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Capital IconMinnesota Legislature

SF 2

1st Engrossment - 90th Legislature, 2017 1st Special Session (2017 - 2017) Posted on 06/07/2017 11:15am

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

Current Version - 1st Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 1.39 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 2.43 2.44 2.45 2.46 2.47 2.48 2.49 2.50 2.51 2.52 2.53 2.54 2.55 2.56 2.57 2.58 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 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 3.37 3.38 3.39 3.40 3.41 3.42 3.43 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 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 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 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 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 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 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
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 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 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 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 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
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 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 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 20.31 20.32 20.33 20.34 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 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 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 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 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 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 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 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 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 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 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
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 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
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 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 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 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 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 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 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 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 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 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 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 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 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 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
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
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 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 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 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 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 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
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
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 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 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 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 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 63.32 63.33 63.34 63.35 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 64.34 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 95.34 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 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 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 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
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
100.29 100.30 100.31 100.32 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13
101.14
101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23
101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8
102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 102.34 102.35 102.36 102.37 102.38 102.39 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 103.34 103.35 103.36 103.37 103.38 103.39 103.40 103.41 103.42 103.43 103.44 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9
104.10 104.11
104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13
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
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
107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 109.1 109.2
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
109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 109.33 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 112.34 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15
113.16
113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24
113.25
113.26 113.27 113.28 113.29 113.30 113.31 113.32 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11
117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 117.33 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23
118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 118.33 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8
120.9 120.10
120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18
122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 122.34 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10
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
123.24 123.25 123.26 123.27 123.28 123.29 123.30 124.1 124.2 124.3
124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 125.34 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13
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
127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29
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
129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 129.34 130.1 130.2 130.3
130.4 130.5
130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14
131.15 131.16
131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 131.33 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 132.33 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19
133.20
133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10
134.11
134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 134.33 134.34 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 135.34 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33
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
138.27 138.28 138.29 138.30 138.31 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11
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
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
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
141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14
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
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
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
144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10
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
146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 147.1 147.2 147.3 147.4 147.5 147.6 147.7
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
148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32
150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27
151.28
151.29 151.30 151.31 152.1 152.2
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
152.29 152.30 152.31 152.32 152.33 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12
153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 155.35 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 156.34 156.35 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11
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
157.29 157.30 157.31 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8
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
158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 159.34 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 161.34 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10
162.11
162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 163.33 163.34 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31
164.32
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
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
167.27 167.28 167.29 167.30 167.31 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15
168.16
168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14
169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 169.33 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10
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
170.27 170.28 170.29 170.30 170.31 170.32 170.33 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26
171.27
171.28 171.29 171.30 171.31 171.32 171.33 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24
172.25
172.26 172.27 172.28 172.29 173.1 173.2 173.3
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
173.28 173.29 173.30 173.31 173.32 174.1 174.2 174.3 174.4
174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18
176.19
176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 177.1 177.2 177.3
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
177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13
178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 179.33
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
180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 182.33 182.34 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 185.1 185.2 185.3
185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8
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
186.27 186.28 186.29 186.30 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 187.33 187.34 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14
189.15 189.16
189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30
191.1 191.2
191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10
191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18
192.19 192.20 192.21
192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 193.1 193.2 193.3 193.4 193.5 193.6
193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 193.33 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21
194.22 194.23 194.24 194.25
194.26 194.27 194.28 194.29 194.30 194.31 194.32 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 195.34 195.35 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21
196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 196.33 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23
198.24
198.25 198.26 198.27 198.28 198.29 198.30 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15
199.16
199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10
200.11
200.12 200.13 200.14 200.15 200.16 200.17 200.18
200.19 200.20
200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 202.1 202.2
202.3 202.4
202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 202.34 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 203.33 203.34 203.35 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 204.34 205.1 205.2 205.3 205.4 205.5 205.6
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
205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 205.33 206.1 206.2 206.3 206.4 206.5 206.6
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
206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33 207.34 208.1 208.2 208.3 208.4 208.5 208.6 208.7
208.8
208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 208.33 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 209.33 209.34 209.35 210.1 210.2
210.3
210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 211.33 211.34 212.1 212.2
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
213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11
213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 213.32 213.33 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 214.32 214.33 214.34 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28
215.29
215.30 215.31 215.32 215.33 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10
216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20
216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27
217.28
217.29 217.30 217.31 217.32 218.1 218.2 218.3 218.4 218.5
218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17
218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17
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
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
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
221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12
222.13 222.14
222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 223.1 223.2 223.3
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
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
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
225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 226.1 226.2 226.3 226.4 226.5 226.6 226.7
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
226.25 226.26 226.27 226.28 226.29 226.30 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15
227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16
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
228.31 228.32 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9
229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 230.1 230.2 230.3 230.4
230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8
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
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
236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25
237.26
237.27 237.28 237.29 237.30 237.31 237.32 237.33 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16
238.17
238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9
239.10 239.11
239.12 239.13 239.14 239.15 239.16 239.17 239.18
239.19
239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18
240.19
240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10
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
242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 242.33 243.1 243.2 243.3
243.4
243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8
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
244.25 244.26 244.27 244.28 244.29 244.30 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17
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
246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23
247.24
247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 247.33 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9
248.10
248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 248.33 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12
249.13 249.14
249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26
250.27
251.1 251.2 251.3 251.4 251.5
251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8
252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 252.33 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 253.33 253.34 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 254.33 255.1 255.2 255.3
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
255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23
256.24
256.25 256.26 256.27 256.28 256.29 256.30 256.31 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21
257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 257.31 257.32 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8
258.9
258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14
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
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
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
261.26 261.27 261.28 261.29 261.30 261.31 261.32 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26
262.27 262.28 262.29 263.1 263.2
263.3 263.4 263.5
263.6 263.7
263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14
264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 264.31 264.32 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 265.32 265.33 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14
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
266.28 266.29 266.30 266.31 266.32 266.33 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24
267.25 267.26 267.27 267.28 267.29 267.30 267.31 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8
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
268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 270.1 270.2 270.3 270.4
270.5
270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14
270.15
270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9
271.10
271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11
273.12
273.13 273.14 273.15 273.16
273.17
273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28
276.29
276.30 276.31 276.32 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16
277.17
277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11
280.12
280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 281.1 281.2 281.3
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
281.24 281.25 281.26 281.27 281.28 281.29 281.30 282.1 282.2 282.3
282.4
282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 282.31 282.32 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15
285.16
285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29
287.30
288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12
290.13
290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28
292.29
293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 294.1 294.2 294.3 294.4
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
295.1
295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22
298.23
298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 298.33 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15
299.16
299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29
301.30
302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10
303.11
303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32 304.1 304.2 304.3 304.4 304.5 304.6 304.7
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
304.27 304.28 304.29 304.30 305.1 305.2
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
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
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
307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16
309.17
309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24 310.25 310.26 310.27 310.28 310.29 310.30 310.31 310.32 311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 312.31 312.32 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 313.33 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 314.32 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 315.32 315.33 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 316.33 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 317.32 317.33 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24
318.25
318.26 318.27 318.28 318.29 318.30 318.31 318.32 318.33 319.1 319.2
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
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
321.1 321.2 321.3 321.4 321.5 321.6
321.7
321.8 321.9 321.10 321.11
321.12
321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 322.34 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 323.33 323.34 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14
324.15
324.16 324.17 324.18 324.19 324.20 324.21
324.22
324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32 325.1 325.2 325.3
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
325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20
326.21
326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 326.32 326.33 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17
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
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
328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 328.33 328.34 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25
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
330.26 330.27 330.28 330.29 330.30 330.31 330.32 330.33 331.1 331.2 331.3 331.4 331.5 331.6 331.7 331.8
331.9
331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 332.1 332.2 332.3
332.4
332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 333.1 333.2 333.3 333.4
333.5
333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 335.32 335.33 336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13
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
337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10
337.11
337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 337.32 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9
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
338.27 338.28 338.29 338.30 338.31 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16
339.17
339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 340.1 340.2 340.3 340.4
340.5
340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12
343.13
343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22
343.23
343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 344.1 344.2
344.3 344.4
344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 344.32 345.1 345.2 345.3 345.4
345.5 345.6
345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20
346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14 347.15 347.16 347.17
347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27
347.28 347.29 347.30 347.31 347.32
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
348.24 348.25 348.26 348.27 348.28 348.29 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16
349.17
349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8
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
351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 352.1 352.2 352.3 352.4 352.5 352.6
352.7
352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 353.32 353.33 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30
354.31
355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9
355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19
356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 357.1 357.2 357.3 357.4 357.5
357.6 357.7
357.8 357.9 357.10 357.11
357.12 357.13 357.14 357.15
357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 358.1 358.2 358.3 358.4 358.5
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
358.26 358.27 358.28 358.29 359.1 359.2 359.3 359.4 359.5 359.6
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
359.21 359.22 359.23 359.24 359.25 359.26 359.27 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16
360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20
361.21 361.22 361.23 361.24
361.25 361.26 361.27 361.28 361.29 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31
363.1 363.2 363.3 363.4 363.5 363.6
363.7 363.8 363.9 363.10 363.11 363.12
363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20
364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29
365.1 365.2 365.3 365.4 365.5 365.6
365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16
366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24
366.25 366.26 366.27 366.28 366.29 366.30 367.1 367.2 367.3
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
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
369.24 369.25 369.26 369.27 369.28 369.29 370.1 370.2 370.3
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
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
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
372.26 372.27 372.28 372.29 372.30 372.31 373.1 373.2 373.3 373.4 373.5
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
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
374.25 374.26 374.27 374.28 375.1 375.2 375.3 375.4 375.5 375.6 375.7
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
375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 376.1 376.2 376.3
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
376.27 376.28 376.29 376.30 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9
377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 378.1 378.2 378.3 378.4 378.5
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
378.28 378.29 378.30 379.1 379.2 379.3 379.4 379.5
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
380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26 381.27
381.28 381.29 381.30 381.31 381.32 382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19 382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 382.31 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11 383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23
383.24 383.25 383.26 383.27 383.28 383.29 384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31
385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 385.31 385.32 385.33 385.34 385.35 385.36 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29 386.30 386.31 386.32 386.33
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
388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 388.32 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9 389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18 389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 389.31 389.32 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14 390.15
390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31 390.32 390.33 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 391.31 392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14 392.15 392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 392.31 392.32 392.33 392.34 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8
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
393.27 393.28 393.29 393.30 393.31 394.1 394.2 394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 394.32 394.33 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28 395.29 395.30 395.31 395.32 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29 396.30 396.31 396.32 397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8 397.9 397.10 397.11 397.12 397.13 397.14 397.15 397.16 397.17 397.18 397.19 397.20 397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29 397.30 397.31 397.32 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16
398.17
398.18 398.19 398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27
398.28 398.29 398.30 398.31 398.32 399.1 399.2 399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 399.30 399.31 399.32 399.33 399.34 399.35 400.1 400.2 400.3 400.4 400.5 400.6 400.7 400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 400.32 400.33 400.34 400.35 400.36 401.1 401.2 401.3
401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16 401.17 401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 402.1 402.2 402.3 402.4 402.5 402.6 402.7 402.8 402.9 402.10 402.11 402.12 402.13 402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25 402.26 402.27 402.28 402.29 402.30 402.31 402.32 403.1 403.2
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
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
404.16 404.17 404.18 404.19 404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21 405.22 405.23 405.24
405.25 405.26 405.27 405.28 405.29 405.30 406.1 406.2
406.3
406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12 406.13 406.14 406.15 406.16 406.17 406.18 406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29 406.30 407.1 407.2 407.3 407.4
407.5 407.6 407.7 407.8 407.9 407.10 407.11
407.12 407.13 407.14 407.15
407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27 407.28 407.29 407.30 408.1 408.2 408.3 408.4 408.5 408.6 408.7
408.8 408.9 408.10 408.11 408.12 408.13 408.14 408.15 408.16 408.17 408.18
408.19 408.20 408.21 408.22 408.23 408.24 408.25 408.26 408.27 408.28 408.29 409.1 409.2 409.3 409.4
409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16
409.17 409.18 409.19 409.20 409.21 409.22 409.23 409.24 409.25 409.26 409.27 409.28 409.29 409.30 410.1 410.2 410.3 410.4 410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14 410.15 410.16 410.17
410.18 410.19 410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27 410.28 410.29
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
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
412.25 412.26 412.27 412.28 412.29 412.30 413.1 413.2 413.3 413.4
413.5 413.6 413.7 413.8 413.9 413.10 413.11 413.12 413.13
413.14 413.15 413.16 413.17 413.18 413.19 413.20 413.21 413.22 413.23 413.24 413.25 413.26 413.27 413.28 413.29 413.30 413.31 414.1 414.2 414.3 414.4 414.5 414.6
414.7 414.8 414.9
414.10 414.11 414.12 414.13 414.14 414.15 414.16 414.17 414.18 414.19 414.20 414.21 414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29 414.30 415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8 415.9
415.10 415.11 415.12 415.13 415.14 415.15 415.16 415.17 415.18 415.19 415.20 415.21 415.22 415.23 415.24 415.25 415.26 415.27 415.28 415.29 416.1 416.2 416.3 416.4 416.5 416.6 416.7 416.8 416.9 416.10 416.11 416.12 416.13 416.14 416.15 416.16 416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24 416.25 416.26 416.27 416.28 417.1 417.2 417.3
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
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
418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26 418.27 418.28 418.29 418.30 418.31 419.1 419.2 419.3 419.4 419.5 419.6 419.7 419.8 419.9 419.10 419.11 419.12 419.13 419.14 419.15 419.16 419.17 419.18 419.19 419.20 419.21 419.22 419.23 419.24 419.25 419.26 419.27 419.28 419.29 419.30 419.31 419.32 419.33 420.1 420.2 420.3 420.4
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
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
421.28 421.29 421.30 421.31 421.32 422.1 422.2 422.3 422.4 422.5 422.6 422.7 422.8 422.9 422.10 422.11 422.12 422.13 422.14 422.15 422.16 422.17 422.18
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
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
423.21 423.22 423.23 423.24 423.25 423.26 423.27 423.28 423.29 423.30 424.1 424.2 424.3 424.4
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
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
425.26 425.27 425.28 425.29 426.1 426.2 426.3 426.4 426.5 426.6 426.7 426.8 426.9 426.10
426.11 426.12 426.13 426.14 426.15
426.16 426.17 426.18 426.19 426.20 426.21 426.22 426.23 426.24 426.25 426.26 426.27 426.28 426.29 426.30 426.31 427.1 427.2 427.3 427.4 427.5 427.6 427.7 427.8 427.9 427.10 427.11 427.12 427.13 427.14 427.15
427.16 427.17 427.18 427.19 427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 427.32 428.1 428.2 428.3
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
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
429.17 429.18 429.19 429.20 429.21 429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30 429.31 429.32 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16 430.17 430.18 430.19 430.20 430.21 430.22 430.23 430.24 430.25 430.26
430.27
430.28 430.29 430.30 430.31 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8
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
431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 432.1 432.2 432.3
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
432.23 432.24 432.25 432.26 432.27 432.28 432.29 432.30 433.1 433.2 433.3 433.4 433.5 433.6 433.7
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
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
434.14 434.15 434.16 434.17 434.18 434.19 434.20 434.21 434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29 434.30 434.31 434.32 435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8 435.9 435.10 435.11 435.12
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
435.29 435.30 435.31 435.32 436.1 436.2 436.3 436.4 436.5 436.6 436.7 436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 436.31 437.1 437.2 437.3 437.4 437.5 437.6 437.7 437.8 437.9 437.10 437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19 437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27 437.28 437.29 437.30 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16 438.17 438.18 438.19 438.20 438.21 438.22 438.23 438.24 438.25 438.26 438.27 438.28 438.29 438.30 438.31 438.32 439.1 439.2 439.3 439.4 439.5 439.6 439.7 439.8 439.9 439.10 439.11 439.12 439.13 439.14 439.16 439.15 439.17 439.18 439.19 439.20 439.21 439.22 439.23 439.24 439.25 439.26 439.27 439.28 439.29 439.30 439.31 439.32 439.33 439.34 439.35 439.36 440.1 440.2 440.4 440.3 440.5 440.6 440.7 440.8 440.9 440.10 440.11 440.12 440.13 440.14 440.15 440.16 440.17 440.18 440.19 440.20 440.21 440.22 440.23 440.24
440.25 440.26 440.27 440.28 440.29 440.30 440.31 440.32
441.1 441.2 441.3 441.4 441.5 441.6 441.7 441.8
441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19 441.20 441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 441.31 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9 442.10 442.11 442.12 442.13 442.14 442.15 442.16 442.17 442.18 442.19
442.20 442.21 442.22 442.23 442.24 442.25 442.26 442.27 442.28 442.29 442.30 443.1 443.2 443.3 443.4 443.5 443.6 443.7 443.8 443.9 443.10 443.11 443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19 443.20 443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28 443.29
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
444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26 444.27 444.28 444.29 444.30 444.31 445.1 445.2 445.3 445.4 445.5 445.6 445.7 445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16 445.17 445.18 445.19 445.20 445.21 445.22 445.23 445.24 445.25 445.26 445.27 445.28 445.29 445.30 445.31 445.32 445.33 446.1 446.2 446.3 446.4 446.5 446.6 446.7 446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16 447.17 447.18 447.19 447.20 447.21 447.22 447.23 447.24 447.25 447.26 447.27 447.28 447.29 447.30 447.31 447.32 447.33 448.1 448.2 448.3 448.4 448.5 448.6 448.7 448.8 448.9 448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21 448.22 448.23 448.24 448.25 448.26 448.27 448.28 448.29 448.30 448.31 448.32 448.33 449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14 449.15 449.16 449.17 449.18 449.19 449.20 449.21 449.22 449.23 449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16 450.17 450.18 450.19 450.20 450.21 450.22 450.23 450.24 450.25 450.26 450.27 450.28 450.29
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
451.31 451.32 451.33 452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13
452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28 452.29 452.30 452.31 452.32 452.33 452.34 453.1 453.2 453.3 453.4 453.5 453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 453.31 453.32 453.33 453.34 453.35
454.1 454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9
454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8 456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16
456.17
456.18 456.19 456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 457.1 457.2 457.3 457.4 457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26
457.27 457.28 457.29 457.30 457.31 458.1 458.2 458.3 458.4 458.5 458.6 458.7 458.8 458.9 458.10 458.11 458.12 458.13 458.14 458.15 458.16 458.17
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
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
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
461.27 461.28 461.29 461.30 461.31 461.32 462.1 462.2 462.3 462.4 462.5 462.6 462.7 462.8 462.9 462.10 462.11 462.12 462.13 462.14 462.15 462.16 462.17 462.18 462.19 462.20 462.21 462.22 462.23 462.24 462.25 462.26 462.27 462.28 462.29 462.30 462.31 462.32 462.33 463.1 463.2
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
463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27 463.28 464.1 464.2 464.3 464.4 464.5 464.6
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
465.1 465.2 465.3 465.4 465.5 465.6 465.7 465.8 465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23 465.24 465.25 465.26 465.27 465.28 465.29 465.30 465.31 465.32 466.1 466.2 466.3 466.4 466.5 466.6 466.7 466.8 466.9 466.10 466.11 466.12 466.13 466.14 466.15
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
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
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
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
470.17 470.18 470.19 470.20 470.21 470.22 470.23 470.24 470.25 470.26 470.27 470.28 470.29 470.30 470.31 470.32 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18 471.19 471.20 471.21
471.22
471.23 471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 472.1 472.2 472.3 472.4
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
472.28 472.29 472.30 472.31 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11 473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19 473.20 473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29
473.30
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
474.15 474.16 474.17 474.18 474.19 474.20 474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29 474.30 474.31 475.1 475.2 475.3 475.4 475.5 475.6 475.7 475.8 475.9 475.10 475.11 475.12 475.13 475.14 475.15 475.16 475.17 475.18 475.19 475.20 475.21 475.22 475.23 475.24 475.25 475.26 475.27 475.28 475.29 475.30 475.31 475.32 475.33 476.1 476.2 476.3 476.4 476.5
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
477.1 477.2 477.3 477.4 477.5 477.6 477.7 477.8 477.9 477.10 477.11 477.12 477.13 477.14 477.15 477.16 477.17 477.18 477.19 477.20 477.21 477.22 477.23 477.24 477.25 477.26 477.27 477.28 477.29 477.30 477.31 478.1 478.2 478.3 478.4 478.5
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
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
479.14 479.15 479.16 479.17 479.18 479.19 479.20 479.21 479.22 479.23 479.24 479.25 479.26 479.27 479.28 479.29 480.1 480.2 480.3 480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20 480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 481.1 481.2 481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10 481.11 481.12 481.13 481.14 481.15 481.16 481.17 481.18 481.19 481.20 481.21 481.22 481.23 481.24 481.25 481.26 481.27 481.28 481.29 481.30 481.31 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10
482.11
482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21 482.22 482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31 482.32 483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10 483.11 483.12 483.13 483.14 483.15 483.16 483.17 483.18 483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28
483.29
483.30 483.31 484.1 484.2 484.3 484.4 484.5 484.6
484.7 484.8 484.9 484.10 484.11 484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21 484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 484.30 484.31 484.32 485.1 485.2 485.3 485.4 485.5 485.6 485.7 485.8 485.9 485.10 485.11 485.12 485.13 485.14 485.15 485.16 485.17 485.18 485.19 485.20 485.21 485.22 485.23 485.24 485.25 485.26 485.27 485.28 485.29 485.30 485.31 485.32 486.1 486.2 486.3 486.4 486.5 486.6 486.7 486.8 486.9 486.10 486.11 486.12 486.13 486.14 486.15 486.16 486.17 486.18 486.19 486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29 487.1 487.2 487.3
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
487.28 487.29 487.30 487.31 488.1 488.2 488.3 488.4 488.5 488.6 488.7 488.8 488.9 488.10 488.11 488.12 488.13
488.14 488.15 488.16 488.17 488.18 488.19 488.20 488.21 488.22 488.23 488.24 488.25 488.26 488.27 488.28 488.29 488.30 489.1 489.2 489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14
489.15 489.16 489.17 489.18
489.19 489.20 489.21 489.22 489.23 489.24 489.25 489.26 489.27 489.28 489.29 490.1 490.2 490.3 490.4 490.5 490.6
490.7 490.8 490.9 490.10 490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27 490.28 490.29 490.30 490.31 490.32 490.33 491.1 491.2 491.3 491.4 491.5 491.6 491.7 491.8 491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20 491.21 491.22 491.23 491.24 491.25 491.26 491.27 491.28 491.29 491.30 491.31 491.32 492.1 492.2 492.3 492.4 492.5 492.6 492.7 492.8 492.9
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
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
493.26 493.27 493.28 493.29 493.30 494.1 494.2 494.3 494.4 494.5 494.6 494.7 494.8 494.9 494.10 494.11 494.12 494.13
494.14 494.15 494.16 494.17 494.18 494.19 494.20 494.21 494.22 494.23 494.24 494.25 494.26 494.27 494.28 494.29 494.30 494.31 494.32 495.1 495.2 495.3 495.4 495.5 495.6 495.7 495.8 495.9 495.10 495.11 495.12 495.13 495.14 495.15 495.16 495.17 495.18 495.19 495.20 495.21 495.22 495.23 495.24 495.25 495.26 495.27 495.28 495.29 495.30 495.31 495.32 495.33 496.1 496.2 496.3 496.4 496.5 496.6 496.7 496.8 496.9 496.10 496.11 496.12 496.13 496.14 496.15 496.16 496.17 496.18 496.19 496.20 496.21 496.22 496.23 496.24 496.25 496.26 496.27 496.28 496.29 496.30 496.31 496.32 496.33 497.1 497.2 497.3 497.4 497.5 497.6 497.7 497.8 497.9 497.10 497.11 497.12 497.13 497.14 497.15 497.16 497.17 497.18 497.19 497.20 497.21 497.22 497.23 497.24 497.25 497.26 497.27 497.28 497.29 497.30
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
498.25 498.26 498.27 498.28 498.29 498.30 499.1 499.2 499.3 499.4 499.5 499.6 499.7 499.8 499.9 499.10 499.11 499.12 499.13 499.14 499.15 499.16 499.17 499.18 499.19 499.20 499.21 499.22 499.23 499.24 499.25 499.26 499.27 499.28 499.29 499.30 499.31 500.1 500.2 500.3
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
500.22 500.23 500.24 500.25 500.26 500.27 500.28 500.29 500.30 500.31 500.32 501.1 501.2 501.3 501.4 501.5 501.6 501.7 501.8 501.9 501.10 501.11 501.12 501.13 501.14 501.15 501.16 501.17 501.18 501.19
501.20 501.21 501.22 501.23 501.24 501.25 501.26 501.27 501.28 501.29 501.30 501.31 502.1 502.2 502.3 502.4 502.5 502.6 502.7 502.8 502.9 502.10 502.11 502.12
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
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
503.26 503.27 503.28 503.29 504.1 504.2 504.3 504.4 504.5 504.6 504.7 504.8
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
504.25 504.26 504.27 504.28 504.29 504.30 504.31 504.32 504.33 505.1 505.2 505.3 505.4 505.5 505.6 505.7 505.8 505.9 505.10 505.11 505.12 505.13 505.14 505.15 505.16 505.17 505.18 505.19 505.20 505.21 505.22 505.23 505.24 505.25 505.26 505.27 505.28 505.29 505.30 505.31 506.1 506.2 506.3 506.4 506.5 506.6 506.7 506.8 506.9
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
506.28 506.29 506.30 506.31 506.32 507.1 507.2 507.3 507.4 507.5 507.6 507.7 507.8 507.9 507.10 507.11 507.12 507.13 507.14 507.15 507.16 507.17 507.18
507.19 507.20 507.21 507.22 507.23 507.24 507.25 507.26 507.27 507.28 507.29 507.30 507.31 507.32 507.33 508.1 508.2 508.3 508.4 508.5 508.6 508.7 508.8 508.9 508.10 508.11 508.12 508.13 508.14 508.15 508.16 508.17 508.18 508.19 508.20 508.21 508.22 508.23 508.24 508.25 508.26 508.27 508.28 508.29 508.30 508.31 508.32
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
509.22 509.23 509.24 509.25 509.26 509.27 509.28 509.29 509.30 509.31 509.32 510.1 510.2 510.3 510.4 510.5 510.6 510.7 510.8 510.9 510.10 510.11 510.12 510.13 510.14 510.15 510.16 510.17 510.18 510.19 510.20 510.21 510.22 510.23 510.24 510.25 510.26 510.27 510.28 510.29 510.30 510.31 510.32 510.33 510.34 511.1 511.2 511.3 511.4 511.5 511.6 511.7 511.8 511.9 511.10 511.11 511.12 511.13 511.14 511.15 511.16 511.17 511.18 511.19 511.20 511.21 511.22 511.23 511.24 511.25 511.26 511.27 511.28 511.29
511.30 511.31 511.32 511.33 511.34 512.1 512.2 512.3 512.4 512.5 512.6 512.7 512.8 512.9 512.10 512.11 512.12 512.13 512.14 512.15 512.16 512.17 512.18 512.19 512.20 512.21 512.22 512.23 512.24 512.25 512.26 512.27 512.28 512.29 512.30 512.31 512.32 513.1 513.2 513.3 513.4 513.5 513.6 513.7 513.8 513.9 513.10 513.11 513.12 513.13 513.14 513.15 513.16 513.17 513.18 513.19 513.20 513.21 513.22 513.23 513.24 513.25 513.26 513.27 513.28 513.29 513.30 513.31 513.32 513.33 513.34 513.35 514.1 514.2 514.3 514.4 514.5 514.6 514.7 514.8 514.9 514.10 514.11 514.12 514.13 514.14 514.15 514.16 514.17 514.18 514.19 514.20 514.21 514.22 514.23 514.24 514.25 514.26 514.27 514.28 514.29 514.30 514.31 514.32 514.33 514.34 515.1 515.2 515.3 515.4 515.5 515.6 515.7 515.8 515.9 515.10 515.11 515.12 515.13 515.14 515.15 515.16 515.17 515.18 515.19 515.20 515.21 515.22 515.23 515.24 515.25 515.26 515.27 515.28 515.29 515.30 515.31 515.32 515.33 515.34 516.1 516.2 516.3 516.4 516.5 516.6 516.7 516.8 516.9 516.10 516.11 516.12 516.13 516.14 516.15 516.16 516.17 516.18 516.19 516.20 516.21 516.22 516.23 516.24 516.25 516.26 516.27 516.28 516.29 516.30 516.31 516.32 516.33 516.34 516.35 517.1 517.2 517.3 517.4 517.5 517.6 517.7 517.8 517.9 517.10 517.11 517.12 517.13 517.14 517.15 517.16 517.17 517.18 517.19 517.20 517.21 517.22 517.23 517.24 517.25 517.26 517.27 517.28 517.29 517.30 517.31 517.32 517.33 517.34 517.35 518.1 518.2 518.3 518.4 518.5 518.6 518.7 518.8 518.9 518.10 518.11 518.12 518.13 518.14 518.15 518.16 518.17 518.18 518.19 518.20 518.21 518.22 518.23 518.24 518.25 518.26 518.27 518.28 518.29 518.30 518.31 518.32 518.33 518.34 519.1 519.2 519.3 519.4 519.5 519.6 519.7 519.8 519.9 519.10 519.11 519.12 519.13 519.14 519.15 519.16 519.17 519.18 519.19 519.20 519.21 519.22 519.23 519.24 519.25 519.26 519.27 519.28 519.29 519.30 519.31 519.32 519.33 519.34
520.1 520.2 520.3 520.4 520.5 520.6 520.7 520.8 520.9 520.10 520.11 520.12 520.13 520.14 520.15 520.16 520.17 520.18 520.19 520.20 520.21 520.22 520.23 520.24 520.25 520.26 520.27 520.28 520.29 520.30 520.31 520.32 520.33 520.34 521.1 521.2 521.3 521.4 521.5 521.6 521.7 521.8 521.9 521.10 521.11 521.12 521.13 521.14 521.15 521.16 521.17 521.18 521.19 521.20 521.21 521.22 521.23 521.24 521.25 521.26 521.27 521.28 521.29 521.30 521.31 521.32 521.33 521.34 522.1 522.2 522.3 522.4 522.5 522.6 522.7 522.8 522.9 522.10 522.11 522.12 522.13 522.14 522.15 522.16 522.17 522.18 522.19 522.20 522.21 522.22
522.23 522.24 522.25 522.26 522.27 522.28 522.29 522.30 522.31 522.32 522.33 523.1 523.2 523.3 523.4
523.5 523.6 523.7 523.8 523.9 523.10 523.11 523.12 523.13 523.14 523.15 523.16 523.17 523.18 523.19
523.20 523.21 523.22 523.23 523.24 523.25 523.26 523.27 523.28 523.29 523.30 523.31 523.32 524.1 524.2 524.3 524.4 524.5 524.6 524.7 524.8 524.9 524.10 524.11 524.12 524.13 524.14 524.15 524.16 524.17 524.18 524.19 524.20
524.21 524.22 524.23 524.24 524.25 524.26 524.27 524.28 524.29 524.30 524.31 524.32 525.1 525.2 525.3 525.4 525.5 525.6 525.7 525.8 525.9 525.10 525.11 525.12 525.13 525.14 525.15 525.16 525.17 525.18 525.19 525.20 525.21 525.22 525.23 525.24 525.25 525.26 525.27 525.28 525.29 525.30 525.31 525.32 525.33 525.34 526.1 526.2 526.3 526.4 526.5 526.6
526.7 526.8 526.9 526.10 526.11 526.12 526.13
526.14 526.15 526.16 526.17 526.18 526.19 526.20 526.21 526.22 526.23 526.24 526.25 526.26 526.27 526.28 526.29 526.30 526.31 527.1 527.2 527.3 527.4 527.5 527.6 527.7 527.8 527.9 527.10 527.11 527.12 527.13 527.14 527.15 527.16 527.17 527.18 527.19 527.20 527.21 527.22 527.23 527.24 527.25 527.26 527.27 527.28 527.29 527.30 527.31 527.32 527.33 528.1 528.2 528.3 528.4 528.5 528.6 528.7 528.8 528.9 528.10 528.11 528.12 528.13 528.14 528.15
528.16 528.17
528.18 528.19
528.20 528.21 528.22 528.23 528.24 528.25 528.26 528.27 528.28 528.29 528.30 528.31 529.1 529.2 529.3 529.4 529.5 529.6 529.7 529.8 529.9 529.10 529.11 529.12 529.13 529.14 529.15 529.16 529.17 529.18 529.19 529.20 529.21 529.22 529.23
529.24 529.25 529.26 529.27 529.28 529.29 529.30 529.31 529.32 530.1 530.2 530.3 530.4 530.5 530.6 530.7 530.8 530.9 530.10 530.11 530.12 530.13 530.14 530.15 530.16 530.17 530.18 530.19
530.20 530.21 530.22 530.23 530.24 530.25 530.26 530.27 530.28 530.29 530.30 530.31 530.32 530.33 531.1 531.2 531.3 531.4 531.5 531.6 531.7
531.8 531.9 531.10 531.11 531.12 531.13 531.14 531.15 531.16 531.17 531.18 531.19 531.20 531.21 531.22 531.23 531.24 531.25 531.26 531.27 531.28 531.29 531.30 531.31 532.1 532.2 532.3 532.4 532.5 532.6 532.7 532.8 532.9 532.10 532.11 532.12 532.13 532.14 532.15 532.16 532.17 532.18 532.19 532.20 532.21 532.22 532.23 532.24 532.25 532.26 532.27 532.28 532.29 532.30 532.31 532.32 532.33 532.34 533.1 533.2 533.3 533.4 533.5 533.6 533.7 533.8 533.9 533.10 533.11 533.12 533.13 533.14 533.15 533.16 533.17 533.18 533.19 533.20 533.21 533.22 533.23 533.24 533.25 533.26 533.27 533.28 533.29 533.30 533.31 534.1 534.2 534.3 534.4 534.5 534.6 534.7 534.8 534.9 534.10 534.11 534.12 534.13 534.14 534.15 534.16 534.17 534.18 534.19 534.20 534.21 534.22 534.23 534.24 534.25 534.26 534.27 534.28
534.29 534.30 534.31 535.1 535.2 535.3 535.4 535.5 535.6 535.7 535.8 535.9 535.10 535.11 535.12 535.13 535.14 535.15 535.16 535.17 535.18 535.19 535.20 535.21 535.22 535.23 535.24 535.25 535.26 535.27 535.28 535.29 535.30 535.31 535.32 535.33 536.1 536.2
536.3 536.4 536.5 536.6 536.7 536.8 536.9 536.10 536.11 536.12 536.13 536.14 536.15 536.16 536.17 536.18 536.19 536.20 536.21 536.22 536.23 536.24 536.25 536.26 536.27 536.28 536.29 536.30 536.31 536.32 537.1 537.2 537.3 537.4 537.5 537.6 537.7 537.8 537.9 537.10 537.11 537.12 537.13 537.14 537.15 537.16 537.17 537.18 537.19 537.20 537.21 537.22 537.23 537.24 537.25 537.26 537.27 537.28 537.29 537.30 538.1 538.2 538.3 538.4 538.5 538.6 538.7 538.8 538.9 538.10 538.11 538.12 538.13 538.14 538.15 538.16 538.17 538.18 538.19 538.20 538.21 538.22 538.23 538.24 538.25 538.26 538.27 538.28 538.29 538.30 538.31 538.32 538.33 539.1 539.2 539.3 539.4 539.5 539.6 539.7 539.8 539.9 539.10 539.11 539.12 539.13 539.14 539.15 539.16
539.17 539.18 539.19 539.20 539.21 539.22 539.23 539.24 539.25 539.26 539.27 539.28 539.29 539.30 539.31 540.1 540.2 540.3 540.4 540.5 540.6 540.7 540.8 540.9 540.10 540.11 540.12 540.13 540.14 540.15 540.16 540.17 540.18 540.19 540.20 540.21 540.22 540.23 540.24 540.25 540.26 540.27 540.28 540.29 540.30 540.31 540.32 541.1 541.2 541.3 541.4 541.5 541.6 541.7 541.8 541.9 541.10 541.11 541.12 541.13 541.14 541.15 541.16 541.17 541.18 541.19 541.20 541.21 541.22 541.23 541.24 541.25 541.26 541.27 541.28 541.29 541.30 541.31 542.1 542.2 542.3 542.4 542.5 542.6 542.7 542.8 542.9 542.10 542.11 542.12 542.13 542.14 542.15 542.16 542.17 542.18 542.19 542.20 542.21 542.22 542.23 542.24 542.25 542.26 542.27 542.28 542.29 542.30 542.31 542.32 543.1 543.2 543.3 543.4 543.5 543.6 543.7 543.8 543.9 543.10 543.11 543.12 543.13 543.14 543.15 543.16 543.17 543.18 543.19 543.20 543.21 543.22 543.23 543.24 543.25 543.26 543.27 543.28 543.29 543.30 543.31 543.32 544.1 544.2 544.3 544.4 544.5 544.6 544.7 544.8 544.9 544.10 544.11 544.12 544.13 544.14 544.15 544.16 544.17 544.18 544.19 544.20 544.21 544.22 544.23 544.24 544.25 544.26 544.27 544.28 544.29 544.30 544.31 544.32 545.1 545.2 545.3 545.4 545.5 545.6 545.7 545.8 545.9 545.10 545.11 545.12 545.13 545.14 545.15 545.16 545.17 545.18 545.19 545.20 545.21 545.22 545.23 545.24 545.25 545.26 545.27 545.28 545.29 545.30 545.31 545.32 545.33 546.1 546.2 546.3 546.4 546.5 546.6 546.7 546.8 546.9 546.10 546.11 546.12 546.13 546.14 546.15 546.16 546.17 546.18 546.19 546.20 546.21 546.22 546.23 546.24 546.25 546.26 546.27 546.28 546.29 546.30 546.31 546.32 546.33 547.1 547.2 547.3 547.4 547.5 547.6 547.7 547.8 547.9 547.10 547.11 547.12 547.13 547.14 547.15 547.16 547.17 547.18 547.19 547.20 547.21 547.22 547.23 547.24 547.25 547.26 547.27 547.28 547.29 547.30 547.31 547.32 547.33 547.34 548.1 548.2 548.3 548.4 548.5
548.6 548.7
548.8 548.9 548.10 548.11 548.12 548.13 548.14 548.15 548.16 548.17 548.18 548.19 548.20 548.21 548.22 548.23 548.24 548.25 548.26 548.27 548.28 548.29 548.30 549.1 549.2
549.3
549.4 549.5 549.6 549.7 549.8 549.9 549.10 549.11 549.12 549.13 549.14 549.15 549.16 549.17 549.18 549.19 549.20 549.21 549.22 549.23 549.24 549.25 549.26 549.27 549.28 549.29 549.30 549.31 550.1 550.2 550.3 550.4
550.5
550.6 550.7 550.8 550.9 550.10 550.11 550.12 550.13 550.14 550.15 550.16 550.17 550.18 550.19 550.20 550.21 550.22 550.23 550.24 550.25 550.26 550.27 550.28 550.29 550.30 550.31 551.1 551.2 551.3 551.4 551.5
551.6
551.7 551.8 551.9 551.10 551.11
551.12
551.13 551.14 551.15 551.16 551.17 551.18 551.19 551.20 551.21 551.22 551.23 551.24 551.25 551.26 551.27 551.28 551.29 551.30 552.1 552.2 552.3 552.4 552.5 552.6 552.7 552.8 552.9 552.10 552.11 552.12 552.13 552.14 552.15 552.16 552.17 552.18 552.19 552.20 552.21 552.22 552.23 552.24 552.25 552.26 552.27 552.28 552.29 552.30 552.31 553.1 553.2 553.3 553.4 553.5 553.6 553.7
553.8
553.9 553.10 553.11 553.12 553.13 553.14
553.15
553.16 553.17 553.18 553.19 553.20 553.21 553.22 553.23 553.24 553.25 553.26 553.27 553.28
553.29
554.1 554.2 554.3 554.4 554.5 554.6 554.7 554.8 554.9 554.10 554.11 554.12 554.13 554.14 554.15 554.16 554.17 554.18 554.19 554.20
554.21
554.22 554.23 554.24 554.25 554.26 554.27 554.28 554.29 554.30 554.31 554.32 555.1 555.2
555.3
555.4 555.5 555.6 555.7 555.8 555.9 555.10 555.11 555.12 555.13 555.14 555.15 555.16 555.17 555.18 555.19 555.20 555.21 555.22 555.23
555.24
555.25 555.26 555.27 555.28 555.29 555.30 555.31 556.1 556.2 556.3 556.4 556.5 556.6 556.7 556.8 556.9 556.10 556.11 556.12 556.13 556.14 556.15 556.16 556.17 556.18 556.19 556.20 556.21 556.22 556.23 556.24 556.25 556.26 556.27 556.28 556.29 556.30 557.1 557.2 557.3 557.4 557.5 557.6 557.7 557.8 557.9 557.10 557.11 557.12 557.13 557.14 557.15 557.16 557.17 557.18 557.19 557.20 557.21 557.22 557.23 557.24 557.25 557.26 557.27 557.28 557.29 557.30 557.31 557.32 558.1 558.2 558.3 558.4 558.5 558.6 558.7 558.8 558.9 558.10 558.11 558.12 558.13 558.14 558.15 558.16 558.17 558.18 558.19 558.20 558.21 558.22 558.23 558.24 558.25
558.26
558.27 558.28 558.29 558.30 559.1 559.2
559.3
559.4 559.5 559.6 559.7 559.8 559.9 559.10 559.11 559.12 559.13 559.14 559.15 559.16 559.17 559.18 559.19 559.20 559.21 559.22 559.23 559.24 559.25 559.26 559.27 559.28 559.29 559.30 559.31 560.1 560.2 560.3 560.4 560.5 560.6 560.7 560.8 560.9 560.10 560.11 560.12 560.13 560.14 560.15 560.16 560.17 560.18 560.19 560.20 560.21 560.22 560.23 560.24 560.25 560.26 560.27 560.28 560.29 560.30 560.31 561.1 561.2 561.3 561.4 561.5 561.6 561.7 561.8 561.9 561.10
561.11
561.12 561.13 561.14 561.15 561.16 561.17 561.18 561.19 561.20 561.21 561.22 561.23 561.24 561.25 561.26 561.27 561.28 561.29 561.30 561.31 561.32 561.33 562.1 562.2
562.3
562.4 562.5 562.6 562.7 562.8 562.9 562.10 562.11 562.12 562.13 562.14 562.15 562.16 562.17 562.18 562.19 562.20 562.21 562.22 562.23 562.24 562.25 562.26 562.27 562.28 562.29 562.30 562.31 562.32 563.1 563.2 563.3 563.4 563.5 563.6 563.7 563.8 563.9 563.10 563.11 563.12 563.13 563.14 563.15 563.16 563.17 563.18
563.19
563.20 563.21 563.22 563.23 563.24 563.25 563.26 563.27 563.28 563.29 563.30 563.31 564.1 564.2 564.3 564.4 564.5 564.6 564.7 564.8 564.9
564.10 564.11 564.12 564.13 564.14 564.15 564.16 564.17 564.18 564.19 564.20 564.21 564.22 564.23 564.24 564.25 564.26 564.27 564.28 564.29 564.30 564.31 565.1 565.2 565.3 565.4 565.5 565.6 565.7 565.8 565.9 565.10 565.11 565.12 565.13 565.14 565.15 565.16 565.17 565.18 565.19 565.20 565.21 565.22 565.23
565.24
565.25 565.26 565.27 565.28 565.29 565.30 566.1 566.2 566.3 566.4 566.5
566.6
566.7 566.8 566.9 566.10 566.11 566.12 566.13 566.14 566.15 566.16 566.17 566.18 566.19 566.20 566.21 566.22 566.23 566.24 566.25 566.26 566.27 566.28 566.29 566.30
567.1 567.2 567.3 567.4
567.5 567.6 567.7 567.8 567.9
567.10
567.11 567.12 567.13 567.14 567.15 567.16 567.17 567.18 567.19 567.20 567.21 567.22 567.23 567.24 567.25 567.26 567.27 567.28 567.29 567.30 567.31 568.1 568.2 568.3 568.4 568.5 568.6 568.7 568.8 568.9 568.10 568.11 568.12 568.13 568.14 568.15 568.16 568.17 568.18 568.19 568.20 568.21 568.22 568.23 568.24 568.25 568.26 568.27 568.28 568.29 568.30 568.31 568.32 568.33 569.1 569.2 569.3 569.4 569.5 569.6 569.7 569.8 569.9 569.10 569.11 569.12 569.13 569.14 569.15 569.16 569.17 569.18 569.19 569.20 569.21 569.22 569.23 569.24 569.25
569.26
569.27 569.28 569.29 569.30 569.31 569.32 570.1 570.2 570.3 570.4 570.5 570.6 570.7 570.8 570.9 570.10 570.11 570.12
570.13
570.14 570.15 570.16 570.17 570.18 570.19 570.20 570.21 570.22 570.23
570.24
570.25 570.26 570.27 570.28 570.29 570.30 571.1 571.2 571.3 571.4 571.5 571.6 571.7 571.8 571.9 571.10 571.11 571.12 571.13
571.14
571.15 571.16 571.17 571.18 571.19 571.20 571.21 571.22 571.23 571.24 571.25 571.26 571.27 571.28 571.29 571.30 571.31 572.1 572.2 572.3 572.4 572.5 572.6 572.7 572.8 572.9 572.10 572.11 572.12 572.13 572.14 572.15 572.16 572.17 572.18 572.19
572.20
572.21 572.22 572.23 572.24 572.25 572.26 572.27 572.28 572.29 572.30 572.31 572.32 573.1 573.2 573.3 573.4 573.5 573.6 573.7 573.8 573.9 573.10 573.11 573.12 573.13 573.14
573.15
573.16 573.17 573.18 573.19 573.20 573.21 573.22 573.23 573.24 573.25 573.26 573.27 573.28 573.29 573.30 573.31 573.32 574.1 574.2 574.3 574.4 574.5 574.6 574.7 574.8 574.9 574.10 574.11 574.12 574.13 574.14 574.15 574.16 574.17 574.18 574.19 574.20 574.21 574.22 574.23 574.24 574.25 574.26 574.27 574.28 574.29 574.30 574.31 574.32
574.33
575.1 575.2 575.3 575.4 575.5 575.6 575.7 575.8 575.9 575.10 575.11 575.12 575.13 575.14 575.15 575.16 575.17 575.18 575.19
575.20
575.21 575.22 575.23 575.24 575.25 575.26 575.27 575.28 575.29 575.30 575.31 576.1 576.2 576.3 576.4 576.5 576.6 576.7 576.8
576.9
576.10 576.11 576.12 576.13 576.14
576.15
576.16 576.17 576.18 576.19 576.20 576.21 576.22 576.23
576.24
576.25 576.26 576.27 576.28 576.29 576.30 576.31
577.1 577.2 577.3 577.4 577.5 577.6
577.7
577.8 577.9 577.10 577.11 577.12 577.13 577.14 577.15 577.16 577.17 577.18 577.19 577.20 577.21 577.22 577.23 577.24 577.25 577.26 577.27 577.28 577.29 577.30 577.31 577.32 577.33 577.34 578.1 578.2 578.3 578.4 578.5 578.6 578.7 578.8 578.9 578.10 578.11 578.12 578.13 578.14 578.15 578.16 578.17 578.18 578.19 578.20 578.21 578.22 578.23 578.24 578.25
578.26
578.27 578.28 578.29 578.30 578.31 578.32 579.1 579.2 579.3 579.4 579.5 579.6 579.7 579.8 579.9 579.10 579.11 579.12 579.13 579.14 579.15 579.16 579.17 579.18 579.19 579.20 579.21 579.22 579.23 579.24 579.25 579.26 579.27 579.28 579.29 579.30
579.31
580.1 580.2 580.3 580.4 580.5 580.6
580.7
580.8 580.9 580.10 580.11 580.12
580.13
580.14 580.15 580.16 580.17 580.18 580.19 580.20 580.21 580.22 580.23 580.24 580.25 580.26 580.27 580.28 580.29 580.30 580.31 581.1 581.2 581.3 581.4 581.5 581.6 581.7 581.8 581.9 581.10 581.11 581.12 581.13 581.14
581.15
581.16 581.17 581.18 581.19 581.20 581.21 581.22 581.23 581.24 581.25 581.26 581.27 581.28 581.29 581.30 581.31 582.1 582.2 582.3 582.4 582.5 582.6 582.7 582.8 582.9 582.10 582.11 582.12 582.13 582.14 582.15 582.16 582.17 582.18 582.19 582.20 582.21 582.22 582.23 582.24 582.25 582.26 582.27 582.28 582.29 582.30 583.1 583.2 583.3 583.4 583.5
583.6
583.7 583.8 583.9 583.10 583.11 583.12 583.13 583.14 583.15 583.16 583.17 583.18 583.19 583.20 583.21 583.22 583.23 583.24 583.25 583.26 583.27 583.28 583.29 583.30 583.31 583.32 584.1 584.2 584.3 584.4 584.5 584.6 584.7 584.8 584.9 584.10 584.11 584.12 584.13 584.14 584.15 584.16 584.17 584.18 584.19 584.20 584.21 584.22 584.23 584.24 584.25 584.26 584.27 584.28 584.29 584.30 584.31 584.32 585.1 585.2 585.3
585.4
585.5 585.6 585.7 585.8 585.9 585.10 585.11 585.12 585.13 585.14 585.15 585.16 585.17 585.18 585.19 585.20 585.21 585.22 585.23 585.24 585.25 585.26 585.27
585.28
585.29 585.30 585.31 586.1 586.2 586.3 586.4 586.5 586.6 586.7 586.8 586.9 586.10 586.11
586.12
586.13 586.14 586.15 586.16 586.17 586.18 586.19 586.20 586.21 586.22 586.23 586.24 586.25 586.26 586.27 586.28 586.29 586.30 586.31 587.1 587.2
587.3
587.4 587.5 587.6 587.7 587.8
587.9
587.10 587.11 587.12 587.13 587.14 587.15 587.16 587.17 587.18 587.19 587.20 587.21 587.22 587.23 587.24 587.25 587.26
587.27
587.28 587.29 587.30 587.31 588.1 588.2 588.3 588.4 588.5 588.6 588.7 588.8 588.9 588.10 588.11
588.12
588.13 588.14 588.15 588.16 588.17 588.18 588.19 588.20
588.21
588.22 588.23 588.24 588.25 588.26 588.27 588.28 588.29 588.30 589.1 589.2 589.3 589.4 589.5 589.6 589.7 589.8 589.9 589.10 589.11 589.12 589.13 589.14 589.15 589.16
589.17
589.18 589.19 589.20 589.21 589.22 589.23 589.24 589.25 589.26 589.27 589.28
589.29
590.1 590.2 590.3 590.4 590.5 590.6 590.7 590.8 590.9 590.10 590.11 590.12 590.13 590.14 590.15 590.16 590.17 590.18 590.19 590.20 590.21 590.22 590.23 590.24 590.25 590.26 590.27 590.28 590.29 590.30 590.31 590.32 591.1
591.2
591.3 591.4 591.5 591.6 591.7 591.8 591.9 591.10 591.11 591.12 591.13 591.14 591.15 591.16 591.17 591.18 591.19 591.20 591.21 591.22 591.23 591.24 591.25
591.26
591.27 591.28 591.29 592.1 592.2 592.3 592.4 592.5
592.6
592.7 592.8 592.9 592.10 592.11
592.12
592.13 592.14 592.15 592.16 592.17 592.18 592.19 592.20 592.21 592.22 592.23 592.24 592.25 592.26 592.27 592.28 593.1 593.2 593.3 593.4 593.5 593.6 593.7 593.8 593.9 593.10 593.11 593.12 593.13 593.14 593.15 593.16 593.17 593.18 593.19 593.20 593.21 593.22 593.23 593.24 593.25 593.26 593.27 593.28 593.29 593.30 593.31 593.32 594.1 594.2 594.3 594.4 594.5 594.6 594.7 594.8 594.9 594.10 594.11 594.12 594.13 594.14 594.15 594.16 594.17 594.18 594.19 594.20 594.21 594.22 594.23 594.24
594.25
594.26 594.27 594.28 594.29 594.30 594.31 595.1 595.2 595.3 595.4 595.5 595.6 595.7 595.8 595.9 595.10 595.11 595.12 595.13 595.14 595.15 595.16 595.17 595.18 595.19 595.20 595.21 595.22 595.23 595.24 595.25 595.26
595.27
595.28 595.29 595.30 595.31 595.32 596.1 596.2 596.3 596.4 596.5 596.6 596.7 596.8 596.9 596.10 596.11 596.12 596.13 596.14 596.15 596.16 596.17 596.18 596.19
596.20
596.21 596.22 596.23 596.24 596.25 596.26 596.27 596.28 596.29 596.30
597.1
597.2 597.3 597.4
597.5
597.6 597.7 597.8
597.9
597.10 597.11 597.12 597.13 597.14 597.15 597.16 597.17 597.18 597.19 597.20 597.21 597.22 597.23 597.24 597.25 597.26 597.27 597.28 598.1 598.2 598.3 598.4 598.5 598.6 598.7 598.8 598.9 598.10 598.11 598.12 598.13 598.14 598.15 598.16 598.17 598.18 598.19 598.20 598.21 598.22 598.23 598.24 598.25 598.26 598.27 598.28 598.29 598.30 598.31 598.32 598.33 599.1 599.2 599.3 599.4 599.5 599.6 599.7 599.8 599.9 599.10 599.11 599.12 599.13 599.14 599.15 599.16 599.17 599.18 599.19 599.20 599.21 599.22 599.23 599.24 599.25 599.26 599.27 599.28 599.29 599.30 599.31 600.1 600.2 600.3 600.4 600.5 600.6 600.7 600.8 600.9 600.10 600.11 600.12 600.13 600.14 600.15 600.16 600.17 600.18 600.19 600.20 600.21 600.22 600.23 600.24 600.25 600.26 600.27 600.28 600.29 600.30 600.31 600.32 600.33 601.1 601.2 601.3 601.4 601.5 601.6 601.7 601.8 601.9 601.10 601.11 601.12 601.13 601.14 601.15 601.16 601.17 601.18 601.19 601.20 601.21 601.22 601.23 601.24 601.25 601.26 601.27 601.28 601.29 601.30 601.31 601.32 601.33 602.1 602.2 602.3 602.4 602.5 602.6 602.7 602.8 602.9 602.10 602.11 602.12 602.13 602.14 602.15 602.16 602.17 602.18 602.19 602.20 602.21 602.22 602.23 602.24 602.25 602.26 602.27 602.28 602.29 602.30 602.31 603.1 603.2 603.3 603.4 603.5 603.6 603.7 603.8 603.9 603.10 603.11 603.12 603.13 603.14 603.15 603.16 603.17 603.18 603.19 603.20 603.21 603.22 603.23 603.24 603.25 603.26 603.27 603.28 603.29
603.30
603.31 603.32 603.33 604.1 604.2 604.3 604.4 604.5 604.6 604.7 604.8 604.9 604.10 604.11 604.12 604.13 604.14 604.15 604.16 604.17 604.18 604.19 604.20 604.21 604.22 604.23 604.24 604.25 604.26 604.27 604.28 604.29 604.30 604.31
604.32
605.1 605.2 605.3 605.4 605.5 605.6 605.7 605.8 605.9 605.10 605.11 605.12 605.13 605.14 605.15 605.16 605.17 605.18
605.19 605.20 605.21 605.22 605.23 605.24 605.25 605.26 605.27 605.28 605.29 605.30 605.31 605.32 606.1 606.2 606.3 606.4 606.5 606.6 606.7 606.8 606.9 606.10 606.11 606.12 606.13 606.14 606.15 606.16
606.17
606.18 606.19 606.20 606.21 606.22 606.23 606.24 606.25 606.26 606.27 606.28 606.29 606.30 606.31 606.32 606.33 607.1 607.2 607.3 607.4 607.5 607.6 607.7 607.8 607.9 607.10 607.11 607.12 607.13 607.14 607.15 607.16 607.17 607.18 607.19 607.20 607.21 607.22 607.23 607.24 607.25 607.26 607.27 607.28 607.29 607.30 607.31 607.32 607.33 607.34 607.35 608.1 608.2 608.3 608.4 608.5
608.6
608.7 608.8 608.9 608.10 608.11 608.12 608.13 608.14 608.15 608.16 608.17 608.18 608.19 608.20 608.21 608.22 608.23 608.24 608.25 608.26 608.27 608.28 608.29 608.30 608.31 608.32 608.33 609.1 609.2 609.3 609.4 609.5 609.6 609.7 609.8 609.9 609.10 609.11 609.12 609.13 609.14 609.15 609.16 609.17 609.18 609.19 609.20 609.21 609.22 609.23 609.24 609.25 609.26 609.27 609.28 609.29 609.30 609.31 610.1 610.2 610.3 610.4 610.5 610.6 610.7 610.8 610.9 610.10 610.11 610.12 610.13 610.14 610.15 610.16 610.17 610.18
610.19
610.20 610.21 610.22 610.23 610.24 610.25 610.26 610.27 610.28 610.29 610.30 610.31 610.32 610.33 610.34 611.1 611.2 611.3 611.4 611.5 611.6 611.7 611.8 611.9 611.10 611.11 611.12 611.13
611.14
611.15 611.16 611.17 611.18 611.19 611.20 611.21 611.22 611.23 611.24 611.25 611.26 611.27 611.28 611.29 611.30 611.31 611.32 611.33 611.34 611.35 612.1 612.2 612.3 612.4 612.5 612.6 612.7 612.8 612.9 612.10 612.11 612.12 612.13 612.14 612.15 612.16 612.17 612.18 612.19 612.20 612.21 612.22 612.23 612.24 612.25 612.26 612.27 612.28 612.29 612.30 612.31 612.32 612.33 612.34 613.1 613.2 613.3 613.4 613.5 613.6 613.7 613.8 613.9 613.10 613.11 613.12 613.13 613.14 613.15 613.16 613.17 613.18 613.19 613.20 613.21 613.22 613.23 613.24 613.25 613.26 613.27 613.28 613.29 613.30 613.31 613.32 613.33 614.1 614.2 614.3 614.4 614.5 614.6 614.7 614.8 614.9
614.10
614.11 614.12 614.13
614.14 614.15
614.16 614.17 614.18 614.19 614.20 614.21 614.22 614.23 614.24 614.25 614.26
614.27 614.28 614.29 614.30 614.31 614.32 615.1 615.2 615.3 615.4 615.5 615.6 615.7 615.8 615.9 615.10 615.11 615.12 615.13 615.14 615.15 615.16 615.17 615.18 615.19 615.20 615.21 615.22 615.23
615.24 615.25
615.26 615.27
615.28 615.29 615.30 616.1 616.2 616.3 616.4 616.5 616.6 616.7 616.8 616.9
616.10 616.11 616.12 616.13 616.14 616.15 616.16 616.17 616.18 616.19 616.20 616.21 616.22 616.23 616.24 616.25 616.26 616.27 616.28 616.29 616.30 616.31 616.32 616.33 617.1 617.2 617.3 617.4 617.5 617.6 617.7 617.8 617.9 617.10 617.11 617.12 617.13 617.14 617.15 617.16 617.17 617.18 617.19 617.20 617.21 617.22 617.23 617.24 617.25 617.26 617.27 617.28 617.29 617.30 617.31 617.32 618.1 618.2 618.3 618.4 618.5 618.6 618.7 618.8 618.9 618.10 618.11 618.12 618.13 618.14 618.15 618.16 618.17 618.18 618.19 618.20 618.21 618.22 618.23 618.24 618.25 618.26 618.27 618.28 618.29 618.30 618.31 618.32 618.33 619.1 619.2 619.3 619.4 619.5 619.6 619.7 619.8 619.9 619.10 619.11 619.12 619.13 619.14 619.15 619.16 619.17 619.18 619.19 619.20 619.21 619.22 619.23 619.24 619.25 619.26 619.27 619.28 619.29 619.30 619.31 619.32 619.33 619.34 619.35 620.1 620.2 620.3 620.4 620.5 620.6 620.7 620.8 620.9 620.10 620.11 620.12 620.13 620.14 620.15 620.16 620.17 620.18 620.19 620.20 620.21 620.22 620.23 620.24 620.25 620.26 620.27 620.28 620.29 620.30 620.31 620.32 620.33 620.34 621.1 621.2 621.3 621.4 621.5 621.6 621.7 621.8 621.9 621.10 621.11 621.12 621.13 621.14 621.15 621.16 621.17 621.18 621.19 621.20 621.21 621.22 621.23 621.24 621.25 621.26 621.27 621.28 621.29 621.30 621.31 621.32 621.33 621.34 622.1 622.2 622.3 622.4 622.5 622.6 622.7 622.8 622.9 622.10 622.11 622.12 622.13 622.14 622.15 622.16 622.17 622.18 622.19 622.20 622.21 622.22 622.23 622.24 622.25 622.26 622.27 622.28 622.29 622.30 622.31 622.32 622.33 622.34 622.35 623.1 623.2 623.3 623.4 623.5 623.6 623.7 623.8 623.9 623.10 623.11 623.12 623.13 623.14 623.15 623.16 623.17 623.18 623.19 623.20 623.21 623.22 623.23 623.24 623.25 623.26 623.27 623.28 623.29 623.30 623.31 623.32 623.33 623.34 623.35 624.1 624.2 624.3 624.4 624.5 624.6 624.7 624.8 624.9 624.10 624.11 624.12 624.13 624.14 624.15 624.16 624.17 624.18 624.19 624.20 624.21 624.22 624.23 624.24 624.25 624.26 624.27 624.28 624.29 624.30 624.31 624.32 624.33 624.34 624.35 625.1 625.2 625.3 625.4 625.5 625.6 625.7 625.8 625.9 625.10 625.11 625.12 625.13 625.14 625.15 625.16 625.17 625.18 625.19 625.20 625.21 625.22 625.23 625.24 625.25 625.26 625.27 625.28 625.29 625.30 625.31 625.32 625.33 625.34 625.35 626.1 626.2 626.3 626.4 626.5 626.6 626.7 626.8 626.9 626.10 626.11 626.12 626.13 626.14 626.15 626.16 626.17 626.18 626.19 626.20 626.21 626.22 626.23 626.24 626.25 626.26 626.27 626.28 626.29 626.30 626.31 626.32 626.33 626.34 626.35 626.36 627.1 627.2 627.3 627.4 627.5 627.6 627.7 627.8 627.9 627.10 627.11 627.12 627.13 627.14 627.15 627.16 627.17 627.18 627.19 627.20 627.21 627.22 627.23 627.24 627.25 627.26 627.27 627.28 627.29 627.30 627.31 627.32 627.33 627.34 628.1 628.2 628.3 628.4 628.5 628.6 628.7 628.8 628.9 628.10 628.11 628.12 628.13 628.14 628.15 628.16 628.17 628.18 628.19 628.20 628.21 628.22 628.23 628.24 628.25 628.26 628.27 628.28 628.29 628.30 628.31 628.32 628.33 628.34 628.35 628.36 629.1 629.2 629.3 629.4 629.5 629.6 629.7 629.8 629.9 629.10 629.11 629.12 629.13 629.14 629.15 629.16 629.17 629.18 629.19 629.20 629.21 629.22 629.23 629.24 629.25 629.26 629.27 629.28 629.29 629.30 629.31 629.32 629.33 629.34 630.1 630.2 630.3 630.4 630.5 630.6 630.7 630.8 630.9 630.10 630.11 630.12 630.13 630.14 630.15 630.16 630.17 630.18 630.19 630.20 630.21 630.22 630.23 630.24 630.25 630.26 630.27 630.28 630.29 630.30 630.31 630.32 630.33 630.34 631.1 631.2 631.3 631.4 631.5 631.6 631.7 631.8 631.9 631.10 631.11 631.12 631.13 631.14 631.15 631.16 631.17 631.18 631.19 631.20 631.21 631.22 631.23 631.24 631.25 631.26 631.27 631.28 631.29 631.30 631.31 631.32 631.33 632.1 632.2 632.3 632.4 632.5 632.6 632.7 632.8 632.9 632.10 632.11 632.12 632.13 632.14 632.15 632.16 632.17 632.18 632.19 632.20 632.21 632.22 632.23 632.24 632.25 632.26 632.27 632.28 632.29 632.30 632.31 632.32 632.33 633.1 633.2 633.3 633.4 633.5 633.6 633.7 633.8 633.9 633.10 633.11 633.12 633.13 633.14 633.15 633.16 633.17 633.18 633.19 633.20 633.21 633.22 633.23 633.24 633.25 633.26 633.27 633.28 633.29 633.30 633.31 633.32 633.33 633.34 633.35 634.1 634.2 634.3 634.4 634.5 634.6 634.7 634.8 634.9 634.10 634.11 634.12 634.13 634.14 634.15 634.16 634.17 634.18 634.19 634.20 634.21 634.22 634.23 634.24 634.25 634.26 634.27 634.28 634.29 634.30 634.31 634.32 634.33 634.34 635.1 635.2 635.3 635.4 635.5 635.6 635.7 635.8 635.9 635.10 635.11 635.12 635.13 635.14 635.15 635.16 635.17 635.18 635.19 635.20 635.21 635.22 635.23 635.24 635.25 635.26 635.27 635.28 635.29 635.30 635.31 635.32 636.1 636.2 636.3 636.4 636.5 636.6 636.7 636.8 636.9 636.10 636.11 636.12 636.13 636.14 636.15 636.16 636.17 636.18 636.19 636.20 636.21 636.22 636.23 636.24 636.25 636.26 636.27 636.28 636.29 636.30 636.31 636.32 636.33 636.34 636.35 636.36 637.1 637.2 637.3 637.4 637.5 637.6 637.7 637.8 637.9 637.10 637.11 637.12 637.13 637.14 637.15 637.16 637.17 637.18 637.19 637.20 637.21 637.22 637.23 637.24 637.25 637.26 637.27 637.28 637.29 637.30 637.31 637.32 637.33 637.34 638.1 638.2 638.3 638.4 638.5 638.6 638.7 638.8 638.9 638.10 638.11 638.12 638.13 638.14 638.15 638.16 638.17 638.18 638.19 638.20 638.21 638.22 638.23 638.24 638.25 638.26 638.27 638.28 638.29 638.30 638.31 638.32 638.33 639.1 639.2 639.3 639.4 639.5 639.6 639.7 639.8 639.9 639.10 639.11 639.12 639.13 639.14 639.15 639.16 639.17 639.18 639.19 639.20 639.21 639.22 639.23 639.24 639.25 639.26 639.27 639.28 639.29 639.30 639.31 639.32 639.33 640.1 640.2 640.3 640.4 640.5 640.6 640.7 640.8 640.9 640.10 640.11 640.12 640.13 640.14 640.15 640.16 640.17 640.18 640.19 640.20 640.21 640.22 640.23 640.24 640.25 640.26 640.27 640.28 640.29 640.30 640.31 640.32 640.33 641.1 641.2 641.3 641.4 641.5 641.6 641.7 641.8 641.9 641.10 641.11 641.12 641.13 641.14 641.15 641.16 641.17 641.18 641.19 641.20 641.21 641.22 641.23 641.24 641.25 641.26 641.27 641.28 641.29 641.30 641.31 641.32 641.33 641.34 641.35 642.1 642.2 642.3 642.4 642.5 642.6 642.7 642.8 642.9 642.10 642.11 642.12 642.13 642.14 642.15 642.16 642.17 642.18 642.19 642.20 642.21 642.22 642.23 642.24 642.25 642.26 642.27 642.28 642.29 642.30 642.31 642.32 642.33 643.1 643.2 643.3 643.4 643.5 643.6 643.7 643.8 643.9 643.10 643.11 643.12 643.13 643.14 643.15 643.16 643.17 643.18 643.19 643.20 643.21 643.22 643.23 643.24 643.25 643.26 643.27 643.28 643.29 643.30 643.31 643.32 643.33 644.1 644.2 644.3 644.4 644.5 644.6 644.7 644.8 644.9 644.10 644.11 644.12 644.13 644.14 644.15 644.16 644.17 644.18 644.19 644.20 644.21 644.22 644.23 644.24 644.25 644.26 644.27 644.28 644.29 644.30 644.31 644.32 644.33 644.34 645.1 645.2 645.3 645.4 645.5 645.6 645.7 645.8 645.9 645.10 645.11 645.12 645.13 645.14 645.15 645.16 645.17 645.18 645.19 645.20 645.21 645.22 645.23 645.24 645.25 645.26 645.27 645.28 645.29 645.30 645.31 645.32 645.33 645.34 645.35 646.1 646.2 646.3 646.4 646.5 646.6 646.7 646.8 646.9 646.10 646.11 646.12 646.13 646.14 646.15 646.16 646.17 646.18 646.19 646.20 646.21 646.22 646.23 646.24 646.25 646.26 646.27 646.28 646.29 646.30 646.31 646.32 646.33 646.34 646.35 647.1 647.2 647.3 647.4 647.5 647.6 647.7 647.8 647.9 647.10 647.11 647.12 647.13 647.14 647.15 647.16 647.17 647.18 647.19 647.20 647.21 647.22 647.23 647.24 647.25 647.26 647.27 647.28 647.29 647.30 647.31 647.32 647.33 647.34 647.35 648.1 648.2 648.3 648.4 648.5 648.6 648.7 648.8 648.9 648.10 648.11 648.12 648.13 648.14 648.15 648.16 648.17 648.18 648.19 648.20 648.21 648.22 648.23 648.24 648.25 648.26 648.27 648.28 648.29 648.30 648.31 648.32 648.33 648.34 649.1 649.2 649.3 649.4 649.5 649.6 649.7 649.8 649.9 649.10 649.11
649.12 649.13 649.14 649.15 649.16 649.17 649.18 649.19 649.20 649.21 649.22 649.23 649.24 649.25 649.26 649.27 649.28 649.29 649.30 649.31 649.32 649.33 649.34 650.1 650.2 650.3 650.4 650.5 650.6 650.7 650.8 650.9 650.10 650.11 650.12 650.13 650.14 650.15 650.16 650.17 650.18 650.19 650.20 650.21 650.22 650.23 650.24 650.25 650.26 650.27 650.28 650.29 650.30 650.31 650.32 650.33 651.1 651.2 651.3 651.4 651.5 651.6 651.7 651.8 651.9 651.10 651.11 651.12 651.13 651.14 651.15 651.16 651.17 651.18 651.19 651.20 651.21 651.22 651.23 651.24 651.25 651.26 651.27 651.28 651.29 651.30 651.31 651.32 651.33 651.34 651.35 651.36 652.1 652.2 652.3 652.4 652.5 652.6 652.7 652.8 652.9 652.10 652.11 652.12 652.13 652.14 652.15 652.16 652.17 652.18 652.19 652.20 652.21 652.22 652.23 652.24 652.25 652.26 652.27 652.28 652.29 652.30 652.31 652.32 652.33 652.34 653.1 653.2 653.3 653.4 653.5 653.6 653.7 653.8 653.9 653.10 653.11 653.12 653.13 653.14 653.15 653.16 653.17 653.18 653.19 653.20 653.21 653.22 653.23 653.24 653.25 653.26 653.27 653.28 653.29 653.30 653.31 653.32 653.33 653.34 653.35 654.1 654.2 654.3 654.4 654.5 654.6 654.7 654.8 654.9 654.10 654.11 654.12 654.13 654.14 654.15 654.16 654.17 654.18 654.19 654.20 654.21 654.22 654.23 654.24 654.25 654.26 654.27 654.28 654.29 654.30 654.31 654.32 654.33 654.34 654.35 655.1 655.2 655.3 655.4 655.5 655.6 655.7 655.8 655.9 655.10 655.11 655.12 655.13 655.14 655.15 655.16 655.17 655.18 655.19 655.20 655.21 655.22 655.23 655.24 655.25 655.26 655.27 655.28 655.29 655.30 655.31 655.32 655.33 655.34 655.35 656.1 656.2 656.3 656.4 656.5 656.6 656.7 656.8 656.9 656.10 656.11 656.12 656.13 656.14 656.15 656.16 656.17 656.18 656.19 656.20 656.21 656.22 656.23
656.24 656.25 656.26 656.27 656.28 656.29 656.30 656.31 656.32 656.33 657.1 657.2 657.3 657.4 657.5 657.6 657.7 657.8 657.9 657.10 657.11 657.12 657.13 657.14 657.15 657.16 657.17 657.18 657.19 657.20 657.21 657.22 657.23 657.24 657.25 657.26 657.27 657.28 657.29 657.30 657.31 657.32 657.33 657.34 658.1 658.2 658.3 658.4 658.5 658.6 658.7 658.8 658.9 658.10 658.11 658.12 658.13 658.14 658.15 658.16 658.17 658.18 658.19 658.20 658.21 658.22 658.23 658.24 658.25 658.26 658.27 658.28 658.29 658.30 658.31 658.32 658.33 658.34 658.35 659.1 659.2 659.3 659.4 659.5 659.6 659.7 659.8 659.9 659.10 659.11 659.12 659.13 659.14 659.15 659.16 659.17 659.18 659.19 659.20 659.21 659.22 659.23 659.24 659.25 659.26 659.27 659.28 659.29 659.30 659.31 660.1 660.2 660.3 660.4 660.5 660.6 660.7
660.8 660.9 660.10 660.11 660.12 660.13 660.14 660.15 660.16 660.17 660.18 660.19 660.20 660.21 660.22 660.23 660.24 660.25 660.26 660.27 660.28 660.29 660.30 660.31 660.32 660.33 661.1 661.2 661.3 661.4 661.5 661.6 661.7 661.8 661.9
661.10 661.11 661.12 661.13
661.14 661.15 661.16 661.17 661.18 661.19 661.20 661.21
661.22
661.23 661.24 661.25 661.26 661.27 661.28 661.29 661.30 662.1 662.2 662.3 662.4 662.5 662.6 662.7 662.8 662.9 662.10 662.11 662.12 662.13 662.14 662.15 662.16 662.17 662.18 662.19 662.20 662.21 662.22 662.23 662.24 662.25 662.26 662.27 662.28 662.29 662.30 662.31 662.32 662.33 662.34 662.35 663.1 663.2 663.3 663.4 663.5 663.6 663.7 663.8 663.9 663.10 663.11 663.12 663.13 663.14 663.15 663.16 663.17 663.18 663.19 663.20 663.21 663.22 663.23 663.24 663.25 663.26 663.27 663.28 663.29 663.30 663.31 663.32 663.33 663.34 664.1 664.2 664.3 664.4 664.5 664.6 664.7 664.8 664.9 664.10 664.11 664.12 664.13 664.14 664.15 664.16 664.17 664.18 664.19 664.20 664.21 664.22 664.23 664.24 664.25 664.26 664.27 664.28 664.29 664.30
664.31 664.32 664.33 665.1 665.2 665.3 665.4 665.5 665.6 665.7 665.8 665.9 665.10 665.11 665.12 665.13 665.14 665.15 665.16 665.17 665.18 665.19 665.20 665.21
665.22
665.23 665.24 665.25 665.26 665.27 665.28 665.29 665.30 665.31 665.32 666.1 666.2 666.3 666.4 666.5 666.6 666.7 666.8 666.9 666.10 666.11 666.12 666.13 666.14 666.15 666.16 666.17 666.18 666.19 666.20 666.21
666.22 666.23 666.24 666.25 666.26 666.27 666.28 666.29 666.30 666.31 666.32 667.1 667.2 667.3 667.4 667.5 667.6 667.7 667.8 667.9 667.10 667.11 667.12 667.13 667.14 667.15 667.16 667.17 667.18 667.19 667.20 667.21 667.22 667.23 667.24 667.25 667.26 667.27 667.28 667.29 667.30 667.31 667.32 667.33 667.34 668.1 668.2 668.3 668.4 668.5 668.6 668.7 668.8 668.9 668.10 668.11 668.12 668.13 668.14 668.15 668.16 668.17 668.18 668.19 668.20 668.21 668.22 668.23 668.24 668.25 668.26 668.27 668.28 668.29 668.30 668.31 668.32 668.33 668.34 668.35 669.1 669.2 669.3 669.4 669.5 669.6 669.7 669.8 669.9 669.10 669.11 669.12 669.13 669.14 669.15 669.16 669.17 669.18 669.19 669.20 669.21 669.22 669.23 669.24 669.25 669.26 669.27 669.28 669.29 669.30 669.31 669.32 669.33 669.34 670.1 670.2 670.3 670.4 670.5 670.6 670.7 670.8 670.9 670.10 670.11 670.12 670.13 670.14 670.15 670.16 670.17 670.18 670.19 670.20 670.21 670.22 670.23 670.24 670.25 670.26 670.27 670.28 670.29 670.30 670.31 670.32 670.33 670.34 670.35 671.1 671.2 671.3 671.4 671.5 671.6 671.7 671.8 671.9 671.10 671.11 671.12 671.13 671.14 671.15 671.16 671.17 671.18 671.19 671.20 671.21 671.22 671.23 671.24 671.25 671.26 671.27 671.28 671.29 671.30 671.31 671.32 671.33 671.34 671.35 672.1 672.2 672.3 672.4 672.5 672.6 672.7 672.8 672.9 672.10 672.11 672.12 672.13 672.14 672.15 672.16 672.17 672.18 672.19 672.20 672.21 672.22 672.23 672.24 672.25 672.26 672.27 672.28 672.29 672.30 672.31 672.32 672.33 672.34 672.35 673.1 673.2 673.3 673.4 673.5 673.6 673.7 673.8 673.9 673.10 673.11 673.12 673.13 673.14 673.15 673.16 673.17 673.18 673.19 673.20 673.21 673.22 673.23 673.24 673.25 673.26 673.27 673.28 673.29 673.30 673.31 673.32 673.33 673.34 673.35 674.1 674.2 674.3 674.4 674.5 674.6 674.7 674.8 674.9 674.10 674.11 674.12 674.13 674.14 674.15 674.16 674.17 674.18 674.19 674.20 674.21 674.22 674.23 674.24 674.25 674.26 674.27 674.28 674.29 674.30 674.31 674.32 674.33 675.1 675.2 675.3 675.4 675.5 675.6 675.7 675.8 675.9 675.10 675.11 675.12 675.13 675.14 675.15 675.16 675.17 675.18 675.19 675.20 675.21 675.22 675.23 675.24 675.25 675.26 675.27 675.28 675.29 675.30 675.31 675.32 675.33 675.34 676.1 676.2 676.3 676.4 676.5 676.6 676.7 676.8 676.9 676.10 676.11 676.12 676.13 676.14 676.15 676.16 676.17 676.18 676.19 676.20 676.21 676.22 676.23 676.24 676.25 676.26 676.27 676.28 676.29 676.30 676.31 676.32 676.33 676.34 676.35 677.1 677.2 677.3 677.4 677.5 677.6 677.7 677.8 677.9 677.10 677.11 677.12 677.13 677.14 677.15 677.16 677.17 677.18 677.19 677.20 677.21 677.22 677.23 677.24 677.25 677.26 677.27 677.28 677.29 677.30 677.31 677.32
678.1 678.2 678.3 678.4 678.5 678.6 678.7 678.8 678.9 678.10 678.11 678.12 678.13 678.14 678.15 678.16 678.17 678.18 678.19 678.20 678.21 678.22 678.23 678.24 678.25 678.26 678.27 678.28 678.29 678.30 678.31 678.32 678.33 678.34
679.1 679.2 679.3 679.4 679.5 679.6
679.7 679.8 679.9 679.10 679.11 679.12 679.13 679.14 679.15 679.16 679.17 679.18
679.19 679.20 679.21 679.22 679.23 679.24 679.25 679.26 679.27 679.28 679.29 679.30 679.31 679.32 679.33 680.1 680.2 680.3 680.4 680.5 680.6
680.7 680.8 680.9
680.10 680.11 680.12
680.13 680.14

