text begin
(1) serve underserved areas;
new text end
new text begin
(2) create a new or expand an existing mobile
program;
new text end
new text begin
(3) serve areas where a high amount of need
is identified;
new text end
new text begin
(4) provide evidence of strong support for the
project from citizens and other institutions in
the community;
new text end
new text begin
(5) leverage funding for the project from
other private and public sources; and
new text end
new text begin
(6) commit to maintaining the program on a
multilayer basis.
new text end
new text begin
Homeless Youth Act. Of this appropriation,
at least $500,000 must be awarded to
providers in greater Minnesota, with at least
25 percent of this amount for new applicant
providers. The commissioner shall provide
outreach and technical assistance to greater
Minnesota providers and new providers to
encourage responding to the request for
proposals.
new text end
new text begin
new text begin Stearns County Veterans Housing.
new text end $85,000 in fiscal year 2016 and $85,000
in fiscal year 2017 are for a grant to
Stearns County to provide administrative
funding in support of a service provider
serving veterans in Stearns County. The
administrative funding grant may be used to
support group residential housing services,
corrections-related services, veteran services,
and other social services related to the service
provider serving veterans in Stearns County.
new text end
new text begin
new text begin Safe Harbor.new text end $800,000 in fiscal year 2016
and $800,000 in fiscal year 2017 are from
the general fund for emergency shelter and
transitional and long-term housing beds for
sexually exploited youth and youth at risk of
sexual exploitation. Of this appropriation,
$150,000 in fiscal year 2016 and $150,000 in
fiscal year 2017 are from the general fund for
statewide youth outreach workers connecting
sexually exploited youth and youth at risk of
sexual exploitation with shelter and services.
new text end
new text begin
Minnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2016 do
not cancel but are available for this purpose
in fiscal year 2017.
new text end
new text begin
Base Level Adjustment. The general fund
base is decreased by $816,000 in fiscal year
2018 and is decreased by $606,000 in fiscal
year 2019.
new text end
|
new text begin
(h) Health Care Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
536,000 new text end |
new text begin
2,482,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
3,341,000 new text end |
new text begin
3,465,000 new text end |
new text begin
Grants for Periodic Data Matching for
Medical Assistance and MinnesotaCare.
Of the general fund appropriation, $26,000
in fiscal year 2016 and $1,276,000 in fiscal
year 2017 are for grants to counties for
costs related to periodic data matching
for medical assistance and MinnesotaCare
recipients under Minnesota Statutes,
section 256B.0561. The commissioner
must distribute these grants to counties in
proportion to each county's number of cases
in the prior year in the affected programs.
new text end
new text begin
Base Level Adjustment. The general fund
base is increased by $1,637,000 in fiscal year
2018 and increased by $1,229,000 in fiscal
year 2019.
new text end
|
new text begin
(i) Other Long-Term Care Grants new text end |
new text begin
1,551,000 new text end |
new text begin
3,069,000 new text end |
||||
new text begin
new text begin Transition Populations. new text end $1,551,000 in fiscal
year 2016 and $1,725,000 in fiscal year 2017
are for home and community-based services
transition grants to assist in providing home
and community-based services and treatment
for transition populations under Minnesota
Statutes, section 256.478.
new text end
new text begin
Base Level Adjustment. The general fund
base is increased by $156,000 in fiscal year
2018 and by $581,000 in fiscal year 2019.
new text end
|
new text begin
(j) Aging and Adult Services Grants new text end |
new text begin
28,463,000 new text end |
new text begin
28,162,000 new text end |
||||
new text begin
new text begin Dementia Grants. new text end $750,000 in fiscal year
2016 and $750,000 in fiscal year 2017
are for the Minnesota Board on Aging for
regional and local dementia grants authorized
in Minnesota Statutes, section 256.975,
subdivision 11.
new text end
|
new text begin
(k) Deaf and Hard-of-Hearing Grants new text end |
new text begin
2,225,000 new text end |
new text begin
2,375,000 new text end |
||||
new text begin
Deaf, Deafblind, and Hard-of-Hearing
Grants. $350,000 in fiscal year 2016 and
$500,000 in fiscal year 2017 are for deaf
and hard-of-hearing grants. The funds
must be used to increase the number of
deafblind Minnesotans receiving services
under Minnesota Statutes, section 256C.261,
and to provide linguistically and culturally
appropriate mental health services to children
who are deaf, deafblind, and hard-of-hearing.
This is a onetime appropriation.
new text end
new text begin
new text begin Base Level Adjustment. new text end The general fund
base is decreased by $500,000 in fiscal year
2018 and by $500,000 in fiscal year 2019.
new text end
|
new text begin
(l) Disabilities Grants new text end |
new text begin
20,820,000 new text end |
new text begin
20,858,000 new text end |
||||
new text begin
new text begin State Quality Council. new text end $573,000 in fiscal
year 2016 and $600,000 in fiscal year
2017 are for the State Quality Council to
provide technical assistance and monitoring
of person-centered outcomes related to
inclusive community living and employment.