A bill for an act
relating to state government; establishing the health and human services budget;
modifying provisions governing community supports, housing, continuing care,
health care, health insurance, direct care and treatment, children and families,
chemical and mental health services, Department of Human Services operations,
Health Department, health licensing boards, opiate abuse prevention, managed
care organizations, and child care development block grant compliance; making
technical changes; modifying terminology and definitions; establishing licensing
fix-it tickets; requiring reports; establishing moratorium on conversion transactions;
modifying fees; making forecast adjustments; appropriating money; amending
Minnesota Statutes 2016, sections 3.972, by adding subdivisions; 13.32, by adding
a subdivision; 13.46, subdivisions 1, 2; 13.84, subdivision 5; 62A.04, subdivision
1; 62A.21, subdivision 2a; 62A.3075; 62D.105; 62E.04, subdivision 11; 62E.05,
subdivision 1; 62E.06, by adding a subdivision; 62K.15; 62U.02; 103I.005,
subdivisions 2, 2a, 12, 20a, 21, by adding subdivisions; 103I.101, subdivisions 2,
5, 6; 103I.105; 103I.111, subdivisions 6, 8; 103I.205, subdivisions 1, 2, 3, 4, 5, 6;
103I.208, subdivisions 1, 2; 103I.235, by adding a subdivision; 103I.301,
subdivisions 1, 2; 103I.315, subdivision 1; 103I.501; 103I.505, subdivisions 1, 2;
103I.515; 103I.525, subdivisions 1, 2, 5, 6, 8; 103I.531, subdivisions 2, 5; 103I.535,
subdivisions 2, 6; 103I.541, subdivisions 1, 2, 2a, 2b, 2c, 2e, 3, 4, 5; 103I.545;
103I.601, subdivisions 2, 4; 103I.711, subdivision 1; 103I.715, subdivision 2;
119B.011, subdivisions 20, 20a; 119B.025, subdivision 1, by adding subdivisions;
119B.03, subdivision 3; 119B.05, subdivision 1; 119B.09, subdivisions 1, 4;
119B.10, subdivision 1, by adding a subdivision; 119B.12, subdivision 2; 119B.13,
subdivisions 1, 6; 144.0722, subdivision 1, as amended; 144.0724, subdivisions
4, 6; 144.122; 144.1501, subdivision 2; 144.4961, subdivisions 3, 4, 5; 144.551,
subdivision 1; 144.562, subdivision 2; 144.99, subdivision 1; 144A.071,
subdivisions 3, as amended, 4a, as amended, 4c, as amended, 4d, as amended;
144A.10, subdivision 4, as amended; 144A.351, subdivision 1; 144A.472,
subdivision 7; 144A.4799, subdivision 3; 144A.70, subdivision 6, by adding a
subdivision; 144A.74; 144D.04, subdivision 2, by adding a subdivision; 144D.06;
145.4131, subdivision 1; 145.4716, subdivision 2; 145.928, subdivision 13; 145.986,
subdivision 1a; 146B.02, subdivisions 2, 3, 5, 8, by adding subdivisions; 146B.03,
subdivisions 6, 7, as amended; 146B.07, subdivision 2; 146B.10, subdivisions 1,
2, by adding a subdivision; 147.01, subdivision 7; 147.02, subdivision 1; 147.03,
subdivision 1; 147B.08, by adding a subdivision; 147C.40, by adding a subdivision;
148.514, subdivision 1; 148.519, subdivisions 1, 2; 148.5194, subdivisions 2, 3,
4, 7, by adding a subdivision; 148.5195, subdivision 2; 148.6402, subdivision 4;
148.6405; 148.6408, subdivision 2; 148.6410, subdivision 2; 148.6412, subdivision
2; 148.6415; 148.6418, subdivisions 1, 2, 4, 5; 148.6420, subdivisions 1, 3, 5;
148.6423; 148.6425, subdivisions 2, 3; 148.6428; 148.6443, subdivisions 5, 6, 7,
8; 148.6445, subdivisions 1, 10; 148.6448; 148.881; 148.89; 148.90, subdivisions
1, 2; 148.905, subdivision 1; 148.907, subdivisions 1, 2; 148.9105, subdivisions
1, 4, 5; 148.916, subdivisions 1, 1a; 148.925; 148.96, subdivision 3; 148.997,
subdivision 1; 148B.53, subdivision 1; 150A.06, subdivisions 3, 8; 150A.10,
subdivision 4; 151.212, subdivision 2; 152.11, by adding a subdivision; 152.25,
subdivision 1, by adding subdivisions; 152.28, by adding a subdivision; 152.33,
by adding a subdivision; 153A.14, subdivisions 1, 2; 153A.17; 157.16, subdivisions
1, 3, 3a; 214.01, subdivision 2; 245.462, subdivision 9; 245.467, subdivision 2;
245.4871, by adding subdivisions; 245.4876, subdivision 2; 245.4889, subdivision
1; 245.814, by adding a subdivision; 245.91, subdivisions 4, 6; 245.94, subdivision
1; 245.97, subdivision 6; 245A.02, subdivisions 2b, 5a, by adding subdivisions;
245A.03, subdivisions 2, 7; 245A.04, subdivisions 4, 14; 245A.06, subdivisions
2, 8, by adding a subdivision; 245A.07, subdivision 3; 245A.09, subdivision 7;
245A.10, subdivision 2; 245A.11, by adding subdivisions; 245A.14, by adding a
subdivision; 245A.16, subdivision 1, by adding a subdivision; 245A.191; 245A.40,
by adding a subdivision; 245A.50, subdivision 5; 245C.02, by adding a subdivision;
245C.03, subdivision 1, by adding a subdivision; 245C.04, subdivisions 1, 8;
245C.05, subdivisions 2b, 4, 5, 7; 245C.08, subdivisions 1, 2, 4; 245C.09, by
adding a subdivision; 245C.10, subdivision 9, by adding subdivisions; 245C.11,
subdivision 3; 245C.15; 245C.16, subdivision 1; 245C.17, subdivision 6; 245C.21,
subdivision 1; 245C.22, subdivisions 5, 7; 245C.23; 245C.24, subdivision 3;
245C.25; 245C.30, subdivision 2; 245D.03, subdivision 1; 245D.04, subdivision
3; 246.18, subdivision 4, by adding a subdivision; 252.27, subdivision 2a; 252.41,
subdivision 3; 252.50, subdivision 5; 253B.10, subdivision 1; 254A.01; 254A.02,
subdivisions 2, 3, 5, 6, 8, 10, by adding subdivisions; 254A.03; 254A.035,
subdivision 1; 254A.04; 254A.08; 254A.09; 254A.19, subdivision 3; 254B.01,
subdivision 3, by adding a subdivision; 254B.03, subdivision 2; 254B.04,
subdivisions 1, 2b; 254B.05, subdivisions 1, 1a, 5; 254B.051; 254B.07; 254B.08;
254B.09; 254B.12, subdivision 2, by adding a subdivision; 254B.13, subdivision
2a; 256.01, by adding a subdivision; 256.045, subdivisions 3, 3a; 256.9657,
subdivision 1; 256.9685, subdivisions 1, 1a; 256.9686, subdivision 8; 256.969,
subdivisions 1, 2b, 3a, 8, 8c, 9, 12; 256.9695, subdivision 1; 256.975, subdivision
7, by adding a subdivision; 256B.04, subdivisions 12, 24; 256B.056, subdivisions
3b, 3c, 5c; 256B.0561, subdivisions 2, 4; 256B.057, subdivision 9, as amended;
256B.059, subdivision 6, as amended; 256B.0621, subdivision 10; 256B.0625,
subdivisions 1, 3b, 6a, 7, 17, 17b, 18h, 20, 31, 45a, 64, by adding subdivisions;
256B.0644; 256B.0653, subdivisions 2, 3, 4, as amended, 5, 6, by adding a
subdivision; 256B.072; 256B.0755, subdivisions 1, 3, 4, by adding a subdivision;
256B.0911, subdivisions 1a, 2b, 3a, 4d, as amended, 5, 6, as amended, by adding
a subdivision; 256B.0915, subdivisions 1, 3a, 3e, 3h, 5, by adding subdivisions;
256B.092, subdivision 4; 256B.0921; 256B.0924, by adding a subdivision;
256B.0943, subdivision 13; 256B.0945, subdivisions 2, 4; 256B.196, subdivisions
2, 3, 4; 256B.35, subdivision 4, as amended; 256B.431, subdivisions 10, 16, 30;
256B.434, subdivisions 4, 4f; 256B.49, subdivisions 11, 15; 256B.4913, subdivision
4a, by adding a subdivision; 256B.4914, subdivisions 2, 3, 5, 6, 7, 8, 9, 10, 16, by
adding a subdivision; 256B.493, subdivisions 1, 2, by adding a subdivision;
256B.50, subdivision 1b; 256B.5012, by adding subdivisions; 256B.69, subdivision
9e, by adding subdivisions; 256B.75; 256B.76, subdivisions 1, as amended, 2;
256B.761; 256B.763; 256B.766; 256C.21; 256C.23, subdivisions 1, 2, by adding
subdivisions; 256C.233, subdivisions 1, 2, 4; 256C.24; 256C.25, subdivision 1;
256C.261; 256C.30; 256D.44, subdivisions 4, as amended, 5, as amended; 256E.30,
subdivision 2; 256I.03, subdivision 8; 256I.04, subdivisions 1, 2d, 2g, 3; 256I.05,
subdivisions 1a, 1c, 1e, 1j, 1m, by adding subdivisions; 256I.06, subdivisions 2,
8; 256J.45, subdivision 2; 256L.03, subdivisions 1, 1a, 5; 256L.11, subdivision 7,
by adding a subdivision; 256L.15, subdivision 2; 256P.06, subdivision 2; 256P.07,
subdivisions 3, 6; 256R.02, subdivisions 4, 17, 18, 19, 22, 42, 52, by adding
subdivisions; 256R.06, subdivision 5; 256R.07, by adding a subdivision; 256R.10,
by adding a subdivision; 256R.37; 256R.40, subdivisions 1, 5; 256R.41; 256R.47;
256R.49, subdivision 1; 260C.451, subdivision 6; 327.15, subdivision 3; 364.09;
609.5315, subdivision 5c; 626.556, subdivisions 2, 3, 3c, 4, 10d, 10e, 10f, 10i;
Laws 2009, chapter 101, article 1, section 12; Laws 2012, chapter 247, article 4,
section 47, as amended; article 6, section 2, subdivision 2; Laws 2013, chapter
108, article 15, section 2, subdivision 2; Laws 2015, chapter 71, article 14, section
3, subdivision 2, as amended; Laws 2017, chapter 2, article 1, sections 2,
subdivision 3; 5; 7; Laws 2017, chapter 13, article 1, section 15; proposing coding
for new law in Minnesota Statutes, chapters 103I; 119B; 137; 144; 147A; 148;
245; 245A; 256; 256B; 256I; 256N; 256R; proposing coding for new law as
Minnesota Statutes, chapters 144H; 245G; repealing Minnesota Statutes 2016,
sections 13.468; 103I.005, subdivisions 8, 14, 15; 103I.451; 119B.07; 144.0571;
144A.351, subdivision 2; 147A.21; 147B.08, subdivisions 1, 2, 3; 147C.40,
subdivisions 1, 2, 3, 4; 148.6402, subdivision 2; 148.6450; 148.906; 148.907,
subdivision 5; 148.908; 148.909, subdivision 7; 148.96, subdivisions 4, 5;
245A.1915; 245A.192; 254A.02, subdivision 4; 256B.19, subdivision 1c;
256B.4914, subdivision 16; 256B.64; 256B.7631; Laws 2012, chapter 247, article
4, section 47, as amended; Laws 2015, chapter 71, article 7, section 54; Minnesota
Rules, parts 5600.2500; 9500.1140, subparts 3, 4, 5, 6; 9530.6405, subparts 1, 1a,
2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18,
20, 21; 9530.6410; 9530.6415; 9530.6420; 9530.6422; 9530.6425; 9530.6430;
9530.6435; 9530.6440; 9530.6445; 9530.6450; 9530.6455; 9530.6460; 9530.6465;
9530.6470; 9530.6475; 9530.6480; 9530.6485; 9530.6490; 9530.6495; 9530.6500;
9530.6505.

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

ARTICLE 1

COMMUNITY SUPPORTS

Section 1.

Minnesota Statutes 2016, section 144A.351, subdivision 1, is amended to read:


Subdivision 1.

Report requirements.

The commissioners of health and human services,
with the cooperation of counties and in consultation with stakeholders, including persons
who need or are using long-term care services and supports, lead agencies, regional entities,
senior, disability, and mental health organization representatives, service providers, and
community members shall prepare a report to the legislature by August 15, 2013, and
biennially thereafter, regarding the status of the full range of long-term care services and
supports for the elderly and children and adults with disabilities and mental illnesses in
Minnesota.new text begin Any amounts appropriated for this report are available in either year of the
biennium.
new text end The report shall address:

(1) demographics and need for long-term care services and supports in Minnesota;

(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances,
and corrective action plans;

(3) status of long-term care services and related mental health services, housing options,
and supports by county and region including:

(i) changes in availability of the range of long-term care services and housing options;

(ii) access problems, including access to the least restrictive and most integrated services
and settings, regarding long-term care services; and

(iii) comparative measures of long-term care services availability, including serving
people in their home areas near family, and changes over time; and

(4) recommendations regarding goals for the future of long-term care services and
supports, policy and fiscal changes, and resource development and transition needs.

Sec. 2.

Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

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

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

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

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

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

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

(5) night supervision services as defined under the brain injury waiver plan; deleted text beginand
deleted text end

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

new text begin (7) individual community living support under section 256B.0915, subdivision 3jnew text end.

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

(1) intervention services, including:

(i) behavioral support services as defined under the brain injury and community access
for disability inclusion waiver plans;

(ii) in-home or out-of-home crisis respite services as defined under the developmental
disability waiver plan; and

(iii) specialist services as defined under the current developmental disability waiver
plan;

(2) in-home support services, including:

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

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

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

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

(3) residential supports and services, including:

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

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

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

(4) day services, including:

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin (a) The amendment to paragraphs (b) and (c), clause (2), is
effective the day following final enactment.
new text end

new text begin (b) The amendments to paragraph (c), clauses (5) to (7), are effective upon federal
approval. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2016, section 252.41, subdivision 3, is amended to read:


Subd. 3.

Day training and habilitation services for adults with developmental
disabilities.

new text begin(a) new text end"Day training and habilitation services for adults with developmental
disabilities" means services that:

(1) include supervision, training, assistance, deleted text beginand supported employment,deleted text endnew text begin center-basednew text end
work-related activities, or other community-integrated activities designed and implemented
in accordance with the individual service and individual habilitation plans required under
Minnesota Rules, parts 9525.0004 to 9525.0036, to help an adult reach and maintain the
highest possible level of independence, productivity, and integration into the community;
and

(2) are provided by a vendor licensed under sections 245A.01 to 245A.16 and 252.28,
subdivision 2
, to provide day training and habilitation services.

new text begin (b) new text endDay training and habilitation services reimbursable under this section do not include
special education and related services as defined in the Education of the Individuals with
Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17),
or vocational services funded under section 110 of the Rehabilitation Act of 1973, United
States Code, title 29, section 720, as amended.

new text begin (c) Day training and habilitation services do not include employment exploration,
employment development, or employment support services as defined in the home and
community-based services waivers for people with disabilities authorized under sections
256B.092 and 256B.49.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 4.

new text begin [256.477] SELF-ADVOCACY GRANTS.
new text end

new text begin (a) The commissioner shall make available a grant for the purposes of establishing and
maintaining a statewide self-advocacy network for persons with intellectual and
developmental disabilities. The self-advocacy network shall:
new text end

new text begin (1) ensure that persons with intellectual and developmental disabilities are informed of
their rights in employment, housing, transportation, voting, government policy, and other
issues pertinent to the intellectual and developmental disability community;
new text end

new text begin (2) provide public education and awareness of the civil and human rights issues persons
with intellectual and developmental disabilities face;
new text end

new text begin (3) provide funds, technical assistance, and other resources for self-advocacy groups
across the state; and
new text end

new text begin (4) organize systems of communications to facilitate an exchange of information between
self-advocacy groups.
new text end

new text begin (b) An organization receiving a grant under paragraph (a) must be an organization
governed by people with intellectual and developmental disabilities that administers a
statewide network of disability groups in order to maintain and promote self-advocacy
services and supports for persons with intellectual and developmental disabilities throughout
the state.
new text end

Sec. 5.

Minnesota Statutes 2016, section 256B.0625, subdivision 6a, is amended to read:


Subd. 6a.

Home health services.

Home health services are those services specified in
Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical assistance
covers home health services at a recipient's home residencenew text begin or in the community where
normal life activities take the recipient
new text end. Medical assistance does not cover home health
services for residents of a hospital, nursing facility, or intermediate care facility, unless the
commissioner of human services has authorized skilled nurse visits for less than 90 days
for a resident at an intermediate care facility for persons with developmental disabilities,
to prevent an admission to a hospital or nursing facility or unless a resident who is otherwise
eligible is on leave from the facility and the facility either pays for the home health services
or forgoes the facility per diem for the leave days that home health services are used. Home
health services must be provided by a Medicare certified home health agency. All nursing
and home health aide services must be provided according to sections 256B.0651 to
256B.0653.

Sec. 6.

Minnesota Statutes 2016, 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.

(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.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
locked to prevent use not as an augmentative communication device, a recipient of waiver
services may use an electronic tablet for a use not related to communication when the
recipient has been authorized under the waiver to receive one or more additional applications
that can be loaded onto the electronic tablet, such that allowing the additional use prevents
the purchase of a separate electronic tablet with waiver funds.

new text begin (g) An order or prescription for medical supplies, equipment, or appliances must meet
the requirements in Code of Federal Regulations, title 42, part 440.70.
new text end

Sec. 7.

Minnesota Statutes 2016, section 256B.0653, subdivision 2, is amended to read:


Subd. 2.

Definitions.

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

(a) "Assessment" means an evaluation of the recipient's medical need for home health
agency services by a registered nurse or appropriate therapist that is conducted within 30
days of a request.

(b) "Home care therapies" means occupational, physical, and respiratory therapy and
speech-language pathology services provided in the home by a Medicare certified home
health agency.

(c) "Home health agency services" means services delivered deleted text beginin the recipient's home
residence, except as specified in section 256B.0625,
deleted text end by a home health agency to a recipient
with medical needs due to illness, disability, or physical conditionsnew text begin in settings permitted
under section 256B.0625, subdivision 6a
new text end.

(d) "Home health aide" means an employee of a home health agency who completes
medically oriented tasks written in the plan of care for a recipient.

(e) "Home health agency" means a home care provider agency that is Medicare-certified.

(f) "Occupational therapy services" mean the services defined in Minnesota Rules, part
9505.0390.

(g) "Physical therapy services" mean the services defined in Minnesota Rules, part
9505.0390.

(h) "Respiratory therapy services" mean the services defined in chapter 147C.

(i) "Speech-language pathology services" mean the services defined in Minnesota Rules,
part 9505.0390.

(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks
required due to a recipient's medical condition that can only be safely provided by a
professional nurse to restore and maintain optimal health.

(k) "Store-and-forward technology" means telehomecare services that do not occur in
real time via synchronous transmissions such as diabetic and vital sign monitoring.

(l) "Telehomecare" means the use of telecommunications technology via live, two-way
interactive audiovisual technology which may be augmented by store-and-forward
technology.

(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to deliver
a skilled nurse visit to a recipient located at a site other than the site where the nurse is
located and is used in combination with face-to-face skilled nurse visits to adequately meet
the recipient's needs.

Sec. 8.

Minnesota Statutes 2016, section 256B.0653, subdivision 3, is amended to read:


Subd. 3.

Home health aide visits.

(a) Home health aide visits must be provided by a
certified home health aide using a written plan of care that is updated in compliance with
Medicare regulations. A home health aide shall provide hands-on personal care, perform
simple procedures as an extension of therapy or nursing services, and assist in instrumental
activities of daily living as defined in section 256B.0659, including assuring that the person
gets to medical appointments if identified in the written plan of care. Home health aide
visits deleted text beginmustdeleted text endnew text begin maynew text end be provided in the recipient's homenew text begin or in the community where normal life
activities take the recipient
new text end.

(b) All home health aide visits must have authorization under section 256B.0652. The
commissioner shall limit home health aide visits to no more than one visit per day per
recipient.

(c) Home health aides must be supervised by a registered nurse or an appropriate therapist
when providing services that are an extension of therapy.

Sec. 9.

Minnesota Statutes 2016, section 256B.0653, subdivision 4, as amended by Laws
2017, chapter 59, section 10, is amended to read:


Subd. 4.

Skilled nurse visit services.

(a) Skilled nurse visit services must be provided
by a registered nurse or a licensed practical nurse under the supervision of a registered nurse,
according to the written plan of care and accepted standards of medical and nursing practice
according to chapter 148. Skilled nurse visit services must be ordered by a physician,
advanced practice registered nurse, or physician assistant and documented in a plan of care
that is reviewed and approved by the ordering physician, advanced practice registered nurse,
or physician assistant at least once every 60 days. All skilled nurse visits must be medically
necessary and provided in the recipient's home residence new text beginor in the community where normal
life activities take the recipient,
new text endnew text begin new text endexcept as allowed under section 256B.0625, subdivision
6a
.