The funding must be used by the State
Quality Council to assure a statewide plan
for systems change in person-centered
planning that will achieve desired outcomes
including increased integrated employment
and community living.
new text end
|
new text begin
(m) Adult Mental Health Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
69,992,000 new text end |
new text begin
71,244,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
1,575,000 new text end |
new text begin
2,473,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
1,733,000 new text end |
new text begin
1,733,000 new text end |
new text begin
Funding Usage. Up to 75 percent of a fiscal
year's appropriation for adult mental health
grants may be used to fund allocations in that
portion of the fiscal year ending December
31.
new text end
new text begin
Culturally Specific Mental Health
Services.
new text end
new text begin
$100,000 in fiscal year 2016 is for
grants to nonprofit organizations to provide
resources and referrals for culturally specific
mental health services to Southeast Asian
veterans born before 1965 who do not qualify
for services available to veterans formally
discharged from the United States armed
forces.
new text end
new text begin
new text begin Problem Gambling.new text end $225,000 in fiscal year
2016 and $225,000 in fiscal year 2017 are
from the lottery prize fund for a grant to the
state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
and training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.
new text end
new text begin
Sustainability Grants. $2,125,000 in fiscal
year 2016 and $2,125,000 in fiscal year 2017
are for sustainability grants under Minnesota
Statutes, section 256B.0622, subdivision 11.
new text end
new text begin
new text begin Beltrami County Mental Health Services
Grant.new text end $1,000,000 in fiscal year 2016 and
$1,000,000 in fiscal year 2017 are from the
general fund for a grant to Beltrami County
to fund the planning and development of
a comprehensive mental health services
program under article 2, section 41,
Comprehensive Mental Health Program
in Beltrami County. This is a onetime
appropriation.
new text end
new text begin
new text begin Base Level Adjustment.new text end The general fund
base is increased by $723,000 in fiscal year
2018 and by $723,000 in fiscal year 2019.
The health care access fund base is decreased
by $1,723,000 in fiscal year 2018 and by
$1,723,000 in fiscal year 2019.
new text end
|
new text begin
(n) Child Mental Health Grants new text end |
new text begin
23,386,000 new text end |
new text begin
24,313,000 new text end |
||||
new text begin
Services and Supports for First Episode
Psychosis. $177,000 in fiscal year 2017 is
for grants under Minnesota Statutes, section
245.4889, to mental health providers to pilot
evidence-based interventions for youth at risk
of developing or experiencing a first episode
of psychosis and for a public awareness
campaign on the signs and symptoms of
psychosis. The base for these grants is
$236,000 in fiscal year 2018 and $301,000 in
fiscal year 2019.
new text end
new text begin
Adverse Childhood Experiences. The base
for grants under Minnesota Statutes, section
245.4889, to children's mental health and
family services collaboratives for adverse
childhood experiences (ACEs) training
grants and for an interactive Web site
connection to support ACEs in Minnesota is
$363,000 in fiscal year 2018 and $363,000 in
fiscal year 2019.
new text end
new text begin
Funding Usage. Up to 75 percent of a fiscal
year's appropriation for child mental health
grants may be used to fund allocations in that
portion of the fiscal year ending December
31.
new text end
new text begin
new text begin Base Level Adjustment.new text end The general fund
base is increased by $422,000 in fiscal year
2018 and is increased by $487,000 in fiscal
year 2019.
new text end
|
new text begin
(o) Chemical Dependency Treatment Support Grants new text end |
new text begin
1,561,000 new text end |
new text begin
1,561,000 new text end |
||||
new text begin
Chemical Dependency Prevention.
$150,000 in fiscal year 2016 and $150,000
in fiscal year 2017 are for grants to
nonprofit organizations to provide chemical
dependency prevention programs in
secondary schools. When making grants, the
commissioner must consider the expertise,
prior experience, and outcomes achieved
by applicants that have provided prevention
programming in secondary education
environments. An applicant for the grant
funds must provide verification to the
commissioner that the applicant has available
and will contribute sufficient funds to match
the grant given by the commissioner. This is
a onetime appropriation.
new text end
new text begin
Fetal Alcohol Syndrome Grants. $250,000
in fiscal year 2016 and $250,000 in fiscal year
2017 are for grants to be administered by the
Minnesota Organization on Fetal Alcohol
Syndrome to provide comprehensive,
gender-specific services to pregnant and
parenting women suspected of or known
to use or abuse alcohol or other drugs.
This appropriation is for grants to no fewer
than three eligible recipients. Minnesota
Organization on Fetal Alcohol Syndrome
must report to the commissioner of human
services annually by January 15 on the
grants funded by this appropriation. The
report must include measurable outcomes for
the previous year, including the number of
pregnant women served and the number of
toxic-free babies born.
new text end
new text begin
new text begin Base Level Adjustment. new text end The general fund
base is decreased by $150,000 in fiscal year
2018 and by $150,000 in fiscal year 2019.
new text end
new text begin Subd. 6. new text end
new text begin
DCT State-Operated Services
|
||||||
new text begin
new text begin Transfer Authority for State-Operated
Services.new text end Money appropriated for
state-operated services may be transferred
between fiscal years of the biennium
with the approval of the commissioner of
management and budget.
new text end
new text begin
The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) DCT State-Operated Services Mental Health new text end |
new text begin
130,070,000 new text end |
new text begin
131,795,000 new text end |
||||
new text begin
new text begin Increased Capacity at AMRTC. new text end $4,108,000
in fiscal year 2016 and $4,108,000 in fiscal
year 2017 are to increase the number
of staffed beds at the Anoka Regional
Treatment Center so that 15 additional beds
are available for patients above the number
of beds that are available on June 30, 2015.
new text end
new text begin
Transfer.