(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of up
to two visits per day per recipient. All visits must be based on assessed needs.

(c) Telehomecare skilled nurse visits are allowed when the recipient's health status can
be accurately measured and assessed without a need for a face-to-face, hands-on encounter.
All telehomecare skilled nurse visits must have authorization and are paid at the same
allowable rates as face-to-face skilled nurse visits.

(d) The provision of telehomecare must be made via live, two-way interactive audiovisual
technology and may be augmented by utilizing store-and-forward technologies. Individually
identifiable patient data obtained through real-time or store-and-forward technology must
be maintained as health records according to sections 144.291 to 144.298. If the video is
used for research, training, or other purposes unrelated to the care of the patient, the identity
of the patient must be concealed.

(e) Authorization for skilled nurse visits must be completed under section 256B.0652.
A total of nine face-to-face skilled nurse visits per calendar year do not require authorization.
All telehomecare skilled nurse visits require authorization.

Sec. 10.

Minnesota Statutes 2016, section 256B.0653, subdivision 5, is amended to read:


Subd. 5.

Home care therapies.

(a) Home care therapies include the following: physical
therapy, occupational therapy, respiratory therapy, and speech and language pathology
therapy services.

(b) Home care therapies must be:

(1) provided in the recipient's residencenew text begin or in the community where normal life activities
take the recipient
new text end after it has been determined the recipient is unable to access outpatient
therapy;

(2) prescribed, ordered, or referred by a physician and documented in a plan of care and
reviewed, according to Minnesota Rules, part 9505.0390;

(3) assessed by an appropriate therapist; and

(4) provided by a Medicare-certified home health agency enrolled as a Medicaid provider
agency.

(c) Restorative and specialized maintenance therapies must be provided according to
Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be used
as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.

(d) For both physical and occupational therapies, the therapist and the therapist's assistant
may not both bill for services provided to a recipient on the same day.

Sec. 11.

Minnesota Statutes 2016, section 256B.0653, subdivision 6, is amended to read:


Subd. 6.

Noncovered home health agency services.

The following are not eligible for
payment under medical assistance as a home health agency service:

(1) telehomecare skilled nurses services that is communication between the home care
nurse and recipient that consists solely of a telephone conversation, facsimile, electronic
mail, or a consultation between two health care practitioners;

(2) the following skilled nurse visits:

(i) for the purpose of monitoring medication compliance with an established medication
program for a recipient;

(ii) administering or assisting with medication administration, including injections,
prefilling syringes for injections, or oral medication setup of an adult recipient, when, as
determined and documented by the registered nurse, the need can be met by an available
pharmacy or the recipient or a family member is physically and mentally able to
self-administer or prefill a medication;

(iii) services done for the sole purpose of supervision of the home health aide or personal
care assistant;

(iv) services done for the sole purpose to train other home health agency workers;

(v) services done for the sole purpose of blood samples or lab draw when the recipient
is able to access these services outside the home; and

(vi) Medicare evaluation or administrative nursing visits required by Medicare;

(3) home health aide visits when the following activities are the sole purpose for the
visit: companionship, socialization, household tasks, transportation, and education; deleted text beginand
deleted text end

(4) home care therapies provided in other settings such as a clinicdeleted text begin, day program,deleted text end or as
an inpatient or when the recipient can access therapy outside of the recipient's residencenew text begin;
and
new text end

new text begin (5) home health agency services without qualifying documentation of a face-to-face
encounter as specified in subdivision 7
new text end.

Sec. 12.

Minnesota Statutes 2016, section 256B.0653, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Face-to-face encounter. new text end

new text begin (a) A face-to-face encounter by a qualifying provider
must be completed for all home health services regardless of the need for prior authorization,
except when providing a onetime perinatal visit by skilled nursing. The face-to-face encounter
may occur through telemedicine as defined in section 256B.0625, subdivision 3b. The
encounter must be related to the primary reason the recipient requires home health services
and must occur within the 90 days before or the 30 days after the start of services. The
face-to-face encounter may be conducted by one of the following practitioners, licensed in
Minnesota:
new text end

new text begin (1) a physician;
new text end

new text begin (2) a nurse practitioner or clinical nurse specialist;
new text end

new text begin (3) a certified nurse midwife; or
new text end

new text begin (4) a physician assistant.
new text end

new text begin (b) The allowed nonphysician practitioner, as described in this subdivision, performing
the face-to-face encounter must communicate the clinical findings of that face-to-face
encounter to the ordering physician. Those clinical findings must be incorporated into a
written or electronic document included in the recipient's medical record. To assure clinical
correlation between the face-to-face encounter and the associated home health services, the
physician responsible for ordering the services must:
new text end

new text begin (1) document that the face-to-face encounter, which is related to the primary reason the
recipient requires home health services, occurred within the required time period; and
new text end

new text begin (2) indicate the practitioner who conducted the encounter and the date of the encounter.
new text end

new text begin (c) For home health services requiring authorization, including prior authorization, home
health agencies must retain the qualifying documentation of a face-to-face encounter as part
of the recipient health service record, and submit the qualifying documentation to the
commissioner or the commissioner's designee upon request.
new text end

Sec. 13.

Minnesota Statutes 2016, section 256B.0911, subdivision 1a, is amended to read:


Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

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

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

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

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

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

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

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

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

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

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

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

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

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

(ii) consumer support grants under section 256.476; or

(iii) section 256B.85;

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

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

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

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

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

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

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

Sec. 14.

Minnesota Statutes 2016, section 256B.0911, subdivision 2b, is amended to read:


Subd. 2b.

MnCHOICES certified assessors.

(a) Each lead agency shall use certified
assessors who have completed MnCHOICES training and the certification processes
determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate
best practices in assessment and support planning including person-centered planning
deleted text begin principalsdeleted text endnew text begin principlesnew text end and have a common set of skills that must ensure consistency and
equitable access to services statewide. A lead agency may choose, according to departmental
policies, to contract with a qualified, certified assessor to conduct assessments and
reassessments on behalf of the lead agency.new text begin Certified assessors must use person-centered
planning principles to conduct an interview that identifies what is important to the person,
the person's needs for supports, health and safety concerns, and the person's abilities, interests,
and goals.
new text end

new text begin Certified assessors are responsible for:
new text end

new text begin (1) ensuring persons are offered objective, unbiased access to resources;
new text end

new text begin (2) ensuring persons have the needed information to support informed choice, including
where and how they choose to live and the opportunity to pursue desired employment;
new text end

new text begin (3) determining level of care and eligibility for long-term services and supports;
new text end

new text begin (4) using the information gathered from the interview to develop a person-centered
community support plan that reflects identified needs and support options within the context
of values, interests, and goals important to the person; and
new text end

new text begin (5) providing the person with a community support plan that summarizes the person's
assessment findings, support options, and agreed-upon next steps.
new text end

(b) MnCHOICES certified assessors are persons with a minimum of a bachelor's degree
in social work, nursing with a public health nursing certificate, or other closely related field
with at least one year of home and community-based experience, or a registered nurse with
at least two years of home and community-based experience who has received training and
certification specific to assessment and consultation for long-term care services in the state.

Sec. 15.

Minnesota Statutes 2016, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 3f. new text end

new text begin Long-term care reassessments and community support plan updates.
new text end

new text begin Reassessments must be tailored using the professional judgment of the assessor to the
person's known needs, strengths, preferences, and circumstances. Reassessments provide
information to support the person's informed choice and opportunities to express choice
regarding activities that contribute to quality of life, as well as information and opportunity
to identify goals related to desired employment, community activities, and preferred living
environment. Reassessments allow for a review of the current support plan's effectiveness,
monitoring of services, and the development of an updated person-centered community
support plan. Reassessments verify continued eligibility or offer alternatives as warranted
and provide an opportunity for quality assurance of service delivery. Face-to-face assessments
must be conducted annually or as required by federal and state laws and rules.
new text end

Sec. 16.

Minnesota Statutes 2016, section 256B.0911, subdivision 4d, as amended by
Laws 2017, chapter 40, article 1, section 69, is amended to read:


Subd. 4d.

Preadmission screening of individuals under 65 years of age.

(a) It is the
policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness
are served in the most integrated setting appropriate to their needs and have the necessary
information to make informed choices about home and community-based service options.

(b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing
facility must be screened prior to admission according to the requirements outlined in section
256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as
required under section 256.975, subdivision 7.

(c) Individuals under 65 years of age who are admitted to nursing facilities with only a
telephone screening must receive a face-to-face assessment from the long-term care
consultation team member of the county in which the facility is located or from the recipient's
county case manager within deleted text begin40 calendar days of admissiondeleted text endnew text begin the timeline established by the
commissioner, based on review of data
new text end.

(d) At the face-to-face assessment, the long-term care consultation team member or
county case manager must perform the activities required under subdivision 3b.

(e) For individuals under 21 years of age, a screening interview which recommends
nursing facility admission must be face-to-face and approved by the commissioner before
the individual is admitted to the nursing facility.

(f) In the event that an individual under 65 years of age is admitted to a nursing facility
on an emergency basis, the Senior LinkAge Line must be notified of the admission on the
next working day, and a face-to-face assessment as described in paragraph (c) must be
conducted within deleted text begin40 calendar days of admissiondeleted text endnew text begin the timeline established by the commissioner,
based on review of data
new text end.

(g) At the face-to-face assessment, the long-term care consultation team member or the
case manager must present information about home and community-based options, including
consumer-directed options, so the individual can make informed choices. If the individual
chooses home and community-based services, the long-term care consultation team member
or case manager must complete a written relocation plan within 20 working days of the
visit. The plan shall describe the services needed to move out of the facility and a time line
for the move which is designed to ensure a smooth transition to the individual's home and
community.

(h) An individual under 65 years of age residing in a nursing facility shall receive a
face-to-face assessment at least every 12 months to review the person's service choices and
available alternatives unless the individual indicates, in writing, that annual visits are not
desired. In this case, the individual must receive a face-to-face assessment at least once
every 36 months for the same purposes.

(i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county
agencies directly for face-to-face assessments for individuals under 65 years of age who
are being considered for placement or residing in a nursing facility.

(j) Funding for preadmission screening follow-up shall be provided to the Disability
Linkage Line for the under-60 population by the Department of Human Services to cover
options counseling salaries and expenses to provide the services described in subdivisions
7a to 7c. The Disability Linkage Line shall employ, or contract with other agencies to
employ, within the limits of available funding, sufficient personnel to provide preadmission
screening follow-up services and shall seek to maximize federal funding for the service as
provided under section 256.01, subdivision 2, paragraph (aa).

Sec. 17.

Minnesota Statutes 2016, section 256B.0911, subdivision 5, is amended to read:


Subd. 5.

Administrative activity.

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

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

Sec. 18.

Minnesota Statutes 2016, section 256B.0911, subdivision 6, as amended by Laws
2017, chapter 40, article 1, section 70, is amended to read:


Subd. 6.

Payment for long-term care consultation services.

(a) Until September 30,
2013, payment for long-term care consultation face-to-face assessment shall be made as
described in this subdivision.

(b) The total payment for each county must be paid monthly by certified nursing facilities
in the county. The monthly amount to be paid by each nursing facility for each fiscal year
must be determined by dividing the county's annual allocation for long-term care consultation
services by 12 to determine the monthly payment and allocating the monthly payment to
each nursing facility based on the number of licensed beds in the nursing facility. Payments
to counties in which there is no certified nursing facility must be made by increasing the
payment rate of the two facilities located nearest to the county seat.

(c) The commissioner shall include the total annual payment determined under paragraph
(b) for each nursing facility reimbursed under section 256B.431, 256B.434, or chapter 256R.

(d) In the event of the layaway, delicensure and decertification, or removal from layaway
of 25 percent or more of the beds in a facility, the commissioner may adjust the per diem
payment amount in paragraph (c) and may adjust the monthly payment amount in paragraph
(b). The effective date of an adjustment made under this paragraph shall be on or after the
first day of the month following the effective date of the layaway, delicensure and
decertification, or removal from layaway.

(e) Payments for long-term care consultation services are available to the county or
counties to cover staff salaries and expenses to provide the services described in subdivision
1a. The county shall employ, or contract with other agencies to employ, within the limits
of available funding, sufficient personnel to provide long-term care consultation services
while meeting the state's long-term care outcomes and objectives as defined in subdivision
1. The county shall be accountable for meeting local objectives as approved by the
commissioner in the biennial home and community-based services quality assurance plan
on a form provided by the commissioner.

(f) Notwithstanding section 256B.0641, overpayments attributable to payment of the
screening costs under the medical assistance program may not be recovered from a facility.

(g) The commissioner of human services shall amend the Minnesota medical assistance
plan to include reimbursement for the local consultation teams.

(h) Until the alternative payment methodology in paragraph (i) is implemented, the
county may bill, as case management services, assessments, support planning, and
follow-along provided to persons determined to be eligible for case management under
Minnesota health care programs. No individual or family member shall be charged for an
initial assessment or initial support plan development provided under subdivision 3a or 3b.

(i) The commissioner shall develop an alternative payment methodology, effective on
October 1, 2013, for long-term care consultation services that includes the funding available
under this subdivision, and for assessments authorized under sections 256B.092 and
256B.0659. In developing the new payment methodology, the commissioner shall consider
the maximization of other funding sources, including federal administrative reimbursement
through federal financial participation funding, for all long-term care consultation activity.
The alternative payment methodology shall include the use of the appropriate time studies
and the state financing of nonfederal share as part of the state's medical assistance program.new text begin
Between July 1, 2017, and June 30, 2019, the state shall pay 84.3 percent of the nonfederal
share as reimbursement to the counties. Beginning July 1, 2019, the state shall pay 81.9
percent of the nonfederal share as reimbursement to the counties.
new text end

Sec. 19.

Minnesota Statutes 2016, section 256B.0921, is amended to read:


256B.0921 HOME AND COMMUNITY-BASED SERVICES INCENTIVE POOL.

The commissioner of human services shall develop an initiative to provide incentives
for innovation innew text begin: (1)new text end achieving integrated competitive employmentdeleted text begin,deleted text endnew text begin; (2) achieving integrated
competitive employment for youth under age 25 upon their graduation from school; (3)
new text end
living in the most integrated settingdeleted text begin,deleted text endnew text begin;new text end and new text begin(4) new text endother 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. deleted text beginThe initial requests
for proposals must be issued by October 1, 2016.
deleted text end

Sec. 20.

Minnesota Statutes 2016, 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 new text beginweighted
average
new text endauthorized rate for the provider new text beginnumber new text endin 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) 0.5 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);

(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); deleted text beginand
deleted text end

(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 begin; and
new text end

new text begin (7) one percent from the rate in effect in clause (6) for the 12-month period immediately
following the time period of clause (6)
new 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.

new text begin EFFECTIVE DATE. new text end

new text begin (a) The amendment to paragraph (b) is effective the day following
final enactment.
new text end

new text begin (b) The amendment to paragraph (c) is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 21.

Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin New services. new text end

new text begin A service added to section 256B.4914 after January 1, 2014, is
not subject to rate stabilization adjustment in this section.
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. 22.

Minnesota Statutes 2016, 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 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; and an assessment tool. Provider observation of an individual's
needs must also be considered.

(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 9deleted text begin:
deleted text end

deleted text begin (i) for respite servicesdeleted text end, a unit of service is deleted text begina day ordeleted text end 15 minutes. deleted text beginWhen a day rate is
authorized, any portion of a calendar day when an individual receives services is billable
as a day; and
deleted text end

deleted text begin (ii) for all other services, a unit of service is 15 minutes.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 23.

Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:


Subd. 3.

Applicable services.

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

(1) 24-hour customized living;

(2) adult day care;

(3) adult day care bath;

(4) behavioral programming;

(5) companion services;

(6) customized living;

(7) day training and habilitation;

(8) housing access coordination;

(9) independent living skills;

(10) in-home family support;

(11) night supervision;

(12) personal support;

(13) prevocational services;

(14) residential care services;

(15) residential support services;

(16) respite services;

(17) structured day services;

(18) supported employment services;

(19) supported living services;

(20) transportation services; deleted text beginand
deleted text end

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

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

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

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

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

deleted text begin (21)deleted text endnew text begin (26)new text end other services as approved by the federal government in the state home and
community-based services plan.

new text begin EFFECTIVE DATE. new text end

new text begin (a) Clause (21) is effective the day following final enactment.
new text end

new text begin (b) Clauses (22) to (25) are effective upon federal approval. The commissioner of human
services shall notify the revisor of statutes when federal approval is obtained.
new text end

new text begin (c) Clause (18) expires upon federal approval. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 24.

Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:


Subd. 5.

Base wage index and standard component values.

(a) The base wage index
is established to determine staffing costs associated with providing services to individuals
receiving home and community-based services. For purposes of developing and calculating
the proposed base wage, Minnesota-specific wages taken from job descriptions and standard
occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in
the most recent edition of the Occupational Handbook must be used. The base wage index
must be calculated as follows:

(1) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home
health aide (SOC code 39-9021); 30 percent of the median wage for nursing deleted text beginaidedeleted text endnew text begin assistantnew text end
(SOC code deleted text begin31-1012deleted text endnew text begin 31-1014new text end); and 20 percent of the median wage for social and human
services aide (SOC code 21-1093); and

(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 20 percent of the median wage for nursing deleted text beginaidedeleted text endnew text begin assistantnew text end (SOC code
deleted text begin 31-1012deleted text endnew text begin 31-1014new text end); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093);

(2) for day services, 20 percent of the median wage for nursing deleted text beginaidedeleted text endnew text begin assistantnew text end (SOC code
deleted text begin 31-1012deleted text endnew text begin 31-1014new text end); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code
21-1093);

(3) for residential asleep-overnight staff, the wage deleted text beginwill be $7.66 per hourdeleted text endnew text begin is the minimum
wage in Minnesota for large employers
new text end, except in a family foster care setting, the wage is
deleted text begin $2.80 per hourdeleted text endnew text begin 36 percent of the minimum wage in Minnesota for large employersnew text end;

(4) for behavior program analyst staff, 100 percent of the median wage for mental health
counselors (SOC code 21-1014);

(5) for behavior program professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(7) for supportive living services staff, 20 percent of the median wage for nursing deleted text beginaidedeleted text endnew text begin
assistant
new text end (SOC code deleted text begin31-1012deleted text endnew text begin 31-1014new text end); 20 percent of the median wage for psychiatric
technician (SOC code 29-2053); and 60 percent of the median wage for social and human
services aide (SOC code 21-1093);

(8) for housing access coordination staff, deleted text begin50deleted text endnew text begin 100new text end percent of the median wage for
community and social services specialist (SOC code 21-1099);deleted text begin and 50 percent of the median
wage for social and human services aide (SOC code 21-1093);
deleted text end

(9) for in-home family support staff, 20 percent of the median wage for nursing aide
(SOC code 31-1012); 30 percent of the median wage for community social service specialist
(SOC code 21-1099); 40 percent of the median wage for social and human services aide
(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC
code 29-2053);

(10) new text beginfor individualized home supports services staff, 40 percent of the median wage for
community social service specialist (SOC code 21-1099); 50 percent of the median wage
for social and human services aide (SOC code 21-1093); and ten percent of the median
wage for psychiatric technician (SOC code 29-2053);
new text end

new text begin (11) new text endfor independent living skills staff, 40 percent of the median wage for community
social service specialist (SOC code 21-1099); 50 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

new text begin (12) for independent living skills specialist staff, 100 percent of mental health and
substance abuse social worker (SOC code 21-1023);
new text end

deleted text begin (11)deleted text endnew text begin (13) new text end for supported employment staff, 20 percent of the median wage for nursing
deleted text begin aidedeleted text endnew text begin assistantnew text end (SOC code deleted text begin31-1012deleted text endnew text begin 31-1014new text end); 20 percent of the median wage for psychiatric
technician (SOC code 29-2053); and 60 percent of the median wage for social and human
services aide (SOC code 21-1093);

new text begin (14) for employment support services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);
new text end

new text begin (15) for employment exploration services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);
new text end

new text begin (16) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);
new text end

deleted text begin (12)deleted text endnew text begin (17)new text end for adult companion staff, 50 percent of the median wage for personal and
home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing deleted text beginaides,
orderlies, and attendants
deleted text endnew text begin assistantnew text end (SOC code deleted text begin31-1012deleted text endnew text begin 31-1014new text end);

deleted text begin (13)deleted text endnew text begin (18)new text end for night supervision staff, 20 percent of the median wage for home health
aide (SOC code 31-1011); 20 percent of the median wage for personal and home health
aide (SOC code 39-9021); 20 percent of the median wage for nursing deleted text beginaidedeleted text endnew text begin assistantnew text end (SOC
code deleted text begin31-1012deleted text endnew text begin 31-1014new text end); 20 percent of the median wage for psychiatric technician (SOC
code 29-2053); and 20 percent of the median wage for social and human services aide (SOC
code 21-1093);

deleted text begin (14)deleted text endnew text begin (19)new text end for respite staff, 50 percent of the median wage for personal and home care
aide (SOC code 39-9021); and 50 percent of the median wage for nursing deleted text beginaides, orderlies,
and attendants
deleted text endnew text begin assistantnew text end (SOC code deleted text begin31-1012deleted text endnew text begin 31-1014new text end);

deleted text begin (15)deleted text endnew text begin (20)new text end for personal support staff, 50 percent of the median wage for personal and
home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing deleted text beginaides,
orderlies, and attendants
deleted text endnew text begin assistantnew text end (SOC code deleted text begin31-1012deleted text endnew text begin 31-1014new text end);

deleted text begin (16)deleted text endnew text begin (21)new text end for supervisory staff, deleted text beginthe basic wage is $17.43 per hourdeleted text endnew text begin, 100 percent of the
median wage for community and social services specialist (SOC code 21-1099),
new text end with new text beginthe
new text end exception of the supervisor of behavior new text beginprofessional, behavior new text endanalystnew text begin,new text end and behavior
specialists, which deleted text beginmust be $30.75 per hourdeleted text endnew text begin is 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031)
new text end;

deleted text begin (17)deleted text endnew text begin (22)new text end for registered nursenew text begin staffnew text end, deleted text beginthe basic wage is $30.82 per hourdeleted text endnew text begin, 100 percent of
the median wage for registered nurses (SOC code 29-1141)
new text end; and

deleted text begin (18)deleted text endnew text begin (23)new text end for licensed practical nursenew text begin staffnew text end, deleted text beginthe basic wage is $18.64 per hourdeleted text endnew text begin 100 percent
of the median wage for licensed practical nurses (SOC code 29-2061)
new text end.

(b) Component values for residential support services are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) general administrative support ratio: 13.25 percent;

(5) program-related expense ratio: 1.3 percent; and

(6) absence and utilization factor ratio: 3.9 percent.

(c) Component values for family foster care are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) general administrative support ratio: 3.3 percent;

(5) program-related expense ratio: 1.3 percent; and

(6) absence factor: 1.7 percent.

(d) Component values for day services for all services are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) program plan support ratio: 5.6 percent;

(5) client programming and support ratio: ten percent;

(6) general administrative support ratio: 13.25 percent;

(7) program-related expense ratio: 1.8 percent; and

(8) absence and utilization factor ratio: deleted text begin3.9deleted text end new text begin9.4new text end percent.

(e) Component values for unit-based services with programming are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) program plan supports ratio: deleted text begin3.1deleted text endnew text begin 15.5new text end percent;

(5) client programming and supports ratio: deleted text begin8.6deleted text endnew text begin 4.7new text end percent;

(6) general administrative support ratio: 13.25 percent;

(7) program-related expense ratio: 6.1 percent; and

(8) absence and utilization factor ratio: 3.9 percent.

(f) Component values for unit-based services without programming except respite are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) program plan support ratio: deleted text begin3.1deleted text endnew text begin 7.0new text end percent;

(5) client programming and support ratio: deleted text begin8.6deleted text endnew text begin 2.3new text end percent;

(6) general administrative support ratio: 13.25 percent;

(7) program-related expense ratio: deleted text begin6.1deleted text endnew text begin 2.9new text end percent; and

(8) absence and utilization factor ratio: 3.9 percent.

(g) Component values for unit-based services without programming for respite are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) general administrative support ratio: 13.25 percent;

(5) program-related expense ratio: deleted text begin6.1deleted text endnew text begin 2.9new text end percent; and

(6) absence and utilization factor ratio: 3.9 percent.

(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor
Statistics available on December 31, 2016. The commissioner shall publish these updated
values and load them into the rate management system. deleted text beginThis adjustment occurs every five
years. For adjustments in 2021 and beyond, the commissioner shall use the data available
on December 31 of the calendar year five years prior.
deleted text end new text beginOn July 1, 2022, and every five years
thereafter, the commissioner shall update the base wage index in paragraph (a) based on
the most recently available wage data by SOC from the Bureau of Labor Statistics. The
commissioner shall publish these updated values and load them into the rate management
system.
new text end

(i) On July 1, 2017, the commissioner shall update the framework components in
deleted text begin paragraphs (b) to (g)deleted text endnew text begin paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f),
clause (5)
new text end; subdivision 6, clauses (8) and (9); and subdivision 7, clauses new text begin(10), new text end(16)new text begin,new text end and (17),
for changes in the Consumer Price Index. The commissioner will adjust these values higher
or lower by the percentage change in the Consumer Price Index-All Items, United States
city average (CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall
publish these updated values and load them into the rate management system. deleted text beginThis adjustment
occurs every five years. For adjustments in 2021 and beyond, the commissioner shall use
the data available on January 1 of the calendar year four years prior and January 1 of the
current calendar year.
deleted text endnew text begin On July 1, 2022, and every five years thereafter, the commissioner
shall update the framework components in paragraph (d), clause (5); paragraph (e), clause
(5); and paragraph (f), clause (5); subdivision 6, clauses (8) and (9); and subdivision 7,
clauses (10), (16), and (17), for changes in the Consumer Price Index. The commissioner
shall adjust these values higher or lower by the percentage change in the CPI-U from the
date of the previous update to the date of the data most recently available prior to the
scheduled update. The commissioner shall publish these updated values and load them into
the rate management system.
new text end

new text begin (j) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer
Price Index items are unavailable in the future, the commissioner shall recommend to the
legislature codes or items to update and replace missing component values.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) The amendments to paragraphs (a) to (g) are effective January
1, 2018, except the amendment to paragraph (a), clauses (3), (21), and (22), and paragraph
(d), clause (8), which are effective January 1, 2019, and the amendment to paragraph (a),
clause (10), which is effective the day following final enactment.
new text end

new text begin (b) The amendments to paragraphs (h) to (j) are effective the day following final
enactment.
new text end

new text begin (c) Paragraph (a), clause (13), expires upon federal approval. The commissioner of
human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 25.

Minnesota Statutes 2016, 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 deleted text begin(16)deleted text endnew text begin (21)new text end;

(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.

(d) 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.

(e) 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. 26.

Minnesota Statutes 2016, section 256B.4914, subdivision 7, is amended to read:


Subd. 7.

Payments for day programs.

Payments for services with day programs
including adult day care, day treatment and habilitation, prevocational services, and structured
day services must be calculated as follows:

(1) determine the number of units of service and staffing ratio to meet a recipient's needs:

(i) the staffing ratios for the units of service provided to a recipient in a typical week
must be averaged to determine an individual's staffing ratio; and

(ii) the commissioner, in consultation with service providers, shall develop a uniform
staffing ratio worksheet to be used to determine staffing ratios under this subdivision;

(2) personnel hourly wage rates 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 day program direct staff hours and nursing hours by the
appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;

(5) multiply the number of day direct staff hours by the product of the supervision span
of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause deleted text begin(16)deleted text endnew text begin (21)new text end;

(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 (d), 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 support ratio in subdivision 5, paragraph (d), 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 (d), clause (3);

(9) for client programming and supports, multiply the result of clause (8) by one plus
the client programming and support ratio in subdivision 5, paragraph (d), clause (5);

(10) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs;

(11) for adult day bath services, add $7.01 per 15 minute unit;

(12) this is the subtotal rate;

(13) sum the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization factor ratio;

(14) divide the result of clause (12) by one minus the result of clause (13). This is the
total payment amount;

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services;

(16) for transportation provided as part of day training and habilitation for an individual
who does not require a lift, add:

(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without
a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a
vehicle with a lift;

(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without
a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a
vehicle with a lift;

(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without
a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a
vehicle with a lift; or

(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift,
$16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle
with a lift;

(17) for transportation provided as part of day training and habilitation for an individual
who does require a lift, add:

(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a
lift, and $15.05 for a shared ride in a vehicle with a lift;

(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a
lift, and $28.16 for a shared ride in a vehicle with a lift;

(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a
lift, and $58.76 for a shared ride in a vehicle with a lift; or

(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift,
and $80.93 for a shared ride in a vehicle with a lift.

Sec. 27.

Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:


Subd. 8.

Payments for unit-based services with programming.

Payments for unit-based
services with programming, including behavior programming, housing access coordination,
in-home family support, independent living skills training, new text beginindependent living skills specialist
services, individualized home supports,
new text endhourly supported living services, new text beginemployment
exploration services, employment development services, supported employment,
new text endand
deleted text begin supporteddeleted text end employment new text beginsupport services new text endprovided 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 deleted text begin(16)deleted text endnew text begin (21)new text end;

(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. new text beginFor
employment support services provided in a shared manner, divide the total payment amount
in clause (12) by the number of service recipients, not to exceed six.
new text endFor independent living
skills training new text beginand individualized home supports new text endprovided 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
Supported employment services in this subdivision expire upon federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 28.

Minnesota Statutes 2016, section 256B.4914, subdivision 9, is amended to read:


Subd. 9.

Payments for unit-based services without programming.

Payments for
unit-based services without programming, including night supervision, personal support,
respite, and companion care 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) for all services except respite, determine the number of units of service to meet a
recipient's needs;

(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rate 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 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 (f), clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause deleted text begin(16)deleted text endnew text begin (21)new text end;

(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 (f), 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 support ratio in subdivision 5, paragraph (f), 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 (f), clause (3);

(9) for client programming and supports, multiply the result of clause (8) by one plus
the client programming and support ratio in subdivision 5, paragraph (f), 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 respite services, determine the number of day units of service to meet an
individual's needs;

(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;

(15) for a recipient requiring deaf and hard-of-hearing customization under subdivision
12, add the customization rate provided in subdivision 12 to the result of clause (14). This
is defined as the customized direct care rate;

(16) multiply the number of direct staff hours by the appropriate staff wage in subdivision
5, paragraph (a);

(17) multiply the number of direct staff hours by the product of the supervisory span of
control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause deleted text begin(16)deleted text endnew text begin (21)new text end;

(18) combine the results of clauses (16) and (17), and multiply the result by one plus
the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g),
clause (2). This is defined as the direct staffing rate;

(19) for employee-related expenses, multiply the result of clause (18) by one plus the
employee-related cost ratio in subdivision 5, paragraph (g), clause (3);

(20) this is the subtotal rate;

(21) sum the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization factor ratio;

(22) divide the result of clause (20) by one minus the result of clause (21). This is the
total payment amount; and

(23) adjust the result of clauses (12) and (22) by a factor to be determined by the
commissioner to adjust for regional differences in the cost of providing services.

Sec. 29.

Minnesota Statutes 2016, 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 under sections
245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided
by a license holder certified under section 245D.33.

(c) new text beginBeginning January 1, 2014, through December 31, 2018, new text endusing 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, 2014new text begin, and the final report
shall be issued by December 31, 2018
new text end.

(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 deleted text beginfor day servicesdeleted text end;

deleted text begin (2) values for transportation rates in residential services;
deleted text end

deleted text begin (3)deleted text endnew text begin (2)new text end values for services where monitoring technology replaces staff time;

deleted text begin (4)deleted text endnew text begin (3)new text end values for indirect services;

deleted text begin (5)deleted text endnew text begin (4)new text end values for nursing;

deleted text begin (6) component values for independent living skills;
deleted text end

deleted text begin (7) component values for family foster care that reflect licensing requirements;
deleted text end

deleted text begin (8) adjustments to other components to replace the budget neutrality factor;
deleted text end

deleted text begin (9) remote monitoring technology for nonresidential services;
deleted text end

deleted text begin (10) values for basic and intensive services in residential services;
deleted text end

deleted text begin (11)deleted text endnew text begin (5)new text end values for the facility use rate in day services, and the weightings used in the
day service ratios and adjustments to those weightings;

deleted text begin (12)deleted text endnew text begin (6)new text end values for workers' compensation as part of employee-related expenses;

deleted text begin (13)deleted text endnew text begin (7)new text end values for unemployment insurance as part of employee-related expenses;

deleted text begin (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
deleted text end

deleted text begin (15)deleted text endnew text begin (8)new text end any changes in state or federal law with deleted text beginandeleted text endnew text begin a directnew text end impact on the underlying
cost of providing home and community-based servicesdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (9) outcome measures, determined by the commissioner, for home and community-based
services rates determined under this section.
new text end

(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, deleted text begin2019deleted text endnew text begin 2020new text end, with another full report, and a full report once every four
years thereafter.

deleted text begin (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.
deleted text end

deleted text begin (g)deleted text endnew text begin (f)new text end The commissioner shall implement a regional adjustment factor to all rate
calculations in subdivisions 6 to 9, effective no later than January 1, 2015. new text beginBeginning July
1, 2017, the commissioner shall renew analysis and implement changes to the regional
adjustment factors when adjustments required under subdivision 5, paragraph (h), occur.
new text end Prior to implementation, the commissioner shall consult with stakeholders on the
methodology to calculate the adjustment.

deleted text begin (h)deleted text endnew text begin (g)new text end 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.

deleted 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.
deleted text end

deleted text begin (j)deleted text endnew text begin (h)new text end 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 begin (i) The commissioner shall study the underlying cost of absence and utilization for day
services. Based on the commissioner's evaluation of the data collected under this paragraph,
the commissioner shall make recommendations to the legislature by January 15, 2018, for
changes, if any, to the absence and utilization factor ratio component value for day services.
new text end

new text begin (j) Beginning July 1, 2017, the commissioner shall collect transportation and trip
information for all day services through the rates management system.
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. 30.

Minnesota Statutes 2016, section 256B.4914, is amended by adding a subdivision
to read:


new text begin Subd. 10a. new text end

new text begin Reporting and analysis of cost data. new text end

new text begin (a) The commissioner must ensure
that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the
service. As determined by the commissioner, in consultation with stakeholders identified
in section 256B.4913, subdivision 5, a provider enrolled to provide services with rates
determined under this section must submit requested cost data to the commissioner to support
research on the cost of providing services that have rates determined by the disability waiver
rates system. Requested cost data may include, but is not limited to:
new text end

new text begin (1) worker wage costs;
new text end

new text begin (2) benefits paid;
new text end

new text begin (3) supervisor wage costs;
new text end

new text begin (4) executive wage costs;
new text end

new text begin (5) vacation, sick, and training time paid;
new text end

new text begin (6) taxes, workers' compensation, and unemployment insurance costs paid;
new text end

new text begin (7) administrative costs paid;
new text end

new text begin (8) program costs paid;
new text end

new text begin (9) transportation costs paid;
new text end

new text begin (10) vacancy rates; and
new text end

new text begin (11) other data relating to costs required to provide services requested by the
commissioner.
new text end

new text begin (b) At least once in any five-year period, a provider must submit cost data for a fiscal
year that ended not more than 18 months prior to the submission date. The commissioner
shall provide each provider a 90-day notice prior to its submission due date. If a provider
fails to submit required reporting data, the commissioner shall provide notice to providers
that have not provided required data 30 days after the required submission date, and a second
notice for providers who have not provided required data 60 days after the required
submission date. The commissioner shall temporarily suspend payments to the provider if
cost data is not received 90 days after the required submission date. Withheld payments
shall be made once data is received by the commissioner.
new text end

new text begin (c) The commissioner shall conduct a random validation of data submitted under
paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation
in paragraph (a) and provide recommendations for adjustments to cost components.
new text end

new text begin (d) The commissioner shall analyze cost documentation in paragraph (a) and, in
consultation with stakeholders identified in section 256B.4913, subdivision 5, may submit
recommendations on component values and inflationary factor adjustments to the chairs
and ranking minority members of the legislative committees with jurisdiction over human
services every four years beginning January 1, 2020. The commissioner shall make
recommendations in conjunction with reports submitted to the legislature according to
subdivision 10, paragraph (e). The commissioner shall release cost data in an aggregate
form, and cost data from individual providers shall not be released except as provided for
in current law.
new text end

new text begin (e) The commissioner, in consultation with stakeholders identified in section 256B.4913,
subdivision 5, shall develop and implement a process for providing training and technical
assistance necessary to support provider submission of cost documentation required under
paragraph (a).
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 2016, section 256B.4914, subdivision 16, is amended to read:


Subd. 16.

Budget neutrality adjustments.

(a) The commissioner shall use the following
adjustments to the rate generated by the framework to assure budget neutrality until the rate
information is available to implement paragraph (b). The rate generated by the framework
shall be multiplied by the appropriate factor, as designated below:

(1) for residential services: 1.003;

(2) for day services: 1.000;

(3) for unit-based services with programming: 0.941; and

(4) for unit-based services without programming: 0.796.

(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated
spending for all home and community-based waiver services under the new payment rates
defined in subdivisions 6 to 9 with estimated spending for the same recipients and services
under the rates in effect on July 1, 2013. This comparison must distinguish spending under
each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and
services for one or more service months after the new rates have gone into effect. The
commissioner shall consult with the commissioner of management and budget on this
analysis to ensure budget neutrality. If estimated spending under the new rates for services
under one or more subdivisions differs in this comparison by 0.3 percent or more, the
commissioner shall assure aggregate budget neutrality across all service areas by adjusting
the budget neutrality factor in paragraph (a) in each subdivision so that total estimated
spending for each subdivision under the new rates matches estimated spending under the
rates in effect on July 1, 2013.

new text begin (c) A service rate developed using values in subdivision 5, paragraph (a), clause (10),
is not subject to budget neutrality adjustments.
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. 32.

Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Culturally affirmative. new text end

new text begin "Culturally affirmative" describes services that are
designed and delivered within the context of the culture, language, and life experiences of
a person who is deaf, a person who is deafblind, and a person who is hard-of-hearing.
new text end

Sec. 33.

Minnesota Statutes 2016, section 256C.23, subdivision 2, is amended to read:


Subd. 2.

Deaf.

"Deaf" means a hearing loss of such severity that the individual must
depend primarily on visual communication such asnew text begin American Sign Language or other signed
language, visual and manual means of communication such as signing systems in English
or Cued Speech,
new text end writing, deleted text beginlipdeleted text endnew text begin speechnew text end reading, deleted text beginmanual communication,deleted text end and gestures.

Sec. 34.

Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision
to read:


new text begin Subd. 2c. new text end

new text begin Interpreting services. new text end

new text begin "Interpreting services" means services that include:
new text end

new text begin (1) interpreting between a spoken language, such as English, and a visual language, such
as American Sign Language;
new text end

new text begin (2) interpreting between a spoken language and a visual representation of a spoken
language, such as Cued Speech and signing systems in English;
new text end

new text begin (3) interpreting within one language where the interpreter uses natural gestures and
silently repeats the spoken message, replacing some words or phrases to give higher visibility
on the lips;
new text end

new text begin (4) interpreting using low vision or tactile methods for persons who have a combined
hearing and vision loss or are deafblind; and
new text end

new text begin (5) interpreting from one communication mode or language into another communication
mode or language that is linguistically and culturally appropriate for the participants in the
communication exchange.
new text end

Sec. 35.

Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Real-time captioning. new text end

new text begin "Real-time captioning" means a method of captioning
in which a caption is simultaneously prepared and displayed or transmitted at the time of
origination by specially trained real-time captioners.
new text end

Sec. 36.

Minnesota Statutes 2016, section 256C.233, subdivision 1, is amended to read:


Subdivision 1.

Deaf and Hard-of-Hearing Services Division.

The commissioners of
deleted text begin human services,deleted text end education, employment and economic development, and health shall deleted text begincreate
a distinct and separate organizational unit to be known as
deleted text endnew text begin advise the commissioner of human
services on the activities of
new text end the Deaf and Hard-of-Hearing Services Division deleted text beginto addressdeleted text endnew text begin.
This division addresses
new text end the developmentaldeleted text begin, social, educational, and occupationaldeleted text end new text beginand
social-emotional
new text end needs ofnew text begin persons who arenew text end deaf,new text begin persons who arenew text end deafblind, andnew text begin persons
who are
new text end hard-of-hearing deleted text beginpersonsdeleted text end through a statewide network of deleted text begincollaborativedeleted text end services and
deleted text begin by coordinating the promulgation of public policies, regulations, legislation, and programs
affecting
deleted text endnew text begin advocates on behalf of and provides information and training about how to best
serve persons who are
new text end deaf,new text begin persons who arenew text end deafblind, andnew text begin persons who arenew text end hard-of-hearing
deleted text begin personsdeleted text end. deleted text beginAn interdepartmental management team shall advise the activities of the Deaf and
Hard-of-Hearing Services Division.
deleted text end The commissioner of human services shall coordinate
the work of the interagency deleted text beginmanagement teamdeleted text endnew text begin advisersnew text end and receive legislative appropriations
for the division.

Sec. 37.

Minnesota Statutes 2016, section 256C.233, subdivision 2, is amended to read:


Subd. 2.

Responsibilities.

The Deaf and Hard-of-Hearing Services Division shall:

(1) establish and maintain a statewide network of regional deleted text beginservice centersdeleted text end new text beginculturally
affirmative services
new text end for new text beginMinnesotans who are new text enddeaf,new text begin Minnesotans who arenew text end deafblind, andnew text begin
Minnesotans who are
new text end hard-of-hearing deleted text beginMinnesotansdeleted text end;

(2) deleted text beginassistdeleted text endnew text begin work across divisions withinnew text end the deleted text beginDepartmentsdeleted text endnew text begin Departmentnew text end of Human Services,
deleted text begin Education, and Employment and Economic Development to coordinate the promulgation
and implementation of public policies, regulations, legislation, programs, and services
affecting
deleted text endnew text begin as well as with other agencies and counties, to ensure that there is an understanding
of:
new text end

new text begin (i) the communication challenges faced by persons who arenew text end deaf,new text begin persons who arenew text end
deafblind, andnew text begin persons who arenew text end hard-of-hearing deleted text beginpersonsdeleted text endnew text begin;
new text end

new text begin (ii) the best practices for accommodating and mitigating communication challenges;
and
new text end

new text begin (iii) the legal requirements for providing access to and effective communication with
persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing
new text end; deleted text beginand
deleted text end

(3) deleted text beginprovide a coordinated system ofdeleted text endnew text begin assess the supply and demandnew text end statewide deleted text begininterpreting
or
deleted text endnew text begin fornew text end interpreter deleted text beginreferraldeleted text end servicesdeleted text begin.deleted text endnew text begin and real-time captioning services, implement strategies
to provide greater access to these services in areas without sufficient supply, and build the
base of service providers across the state;
new text end

new text begin (4) maintain a statewide information resource that includes contact information and
professional certification credentials of interpreting service providers and real-time captioning
service providers;
new text end

new text begin (5) provide culturally affirmative mental health services to persons who are deaf, persons
who are deafblind, and persons who are hard-of-hearing who:
new text end

new text begin (i) use a visual language such as American Sign Language or a tactile form of a language;
or
new text end

new text begin (ii) otherwise need culturally affirmative therapeutic services;
new text end

new text begin (6) research and develop best practices and recommendations for emerging issues;
new text end

new text begin (7) provide as much information as practicable on the division's stand-alone Web site
in American Sign Language; and
new text end

new text begin (8) report to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services biennially, beginning on January 1, 2019, on the following:
new text end

new text begin (i) the number of regional service center staff, the location of the office of each staff
person, other service providers with which they are colocated, the number of people served
by each staff person and a breakdown of whether each person was served on-site or off-site,
and for those served off-site, a list of locations where services were delivered and the number
who were served in-person and the number who were served via technology;
new text end

new text begin (ii) the amount and percentage of the division budget spent on reasonable
accommodations for staff;
new text end

new text begin (iii) the number of people who use demonstration equipment and consumer evaluations
of the experience;
new text end

new text begin (iv) the number of training sessions provided by division staff, the topics covered, the
number of participants, and consumer evaluations, including a breakdown by delivery
method such as in-person or via technology;
new text end

new text begin (v) the number of training sessions hosted at a division location provided by another
service provider, the topics covered, the number of participants, and consumer evaluations,
including a breakdown by delivery method such as in-person or via technology;
new text end

new text begin (vi) for each grant awarded, the amount awarded to the grantee and a summary of the
grantee's results, including consumer evaluations of the services or products provided;
new text end

new text begin (vii) the number of people on waiting lists for any services provided by division staff
or for services or equipment funded through grants awarded by the division;
new text end

new text begin (viii) the amount of time staff spent driving to appointments to deliver direct one-to-one
client services in locations outside of the regional service centers; and
new text end

new text begin (ix) the regional needs and feedback on addressing service gaps identified by the advisory
committees.
new text end

Sec. 38.

Minnesota Statutes 2016, section 256C.24, subdivision 1, is amended to read:


Subdivision 1.

Location.

The Deaf and Hard-of-Hearing Services Division shall establish
deleted text begin up to eightdeleted text endnew text begin at least sixnew text end regional service centers fornew text begin persons who arenew text end deaf andnew text begin persons who
are
new text end hard-of-hearing deleted text beginpersonsdeleted text end. The centers shall be distributed regionally to provide access
fornew text begin persons who arenew text end deaf,new text begin persons who arenew text end deafblind, andnew text begin persons who arenew text end hard-of-hearing
deleted text begin personsdeleted text end in all parts of the state.

Sec. 39.

Minnesota Statutes 2016, section 256C.24, subdivision 2, is amended to read:


Subd. 2.

Responsibilities.

Each regional service center shall:

(1) deleted text beginserve as a central entry point fordeleted text endnew text begin establish connections and collaborations and explore
co-locating with other public and private entities providing services to persons who are
new text end
deaf,new text begin persons who arenew text end deafblind, andnew text begin persons who arenew text end hard-of-hearing deleted text beginpersons in need of
services and make referrals to the services needed
deleted text endnew text begin in the regionnew text end;

new text begin (2) for those in need of services, assist in coordinating services between service providers
and persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing,
and the persons' families, and make referrals to the services needed;
new text end

deleted text begin (2)deleted text endnew text begin (3)new text end employ staff trained to work withnew text begin persons who arenew text end deaf,new text begin persons who arenew text end deafblind,
andnew text begin persons who arenew text end hard-of-hearing deleted text beginpersonsdeleted text end;

deleted text begin (3)deleted text endnew text begin (4) if adequate services are not available from another public or private service
provider in the region,
new text end provide deleted text beginto alldeleted text endnew text begin individual assistance to persons who arenew text end deaf, new text beginpersons
who are
new text enddeafblind, andnew text begin persons who arenew text end hard-of-hearing deleted text beginpersons access to interpreter services
which are necessary to help them obtain services
deleted text endnew text begin, and the persons' familiesnew text endnew text begin. Individual
culturally affirmative assistance may be provided using technology only in areas of the state
where a person has access to sufficient quality telecommunications or broadband services
to allow effective communication. When a person who is deaf, a person who is deafblind,
or a person who is hard-of-hearing does not have access to sufficient telecommunications
or broadband service, individual assistance shall be available in person
new text end;

new text begin (5) identify regional training needs, work with deaf and hard-of-hearing services training
staff, and collaborate with others to deliver training for persons who are deaf, persons who
are deafblind, and persons who are hard-of-hearing, and the persons' families, and other
service providers about subjects including the persons' rights under the law, American Sign
Language, and the impact of hearing loss and options for accommodating it;
new text end

deleted text begin (4) implement a plan to provide loaned equipment and resource materials to deaf,
deafblind, and hard-of-hearing
deleted text end new text begin(6) have a mobile or permanent lab where new text endpersonsnew text begin who are
deaf, persons who are deafblind, and persons who are hard-of-hearing can try a selection
of modern assistive technology and equipment to determine what would best meet the
persons' needs
new text end;

deleted text begin (5) cooperate with responsible departments and administrative authorities to provide
access for deaf, deafblind, and hard-of-hearing persons to services provided by state, county,
and regional agencies;
deleted text end

deleted text begin (6)deleted text endnew text begin (7)new text end collaborate with the Resource Center for the Deaf and Hard-of-Hearing Persons,
other divisions of the Department of Educationdeleted text begin,deleted text end and local school districts to develop and
deliver programs and services for families with new text beginchildren who are new text enddeaf, new text beginchildren who are
new text end deafblind, or new text beginchildren who are new text endhard-of-hearing deleted text beginchildrendeleted text end and to support school personnel
serving these children;

deleted text begin (7) when possible,deleted text endnew text begin (8)new text end provide training to the social service or income maintenance staff
employed by counties or by organizations with whom counties contract for services to
ensure that communication barriers which preventnew text begin persons who arenew text end deaf, new text beginpersons who are
new text end deafblind, andnew text begin persons who arenew text end hard-of-hearing deleted text beginpersonsdeleted text end from using services are removed;

deleted text begin (8) when possible,deleted text endnew text begin (9)new text end provide training to deleted text beginstate and regionaldeleted text end human service agenciesnew text begin in
the region
new text end regarding program access for new text beginpersons who are new text enddeaf, new text beginpersons who are new text enddeafblind,
and new text beginpersons who are new text endhard-of-hearing deleted text beginpersonsdeleted text end; deleted text beginand
deleted text end

deleted text begin (9)deleted text endnew text begin (10)new text end assess the ongoing need and supply of services for new text beginpersons who are new text enddeaf, new text beginpersons
who are
new text enddeafblind, and new text beginpersons who are new text endhard-of-hearing deleted text beginpersonsdeleted text end in all parts of the statenew text begin,
annually consult with the division's advisory committees to identify regional needs and
solicit feedback on addressing service gaps,
new text end and cooperate with public and private service
providers to develop these servicesdeleted text begin.deleted text endnew text begin;
new text end

new text begin (11) provide culturally affirmative mental health services to persons who are deaf,
persons who are deafblind, and persons who are hard-of-hearing who:
new text end

new text begin (i) use a visual language such as American Sign Language or a tactile form of a language;
or
new text end

new text begin (ii) otherwise need culturally affirmative therapeutic services; and
new text end

new text begin (12) establish partnerships with state and regional entities statewide that have the
technological capacity to provide Minnesotans with virtual access to the division's services
and division-sponsored training via technology.
new text end

Sec. 40.