new text end
new text begin
Notwithstanding Minnesota
Statutes, section 246.18, subdivision 8,
the commissioner of human services shall
transfer $2,000,000 in fiscal year 2017 from
the account under Minnesota Statutes, section
246.18, subdivision 8, in the special revenue
fund to the general fund. This is a onetime
transfer for repeal of never implemented
grants for mental health specialty treatment
services.
new text end
new text begin
Dedicated Receipts Available. Of the
revenue received under Minnesota Statutes,
section 246.18, subdivision 8, paragraph
(a), up to $1,000,000 each year is available
for the purposes of Minnesota Statutes,
section 246.18, subdivision 8, paragraph (b),
clause (1); and up to $2,713,000 each year
is available for the purposes of Minnesota
Statutes, section 246.18, subdivision 8,
paragraph (b), clause (3).
new text end
new text begin
Transfers from State-Operated Services
Account. (a) If the commissioner of
human services notifies the commissioner
of management and budget by July 31,
2015, that the fiscal year 2015 general
fund expenditures exceed the general fund
appropriation for state-operated services
mental health to the Department of Human
Services, notwithstanding Minnesota
Statutes, section 246.18, subdivision 8,
the commissioner of human services,
with the approval of the commissioner of
management and budget, shall transfer up
to $1,000,000 in fiscal year 2015 from the
account under Minnesota Statutes, section
246.18, subdivision 8, in the special revenue
fund to the general fund. The amount
transferred under this paragraph must
not exceed the amount of the fiscal year
2015 negative balance in the general fund
appropriation for state-operated services
mental health to the Department of Human
Services. The amount transferred under
this paragraph, up to $1,000,000 in fiscal
year 2015, is appropriated from the general
fund to the commissioner of human services
for state-operated services mental health
expenditures. This paragraph is effective the
day following final enactment and expires
on October 1, 2015. Any amount transferred
under this paragraph that is not expended
by September 30, 2015, shall cancel to
the account from which the amount was
transferred.
new text end
new text begin
(b) If the commissioner of human services
notifies the commissioner of management
and budget by July 31, 2015, that the
balance in fiscal year 2015 in the Minnesota
state-operated community services fund is a
negative amount, notwithstanding Minnesota
Statutes, section 246.18, subdivision 8, the
commissioner of human services, with the
approval of the commissioner of management
and budget, shall transfer up to $3,200,000
in fiscal year 2015 from the account
under Minnesota Statutes, section 246.18,
subdivision 8, in the special revenue fund
to the Minnesota state-operated community
services fund. The amount transferred under
this paragraph must not exceed the amount
of the fiscal year 2015 negative balance in
the Minnesota state-operated community
services fund. This paragraph is effective the
day following final enactment and expires
on October 1, 2015. Any amount transferred
under this paragraph that is not expended
by September 30, 2015, shall cancel to
the account from which the amount was
transferred.
new text end
new text begin
Appropriations Retroactive to Fiscal Year
2015. If the commissioner of human services
notifies the commissioner of management and
budget by July 31, 2015, that the fiscal year
2015 general fund expenditures exceed the
general fund appropriation for state-operated
services mental health to the Department of
Human Services, up to $5,000,000 of this
appropriation in fiscal year 2016 may be
used in fiscal year 2015 for state-operated
services mental health expenditures. The
commissioner of human services must
report to the commissioner of management
and budget the purpose and amount of any
expenditures under this paragraph, and the
commissioner of management and budget
must approve the total amount attributable to
this paragraph. This paragraph is effective
the day following final enactment and expires
on October 1, 2015.
new text end
|
new text begin
(b) DCT State-Operated Services Enterprise Services new text end |
new text begin
9,626,000 new text end |
new text begin
6,113,000 new text end |
||||
new text begin
Community Addiction Recovery
Enterprise. $9,626,000 in fiscal year 2016
and $6,113,000 in fiscal year 2017 are for
the C.A.R.E. program. The commissioner
must transfer these amounts to the enterprise
fund for the Community Addiction Recovery
Enterprise. The base for this purpose
is $5,991,000 in fiscal year 2018 and
$5,991,000 in fiscal year 2019.
new text end
new text begin
Transfers from Consolidated Chemical
Dependency Treatment Fund. (a) If the
commissioner of human services notifies the
commissioner of management and budget by
July 31, 2015, that the balance in fiscal year
2015 in the community addiction recovery
enterprise fund is a negative amount,
notwithstanding Minnesota Statutes, section
254B.06, subdivision 1, the commissioner
of human services, with the approval of the
commissioner of management and budget,
shall transfer $2,000,000 in fiscal year 2015
from the consolidated chemical dependency
treatment fund account in the special revenue
fund to the community addiction recovery
enterprise fund. The amount transferred
under this paragraph must not exceed the
amount of the fiscal year 2015 negative
balance in the community addiction recovery
enterprise fund. This paragraph is effective
the day following final enactment and expires
on October 1, 2015. Any amount transferred
under this paragraph that is not expended
by September 30, 2015, shall cancel to
the account from which the amount was
transferred.
new text end
new text begin
(b) If the commissioner of human services
notifies the commissioner of management
and budget by July 31, 2015, that the
fiscal year 2015 general fund expenditures
exceed the general fund appropriation
for state-operated services mental health
to the Department of Human Services,
notwithstanding Minnesota Statutes, section
254B.06, subdivision 1, the commissioner
of human services, with the approval of the
commissioner of management and budget,
shall transfer $1,500,000 in fiscal year 2015
from the consolidated chemical dependency
treatment fund account in the special revenue
fund to the general fund. $1,500,000 in
fiscal year 2015 is appropriated from the
general fund to the commissioner of human
services for state-operated services mental
health expenditures. The amount transferred
under this paragraph must not exceed the
amount of the fiscal year 2015 negative
balance in the general fund appropriation
for state-operated services mental health to
the Department of Human Services. This
paragraph is effective the day following final
enactment and expires on October 1, 2015.
Any amount transferred under this paragraph
that is not expended by September 30, 2015,
shall cancel to the account from which the
amount was transferred.
new text end
new text begin
new text begin Base Level Adjustment. new text end The general fund
base is decreased by $122,000 in fiscal year
2018 and by $122,000 in fiscal year 2019.
new text end
|
new text begin
(c) DCT State-Operated Services Minnesota Security Hospital new text end |
new text begin
81,821,000 new text end |
new text begin
83,233,000 new text end |
||||
new text begin
Base Level Adjustment. The general fund
base is increased by $17,000 in fiscal year
2018 and by $34,000 in fiscal year 2019.
new text end
new text begin Subd. 7. new text end
new text begin
DCT Minnesota Sex Offender
|
new text begin
83,686,000 new text end |
new text begin
84,927,000 new text end |
||||
new text begin
Transfer Authority for Minnesota Sex
Offender Program. Money appropriated
for the Minnesota sex offender program
may be transferred between fiscal years
of the biennium with the approval of the
commissioner of management and budget.
new text end
new text begin
Limited Carryforward Allowed.
Notwithstanding any contrary provision
in this article, of this appropriation, up to
$875,000 in fiscal year 2016 and $2,625,000
in fiscal year 2017 are available until June
30, 2019.
new text end
new text begin
Minnesota Sex Offender Program. Any
funds from the appropriation made by Laws
2014, chapter 312, article 30, section 2,
subdivision 6, that are not used for payment
of court-ordered costs in compliance with
the United States District Court order of
February 20, 2014, in the matter of Karsjens
et al. v. Jesson et al., including any funds
returned by the court that had been deposited
with the court but not spent, may be used by
the commissioner of human services to offset
past and future litigation expenses in the
same matter and to comply with any future
orders of the United States District Court.
new text end
new text begin Subd. 8. new text end
new text begin
Technical Activities
|
new text begin
82,671,000 new text end |
new text begin
83,427,000 new text end |
||||
new text begin
This appropriation is from the federal TANF
fund.
new text end
new text begin
Base Level Adjustment. The TANF fund
appropriation is increased by $392,000 in
fiscal year 2018 and by $80,000 in fiscal year
2019.
new text end
Sec. 3. new text begin COMMISSIONER OF HEALTH
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
188,912,000 new text end |
new text begin
$ new text end |
new text begin
188,939,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2016 new text end |
new text begin
2017 new text end |
|
|
new text begin
General new text end |
new text begin
89,369,000 new text end |
new text begin
91,357,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
53,843,000 new text end |
new text begin
52,448,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
33,987,000 new text end |
new text begin
33,421,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Health Improvement
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
68,653,000 new text end |
new text begin
68,984,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
6,264,000 new text end |
new text begin
6,182,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
33,987,000 new text end |
new text begin
33,421,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
Violence Against Asian Women Working
Group.
new text end
new text begin
$200,000 in fiscal year 2016 from
the general fund is for the working group on
violence against Asian women and children.
new text end
new text begin
MERC Program.
new text end
new text begin
$1,000,000 in fiscal year
2016 and $1,000,000 in fiscal year 2017 are
from the general fund for the MERC program
under Minnesota Statutes, section 62J.692,
subdivision 4.
new text end
new text begin
Poison Information Center Grants.
new text end
new text begin
$750,000 in fiscal year 2016 and $750,000 in
fiscal year 2017 are from the general fund
for regional poison information center grants
under Minnesota Statutes, section 145.93.
new text end
new text begin
Advanced Care Planning.
new text end
new text begin
$250,000 in
fiscal year 2016 is from the general fund
to award a grant to a statewide advance
care planning resource organization that has
expertise in convening and coordinating
community-based strategies to encourage
individuals, families, caregivers, and health
care providers to begin conversations
regarding end-of-life care choices that
express an individual's health care values
and preferences and are based on informed
health care decisions. This is a onetime
appropriation.
new text end
new text begin
Early Dental Prevention Initiatives.
new text end
new text begin
$172,000 in fiscal year 2016 and $140,000 in
fiscal year 2017 are for the development and
distribution of the early dental prevention
initiative under Minnesota Statutes, section
144.3875.
new text end
new text begin
International Medical Graduate
Assistance Program.
new text end
new text begin
(a) $500,000 in fiscal
year 2016 and $500,000 in fiscal year 2017
are from the health care access fund for
the grant programs and necessary contracts
under Minnesota Statutes, section 144.1911,
subdivisions 3, paragraph (a), clause (4), and
4 and 5. The commissioner may use up to
$133,000 per year of the appropriation for
international medical graduate assistance
program administration duties in Minnesota
Statutes, section 144.1911, subdivisions
3, 9, and 10, and for administering the
grant programs under Minnesota Statutes,
section 144.1911, subdivisions 4, 5,
and 6. The commissioner shall develop
recommendations for any additional funding
required for initiatives needed to achieve the
objectives of Minnesota Statutes, section
144.1911. The commissioner shall report the
funding recommendations to the legislature
by January 15, 2016, in the report required
under Minnesota Statutes, section 144.1911,
subdivision 10. The base for this purpose is
$1,000,000 in fiscal years 2018 and 2019.
new text end
new text begin
(b) $500,000 in fiscal year 2016 and
$500,000 in fiscal year 2017 are from the
health care access fund for transfer to the
revolving international medical graduate
residency account established in Minnesota
Statutes, section 144.1911, subdivision 6.