Minnesota Statutes 2016, section 256C.24, subdivision 3, is amended to read:


Subd. 3.

Advisory committee.

The director of the Deaf and Hard-of-Hearing Services
Division shall appoint deleted text beginan advisory committeedeleted text endnew text begin eight advisory committeesnew text end of up to nine
persons deleted text beginfor each regional service areadeleted text endnew text begin per advisory committeenew text end. new text beginEach committee shall represent
a specific region of the state. The director shall determine the boundaries of each advisory
committee region. The committees shall advise the director on the needs of persons who
are deaf, persons who are deafblind, and persons who are hard-of-hearing and service gaps
in the region of the state the committee represents.
new text endMembers shall include persons who are
deaf, new text beginpersons who are new text enddeafblind, and new text beginpersons who are new text endhard-of-hearing, persons who have
communication disabilities, parents of children who are deaf andnew text begin parents of children who
are
new text end hard-of-hearing, parents of children who have communication disabilities, and
representatives of county and regional human services, including representatives of private
service providers. At least 50 percent of the members must be deaf or deafblind or
hard-of-hearing or have a communication disability. Committee members shall serve for a
three-year term deleted text beginand shall serve no more than two consecutive termsdeleted text endnew text begin, and may be appointed
to consecutive terms
new text end. Each advisory committee shall elect a chair. The director of the Deaf
and Hard-of-Hearing Services Division shall assign staff to serve as nonvoting members of
the committee. Members shall not receive a per diem. Otherwise, the compensation, removal
of members, and filling of vacancies on the committee shall be as provided in section
15.0575.

Sec. 41.

Minnesota Statutes 2016, section 256C.261, is amended to read:


256C.261 SERVICES FOR new text beginPERSONS WHO ARE new text endDEAFBLIND deleted text beginPERSONSdeleted text end.

(a) The commissioner of human services shall deleted text begincombine the existing biennial base level
funding for deafblind services into a single grant program. At least 35 percent of the total
funding is awarded for services and other supports to deafblind children and their families
and at least 25 percent is awarded for services and other supports to deafblind adults.
deleted text endnew text begin use
at least 35 percent of the deafblind services biennial base level grant funding for services
and other supports for a child who is deafblind and the child's family. The commissioner
shall use at least 25 percent of the deafblind services biennial base level grant funding for
services and other supports for an adult who is deafblind.
new text end

The commissioner shall award grants for the purposes of:

(1) providing services and supports to deleted text beginindividualsdeleted text endnew text begin personsnew text end who are deafblind; and

(2) developing and providing training to counties and the network of senior citizen
service providers. The purpose of the training grants is to teach counties how to use existing
programs that capture federal financial participation to meet the needs of eligible new text beginpersons
who are
new text enddeafblind deleted text beginpersonsdeleted text end and to build capacity of senior service programs to meet the
needs of seniors with a dual sensory hearing and vision loss.

(b) The commissioner may make grants:

(1) for services and training provided by organizations; and

(2) to develop and administer consumer-directed services.

new text begin (c) Consumer-directed services shall be provided in whole by grant-funded providers.
The deaf and hard-of-hearing regional service centers shall not provide any aspect of a
grant-funded consumer-directed services program.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end Any entity that is able to satisfy the grant criteria is eligible to receive a grant
under paragraph (a).

deleted text begin (d)deleted text endnew text begin (e)new text end Deafblind service providers may, but are not required to, provide intervenor
services as part of the service package provided with grant funds under this section.

Sec. 42.

Minnesota Statutes 2016, section 256C.30, is amended to read:


256C.30 DUTIES OF HUMAN SERVICES COMMISSIONER.

(a) As described in this section, the commissioner of human services must enter into
grant agreements with television stations to make live local news programming accessible
to new text beginpersons who are new text enddeaf, new text beginpersons who are new text endhard-of-hearing, andnew text begin persons who arenew text end deafblind
deleted text begin personsdeleted text end as defined in section 256C.23.

(b) The grant agreements must provide for:

(1) real-time captioning services for broadcasting that is not emergency broadcasting
subject to Code of Federal Regulations, title 47, section 79.2;

(2) real-time captioning services for commercial broadcasters in areas of Minnesota
where commercial broadcasters are not subject to the live programming closed-captioning
requirements of Code of Federal Regulations, title 47, section 79.1(d); and

(3) real-time captioning for large-market noncommercial broadcasters who produce live
news programming.

(c) For the purposes of this section, "real-time captioning" means a method of captioning
in which captions are simultaneously prepared and transmitted at the time of origination by
specially trained real-time captioners.

new text begin EFFECTIVE DATE. new text end

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

Sec. 43.

Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter
312, article 27, section 72, and Laws 2016, chapter 144, section 1, the effective date, is
amended to read:


EFFECTIVE DATE.

deleted text begin The amendments to this section are effective on June 1, 2016,
and expire on the date Laws 2015, chapter 71, article 7, section 54, becomes effective. The
commissioner of human services shall notify the revisor of statutes when Laws 2015, chapter
71, article 7, section 54, becomes effective.
deleted text end new text begin Notwithstanding any other law to the contrary,
the exception in this section is effective until the exception under section 44 or under Laws
2015, chapter 71, article 7, section 54, becomes effective, whichever occurs first. The
commissioner of human services shall notify the revisor of statutes when section 44 or Laws
2015, chapter 71, article 7, section 54, is effective.
new text end

Sec. 44. new text beginEXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS
BUDGET METHODOLOGY EXCEPTION.
new text end

new text begin (a) No later than September 30, 2017, 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 expand the exception to the consumer-directed community
supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide
up to 30 percent more funds for either:
new text end

new text begin (1) consumer-directed community supports participants who have a coordinated service
and support plan which identifies the need for an increased amount of services or supports
under consumer-directed community supports than the amount they are currently receiving
under the consumer-directed community supports budget methodology:
new text end

new text begin (i) to increase the amount of time a person works or otherwise improves employment
opportunities;
new text end

new text begin (ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes,
section 256D.44, subdivision 5, paragraph (f), clause (1), item (ii), or paragraph (g); or
new text end

new text begin (iii) to develop and implement a positive behavior support plan; or
new text end

new text begin (2) home and community-based waiver participants who are currently using licensed
providers for (i) employment supports or services during the day; or (ii) residential services,
either of which cost more annually than the person would spend under a consumer-directed
community supports plan for any or all of the supports needed to meet the goals identified
in paragraph (a), clause (1), items (i), (ii), and (iii).
new text end

new text begin (b) The exception under paragraph (a), clause (1), is limited to those persons who can
demonstrate that they will have to discontinue using consumer-directed community supports
and accept other non-self-directed waiver services because their supports needed for the
goals described in paragraph (a), clause (1), items (i), (ii), and (iii), cannot be met within
the consumer-directed community supports budget limits.
new text end

new text begin (c) The exception under paragraph (a), clause (2), is limited to those persons who can
demonstrate that, upon choosing to become a consumer-directed community supports
participant, the total cost of services, including the exception, will be less than the cost of
current waiver services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin The exception under this section is effective October 1, 2017, or
upon federal approval, whichever is later. Notwithstanding any other law to the contrary,
the exception in Laws 2016, chapter 144, section 1, remains in effect until the exception
under Laws 2015, chapter 71, article 7, section 54, or under this section becomes effective,
whichever occurs first. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end

Sec. 45.

new text begin CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
METHODOLOGY EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND
CRISIS RESIDENTIAL SETTINGS.
new text end

new text begin (a) By September 30, 2017, the commissioner shall establish an institutional and crisis
bed consumer-directed community supports budget exception process in the home and
community-based services waivers under Minnesota Statutes, sections 256B.092 and
256B.49. This budget exception process shall be available for any individual who:
new text end

new text begin (1) is not offered available and appropriate services within 60 days since approval for
discharge from the individual's current institutional setting; and
new text end

new text begin (2) requires services that are more expensive than appropriate services provided in a
noninstitutional setting using the consumer-directed community supports option.
new text end

new text begin (b) Institutional settings for purposes of this exception include intermediate care facilities
for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka
Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget
exception shall be limited to no more than the amount of appropriate services provided in
a noninstitutional setting as determined by the lead agency managing the individual's home
and community-based services waiver. The lead agency shall notify the Department of
Human Services of the budget exception.
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. 46. new text beginCONSUMER-DIRECTED COMMUNITY SUPPORTS REVISED BUDGET
METHODOLOGY REPORT.
new text end

new text begin (a) The commissioner of human services, in consultation with stakeholders and others
including representatives of lead agencies, home and community-based services waiver
participants using consumer-directed community supports, advocacy groups, state agencies,
the Institute on Community Integration at the University of Minnesota, and service and
financial management providers, shall develop a revised consumer-directed community
supports budget methodology. The new methodology shall be based on (1) the costs of
providing services as reflected by the wage and other relevant components incorporated in
the disability waiver rate formulas under Minnesota Statutes, chapter 256B, and (2)
state-to-county waiver-funding methodologies. The new methodology should develop
individual consumer-directed community supports budgets comparable to those provided
for similar needs individuals if paying for non-consumer-directed community supports
waiver services.
new text end

new text begin (b) By December 15, 2018, the commissioner shall report a revised consumer-directed
community supports budget methodology, including proposed legislation and funding
necessary to implement the new methodology, to the chairs and ranking minority members
of the house of representatives and senate committees with jurisdiction over health and
human services.
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. new text beginFEDERAL WAIVER AMENDMENTS.
new text end

new text begin The commissioner of human services shall submit necessary waiver amendments to the
Centers for Medicare and Medicaid Services to add employment exploration services,
employment development services, and employment support services to the home and
community-based services waivers authorized under Minnesota Statutes, sections 256B.092
and 256B.49. The commissioner shall also submit necessary waiver amendments to remove
community-based employment services from day training and habilitation and prevocational
services. The commissioner shall submit all necessary waiver amendments by October 1,
2017.
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. new text beginTRANSPORTATION STUDY.
new text end

new text begin The commissioner of human services, with cooperation from lead agencies and in
consultation with stakeholders, shall conduct a study to identify opportunities to increase
access to transportation services for an individual who receives home and community-based
services. The commissioner shall submit a report with recommendations to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services by January 15, 2019. The report shall:
new text end

new text begin (1) study all aspects of the current transportation service network, including the fleet
available, the different rate-setting methods currently used, methods that an individual uses
to access transportation, and the diversity of available provider agencies;
new text end

new text begin (2) identify current barriers for an individual accessing transportation and for a provider
providing waiver services transportation in the marketplace;
new text end

new text begin (3) identify efficiencies and collaboration opportunities to increase available
transportation, including transportation funded by medical assistance, and available regional
transportation and transit options;
new text end

new text begin (4) study transportation solutions in other states for delivering home and community-based
services;
new text end

new text begin (5) study provider costs required to administer transportation services;
new text end

new text begin (6) make recommendations for coordinating and increasing transportation accessibility
across the state; and
new text end

new text begin (7) make recommendations for the rate setting of waivered transportation.
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. 49. new text beginDIRECTION TO COMMISSIONER; TELECOMMUNICATION
EQUIPMENT PROGRAM.
new text end

new text begin The commissioner of human services shall work in consultation with the Commission
of Deaf, Deafblind, and Hard-of-Hearing Minnesotans to provide recommendations by
January 15, 2018, to the chairs and ranking minority members of the house of representatives
and senate committees with jurisdiction over human services to modernize the
telecommunication equipment program. The recommendations must address:
new text end

new text begin (1) types of equipment and supports the program should provide to ensure people with
communication difficulties have equitable access to telecommunications services;
new text end

new text begin (2) additional services the program should provide, such as education about technology
options that can improve a person's access to telecommunications services; and
new text end

new text begin (3) how the current program's service delivery structure might be improved to better
meet the needs of people with communication disabilities.
new text end

new text begin The commissioner shall also provide draft legislative language to accomplish the
recommendations. Final recommendations, the final report, and draft legislative language
must be approved by both the commissioner and the chair of the Commission of Deaf,
Deafblind, and Hard-of-Hearing Minnesotans.
new text end

Sec. 50. new text beginDIRECTION TO COMMISSIONER; BILLING FOR MENTAL HEALTH
SERVICES.
new text end

new text begin By January 1, 2018, the commissioner of human services shall report to the chairs and
ranking minority members of the house of representatives and senate committees with
jurisdiction over deaf and hard-of-hearing services on the potential costs and benefits of the
Deaf and Hard-of-Hearing Services Division billing for the cost of providing mental health
services.
new text end

Sec. 51. new text beginDIRECTION TO COMMISSIONER; MnCHOICES ASSESSMENT TOOL.
new text end

new text begin The commissioner of human services shall work with lead agencies responsible for
conducting long-term consultation services under Minnesota Statutes, section 256B.0911,
to modify the MnCHOICES assessment tool and related policies to:
new text end

new text begin (1) reduce assessment times;
new text end

new text begin (2) create efficiencies within the tool and within practice and policy for conducting
assessments and support planning;
new text end

new text begin (3) implement policy changes reducing the frequency and depth of assessment and
reassessment, while ensuring federal compliance with medical assistance and disability
waiver eligibility requirements; and
new text end

new text begin (4) evaluate alternative payment methods.
new text end

Sec. 52. new text beginRANDOM MOMENT TIME STUDY EVALUATION REQUIRED.
new text end

new text begin The commissioner of human services shall implement administrative efficiencies and
evaluate the random moment time study methodology for reimbursement of costs associated
with county duties required under Minnesota Statutes, section 256B.0911. The evaluation
must determine whether random moment is efficient and effective in supporting functions
of assessment and support planning and the purpose under Minnesota Statutes, section
256B.0911, subdivision 1. The commissioner shall submit a report to the chairs and ranking
minority members of the house of representatives and senate committees with jurisdiction
over health and human services by January 15, 2019.
new text end

Sec. 53. new text beginRATE INCREASE FOR SELF-DIRECTED WORKFORCE
NEGOTIATIONS.
new text end

new text begin (a) Notwithstanding any other law or rule to the contrary, effective July 1, 2017, and
within available appropriations, the commissioner of human services shall have the authority
to implement rate adjustments to comply with wages and benefits negotiated in the labor
agreement between the state of Minnesota and the Service Employees International Union
(SEIU) Healthcare Minnesota for the period between July 1, 2017, and June 30, 2019.
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 by Minnesota Statutes, section 256B.0711, subdivision
1, paragraph (b).
new text end

Sec. 54. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2016, section 144A.351, subdivision 2, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2016, section 256B.4914, subdivision 16, new text end new text begin is repealed effective
January 1, 2018.
new text end

new text begin (c) 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, Laws 2015, chapter 71, article 7, section 58, Laws 2016, chapter
144, section 1; and Laws 2015, chapter 71, article 7, section 54,
new text end new text begin are repealed upon the
effective date of section 44.
new text end

new text begin (d) new text end new text begin Minnesota Statutes 2016, sections 256C.23, subdivision 3; 256C.233, subdivision
4; and 256C.25, subdivisions 1 and 2,
new text end new text begin are repealed.
new text end

ARTICLE 2

HOUSING

Section 1.

Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:


Subd. 2.

Contents of contract.

A housing with services contract, which need not be
entitled as such to comply with this section, shall include at least the following elements in
itself or through supporting documents or attachments:

(1) the name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners is not a natural person, identification of the type of business entity of
the owner or owners;

(3) the name and mailing address of the managing agent, through management agreement
or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept service
of process on behalf of the owner or owners and managing agent;

(5) a statement describing the registration and licensure status of the establishment and
any provider providing health-related or supportive services under an arrangement with the
establishment;

(6) the term of the contract;

(7) a description of the services to be provided to the resident in the base rate to be paid
by resident, including a delineation of the portion of the base rate that constitutes rent and
a delineation of charges for each service included in the base rate;

(8) a description of any additional services, including home care services, available for
an additional fee from the establishment directly or through arrangements with the
establishment, and a schedule of fees charged for these services;

(9) a description of the process through which the contract may be modified, amended,
or terminated, including whether a move to a different room or sharing a room would be
required in the event that the tenant can no longer pay the current rent;

(10) a description of the establishment's complaint resolution process available to residents
including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;

(11) the resident's designated representative, if any;

(12) the establishment's referral procedures if the contract is terminated;

(13) requirements of residency used by the establishment to determine who may reside
or continue to reside in the housing with services establishment;

(14) billing and payment procedures and requirements;

(15) a statement regarding the ability of deleted text beginresidentsdeleted text endnew text begin a residentnew text end to receive services from
service providers with whom the establishment does not have an arrangement;

(16) a statement regarding the availability of public funds for payment for residence or
services in the establishment; and

(17) a statement regarding the availability of and contact information for long-term care
consultation services under section 256B.0911 in the county in which the establishment is
located.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2016, section 144D.04, is amended by adding a subdivision to
read:


new text begin Subd. 2a. new text end

new text begin Additional contract requirements. new text end

new text begin (a) For a resident receiving one or more
health-related services from the establishment's arranged home care provider, as defined in
section 144D.01, subdivision 6, the contract must include the requirements in paragraph
(b). A restriction of a resident's rights under this subdivision is allowed only if determined
necessary for health and safety reasons identified by the home care provider's registered
nurse in an initial assessment or reassessment, as defined under section 144A.4791,
subdivision 8, and documented in the written service plan under section 144A.4791,
subdivision 9. Any restrictions of those rights for people served under sections 256B.0915
and 256B.49 must be documented in the resident's coordinated service and support plan
(CSSP), as defined under sections 256B.0915, subdivision 6 and 256B.49, subdivision 15.
new text end

new text begin (b) The contract must include a statement:
new text end

new text begin (1) regarding the ability of a resident to furnish and decorate the resident's unit within
the terms of the lease;
new text end

new text begin (2) regarding the resident's right to access food at any time;
new text end

new text begin (3) regarding a resident's right to choose the resident's visitors and times of visits;
new text end

new text begin (4) regarding the resident's right to choose a roommate if sharing a unit; and
new text end

new text begin (5) notifying the resident of the resident's right to have and use a lockable door to the
resident's unit. The landlord shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible.
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. 3.

Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:


Subd. 7.

Licensing moratorium.

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

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

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

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

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

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

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

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

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

new text begin (7) new foster care licenses or community residential setting licenses for people receiving
services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until June 30, 2018. This exception is available when:
new text end

new text begin (i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and
new text end

new text begin (ii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the unlicensed
setting as determined by the lead agency
new text end.

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

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department deleted text beginshalldeleted text end new text beginmay
new text end decrease the statewide licensed capacity for adult foster care settings deleted text beginwhere the physical
location is not the primary residence of the license holder, or for adult community residential
settings, if the voluntary changes described in paragraph (e) are not sufficient to meet the
savings required by reductions in licensed bed capacity under Laws 2011, First Special
Session chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term
care residential services capacity within budgetary limits. Implementation of the statewide
licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense
up to 128 beds by June 30, 2014, using the needs determination process. Prior to any
involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies
and license holders to determine which adult foster care settings, where the physical location
is not the primary residence of the license holder, or community residential settings, are
licensed for up to five beds, but have operated at less than full capacity for 12 or more
months as of March 1, 2014. The settings that meet these criteria must be the first to be
considered for an involuntary decrease in statewide licensed capacity, up to a maximum of
35 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall
prioritize the selection of those beds to be closed based on the length of time the beds have
been vacant. The longer a bed has been vacant, the higher priority it must be given for
closure. Under this paragraph, the commissioner has the authority to reduce unused licensed
capacity of a current foster care program, or the community residential settings, to accomplish
the consolidation or closure of settings. Under this paragraph, the commissioner has the
authority to manage statewide capacity, including adjusting the capacity available to each
county and adjusting statewide available capacity, to meet the statewide needs identified
through the process in paragraph (e). A decreased licensed capacity according to this
paragraph is not subject to appeal under this chapter
deleted text end.

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

(e) A resource need determination process, managed at the state level, using the available
reports required by section 144A.351, and other data and information shall be used to
determine where the reduced capacity deleted text beginrequireddeleted text end new text begindetermined new text endunder deleted text beginparagraph (c)deleted text endnew text begin section
256B.493
new text end will be implemented. The commissioner shall consult with the stakeholders
described in section 144A.351, and employ a variety of methods to improve the state's
capacity to meet new text beginthe informed decisions of those people who want to move out of corporate
foster care or community residential settings,
new text endlong-term deleted text begincaredeleted text end service needs within budgetary
limits, including seeking proposals from service providers or lead agencies to change service
type, capacity, or location to improve services, increase the independence of residents, and
better meet needs identified by the long-term deleted text begincaredeleted text end services new text beginand supports new text endreports and statewide
data and information.deleted text begin By February 1, 2013, and August 1, 2014, and each following year,
deleted text enddeleted text begin the commissioner shall provide information and data deleted text enddeleted text beginon deleted text enddeleted text beginthe overalldeleted text enddeleted text begin capacity of deleted text enddeleted text beginlicensed
long-term
deleted text enddeleted text begincaredeleted text enddeleted text begin servicesdeleted text enddeleted text begin, actions taken under this subdivision to manage deleted text enddeleted text beginstatewide long-term
deleted text enddeleted text begin caredeleted text enddeleted text begin services and supports resources, and any recommendations for deleted text enddeleted text beginchange to the legislative
committees with jurisdiction over health and human services budget.
deleted text end

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

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

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

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

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

Sec. 4.

Minnesota Statutes 2016, section 245A.04, subdivision 14, is amended to read:


Subd. 14.

Policies and procedures for program administration required and
enforceable.

(a) The license holder shall develop program policies and procedures necessary
to maintain compliance with licensing requirements under Minnesota Statutes and Minnesota
Rules.

(b) The license holder shall:

(1) provide training to program staff related to their duties in implementing the program's
policies and procedures developed under paragraph (a);

(2) document the provision of this training; and

(3) monitor implementation of policies and procedures by program staff.

(c) The license holder shall keep program policies and procedures readily accessible to
staff and index the policies and procedures with a table of contents or another method
approved by the commissioner.

new text begin (d) An adult foster care license holder that provides foster care services to a resident
under section 256B.0915 must annually provide a copy of the resident termination policy
under section 245A.11, subdivision 11, to a resident covered by the policy.
new text end

Sec. 5.

Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
read:


new text begin Subd. 9. new text end

new text begin Adult foster care bedrooms. new text end

new text begin (a) A resident receiving services must have a
choice of roommate. Each roommate must consent in writing to sharing a bedroom with
one another. The license holder is responsible for notifying a resident of the resident's right
to request a change of roommate.
new text end

new text begin (b) The license holder must provide a lock for each resident's bedroom door, unless
otherwise indicated for the resident's health, safety, or well-being. A restriction on the use
of the lock must be documented and justified in the resident's individual abuse prevention
plan required by sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision
14.For a resident served under section 256B.0915, the case manager must be part of the
interdisciplinary team under section 245A.65, subdivision 2, paragraph (b).
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. 6.

Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
read:


new text begin Subd. 10. new text end

new text begin Adult foster care resident rights. new text end

new text begin (a) The license holder shall ensure that a
resident and a resident's legal representative are given, at admission:
new text end

new text begin (1) an explanation and copy of the resident's rights specified in paragraph (b);
new text end

new text begin (2) a written summary of the Vulnerable Adults Protection Act prepared by the
department; and
new text end

new text begin (3) the name, address, and telephone number of the local agency to which a resident or
a resident's legal representative may submit an oral or written complaint.
new text end

new text begin (b) Adult foster care resident rights include the right to:
new text end

new text begin (1) have daily, private access to and use of a non-coin-operated telephone for local and
long-distance telephone calls made collect or paid for by the resident;
new text end

new text begin (2) receive and send, without interference, uncensored, unopened mail or electronic
correspondence or communication;
new text end

new text begin (3) have use of and free access to common areas in the residence and the freedom to
come and go from the residence at will;
new text end

new text begin (4) have privacy for visits with the resident's spouse, next of kin, legal counsel, religious
adviser, or others, according to section 363A.09 of the Human Rights Act, including privacy
in the resident's bedroom;
new text end

new text begin (5) keep, use, and access the resident's personal clothing and possessions as space permits,
unless this right infringes on the health, safety, or rights of another resident or household
member, including the right to access the resident's personal possessions at any time;
new text end

new text begin (6) choose the resident's visitors and time of visits and participate in activities of
commercial, religious, political, and community groups without interference if the activities
do not infringe on the rights of another resident or household member;
new text end

new text begin (7) if married, privacy for visits by the resident's spouse, and, if both spouses are residents
of the adult foster home, the residents have the right to share a bedroom and bed;
new text end

new text begin (8) privacy, including use of the lock on the resident's bedroom door or unit door. A
resident's privacy must be respected by license holders, caregivers, household members,
and volunteers by knocking on the door of a resident's bedroom or bathroom and seeking
consent before entering, except in an emergency;
new text end

new text begin (9) furnish and decorate the resident's bedroom or living unit;
new text end

new text begin (10) engage in chosen activities and have an individual schedule supported by the license
holder that meets the resident's preferences;
new text end

new text begin (11) freedom and support to access food at any time;
new text end

new text begin (12) have personal, financial, service, health, and medical information kept private, and
be advised of disclosure of this information by the license holder;
new text end

new text begin (13) access records and recorded information about the resident according to applicable
state and federal law, regulation, or rule;
new text end

new text begin (14) be free from maltreatment;
new text end

new text begin (15) be treated with courtesy and respect and receive respectful treatment of the resident's
property;
new text end

new text begin (16) reasonable observance of cultural and ethnic practice and religion;
new text end

new text begin (17) be free from bias and harassment regarding race, gender, age, disability, spirituality,
and sexual orientation;
new text end

new text begin (18) be informed of and use the license holder's grievance policy and procedures,
including how to contact the highest level of authority in the program;
new text end

new text begin (19) assert the resident's rights personally, or have the rights asserted by the resident's
family, authorized representative, or legal representative, without retaliation; and
new text end

new text begin (20) give or withhold written informed consent to participate in any research or
experimental treatment.
new text end

new text begin (c) A restriction of a resident's rights under paragraph (b), clauses (1) to (4), (6), (8),
(10), and (11), is allowed only if determined necessary to ensure the health, safety, and
well-being of the resident. Any restriction of a resident's right must be documented and
justified in the resident's individual abuse prevention plan required by sections 245A.65,
subdivision 2, paragraph (b) and 626.557, subdivision 14. For a resident served under section
256B.0915, the case manager must be part of the interdisciplinary team under section
245A.65, subdivision 2, paragraph (b). The restriction must be implemented in the least
restrictive manner necessary to protect the resident and provide support to reduce or eliminate
the need for the restriction.
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. 7.

Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
read:


new text begin Subd. 11. new text end

new text begin Adult foster care service termination for elderly waiver participants. new text end

new text begin (a)
This subdivision applies to foster care services for a resident served under section 256B.0915.
new text end

new text begin (b) The foster care license holder must establish policies and procedures for service
termination that promote continuity of care and service coordination with the resident and
the case manager and with another licensed caregiver, if any, who also provides support to
the resident. The policy must include the requirements specified in paragraphs (c) to (h).
new text end

new text begin (c) The license holder must allow a resident to remain in the program and cannot terminate
services unless:
new text end

new text begin (1) the termination is necessary for the resident's health, safety, and well-being and the
resident's needs cannot be met in the facility;
new text end

new text begin (2) the safety of the resident or another resident in the program is endangered and positive
support strategies were attempted and have not achieved and effectively maintained safety
for the resident or another resident in the program;
new text end

new text begin (3) the health, safety, and well-being of the resident or another resident in the program
would otherwise be endangered;
new text end

new text begin (4) the program was not paid for services;
new text end

new text begin (5) the program ceases to operate; or
new text end

new text begin (6) the resident was terminated by the lead agency from waiver eligibility.
new text end

new text begin (d) Before giving notice of service termination, the license holder must document the
action taken to minimize or eliminate the need for termination. The action taken by the
license holder must include, at a minimum:
new text end

new text begin (1) consultation with the resident's interdisciplinary team to identify and resolve issues
leading to a notice of service termination; and
new text end

new text begin (2) a request to the case manager or other professional consultation or intervention
services to support the resident in the program. This requirement does not apply to a notice
of service termination issued under paragraph (c), clause (4) or (5).
new text end

new text begin (e) If, based on the best interests of the resident, the circumstances at the time of notice
were such that the license holder was unable to take the action specified in paragraph (d),
the license holder must document the specific circumstances and the reason the license
holder was unable to take the action.
new text end

new text begin (f) The license holder must notify the resident or the resident's legal representative and
the case manager in writing of the intended service termination. The notice must include:
new text end

new text begin (1) the reason for the action;
new text end

new text begin (2) except for service termination under paragraph (c), clause (4) or (5), a summary of
the action taken to minimize or eliminate the need for termination and the reason the action
failed to prevent the termination;
new text end

new text begin (3) the resident's right to appeal the service termination under section 256.045, subdivision
3, paragraph (a); and
new text end

new text begin (4) the resident's right to seek a temporary order staying the service termination according
to the procedures in section 256.045, subdivision 4a, or subdivision 6, paragraph (c).
new text end

new text begin (g) Notice of the proposed service termination must be given at least 30 days before
terminating a resident's service.
new text end

new text begin (h) After the resident receives the notice of service termination and before the services
are terminated, the license holder must:
new text end

new text begin (1) work with the support team or expanded support team to develop reasonable
alternatives to support continuity of care and to protect the resident;
new text end

new text begin (2) provide information requested by the resident or case manager; and
new text end

new text begin (3) maintain information about the service termination, including the written notice of
service termination, in the resident's record.
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.

Minnesota Statutes 2016, section 245D.04, subdivision 3, is amended to read:


Subd. 3.

Protection-related rights.

(a) A person's protection-related rights include the
right to:

(1) have personal, financial, service, health, and medical information kept private, and
be advised of disclosure of this information by the license holder;

(2) access records and recorded information about the person in accordance with
applicable state and federal law, regulation, or rule;

(3) be free from maltreatment;

(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited
procedure identified in section 245D.06, subdivision 5, or successor provisions, except for:
(i) emergency use of manual restraint to protect the person from imminent danger to self
or others according to the requirements in section 245D.061 or successor provisions; or (ii)
the use of safety interventions as part of a positive support transition plan under section
245D.06, subdivision 8, or successor provisions;

(5) receive services in a clean and safe environment when the license holder is the owner,
lessor, or tenant of the service site;

(6) be treated with courtesy and respect and receive respectful treatment of the person's
property;

(7) reasonable observance of cultural and ethnic practice and religion;

(8) be free from bias and harassment regarding race, gender, age, disability, spirituality,
and sexual orientation;

(9) be informed of and use the license holder's grievance policy and procedures, including
knowing how to contact persons responsible for addressing problems and to appeal under
section 256.045;

(10) know the name, telephone number, and the Web site, e-mail, and street addresses
of protection and advocacy services, including the appropriate state-appointed ombudsman,
and a brief description of how to file a complaint with these offices;

(11) assert these rights personally, or have them asserted by the person's family,
authorized representative, or legal representative, without retaliation;

(12) give or withhold written informed consent to participate in any research or
experimental treatment;

(13) associate with other persons of the person's choice;

(14) personal privacy; and

(15) engage in chosen activities.

(b) For a person residing in a residential site licensed according to chapter 245A, or
where the license holder is the owner, lessor, or tenant of the residential service site,
protection-related rights also include the right to:

(1) have daily, private access to and use of a non-coin-operated telephone for local calls
and long-distance calls made collect or paid for by the person;

(2) receive and send, without interference, uncensored, unopened mail or electronic
correspondence or communication;

(3) have use of and free access to common areas in the residence; and

(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious deleted text beginadvisordeleted text endnew text begin
adviser
new text end, or others, in accordance with section 363A.09 of the Human Rights Act, including
privacy in the person's bedroomdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) have access to three nutritionally balanced meals and nutritious snacks between
meals each day.
new text end

(c) Restriction of a person's rights under paragraph (a), clauses (13) to (15), or paragraph
(b) is allowed only if determined necessary to ensure the health, safety, and well-being of
the person. Any restriction of those rights must be documented in the person's coordinated
service and support plan or coordinated service and support plan addendum. The restriction
must be implemented in the least restrictive alternative manner necessary to protect the
person and provide support to reduce or eliminate the need for the restriction in the most
integrated setting and inclusive manner. The documentation must include the following
information:

(1) the justification for the restriction based on an assessment of the person's vulnerability
related to exercising the right without restriction;

(2) the objective measures set as conditions for ending the restriction;

(3) a schedule for reviewing the need for the restriction based on the conditions for
ending the restriction to occur semiannually from the date of initial approval, at a minimum,
or more frequently if requested by the person, the person's legal representative, if any, and
case manager; and

(4) signed and dated approval for the restriction from the person, or the person's legal
representative, if any. A restriction may be implemented only when the required approval
has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the
right must be immediately and fully restored.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2016, section 256.045, subdivision 3, is amended to read:


Subd. 3.

State agency hearings.

(a) State agency hearings are available for the following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food Stamp Act whose application for assistance is denied, not acted upon with
reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed
to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section 626.556 is denied or not
acted upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under section 626.556, after the individual or facility has exercised the
right to administrative reconsideration under section 626.556;

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;

(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, from residential supports and services as defined in section 245D.03, subdivision 1,
paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a; deleted text beginor
deleted text end

(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914deleted text begin.deleted text endnew text begin; or
new text end

new text begin (14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4a.
new text end

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.

(e) The scope of hearings under paragraph (a), deleted text beginclausedeleted text endnew text begin clausesnew text end (12)new text begin and (14)new text end, shall be
limited to whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a
, paragraph (b),new text begin or 245A.11, subdivision 11,new text end and whether the requirements
of section 245D.10, subdivision 3a, deleted text beginparagraphdeleted text endnew text begin paragraphsnew text end (c)new text begin to (e), or 245A.11, subdivision
2a, paragraphs (d) to (f)
new text end, were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.

(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.

(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.

(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.

(i) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

new text begin [256B.051] HOUSING SUPPORT SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin Housing support services are established to provide housing
support services to an individual with a disability that limits the individual's ability to obtain
or maintain stable housing. The services support an individual's transition to housing in the
community and increase long-term stability in housing, to avoid future periods of being at
risk of homelessness or institutionalization.
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 terms defined in this
subdivision have the meanings given.
new text end

new text begin (b) "At-risk of homelessness" means (1) an individual that is faced with a set of
circumstances likely to cause the individual to become homeless, or (2) an individual
previously homeless, who will be discharged from a correctional, medical, mental health,
or treatment center, who lacks sufficient resources to pay for housing and does not have a
permanent place to live.
new text end

new text begin (c) "Commissioner" means the commissioner of human services.
new text end

new text begin (d) "Homeless" means an individual or family lacking a fixed, adequate nighttime
residence.
new text end

new text begin (e) "Individual with a disability" means:
new text end

new text begin (1) an individual who is aged, blind, or disabled as determined by the criteria used by
the title 11 program of the Social Security Act, United States Code, title 42, section 416,
paragraph (i), item (1); or
new text end

new text begin (2) an individual who meets a category of eligibility under section 256D.05, subdivision
1, paragraph (a), clauses (1), (3), (5) to (9), or (14).
new text end

new text begin (f) "Institution" means a setting as defined in section 256B.0621, subdivision 2, clause
(3), and the Minnesota Security Hospital as defined in section 253.20.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin An individual with a disability is eligible for housing support services
if the individual:
new text end

new text begin (1) is 18 years of age or older;
new text end

new text begin (2) is enrolled in medical assistance;
new text end

new text begin (3) has an assessment of functional need that determines a need for services due to
limitations caused by the individual's disability;
new text end

new text begin (4) resides in or plans to transition to a community-based setting as defined in Code of
Federal Regulations, title 42, section 441.301(c); and
new text end

new text begin (5) has housing instability evidenced by:
new text end

new text begin (i) being homeless or at-risk of homelessness;
new text end

new text begin (ii) being in the process of transitioning from, or having transitioned in the past six
months from, an institution or licensed or registered setting;
new text end

new text begin (iii) being eligible for waiver services under section 256B.0915, 256B.092, or 256B.49;
or
new text end

new text begin (iv) having been identified by a long-term care consultation under section 256B.0911
as at risk of institutionalization.
new text end

new text begin Subd. 4. new text end

new text begin Assessment requirements. new text end

new text begin (a) An individual's assessment of functional need
must be conducted by one of the following methods:
new text end

new text begin (1) an assessor according to the criteria established in section 256B.0911, subdivision
3a, using a format established by the commissioner;
new text end

new text begin (2) documented need for services as verified by a professional statement of need as
defined in section 256I.03, subdivision 12; or
new text end

new text begin (3) according to the continuum of care coordinated assessment system established in
Code of Federal Regulations, title 24, section 578.3, using a format established by the
commissioner.
new text end

new text begin (b) An individual must be reassessed within one year of initial assessment, and annually
thereafter.
new text end

new text begin Subd. 5. new text end

new text begin Housing support services. new text end

new text begin (a) Housing support services include housing
transition services and housing and tenancy sustaining services.
new text end

new text begin (b) Housing transition services are defined as:
new text end

new text begin (1) tenant screening and housing assessment;
new text end

new text begin (2) assistance with the housing search and application process;
new text end

new text begin (3) identifying resources to cover onetime moving expenses;
new text end

new text begin (4) ensuring a new living arrangement is safe and ready for move-in;
new text end

new text begin (5) assisting in arranging for and supporting details of a move; and
new text end

new text begin (6) developing a housing support crisis plan.
new text end

new text begin (c) Housing and tenancy sustaining services include:
new text end

new text begin (1) prevention and early identification of behaviors that may jeopardize continued stable
housing;
new text end

new text begin (2) education and training on roles, rights, and responsibilities of the tenant and the
property manager;
new text end

new text begin (3) coaching to develop and maintain key relationships with property managers and
neighbors;
new text end

new text begin (4) advocacy and referral to community resources to prevent eviction when housing is
at risk;
new text end

new text begin (5) assistance with housing recertification process;
new text end

new text begin (6) coordination with the tenant to regularly review, update, and modify housing support
and crisis plan; and
new text end

new text begin (7) continuing training on being a good tenant, lease compliance, and household
management.
new text end

new text begin (d) A housing support service may include person-centered planning for people who are
not eligible to receive person-centered planning through any other service, if the
person-centered planning is provided by a consultation service provider that is under contract
with the department and enrolled as a Minnesota health care program.
new text end

new text begin Subd. 6. new text end

new text begin Provider qualifications and duties. new text end

new text begin A provider eligible for reimbursement
under this section shall:
new text end

new text begin (1) enroll as a medical assistance Minnesota health care program provider and meet all
applicable provider standards and requirements;
new text end

new text begin (2) demonstrate compliance with federal and state laws and policies for housing support
services as determined by the commissioner;
new text end

new text begin (3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results; and
new text end

new text begin (4) directly provide housing support services and not use a subcontractor or reporting
agent.
new text end

new text begin Subd. 7. new text end

new text begin Housing support supplemental service rates. new text end

new text begin Supplemental service rates for
individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph
(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year
period. This reduction only applies to supplemental service rates for individuals eligible for
housing support services under this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) Subdivisions 1 to 6 are contingent upon federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

new text begin (b) Subdivision 7 is contingent upon federal approval of subdivisions 1 to 6. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 11.

Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:


Subd. 3a.

Assessment and support planning.

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

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

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

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

(e) The person or the person's legal representative must be provided with a written
community support plan within 40 calendar days of the assessment visit, regardless of
whether the individual is eligible for Minnesota health care programs. The written community
support plan must include:

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

(2) the individual's options and choices to meet identified needs, including all available
options for case management services and providers;

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

(4) referral information; and

(5) informal caregiver supports, if applicable.

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

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

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

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

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

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

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

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

(5) information about Minnesota health care programs;

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

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

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

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

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

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

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

Sec. 12.

Minnesota Statutes 2016, section 256B.0915, subdivision 1, is amended to read:


Subdivision 1.

Authority.

new text begin(a) new text endThe commissioner is authorized to apply for a home and
community-based services waiver for the elderly, authorized under section 1915(c) of the
Social Security Act, in order to obtain federal financial participation to expand the availability
of services for persons who are eligible for medical assistance. The commissioner may
apply for additional waivers or pursue other federal financial participation which is
advantageous to the state for funding home care services for the frail elderly who are eligible
for medical assistance. The provision of waivered services to elderly and disabled medical
assistance recipients must comply with the criteria for service definitions and provider
standards approved in the waiver.

new text begin (b) The commissioner shall comply with the requirements in the federally approved
transition plan for the home and community-based services waivers authorized under this
section.
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. 13.

Minnesota Statutes 2016, section 256B.092, subdivision 4, is amended to read:


Subd. 4.

Home and community-based services for developmental disabilities.

(a)
The commissioner shall make payments to approved vendors participating in the medical
assistance program to pay costs of providing home and community-based services, including
case management service activities provided as an approved home and community-based
service, to medical assistance eligible persons with developmental disabilities who have
been screened under subdivision 7 and according to federal requirements. Federal
requirements include those services and limitations included in the federally approved
application for home and community-based services for persons with developmental
disabilities and subsequent amendments.

(b) Effective July 1, 1995, contingent upon federal approval and state appropriations
made available for this purpose, and in conjunction with Laws 1995, chapter 207, article 8,
section 40, the commissioner of human services shall allocate resources to county agencies
for home and community-based waivered services for persons with developmental disabilities
authorized but not receiving those services as of June 30, 1995, based upon the average
resource need of persons with similar functional characteristics. To ensure service continuity
for service recipients receiving home and community-based waivered services for persons
with developmental disabilities prior to July 1, 1995, the commissioner shall make available
to the county of financial responsibility home and community-based waivered services
resources based upon fiscal year 1995 authorized levels.

(c) Home and community-based resources for all recipients shall be managed by the
county of financial responsibility within an allowable reimbursement average established
for each county. Payments for home and community-based services provided to individual
recipients shall not exceed amounts authorized by the county of financial responsibility.
For specifically identified former residents of nursing facilities, the commissioner shall be
responsible for authorizing payments and payment limits under the appropriate home and
community-based service program. Payment is available under this subdivision only for
persons who, if not provided these services, would require the level of care provided in an
intermediate care facility for persons with developmental disabilities.

new text begin (d) The commissioner shall comply with the requirements in the federally approved
transition plan for the home and community-based services waivers for the elderly authorized
under this section.
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. 14.

Minnesota Statutes 2016, section 256B.49, subdivision 11, is amended to read:


Subd. 11.

Authority.

(a) The commissioner is authorized to apply for home and
community-based service waivers, as authorized under section 1915(c) of the Social Security
Act to serve persons under the age of 65 who are determined to require the level of care
provided in a nursing home and persons who require the level of care provided in a hospital.
The commissioner shall apply for the home and community-based waivers in order to:

(1) promote the support of persons with disabilities in the most integrated settings;

(2) expand the availability of services for persons who are eligible for medical assistance;

(3) promote cost-effective options to institutional care; and

(4) obtain federal financial participation.

(b) The provision of waivered services to medical assistance recipients with disabilities
shall comply with the requirements outlined in the federally approved applications for home
and community-based services and subsequent amendments, including provision of services
according to a service plan designed to meet the needs of the individual. For purposes of
this section, the approved home and community-based application is considered the necessary
federal requirement.

(c) The commissioner shall provide interested persons serving on agency advisory
committees, task forces, the Centers for Independent Living, and others who request to be
on a list to receive, notice of, and an opportunity to comment on, at least 30 days before
any effective dates, (1) any substantive changes to the state's disability services program
manual, or (2) changes or amendments to the federally approved applications for home and
community-based waivers, prior to their submission to the federal Centers for Medicare
and Medicaid Services.

(d) The commissioner shall seek approval, as authorized under section 1915(c) of the
Social Security Act, to allow medical assistance eligibility under this section for children
under age 21 without deeming of parental income or assets.

(e) The commissioner shall seek approval, as authorized under section 1915(c) of the
Social Act, to allow medical assistance eligibility under this section for individuals under
age 65 without deeming the spouse's income or assets.

new text begin (f) The commissioner shall comply with the requirements in the federally approved
transition plan for the home and community-based services waivers authorized under this
section.
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. 15.

Minnesota Statutes 2016, section 256B.49, subdivision 15, is amended to read:


Subd. 15.

Coordinated service and support plan; comprehensive transitional service
plan; maintenance service plan.

(a) Each recipient of home and community-based waivered
services shall be provided a copy of the written coordinated service and support plan which
meets the requirements in section 256B.092, subdivision 1b.

(b) In developing the comprehensive transitional service plan, the individual receiving
services, the case manager, and the guardian, if applicable, will identify the transitional
service plan fundamental service outcome and anticipated timeline to achieve this outcome.
Within the first 20 days following a recipient's request for an assessment or reassessment,
the transitional service planning team must be identified. A team leader must be identified
who will be responsible for assigning responsibility and communicating with team members
to ensure implementation of the transition plan and ongoing assessment and communication
process. The team leader should be an individual, such as the case manager or guardian,
who has the opportunity to follow the recipient to the next level of service.

Within ten days following an assessment, a comprehensive transitional service plan must
be developed incorporating elements of a comprehensive functional assessment and including
short-term measurable outcomes and timelines for achievement of and reporting on these
outcomes. Functional milestones must also be identified and reported according to the
timelines agreed upon by the transitional service planning team. In addition, the
comprehensive transitional service plan must identify additional supports that may assist
in the achievement of the fundamental service outcome such as the development of greater
natural community support, increased collaboration among agencies, and technological
supports.

The timelines for reporting on functional milestones will prompt a reassessment of
services provided, the units of services, rates, and appropriate service providers. It is the
responsibility of the transitional service planning team leader to review functional milestone
reporting to determine if the milestones are consistent with observable skills and that
milestone achievement prompts any needed changes to the comprehensive transitional
service plan.

For those whose fundamental transitional service outcome involves the need to procure
housing, a plan for the recipient to seek the resources necessary to secure the least restrictive
housing possible should be incorporated into the plan, including employment and public
supports such as housing access and shelter needy funding.

(c) Counties and other agencies responsible for funding community placement and
ongoing community supportive services are responsible for the implementation of the
comprehensive transitional service plans. Oversight responsibilities include both ensuring
effective transitional service delivery and efficient utilization of funding resources.

(d) Following one year of transitional services, the transitional services planning team
will make a determination as to whether or not the individual receiving services requires
the current level of continuous and consistent support in order to maintain the recipient's
current level of functioning. Recipients who are determined to have not had a significant
change in functioning for 12 months must move from a transitional to a maintenance service
plan. Recipients on a maintenance service plan must be reassessed to determine if the
recipient would benefit from a transitional service plan at least every 12 months and at other
times when there has been a significant change in the recipient's functioning. This assessment
should consider any changes to technological or natural community supports.

(e) When a county is evaluating denials, reductions, or terminations of home and
community-based services under this section for an individual, the case manager shall offer
to meet with the individual or the individual's guardian in order to discuss the prioritization
of service needs within the coordinated service and support plan, comprehensive transitional
service plan, or maintenance service plan. The reduction in the authorized services for an
individual due to changes in funding for waivered services may not exceed the amount
needed to ensure medically necessary services to meet the individual's health, safety, and
welfare.

deleted text begin (f) At the time of reassessment, local agency case managers shall assess each recipient
of community access for disability inclusion or brain injury waivered services currently
residing in a licensed adult foster home that is not the primary residence of the license
holder, or in which the license holder is not the primary caregiver, to determine if that
recipient could appropriately be served in a community-living setting. If appropriate for the
recipient, the case manager shall offer the recipient, through a person-centered planning
process, the option to receive alternative housing and service options. In the event that the
recipient chooses to transfer from the adult foster home, the vacated bed shall not be filled
with another recipient of waiver services and group residential housing and the licensed
capacity shall be reduced accordingly, unless the savings required by the licensed bed closure
reductions under Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40,
paragraph (f), for foster care settings where the physical location is not the primary residence
of the license holder are met through voluntary changes described in section 245A.03,
subdivision 7
, paragraph (e), or as provided under paragraph (a), clauses (3) and (4). If the
adult foster home becomes no longer viable due to these transfers, the county agency, with
the assistance of the department, shall facilitate a consolidation of settings or closure. This
reassessment process shall be completed by July 1, 2013.
deleted text end

Sec. 16.

Minnesota Statutes 2016, section 256B.493, subdivision 1, is amended to read:


Subdivision 1.

Commissioner's duties; report.

The commissioner of human services
deleted text begin shall solicit proposals for the conversion of services provided for persons with disabilities
in settings licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, or community
residential settings licensed under chapter 245D, to other types of community settings in
conjunction with the closure of identified licensed adult foster care settings
deleted text endnew text begin has the authority
to manage statewide licensed corporate foster care or community residential settings capacity,
including the reduction and realignment of licensed capacity of a current foster care or
community residential settings to accomplish the consolidation or closure of settings. The
commissioner shall implement a program for planned closure of licensed corporate adult
foster care or community residential settings, necessary as a preferred method to: (1) respond
to the informed decisions of those individuals who want to move out of these settings into
other types of community settings; and (2) achieve necessary budgetary savings required
in section 245A.03, subdivision 7, paragraphs (c) and (d)
new text end.

Sec. 17.

Minnesota Statutes 2016, section 256B.493, subdivision 2, is amended to read:


Subd. 2.

Planned closure process needs determination.

deleted text beginThe commissioner shall
announce and implement a program for planned closure of adult foster care homes. Planned
closure shall be the preferred method for achieving necessary budgetary savings required
by the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph
(c). If additional closures are required to achieve the necessary savings, the commissioner
shall use the process and priorities in section 245A.03, subdivision 7, paragraph (c)
deleted text endnew text begin A
resource need determination process, managed at the state level, using available reports
required by section 144A.351 and other data and information shall be used by the
commissioner to align capacity where needed
new text end.

Sec. 18.

Minnesota Statutes 2016, section 256B.493, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Closure process. new text end

new text begin (a) The commissioner shall work with stakeholders to
establish a process for the application, review, approval, and implementation of setting
closures. Voluntary proposals from license holders for consolidation and closure of adult
foster care or community residential settings are encouraged. Whether voluntary or
involuntary, all closure plans must include:
new text end

new text begin (1) a description of the proposed closure plan, identifying the home or homes and
occupied beds;
new text end

new text begin (2) the proposed timetable for the proposed closure, including the proposed dates for
notification to people living there and the affected lead agencies, commencement of closure,
and completion of closure;
new text end

new text begin (3) the proposed relocation plan jointly developed by the counties of financial
responsibility, the people living there and their legal representatives, if any, who wish to
continue to receive services from the provider, and the providers for current residents of
any adult foster care home designated for closure; and
new text end

new text begin (4) documentation from the provider in a format approved by the commissioner that all
the adult foster care homes or community residential settings receiving a planned closure
rate adjustment under the plan have accepted joint and severable for recovery of
overpayments under section 256B.0641, subdivision 2, for the facilities designated for
closure under this plan.
new text end

new text begin (b) The commissioner shall give first priority to closure plans which:
new text end

new text begin (1) target counties and geographic areas which have:
new text end

new text begin (i) need for other types of services;
new text end

new text begin (ii) need for specialized services;
new text end

new text begin (iii) higher than average per capita use of licensed corporate foster care or community
residential settings; or
new text end

new text begin (iv) residents not living in the geographic area of their choice;
new text end

new text begin (2) demonstrate savings of medical assistance expenditures; and
new text end

new text begin (3) demonstrate that alternative services are based on the recipient's choice of provider
and are consistent with federal law, state law, and federally approved waiver plans.
new text end

new text begin The commissioner shall also consider any information provided by people using services,
their legal representatives, family members, or the lead agency on the impact of the planned
closure on people and the services they need.
new text end

new text begin (c) For each closure plan approved by the commissioner, a contract must be established
between the commissioner, the counties of financial responsibility, and the participating
license holder.
new text end

Sec. 19.

Minnesota Statutes 2016, section 256D.44, subdivision 4, as amended by Laws
2017, chapter 59, section 12, is amended to read:


Subd. 4.

Temporary absence due to illness.

For the purposes of this subdivision, "home"
means a residence owned or rented by a recipient or the recipient's spouse. deleted text beginHome does not
include a group residential housing facility.
deleted text end Assistance payments for recipients who are
temporarily absent from their home due to hospitalization for illness must continue at the
same level of payment during their absence if the following criteria are met:

(1) a physician, advanced practice registered nurse, or physician assistant certifies that
the absence is not expected to continue for more than three months;

(2) a physician, advanced practice registered nurse, or physician assistant certifies that
the recipient will be able to return to independent living; and

(3) the recipient has expenses associated with maintaining a residence in the community.

Sec. 20.

Minnesota Statutes 2016, section 256D.44, subdivision 5, as amended by Laws
2017, chapter 40, article 1, section 84, and Laws 2017, chapter 59, section 13, is amended
to read:


Subd. 5.

Special needs.

new text begin(a) new text endIn addition to the state standards of assistance established
in subdivisions 1 to 4, payments are allowed for the following special needs of recipients
of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a deleted text begingroup residentialdeleted text endnew text begin setting authorized to receivenew text end housing deleted text beginfacilitydeleted text endnew text begin support payments
under chapter 256I
new text end.

deleted text begin (a)deleted text endnew text begin (b)new text end The county agency shall pay a monthly allowance for medically prescribed diets
if the cost of those additional dietary needs cannot be met through some other maintenance
benefit. The need for special diets or dietary items must be prescribed by a licensed physician,
advanced practice registered nurse, or physician assistant. Costs for special diets shall be
determined as percentages of the allotment for a one-person household under the thrifty
food plan as defined by the United States Department of Agriculture. The types of diets and
the percentages of the thrifty food plan that are covered are as follows:

(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;

(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of
thrifty food plan;

(3) controlled protein diet, less than 40 grams and requires special products, 125 percent
of thrifty food plan;

(4) low cholesterol diet, 25 percent of thrifty food plan;

(5) high residue diet, 20 percent of thrifty food plan;

(6) pregnancy and lactation diet, 35 percent of thrifty food plan;

(7) gluten-free diet, 25 percent of thrifty food plan;

(8) lactose-free diet, 25 percent of thrifty food plan;

(9) antidumping diet, 15 percent of thrifty food plan;

(10) hypoglycemic diet, 15 percent of thrifty food plan; or

(11) ketogenic diet, 25 percent of thrifty food plan.

deleted text begin (b)deleted text endnew text begin (c)new text end Payment for nonrecurring special needs must be allowed for necessary home
repairs or necessary repairs or replacement of household furniture and appliances using the
payment standard of the AFDC program in effect on July 16, 1996, for these expenses, as
long as other funding sources are not available.

deleted text begin (c)deleted text endnew text begin (d)new text end A fee for guardian or conservator service is allowed at a reasonable rate negotiated
by the county or approved by the court. This rate shall not exceed five percent of the
assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian
or conservator is a member of the county agency staff, no fee is allowed.

deleted text begin (d)deleted text endnew text begin (e)new text end The county agency shall continue to pay a monthly allowance of $68 for restaurant
meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and
who eats two or more meals in a restaurant daily. The allowance must continue until the
person has not received Minnesota supplemental aid for one full calendar month or until
the person's living arrangement changes and the person no longer meets the criteria for the
restaurant meal allowance, whichever occurs first.

deleted text begin (e)deleted text endnew text begin (f)new text end A fee of ten percent of the recipient's gross income or $25, whichever is less, is
allowed for representative payee services provided by an agency that meets the requirements
under SSI regulations to charge a fee for representative payee services. This special need
is available to all recipients of Minnesota supplemental aid regardless of their living
arrangement.

deleted text begin (f)deleted text endnew text begin (g)new text end(1) Notwithstanding the language in this subdivision, an amount equal tonew text begin one-half
of
new text end the maximum deleted text beginallotment authorized by the federal Food Stamp Program for adeleted text endnew text begin federal
Supplemental Security Income payment amount for a
new text end single individual which is in effect
on the first day of July of each year will be added to the standards of assistance established
in subdivisions 1 to 4 for adults under the age of 65 who qualify as deleted text beginshelter needydeleted text endnew text begin in need
of housing assistance
new text end and are:

(i) relocating from an institution, new text begina setting authorized to receive housing support under
chapter 256I,
new text endor an adult mental health residential treatment program under section
256B.0622; deleted text beginor
deleted text end

(ii) new text begineligible for personal care assistance under section 256B.0659; or
new text end

new text begin (iii) new text endhome and community-based waiver recipients living in their own home or rented
or leased apartment.

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter
needy benefit under this paragraph is considered a household of one. An eligible individual
who receives this benefit prior to age 65 may continue to receive the benefit after the age
of 65.

(3) "deleted text beginShelter needydeleted text endnew text begin Housing assistancenew text end" means that the assistance unit incurs monthly
shelter costs that exceed 40 percent of the assistance unit's gross income before the application
of this special needs standard. "Gross income" for the purposes of this section is the
applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the
standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient
of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income,
shall not be considered deleted text beginshelter needydeleted text endnew text begin in need of housing assistancenew text end for purposes of this
paragraph.

new text begin EFFECTIVE DATE. new text end

new text begin Paragraphs (a) to (f) are effective July 1, 2017. Paragraph (g),
clause (1), is effective July 1, 2020, except paragraph (g), clause (1), items (ii) and (iii), are
effective July 1, 2017.
new text end

Sec. 21.

Minnesota Statutes 2016, section 256I.03, subdivision 8, is amended to read:


Subd. 8.

Supplementary services.

"Supplementary services" means new text beginhousing support
new text end services provided to deleted text beginresidents of group residential housing providersdeleted text endnew text begin individualsnew text end in addition
to room and board including, but not limited to, oversight and up to 24-hour supervision,
medication reminders, assistance with transportation, arranging for meetings and
appointments, and arranging for medical and social services.

Sec. 22.

Minnesota Statutes 2016, section 256I.04, subdivision 1, is amended to read:


Subdivision 1.

Individual eligibility requirements.

An individual is eligible for and
entitled to a deleted text begingroup residentialdeleted text end housing new text beginsupport new text endpayment to be made on the individual's behalf
if the agency has approved the deleted text beginindividual's residence in a group residentialdeleted text end new text beginsetting where
the individual will receive
new text endhousing deleted text beginsettingdeleted text end new text beginsupport new text endand the individual meets the requirements
in paragraph (a) deleted text beginordeleted text endnew text begin,new text end (b)new text begin, or (c)new text end.

(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 deleted text begingroup residentialdeleted text end housing new text beginsupport new text endin which the individual resides.

(b) The individual meets a category of eligibility under section 256D.05, subdivision 1,
paragraph (a), clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable, and the
individual's resources are less than the standards specified by section 256P.02, and the
individual's countable income as determined under section 256P.06, 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 deleted text begingroup residentialdeleted text end housing new text beginsupport
new text end in which the individual resides.

new text begin (c) The individual receives licensed residential crisis stabilization services under section
256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive
concurrent housing support payments if receiving licensed residential crisis stabilization
services under section 256B.0624, subdivision 7.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (c) is effective October 1, 2017.
new text end

Sec. 23.

Minnesota Statutes 2016, section 256I.04, subdivision 2d, is amended to read:


Subd. 2d.

Conditions of payment; commissioner's right to suspend or terminate
agreement.

(a) deleted text beginGroup residentialdeleted text end Housing deleted text beginor supplementary servicesdeleted text endnew text begin supportnew text end 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 new text beginroom and board or supplementary new text endservices deleted text beginor housingdeleted text end found by the commissioner to be
performed or provided in violation of federal, state, or local law, ordinance, rule, or
regulation.

(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.

(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.

Sec. 24.

Minnesota Statutes 2016, section 256I.04, subdivision 2g, is amended to read:


Subd. 2g.

Crisis shelters.

Secure crisis shelters for battered women and their children
designated by the Minnesota Department of Corrections are not deleted text begingroup residencesdeleted text endnew text begin eligible
for housing support
new text end under this chapter.

Sec. 25.

Minnesota Statutes 2016, section 256I.04, subdivision 3, is amended to read:


Subd. 3.

Moratorium on development of deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end beds.

(a) Agencies shall not enter into agreements for new deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end beds
with total rates in excess of the MSA equivalent rate except:

(1) for deleted text begingroup residential housingdeleted text end establishments licensed under chapter 245D 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 deleted text begin190deleted text end new text begin226 new text endsupportive
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 deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end 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 deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end supplementarynew text begin servicenew text end rate. A resident in a
demonstration project site who no longer participates in the demonstration program shall
retain eligibility for a deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end 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 deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end contract with the county and has been licensed as
a board and lodge facility with special services since 1980;

(5) for a deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end 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 deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end provider that currently operates a
304-bed facility in Minneapolis, and a 44-bed facility in Duluth;

(7) for a deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end 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 deleted text begingroup residentialdeleted text end facilitynew text begin authorized for recipients of housing supportnew text end 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) An agency may enter into a deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end agreement for beds
with rates in excess of the MSA equivalent rate in addition to those currently covered under
a deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end 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 deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end payment, or as a result of the downsizing of a deleted text begingroup
residential housing
deleted text end settingnew text begin authorized for recipients of housing supportnew text end. The transfer of
available beds from one agency to another can only occur by the agreement of both agencies.

Sec. 26.

Minnesota Statutes 2016, section 256I.05, subdivision 1a, is amended to read:


Subd. 1a.

Supplementary service rates.

(a) Subject to the provisions of section 256I.04,
subdivision 3
, the county agency may negotiate a payment not to exceed $426.37 for other
services necessary to provide room and board deleted text beginprovided by the group residencedeleted text end if the residence
is licensed by or registered by the Department of Health, or licensed by the Department of
Human Services to provide services in addition to room and board, and if the provider of
services is not also concurrently receiving funding for services for a recipient under a home
and community-based waiver under title XIX of the Social Security Act; or funding from
the medical assistance program under section 256B.0659, for personal care services for
residents in the setting; or residing in a setting which receives funding under section 245.73.
If funding is available for other necessary services through a home and community-based
waiver, or personal care services under section 256B.0659, then the deleted text beginGRHdeleted text endnew text begin housing supportnew text end
rate is limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case
may the supplementary service rate exceed $426.37. The registration and licensure
requirement does not apply to establishments which are exempt from state licensure because
they are located on Indian reservations and for which the tribe has prescribed health and
safety requirements. Service payments under this section may be prohibited under rules to
prevent the supplanting of federal funds with state funds. The commissioner shall pursue
the feasibility of obtaining the approval of the Secretary of Health and Human Services to
provide home and community-based waiver services under title XIX of the Social Security
Act for residents who are not eligible for an existing home and community-based waiver
due to a primary diagnosis of mental illness or chemical dependency and shall apply for a
waiver if it is determined to be cost-effective.

(b) The commissioner is authorized to make cost-neutral transfers from the deleted text beginGRHdeleted text endnew text begin housing
support
new text end fund for beds under this section to other funding programs administered by the
department after consultation with the county or counties in which the affected beds are
located. The commissioner may also make cost-neutral transfers from the deleted text beginGRHdeleted text endnew text begin housing
support
new text end fund to county human service agencies for beds permanently removed from the
deleted text begin GRHdeleted text endnew text begin housing supportnew text end census under a plan submitted by the county agency and approved
by the commissioner. The commissioner shall report the amount of any transfers under this
provision annually to the legislature.

(c) Counties must not negotiate supplementary service rates with providers of deleted text begingroup
residential
deleted text end housing new text beginsupport new text endthat are licensed as board and lodging with special services and
that do not encourage a policy of sobriety on their premises and make referrals to available
community services for volunteer and employment opportunities for residents.

Sec. 27.

Minnesota Statutes 2016, section 256I.05, subdivision 1c, is amended to read:


Subd. 1c.

Rate increases.

An agency may not increase the rates negotiated for deleted text begingroup
residential
deleted text end housing new text beginsupport new text endabove those in effect on June 30, 1993, except as provided in
paragraphs (a) to (f).

(a) An agency may increase the rates for deleted text begingroup residential housing settingsdeleted text endnew text begin room and
board
new text end to the MSA equivalent rate for those settings whose current rate is below the MSA
equivalent rate.

(b) An agency may increase the rates for residents in adult foster care whose difficulty
of care has increased. The total deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end rate for these residents
must not exceed the maximum rate specified in subdivisions 1 and 1a. Agencies must not
include nor increase deleted text begingroup residential housingdeleted text end 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 deleted text begina group residentialdeleted text end housing deleted text beginrate is used to paydeleted text endnew text begin support paysnew text end 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 deleted text begingroup residential housingdeleted text end 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, an 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 9549.0051 to
9549.0058.

Sec. 28.

Minnesota Statutes 2016, section 256I.05, subdivision 1e, is amended to read:


Subd. 1e.

Supplementary rate for certain facilities.

(a) Notwithstanding the provisions
of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per
month, including any legislatively authorized inflationary adjustments, for a deleted text begingroup residentialdeleted text end
housing new text beginsupport new text endprovider that:

(1) is located in Hennepin County and has had a deleted text begingroup residentialdeleted text end housing new text beginsupport
new text end contract with the county since June 1996;

(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 26-bed
facility; and

(3) serves a chemically dependent clientele, providing 24 hours per day supervision and
limiting a resident's maximum length of stay to 13 months out of a consecutive 24-month
period.

(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per
month, including any legislatively authorized inflationary adjustments, of a deleted text begingroup residentialdeleted text endnew text begin
housing support
new text end provider that:

(1) is located in St. Louis County and has had a deleted text begingroup residentialdeleted text end housing new text beginsupport new text endcontract
with the county since 2006;

(2) operates a 62-bed facility; and

(3) serves a chemically dependent adult male clientele, providing 24 hours per day
supervision and limiting a resident's maximum length of stay to 13 months out of a
consecutive 24-month period.

(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
to exceed $700 per month, including any legislatively authorized inflationary adjustments,
for the deleted text begingroup residentialdeleted text end provider described under paragraphs (a) and (b), not to exceed an
additional 115 beds.

Sec. 29.

Minnesota Statutes 2016, section 256I.05, subdivision 1j, is amended to read:


Subd. 1j.

Supplementary rate for certain facilities; Crow Wing County.

Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a county
agency shall negotiate a supplementary rate in addition to the rate specified in subdivision
1, not to exceed $700 per month, including any legislatively authorized inflationary
adjustments, for a new 65-bed facility in Crow Wing County that will serve chemically
dependent persons operated by a deleted text begingroup residentialdeleted text end housing new text beginsupport new text endprovider that currently
operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which opened in
January of 2006.

Sec. 30.

Minnesota Statutes 2016, section 256I.05, subdivision 1m, is amended to read:


Subd. 1m.

Supplemental rate for certain facilities; Hennepin and Ramsey Counties.

deleted text begin (a)deleted text end Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
shall negotiate a supplemental service rate in addition to the rate specified in subdivision
1, not to exceed deleted text begin$700 per monthdeleted text end new text beginthe maximum rate in subdivision 1anew text end or the existing monthly
rate, whichever is higher, including any legislatively authorized inflationary adjustments,
for a deleted text begingroup residentialdeleted text end housing new text beginsupport new text endprovider that operates two ten-bed facilities, one
located in Hennepin County and one located in Ramsey County, which provide community
support and serve the mental health needs of individuals who have chronically lived
unsheltered, providing 24-hour-per-day supervision.

deleted text begin (b) An individual who has lived in one of the facilities under paragraph (a), who is being
transitioned to independent living as part of the program plan continues to be eligible for
deleted text end deleted text begin group residential housing and the supplemental service rate negotiated with deleted text end deleted text begin the county under
paragraph (a).
deleted text end

Sec. 31.

Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1p. new text end

new text begin Supplementary rate; St. Louis County. new text end

new text begin Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per
month, including any legislatively authorized inflationary adjustments, for a housing support
provider that:
new text end

new text begin (1) is located in St. Louis County and has had a housing support contract with the county
since July 2016;
new text end

new text begin (2) operates a 35-bed facility;
new text end

new text begin (3) serves women who are chemically dependent, mentally ill, or both;
new text end

new text begin (4) provides 24-hour per day supervision;
new text end

new text begin (5) provides on-site support with skilled professionals, including a licensed practical
nurse, registered nurses, peer specialists, and resident counselors; and
new text end

new text begin (6) provides independent living skills training and assistance with family reunification.
new text end

Sec. 32.

Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1q. new text end

new text begin Supplemental rate; Olmsted County. new text end

new text begin Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per
month, including any legislatively authorized inflationary adjustments, for a housing support
provider located in Olmsted County that operates long-term residential facilities with a total
of 104 beds that serve chemically dependent men and women and provide 24-hour-a-day
supervision and other support services.
new text end

Sec. 33.

Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1r. new text end

new text begin Supplemental rate; Anoka County. new text end

new text begin Notwithstanding the provisions in this
section, a county agency shall negotiate a supplemental rate for 42 beds in addition to the
rate specified in subdivision 1, not to exceed the maximum rate allowed under subdivision
1a, including any legislatively authorized inflationary adjustments, for a housing support
provider that is located in Anoka County and provides emergency housing on the former
Anoka Regional Treatment Center campus.
new text end

Sec. 34.

Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Transfer of emergency shelter funds. new text end

new text begin (a) The commissioner shall make a
cost-neutral transfer of funding from the housing support fund to county human service
agencies for emergency shelter beds removed from the housing support census under a
biennial plan submitted by the county and approved by the commissioner. The plan must
describe: (1) anticipated and actual outcomes for persons experiencing homelessness in
emergency shelters; (2) improved efficiencies in administration; (3) requirements for
individual eligibility; and (4) plans for quality assurance monitoring and quality assurance
outcomes. The commissioner shall review the county plan to monitor implementation and
outcomes at least biennially, and more frequently if the commissioner deems necessary.
new text end

new text begin (b) The funding under paragraph (a) may be used for the provision of room and board
or supplemental services according to section 256I.03, subdivisions 2 and 8. Providers must
meet the requirements of section 256I.04, subdivisions 2a to 2f. Funding must be allocated
annually, and the room and board portion of the allocation shall be adjusted according to
the percentage change in the housing support room and board rate. The room and board
portion of the allocation shall be determined at the time of transfer. The commissioner or
county may return beds to the housing support fund with 180 days' notice, including financial
reconciliation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 35.

Minnesota Statutes 2016, section 256I.06, subdivision 2, is amended to read:


Subd. 2.

Time of payment.

A county agency may make payments deleted text beginto a group residencedeleted text end
in advance for an individual whose stay deleted text beginin the group residencedeleted text end is expected to last beyond
the calendar month for which the payment is made. deleted text beginGroup residentialdeleted text end Housingnew text begin supportnew text end
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 deleted text begingroupdeleted text end residence.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 36.

Minnesota Statutes 2016, section 256I.06, subdivision 8, is amended to read:


Subd. 8.

Amount of deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end payment.

(a) The amount of
a deleted text begingroup residential housingdeleted text endnew text begin room and boardnew text end 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 deleted text begingroup residential housing
charge
deleted text endnew text begin room and board ratenew text end for that same month. The deleted text begingroup residentialdeleted text end housing deleted text beginchargedeleted text endnew text begin
support payment
new text end is determined by multiplying the deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end rate
times the period of time the individual was a resident or temporarily absent under section
256I.05, subdivision 1c, paragraph (d).

(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 begin (c) For an individual who receives licensed residential crisis stabilization services under
section 256B.0624, subdivision 7, the amount of housing support payment is determined
by multiplying the housing support rate times the period of time the individual was a resident.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (c) is effective October 1, 2017.
new text end

Sec. 37.

new text begin [256I.09] COMMUNITY LIVING INFRASTRUCTURE.
new text end

new text begin The commissioner shall award grants to agencies through an annual competitive process.
Grants awarded under this section may be used for: (1) outreach to locate and engage people
who are homeless or residing in segregated settings to screen for basic needs and assist with
referral to community living resources; (2) building capacity to provide technical assistance
and consultation on housing and related support service resources for persons with both
disabilities and low income; or (3) streamlining the administration and monitoring activities
related to housing support funds. Agencies may collaborate and submit a joint application
for funding under this section.
new text end

Sec. 38. new text beginGROUP RESIDENTIAL HOUSING; HOUSING SUPPORT SERVICES
PLAN TO REVIEW SUPPLEMENTAL SERVICE RATES.
new text end

new text begin (a) Since 1993, group residential housing supplementary service rates have been
established in statute without a standard rate setting methodology, nor information about
or an analysis of the actual cost the provider will sustain to provide the services. There are
approximately 200 providers that receive more than 65 different monthly supplemental rates
ranging from $44 to $5,000. Further, there are wide discrepancies between the services that
are provided for the supplemental rate payment.
new text end

new text begin (b) The commissioner of human services shall develop: (1) a plan to review all
supplemental rates over a sufficient time period, to be determined by the commissioner; (2)
a process to modify the rate if it is either inadequate or excessive; and (3) a process to review
supplemental rates prospectively, so the legislature has the foundation necessary in which
to make a decision as to whether to approve the request for a supplemental rate. The
information must be provided in a report to the senate and house of representatives
committees with jurisdiction over group residential housing issues, along with proposed
legislation to effectuate the plan and processes and a fiscal estimate by December 1, 2018.
new text end

Sec. 39. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin In each section of Minnesota Statutes referred to in column A, the revisor of statutes
shall change the phrase in column B to the phrase in column C. The revisor may make
technical and other necessary changes to sentence structure to preserve the meaning of the
text. The revisor shall make other changes in chapter titles; section, subdivision, part, and
subpart headnotes; and in other terminology necessary as a result of the enactment of this
section.
new text end

new text begin Column A
new text end
new text begin Column B
new text end
new text begin Column C
new text end
new text begin 144A.071, subdivision 4d
new text end
new text begin group residential housing
new text end
new text begin housing support under chapter
256I
new text end
new text begin 201.061, subdivision 3
new text end
new text begin group residential housing
new text end
new text begin setting authorized to provide
housing support
new text end
new text begin 244.052, subdivision 4c
new text end
new text begin group residential housing
facility
new text end
new text begin licensed setting authorized to
provide housing support
under section 256I.04
new text end
new text begin 245.466, subdivision 7
new text end
new text begin under group residential
housing
new text end
new text begin by housing support under
chapter 256I
new text end
new text begin 245.466, subdivision 7
new text end
new text begin from group residential housing
new text end
new text begin from housing support
new text end
new text begin 245.4661, subdivision 6
new text end
new text begin group residential housing
new text end
new text begin housing support under chapter
256I
new text end
new text begin 245C.10, subdivision 11
new text end
new text begin group residential housing or
supplementary services
new text end
new text begin housing support
new text end
new text begin 256.01, subdivision 18
new text end
new text begin group residential housing
new text end
new text begin housing support under chapter
256I
new text end
new text begin 256.017, subdivision 1
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256.98, subdivision 8
new text end
new text begin group residential housing
new text end
new text begin housing support under chapter
256I
new text end
new text begin 256B.49, subdivision 15
new text end
new text begin group residential housing
new text end
new text begin housing support under chapter
256I
new text end
new text begin 256B.4914, subdivision 10
new text end
new text begin group residential housing rate
3 costs
new text end
new text begin housing support rate 3 costs
under chapter 256I
new text end
new text begin 256B.501, subdivision 4b
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256B.77, subdivision 12
new text end
new text begin residential services covered
under the group residential
housing program
new text end
new text begin housing support services
under chapter 256I
new text end
new text begin 256D.44, subdivision 2
new text end
new text begin group residential housing
facility
new text end
new text begin setting authorized to provide
housing support
new text end
new text begin 256G.01, subdivision 3
new text end
new text begin group residential housing
new text end
new text begin housing support under chapter
256I
new text end
new text begin 256I.01
new text end
new text begin Group Residential Housing
new text end
new text begin Housing Support
new text end
new text begin 256I.02
new text end
new text begin Group Residential Housing
new text end
new text begin Housing Support
new text end
new text begin 256I.03, subdivision 2
new text end
new text begin "Group residential housing"
new text end
new text begin "Room and board"
new text end
new text begin 256I.03, subdivision 2
new text end
new text begin Group residential housing
new text end
new text begin The room and board
new text end
new text begin 256I.03, subdivision 3
new text end
new text begin "Group residential housing"
new text end
new text begin "Housing support"
new text end
new text begin 256I.03, subdivision 6
new text end
new text begin group residential housing
new text end
new text begin room and board
new text end
new text begin 256I.03, subdivisions 7 and 9
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256I.04, subdivisions 1a, 1b,
1c, and 2
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256I.04, subdivision 2a
new text end
new text begin provide group residential
housing
new text end
new text begin provide housing support
new text end
new text begin 256I.04, subdivision 2a
new text end
new text begin of group residential housing
or supplementary services
new text end
new text begin of housing support
new text end
new text begin 256I.04, subdivision 2a
new text end
new text begin complete group residential
housing
new text end
new text begin complete housing support
new text end
new text begin 256I.04, subdivision 2b
new text end
new text begin group residential housing or
supplementary services
new text end
new text begin housing support
new text end
new text begin 256I.04, subdivision 2b
new text end
new text begin provision of group residential
housing
new text end
new text begin provision of housing support
new text end
new text begin 256I.04, subdivision 2c
new text end
new text begin group residential housing or
supplementary services
new text end
new text begin housing support
new text end
new text begin 256I.04, subdivision 2e
new text end
new text begin group residential housing or
supplementary services
new text end
new text begin housing support
new text end
new text begin 256I.04, subdivision 4
new text end
new text begin group residential housing
payment for room and board
new text end
new text begin room and board rate
new text end
new text begin 256I.05, subdivision 1
new text end
new text begin living in group residential
housing
new text end
new text begin receiving housing support
new text end
new text begin 256I.05, subdivisions 1h, 1k,
1l, 7b, and 7c
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256I.05, subdivision 2
new text end
new text begin group residential housing
new text end
new text begin room and board
new text end
new text begin 256I.05, subdivision 3
new text end
new text begin group residential housing
new text end
new text begin room and board
new text end
new text begin 256I.05, subdivision 6
new text end
new text begin reside in group residential
housing
new text end
new text begin receive housing support
new text end
new text begin 256I.06, subdivisions 1, 3, 4,
and 6
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256I.06, subdivision 7
new text end
new text begin group residential housing
new text end
new text begin the housing support
new text end
new text begin 256I.08
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256P.03, subdivision 1
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256P.05, subdivision 1
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256P.07, subdivision 1
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 256P.08, subdivision 1
new text end
new text begin group residential housing
new text end
new text begin housing support
new text end
new text begin 290A.03, subdivision 8
new text end
new text begin accepts group residential
housing
new text end
new text begin accepts housing support
new text end
new text begin 290A.03, subdivision 8
new text end
new text begin the group residential housing
program
new text end
new text begin the housing support program
new text end

ARTICLE 3

CONTINUING CARE

Section 1.

Minnesota Statutes 2016, section 144.0724, subdivision 4, is amended to read:


Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and electronically
submit to the commissioner of health MDS assessments that conform with the assessment
schedule defined by Code of Federal Regulations, title 42, section 483.20, and published
by the United States Department of Health and Human Services, Centers for Medicare and
Medicaid Services, in the Long Term Care Assessment Instrument User's Manual, version
3.0, and subsequent updates when issued by the Centers for Medicare and Medicaid Services.
The commissioner of health may substitute successor manuals or question and answer
documents published by the United States Department of Health and Human Services,
Centers for Medicare and Medicaid Services, to replace or supplement the current version
of the manual or document.

(b) The assessments used to determine a case mix classification for reimbursement
include the following:

(1) a new admission assessment;

(2) an annual assessment which must have an assessment reference date (ARD) within
92 days of the previous assessment and the previous comprehensive assessment;

(3) a significant change in status assessment must be completed within 14 days of the
identification of a significant changenew text begin, whether improvement or decline, and regardless of
the amount of time since the last significant change in status assessment
new text end;

(4) all quarterly assessments must have an assessment reference date (ARD) within 92
days of the ARD of the previous assessment;

(5) any significant correction to a prior comprehensive assessment, if the assessment
being corrected is the current one being used for RUG classification; and

(6) any significant correction to a prior quarterly assessment, if the assessment being
corrected is the current one being used for RUG classification.

(c) In addition to the assessments listed in paragraph (b), the assessments used to
determine nursing facility level of care include the following:

(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
the Senior LinkAge Line or other organization under contract with the Minnesota Board on
Aging; and

(2) a nursing facility level of care determination as provided for under section 256B.0911,
subdivision 4e
, as part of a face-to-face long-term care consultation assessment completed
under section 256B.0911, by a county, tribe, or managed care organization under contract
with the Department of Human Services.

Sec. 2.

Minnesota Statutes 2016, section 144.0724, subdivision 6, is amended to read:


Subd. 6.

Penalties for late or nonsubmission.

(a) A facility that fails to complete or
submit an assessment according to subdivisions 4 and 5 for a RUG-IV classification within
seven days of the time requirements listed in the Long-Term Care Facility Resident
Assessment Instrument User's Manual is subject to a reduced rate for that resident. The
reduced rate shall be the lowest rate for that facility. The reduced rate is effective on the
day of admission for new admission assessments, on the ARD for significant change in
status assessments, or on the day that the assessment was due for all other assessments and
continues in effect until the first day of the month following the date of submission and
acceptance of the resident's assessment.

(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days
are equal to or greater than deleted text begin1.0deleted text endnew text begin 0.1new text end percent of the total operating costs on the facility's most
recent annual statistical and cost report, a facility may apply to the commissioner of human
services for a reduction in the total penalty amount. The commissioner of human services,
in consultation with the commissioner of health, may, at the sole discretion of the
commissioner of human services, limit the penalty for residents covered by medical assistance
to deleted text begin15deleted text endnew text begin tennew text end days.

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2016, section 144.562, subdivision 2, is amended to read:


Subd. 2.

Eligibility for license condition.

(a) A hospital is not eligible to receive a
license condition for swing beds unless (1) it either has a licensed bed capacity of less than
50 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42,
section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that
were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed
capacity of less than 65 beds and the available nursing homes within 50 miles have had, in
the aggregate, an average occupancy rate of 96 percent or higher in the most recent two
years as documented on the statistical reports to the Department of Health; and (2) it is
located in a rural area as defined in the federal Medicare regulations, Code of Federal
Regulations, title 42, section 482.66.

(b) Except for those critical access hospitals 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 have an attached nursing home or that owned a nursing home located in the
same municipality as of May 1, 2005, eligible hospitals are allowed a total of 2,000 days
of swing bed use per year. Critical access hospitals that have an attached nursing home or
that owned a nursing home located in the same municipality as of May 1, 2005, are allowed
swing bed use as provided in federal law.

(c) Except for critical access hospitals that have an attached nursing home or that owned
a nursing home located in the same municipality as of May 1, 2005, the commissioner of
health may approve swing bed use beyond 2,000 days as long as there are no Medicare
certified skilled nursing facility beds available within 25 miles of that hospital that are
willing to admit the patientnew text begin and the patient agrees to the referral being sent to the skilled
nursing facility
new text end. Critical access hospitals exceeding 2,000 swing bed days must maintain
documentation that they have contacted skilled nursing facilities within 25 miles to determine
if any skilled nursing facility beds are available that are willing to admit the patientnew text begin and the
patient agrees to the referral being sent to the skilled nursing facility
new text end.

(d) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which
this limit applies may admit six additional patients to swing beds each year without seeking
approval from the commissioner or being in violation of this subdivision. These six swing
bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals
subject to this limit.

(e) A health care system that is in full compliance with this subdivision may allocate its
total limit of swing bed days among the hospitals within the system, provided that no hospital
in the system without an attached nursing home may exceed 2,000 swing bed days per year.

Sec. 4.

Minnesota Statutes 2016, section 144A.071, subdivision 4d, as amended by Laws
2017, chapter 40, article 1, section 25, is amended to read:


Subd. 4d.

Consolidation of nursing facilities.

(a) The commissioner of health, in
consultation with the commissioner of human services, may approve a request for
consolidation of nursing facilities which includes the closure of one or more facilities and
the upgrading of the physical plant of the remaining nursing facility or facilities, the costs
of which exceed the threshold project limit under subdivision 2, clause (a). The
commissioners shall consider the criteria in this section, section 144A.073, and section
256R.40, in approving or rejecting a consolidation proposal. In the event the commissioners
approve the request, the commissioner of human services shall calculate an external fixed
costs rate adjustment according to clauses (1) to (3):

(1) the closure of beds shall not be eligible for a planned closure rate adjustment under
section 256R.40, subdivision 5;

(2) the construction project permitted in this clause shall not be eligible for a threshold
project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception
adjustment under section 144A.073; and

(3) the payment rate for external fixed costs for a remaining facility or facilities shall
be increased by an amount equal to 65 percent of the projected net cost savings to the state
calculated in paragraph (b), divided by the state's medical assistance percentage of medical
assistance dollars, and then divided by estimated medical assistance resident days, as
determined in paragraph (c), of the remaining nursing facility or facilities in the request in
this paragraph. The rate adjustment is effective on the deleted text beginlater of the first day of the month
following
deleted text endnew text begin first day of the month of January or July, whichever date occurs first following
both the
new text end completion of the construction upgrades in the consolidation plan deleted text beginor the first day
of the month following
deleted text endnew text begin andnew text end the complete deleted text beginclosure of a facilitydeleted text endnew text begin closure of the facility or
facilities
new text end designated for closure in the consolidation plan. If more than one facility is receiving
upgrades in the consolidation plan, each facility's date of construction completion must be
evaluated separately.

(b) For purposes of calculating the net cost savings to the state, the commissioner shall
consider clauses (1) to (7):

(1) the annual savings from estimated medical assistance payments from the net number
of beds closed taking into consideration only beds that are in active service on the date of
the request and that have been in active service for at least three years;

(2) the estimated annual cost of increased case load of individuals receiving services
under the elderly waiver;

(3) the estimated annual cost of elderly waiver recipients receiving support under group
residential housing;

(4) the estimated annual cost of increased case load of individuals receiving services
under the alternative care program;

(5) the annual loss of license surcharge payments on closed beds;

(6) the savings from not paying planned closure rate adjustments that the facilities would
otherwise be eligible for under section 256R.40; and

(7) the savings from not paying external fixed costs payment rate adjustments from
submission of renovation costs that would otherwise be eligible as threshold projects under
section 256B.434, subdivision 4f.

(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical
assistance resident days of the remaining facility or facilities shall be computed assuming
95 percent occupancy multiplied by the historical percentage of medical assistance resident
days of the remaining facility or facilities, as reported on the facility's or facilities' most
recent nursing facility statistical and cost report filed before the plan of closure is submitted,
multiplied by 365.

(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy
percentages will be those reported on the facility's or facilities' most recent nursing facility
statistical and cost report filed before the plan of closure is submitted, and the average
payment rates shall be calculated based on the approved payment rates in effect at the time
the consolidation request is submitted.

(e) To qualify for the external fixed costs payment rate adjustment under this subdivision,
the closing facilities shall:

(1) submit an application for closure according to section 256R.40, subdivision 2; and

(2) follow the resident relocation provisions of section 144A.161.

(f) The county or counties in which a facility or facilities are closed under this subdivision
shall not be eligible for designation as a hardship area under subdivision 3 for five years
from the date of the approval of the proposed consolidation. The applicant shall notify the
county of this limitation and the county shall acknowledge this in a letter of support.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for consolidations occurring after July
1, 2017.
new text end

Sec. 5.

Minnesota Statutes 2016, section 144A.74, is amended to read:


144A.74 MAXIMUM CHARGES.

A supplemental nursing services agency must not bill or receive payments from a nursing
home licensed under this chapter at a rate higher than 150 percent of the sum of the weighted
average wage rate, plus a factor determined by the commissioner to incorporate payroll
taxes as defined in deleted text beginMinnesota Rules, part 9549.0020, subpart 33deleted text endnew text begin section 256R.02, subdivision
37
new text end, for the applicable employee classification for the geographic group deleted text beginto which the nursingdeleted text end
deleted text begin home is assigned under Minnesota Rules, part 9549.0052deleted text endnew text begin specified in section 256R.23,
subdivision 4
new text end. The weighted average wage rates must be determined by the commissioner
of human services and reported to the commissioner of health on an annual basis. Wages
are defined as hourly rate of pay and shift differential, including weekend shift differential
and overtime. Facilities shall provide information necessary to determine weighted average
wage rates to the commissioner of human services in a format requested by the commissioner.
The maximum rate must include all charges for administrative fees, contract fees, or other
special charges in addition to the hourly rates for the temporary nursing pool personnel
supplied to a nursing home.new text begin A nursing home that pays for the actual travel and housing costs
for supplemental nursing services agency staff working at the facility and that pays these
costs to the employee, the agency, or another vendor, is not violating the limitation on
charges described in this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 6.

Minnesota Statutes 2016, section 256.975, subdivision 7, is amended to read:


Subd. 7.

Consumer information and assistance and long-term care options
counseling; Senior LinkAge Line.

(a) The Minnesota Board on Aging shall operate a
statewide service to aid older Minnesotans and their families in making informed choices
about long-term care options and health care benefits. Language services to persons with
limited English language skills may be made available. The service, known as Senior
LinkAge Line, shall serve older adults as the designated Aging and Disability Resource
Center under United States Code, title 42, section 3001, the Older Americans Act
Amendments of 2006 in partnership with the Disability Linkage Line under section 256.01,
subdivision 24
, and must be available during business hours through a statewide toll-free
number and the Internet. The Minnesota Board on Aging shall consult with, and when
appropriate work through, the area agencies on aging counties, and other entities that serve
aging and disabled populations of all ages, to provide and maintain the telephone
infrastructure and related support for the Aging and Disability Resource Center partners
which agree by memorandum to access the infrastructure, including the designated providers
of the Senior LinkAge Line and the Disability Linkage Line.

(b) The service must provide long-term care options counseling by assisting older adults,
caregivers, and providers in accessing information and options counseling about choices in
long-term care services that are purchased through private providers or available through
public options. The service must:

(1) develop and provide for regular updating of a comprehensive database that includes
detailed listings in both consumer- and provider-oriented formats that can provide search
results down to the neighborhood level;

(2) make the database accessible on the Internet and through other telecommunication
and media-related tools;

(3) link callers to interactive long-term care screening tools and make these tools available
through the Internet by integrating the tools with the database;

(4) develop community education materials with a focus on planning for long-term care
and evaluating independent living, housing, and service options;

(5) conduct an outreach campaign to assist older adults and their caregivers in finding
information on the Internet and through other means of communication;

(6) implement a messaging system for overflow callers and respond to these callers by
the next business day;

(7) link callers with county human services and other providers to receive more in-depth
assistance and consultation related to long-term care options;

(8) link callers with quality profiles for nursing facilities and other home and
community-based services providers developed by the commissioners of health and human
services;

(9) develop an outreach plan to seniors and their caregivers with a particular focus on
establishing a clear presence in places that seniors recognize and:

(i) place a significant emphasis on improved outreach and service to seniors and their
caregivers by establishing annual plans by neighborhood, city, and county, as necessary, to
address the unique needs of geographic areas in the state where there are dense populations
of seniors;

(ii) establish an efficient workforce management approach and assign community living
specialist staff and volunteers to geographic areas as well as aging and disability resource
center sites so that seniors and their caregivers and professionals recognize the Senior
LinkAge Line as the place to call for aging services and information;

(iii) recognize the size and complexity of the metropolitan area service system by working
with metropolitan counties to establish a clear partnership with them, including seeking
county advice on the establishment of local aging and disabilities resource center sites; and

(iv) maintain dashboards with metrics that demonstrate how the service is expanding
and extending or enhancing its outreach efforts in dispersed or hard to reach locations in
varied population centers;

(10) incorporate information about the availability of housing options, as well as
registered housing with services and consumer rights within the MinnesotaHelp.info network
long-term care database to facilitate consumer comparison of services and costs among
housing with services establishments and with other in-home services and to support financial
self-sufficiency as long as possible. Housing with services establishments and their arranged
home care providers shall provide information that will facilitate price comparisons, including
delineation of charges for rent and for services available. The commissioners of health and
human services shall align the data elements required by section 144G.06, the Uniform
Consumer Information Guide, and this section to provide consumers standardized information
and ease of comparison of long-term care options. The commissioner of human services
shall provide the data to the Minnesota Board on Aging for inclusion in the
MinnesotaHelp.info network long-term care database;

(11) provide long-term care options counseling. Long-term care options counselors shall:

(i) for individuals not eligible for case management under a public program or public
funding source, provide interactive decision support under which consumers, family
members, or other helpers are supported in their deliberations to determine appropriate
long-term care choices in the context of the consumer's needs, preferences, values, and
individual circumstances, including implementing a community support plan;

(ii) provide Web-based educational information and collateral written materials to
familiarize consumers, family members, or other helpers with the long-term care basics,
issues to be considered, and the range of options available in the community;

(iii) provide long-term care futures planning, which means providing assistance to
individuals who anticipate having long-term care needs to develop a plan for the more
distant future; and

(iv) provide expertise in benefits and financing options for long-term care, including
Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
private pay options, and ways to access low or no-cost services or benefits through
volunteer-based or charitable programs;

(12) using risk management and support planning protocols, provide long-term care
options counselingnew text begin under clause (13)new text end to current residents of nursing homes deemed
appropriate for discharge by the commissionerdeleted text begin, former residents of nursing homes who
were discharged to community settings, and older adults who request service after
consultation with the Senior LinkAge Line under clause (13). The Senior LinkAge Line
shall also receive referrals from the residents or staff of nursing homes.
deleted text endnew text begin who meet a profile
that demonstrates that the consumer is either at risk of readmission to a nursing home or
hospital, or would benefit from long-term care options counseling to age in place.
new text end The Senior
LinkAge Line shall identify and contact residentsnew text begin or patientsnew text end deemed appropriate deleted text beginfor
discharge
deleted text end by developing targeting criterianew text begin and creating a profilenew text end in consultation with the
commissioner deleted text beginwhodeleted text endnew text begin. The commissionernew text end shall provide designated Senior LinkAge Line contact
centers with a list ofnew text begin current or formernew text end nursing home residentsnew text begin or people discharged from a
hospital or for whom Medicare home care has ended,
new text end that meet the criteria as being
appropriate for deleted text begindischarge planningdeleted text endnew text begin long-term care options counseling through a referralnew text end via
a secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a
preference to receive long-term care options counseling, with initial assessment and, if
appropriate, a referral to:

(i) long-term care consultation services under section 256B.0911;

(ii) designated care coordinators of contracted entities under section 256B.035 for persons
who are enrolled in a managed care plan; or

(iii) the long-term care consultation team for those who are eligible for relocation service
coordination due to high-risk factors or psychological or physical disability; and

(13) develop referral protocols and processes that will assist certified health care homesnew text begin,
Medicare home care,
new text end and hospitals to identify at-risk older adults and determine when to
refer these individuals to the Senior LinkAge Line for long-term care options counseling
under this section. The commissioner is directed to work with the commissioner of health
to develop protocols that would comply with the health care home designation criteria and
protocols available at the time of hospital dischargenew text begin or the end of Medicare home carenew text end. The
commissioner shall keep a record of the number of people who choose long-term care
options counseling as a result of this section.

(c) Nursing homes shall provide contact information to the Senior LinkAge Line for
residents identified in paragraph (b), clause (12), to provide long-term care options counseling
pursuant to paragraph (b), clause (11). The contact information for residents shall include
all information reasonably necessary to contact residents, including first and last names,
permanent and temporary addresses, telephone numbers, and e-mail addresses.

new text begin (d) The Senior LinkAge Line shall determine when it is appropriate to refer a consumer
who receives long-term care options counseling under paragraph (b), clause (12) or (13),
and who uses an unpaid caregiver to the self-directed caregiver service under subdivision
12.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 7.

Minnesota Statutes 2016, section 256.975, is amended by adding a subdivision to
read:


new text begin Subd. 12. new text end

new text begin Self-directed caregiver grants. new text end

new text begin Beginning on July 1, 2019, the Minnesota
Board on Aging shall administer self-directed caregiver grants to support at risk family
caregivers of older adults or others eligible under the Older Americans Act of 1965, United
States Code, title 42, chapter 35, sections 3001 to 3058ff, to sustain family caregivers in
the caregivers' roles so older adults can remain at home longer. The board shall give priority
to consumers referred under section 256.975, subdivision 7, paragraph (d).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 8.

Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:


Subd. 3a.

Assessment and support planning.

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

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

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

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

(e) The person or the person's legal representative must be provided with a written
community support plan within 40 calendar days of the assessment visit, regardless of
whether the individual is eligible for Minnesota health care programs.

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

new text begin (g) new text endThe written community support plan must include:

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

(2) the individual's options and choices to meet identified needs, including all available
options for case management services and providers;

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

(4) referral information; and

(5) informal caregiver supports, if applicable.

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

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

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

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

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

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

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

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

(5) information about Minnesota health care programs;

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

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

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

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

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

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

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

Sec. 9.

Minnesota Statutes 2016, section 256B.0915, subdivision 3a, is amended to read:


Subd. 3a.

Elderly waiver cost limits.

(a) Effective on the first day of the state fiscal
year in which the resident assessment system as described in section deleted text begin256B.438deleted text endnew text begin 256R.17new text end 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 monthly limit of the case mix resident class to which the waiver client
would be assigned under Minnesota Rules, parts 9549.0051 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.new text begin If a legislatively authorized increase
is service-specific, the monthly cost limit shall be adjusted based on the overall average
increase to the elderly waiver program.
new text end

(b) The monthly limit for the cost of waivered services under paragraph (a) to an
individual elderly waiver client assigned to a case mix classification A 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 paragraphs (a) and (e).

(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), (b), (d), or (e),
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), (b), (d), or (e).

(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 paragraphs (a) and (e).

(e) Effective deleted text beginJuly 1, 2016deleted text endnew text begin January 1, 2018new text end, and each deleted text beginJulydeleted text endnew text begin Januarynew text end 1 thereafter, the monthly
cost limits for elderly waiver services in effect on the previous deleted text beginJune 30deleted text endnew text begin December 31new text end shall
be increased by the difference between any legislatively adopted home and community-based
provider rate increases effective on deleted text beginJulydeleted text endnew text begin Januarynew text end 1 or since the previous deleted text beginJulydeleted text endnew text begin Januarynew text end 1 and
the average statewide percentage increase in nursing facility operating payment rates under
deleted text begin sections 256B.431, 256B.434, and 256B.441deleted text endnew text begin chapter 256Rnew text end, 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 deleted text beginJulydeleted text endnew text begin Januarynew text end 1, or occurring since
the previous deleted text beginJulydeleted text endnew text begin Januarynew text end 1.

Sec. 10.

Minnesota Statutes 2016, 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 deleted text begingreater of either thedeleted text end statewide deleted text beginor any of the geographic groups'deleted text end
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 9549.0051
to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph
(a). deleted text beginEffectivedeleted text end On July 1 of deleted text beginthe state fiscaldeleted text endnew text begin eachnew text end year deleted text beginin 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
deleted text end, 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) deleted text beginEffective July 1, 2011,deleted text end 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 deleted text begin(d)deleted text endnew text begin (e)new text end, nor for additional units of any allowable
component service beyond those approved in the service plan by the lead agency.

(h) Effective deleted text beginJuly 1, 2016deleted text endnew text begin January 1, 2018new text end, and each deleted text beginJulydeleted text endnew text begin Januarynew text end 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 deleted text beginJulydeleted text endnew text begin Januarynew text end 1 or since the previous deleted text beginJulydeleted text endnew text begin Januarynew text end 1 and
the average statewide percentage increase in nursing facility operating payment rates under
deleted text begin sections 256B.431, 256B.434, and 256B.441deleted text endnew text begin chapter 256Rnew text end, 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 deleted text beginJulydeleted text endnew text begin Januarynew text end 1, or occurring since
the previous deleted text beginJulydeleted text endnew text begin Januarynew text end 1.

new text begin EFFECTIVE DATE. new text end

new text begin This section prevails over any conflicting amendment regardless
of the order of enactment.
new text end

Sec. 11.

Minnesota Statutes 2016, 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 9549.0051 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 9549.0051 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.

(j) Effective deleted text beginJuly 1, 2016deleted text endnew text begin January 1, 2018new text end, and each deleted text beginJulydeleted text endnew text begin Januarynew text end 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 deleted text beginJulydeleted text endnew text begin Januarynew text end 1 or since the previous
deleted text begin Julydeleted text endnew text begin Januarynew text end 1 and the average statewide percentage increase in nursing facility operating
payment rates under deleted text beginsections 256B.431, 256B.434, and 256B.441deleted text endnew text begin chapter 256Rnew text end, 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 deleted text beginJulydeleted text endnew text begin Januarynew text end 1, or occurring
since the previous deleted text beginJulydeleted text endnew text begin Januarynew text end 1.

Sec. 12.

Minnesota Statutes 2016, section 256B.0915, subdivision 5, is amended to read:


Subd. 5.

Assessments and reassessments for waiver clients.