This is a onetime appropriation.
new text end
new text begin
Federally Qualified Health Centers.
new text end
new text begin
$1,000,000 in fiscal year 2016 and
$1,000,000 in fiscal year 2017 are from the
general fund to provide subsidies to federally
qualified health centers under Minnesota
Statutes, section 145.9269. This is a onetime
appropriation.
new text end
new text begin
Organ Donation.
new text end
new text begin
$200,000 in fiscal year
2016 is from the general fund to establish
a grant program to develop and create
culturally appropriate outreach programs that
provide education about the importance of
organ donation. Grants shall be awarded to
a federally designated organ procurement
organization and hospital system that
performs transplants. This is a onetime
appropriation.
new text end
new text begin
Primary Care Residency.
new text end
new text begin
$1,500,000 in
fiscal year 2016 and $1,500,000 in fiscal
year 2017 are from the general fund for
the purposes of the primary care residency
expansion grant program under Minnesota
Statutes, section 144.1506.
new text end
new text begin
Somali Women's Health Pilot Program.
new text end
new text begin
(a) The commissioner of health shall
establish a pilot program between one or
more federally qualified health centers, as
defined under Minnesota Statutes, section
145.9269, a nonprofit organization that
helps Somali women, and the Minnesota
Evaluation Studies Institute, to develop
a promising strategy to address the
preventative and primary health care needs
of, and address health inequities experienced
by, first generation Somali women. The
pilot program must collaboratively develop
a patient flow process for first generation
Somali women by:
new text end
new text begin
(1) addressing and identifying clinical and
cultural barriers to Somali women accessing
preventative and primary care, including,
but not limited to, cervical and breast cancer
screenings;
new text end
new text begin
(2) developing a culturally appropriate health
curriculum for Somali women based on
the outcomes from the community-based
participatory research report "Cultural
Traditions and the Reproductive Health
of Somali Refugees and Immigrants" to
increase the health literacy of Somali women
and develop culturally specific health care
information; and
new text end
new text begin
(3) training the federally qualified health
center's providers and staff to enhance
provider and staff cultural competence
regarding the cultural barriers, including
female genital cutting.
new text end
new text begin
(b) The pilot program must develop a process
that results in increased screening rates
for cervical and breast cancer and can be
replicated by other providers serving ethnic
minorities. The pilot program must conduct
an evaluation of the new patient flow process
used by Somali women to access federally
qualified health centers services.
new text end
new text begin
(c) The pilot program must report the
outcomes to the commissioner by June 30,
2017.
new text end
new text begin
(d) $110,000 in fiscal year 2016 is for the
Somali women's health pilot program. Of
this appropriation, the commissioner may
use up to $10,000 to administer the program.
This appropriation is available until June 30,
2017. This is a onetime appropriation.
new text end
new text begin
new text begin Menthol Cigarette Usage in
African-American Community
Intervention Grants.new text end Of the health care
access fund appropriation for the statewide
health improvement program, $200,000 in
fiscal year 2016 is for at least one grant that
must be awarded by the commissioner to
implement strategies and interventions to
reduce the disproportionately high usage of
cigarettes by African-Americans, especially
the use of menthol-flavored cigarettes, as
well as the disproportionate harm tobacco
causes in that community. The grantee shall
engage members of the African-American
community and community-based
organizations. This grant shall be awarded
as part of the statewide health improvement
program grants awarded on November 1,
2015, and must meet the requirements of
Minnesota Statutes, section 145.986.
new text end
new text begin
Targeted Home Visiting System. (a)
$75,000 in fiscal year 2016 is for the
commissioner of health, in consultation
with the commissioners of human services
and education, community health boards,
tribal nations, and other home visiting
stakeholders, to design baseline training
for new home visitors to ensure statewide
coordination across home visiting programs.
new text end
new text begin
(b) $575,000 in fiscal year 2016 and
$2,000,000 fiscal year 2017 are to provide
grants to community health boards and
tribal nations for start-up grants for new
nurse-family partnership programs and
for grants to expand existing programs
to serve first-time mothers, prenatally by
28 weeks gestation until the child is two
years of age, who are eligible for medical
assistance under Minnesota Statutes, chapter
256B, or the federal Special Supplemental
Nutrition Program for Women, Infants, and
Children. The commissioner shall award
grants to community health boards or tribal
nations in metropolitan and rural areas of
the state. Priority for all grants shall be
given to nurse-family partnership programs
that provide services through a Minnesota
health care program-enrolled provider that
accepts medical assistance. Additionally,
priority for grants to rural areas shall be
given to community health boards and tribal
nations that expand services within regional
partnerships that provide the nurse-family
partnership program. Funding available
under this paragraph may only be used to
supplement, not to replace, funds being used
for nurse-family partnership home visiting
services as of June 30, 2015.
new text end
new text begin
new text begin Opiate Antagonists. new text end $270,000 in fiscal
year 2016 and $20,000 in fiscal year 2017
are from the general fund for grants to the
eight regional emergency medical services
programs to purchase opiate antagonists
and educate and train emergency medical
services persons, as defined in Minnesota
Statutes, section 144.7401, subdivision
4, clauses (1) and (2), in the use of these
antagonists in the event of an opioid or
heroin overdose. For the purposes of
this paragraph, "opiate antagonist" means
naloxone hydrochloride or any similarly
acting drug approved by the federal Food
and Drug Administration for the treatment of
drug overdose. Grants under this paragraph
must be distributed to all eight regional
emergency medical services programs. This
is a onetime appropriation and is available
until June 30, 2017. The commissioner may
use up to $20,000 of the amount for opiate
antagonists for administration.
new text end
new text begin
Local and Tribal Public Health Grants. (a)
$894,000 in fiscal year 2016 and $894,000 in
fiscal year 2017 are for an increase in local
public health grants for community health
boards under Minnesota Statutes, section
145A.131, subdivision 1, paragraph (e).
new text end
new text begin
(b) $106,000 in fiscal year 2016 and $106,000
in fiscal year 2017 are for an increase in
special grants to tribal governments under
Minnesota Statutes, section 145A.14,
subdivision 2a.
new text end
new text begin
HCBS Employee Scholarships.
new text end
new text begin
$1,000,000
in fiscal year 2016 and $1,000,000 in fiscal
year 2017 are from the general fund for
the home and community-based services
employee scholarship program under
Minnesota Statutes, section 144.1503. The
commissioner may use up to $50,000 of the
amount for the HCBS employee scholarships
for administration.
new text end
new text begin
Family Planning Special Projects.
$1,000,000 in fiscal year 2016 and
$1,000,000 in fiscal year 2017 are from the
general fund for family planning special
project grants under Minnesota Statutes,
section 145.925.
new text end
new text begin
Positive Alternatives. $1,000,000 in fiscal
year 2016 and $1,000,000 in fiscal year
2017 are from the general fund for positive
abortion alternatives under Minnesota
Statutes, section 145.4235.
new text end
new text begin
Safe Harbor for Sexually Exploited Youth.
$700,000 in fiscal year 2016 and $700,000 in
fiscal year 2017 are from the general fund
for the safe harbor program under Minnesota
Statutes, sections 145.4716 to 145.4718.
Funds shall be used for grants to increase
the number of regional navigators; training
for professionals who engage with exploited
or at-risk youth; implementing statewide
protocols and best practices for effectively
identifying, interacting with, and referring
sexually exploited youth to appropriate
resources; and program operating costs.
new text end
new text begin
Health Care Grants for Uninsured
Individuals. (a) $125,000 in fiscal year 2016
and $125,000 in fiscal year 2017 are from
the general fund for dental provider grants
in Minnesota Statutes, section 145.929,
subdivision 1.
new text end
new text begin
(b) $437,500 in fiscal year 2016 and $437,500
in fiscal year 2017 are from the general fund
for community mental health program grants
in Minnesota Statutes, section 145.929,
subdivision 2.
new text end
new text begin
(c) $1,500,000 in fiscal year 2016 and
$1,500,000 in fiscal year 2017 are from the
general fund for the emergency medical
assistance outlier grant program in Minnesota
Statutes, section 145.929, subdivision 3.
new text end
new text begin
(d) $437,500 of the general fund
appropriation in fiscal years 2016 and 2017
is for community health center grants under
Minnesota Statutes, section 145.9269. A
community health center that receives a grant
from this appropriation is not eligible for a
grant under paragraph (b).
new text end
new text begin
(e) The commissioner may use up to $25,000
of the appropriations for health care grants
for uninsured individuals in fiscal years 2016
and 2017 for grant administration.
new text end
new text begin
new text begin TANF Appropriations.new text end (a) $1,156,000 of
the TANF funds is appropriated each year of
the biennium to the commissioner for family
planning grants under Minnesota Statutes,
section 145.925.
new text end
new text begin
(b) $3,579,000 of the TANF funds is
appropriated each year of the biennium to
the commissioner for home visiting and
nutritional services listed under Minnesota
Statutes, section 145.882, subdivision 7,
clauses (6) and (7). Funds must be distributed
to community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1.
new text end
new text begin
(c) $2,000,000 of the TANF funds is
appropriated each year of the biennium to
the commissioner for decreasing racial and
ethnic disparities in infant mortality rates
under Minnesota Statutes, section 145.928,
subdivision 7.
new text end
new text begin
(d) $4,978,000 of the TANF funds is
appropriated each year of the biennium to the
commissioner for the family home visiting
grant program according to Minnesota
Statutes, section 145A.17. $4,000,000 of the
funding must be distributed to community
health boards according to Minnesota
Statutes, section 145A.131, subdivision 1.
$978,000 of the funding must be distributed to
tribal governments as provided in Minnesota
Statutes, section 145A.14, subdivision 2a.
new text end
new text begin
(e) The commissioner may use up to 6.23
percent of the funds appropriated each fiscal
year to conduct the ongoing evaluations
required under Minnesota Statutes, section
145A.17, subdivision 7, and training and
technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end
new text begin
new text begin TANF Carryforward.new text end Any unexpended
balance of the TANF appropriation in the
first year of the biennium does not cancel but
is available for the second year.
new text end
new text begin
Health Professional Loan Forgiveness.