(a) Each client shall
receive an initial assessment of strengths, informal supports, and need for services in
accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a client
served under the elderly waiver must be conducted at least every 12 months deleted text beginand at other
times when the case manager determines that there has been significant change in the client's
functioning. This may include instances where the client is discharged from the hospital
deleted text end.
There must be a determination that the client requires nursing facility level of care as defined
in section 256B.0911, subdivision 4e, at initial and subsequent assessments to initiate and
maintain participation in the waiver program.

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

new text begin (c) The lead agency shall conduct a change-in-condition reassessment before the annual
reassessment in cases where a client's condition changed due to a major health event, an
emerging need or risk, worsening health condition, or cases where the current services do
not meet the client's needs. A change-in-condition reassessment may be initiated by the lead
agency, or it may be requested by the client or requested on the client's behalf by another
party, such as a provider of services. The lead agency shall complete a change-in-condition
reassessment no later than 20 calendar days from the request. The lead agency shall conduct
these assessments in a timely manner and expedite urgent requests. The lead agency shall
evaluate urgent requests based on the client's needs and risk to the client if a reassessment
is not completed.
new text end

Sec. 13.

Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Payment rates; application. new text end

new text begin The payment methodologies in subdivisions 12
to 16 apply to elderly waiver and elderly waiver customized living under this section,
alternative care under section 256B.0913, essential community supports under section
256B.0922, and community access for disability inclusion customized living, brain injury
customized living, and elderly waiver foster care and residential care.
new text end

Sec. 14.

Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin Payment rates; phase-in. new text end

new text begin Effective January 1, 2019, all rates and rate
components for services under subdivision 11 shall be the sum of ten percent of the rates
calculated under subdivisions 13 to 16 and 90 percent of the rates calculated using the rate
methodology in effect as of June 30, 2017.
new text end

Sec. 15.

Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
to read:


new text begin Subd. 13. new text end

new text begin Payment rates; establishment. new text end

new text begin (a) When establishing the base wages
according to subdivision 14, the commissioner shall use standard occupational classification
(SOC) codes from the Bureau of Labor Statistics as defined in the edition of the Occupational
Handbook published immediately prior to January 1, 2019, using Minnesota-specific wages
taken from job descriptions.
new text end

new text begin (b) Beginning January 1, 2019, and every January 1 thereafter, the commissioner shall
establish factors, component rates, and rates according to subdivisions 15 and 16, using
base wages established according to paragraph (a) and subdivision 14.
new text end

Sec. 16.

Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
to read:


new text begin Subd. 14. new text end

new text begin Payment rates; base wage index. new text end

new text begin (a) Base wages are calculated for customized
living, foster care, and residential care component services as follows:
new text end

new text begin (1) the home management and support services base wage equals 33.33 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home
care aide (SOC code 39-9021); 33.33 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for food preparation workers (SOC code 35-2021); and
33.34 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
for maids and housekeeping cleaners (SOC code 37-2012);
new text end

new text begin (2) the home care aide base wage equals 50 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for home health aides (SOC code
31-1011); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for nursing assistants (SOC code 31-1014);
new text end

new text begin (3) the home health aide base wage equals 20 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
31-1014); and
new text end

new text begin (4) the medication setups by licensed practical nurse base wage equals ten percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
and licensed vocational nurses (SOC code 29-2061); and 90 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code
29-1141).
new text end

new text begin (b) Base wages are calculated for the following services as follows:
new text end

new text begin (1) the chore services base wage equals 100 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for landscaping and groundskeeping
workers (SOC code 37-3011);
new text end

new text begin (2) the companion services base wage equals 50 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for personal and home care aides (SOC
code 39-9021); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for maids and housekeeping cleaners (SOC code 37-2012);
new text end

new text begin (3) the homemaker services and assistance with personal care base wage equals 60
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
personal and home care aide (SOC code 39-9021); 20 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
31-1014); and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for maids and housekeeping cleaners (SOC code 37-2012);
new text end

new text begin (4) the homemaker services and cleaning base wage equals 60 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home
care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
housekeeping cleaners (SOC code 37-2012);
new text end

new text begin (5) the homemaker services and home management base wage equals 60 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home
care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
housekeeping cleaners (SOC code 37-2012);
new text end

new text begin (6) the in-home respite care services base wage equals five percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code
29-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
wage for nursing assistants (SOC code 31-1014); and 20 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
vocational nurses (SOC code 29-2061);
new text end

new text begin (7) the out-of-home respite care services base wage equals five percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for registered nurses
(SOC code 29-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for nursing assistants (SOC code 31-1014); and 20 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
and licensed vocational nurses (SOC code 29-2061); and
new text end

new text begin (8) the individual community living support base wage equals 20 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
and licensed vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
31-1014).
new text end

new text begin (c) Base wages are calculated for the following values as follows:
new text end

new text begin (1) the registered nurse base wage equals 100 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code
29-1141); and
new text end

new text begin (2) the social worker base wage equals 100 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for medical and public health social
workers (SOC code 21-1022).
new text end

new text begin (d) If any of the SOC codes and positions are no longer available, the commissioner
shall, in consultation with stakeholders, select a new SOC code and position that is the
closest match to the previously used SOC position.
new text end

Sec. 17.

Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
to read:


new text begin Subd. 15. new text end

new text begin Payment rates; factors. new text end

new text begin The commissioner shall use the following factors:
new text end

new text begin (1) the payroll taxes and benefits factor is the sum of net payroll taxes and benefits
divided by the sum of all salaries for all nursing facilities on the most recent and available
cost report;
new text end

new text begin (2) the general and administrative factor is the sum of net general and administrative
expenses minus administrative salaries divided by total operating expenses for all nursing
facilities on the most recent and available cost report;
new text end

new text begin (3) the program plan support factor is 12.8 percent to cover the cost of direct service
staff needed to provide support for the home and community-based service when not engaged
in direct contact with clients.
new text end

new text begin (4) the registered nurse management and supervision factor equals 15 percent of the
product of the position's base wage and the sum of the factors in clauses (1) to (3); and
new text end

new text begin (5) the social worker supervision factor equals 15 percent of the product of the position's
base wage and the sum of the factors in clauses (1) to (3).
new text end

Sec. 18.

Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
to read:


new text begin Subd. 16. new text end

new text begin Payment rates; component rates. new text end

new text begin (a) For the purposes of this subdivision,
the "adjusted base wage" for a position equals the position's base wage plus:
new text end

new text begin (1) the position's base wage multiplied by the payroll taxes and benefits factor;
new text end

new text begin (2) the position's base wage multiplied by the general and administrative factor; and
new text end

new text begin (3) the position's base wage multiplied by the program plan support factor.
new text end

new text begin (b) For medication setups by licensed nurse, registered nurse, and social worker services,
the component rate for each service equals the respective position's adjusted base wage.
new text end

new text begin (c) For home management and support services, home care aide, and home health aide
services, the component rate for each service equals the respective position's adjusted base
wage plus the registered nurse management and supervision factor.
new text end

new text begin (d) The home management and support services component rate shall be used for payment
for socialization and transportation component rates under elderly waiver customized living.
new text end

new text begin (e) The 15-minute unit rates for chore services and companion services are calculated
as follows:
new text end

new text begin (1) sum the adjusted base wage for the respective position and the social worker factor;
and
new text end

new text begin (2) divide the result of clause (1) by four.
new text end

new text begin (f) The 15-minute unit rates for homemaker services and assistance with personal care,
homemaker services and cleaning, and homemaker services and home management are
calculated as follows:
new text end

new text begin (1) sum the adjusted base wage for the respective position and the registered nurse
management and supervision factor; and
new text end

new text begin (2) divide the result of clause (1) by four.
new text end

new text begin (g) The 15-minute unit rate for in-home respite care services is calculated as follows:
new text end

new text begin (1) sum the adjusted base wage for in-home respite care services and the registered nurse
management and supervision factor; and
new text end

new text begin (2) divide the result of clause (1) by four.
new text end

new text begin (h) The in-home respite care services daily rate equals the in-home respite care services
15-minute unit rate multiplied by 18.
new text end

new text begin (i) The 15-minute unit rate for out-of-home respite care is calculated as follows:
new text end

new text begin (1) sum the out-of-home respite care services adjusted base wage and the registered
nurse management and supervision factor; and
new text end

new text begin (2) divide the result of clause (1) by four.
new text end

new text begin (j) The out-of-home respite care services daily rate equals the out-of-home respite care
services 15-minute unit rate multiplied by 18.
new text end

new text begin (k) The individual community living support rate is calculated as follows:
new text end

new text begin (1) sum the adjusted base wage for the home care aide rate in subdivision 14, paragraph
(a), clause (2), and the social worker factor; and
new text end

new text begin (2) divide the result of clause (1) by four.
new text end

new text begin (l) The home delivered meals rate equals $9.30. Beginning July 1, 2018, the commissioner
shall increase the home delivered meals rate every July 1 by the percent increase in the
nursing facility dietary per diem using the two most recent and available nursing facility
cost reports.
new text end

new text begin (m) The adult day services rate is based on the home care aide rate in subdivision 14,
paragraph (a), clause (2), plus the additional factors from subdivision 15, except that the
general and administrative factor used shall be 20 percent. The nonregistered nurse portion
of the rate shall be multiplied by 0.25, to reflect an assumed-ratio staffing of one caregiver
to four clients, and divided by four to determine the 15-minute unit rate. The registered
nurse portion is divided by four to determine the 15-minute unit rate and $0.63 per 15-minute
unit is added to cover the cost of meals.
new text end

new text begin (n) The adult day services bath 15-minute unit rate is the same as the calculation of the
adult day services 15-minute unit rate without the adjustment for staffing ratio.
new text end

new text begin (o) If a bath is authorized for an adult day services client, at least two 15-minute units
must be authorized to allow for adequate time to meet client needs. Adult day services may
be authorized for up to 48 units, or 12 hours, per day based on client and family caregiver
needs.
new text end

Sec. 19.

Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
to read:


new text begin Subd. 17. new text end

new text begin Evaluation of rate methodology. new text end

new text begin The commissioner, in consultation with
stakeholders, shall conduct a study to evaluate the following:
new text end

new text begin (1) base wages in subdivision 14, to determine if the standard occupational classification
codes for each rate and component rate are an appropriate representation of staff who deliver
the services; and
new text end

new text begin (2) factors in subdivision 15, and adjusted base wage calculation in subdivision 16, to
determine if the factors and calculations appropriately address nonwage provider costs.
new text end

new text begin By January 1, 2019, the commissioner shall submit a report to the legislature on the
changes to the rate methodology in this statute, based on the results of the evaluation. Where
feasible, the report shall address the impact of the new rates on the workforce situation and
client access to services. The report should include any changes to the rate calculations
methods that the commissioner recommends.
new text end

Sec. 20.

Minnesota Statutes 2016, section 256B.431, subdivision 10, is amended to read:


Subd. 10.

Property rate adjustments and construction projects.

A nursing facility
completing a construction project that is eligible for a rate adjustment under section
256B.434, subdivision 4f, and that was not approved through the moratorium exception
process in section 144A.073 must request from the commissioner a property-related payment
rate adjustment. deleted text beginIf the request is made within 60 days after the construction project's
completion date,
deleted text end The effective date of the rate adjustment is the first of the month new text beginof January
or July, whichever occurs first
new text endfollowing new text beginboth new text endthe new text beginconstruction project's new text endcompletion datenew text begin
and submission of the provider's rate adjustment request
new text end. deleted text beginIf the request is made more than
60 days after the completion date, the rate adjustment is effective on the first of the month
following the request.
deleted text end The commissioner shall provide a rate notice reflecting the allowable
costs within 60 days after receiving all the necessary information to compute the rate
adjustment. No sooner than the effective date of the rate adjustment for the construction
project, a nursing facility may adjust its rates by the amount anticipated to be allowed. Any
amounts collected from private pay residents in excess of the allowable rate must be repaid
to private pay residents with interest at the rate used by the commissioner of revenue for
the late payment of taxes and in effect on the date the rate increase is effective. Construction
projects with completion dates within one year of the completion date associated with the
property rate adjustment request and phased projects with project completion dates within
three years of the last phase of the phased project must be aggregated for purposes of the
minimum thresholds in subdivisions 16 and 17, and the maximum threshold in section
144A.071, subdivision 2. "Construction project" and "project construction costs" have the
meanings given them in Minnesota Statutes, section 144A.071, subdivision 1a.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for projects completed after January 1,
2018.
new text end

Sec. 21.

Minnesota Statutes 2016, section 256B.431, subdivision 16, is amended to read:


Subd. 16.

Major additions and replacements; equity incentive.

For rate years beginning
after June 30, 1993, if a nursing facility acquires capital assets in connection with a project
approved under the moratorium exception process in section 144A.073 or in connection
with an addition to or replacement of buildings, attached fixtures, or land improvements
for which the total historical cost of those capital asset additions exceeds the lesser of
$150,000 or ten percent of the most recent appraised value, the nursing facility shall be
eligible for an equity incentive payment rate as in paragraphs (a) to (d). This computation
is separate from the determination of the nursing facility's rental rate. An equity incentive
payment rate as computed under this subdivision is limited to one in a 12-month period.

(a) An eligible nursing facility shall receive an equity incentive payment rate equal to
the allowable historical cost of the capital asset acquired, minus the allowable debt directly
identified to that capital asset, multiplied by the equity incentive factor as described in
paragraphs (b) and (c), and divided by the nursing facility's occupancy factor under
subdivision 3f, paragraph (c). This amount shall be added to the nursing facility's total
payment rate and shall be effective the same day as the incremental increase in paragraph
(d) or subdivision 17. The allowable historical cost of the capital assets and the allowable
debt shall be determined as provided in Minnesota Rules, parts 9549.0010 to 9549.0080,
and this section.

(b) The equity incentive factor shall be determined under clauses (1) to (4):

(1) divide the initial allowable debt in paragraph (a) by the initial historical cost of the
capital asset additions referred to in paragraph (a), then cube the quotient,

(2) subtract the amount calculated in clause (1) from the number one,

(3) determine the difference between the rental factor and the lesser of two percentage
points above the posted yield for standard conventional fixed rate mortgages of the Federal
Home Loan Mortgage Corporation as published in the Wall Street Journal and in effect on
the first day of the month the debt or cost is incurred, or 16 percent,

(4) multiply the amount calculated in clause (2) by the amount calculated in clause (3).

(c) The equity incentive payment rate shall be limited to the term of the allowable debt
in paragraph (a), not greater than 20 years nor less than ten years. If no debt is incurred in
acquiring the capital asset, the equity incentive payment rate shall be paid for ten years. The
sale of a nursing facility under subdivision 14 shall terminate application of the equity
incentive payment rate effective on the date provided in subdivision 14, paragraph (f), for
the sale.

(d) A nursing facility with an addition to or a renovation of its buildings, attached fixtures,
or land improvements meeting the criteria in this subdivision and not receiving the
property-related payment rate adjustment in subdivision 17, shall receive the incremental
increase in the nursing facility's rental rate as determined under Minnesota Rules, parts
9549.0010 to 9549.0080, and this section. The incremental increase shall be added to the
nursing facility's property-related payment rate. The effective date of this incremental
increase shall be the first day of the month new text beginof January or July, whichever occurs first
new text end following the deleted text beginmonth indeleted text endnew text begin date onnew text end which the addition or replacement is completed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for additions or replacements completed
after January 1, 2018.
new text end

Sec. 22.

Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:


Subd. 30.

Bed layaway and delicensure.

(a) For rate years beginning on or after July
1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway
shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph
(c), and calculation of the rental per diem, have those beds given the same effect as if the
beds had been delicensed so long as the beds remain on layaway. At the time of a layaway,
a facility may change its single bed election for use in calculating capacity days under
Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be
effective the first day of the month new text beginof January or July, whichever occurs first new text endfollowing the
deleted text begin month indeleted text end new text begindate on new text endwhich the layaway of the beds becomes effective under section 144A.071,
subdivision 4b
.

(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to
the contrary under section 256B.434, a nursing facility reimbursed under that section deleted text beginwhichdeleted text endnew text begin
that
new text end has placed beds on layaway shall, for so long as the beds remain on layaway, be allowed
to:

(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;

(2) retain or change the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and

(3) establish capacity days based on the number of beds immediately prior to the layaway
and the number of beds after the layaway.

The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and
(3). If a facility reimbursed under section 256B.434 completes a moratorium exception
project after its base year, the base year property rate shall be the moratorium project property
rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
paragraph (c). The property payment rate increase shall be effective the first day of the
month new text beginof January or July, whichever occurs first new text endfollowing the deleted text beginmonth indeleted text end new text begindate on new text endwhich the
layaway of the beds becomes effective.

(c) If a nursing facility removes a bed from layaway status in accordance with section
144A.071, subdivision 4b, the commissioner shall establish capacity days based on the
number of licensed and certified beds in the facility not on layaway and shall reduce the
nursing facility's property payment rate in accordance with paragraph (b).

(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision
to the contrary under section 256B.434, a nursing facility reimbursed under that sectiondeleted text begin,
which
deleted text endnew text begin thatnew text end has delicensed beds after July 1, 2000, by giving notice of the delicensure to the
commissioner of health according to the notice requirements in section 144A.071, subdivision
4b
, shall be allowed to:

(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;

(2) retain or change the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and

(3) establish capacity days based on the number of beds immediately prior to the
delicensure and the number of beds after the delicensure.

The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the delicensure of beds and clauses (1), (2),
and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception
project after its base year, the base year property rate shall be the moratorium project property
rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
paragraph (c). The property payment rate increase shall be effective the first day of the
month new text beginof January or July, whichever occurs first new text endfollowing the deleted text beginmonth indeleted text end new text begindate on new text endwhich the
delicensure of the beds becomes effective.

(e) For nursing facilities reimbursed under this section or section 256B.434, any beds
placed on layaway shall not be included in calculating facility occupancy as it pertains to
leave days defined in Minnesota Rules, part 9505.0415.

(f) For nursing facilities reimbursed under this section or section 256B.434, the rental
rate calculated after placing beds on layaway may not be less than the rental rate prior to
placing beds on layaway.

(g) A nursing facility receiving a rate adjustment as a result of this section shall comply
with section deleted text begin256B.47, subdivision 2deleted text endnew text begin 256R.06, subdivision 5new text end.

(h) A facility that does not utilize the space made available as a result of bed layaway
or delicensure under this subdivision to reduce the number of beds per room or provide
more common space for nursing facility uses or perform other activities related to the
operation of the nursing facility shall have its property rate increase calculated under this
subdivision reduced by the ratio of the square footage made available that is not used for
these purposes to the total square footage made available as a result of bed layaway or
delicensure.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for layaways occurring after July 1, 2017.
new text end

Sec. 23.

Minnesota Statutes 2016, section 256B.434, subdivision 4, is amended to read:


Subd. 4.

Alternate rates for nursing facilities.

new text beginEffective for the rate years beginning
on and after January 1, 2019,
new text end a nursing facility's deleted text begincase mixdeleted text endnew text begin propertynew text end payment deleted text beginratesdeleted text end new text beginrate new text endfor
the second and subsequent years of a facility's contract under this section are the previous
rate year's deleted text begincontractdeleted text end new text beginproperty new text endpayment deleted text beginratesdeleted text end new text beginrate new text endplus an inflation adjustment deleted text beginand, 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
deleted text end. 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 deleted text begincommissioner
of management and budget's national economic consultant
deleted text endnew text begin Reports and Forecasts Division
of the Department of Human Services
new text end, 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. deleted text beginFor 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, January 1, 2016, and January 1,
2017, 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 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. 24.

Minnesota Statutes 2016, section 256B.434, subdivision 4f, is amended to read:


Subd. 4f.

Construction project rate adjustments effective October 1, 2006.

(a)
Effective October 1, 2006, facilities reimbursed under this section may receive a property
rate adjustment for construction projects exceeding the threshold in section 256B.431,
subdivision 16, and below the threshold in section 144A.071, subdivision 2, clause (a). For
these projects, capital assets purchased shall be counted as construction project costs for a
rate adjustment request made by a facility if they are: (1) purchased within 24 months of
the completion of the construction project; (2) purchased after the completion date of any
prior construction project; and (3) are not purchased prior to July 14, 2005. Except as
otherwise provided in this subdivision, the definitions, rate calculation methods, and
principles in sections 144A.071 and 256B.431 and Minnesota Rules, parts 9549.0010 to
9549.0080, shall be used to calculate rate adjustments for allowable construction projects
under this subdivision and section 144A.073. Facilities completing construction projects
between October 1, 2005, and October 1, 2006, are eligible to have a property rate adjustment
effective October 1, 2006. Facilities completing projects after October 1, 2006, are eligible
for a property rate adjustment effective on the first day of the month following the completion
date.new text begin Facilities completing projects after January 1, 2018, are eligible for a property rate
adjustment effective on the first day of the month of January or July, whichever occurs
immediately following the completion date.
new text end

(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under
section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a
construction project on or after October 1, 2004, and do not have a contract under subdivision
3 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431,
subdivision 10, through September 30, 2006. If the request results in the commissioner
determining a rate adjustment is allowable, the rate adjustment is effective on the first of
the month following project completion. These facilities shall be allowed to accumulate
construction project costs for the period October 1, 2004, to September 30, 2006.

(c) Facilities shall be allowed construction project rate adjustments no sooner than 12
months after completing a previous construction project. Facilities must request the rate
adjustment according to section 256B.431, subdivision 10.

(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060,
subpart 11. For rate calculations under this section, the number of licensed beds in the
nursing facility shall be the number existing after the construction project is completed and
the number of days in the nursing facility's reporting period shall be 365.

(e) The value of assets to be recognized for a total replacement project as defined in
section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value
of assets to be recognized for all other projects shall be computed as described in clause
(2).

(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the
maximum amount of assets allowable in a facility's property rate calculation. If a facility's
current request for a rate adjustment results from the completion of a construction project
that was previously approved under section 144A.073, the assets to be used in the rate
calculation cannot exceed the lesser of the amount determined under sections 144A.071,
subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction
project. A current request that is not the result of a project under section 144A.073 cannot
exceed the limit under section 144A.071, subdivision 2, paragraph (a). Applicable credits
must be deducted from the cost of the construction project.

(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be
used to compute the maximum amount of assets allowable in a facility's property rate
calculation.

(ii) The value of a facility's assets to be compared to the amount in item (i) begins with
the total appraised value from the last rate notice a facility received when its rates were set
under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value
shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each
rate year the facility received an inflation factor on its property-related rate when its rates
were set under this section. The value of assets listed as previous capital additions, capital
additions, and special projects on the facility's base year rate notice and the value of assets
related to a construction project for which the facility received a rate adjustment when its
rates were determined under this section shall be added to the indexed appraised value.

(iii) The maximum amount of assets to be recognized in computing a facility's rate
adjustment after a project is completed is the lesser of the aggregate replacement-cost-new
limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the
construction project.

(iv) If a facility's current request for a rate adjustment results from the completion of a
construction project that was previously approved under section 144A.073, the assets to be
added to the rate calculation cannot exceed the lesser of the amount determined under
sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable
costs of the construction project. A current request that is not the result of a project under
section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2,
paragraph (a). Assets disposed of as a result of a construction project and applicable credits
must be deducted from the cost of the construction project.

(f) For construction projects approved under section 144A.073, allowable debt may
never exceed the lesser of the cost of the assets purchased, the threshold limit in section
144A.071, subdivision 2, or the replacement-cost-new limit less previously existing capital
debt.

(g) For construction projects that were not approved under section 144A.073, allowable
debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such
construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously
existing capital debt. Amounts of debt taken out that exceed the costs of a construction
project shall not be allowed regardless of the use of the funds.

For all construction projects being recognized, interest expense and average debt shall
be computed based on the first 12 months following project completion. "Previously existing
capital debt" means capital debt recognized on the last rate determined under section
256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt
recognized for a construction project for which the facility received a rate adjustment when
its rates were determined under this section.

For a total replacement project as defined in section 256B.431, subdivision 17d, the
value of previously existing capital debt shall be zero.

(h) In addition to the interest expense allowed from the application of paragraph (f), the
amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and
(3), will be added to interest expense.

(i) The equity portion of the construction project shall be computed as the allowable
assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be
multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added.
This sum must be divided by 95 percent of capacity days to compute the construction project
rate adjustment.

(j) For projects that are not a total replacement of a nursing facility, the amount in
paragraph (i) is adjusted for nonreimbursable areas and then added to the current property
payment rate of the facility.

(k) For projects that are a total replacement of a nursing facility, the amount in paragraph
(i) becomes the new property payment rate after being adjusted for nonreimbursable areas.
Any amounts existing in a facility's rate before the effective date of the construction project
for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements
under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431,
subdivision 19, shall be removed from the facility's rates.

(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060,
subpart 10, as the result of construction projects under this section. Allowable equipment
shall be included in the construction project costs.

(m) Capital assets purchased after the completion date of a construction project shall be
counted as construction project costs for any future rate adjustment request made by a facility
under section 144A.071, subdivision 2, clause (a), if they are purchased within 24 months
of the completion of the future construction project.

(n) In subsequent rate years, the property payment rate for a facility that results from
the application of this subdivision shall be the amount inflated in subdivision 4.

(o) Construction projects are eligible for an equity incentive under section 256B.431,
subdivision 16. When computing the equity incentive for a construction project under this
subdivision, only the allowable costs and allowable debt related to the construction project
shall be used. The equity incentive shall not be a part of the property payment rate and not
inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing
facilities reimbursed under this section shall be allowed for a duration determined under
section 256B.431, subdivision 16, paragraph (c).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 25.

Minnesota Statutes 2016, section 256B.50, subdivision 1b, is amended to read:


Subd. 1b.

Filing an appeal.

To appeal, the provider shall file with the commissioner a
written notice of appeal; the appeal must be postmarked or received by the commissioner
within 60 days of the new text beginpublication new text enddate deleted text beginthe determination of the payment rate was mailed or
personally received by a provider, whichever is earlier
deleted text endnew text begin printed on the rate noticenew text end. The notice
of appeal must specify each disputed item; the reason for the dispute; the total dollar amount
in dispute for each separate disallowance, allocation, or adjustment of each cost item or part
of a cost item; the computation that the provider believes is correct; the authority in statute
or rule upon which the provider relies for each disputed item; the name and address of the
person or firm with whom contacts may be made regarding the appeal; and other information
required by the commissioner.

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2016, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Therapeutic leave days. new text end

new text begin Notwithstanding Minnesota Rules, part 9505.0415,
subpart 7, a vacant bed in an intermediate care facility for persons with developmental
disabilities shall be counted as a reserved bed when determining occupancy rates and
eligibility for payment of a therapeutic leave day.
new text end

Sec. 27.

Minnesota Statutes 2016, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 17. new text end

new text begin ICF/DD rate increase effective July 1, 2017; Murray County. new text end

new text begin Effective
July 1, 2017, the daily rate for an intermediate care facility for persons with developmental
disabilities located in Murray County that is classified as a class B facility and licensed for
14 beds is $400. This increase is in addition to any other increase that is effective on July
1, 2017.
new text end

Sec. 28.

Minnesota Statutes 2016, section 256R.02, subdivision 4, is amended to read:


Subd. 4.

Administrative costs.

"Administrative costs" means the identifiable 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, deleted text beginanddeleted text end permits except as provided in the external fixed
costs category, employee recognition, travel including meals and lodging, all training except
as specified in subdivision 17, voice and data communication or transmission, office supplies,
property and liability insurance and other forms of insurance deleted text beginnot designated to other areasdeleted text endnew text begin
except insurance that is a fringe benefit under subdivision 22
new text end, 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 directors fees, working capital interest expense, deleted text beginanddeleted text end bad debtsnew text begin,new text end deleted text beginanddeleted text end
bad debt collection feesnew text begin, and costs incurred for travel and housing for persons employed by
a supplemental nursing services agency as defined in section 144A.70, subdivision 6
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 29.

Minnesota Statutes 2016, section 256R.02, subdivision 17, is amended to read:


Subd. 17.

Direct care costs.

"Direct care costs" means costs for the wages of nursing
administration, direct care registered nurses, licensed practical nurses, certified nursing
assistants, trained medication aides, employees conducting training in resident care topics
and associated fringe benefits and payroll taxes; services from a supplemental nursing
services agency; supplies that are stocked at nursing stations or on the floor and distributed
or used individually, including, but not limited to: alcohol, applicators, cotton balls,
incontinence pads, disposable ice bags, dressings, bandages, water pitchers, tongue
depressors, disposable gloves, enemas, enema equipment, soap, medication cups, diapers,
plastic waste bags, sanitary products, thermometers, hypodermic needles and syringes,
clinical reagents or similar diagnostic agents, drugs that are not paid on a separate fee
schedule by the medical assistance program or any other payer, and technology related to
the provision of nursing care to residents, such as electronic charting systems; costs of
materials used for resident care training, and training courses outside of the facility attended
by direct care staff on resident care topicsnew text begin; and costs for nurse consultants, pharmacy
consultants, and medical directors. Salaries and payroll taxes for nurse consultants who
work out of a central office must be allocated proportionately by total resident days or by
direct identification to the nursing facilities served by those consultants
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 30.

Minnesota Statutes 2016, section 256R.02, subdivision 18, is amended to read:


Subd. 18.

Employer health insurance costs.

"Employer health insurance costs" means
premium expenses for group coverage deleted text beginand reinsurance,deleted text endnew text begin;new text end actual expenses incurred for
self-insured plans, new text beginincluding reinsurance; new text endand employer contributions to employee health
reimbursement and health savings accounts. Premium and expense costs and contributions
are allowable for (1) all employees and (2) the spouse and dependents of new text beginthose new text endemployees
who deleted text beginmeet the definition of full-time employees under the federal Affordable Care Act,
Public Law 111-148
deleted text endnew text begin are employed on average at least 30 hours per weeknew 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 2016, section 256R.02, subdivision 19, is amended to read:


Subd. 19.

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;
family advisory council fee under section 144A.33; scholarships under section 256R.37;
planned closure rate adjustments under section 256R.40; consolidation rate adjustments
under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d;
single-bed room incentives under section 256R.41; property taxes, assessments, and payments
in lieu of taxes; employer health insurance costs; quality improvement incentive payment
rate adjustments under section 256R.39; performance-based incentive payments under
section 256R.38; special dietary needs under section 256R.51; new text beginrate adjustments for
compensation-related costs for minimum wage changes under section 256R.49 provided
on or after January 1, 2018;
new text endand Public Employees Retirement Associationnew text begin employer costsnew text end.

Sec. 32.

Minnesota Statutes 2016, section 256R.02, subdivision 22, is amended to read:


Subd. 22.

Fringe benefit costs.

"Fringe benefit costs" means the costs for group life,
dental, workers' compensation, deleted text beginand other employee insurances anddeleted text endnew text begin short- and long-term
disability, long-term care insurance, accident insurance, supplemental insurance, legal
assistance insurance, profit sharing, health insurance costs not covered under subdivision
18, including costs associated with part-time employee family members or retirees, and
new text end
pensionnew text begin and retirement plan contributionsnew text end, except for the Public Employees Retirement
Association deleted text beginand employer health insurance costs; profit sharing; and retirement plans for
which the employer pays all or a portion of the
deleted text end costs.

Sec. 33.

Minnesota Statutes 2016, section 256R.02, subdivision 42, is amended to read:


Subd. 42.

Raw food costs.

"Raw food costs" means the cost of food provided to nursing
facility residentsnew text begin and the allocation of dietary creditsnew text end. Also included are special dietary
supplements used for tube feeding or oral feeding, such as elemental high nitrogen diet.

Sec. 34.

Minnesota Statutes 2016, section 256R.02, is amended by adding a subdivision
to read:


new text begin Subd. 42a. new text end

new text begin Real estate taxes. new text end

new text begin "Real estate taxes" means the real estate tax liability shown
on the annual property tax statement of the nursing facility for the reporting period. The
term does not include personnel costs or fees for late payment.
new text end

Sec. 35.

Minnesota Statutes 2016, section 256R.02, is amended by adding a subdivision
to read:


new text begin Subd. 48a. new text end

new text begin Special assessments. new text end

new text begin "Special assessments" means the actual special
assessments and related interest paid during the reporting period. The term does not include
personnel costs or fees for late payment.
new text end

Sec. 36.

Minnesota Statutes 2016, section 256R.02, subdivision 52, is amended to read:


Subd. 52.

Therapy costs.

"Therapy costs" means any costs related to deleted text beginmedical assistancedeleted text end
therapy services provided to residents that are not deleted text beginbilleddeleted text end separatelynew text begin billablenew text end from the daily
operating rate.

Sec. 37.

Minnesota Statutes 2016, section 256R.06, subdivision 5, is amended to read:


Subd. 5.

Notice to residents.

(a) No increase in nursing facility rates for private paying
residents shall be effective unless the nursing facility notifies the resident or person
responsible for payment of the increase in writing 30 days before the increase takes effect.new text begin
The notice must include the amount of the rate increase, the new payment rate, and the date
the rate increase takes effect.
new text end

A nursing facility may adjust its rates without giving the notice required by this
subdivision when the purpose of the rate adjustment is to reflect a change in the case mix
classification of the resident.new text begin The nursing facility shall notify private pay residents of any
rate increase related to a change in case mix classifications in a timely manner after
confirmation of the case mix classification change is received from the Department of
Health.
new text end

If the state fails to set rates as required by section 256R.09, subdivision 1, the time
required for giving notice is decreased by the number of days by which the state was late
in setting the rates.

(b) If the state does not set rates by the date required in section 256R.09, subdivision 1,
new text begin or otherwise provides nursing facilities with retroactive notification of the amount of a rate
increase,
new text endnursing facilities shall meet the requirement for advance notice by informing the
resident or person responsible for payments, on or before the effective date of the increase,
that a rate increase will be effective on that date.new text begin The requirements of paragraph (a) do not
apply to situations described in this paragraph.
new text end

If the exact amount has not yet been determined, the nursing facility may raise the rates
by the amount anticipated to be allowed. Any amounts collected from private pay residents
in excess of the allowable rate must be repaid to private pay residents with interest at the
rate used by the commissioner of revenue for the late payment of taxes and in effect on the
date the rate increase is effective.

Sec. 38.

Minnesota Statutes 2016, section 256R.07, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Electronic signature. new text end

new text begin For documentation requiring a signature under this
chapter or section 256B.431 or 256B.434, use of an electronic signature as defined under
section 325L.02, paragraph (h), is allowed.
new text end

Sec. 39.

Minnesota Statutes 2016, section 256R.10, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Not specified allowed costs. new text end

new text begin When the cost category for allowed cost items or
services is not specified in this chapter or the provider reimbursement manual, the
commissioner, in consultation with stakeholders, shall determine the cost category for the
allowed cost item or service.
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. 40.

new text begin [256R.18] REPORT BY COMMISSIONER OF HUMAN SERVICES.
new text end

new text begin Beginning January 1, 2019, the commissioner shall provide to the house of representatives
and senate committees with jurisdiction over nursing facility payment rates a biennial report
on the effectiveness of the reimbursement system in improving quality, restraining costs,
and any other features of the system as determined by the commissioner.
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 2016, section 256R.37, is amended to read:


256R.37 SCHOLARSHIPS.

(a) 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 rate 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 ten hours
per week at the facility except the administrator, and to reimburse student loan expenses
for newly hired deleted text beginand recently graduateddeleted text end registered nurses and licensed practical nurses, and
training expenses for nursing assistants as specified in section 144A.611, subdivisions 2
and 4, who are newly hired deleted text beginand have graduated within the last 12 monthsdeleted 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) All facilities may annually request a rate adjustment under this section by submitting
information to the commissioner on a schedule and in a form supplied by the commissioner.
The commissioner shall allow a scholarship payment rate equal to the reported and allowable
costs divided by resident days.

(c) In calculating the per diem under paragraph (b), the commissioner shall allow costs
related to tuition, direct educational expenses, and reasonable costs as defined by the
commissioner for child care costs and transportation expenses related to direct educational
expenses.

(d) The rate increase under this section 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 section.

(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 begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 42.

Minnesota Statutes 2016, section 256R.40, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Closure" means the cessation of operations of a nursing facility and delicensure and
decertification of all beds within the facility.

(c) "Closure plan" means a plan to close a nursing facility and reallocate a portion of
the resulting savings to provide planned closure rate adjustments at other facilities.

(d) "Commencement of closure" means the date on which residents and designated
representatives are notified of a planned closure as provided in section 144A.161, subdivision
5a, as part of an approved closure plan.

(e) "Completion of closure" means the date on which the final resident of the nursing
facility designated for closure in an approved closure plan is discharged from the facilitynew text begin
or the date that beds from a partial closure are delicensed and decertified
new text end.

(f) "Partial closure" means the delicensure and decertification of a portion of the beds
within the facility.

(g) "Planned closure rate adjustment" means an increase in a nursing facility's operating
rates resulting from a planned closure or a planned partial closure of another facility.

Sec. 43.

Minnesota Statutes 2016, section 256R.40, subdivision 5, is amended to read:


Subd. 5.

Planned closure rate adjustment.

(a) The commissioner shall calculate the
amount of the planned closure rate adjustment available under subdivision 6 according to
clauses (1) to (4):

(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;

(2) the total number of beds in the nursing facility or facilities receiving the planned
closure rate adjustment must be identified;

(3) capacity days are determined by multiplying the number determined under clause
(2) by 365; and

(4) the planned closure rate adjustment is the amount available in clause (1), divided by
capacity days determined under clause (3).

(b) A planned closure rate adjustment under this section is effective on the first day of
the month new text beginof January or July, whichever occurs immediately new text endfollowing completion of closure
of the facility designated for closure in the application and becomes part of the nursing
facility's external fixed payment rate.

(c) Upon the request of a closing facility, the commissioner must allow the facility a
closure rate adjustment as provided under section 144A.161, subdivision 10.

(d) A facility that has received a planned closure rate adjustment may reassign it to
another facility that is under the same ownership at any time within three years of its effective
date. The amount of the adjustment is computed according to paragraph (a).

(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the
commissioner shall recalculate planned closure rate adjustments for facilities that delicense
beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar
amount. The recalculated planned closure rate adjustment is effective from the date the per
bed dollar amount is increased.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for closures occurring after July 1, 2017.
new text end

Sec. 44.

Minnesota Statutes 2016, section 256R.41, is amended to read:


256R.41 SINGLE-BED ROOM INCENTIVE.

(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed
under this chapter shall be increased by 20 percent multiplied by the ratio of the number of
new single-bed rooms created divided by the number of active beds on July 1, 2005, for
each bed closure that results in the creation of a single-bed room after July 1, 2005. The
commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each
year. For eligible bed closures for which the commissioner receives a notice from a facility
deleted text begin during a calendar quarterdeleted text end that a bed has been delicensed and a new single-bed room has
been established, the rate adjustment in this paragraph shall be effective onnew text begin eithernew text end the first
day of the deleted text beginseconddeleted text end month new text beginof January or July, whichever occurs first new text endfollowing deleted text beginthat calendar
quarter
deleted text endnew text begin the date of the bed delicensurenew text end.

(b) A nursing facility is prohibited from discharging residents for purposes of establishing
single-bed rooms. A nursing facility must submit documentation to the commissioner in a
form prescribed by the commissioner, certifying the occupancy status of beds closed to
create single-bed rooms. In the event that the commissioner determines that a facility has
discharged a resident for purposes of establishing a single-bed room, the commissioner shall
not provide a rate adjustment under paragraph (a).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for closures occurring after July 1, 2017.
new text end

Sec. 45.

Minnesota Statutes 2016, section 256R.47, is amended to read:


256R.47 RATE ADJUSTMENT FOR 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. 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 section 256R.21, subdivision 3, 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 256R.43, 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 shall 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) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to
designated critical access nursing facilities.

(d) Designation of a critical access nursing facility is for a period of two years, after
which the benefits allowed under paragraph (c) shall be removed. Designated facilities may
apply for continued designation.

(e) This section is suspended and no state or federal funding shall be appropriated or
allocated for the purposes of this section from January 1, 2016, to December 31, deleted text begin2017deleted text endnew text begin 2019new 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. 46.

Minnesota Statutes 2016, section 256R.49, subdivision 1, is amended to read:


Subdivision 1.

Rate adjustments for compensation-related costs.

(a) deleted text beginOperating payment
rates of all nursing facilities that are reimbursed under this chapter shall be increased effective
for rate years beginning on and after October 1, 2014, to address changes in compensation
costs for nursing facility employees paid less than $14 per hour in accordance with this
section.
deleted text endnew text begin Rate increases provided under this section before October 1, 2016, expire effective
January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective
January 1, 2019.
new text end

(b) Nursing facilities that receive approval of the applications in subdivision 2 must
receive rate adjustments according to subdivision 4. The rate adjustments must be used to
pay compensation costs for nursing facility employees paid less than $14 per hour.

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. new text beginDIRECTION TO THE COMMISSIONER; ADULT DAY SERVICES
STAFFING RATIOS; ELDERLY WAIVER.
new text end

new text begin The commissioner of human services shall:
new text end

new text begin (1) study existing adult day services models, including resident acuity, staffing and
support levels, and quality assurance;
new text end

new text begin (2) project demand for adult day services into the future; and
new text end

new text begin (3) report to the legislature by January 1, 2019.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 48.

new text begin ALZHEIMER'S DISEASE WORKING GROUP.
new text end

new text begin Subdivision 1. new text end

new text begin Members. new text end

new text begin (a) The Minnesota Board on Aging must appoint 16 members
to an Alzheimer's disease working group, as follows:
new text end

new text begin (1) a caregiver of a person who has been diagnosed with Alzheimer's disease;
new text end

new text begin (2) a person who has been diagnosed with Alzheimer's disease;
new text end

new text begin (3) two representatives from the nursing facility or senior housing profession;
new text end

new text begin (4) a representative of the home care or adult day services profession;
new text end

new text begin (5) two geriatricians, one of whom serves a diverse or underserved community;
new text end

new text begin (6) a psychologist who specializes in dementia care;
new text end

new text begin (7) an Alzheimer's researcher;
new text end

new text begin (8) a representative of the Alzheimer's Association;
new text end

new text begin (9) two members from community-based organizations serving one or more diverse or
underserved communities;
new text end

new text begin (10) the commissioner of human services or a designee;
new text end

new text begin (11) the commissioner of health or a designee;
new text end

new text begin (12) the ombudsman for long-term care or a designee; and
new text end

new text begin (13) one member of the Minnesota Board on Aging, selected by the board.
new text end

new text begin (b) The executive director of the Minnesota Board on Aging serves on the working group
as a nonvoting member.
new text end

new text begin (c) The appointing authorities under this subdivision must complete their appointments
no later than December 15, 2017.
new text end

new text begin (d) To the extent practicable, the membership of the working group must reflect the
diversity in Minnesota, and must include representatives from rural and metropolitan areas
and representatives of different ethnicities, races, genders, ages, cultural groups, and abilities.
new text end

new text begin Subd. 2. new text end

new text begin Duties; recommendations. new text end

new text begin The Alzheimer's disease working group must
review and revise the 2011 report, Preparing Minnesota for Alzheimer's: the Budgetary,
Social and Personal Impacts. The working group shall consider and make recommendations
and findings on the following issues as related to Alzheimer's disease or other dementias:
new text end

new text begin (1) analysis and assessment of public health and health care data to accurately determine
trends and disparities in cognitive decline;
new text end

new text begin (2) public awareness, knowledge, and attitudes, including knowledge gaps, stigma,
availability of information, and supportive community environments;
new text end

new text begin (3) risk reduction, including health education and health promotion on risk factors,
safety, and potentially avoidable hospitalizations;
new text end

new text begin (4) diagnosis and treatment, including early detection, access to diagnosis, quality of
dementia care, and cost of treatment;
new text end

new text begin (5) professional education and training, including geriatric education for licensed health
care professionals and dementia-specific training for direct care workers, first responders,
and other professionals in communities;
new text end

new text begin (6) residential services, including cost to families as well as regulation and licensing
gaps; and
new text end

new text begin (7) cultural competence and responsiveness to reduce health disparities and improve
access to high-quality dementia care.
new text end

new text begin Subd. 3. new text end

new text begin Meetings. new text end

new text begin The Board on Aging must convene the first meeting of the working
group no later than January 15, 2018. Before the first meeting, the Board on Aging must
designate one member to serve as chair. Meetings of the working group must be open to
the public, and to the extent practicable, technological means, such as Web casts, shall be
used to reach the greatest number of people throughout the state. The working group may
not meet more than five times.
new text end

new text begin Subd. 4. new text end

new text begin Compensation. new text end

new text begin Members of the working group serve without compensation,
but may be reimbursed for allowed actual and necessary expenses incurred in the performance
of the member's duties for the working group in the same manner and amount as authorized
by the commissioner's plan adopted under Minnesota Statutes, section 43A.18, subdivision
2.
new text end

new text begin Subd. 5. new text end

new text begin Administrative support. new text end

new text begin The Minnesota Board on Aging shall provide
administrative support and arrange meeting space for the working group.
new text end

new text begin Subd. 6. new text end

new text begin Report. new text end

new text begin The Board on Aging must submit a report providing the findings and
recommendations of the working group, including any draft legislation necessary to
implement the recommendations, to the governor and chairs and ranking minority members
of the legislative committees with jurisdiction over health care by January 15, 2019.
new text end

new text begin Subd. 7. new text end

new text begin Expiration. new text end

new text begin The working group expires June 30, 2019, or the day after the
working group submits the report required in subdivision 6, whichever is earlier.
new text end

Sec. 49. new text beginELECTRONIC SERVICE DELIVERY DOCUMENTATION SYSTEM.
new text end

new text begin Subdivision 1. new text end

new text begin Documentation; establishment. new text end

new text begin The commissioner of human services
shall establish implementation requirements and standards for an electronic service delivery
documentation system to comply with the 21st Century Cures Act, Public Law 114-255.
Within available appropriations, the commissioner shall take steps to comply with the
electronic visit verification requirements in the 21st Century Cures Act, Public Law 114-255.
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 in this subdivision have
the meanings given them.
new text end

new text begin (b) "Electronic service delivery documentation" means the electronic documentation of
the:
new text end

new text begin (1) type of service performed;
new text end

new text begin (2) individual receiving the service;
new text end

new text begin (3) date of the service;
new text end

new text begin (4) location of the service delivery;
new text end

new text begin (5) individual providing the service; and
new text end

new text begin (6) time the service begins and ends.
new text end

new text begin (c) "Electronic service delivery documentation system" means a system that provides
electronic service delivery documentation that complies with the 21st Century Cures Act,
Public Law 114-255, and the requirements of subdivision 3.
new text end

new text begin (d) "Service" means one of the following:
new text end

new text begin (1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625,
subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; or
new text end

new text begin (2) community first services and supports under Minnesota Statutes, section 256B.85.
new text end

new text begin Subd. 3. new text end

new text begin Requirements. new text end

new text begin (a) In developing implementation requirements for an electronic
service delivery documentation system, the commissioner shall consider electronic visit
verification systems and other electronic service delivery documentation methods. The
commissioner shall convene stakeholders that will be impacted by an electronic service
delivery system, including service providers and their representatives, service recipients
and their representatives, and, as appropriate, those with expertise in the development and
operation of an electronic service delivery documentation system, to ensure that the
requirements:
new text end

new text begin (1) are minimally administratively and financially burdensome to a provider;
new text end

new text begin (2) are minimally burdensome to the service recipient and the least disruptive to the
service recipient in receiving and maintaining allowed services;
new text end

new text begin (3) consider existing best practices and use of electronic service delivery documentation;
new text end

new text begin (4) are conducted according to all state and federal laws;
new text end

new text begin (5) are effective methods for preventing fraud when balanced against the requirements
of clauses (1) and (2); and
new text end

new text begin (6) are consistent with the Department of Human Services' policies related to covered
services, flexibility of service use, and quality assurance.
new text end

new text begin (b) The commissioner shall make training available to providers on the electronic service
delivery documentation system requirements.
new text end

new text begin (c) The commissioner shall establish baseline measurements related to preventing fraud
and establish measures to determine the effect of electronic service delivery documentation
requirements on program integrity.
new text end

new text begin Subd. 4. new text end

new text begin Legislative report. new text end

new text begin (a) The commissioner shall submit a report by January 15,
2018, to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services with recommendations, based on the requirements of
subdivision 3, to establish electronic service delivery documentation system requirements
and standards. The report shall identify:
new text end

new text begin (1) the essential elements necessary to operationalize a base-level electronic service
delivery documentation system to be implemented by January 1, 2019; and
new text end

new text begin (2) enhancements to the base-level electronic service delivery documentation system to
be implemented by January 1, 2019, or after, with projected operational costs and the costs
and benefits for system enhancements.
new text end

new text begin (b) The report must also identify current regulations on service providers that are either
inefficient, minimally effective, or will be unnecessary with the implementation of an
electronic service delivery documentation system.
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. 50. new text beginREVISOR'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, and Department of Human Services shall
prepare legislation for the 2018 legislative session to recodify laws governing the elderly
waiver program in Minnesota Statutes, chapter 256B.
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 4

HEALTH CARE

Section 1.

Minnesota Statutes 2016, section 3.972, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Audits of Department of Human Services. new text end

new text begin (a) To ensure continuous
legislative oversight and accountability, the legislative auditor shall give high priority to
auditing the programs, services, and benefits administered by the Department of Human
Services. The audits shall determine whether the department offered programs and provided
services and benefits only to eligible persons and organizations, and complied with applicable
legal requirements.
new text end

new text begin (b) The legislative auditor shall, based on an assessment of risk and using professional
standards to provide a statistically significant sample, no less than three times each year,
test a representative sample of persons enrolled in a medical assistance program or
MinnesotaCare to determine whether they are eligible to receive benefits under those
programs. The legislative auditor shall report the results to the commissioner of human
services and recommend corrective actions. The commissioner shall provide a response to
the legislative auditor within 20 business days, including corrective actions to be taken to
address any problems identified by the legislative auditor and anticipated completion dates.
The legislative auditor shall monitor the commissioner's implementation of corrective actions
and periodically report the results to the Legislative Audit Commission and the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services policy and finance. The legislative auditor's reports to the commission and
the chairs and ranking minority members must include recommendations for any legislative
actions needed to ensure that medical assistance and MinnesotaCare benefits are provided
only to eligible persons.
new text end

Sec. 2.