$2,631,000 in fiscal year 2016 and $2,631,000
in fiscal year 2017 are from the general
fund for the purposes of Minnesota Statutes,
section 144.1501. Of this appropriation, the
commissioner may use up to $131,000 each
year to administer the program.
new text end
new text begin
Minnesota Stroke System. $350,000 in
fiscal year 2016 and $350,000 in fiscal
year 2017 are from the general fund for the
Minnesota stroke system.
new text end
new text begin
Prevention of Violence in Health Care.
new text end
new text begin
$50,000 in fiscal year 2016 is to continue the
prevention of violence in health care program
and creating violence prevention resources
for hospitals and other health care providers
to use in training their staff on violence
prevention. This is a onetime appropriation
and is available until June 30, 2017.
new text end
new text begin
new text begin Health Care Savings Determinations. new text end (a)
The health care access fund base for the state
health improvement program is decreased by
$261,000 in fiscal year 2016 and decreased
by $110,000 in fiscal year 2017.
new text end
new text begin
(b) $261,000 in fiscal year 2016 and $110,000
in fiscal year 2017 are from the health care
access fund for the forecasting, cost reporting,
and analysis required by Minnesota Statutes,
section 62U.10, subdivisions 6 and 7.
new text end
new text begin
Base Level Adjustments. The general fund
base is decreased by $1,070,000 in fiscal
year 2018 and by $1,020,000 in fiscal year
2019. The state government special revenue
fund base is increased by $33,000 in fiscal
year 2018. The health care access fund base
is increased by $610,000 in fiscal year 2018
and by $23,000 in fiscal year 2019.
new text end
new text begin Subd. 3. new text end
new text begin
Health Protection
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
12,506,000 new text end |
new text begin
14,149,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
47,579,000 new text end |
new text begin
46,266,000 new text end |
new text begin
Base Level Adjustments. The state
government special revenue fund base is
increased by $322,000 in fiscal year 2018
and by $300,000 in fiscal year 2019.
new text end
new text begin Subd. 4. new text end
new text begin
Administrative Support Services
|
new text begin
8,210,000 new text end |
new text begin
8,224,000 new text end |
||||
Sec. 4. new text begin HEALTH-RELATED BOARDS
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
19,707,000 new text end |
new text begin
$ new text end |
new text begin
19,597,000 new text end |
||
new text begin
This appropriation is from the state
government special revenue fund. The
amounts that may be spent for each purpose
are specified in the following subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Board of Chiropractic Examiners
|
new text begin
507,000 new text end |
new text begin
513,000 new text end |
||||
new text begin Subd. 3. new text end
new text begin
Board of Dentistry
|
new text begin
2,192,000 new text end |
new text begin
2,206,000 new text end |
||||
new text begin
This appropriation includes $864,000 in fiscal
year 2016 and $878,000 in fiscal year 2017
for the health professional services program.
new text end
new text begin Subd. 4. new text end
new text begin
Board of Dietetics and Nutrition
|
new text begin
113,000 new text end |
new text begin
115,000 new text end |
||||
new text begin Subd. 5. new text end
new text begin
Board of Marriage and Family
|
new text begin
234,000 new text end |
new text begin
237,000 new text end |
||||
new text begin Subd. 6. new text end
new text begin
Board of Medical Practice
|
new text begin
3,933,000 new text end |
new text begin
3,962,000 new text end |
||||
new text begin Subd. 7. new text end
new text begin
Board of Nursing
|
new text begin
4,189,000 new text end |
new text begin
4,243,000 new text end |
||||
new text begin Subd. 8. new text end
new text begin
Board of Nursing Home
|
new text begin
2,365,000 new text end |
new text begin
2,062,000 new text end |
||||
new text begin
Administrative Services Unit - Operating
Costs. Of this appropriation, $1,482,000
in fiscal year 2016 and $1,497,000 in
fiscal year 2017 are for operating costs
of the administrative services unit. The
administrative services unit may receive
and expend reimbursements for services
performed by other agencies.
new text end
new text begin
Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2016
and $150,000 in fiscal year 2017 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end
new text begin
Administrative Services Unit - Retirement
Costs. Of this appropriation, $320,000 in
fiscal year 2016 is a onetime appropriation
to the administrative services unit to pay for
the retirement costs of health-related board
employees. This funding may be transferred
to the health board incurring the retirement
costs. These funds are available either year
of the biennium.
new text end
new text begin
Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of
this appropriation, $200,000 in fiscal year
2016 and $200,000 in fiscal year 2017 are
for costs of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded
under this section. Upon certification by a
health-related board to the administrative
services unit that the costs will be incurred
and that there is insufficient money available
to pay for the costs out of money currently
available to that board, the administrative
services unit is authorized to transfer money
from this appropriation to the board for
payment of those costs with the approval
of the commissioner of management and
budget. The commissioner of management
and budget must require any board that
has an unexpended balance for an amount
transferred under this paragraph to transfer
the unexpended amount to the administrative
services unit to be deposited in the state
government special revenue fund.