Minnesota Statutes 2016, section 3.972, is amended by adding a subdivision to
read:


new text begin Subd. 2b. new text end

new text begin Audits of managed care organizations. new text end

new text begin (a) The legislative auditor shall audit
each managed care organization that contracts with the commissioner of human services to
provide health care services under sections 256B.69, 256B.692, and 256L.12. The legislative
auditor shall design the audits to determine if a managed care organization used the public
money in compliance with federal and state laws, rules, and in accordance with provisions
in the managed care organization's contract with the commissioner of human services. The
legislative auditor shall determine the schedule and scope of the audit work and may contract
with vendors to assist with the audits. The managed care organization must cooperate with
the legislative auditor and must provide the legislative auditor with all data, documents, and
other information, regardless of classification, that the legislative auditor requests to conduct
an audit. The legislative auditor shall periodically report audit results and recommendations
to the Legislative Audit Commission and the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance.
new text end

new text begin (b) For purposes of this subdivision, a "managed care organization" means a
demonstration provider as defined under section 256B.69, subdivision 2.
new text end

Sec. 3.

Minnesota Statutes 2016, section 62U.02, is amended to read:


62U.02 PAYMENT RESTRUCTURING; QUALITY INCENTIVE PAYMENTS.

Subdivision 1.

Development.

(a) The commissioner of health shall develop a standardized
set of measures new text beginfor use by health plan companies as specified in subdivision 5. As part of
the standardized set of measures, the commissioner shall establish statewide measures
new text endby
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. deleted text beginQuality
measures must be based on medical evidence and be developed through a process in which
providers participate.
deleted text end The new text beginstatewide new text endmeasures shall be used for the quality incentive payment
system developed in subdivision 2 and new text beginthe quality transparency requirements in subdivision
3. The statewide measures
new text endmust:

new text begin (1) for purposes of assessing the quality of care provided at physician clinics, including
clinics certified as health care homes under section 256B.0751, be selected from the available
measures as defined in Code of Federal Regulations, title 42, part 414 or 495, as amended,
unless the stakeholders identified under paragraph (b) determine that a particular diagnosis,
condition, service, or procedure is not reflected in any of the available measures in a way
that meets identified needs;
new text end

new text begin (2) be based on medical evidence;
new text end

new text begin (3) be developed through a process in which providers participate and consumer and
community input and perspectives are obtained;
new text end

deleted text begin (1)deleted text endnew text begin (4)new text end include uniform definitions, measures, and forms for submission of data, to the
greatest extent possible;

deleted text begin (2)deleted text endnew text begin (5)new text end seek to avoid increasing the administrative burden on health care providers;new text begin and
new text end

deleted text begin (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;
deleted text end

deleted text begin (4)deleted text endnew text begin (6)new text end place a priority on measures of health care outcomes, rather than process measures,
wherever possibledeleted text begin; and
deleted text end

deleted text begin (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
deleted text end.

new text begin The measures may also include measures of care infrastructure and patient satisfaction.
new text end

new text begin (b) By June 30, 2018, the commissioner shall develop a measurement framework that
identifies the most important elements for assessing the quality of care, articulates statewide
quality improvement goals, ensures clinical relevance, fosters alignment with other
measurement efforts, and defines the roles of stakeholders. By December 15, 2018, the
commissioner shall use the framework to update the statewide measures used 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. No more than six statewide
measures shall be required for single-specialty physician practices and no more than ten
statewide measures shall be required for multispecialty physician practices. Measures in
addition to the six statewide measures for single-specialty practices and the ten statewide
measures for multispecialty practices may be included for a physician practice if derived
from administrative claims data. Care infrastructure measures collected according to section
62J.495 shall not be counted toward the maximum number of measures specified in this
paragraph. The commissioner shall develop the framework in consultation with stakeholders
that include consumer, community, and advocacy organizations representing diverse
communities and patients; health plan companies; health care providers whose quality is
assessed, including providers who serve primarily socioeconomically complex patient
populations; health care purchasers; community health boards; and quality improvement
and measurement organizations. The commissioner, in consultation with stakeholders, shall
review the framework at least once every three years. The commissioner shall also submit
a report to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance by September 30, 2018,
summarizing the development of the measurement framework and making recommendations
on the type and appropriate maximum number of measures in the statewide measures set
for implementation on January 1, 2020.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end 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 new text beginor composite indices of multiple factorsnew text end 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 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.

deleted text begin (c)deleted text endnew text begin (d)new text end The new text beginstatewide new text endmeasures shall be reviewed at least annually by the commissioner.

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 populations, including those with risk factors related to race, ethnicity, language, country
of origin, and sociodemographic factors.

(c) The requirements of section 62Q.101 do not apply under this incentive payment
system.

Subd. 3.

Quality transparency.

(a) The commissioner shall establish standards for
measuring health outcomes, establish a system for risk adjusting quality measures, and issue
deleted text begin annualdeleted text endnew text begin periodicnew text end public reports on new text begintrends in new text endprovider quality deleted text beginbeginning July 1, 2010deleted text endnew text begin at the
statewide, regional, or clinic levels
new text end.

(b) Effective July 1, 2017, the risk adjustment system established under this subdivision
shall adjust for patient characteristics identified under subdivision 1, paragraph deleted text begin(b)deleted text endnew text begin (c)new text end, 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 subdivision 4.

(c) deleted text beginBy January 1, 2010,deleted text end Physician clinics and hospitals shall submit standardized
deleted text begin electronicdeleted text end information deleted text beginon the outcomes and processes associated with patient caredeleted text endnew text begin for the
identified statewide measures
new text end to the commissioner or the commissioner's designee new text beginin the
formats specified by the commissioner, which must include alternative formats for clinics
or hospitals experiencing technological or economic barriers to submission in standardized
electronic form
new text end. deleted text beginIn 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.
deleted text enddeleted text begin The commissioner shall ensure that any quality data
reporting requirements
deleted text enddeleted text beginestablished under this subdivision are not duplicative of publicly
reported, communitywide
deleted text enddeleted text beginquality reporting activities currently under way in Minnesota.
deleted text endnew text begin The commissioner shall ensure that any quality data reporting requirements for physician
clinics are aligned with the specifications and timelines for the selected measures as defined
in subdivision 1, paragraph (a), clause (1). The commissioner may develop additional data
on race, ethnicity, preferred language, country of origin, or other sociodemographic factors
as identified under subdivision 1, paragraph (c), and as required for stratification or risk
adjustment. None of the statewide measures selected shall require providers to use an external
vendor to administer or collect data.
new text enddeleted text beginNothingdeleted text end deleted text beginin this subdivision is intended to replace or
duplicate current privately supported activities
deleted text enddeleted text beginrelated to quality measurement and reporting
in Minnesota.
deleted text end

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 providers, including providers serving high
concentrations of patients and communities impacted by health disparities; health plan
companies; consumers, including consumers representing groups who experience health
disparities; employers or other health care purchasers; 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.

Subd. 5.

Implementation.

deleted text begin(a) By January 1, 2010,deleted text end Health plan companies shall use the
standardized deleted text beginqualitydeleted text endnew text begin set ofnew text end measures established under this section and shall not require
providers to use and report health plan company-specific quality and outcome measures.

deleted text begin (b) By July 1, 2010, the commissioner of management and budget shall implement this
incentive payment system for all participants in the state employee group insurance program.
deleted text end

Sec. 4.

Minnesota Statutes 2016, section 256.01, is amended by adding a subdivision to
read:


new text begin Subd. 18f. new text end

new text begin Asset verification system. new text end

new text begin The commissioner shall implement the Asset
Verification System (AVS) according to Public Law 110-252, title VII, section 7001(d), to
verify assets for an individual applying for or renewing health care benefits under section
256B.055, subdivision 7.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 5.

Minnesota Statutes 2016, section 256.9685, subdivision 1, is amended to read:


Subdivision 1.

Authority.

deleted text begin(a)deleted text end The commissioner shall establish procedures for
determining medical assistance payment rates under a prospective payment system for
inpatient hospital services in hospitals that qualify as vendors of medical assistance. The
commissioner shall establish, by rule, procedures for implementing this section and sections
256.9686, 256.969, and 256.9695. Services must meet the requirements of section 256B.04,
subdivision 15
, to be eligible for payment.

deleted text begin (b) The commissioner may reduce the types of inpatient hospital admissions that are
required to be certified as medically necessary after notice in the State Register and a 30-day
comment period.
deleted text end

Sec. 6.

Minnesota Statutes 2016, section 256.9685, subdivision 1a, is amended to read:


Subd. 1a.

Administrative reconsideration.

Notwithstanding section 256B.04,
subdivision 15
, the commissioner shall establish an administrative reconsideration process
for appeals of inpatient hospital services determined to be medically unnecessary. A physician
or hospital may request a reconsideration of the decision that inpatient hospital services are
not medically necessary by submitting a written request for review to the commissioner
within 30 days after receiving notice of the decision. The reconsideration process shall take
place prior to the procedures of subdivision 1b and shall be conducted by deleted text beginphysiciansdeleted text endnew text begin the
medical review agent
new text end that deleted text beginaredeleted text endnew text begin isnew text end independent of the case under reconsideration. deleted text beginA majority
decision by the physicians is necessary to make a determination that the services were not
medically necessary.
deleted text end

Sec. 7.

Minnesota Statutes 2016, section 256.9686, subdivision 8, is amended to read:


Subd. 8.

Rate year.

"Rate year" means a calendar year from January 1 to December 31.new text begin
Effective with the 2012 base year, rate year means a state fiscal year from July 1 to June
30.
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.

Minnesota Statutes 2016, 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 Centers for Medicare and Medicaid Services Inpatient Hospital Market Basket. The
commissioner shall use the indices as forecasted for the midpoint of the prior rate year to
the midpoint of the current rate year.

(b) new text beginExcept as authorized under this section, new text endfor 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 9.

Minnesota Statutes 2016, 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 the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), 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 the nextnew text begin twonew text end rebasing
deleted text begin that occursdeleted text endnew text begin periodsnew 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, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;

(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.new text begin In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.
new text end

(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. new text beginChanges in costs
between base years shall be measured using the lower of the hospital cost index defined in
subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
claim.
new text endThe 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.

(i) Effective for discharges occurring on or after July 1, 2015,new text begin inpatientnew text end 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:

(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;

(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

(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.

(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:

(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;

(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;

(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;

(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);

(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and

(6) geographic location.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 10.

Minnesota Statutes 2016, 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
deleted text begin 11 ordeleted text end 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 deleted text beginthedeleted text end 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.

(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 begin (l) Effective for discharges on and after July 1, 2017, from hospitals paid under
subdivision 2b, paragraph (a), clause (2), the rate adjustments in this subdivision must be
incorporated into the rates and must not be applied to each claim.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 11.

Minnesota Statutes 2016, section 256.969, subdivision 8, is amended to read:


Subd. 8.

Unusual length of stay experience.

(a) The commissioner shall establish day
outlier thresholds for each diagnostic category established under subdivision 2 at two standard
deviations beyond the mean length of stay. Payment for the days beyond the outlier threshold
shall be in addition to the operating and property payment rates per admission established
under subdivisions 2 and 2b. Payment for outliers shall be at 70 percent of the allowable
operating cost, after adjustment by the case mix index, hospital cost index, relative values
and the disproportionate population adjustment. The outlier threshold for neonatal and burn
diagnostic categories shall be established at one standard deviation beyond the mean length
of stay, and payment shall be at 90 percent of allowable operating cost calculated in the
same manner as other outliers. A hospital may choose an alternative to the 70 percent outlier
payment that is at a minimum of 60 percent and a maximum of 80 percent if the
commissioner is notified in writing of the request by October 1 of the year preceding the
rate year. The chosen percentage applies to all diagnostic categories except burns and
neonates. The percentage of allowable cost that is unrecognized by the outlier payment shall
be added back to the base year operating payment rate per admission.

(b) Effective fornew text begin admissions andnew text end transfers occurring on and after November 1, 2014, the
commissioner shall establish payment rates for outlier payments that are based on Medicare
methodologies.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 12.

Minnesota Statutes 2016, section 256.969, subdivision 8c, is amended to read:


Subd. 8c.

Hospital residents.

new text begin(a) new text endFor discharges occurring on or after November 1,
2014, payments for hospital residents shall be made as follows:

(1) payments for the first 180 days of inpatient care shall be the APR-DRG system plus
any outliers; and

(2) payment for all medically necessary patient care subsequent to the first 180 days
shall be reimbursed at a rate computed by multiplying the statewide average cost-to-charge
ratio by the usual and customary charges.

new text begin (b) For discharges occurring on or after July 1, 2017, payment for hospital residents
shall be equal to the payments under subdivision 8, paragraph (b).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 13.

Minnesota Statutes 2016, 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. 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.

(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:

(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;

(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;

(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;

(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;

(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

(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.

(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 deleted text beginnonchildren'sdeleted text endnew text begin non-children'snew text end
hospitals that have a medical assistance utilization rate that is at least one standard deviation
above the mean.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 14.

Minnesota Statutes 2016, section 256.969, subdivision 12, is amended to read:


Subd. 12.

Rehabilitation hospitals and distinct parts.

(a) Units of hospitals that are
recognized as rehabilitation distinct parts by the Medicare program shall have separate
provider numbers under the medical assistance program for rate establishment and billing
purposes only. These units shall also have operating payment rates and the disproportionate
population adjustment, if allowed by federal law, established separately from other inpatient
hospital services.

(b) The commissioner shall establish separate relative values under subdivision 2 for
rehabilitation hospitals and distinct parts as defined by the Medicare program. Effective for
discharges occurring on and after November 1, 2014, the commissioner, to the extent
possible, shall replicate the existing payment rate methodology under the new diagnostic
classification system. The result must be budget neutral, ensuring that the total aggregate
payments under the new system are equal to the total aggregate payments made for the same
number and types of services in the base year, calendar year 2012.

(c) For individual hospitals that did not have separate medical assistance rehabilitation
provider numbers or rehabilitation distinct parts in the base year, hospitals shall provide the
information needed to separate rehabilitation distinct part cost and claims data from other
inpatient service data.

new text begin (d) Effective with discharges on or after July 1, 2017, payment to rehabilitation hospitals
shall be established under subdivision 2b, paragraph (a), clause (4).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 15.

Minnesota Statutes 2016, section 256.9695, subdivision 1, is amended to read:


Subdivision 1.

Appeals.

A hospital may appeal a decision arising from the application
of standards or methods under section 256.9685, 256.9686, or 256.969, if an appeal would
result in a change to the hospital's payment rate or payments. Both overpayments and
underpayments that result from the submission of appeals shall be implemented. Regardless
of any appeal outcome, relative valuesnew text begin, Medicare wage indexes, Medicare cost-to-charge
ratios, and policy adjusters
new text end shall not be deleted text beginrecalculateddeleted text endnew text begin changednew text end. The appeal shall be heard by
an administrative law judge according to sections 14.57 to 14.62, or upon agreement by
both parties, according to a modified appeals procedure established by the commissioner
and the Office of Administrative Hearings. In any proceeding under this section, the appealing
party must demonstrate by a preponderance of the evidence that the commissioner's
determination is incorrect or not according to law.

deleted text begin (a)deleted text end To appeal a payment rate or payment determination or a determination made from
base year information, the hospital shall file a written appeal request to the commissioner
within 60 days of the date the new text beginpreliminary new text endpayment rate determination was mailed. The
appeal request shall specify: (i) the disputed items; (ii) the authority in federal or state statute
or rule upon which the hospital relies for each disputed item; and (iii) the name and address
of the person to contact regarding the appeal. Facts to be considered in any appeal of base
year information are limited to those in existence deleted text beginat the time the payment rates of the first
rate year were established from the base year information. In the case of Medicare settled
appeals, the 60-day appeal period shall begin on the mailing date of the notice by the
Medicare program or the date the medical assistance payment rate determination notice is
mailed, whichever is later
deleted text endnew text begin 12 months after the last day of the calendar year that is the base
year for the payment rates in dispute
new text end.

deleted text begin (b) To appeal a payment rate or payment change that results from a difference in case
mix between the base year and a rate year, the procedures and requirements of paragraph
(a) apply. However, the appeal must be filed with the commissioner within 120 days after
the end of a rate year. A case mix appeal must apply to the cost of services to all medical
assistance patients that received inpatient services from the hospital during the rate year
appealed. For case mix appeals filed after January 1, 1997, the difference in case mix and
the corresponding payment adjustment must exceed a threshold of five percent.
deleted text end

Sec. 16.

Minnesota Statutes 2016, section 256B.04, subdivision 12, is amended to read:


Subd. 12.

Limitation on services.

(a) Place limits on the types of services covered by
medical assistance, the frequency with which the same or similar services may be covered
by medical assistance for an individual recipient, and the amount paid for each covered
service. The state agency shall promulgate rules establishing maximum reimbursement rates
for emergency and nonemergency transportation.

The rules shall provide:

(1) an opportunity for all recognized transportation providers to be reimbursed for
nonemergency transportation consistent with the maximum rates established by the agency;new text begin
and
new text end

(2) reimbursement of public and private nonprofit providers serving the disabled
population generally at reasonable maximum rates that reflect the cost of providing the
service regardless of the fare that might be charged by the provider for similar services to
individuals other than those receiving medical assistance or medical care under this chapterdeleted text begin;
and
deleted text endnew text begin.
new text end

deleted text begin (3) reimbursement for each additional passenger carried on a single trip at a substantially
lower rate than the first passenger carried on that trip.
deleted text end

(b) The commissioner shall encourage providers reimbursed under this chapter to
coordinate their operation with similar services that are operating in the same community.
To the extent practicable, the commissioner shall encourage eligible individuals to utilize
less expensive providers capable of serving their needs.

(c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective
on January 1, 1981, "recognized provider of transportation services" means an operator of
special transportation service as defined in section 174.29 that has been issued a current
certificate of compliance with operating standards of the commissioner of transportation
or, if those standards do not apply to the operator, that the agency finds is able to provide
the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized
transportation provider" includes an operator of special transportation service that the agency
finds is able to provide the required transportation in a safe and reliable manner.

Sec. 17.

Minnesota Statutes 2016, section 256B.04, subdivision 24, is amended to read:


Subd. 24.

Medicaid waiver requests and state plan amendments.

new text beginThe commissioner
shall notify the chairs and ranking minority members of the legislative committees with
jurisdiction over medical assistance at least 30 days before submitting a new Medicaid
waiver request to the federal government.
new text endPrior to submitting any Medicaid waiver request
or Medicaid state plan amendment to the federal government for approval, the commissioner
shall publish the text of the waiver request or state plan amendment, and a summary of and
explanation of the need for the request, on the agency's Web site and provide a 30-day public
comment period. The commissioner shall notify the public of the availability of this
information through the agency's electronic subscription service. The commissioner shall
consider public comments when preparing the final waiver request or state plan amendment
that is to be submitted to the federal government for approval. The commissioner shall also
publish on the agency's Web site notice of any federal decision related to the state request
for approval, within 30 days of the decision. This notice must describe any modifications
to the state request that have been agreed to by the commissioner as a condition of receiving
federal approval.

Sec. 18.

Minnesota Statutes 2016, section 256B.056, subdivision 3b, is amended to read:


Subd. 3b.

Treatment of trusts.

(a) A "medical assistance qualifying trust" is a revocable
or irrevocable trust, or similar legal device, established on or before August 10, 1993, by a
person or the person's spouse under the terms of which the person receives or could receive
payments from the trust principal or income and the trustee has discretion in making payments
to the person from the trust principal or income. Notwithstanding that definition, a medical
assistance qualifying trust does not include: (1) a trust set up by will; (2) a trust set up before
April 7, 1986, solely to benefit a person with a developmental disability living in an
intermediate care facility for persons with developmental disabilities; or (3) a trust set up
by a person with payments made by the Social Security Administration pursuant to the
United States Supreme Court decision in Sullivan v. Zebley, 110 S. Ct. 885 (1990). The
maximum amount of payments that a trustee of a medical assistance qualifying trust may
make to a person under the terms of the trust is considered to be available assets to the
person, without regard to whether the trustee actually makes the maximum payments to the
person and without regard to the purpose for which the medical assistance qualifying trust
was established.

(b) deleted text beginExcept as provided in paragraphs (c) and (d),deleted text end Trusts established after August 10,
1993, are treated according to deleted text beginsection 13611(b) of the Omnibus Budget Reconciliation Act
of 1993 (OBRA), Public Law 103-66
deleted text endnew text begin United States Code, title 42, section 1396p(d)new text end.

(c) For purposes of paragraph (d), a pooled trust means a trust established under United
States Code, title 42, section 1396p(d)(4)(C).

(d) A beneficiary's interest in a pooled trust is considered an available asset unless the
trust provides that upon the death of the beneficiary or termination of the trust during the
beneficiary's lifetime, whichever is sooner, the department receives any amount, up to the
amount of medical assistance benefits paid on behalf of the beneficiary, remaining in the
beneficiary's trust account after a deduction for reasonable administrative fees and expenses,
and an additional remainder amount. The retained remainder amount of the subaccount
must not exceed ten percent of the account value at the time of the beneficiary's death or
termination of the trust, and must only be used for the benefit of disabled individuals who
have a beneficiary interest in the pooled trust.

new text begin (e) Trusts may be established on or after December 12, 2016, by a person who has been
determined to be disabled, according to United States Code, title 42, section 1396p(d)(4)(A),
as amended by section 5007 of the 21st Century Cures Act, Public Law 114-255.
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. 19.

Minnesota Statutes 2016, section 256B.056, subdivision 3c, is amended to read:


Subd. 3c.

Asset limitations for families and children.

(a) A household of two or more
persons must not own more than $20,000 in total net assets, and a household of one person
must not own more than $10,000 in total net assets. In addition to these maximum amounts,
an eligible individual or family may accrue interest on these amounts, but they must be
reduced to the maximum at the time of an eligibility redetermination. The value of assets
that are not considered in determining eligibility for medical assistance for families and
children is the value of those assets excluded under the AFDC state plan as of July 16, 1996,
as required by the Personal Responsibility and Work Opportunity Reconciliation Act of
1996 (PRWORA), Public Law 104-193, with the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business up to $200,000 are not considereddeleted text begin,
except that a bank account that contains personal income or assets, or is used to pay personal
expenses, is not considered a capital or operating asset of a trade or business
deleted text end;

(3) one motor vehicle is excluded for each person of legal driving age who is employed
or seeking employment;

(4) assets designated as burial expenses are excluded to the same extent they are excluded
by the Supplemental Security Income program;

(5) court-ordered settlements up to $10,000 are not considered;

(6) individual retirement accounts and funds are not considered;

(7) assets owned by children are not considered; and

(8) effective July 1, 2009, certain assets owned by American Indians are excluded 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.

deleted text begin The assets specified in clause (2) must be disclosed to the local agency at the time of
application and at the time of an eligibility redetermination, and must be verified upon
request of the local agency.
deleted text end

(b) Beginning January 1, 2014, this subdivision applies only to parents and caretaker
relatives who qualify for medical assistance under subdivision 5.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 20.

Minnesota Statutes 2016, 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 begin80deleted text endnew text begin 81new text end percent of the federal poverty
guidelines.

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2016, section 256B.0561, subdivision 2, is amended to read:


Subd. 2.

Periodic data matching.

(a) Beginning deleted text beginMarch 1, 2016deleted text endnew text begin April 1, 2018new text end, 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.

(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.

(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.

(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.

Sec. 22.

Minnesota Statutes 2016, section 256B.0561, subdivision 4, is amended to read:


Subd. 4.

Report.

By September 1, deleted text begin2017deleted text endnew text begin 2019new text end, 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.

Sec. 23.

Minnesota Statutes 2016, section 256B.057, subdivision 9, as amended by Laws
2017, chapter 59, section 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, advanced practice registered nurse, or physician
assistant; 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 $35 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 one-half of one 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. deleted text beginGood cause exists if the
requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to D, are
met
deleted text endnew text begin "Good cause" means an excuse for the enrollee's failure to pay the required premium
when due because the circumstances were beyond the enrollee's control or not reasonably
foreseeable. The commissioner shall determine whether good cause exists based on the
weight of the supporting evidence submitted by the enrollee to demonstrate good cause
new text end.
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 the day following final enactment.
new text end

Sec. 24.

Minnesota Statutes 2016, section 256B.059, subdivision 6, as amended by Laws
2017, chapter 40, article 1, section 66, is amended to read:


Subd. 6.

Temporary application.

(a) During the period in which rules against spousal
impoverishment are temporarily applied according to section 2404 of the Patient Protection
Affordable Care Act, Public Law 111-148, as amended by the Health Care and Education
Reconciliation Act of 2010, Public Law 111-152, this section applies to an institutionalized
spouse:

(1) applying for home and community-based waivers under sections 256B.092, 256B.093,
and 256B.49 on or after June 1, 2016;

(2) enrolled in home and community-based waivers under sections 256B.092, 256B.093,
and 256B.49 before June 1, 2016new text begin, based on an application submitted on or after January 1,
2014
new text end; or

(3) applying for services under section 256B.85 upon the effective date of that section.

(b) During the applicable period of paragraph (a), the definition of "institutionalized
spouse" in subdivision 1, paragraph (e), also includes an institutionalized spouse referenced
in paragraph (a).

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2016, section 256B.0621, subdivision 10, is amended to read:


Subd. 10.

Payment rates.

The commissioner shall set payment rates for targeted case
management under this subdivision. Case managers may bill according to the following
criteria:

(1) for relocation targeted case management, case managers may bill for direct case
management activities, including face-to-face deleted text beginanddeleted text endnew text begin contact,new text end telephone deleted text begincontactsdeleted text endnew text begin contactnew text end, new text beginand
interactive video contact according to section 256B.0924, subdivision 4a,
new text endin the lesser of:

(i) 180 days preceding an eligible recipient's discharge from an institution; or

(ii) the limits and conditions which apply to federal Medicaid funding for this service;

(2) for home care targeted case management, case managers may bill for direct case
management activities, including face-to-face and telephone contacts; and

(3) billings for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 26.

Minnesota Statutes 2016, section 256B.0625, subdivision 1, is amended to read:


Subdivision 1.

Inpatient hospital services.

new text begin(a) new text endMedical assistance covers inpatient
hospital services. A second medical opinion is required prior to reimbursement for elective
surgeries requiring a second opinion. The commissioner shall publish in the State Register
a list of elective surgeries that require a second medical opinion prior to reimbursement,
and the criteria and standards for deciding whether an elective surgery should require a
second medical opinion. The list and the criteria and standards are not subject to the
requirements of sections 14.001 to 14.69. The commissioner's decision whether a second
medical opinion is required, made in accordance with rules governing that decision, is not
subject to administrative appeal.

new text begin (b) When determining medical necessity for inpatient hospital services, the medical
review agent shall follow industry standard medical necessity criteria in determining the
following:
new text end

new text begin (1) whether a recipient's admission is medically necessary;
new text end

new text begin (2) whether the inpatient hospital services provided to the recipient were medically
necessary;
new text end

new text begin (3) whether the recipient's continued stay was or will be medically necessary; and
new text end

new text begin (4) whether all medically necessary inpatient hospital services were provided to the
recipient.
new text end

new text begin The medical review agent will determine medical necessity of inpatient hospital services,
including inpatient psychiatric treatment, based on a review of the patient's medical condition
and records, in conjunction with industry standard evidence-based criteria to ensure consistent
and optimal application of medical appropriateness criteria.
new text end

Sec. 27.

Minnesota Statutes 2016, section 256B.0625, subdivision 3b, is amended to read:


Subd. 3b.

Telemedicine services.

(a) Medical assistance covers medically necessary
services and consultations delivered by a licensed health care provider via telemedicine in
the same manner as if the service or consultation was delivered in person. Coverage is
limited to three telemedicine services per enrollee per calendar week. Telemedicine services
shall be paid at the full allowable rate.

(b) The commissioner shall establish criteria that a health care provider must attest to
in order to demonstrate the safety or efficacy of delivering a particular service via
telemedicine. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
via telemedicine;

(2) has written policies and procedures specific to telemedicine services that are regularly
reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the telemedicine service is rendered;

(4) has established protocols addressing how and when to discontinue telemedicine
services; and

(5) has an established quality assurance process related to telemedicine services.

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service provided by telemedicine to a medical assistance enrollee.
Health care service records for services provided by telemedicine must meet the requirements
set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:

(1) the type of service provided by telemedicine;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the licensed health care provider's basis for determining that telemedicine is an
appropriate and effective means for delivering the service to the enrollee;

(4) the mode of transmission of the telemedicine service and records evidencing that a
particular mode of transmission was utilized;

(5) the location of the originating site and the distant site;

(6) if the claim for payment is based on a physician's telemedicine consultation with
another physician, the written opinion from the consulting physician providing the
telemedicine consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

(d) For purposes of this subdivision, unless otherwise covered under this chapter,
"telemedicine" is defined as the delivery of health care services or consultations while the
patient is at an originating site and the licensed health care provider is at a distant site. A
communication between licensed health care providers, or a licensed health care provider
and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission
does not constitute telemedicine consultations or services. Telemedicine may be provided
by means of real-time two-way, interactive audio and visual communications, including the
application of secure video conferencing or store-and-forward technology to provide or
support health care delivery, which facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care.

(e) For purposes of this section, "licensed health care provider" deleted text beginis defineddeleted text end new text beginmeans a
licensed health care provider
new text endunder section 62A.671, subdivision 6new text begin,new text endnew text begin and a mental health
practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision 26,
working under the general supervision of a mental health professional
new text end
; "health care provider"
is defined under section 62A.671, subdivision 3; and "originating site" is defined under
section 62A.671, subdivision 7.

new text begin EFFECTIVE DATE. new text end

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

Sec. 28.

Minnesota Statutes 2016, section 256B.0625, subdivision 7, is amended to read:


Subd. 7.

Home care nursing.

Medical assistance covers home care nursing services in
a recipient's home. Recipients who are authorized to receive home care nursing services in
their home may use approved hours outside of the home during hours when normal life
activities take them outside of their home. To use home care nursing services at school, the
recipient or responsible party must provide written authorization in the care plan identifying
the chosen provider and the daily amount of services to be used at school. Medical assistance
does not cover home care nursing services for residents of a hospital, nursing facility,
intermediate care facility, or a health care facility licensed by the commissioner of health,
deleted text begin except as authorized in section 256B.64 for ventilator-dependent recipients in hospitals ordeleted text end
unless a resident who is otherwise eligible is on leave from the facility and the facility either
pays for the home care nursing services or forgoes the facility per diem for the leave days
that home care nursing services are used. Total hours of service and payment allowed for
services outside the home cannot exceed that which is otherwise allowed in an in-home
setting according to sections 256B.0651 and 256B.0654 . All home care nursing services
must be provided according to the limits established under sections 256B.0651, 256B.0653,
and 256B.0654. Home care nursing services may not be reimbursed if the nurse is the family
foster care provider of a recipient who is under age 18, unless allowed under section
256B.0654, subdivision 4.

Sec. 29.

Minnesota Statutes 2016, 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.

(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,
deleted text begin common carrierdeleted text endnew text begin nonemergency medical transportation companynew text end, 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) taxicabsnew text begin that meet the requirements of this subdivisionnew text end;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) 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) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) 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.

(f) 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 of transportation under paragraph (i), clauses (4), (5), (6), and (7).

(g) 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 wheelchairsnew text begin, child seats,new text end or stretchers in the vehicle.

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.

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. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(h) 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.

(i) The covered modes of transportationdeleted text begin, which may not be implemented without a new
rate structure,
deleted text end are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance 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 public transit 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 provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (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 is 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.

(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) 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 government.

(k) 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.

(l) 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.

(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), 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:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(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;

(4) $13 for the base rate and $1.30 per mile for assisted transport;

(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(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.

(n) 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 (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).

(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

(p) 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.

new text begin (q) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).
new text end

Sec. 30.

Minnesota Statutes 2016, section 256B.0625, subdivision 17b, is amended to
read:


Subd. 17b.

Documentation required.

(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain odometer and other records
sufficient to distinguish individual trips with specific vehicles and drivers. The documentation
may be collected and maintained using electronic systems or software or in paper form but
must be made available and produced upon request. Program funds paid for transportation
that is not documented according to this subdivision shall be recovered by the department.

(b) A nonemergency medical transportation provider must compile transportation records
that meet the following requirements:

(1) the record must be in English and must be legible according to the standard of a
reasonable person;

(2) the recipient's name must be on each page of the record; and

(3) each entry in the record must document:

(i) the date on which the entry is made;

(ii) the date or dates the service is provided;

(iii) the printed last name, first name, and middle initial of the driver;

(iv) the signature of the driver attesting to the following: "I certify that I have accurately
reported in this record the trip miles I actually drove and the dates and times I actually drove
them. I understand that misreporting the miles driven and hours worked is fraud for which
I could face criminal prosecution or civil proceedings.";

(v) the signature of the recipient or authorized party attesting to the following: "I certify
that I received the reported transportation service.", or the signature of the provider of
medical services certifying that the recipient was delivered to the provider;

(vi) the address, or the description if the address is not available, of both the origin and
destination, and the mileage for the most direct route from the origin to the destination;

(vii) the mode of transportation in which the service is provided;

(viii) the license plate number of the vehicle used to transport the recipient;

(ix) whether the service was ambulatory or nonambulatory deleted text beginuntil the modes under
subdivision 17 are implemented
deleted text end;

(x) the time of the pickup and the time of the drop-off with "a.m." and "p.m."
designations;

(xi) the name of the extra attendant when an extra attendant is used to provide special
transportation service; and

(xii) the electronic source documentation used to calculate driving directions and mileage.

Sec. 31.

Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:


new text begin Subd. 17c. new text end

new text begin Nursing facility transports. new text end

new text begin A Minnesota health care program enrollee
residing in, or being discharged from, a licensed nursing facility is exempt from a level of
need determination and is eligible for nonemergency medical transportation services until
the enrollee no longer resides in a licensed nursing facility, as provided in section 256B.04,
subdivision 14a.
new text end

Sec. 32.

Minnesota Statutes 2016, section 256B.0625, subdivision 18h, is amended to
read:


Subd. 18h.

Managed care.

new text begin(a) new text endThe following subdivisions deleted text begindo notdeleted text end apply to managed
care plans and county-based purchasing plans:

(1) subdivision 17, paragraphs deleted text begin(d) to (k)deleted text endnew text begin (a), (b), (i), and (n)new text end;

(2) subdivision deleted text begin18edeleted text endnew text begin 18new text end; and

(3) subdivision deleted text begin18gdeleted text endnew text begin 18anew text end.

new text begin (b) A nonemergency medical transportation provider must comply with the operating
standards for special transportation service specified in sections 174.29 to 174.30 and
Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
vehicles are exempt from the requirements in this paragraph.
new text end

Sec. 33.

Minnesota Statutes 2016, section 256B.0625, subdivision 20, is amended to read:


Subd. 20.

Mental health case management.

(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:

(1) at least a face-to-face contact with the adult or the adult's legal representativenew text begin or a
contact by interactive video that meets the requirements of subdivision 20b
new text end; or

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact new text beginor a contact by interactive video that meets the requirements
of subdivision 20b
new text endwith the adult or the adult's legal representative within the preceding
two months.

(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract with
a county or Indian tribe shall be based on a monthly rate negotiated by the host county or
tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribe may negotiate a team rate with a vendor who is a member of the team. The team
shall determine how to distribute the rate among its members. No reimbursement received
by contracted vendors shall be returned to the county or tribe, except to reimburse the county
or tribe for advance funding provided by the county or tribe to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.

(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

new text begin (p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 34.

Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:


new text begin Subd. 20b. new text end

new text begin Mental health targeted case management through interactive video. new text end

new text begin (a)
Subject to federal approval, contact made for targeted case management by interactive video
shall be eligible for payment if:
new text end

new text begin (1) the person receiving targeted case management services is residing in:
new text end

new text begin (i) a hospital;
new text end

new text begin (ii) a nursing facility; or
new text end

new text begin (iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
establishment or lodging establishment that provides supportive services or health supervision
services according to section 157.17 that is staffed 24 hours a day, seven days a week;
new text end

new text begin (2) interactive video is in the best interests of the person and is deemed appropriate by
the person receiving targeted case management or the person's legal guardian, the case
management provider, and the provider operating the setting where the person is residing;
new text end

new text begin (3) the use of interactive video is approved as part of the person's written personal service
or case plan, taking into consideration the person's vulnerability and active personal
relationships; and
new text end

new text begin (4) interactive video is used for up to, but not more than, 50 percent of the minimum
required face-to-face contact.
new text end

new text begin (b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of interactive video under this subdivision and
has the right to refuse the use of interactive video at any time.
new text end

new text begin (c) The commissioner shall establish criteria that a targeted case management provider
must attest to in order to demonstrate the safety or efficacy of delivering the service via
interactive video. The attestation may include that the case management provider has:
new text end

new text begin (1) written policies and procedures specific to interactive video services that are regularly
reviewed and updated;
new text end

new text begin (2) policies and procedures that adequately address client safety before, during, and after
the interactive video services are rendered;
new text end

new text begin (3) established protocols addressing how and when to discontinue interactive video
services; and
new text end

new text begin (4) established a quality assurance process related to interactive video services.
new text end

new text begin (d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by interactive
video:
new text end

new text begin (1) 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 (2) the basis for determining that interactive video is an appropriate and effective means
for delivering the service to the person receiving case management services;
new text end

new text begin (3) the mode of transmission of the interactive video services and records evidencing
that a particular mode of transmission was utilized;
new text end

new text begin (4) the location of the originating site and the distant site; and
new text end

new text begin (5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 35.

Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:


new text begin Subd. 31c. new text end

new text begin Preferred incontinence product program. new text end

new text begin The commissioner shall
implement a preferred incontinence product program by July 1, 2018. The program shall
require the commissioner to volume purchase incontinence products and related supplies
in accordance with section 256B.04, subdivision 14. Medical assistance coverage for
incontinence products and related supplies shall conform to the limitations established under
the program.
new text end

Sec. 36.

Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:


new text begin Subd. 56a. new text end

new text begin Post-arrest community-based service coordination. new text end

new text begin (a) Medical assistance
covers post-arrest community-based service coordination for an individual who:
new text end

new text begin (1) has been identified as having a mental illness or substance use disorder using a
screening tool approved by the commissioner;
new text end

new text begin (2) does not require the security of a public detention facility and is not considered an
inmate of a public institution as defined in Code of Federal Regulations, title 42, section
435.1010;
new text end

new text begin (3) meets the eligibility requirements in section 256B.056; and
new text end

new text begin (4) has agreed to participate in post-arrest community-based service coordination through
a diversion contract in lieu of incarceration.
new text end

new text begin (b) Post-arrest community-based service coordination means navigating services to
address a client's mental health, chemical health, social, economic, and housing needs, or
any other activity targeted at reducing the incidence of jail utilization and connecting
individuals with existing covered services available to them, including, but not limited to,
targeted case management, waiver case management, or care coordination.
new text end

new text begin (c) Post-arrest community-based service coordination must be provided by an individual
who is an employee of a county or is under contract with a county to provide post-arrest
community-based coordination and is qualified under one of the following criteria:
new text end

new text begin (1) a licensed mental health professional as defined in section 245.462, subdivision 18,
clauses (1) to (6);
new text end

new text begin (2) a mental health practitioner as defined in section 245.462, subdivision 17, working
under the clinical supervision of a mental health professional; or
new text end

new text begin (3) a certified peer specialist under section 256B.0615, working under the clinical
supervision of a mental health professional.
new text end

new text begin (d) Reimbursement is allowed for up to 60 days following the initial determination of
eligibility.
new text end

new text begin (e) Providers of post-arrest community-based service coordination shall annually report
to the commissioner on the number of individuals served, and number of the
community-based services that were accessed by recipients. The commissioner shall ensure
that services and payments provided under post-arrest community-based service coordination
do not duplicate services or payments provided under section 256B.0625, subdivision 20,
256B.0753, 256B.0755, or 256B.0757.
new text end

new text begin (f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for
post-arrest community-based service coordination services shall be provided by the county
providing the services, from sources other than federal funds or funds used to match other
federal funds.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval for services
provided on or after July 1, 2017. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.
new text end

Sec. 37.

Minnesota Statutes 2016, section 256B.0625, subdivision 64, is amended to read:


Subd. 64.

Investigational drugs, biological products, and devices.

new text begin(a) new text endMedical
assistance and the early periodic screening, diagnosis, and treatment (EPSDT) program do
not cover costs incidental to, associated with, or resulting from the use of investigational
drugs, biological products, or devices as defined in section 151.375.

new text begin (b) Notwithstanding paragraph (a), stiripentol may be covered by the EPSDT program
if all the following conditions are met:
new text end

new text begin (1) the use of stiripentol is determined to be medically necessary;
new text end

new text begin (2) the enrollee has a documented diagnosis of Dravet syndrome, regardless of whether
an SCN1A genetic mutation is found, or the enrollee is a child with malignant migrating
partial epilepsy in infancy due to an SCN2A genetic mutation;
new text end

new text begin (3) all other available covered prescription medications that are medically necessary for
the enrollee have been tried without successful outcomes; and
new text end

new text begin (4) the United States Food and Drug Administration has approved the treating physician's
individual patient investigational new drug application (IND) for the use of stiripentol for
treatment.
new text end

new text begin This paragraph does not apply to MinnesotaCare coverage under chapter 256L.
new text end

Sec. 38.

Minnesota Statutes 2016, section 256B.0644, is amended to read:


256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
PROGRAMS.

(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a health
maintenance organization, as defined in chapter 62D, must participate as a provider or
contractor in the medical assistance program and MinnesotaCare as a condition of
participating as a provider in health insurance plans and programs or contractor for state
employees established under section 43A.18, the public employees insurance program under
section 43A.316, for health insurance plans offered to local statutory or home rule charter
city, county, and school district employees, the workers' compensation system under section
176.135, and insurance plans provided through the Minnesota Comprehensive Health
Association under sections 62E.01 to 62E.19. The limitations on insurance plans offered to
local government employees shall not be applicable in geographic areas where provider
participation is limited by managed care contracts with the Department of Human Services.new text begin
This section does not apply to dental service providers providing dental services outside
the seven-county metropolitan area.
new text end

(b) For providers other than health maintenance organizations, participation in the medical
assistance program means that:

(1) the provider accepts new medical assistance and MinnesotaCare patients;

(2) for providers other than dental service providers, at least 20 percent of the provider's
patients are covered by medical assistance and MinnesotaCare as their primary source of
coverage; or

(3) for dental service providersnew text begin providing dental services in the seven-county metropolitan
area
new text end, at least ten percent of the provider's patients are covered by medical assistance and
MinnesotaCare as their primary source of coverage, or the provider accepts new medical
assistance and MinnesotaCare patients who are children with special health care needs. For
purposes of this section, "children with special health care needs" means children up to age
18 who: (i) require health and related services beyond that required by children generally;
and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
neurological diseases; visual impairment or deafness; Down syndrome and other genetic
disorders; autism; fetal alcohol syndrome; and other conditions designated by the
commissioner after consultation with representatives of pediatric dental providers and
consumers.

(c) Patients seen on a volunteer basis by the provider at a location other than the provider's
usual place of practice may be considered in meeting the participation requirement in this
section. The commissioner shall establish participation requirements for health maintenance
organizations. The commissioner shall provide lists of participating medical assistance
providers on a quarterly basis to the commissioner of management and budget, the
commissioner of labor and industry, and the commissioner of commerce. Each of the
commissioners shall develop and implement procedures to exclude as participating providers
in the program or programs under their jurisdiction those providers who do not participate
in the medical assistance program. The commissioner of management and budget shall
implement this section through contracts with participating health and dental carriers.

(d) A volunteer dentist who has signed a volunteer agreement under section 256B.0625,
subdivision 9a
, shall not be considered to be participating in medical assistance or
MinnesotaCare for the purpose of this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon receipt of any necessary federal
waiver or approval. The commissioner of human services shall notify the revisor of statutes
if a federal waiver or approval is sought and, if sought, when a federal waiver or approval
is obtained.
new text end

Sec. 39.

Minnesota Statutes 2016, section 256B.072, is amended to read:


256B.072 PERFORMANCE REPORTING AND QUALITY IMPROVEMENT
SYSTEM.

new text begin Subdivision 1. new text end

new text begin Performance measures. new text end

(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 deleted text beginmeasures publisheddeleted text end
deleted text begin by nonprofit Minnesota or national organizations that produce and disseminate health care
deleted text enddeleted text begin quality measures or evidence-based health care guidelinesdeleted text endnew text begin section 62U.02, subdivision 1,
paragraph (a), clause (1)
new text end. 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.

(e) Performance measures must be stratified as provided under section 62U.02,
subdivision 1, paragraph deleted text begin(b)deleted text endnew text begin (c)new text end, and risk-adjusted as specified in section 62U.02, subdivision
3, paragraph (b).

new text begin (f) Notwithstanding paragraph (b), by January 1, 2019, the commissioner shall consider
and appropriately adjust quality metrics and benchmarks for providers who primarily serve
socioeconomically complex patient populations and request to be scored on additional
measures in this subdivision. This applies to all Minnesota health care programs, including
for patient populations enrolled in health plans, county-based purchasing plans, or managed
care organizations and for value-based purchasing arrangements, including, but not limited
to, initiatives operating under sections 256B.0751, 256B.0753, 256B.0755, 256B.0756, and
256B.0757.
new text end

new text begin (g) Assessment of patient satisfaction with chronic pain management for the purpose of
determining compensation or quality incentive payments is prohibited. The commissioner
shall require managed care plans, county-based purchasing plans, and integrated health
partnerships to comply with this requirement as a condition of contract. This prohibition
does not apply to:
new text end

new text begin (1) assessing patient satisfaction with chronic pain management for the purpose of quality
improvement; and
new text end

new text begin (2) pain management as a part of a palliative care treatment plan to treat patients with
cancer or patients receiving hospice care.
new text end

new text begin Subd. 2. new text end

new text begin Adjustment of quality metrics for special populations. new text end

new text begin Notwithstanding
subdivision 1, paragraph (b), by January 1, 2019, the commissioner shall consider and
appropriately adjust quality metrics and benchmarks for providers who primarily serve
socio-economically complex patient populations and request to be scored on additional
measures in this subdivision. This requirement applies to all medical assistance and
MinnesotaCare programs and enrollees, including persons enrolled in managed care and
county-based purchasing plans or other managed care organizations, persons receiving care
under fee-for-service, and persons receiving care under value-based purchasing arrangements,
including but not limited to initiatives operating under sections 256B.0751, 256B.0753,
256B.0755, 256B.0756, and 256B.0757.
new text end

Sec. 40.

Minnesota Statutes 2016, section 256B.0755, subdivision 1, is amended to read:


Subdivision 1.

Implementation.

(a) The commissioner shall deleted text begindevelop and authorizedeleted text endnew text begin
continue
new text end a demonstration projectnew text begin established under this sectionnew text end to test alternative and
innovativenew text begin integratednew text end health deleted text begincare delivery systemsdeleted text endnew text begin partnershipsnew text end, including accountable care
organizations that provide services to a specified patient population for an agreed-upon total
cost of care or risk/gain sharing payment arrangement. The commissioner shall develop a
request for proposals for participation in the demonstration project in consultation with
hospitals, primary care providers, health plans, and other key stakeholders.

(b) In developing the request for proposals, the commissioner shall:

(1) establish uniform statewide methods of forecasting utilization and cost of care for
the appropriate Minnesota public program populations, to be used by the commissioner for
the deleted text beginhealth care delivery systemdeleted text endnew text begin integrated health partnershipnew text end projects;

(2) identify key indicators of quality, access, patient satisfaction, and other performance
indicators that will be measured, in addition to indicators for measuring cost savings;

(3) allow maximum flexibility to encourage innovation and variation so that a variety
of provider collaborations are able to become deleted text beginhealth care delivery systemsdeleted text endnew text begin integrated health
partnerships, and may be customized for the special needs and barriers of patient populations
experiencing health disparities due to social, economic, racial, or ethnic factors,
new text end;

(4) encourage and authorize different levels and types of financial risk;

(5) encourage and authorize projects representing a wide variety of geographic locations,
patient populations, provider relationships, and care coordination models;

(6) encourage projects that involve close partnerships between the deleted text beginhealth care delivery
system
deleted text endnew text begin integrated health partnershipnew text end and counties and nonprofit agencies that provide services
to patients enrolled with the deleted text beginhealth care delivery systemdeleted text endnew text begin integrated health partnershipnew text end,
including social services, public health, mental health, community-based services, and
continuing care;

(7) encourage projects established by community hospitals, clinics, and other providers
in rural communities;

(8) identify required covered services for a total cost of care model or services considered
in whole or partially in an analysis of utilization for a risk/gain sharing model;

(9) establish a mechanism to monitor enrollment;

(10) establish quality standards for the deleted text begindelivery systemdeleted text endnew text begin integrated health partnershipnew text end
demonstrationsnew text begin that are appropriate for the particular patient population to be servednew text end; and

(11) encourage participation of privately insured population so as to create sufficient
alignment in demonstration systems.

(c) To be eligible to participate in deleted text beginthe demonstration projectdeleted text endnew text begin an integrated health
partnership
new text end, a health care delivery system must:

(1) provide required covered services and care coordination to recipients enrolled in the
deleted text begin health care delivery systemdeleted text endnew text begin integrated health partnershipnew text end;

(2) establish a process to monitor enrollment and ensure the quality of care provided;

(3) in cooperation with counties and community social service agencies, coordinate the
delivery of health care services with existing social services programs;

(4) provide a system for advocacy and consumer protection; and

(5) adopt innovative and cost-effective methods of care delivery and coordination, which
may include the use of allied health professionals, telemedicine, patient educators, care
coordinators, and community health workers.

(d) deleted text beginA health care delivery systemdeleted text endnew text begin An integrated health partnershipnew text end demonstration may
be formed by the following groups of providers of services and suppliers if they have
established a mechanism for shared governance:

(1) professionals in group practice arrangements;

(2) networks of individual practices of professionals;

(3) partnerships or joint venture arrangements between hospitals and health care
professionals;

(4) hospitals employing professionals; and

(5) other groups of providers of services and suppliers as the commissioner determines
appropriate.

A managed care plan or county-based purchasing plan may participate in this
demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).

deleted text begin A health care delivery systemdeleted text endnew text begin An integrated health partnershipnew text end may contract with a
managed care plan or a county-based purchasing plan to provide administrative services,
including the administration of a payment system using the payment methods established
by the commissioner for deleted text beginhealth care delivery systemsdeleted text endnew text begin integrated health partnershipsnew text end.

(e) The commissioner may require deleted text begina health care delivery systemdeleted text endnew text begin an integrated health
partnership
new text end to enter into additional third-party contractual relationships for the assessment
of risk and purchase of stop loss insurance or another form of insurance risk management
related to the delivery of care described in paragraph (c).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 41.

Minnesota Statutes 2016, section 256B.0755, subdivision 3, is amended to read:


Subd. 3.