new text end
new text begin Subd. 9. new text end
new text begin
Board of Optometry
|
new text begin
138,000 new text end |
new text begin
143,000 new text end |
||||
new text begin Subd. 10. new text end
new text begin
Board of Pharmacy
|
new text begin
2,847,000 new text end |
new text begin
2,888,000 new text end |
||||
new text begin Subd. 11. new text end
new text begin
Board of Physical Therapy
|
new text begin
354,000 new text end |
new text begin
359,000 new text end |
||||
new text begin Subd. 12. new text end
new text begin
Board of Podiatry
|
new text begin
78,000 new text end |
new text begin
79,000 new text end |
||||
new text begin Subd. 13. new text end
new text begin
Board of Psychology
|
new text begin
874,000 new text end |
new text begin
884,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Board of Social Work
|
new text begin
1,141,000 new text end |
new text begin
1,155,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Board of Veterinary Medicine
|
new text begin
262,000 new text end |
new text begin
265,000 new text end |
||||
new text begin Subd. 16. new text end
new text begin
Board of Behavioral Health and
|
new text begin
480,000 new text end |
new text begin
486,000 new text end |
||||
Sec. 5. new text begin EMERGENCY MEDICAL SERVICES
|
new text begin
$ new text end |
new text begin
2,904,000 new text end |
new text begin
$ new text end |
new text begin
3,037,000 new text end |
||
new text begin
Cooper/Sams Volunteer Ambulance
Program. $700,000 in fiscal year 2016 and
$700,000 in fiscal year 2017 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.
new text end
new text begin
(a) Of this amount, $611,000 in fiscal year
2016 and $611,000 in fiscal year 2017
are for the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.
new text end
new text begin
(b) Of this amount, $89,000 in fiscal year
2016 and $89,000 in fiscal year 2017 are
for the operations of the ambulance service
personnel longevity award and incentive
program under Minnesota Statutes, section
144E.40.
new text end
new text begin
Ambulance Training Grant. $361,000 in
fiscal year 2016 and $361,000 in fiscal year
2017 are for training grants.
new text end
new text begin
EMSRB Board Operations. $1,226,000 in
fiscal year 2016 and $1,360,000 in fiscal year
2017 are for board operations.
new text end
new text begin
new text begin Regional Grants.new text end $585,000 in fiscal year
2016 and $585,000 in fiscal year 2017 are
for regional emergency medical services
programs, to be distributed equally to the
eight emergency medical service regions.
new text end
Sec. 6. new text begin COUNCIL ON DISABILITY
|
new text begin
$ new text end |
new text begin
622,000 new text end |
new text begin
$ new text end |
new text begin
629,000 new text end |
||
Sec. 7. new text begin OMBUDSMAN FOR MENTAL
|
new text begin
$ new text end |
new text begin
1,917,000 new text end |
new text begin
$ new text end |
new text begin
2,032,000 new text end |
||
Sec. 8. new text begin OMBUDSPERSONS FOR FAMILIES
|
new text begin
$ new text end |
new text begin
392,000 new text end |
new text begin
$ new text end |
new text begin
453,000 new text end |
||
Sec. 9. new text begin COMMISSIONER OF COMMERCE
|
new text begin
$ new text end |
new text begin
210,000 new text end |
new text begin
$ new text end |
new text begin
213,000 new text end |
||
new text begin
The commissioner of commerce shall
develop a proposal to allow individuals
to purchase qualified health plans outside
of MNsure directly from health plan
companies and to allow eligible individuals
to receive advanced premium tax credits and
cost-sharing reductions when purchasing
qualified health plans outside of MNsure.
new text end
Sec. 10. new text begin APPROPRIATION.
new text end
new text begin
$455,000,000 is appropriated in fiscal year 2015 from the general fund to the
commissioner of human services. The commissioner of human services must transfer
$455,000,000 from the general fund to the health care access fund by June 30, 2015.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 11.
Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision
to read:
new text begin Subd. 40. new text end
new text begin Nonfederal share transfers. new text end
new text begin
The nonfederal share of activities for
which federal administrative reimbursement is appropriated to the commissioner may
be transferred to the special revenue fund.
new text end
Sec. 12. new text begin TRANSFERS.
new text end
new text begin Subdivision 1. new text end
new text begin Grants. new text end
new text begin
The commissioner of human services, with the approval of
the commissioner of management and budget, may transfer unencumbered appropriation
balances for the biennium ending June 30, 2017, within fiscal years among the MFIP,
general assistance, general assistance medical care under Minnesota Statutes 2009
Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP
child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental
aid, and group residential housing programs, the entitlement portion of Northstar Care
for Children under Minnesota Statutes, chapter 256N, and the entitlement portion of
the chemical dependency consolidated treatment fund, and between fiscal years of the
biennium. The commissioner shall inform the chairs and ranking minority members of
the senate Health and Human Services Finance Division and the house of representatives
Health and Human Services Finance Committee quarterly about transfers made under
this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Administration. new text end
new text begin
Positions, salary money, and nonsalary administrative
money may be transferred within the Departments of Health and Human Services as the
commissioners consider necessary, with the advance approval of the commissioner of
management and budget. The commissioner shall inform the chairs and ranking minority
members of the senate Health and Human Services Finance Division and the house of
representatives Health and Human Services Finance Committee quarterly about transfers
made under this subdivision.
new text end
Sec. 13. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end
new text begin
The commissioners of health and human services shall not use indirect cost
allocations to pay for the operational costs of any program for which they are responsible.
new text end
Sec. 14. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2017, unless a
different expiration date is explicit.
new text end
Sec. 15. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2015, unless a different effective date is specified.
new text end