Accountability.

(a) deleted text beginHealth care delivery systemsdeleted text endnew text begin Integrated health partnershipsnew text end
must accept responsibility for the quality of care based on standards established under
subdivision 1, paragraph (b), clause (10), and the cost of care or utilization of services
provided to its enrollees under subdivision 1, paragraph (b), clause (1).new text begin Accountability
standards must be appropriate to the particular population served.
new text end

(b) deleted text beginA health care delivery systemdeleted text endnew text begin An integrated health partnershipnew text end may contract and
coordinate with providers and clinics for the delivery of services and shall contract with
community health clinics, federally qualified health centers, community mental health
centers or programs, county agencies, and rural clinics to the extent practicable.

(c) deleted text beginA health care delivery systemdeleted text endnew text begin An integrated health partnershipnew text end must indicate how it
will coordinate with other services affecting its patients' health, quality of care, and cost of
care that are provided by other providers, county agencies, and other organizations in the
local service area. The deleted text beginhealth care delivery systemdeleted text endnew text begin integrated health partnershipnew text end must indicate
how it will engage other providers, counties, and organizations, including county-based
purchasing plans, that provide services to patients of the deleted text beginhealth care delivery systemdeleted text endnew text begin
integrated health partnership
new text end on issues related to local population health, including applicable
local needs, priorities, and public health goals. The deleted text beginhealth care delivery systemdeleted text endnew text begin integrated
health partnership
new text end must describe how local providers, counties, organizations, including
county-based purchasing plans, and other relevant purchasers were consulted in developing
the application to participate in the demonstration project.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 42.

Minnesota Statutes 2016, section 256B.0755, subdivision 4, is amended to read:


Subd. 4.

Payment system.

(a) In developing a payment system for deleted text beginhealth care delivery
systems
deleted text endnew text begin integrated health partnershipsnew text end, the commissioner shall establish a total cost of care
benchmark or a risk/gain sharing payment model to be paid for services provided to the
recipients enrolled in deleted text begina health care delivery systemdeleted text endnew text begin an integrated health partnershipnew text end.

(b) The payment system may include incentive payments to deleted text beginhealth care delivery systemsdeleted text endnew text begin
integrated health partnerships
new text end that meet or exceed annual quality and performance targets
realized through the coordination of care.

(c) An amount equal to the savings realized to the general fund as a result of the
demonstration project shall be transferred each fiscal year to the health care access fund.

new text begin (d) The payment system shall include a population-based payment that supports care
coordination services for all enrollees served by the integrated health partnerships, and is
risk-adjusted to reflect varying levels of care coordination intensiveness for enrollees with
chronic conditions, limited English skills, cultural differences, are homeless, or experience
health disparities or other barriers to health care. The population-based payment shall be a
per member, per month payment paid at least on a quarterly basis. Integrated health
partnerships receiving this payment must continue to meet cost and quality metrics under
the program to maintain eligibility for the population-based payment. An integrated health
partnership is eligible to receive a payment under this paragraph even if the partnership is
not participating in a risk-based or gain-sharing payment model and regardless of the size
of the patient population served by the integrated health partnership. Any integrated health
partnership participant certified as a health care home under section 256B.0751 that agrees
to a payment method that includes population-based payments for care coordination is not
eligible to receive health care home payment or care coordination fee authorized under
section 62U.03 or 256B.0753, subdivision 1, or in-reach care coordination under section
256B.0625, subdivision 56, for any medical assistance or MinnesotaCare recipients enrolled
or attributed to the integrated health partnership under this demonstration.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 43.

Minnesota Statutes 2016, section 256B.0755, is amended by adding a subdivision
to read:


new text begin Subd. 9. new text end

new text begin Patient incentives. new text end

new text begin The commissioner may authorize an integrated health
partnership to provide incentives for patients to:
new text end

new text begin (1) see a primary care provider for an initial health assessment;
new text end

new text begin (2) maintain a continuous relationship with the primary care provider; and
new text end

new text begin (3) participate in ongoing health improvement and coordination of care activities.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018, or upon federal approval,
whichever is later.
new text end

Sec. 44.

Minnesota Statutes 2016, section 256B.0924, is amended by adding a subdivision
to read:


new text begin Subd. 4a. new text end

new text begin Targeted case management through interactive video. new text end

new text begin (a) Subject to federal
approval, contact made for targeted case management by interactive video shall be eligible
for payment under subdivision 6 if:
new text end

new text begin (1) the person receiving targeted case management services is residing in:
new text end

new text begin (i) a hospital;
new text end

new text begin (ii) a nursing facility; or
new text end

new text begin (iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
establishment or lodging establishment that provides supportive services or health supervision
services according to section 157.17 that is staffed 24 hours a day, seven days a week;
new text end

new text begin (2) interactive video is in the best interests of the person and is deemed appropriate by
the person receiving targeted case management or the person's legal guardian, the case
management provider, and the provider operating the setting where the person is residing;
new text end

new text begin (3) the use of interactive video is approved as part of the person's written personal service
or case plan; and
new text end

new text begin (4) interactive video is used for up to, but not more than, 50 percent of the minimum
required face-to-face contact.
new text end

new text begin (b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of interactive video under this subdivision and
has the right to refuse the use of interactive video at any time.
new text end

new text begin (c) The commissioner shall establish criteria that a targeted case management provider
must attest to in order to demonstrate the safety or efficacy of delivering the service via
interactive video. The attestation may include that the case management provider has:
new text end

new text begin (1) written policies and procedures specific to interactive video services that are regularly
reviewed and updated;
new text end

new text begin (2) policies and procedures that adequately address client safety before, during, and after
the interactive video services are rendered;
new text end

new text begin (3) established protocols addressing how and when to discontinue interactive video
services; and
new text end

new text begin (4) established a quality assurance process related to interactive video services.
new text end

new text begin (d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by interactive
video:
new text end

new text begin (1) 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 (2) the basis for determining that interactive video is an appropriate and effective means
for delivering the service to the person receiving case management services;
new text end

new text begin (3) the mode of transmission of the interactive video services and records evidencing
that a particular mode of transmission was utilized;
new text end

new text begin (4) the location of the originating site and the distant site; and
new text end

new text begin (5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 45.

Minnesota Statutes 2016, section 256B.196, subdivision 2, is amended to read:


Subd. 2.

Commissioner's duties.

(a) For the purposes of this subdivision and subdivision
3, the commissioner shall determine the fee-for-service outpatient hospital services upper
payment limit for nonstate government hospitals. The commissioner shall then determine
the amount of a supplemental payment to Hennepin County Medical Center and Regions
Hospital for these services that would increase medical assistance spending in this category
to the aggregate upper payment limit for all nonstate government hospitals in Minnesota.
In making this determination, the commissioner shall allot the available increases between
Hennepin County Medical Center and Regions Hospital based on the ratio of medical
assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner
shall adjust this allotment as necessary based on federal approvals, the amount of
intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors,
in order to maximize the additional total payments. The commissioner shall inform Hennepin
County and Ramsey County of the periodic intergovernmental transfers necessary to match
federal Medicaid payments available under this subdivision in order to make supplementary
medical assistance payments to Hennepin County Medical Center and Regions Hospital
equal to an amount that when combined with existing medical assistance payments to
nonstate governmental hospitals would increase total payments to hospitals in this category
for outpatient services to the aggregate upper payment limit for all hospitals in this category
in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make
supplementary payments to Hennepin County Medical Center and Regions Hospital.

(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians and other billing professionals affiliated
with Hennepin County Medical Center and with Regions Hospital. The upper payment limit
shall be based on the average commercial rate or be determined using another method
acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
necessary to match the federal Medicaid payments available under this subdivision in order
to make supplementary payments to physicians and other billing professionals affiliated
with Hennepin County Medical Center and to make supplementary payments to physicians
and other billing professionals affiliated with Regions Hospital through HealthPartners
Medical Group equal to the difference between the established medical assistance payment
for physician and other billing professional services and the upper payment limit. Upon
receipt of these periodic transfers, the commissioner shall make supplementary payments
to physicians and other billing professionals affiliated with Hennepin County Medical Center
and shall make supplementary payments to physicians and other billing professionals
affiliated with Regions Hospital through HealthPartners Medical Group.

(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make monthly
voluntary intergovernmental transfers to the commissioner in amounts not to exceed
$12,000,000 per year from Hennepin County and $6,000,000 per year from Ramsey County.
The commissioner shall increase the medical assistance capitation payments to any licensed
health plan under contract with the medical assistance program that agrees to make enhanced
payments to Hennepin County Medical Center or Regions Hospital. The increase shall be
in an amount equal to the annual value of the monthly transfers plus federal financial
participation, with each health plan receiving its pro rata share of the increase based on the
pro rata share of medical assistance admissions to Hennepin County Medical Center and
Regions Hospital by those plans. new text beginFor the purposes of this paragraph, "the base amount"
means the total annual value of increased medical assistance capitation payments, including
the voluntary intergovernmental transfers, under this paragraph in calendar year 2017. For
managed care contracts beginning on or after January 1, 2018, the commissioner shall reduce
the total annual value of increased medical assistance capitation payments under this
paragraph by an amount equal to ten percent of the base amount, and by an additional ten
percent of the base amount for each subsequent contract year until December 31, 2025.
new text end
Upon the request of the commissioner, health plans shall submit individual-level cost data
for verification purposes. The commissioner may ratably reduce these payments on a pro
rata basis in order to satisfy federal requirements for actuarial soundness. If payments are
reduced, transfers shall be reduced accordingly. Any licensed health plan that receives
increased medical assistance capitation payments under the intergovernmental transfer
described in this paragraph shall increase its medical assistance payments to Hennepin
County Medical Center and Regions Hospital by the same amount as the increased payments
received in the capitation payment described in this paragraph. new text beginThis paragraph expires
January 1, 2026.
new text end

(d) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for ambulance services affiliated with Hennepin County
Medical Center and the city of St. Paulnew text begin, and ambulance services owned and operated by
another governmental entity that chooses to participate by requesting the commissioner to
determine an upper payment limit
new text end. The upper payment limit shall be based on the average
commercial rate or be determined using another method acceptable to the Centers for
Medicare and Medicaid Services. The commissioner shall inform Hennepin County deleted text beginanddeleted text endnew text begin,new text end
the city of St. Paulnew text begin, and other participating governmental entitiesnew text end of the periodic
intergovernmental transfers necessary to match the federal Medicaid payments available
under this subdivision in order to make supplementary payments to Hennepin County
Medical Center deleted text beginanddeleted text endnew text begin,new text end the city of St. Paulnew text begin, and other participating governmental entitiesnew text end equal
to the difference between the established medical assistance payment for ambulance services
and the upper payment limit. Upon receipt of these periodic transfers, the commissioner
shall make supplementary payments to Hennepin County Medical Center deleted text beginanddeleted text endnew text begin,new text end the city of
St. Pauldeleted text begin.deleted text endnew text begin, and other participating governmental entities. A tribal government that owns and
operates an ambulance service is not eligible to participate under this subdivision.
new text end

(e)new text begin For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians, dentists, and other billing professionals
affiliated with the University of Minnesota and University of Minnesota Physicians. The
upper payment limit shall be based on the average commercial rate or be determined using
another method acceptable to the Centers for Medicare and Medicaid Services. The
commissioner shall inform the University of Minnesota Medical School and University of
Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to
match the federal Medicaid payments available under this subdivision in order to make
supplementary payments to physicians, dentists, and other billing professionals affiliated
with the University of Minnesota and the University of Minnesota Physicians equal to the
difference between the established medical assistance payment for physician, dentist, and
other billing professional services and the upper payment limit. Upon receipt of these periodic
transfers, the commissioner shall make supplementary payments to physicians, dentists,
and other billing professionals affiliated with the University of Minnesota and the University
of Minnesota Physicians.
new text end

new text begin (f)new text end The commissioner shall inform the transferring governmental entities on an ongoing
basis of the need for any changes needed in the intergovernmental transfers in order to
continue the payments under paragraphs (a) to deleted text begin(d)deleted text endnew text begin (e)new text end, at their maximum level, including
increases in upper payment limits, changes in the federal Medicaid match, and other factors.

deleted text begin (f)deleted text endnew text begin (g)new text end The payments in paragraphs (a) to deleted text begin(d)deleted text endnew text begin (e)new text end shall be implemented independently of
each other, subject to federal approval and to the receipt of transfers under subdivision 3.

new text begin (h) All of the data and funding transactions related to the payments in paragraphs (a) to
(e) shall be between the commissioner and the governmental entities.
new text end

new text begin (i) For purposes of this subdivision, billing professionals are limited to physicians, nurse
practitioners, nurse midwives, clinical nurse specialists, physician assistants,
anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and
dental therapists.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (d) 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 received.
new text end

Sec. 46.

Minnesota Statutes 2016, section 256B.196, subdivision 3, is amended to read:


Subd. 3.

Intergovernmental transfers.

Based on the determination by the commissioner
under subdivision 2, Hennepin County and Ramsey County shall make periodic
intergovernmental transfers to the commissioner for the purposes of subdivision 2, paragraphs
(a) and (b). All of the intergovernmental transfers made by Hennepin County shall be used
to match federal payments to Hennepin County Medical Center under subdivision 2,
paragraph (a), and to physicians and other billing professionals affiliated with Hennepin
County Medical Center under subdivision 2, paragraph (b). All of the intergovernmental
transfers made by Ramsey County shall be used to match federal payments to Regions
Hospital under subdivision 2, paragraph (a), and to physicians and other billing professionals
affiliated with Regions Hospital through HealthPartners Medical Group under subdivision
2, paragraph (b).new text begin All of the intergovernmental transfer payments made by the University of
Minnesota Medical School and the University of Minnesota School of Dentistry shall be
used to match federal payments to the University of Minnesota and the University of
Minnesota Physicians under subdivision 2, paragraph (e).
new text end

Sec. 47.

Minnesota Statutes 2016, section 256B.196, subdivision 4, is amended to read:


Subd. 4.

Adjustments permitted.

(a) The commissioner may adjust the
intergovernmental transfers under subdivision 3 and the payments under subdivision 2,
based on the commissioner's determination of Medicare upper payment limits,
hospital-specific charge limits, hospital-specific limitations on disproportionate share
payments, medical inflation, actuarial certification, new text beginaverage commercial rates for physician
and other professional services as defined in this section,
new text endand cost-effectiveness for purposes
of federal waivers. Any adjustments must be made on a proportional basis. The commissioner
may make adjustments under this subdivision only after consultation with the affected
countiesnew text begin, university schools,new text end and hospitals. All payments under subdivision 2 and all
intergovernmental transfers under subdivision 3 are limited to amounts available after all
other base rates, adjustments, and supplemental payments in chapter 256B are calculated.

(b) The ratio of medical assistance payments specified in subdivision 2 to the voluntary
intergovernmental transfers specified in subdivision 3 shall not be reduced except as provided
under paragraph (a).

Sec. 48.

Minnesota Statutes 2016, section 256B.69, subdivision 9e, is amended to read:


Subd. 9e.

Financial audits.

deleted text begin(a)deleted text end The legislative auditor shall deleted text beginconduct or contract with
vendors to conduct independent third-party financial audits of the information required to
be provided by
deleted text endnew text begin auditnew text end managed care plans and county-based purchasing plans deleted text beginunder
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
deleted text endnew text begin to determine
if a managed care plan or county-based purchasing plan used public money in compliance
with federal and state laws, rules, and in accordance with provisions in the plan's contract
with the commissioner. The legislative auditor shall conduct the audits in accordance with
section 3.972, subdivision 2b
new text end.

deleted 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.
deleted text end

Sec. 49.

Minnesota Statutes 2016, 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. 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 begin Effective for services delivered on or after the first day of the hospital's fiscal
year ending in 2016, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.
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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 50.

Minnesota Statutes 2016, section 256B.76, subdivision 1, as amended by Laws
2017, chapter 40, article 1, section 79, 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;

(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.

(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 begin (h) Any ratables effective before July 1, 2015, do not apply to autism early intensive
intervention benefits described in section 256B.0949.
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 2016, 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.

(k) Effective for services rendered on or after July 1, 2015, through December 31, 2016,
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, through December 31, 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.

(l) Effective for services provided on or after January 1, 2017, the commissioner shall
increase payment rates by 9.65 percent for dental services provided outside of the
seven-county metropolitan area. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, or Indian health
services. Effective January 1, 2017, 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.

new text begin (m) Effective for services provided on or after July 1, 2017, the commissioner shall
increase payment rates by 23.8 percent for dental services provided to enrollees under the
age of 21. This rate increase does not apply to state-operated dental clinics in paragraph (f),
federally qualified health centers, rural health centers, or Indian health centers. This rate
increase does not apply to managed care plans and county-based purchasing plans.
new text end

Sec. 52.

Minnesota Statutes 2016, section 256B.761, is amended to read:


256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

(a) Effective for services rendered on or after July 1, 2001, payment for medication
management provided to psychiatric patients, outpatient mental health services, day treatment
services, home-based mental health services, and family community support services shall
be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of
1999 charges.

(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation services in the most recent
calendar year who are medical assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient rehabilitation facility and
provided to residents of nursing facilities owned by the entity.

(c) The commissioner shall establish three levels of payment for mental health diagnostic
assessment, based on three levels of complexity. The aggregate payment under the tiered
rates must not exceed the projected aggregate payments for mental health diagnostic
assessment under the previous single rate. The new rate structure is effective January 1,
2011, or upon federal approval, whichever is later.

(d) In addition to rate increases otherwise provided, the commissioner may restructure
coverage policy and rates to improve access to adult rehabilitative mental health services
under section 256B.0623 and related mental health support services under section 256B.021,
subdivision 4
, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected
state share of increased costs due to this paragraph is transferred from adult mental health
grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent
base adjustment for subsequent fiscal years. Payments made to managed care plans and
county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect
the rate changes described in this paragraph.

new text begin (e) Any ratables effective before July 1, 2015, do not apply to autism early intensive
intervention benefits described in section 256B.0949.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 53.

new text begin [256B.7635] REIMBURSEMENT FOR EVIDENCE-BASED PUBLIC
HEALTH NURSE HOME VISITS.
new text end

new text begin Effective for services provided on or after January 1, 2018, prenatal and postpartum
follow-up home visits provided by public health nurses or registered nurses supervised by
a public health nurse using evidence-based models shall be paid $140 per visit.
Evidence-based postpartum follow-up home visits must be administered by home visiting
programs that meet the United States Department of Health and Human Services criteria
for evidence-based models and are identified by the commissioner of health as eligible to
be implemented under the Maternal, Infant, and Early Childhood Home Visiting program.
Home visits must target mothers and their children beginning with prenatal visits through
age three for the child.
new text end

Sec. 54.

Minnesota Statutes 2016, 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 as
determined under paragraphs (i) and (j).

(g) 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, prostheticsnew text begin,new text end and orthoticsdeleted text begin, and laboratory servicesdeleted text end 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.

(h) 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.

(i) Effective for services provided on or after July 1, 2015, the following categories ofnew text begin
medical supplies and
new text end durable medical equipment shall be individually priced items: 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. The
commissioner shall not apply any medical assistance rate reductions to durable medical
equipment as a result of Medicare competitive bidding.

(j) Effective for services provided on or after July 1, 2015, medical assistance payment
rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased
as follows:

(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that
were subject to the Medicare competitive bid that took effect in January of 2009 shall be
increased by 9.5 percent; and

(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on
the medical assistance fee schedule, whether or not subject to the Medicare competitive bid
that took effect in January of 2009, shall be increased by 2.94 percent, with this increase
being applied after calculation of any increased payment rate under clause (1).

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, items provided to dually eligible recipients when Medicare is the primary payer
for the item, and individually priced items identified in paragraph (i). Payments made to
managed care plans and county-based purchasing plans shall not be adjusted to reflect the
rate increases in this paragraph.

new text begin (k) Effective for nonpressure support ventilators provided on or after January 1, 2016,
the rate shall be the lower of the submitted charge or the Medicare fee schedule rate. Effective
for pressure support ventilators provided on or after January 1, 2016, the rate shall be the
lower of the submitted charge or 47 percent above the Medicare fee schedule rate. For
payments made in accordance with this paragraph, if, and to the extent that, the commissioner
identifies that the state has received federal financial participation for ventilators in excess
of the amount allowed effective January 1, 2018, under United States Code, title 42, section
1396b(i)(27), the state shall repay the excess amount to the Centers for Medicare and
Medicaid Services with state funds and maintain the full payment rate under this paragraph.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2016.
new text end

Sec. 55.

Minnesota Statutes 2016, section 256L.03, subdivision 1, is amended to read:


Subdivision 1.

Covered health services.

(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation
services, personal care assistance and case management services, and nursing home or
intermediate care facilities services.

(b) No public funds shall be used for coverage of abortion under MinnesotaCare except
where the life of the female would be endangered or substantial and irreversible impairment
of a major bodily function would result if the fetus were carried to term; or where the
pregnancy is the result of rape or incest.

(c) Covered health services shall be expanded as provided in this section.

new text begin (d) For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.
new text end

Sec. 56.

Minnesota Statutes 2016, section 256L.03, subdivision 1a, is amended to read:


Subd. 1a.

Children; MinnesotaCare health care reform waiver.

Children are eligible
for coverage of all services that are eligible for reimbursement under the medical assistance
program according to chapter 256B, exceptnew text begin special education services andnew text end that abortion
services under MinnesotaCare shall be limited as provided under subdivision 1. Children
are exempt from the provisions of subdivision 5, regarding co-payments. Children who are
lawfully residing in the United States but who are not "qualified noncitizens" under title IV
of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public
Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage of all
services provided under the medical assistance program according to chapter 256B.

Sec. 57.

Minnesota Statutes 2016, section 256L.03, subdivision 5, is amended to read:


Subd. 5.

Cost-sharing.

deleted text begin (a) Except as otherwise provided in this subdivision, the
MinnesotaCare benefit plan shall include the following cost-sharing requirements for all
enrollees:
deleted text end

deleted text begin (1) $3 per prescription for adult enrollees;
deleted text end

deleted text begin (2) $25 for eyeglasses for adult enrollees;
deleted text end

deleted text begin (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 assistant, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist;
deleted text end

deleted text begin (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
deleted text end

deleted text begin (5) a family deductible equal to $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.
deleted text end

deleted text begin (b) Paragraph (a) doesdeleted text endnew text begin (a) Co-payments, coinsurance, and deductibles donew text end not apply to
children under the age of 21 and to American Indians as defined in Code of Federal
Regulations, title 42, section deleted text begin447.51deleted text endnew text begin 600.5new text end.

deleted text begin (c) Paragraph (a), clause (3), does not apply to mental health services.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (f)deleted text endnew text begin (b)new text end The commissioner shall deleted text beginincreasedeleted text endnew text begin adjustnew text end co-paymentsnew text begin, coinsurance, and deductiblesnew text end
for covered services in a manner sufficient to deleted text beginreducedeleted text endnew text begin maintainnew text end 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.

deleted text begin (g)deleted text endnew text begin (c)new text end The cost-sharing changes authorized under paragraph deleted text begin(f)deleted text endnew text begin (b)new text end 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 begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 58.

Minnesota Statutes 2016, section 256L.11, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Dental providers. new text end

new text begin Effective for dental services provided to MinnesotaCare
enrollees on or after January 1, 2018, the commissioner shall increase payment rates to
dental providers by 54 percent. Payments made to prepaid health plans under section 256L.12
shall reflect the payment increase described in this subdivision. The prepaid health plans
under contract with the commissioner shall provide payments to dental providers that are
at least equal to a rate that includes the payment rate specified in this subdivision, and if
applicable to the provider, the rates described under subdivision 7.
new text end

Sec. 59.

Minnesota Statutes 2016, section 256L.11, subdivision 7, is amended to read:


Subd. 7.

Critical access dental providers.

Effective for dental services provided to
MinnesotaCare enrollees on or after July 1, deleted text begin2016deleted text endnew text begin 2017new text end, the commissioner shall increase
payment rates to dentists and dental clinics deemed by the commissioner to be critical access
providers under section 256B.76, subdivision 4, by deleted text begin32.5deleted text endnew text begin 20new text end percent above the payment rate
that would otherwise be paid to the providerdeleted text begin, except for a dental clinic or dental group
described in section 256B.76, subdivision 4, paragraph (b), in which the commissioner shall
increase the payment rate by 30 percent above the payment rate that would otherwise be
paid to the provider
deleted text end. The commissioner shall pay the prepaid health plans under contract
with the commissioner amounts sufficient to reflect this rate increase. The prepaid health
plan must pass this rate increase to providers who have been identified by the commissioner
as critical access dental providers under section 256B.76, subdivision 4.

Sec. 60.

Minnesota Statutes 2016, 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 (d).

(c) Paragraph (b) does not apply to:

(1) children 20 years of age or younger; and

(2) individuals with household incomes below 35 percent of the federal poverty
guidelines.

(d) 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
35%
55%
$4
55%
80%
$6
80%
90%
$8
90%
100%
$10
100%
110%
$12
110%
120%
$14
120%
130%
$15
130%
140%
$16
140%
150%
$25
150%
160%
deleted text begin $29 deleted text end new text begin $37
new text end
160%
170%
deleted text begin $33 deleted text end new text begin $44
new text end
170%
180%
deleted text begin $38 deleted text end new text begin $52
new text end
180%
190%
deleted text begin $43 deleted text end new text begin $61
new text end
190%
new text begin 200%
new text end
deleted text begin $50 deleted text end new text begin $71
new text end
new text begin 200%
new text end
new text begin $80
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2015.
new text end

Sec. 61. new text beginCAPITATION PAYMENT DELAY.
new text end

new text begin (a) The commissioner of human services shall delay the medical assistance capitation
payment to managed care plans and county-based purchasing plans due in May 2019 until
July 1, 2019. The payment shall be made no earlier than July 1, 2019, and no later than July
31, 2019.
new text end

new text begin (b) The commissioner of human services shall delay the medical assistance capitation
payment to managed care plans and county-based purchasing plans due in May 2021 until
July 1, 2021. The payment shall be made no earlier than July 1, 2021, and no later than July
31, 2021.
new text end

Sec. 62. new text beginFEDERAL WAIVER OR APPROVAL; STATE PROGRAM
PARTICIPATION REQUIREMENT.
new text end

new text begin The commissioner of human services shall seek any federal waiver or approval necessary
to implement section 38.
new text end

Sec. 63. new text beginOPIOID USE AND ACUPUNCTURE STUDY.
new text end

new text begin (a) The commissioner of human services, within the limits of available appropriations,
shall study the use of opiates for the treatment of chronic pain conditions when acupuncture
services are also part of the treatment for chronic pain as compared to opiate use among
medical assistance recipients who are not receiving acupuncture. In comparing the sample
groups, the commissioner shall look at each group's opiate use and other services as identified
by the commissioner.
new text end

new text begin (b) The aggregate findings of the study shall be submitted by the commissioner to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health and human services policy and finance by February 15, 2018. The report shall not
contain or disclose any patient identifying data.
new text end

Sec. 64. new text beginSTUDY OF PAYMENT RATES FOR DURABLE MEDICAL EQUIPMENT
AND SUPPLIES.
new text end

new text begin The commissioner of human services shall study the impact of basing medical assistance
payment for durable medical equipment and medical supplies on Medicare payment rates,
as limited by the payment provisions in the 21st Century Cures Act, Public Law 114-255,
on access by medical assistance enrollees to these items. The study must include
recommendations for ensuring and improving access by medical assistance enrollees to
durable medical equipment and medical supplies. The commissioner shall report study
results and recommendations to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services policy and finance by January
1, 2019.
new text end

Sec. 65. new text beginELIGIBILITY VERIFICATION FEDERAL COMPLIANCE.
new text end

new text begin The commissioner of human services shall implement a process to terminate coverage
for medical assistance enrollees who fail to submit requested verifications within 95 days
of coverage approval. The commissioner shall implement a manual process by July 1, 2017,
with the counties and tribal agencies, and provide them with instructions and necessary
reports. The commissioner shall ensure that the Minnesota eligibility technology system
(METS) has the required functionality to implement an automated process by April 1, 2018.
new text end

Sec. 66. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes, in the next edition of Minnesota Statutes, shall change the term
"health care delivery system" and similar terms to "integrated health partnership" and similar
terms, wherever it appears in Minnesota Statutes, section 256B.0755.
new text end

Sec. 67. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2016, sections 256B.19, subdivision 1c; and 256B.64, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, part 9500.1140, subparts 3, 4, 5, and 6, new text end new text begin are repealed.
new text end

ARTICLE 5

HEALTH INSURANCE

Section 1.

Minnesota Statutes 2016, section 62A.04, subdivision 1, is amended to read:


Subdivision 1.

Reference.

new text begin(a) new text endAny reference to "standard provisions" which may appear
in other sections and which refer to accident and sickness or accident and health insurance
shall hereinafter be construed as referring to accident and sickness policy provisions.

new text begin (b) Notwithstanding paragraph (a), the following do not apply to health plans:
new text end

new text begin (1) subdivision 2, clauses (5) to (10) and (12);
new text end

new text begin (2) subdivision 3, clauses (1) and (3) to (7); and
new text end

new text begin (3) subdivisions 6 and 10.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for policies offered, sold, issued, or
renewed on or after January 1, 2018.
new text end

Sec. 2.

Minnesota Statutes 2016, section 62A.21, subdivision 2a, is amended to read:


Subd. 2a.

Continuation privilege.

Every policy described in subdivision 1 shall contain
a provision which permits continuation of coverage under the policy for the insured's deleted text beginformer
spouse and
deleted text end dependent children deleted text beginupondeleted text endnew text begin, which is defined as required by section 62A.302, and
former spouse, who was covered on the day before the
new text end entry of a valid decree of dissolution
of marriage. The coverage shall be continued until the earlier of the following dates:

(a) the date the insured's former spouse becomes covered under any other group health
plan; or

(b) the date coverage would otherwise terminate under the policy.

If the coverage is provided under a group policy, any required premium contributions
for the coverage shall be paid by the insured on a monthly basis to the group policyholder
for remittance to the insurer. The policy must require the group policyholder to, upon request,
provide the insured with written verification from the insurer of the cost of this coverage
promptly at the time of eligibility for this coverage and at any time during the continuation
period. In no event shall the amount of premium charged exceed 102 percent of the cost to
the plan for such period of coverage for other similarly situated spouses and dependent
children with respect to whom the marital relationship has not dissolved, without regard to
whether such cost is paid by the employer or employee.

Upon request by the insured's former spousenew text begin, who was covered on the day before the
entry of a valid decree of dissolution,
new text end or dependent child, a health carrier must provide the
instructions necessary to enable the child or former spouse to elect continuation of coverage.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for policies offered, sold, issued, or
renewed on or after January 1, 2018.
new text end

Sec. 3.

Minnesota Statutes 2016, section 62A.3075, is amended to read:


62A.3075 CANCER CHEMOTHERAPY TREATMENT COVERAGE.

(a) A health plan company that provides coverage under a health plan for cancer
chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance
amount for a prescribed, orally administered anticancer medication that is used to kill or
slow the growth of cancerous cells than what the health plan requires for an intravenously
administered or injected cancer medication that is provided, regardless of formulation or
benefit category determination by the health plan company.

(b) A health plan company must not achieve compliance with this section by imposing
an increase in co-payment, deductible, or coinsurance amount for an intravenously
administered or injected cancer chemotherapy agent covered under the health plan.

(c) Nothing in this section shall be interpreted to prohibit a health plan company from
requiring prior authorization or imposing other appropriate utilization controls in approving
coverage for any chemotherapy.

(d) A plan offered by the commissioner of management and budget under section 43A.23
is deemed to be at parity and in compliance with this section.

(e) A health plan company is in compliance with this section if it does not include orally
administered anticancer medication in the fourth tier of its pharmacy benefit.

new text begin (f) A health plan company that provides coverage under a health plan for cancer
chemotherapy treatment must indicate the level of coverage for orally administered anticancer
medication within its pharmacy benefit filing with the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 4.

Minnesota Statutes 2016, section 62D.105, is amended to read:


62D.105 COVERAGE OF CURRENT SPOUSEnew text begin, FORMER SPOUSE,new text end AND
CHILDREN.

Subdivision 1.

Requirement.

Every health maintenance contract, which in addition to
covering the enrollee also provides coverage to the spouse deleted text beginanddeleted text endnew text begin,new text end dependent childrennew text begin, which
is defined as required by section 62A.302, and former spouse who was covered on the day
before the entry of a valid decree of dissolution of marriage,
new text end of the enrollee shall: (1) permit
the spousenew text begin, former spouse,new text end and dependent children to elect to continue coverage when the
enrollee becomes enrolled for benefits under title XVIII of the Social Security Act
(Medicare); and (2) permit the dependent children to continue coverage when they cease
to be dependent children under the generally applicable requirement of the plan.

Subd. 2.

Continuation privilege.

The coverage described in subdivision 1 may be
continued until the earlier of the following dates:

(1) the date coverage would otherwise terminate under the contract;

(2) 36 months after continuation by the spousenew text begin, former spouse,new text end or dependent was elected;
or

(3) the date the spousenew text begin, former spouse,new text end or dependent children become covered under
another group health plan or Medicare.

If coverage is provided under a group policy, any required fees for the coverage shall
be paid by the enrollee on a monthly basis to the group contract holder for remittance to the
health maintenance organization. In no event shall the fee charged exceed 102 percent of
the cost to the plan for such coverage for other similarly situated spouse and dependent
children to whom subdivision 1 is not applicable, without regard to whether such cost is
paid by the employer or employee.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for policies offered, sold, issued, or
renewed on or after January 1, 2018.
new text end

Sec. 5.

Minnesota Statutes 2016, section 62E.04, subdivision 11, is amended to read:


Subd. 11.

deleted text beginEssential health benefits packagedeleted text endnew text begin Affordable Care Act compliant plansnew text end.

For deleted text beginindividual or small group health plans that include the essential health benefits package
and are
deleted text endnew text begin any policy of accident and health insurance subject to the requirements of the
Affordable Care Act, as defined under section 62A.011, subdivision 1a, that is
new text end offered, sold,
issued, or renewed on or after January 1, deleted text begin2014deleted text endnew text begin 2018new text end, the requirements of this section do not
apply.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for policies offered, sold, issued, or
renewed on or after January 1, 2018.
new text end

Sec. 6.

Minnesota Statutes 2016, section 62E.05, subdivision 1, is amended to read:


Subdivision 1.

Certification.

Upon application by an insurer, fraternal, or employer for
certification of a plan of health coverage as a qualified plan or a qualified Medicare
supplement plan for the purposes of sections 62E.01 to 62E.19, the commissioner shall
make a determination within 90 days as to whether the plan is qualified. All plans of health
coverage, except Medicare supplement policies, shall be labeled as "qualified" or
"nonqualified" on the front of the policy or contract, or on the schedule page. All qualified
plans shall indicate whether they are number one, two, or three coverage plans.new text begin For any
policy of accident and health insurance subject to the requirements of the Affordable Care
Act, as defined under section 62A.011, subdivision 1a, that is offered, sold, issued, or
renewed on or after January 1, 2018, the requirements of this section do not apply.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for policies offered, sold, issued, or
renewed on or after January 1, 2018.
new text end

Sec. 7.

Minnesota Statutes 2016, section 62E.06, is amended by adding a subdivision to
read:


new text begin Subd. 5. new text end

new text begin Affordable Care Act compliant plans. new text end

new text begin For any policy of accident and health
insurance subject to the requirements of the Affordable Care Act, as defined under section
62A.011, subdivision 1a, that is offered, sold, issued, or renewed on or after January 1,
2018, the requirements of this section do not apply.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for policies offered, sold, issued, or
renewed on or after January 1, 2018.
new text end

Sec. 8.

Laws 2017, chapter 2, article 1, section 5, is amended to read:


Sec. 5. SUNSET.

This article deleted text beginsunsets June 30deleted text endnew text begin, other than section 2, subdivision 5; section 3; and section
7, sunsets August 31
new text end, 2018.

Sec. 9.

Laws 2017, chapter 2, article 1, section 7, is amended to read:


Sec. 7. APPROPRIATIONS.

(a) $311,788,000 in fiscal year 2017 is appropriated from the general fund to the
commissioner of management and budget for premium assistance under section 2. This
appropriation is onetime and is available through deleted text beginJune 30deleted text endnew text begin August 31new text end, 2018.

(b) $157,000 in fiscal year 2017 is appropriated from the general fund to the legislative
auditor for purposes of section 3. This appropriation is onetime.

(c) Any unexpended amount from the appropriation in paragraph (a) after June 30, 2018,
shall be transferred deleted text beginon July 1deleted text endnew text begin no later than August 31new text end, 2018, from the general fund to the
budget reserve account under Minnesota Statutes, section 16A.152, subdivision 1a.

Sec. 10.

Laws 2017, chapter 13, article 1, section 15, is amended to read:


Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.

(a) The Minnesota Comprehensive Health Association shall fund the operational and
administrative costs and reinsurance payments of the Minnesota security plan and association
using the following amounts deposited in the premium security plan account in Minnesota
Statutes, section 62E.25, subdivision 1, in the following order:

(1) any federal funding available;

(2) funds deposited under article 1, sections 12 and 13;

(3) any state funds from the health care access fund; and

(4) any state funds from the general fund.

(b) The association shall transfer from the premium security plan account any deleted text begingeneral
fund amount
deleted text endnew text begin state fundsnew text end not used for the Minnesota premium security plan by June 30,
2021, to the commissioner of commerce. Any amount transferred to the commissioner of
commerce shall be deposited in the deleted text begingeneral fund.
deleted text end

deleted text begin (c) The association shall transfer from the premium security plan account any health
care access fund amount not used for the Minnesota premium security plan by June 30,
2021, to the commissioner of commerce. Any amount transferred to the commissioner of
commerce shall be deposited in the
deleted text end health care access fund in Minnesota Statutes, section
16A.724.

deleted text begin (d)deleted text endnew text begin (c)new text end The Minnesota Comprehensive Health Association may not spend more than
$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019
for the operational and administrative costs of, and reinsurance payments under, the
Minnesota premium security plan.

Sec. 11. new text beginMORATORIUM ON CONVERSION TRANSACTIONS.
new text end

new text begin (a) Notwithstanding Laws 2017, chapter 2, article 2, a nonprofit health service plan
corporation operating under Minnesota Statutes, chapter 62C, or health maintenance
organization operating under Minnesota Statutes, chapter 62D, as of January 1, 2017, may
only merge or consolidate with; or convert, or transfer all or a substantial portion of its
assets to an entity that is a corporation organized under Minnesota Statutes, chapter 317A.
new text end

new text begin (b) Paragraph (a) does not apply if the service plan corporation or health maintenance
organization files an intent to dissolve due to insolvency of the corporation in accordance
with Minnesota Statutes, chapter 317A, or insolvency proceedings are commenced under
Minnesota Statutes, chapter 60B.
new text end

new text begin (c) Nothing in this section shall be construed to authorize a health maintenance
organization or a nonprofit health service plan corporation to engage in any transaction or
activities not otherwise permitted under state law.
new text end

new text begin (d) This section expires July 1, 2019.
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 6

DIRECT CARE AND TREATMENT

Section 1.

Minnesota Statutes 2016, section 252.50, subdivision 5, is amended to read:


Subd. 5.

Location of programs.

(a) In determining the location of state-operated,
community-based programs, the needs of the individual client shall be paramount. The
commissioner shall also take into account:

(1) new text beginprioritization of beds in state-operated, community-based programs for individuals
with complex behavioral needs that cannot be met by private community-based providers;
new text end

new text begin (2) choices made by individuals who chose to move to a more integrated setting, and
shall coordinate with the lead agency to ensure that appropriate person-centered transition
plans are created;
new text end

new text begin (3) new text endthe personal preferences of the persons being served and their families as determined
by Minnesota Rules, parts 9525.0004 to 9525.0036;

deleted text begin (2)deleted text endnew text begin (4) thenew text end location of the support services established by the individual service plans of
the persons being served;

deleted text begin (3)deleted text endnew text begin (5)new text end the appropriate grouping of the persons served;

deleted text begin (4)deleted text endnew text begin (6)new text end the availability of qualified staff;

deleted text begin (5)deleted text endnew text begin (7)new text end the need for state-operated, community-based programs in the geographical region
of the state; and

deleted text begin (6)deleted text endnew text begin (8)new text end a reasonable commuting distance from a regional treatment center or the residences
of the program staff.

(b) State-operated, community-based programs must be located according to section
252.28.

Sec. 2.

Minnesota Statutes 2016, section 253B.10, subdivision 1, is amended to read:


Subdivision 1.

Administrative requirements.

(a) When a person is committed, the
court shall issue a warrant or an order committing the patient to the custody of the head of
the treatment facility. The warrant or order shall state that the patient meets the statutory
criteria for civil commitment.

(b) The commissioner shall prioritize patients being admitted from jail or a correctional
institution who are:

(1) ordered confined in a state hospital for an examination under Minnesota Rules of
Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;

(2) under civil commitment for competency treatment and continuing supervision under
Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;

(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
detained in a state hospital or other facility pending completion of the civil commitment
proceedings; or

(4) committed under this chapter to the commissioner after dismissal of the patient's
criminal charges.

Patients described in this paragraph must be admitted to a service operated by the
commissioner within 48 hours. The commitment must be ordered by the court as provided
in section 253B.09, subdivision 1, paragraph (c).

(c) Upon the arrival of a patient at the designated treatment facility, the head of the
facility shall retain the duplicate of the warrant and endorse receipt upon the original warrant
or acknowledge receipt of the order. The endorsed receipt or acknowledgment must be filed
in the court of commitment. After arrival, the patient shall be under the control and custody
of the head of the treatment facility.

(d) Copies of the petition for commitment, the court's findings of fact and conclusions
of law, the court order committing the patient, the report of the examiners, and the prepetition
reportnew text begin, and any medical and behavioral information availablenew text end shall be provided deleted text beginpromptlydeleted text end
new text begin at the time of admission of a patientnew text end to the new text begindesignatednew text end treatment facility.new text begin This information
shall also be provided by the head of the treatment facility to treatment facility staff in a
consistent and timely manner and pursuant to all applicable laws.
new text end

Sec. 3. new text beginREVIEW OF ALTERNATIVES TO STATE-OPERATED GROUP HOMES
HOUSING ONE PERSON.
new text end

new text begin The commissioner of human services shall review the potential for, and the viability of,
alternatives to state-operated group homes housing one person. The intent is to create housing
options for individuals who do not belong in an institutionalized setting, but need additional
support before transitioning to a more independent community placement. The review shall
include an analysis of existing housing settings operated by counties and private providers,
as well as the potential for new housing settings, and determine the viability for use by
state-operated services. The commissioner shall seek input from interested stakeholders as
part of the review. An update, including alternatives identified, will be provided by the
commissioner to the members of the legislative committees having jurisdiction over human
services issues no later than January 15, 2018.
new text end

ARTICLE 7

CHILDREN AND FAMILIES

Section 1.

Minnesota Statutes 2016, section 13.32, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin Access by welfare system. new text end

new text begin County personnel in the welfare system may
request access to education data in order to coordinate services for a student or family. The
request must be submitted to the chief administrative officer of the school and must include
the basis for the request and a description of the information that is requested. The chief
administrative officer must provide a copy of the request to the parent or legal guardian of
the student who is the subject of the request, along with a form the parent or legal guardian
may execute to consent to the release of specified information to the requester. Education
data may be released under this subdivision only if the parent or legal guardian gives
informed consent to the release.
new text end

Sec. 2.

Minnesota Statutes 2016, section 13.46, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

As used in this section:

(a) "Individual" means an individual according to section 13.02, subdivision 8, but does
not include a vendor of services.

(b) "Program" includes all programs for which authority is vested in a component of the
welfare system according to statute or federal law, including, but not limited to, new text beginNative
American tribe programs that provide a service component of the welfare system,
new text endthe aid
to families with dependent children program formerly codified in sections 256.72 to 256.87,
Minnesota family investment program, temporary assistance for needy families program,
medical assistance, general assistance, general assistance medical care formerly codified in
chapter 256D, child care assistance program, and child support collections.

(c) "Welfare system" includes the Department of Human Services, local social services
agencies, county welfare agencies, new text begincounty public health agencies, county veteran services
agencies, county housing agencies,
new text endprivate licensing agencies, the public authority responsible
for child support enforcement, human services boards, community mental health center
boards, state hospitals, state nursing homes, the ombudsman for mental health and
developmental disabilities, new text beginNative American tribes to the extent a tribe provides a service
component of the welfare system,
new text endand persons, agencies, institutions, organizations, and
other entities under contract to any of the above agencies to the extent specified in the
contract.

(d) "Mental health data" means data on individual clients and patients of community
mental health centers, established under section 245.62, mental health divisions of counties
and other providers under contract to deliver mental health services, or the ombudsman for
mental health and developmental disabilities.

(e) "Fugitive felon" means a person who has been convicted of a felony and who has
escaped from confinement or violated the terms of probation or parole for that offense.

(f) "Private licensing agency" means an agency licensed by the commissioner of human
services under chapter 245A to perform the duties under section 245A.16.

Sec. 3.

Minnesota Statutes 2016, 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; coordinate services for an individual or family;
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, medical programs under chapter 256B or 256L, or a medical program formerly
codified under chapter 256D; 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 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, 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, medical programs under chapter 256B or 256L, or a
medical program formerly codified under chapter 256D;

(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;

(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 law; deleted text beginor
deleted text end

(31) to a health care provider governed by sections 144.291 to 144.298, to the extent
necessary to coordinate servicesnew text begin;
new text end

new text begin (32) to the chief administrative officer of a school to coordinate services for a student
and family; data that may be disclosed under this clause are limited to name, date of birth,
gender, and address; or
new text end

new text begin (33) to county correctional agencies to the extent necessary to coordinate services and
diversion programs; data that may be disclosed under this clause are limited to name, client
demographics, program, case status, and county worker information
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. 4.

Minnesota Statutes 2016, section 13.84, subdivision 5, is amended to read:


Subd. 5.

Disclosure.

Private or confidential court services data shall not be disclosed
except:

(a) pursuant to section 13.05;

(b) pursuant to a statute specifically authorizing disclosure of court services data;

(c) with the written permission of the source of confidential data;

(d) to the court services department, parole or probation authority or state or local
correctional agency or facility having statutorily granted supervision over the individual
subject of the datanew text begin, or to county personnel within the welfare systemnew text end;

(e) pursuant to subdivision 6;

(f) pursuant to a valid court order; or

(g) pursuant to section 611A.06, subdivision 3a.

Sec. 5.

Minnesota Statutes 2016, section 119B.011, subdivision 20, is amended to read:


Subd. 20.

Transition year families.

"Transition year families" means families who have
received MFIP assistance, or who were eligible to receive MFIP assistance after choosing
to discontinue receipt of the cash portion of MFIP assistance under section 256J.31,
subdivision 12
, or families who have received DWP assistance under section 256J.95 for
at least three of the last six months before losing eligibility for MFIP or DWP.
new text begin Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, subpart 2,
new text end transition year child care may be used to support employmentnew text begin, approved education or training
programs,
new text end or job searchnew text begin that meets the requirements of section 119B.10new text end. Transition year
child care is not available to families who have been disqualified from MFIP or DWP due
to fraud.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 23, 2017.
new text end

Sec. 6.

Minnesota Statutes 2016, section 119B.011, subdivision 20a, is amended to read:


Subd. 20a.

Transition year extension families.

"Transition year extension families"
means families who have completed their transition year of child care assistance under this
subdivision and who are eligible for, but on a waiting list for, services under section 119B.03.
For purposes of sections 119B.03, subdivision 3, and 119B.05, subdivision 1, clause (2),
families participating in extended transition year shall not be considered transition year
families. new text beginNotwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090,
subpart 2,
new text endtransition year extension child care may be used to support employmentnew text begin, approved
education or training programs,
new text end or a job search that meets the requirements of section
119B.10 for the length of time necessary for families to be moved from the basic sliding
fee waiting list into the basic sliding fee program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 23, 2017.
new text end

Sec. 7.

Minnesota Statutes 2016, section 119B.025, subdivision 1, is amended to read:


Subdivision 1.

deleted text beginFactors which must be verifieddeleted text endnew text begin Applicationsnew text end.

(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) new text begincounted new text endincome;

(8) spousal support and child support payments made to persons outside the household;

(9) residence; and

(10) inconsistent information, if related to eligibility.

(b) deleted text beginIf 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. When the 30th day after the
date the form was due falls on a Saturday, Sunday, or legal holiday, the 30-day time period
is extended to include the next succeeding day that is not a Saturday, Sunday, or legal
holiday. 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. 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.
deleted text endnew text begin
The county must mail a notice of approval or denial of assistance to the applicant within
30 calendar days after receiving the application. The county may extend the response time
by 15 calendar days if the applicant is informed of the extension.
new text end

deleted text begin (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.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 23, 2017.
new text end

Sec. 8.

Minnesota Statutes 2016, section 119B.025, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin Redeterminations. new text end

new text begin (a) Notwithstanding Minnesota Rules, part 3400.0180, item
A, the county shall conduct a redetermination according to paragraphs (b) and (c).
new text end

new text begin (b) The county shall use the redetermination form developed by the commissioner. The
county must verify the factors listed in subdivision 1, paragraph (a), as part of the
redetermination.
new text end

new text begin (c) An applicant's eligibility must be redetermined no more frequently than every 12
months. The following criteria apply:
new text end

new text begin (1) a family meets the eligibility redetermination requirements if a complete
redetermination form and all required verifications are received within 30 days after the
date the form was due;
new text end

new text begin (2) if the 30th day after the date the form was due falls on a Saturday, Sunday, or holiday,
the 30-day time period is extended to include the next day that is not a Saturday, Sunday,
or holiday. Assistance shall be payable retroactively from the redetermination due date;
new text end

new text begin (3) for a family where at least one parent is younger than 21 years of age, does not have
a high school degree or general equivalency diploma, and is a student in a school district
or another similar program that provides or arranges for child care, parenting, social services,
career and employment supports, and academic support to achieve high school graduation,
the redetermination of eligibility may be deferred beyond 12 months, to the end of the
student's school year; and
new text end

new text begin (4) a family and the family's providers must be notified that the family's redetermination
is due at least 45 days before the end of the family's 12-month eligibility period.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 23, 2017.
new text end

Sec. 9.

Minnesota Statutes 2016, section 119B.025, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Changes in eligibility. new text end

new text begin (a) The county shall process a change in eligibility
factors according to paragraphs (b) to (g).
new text end

new text begin (b) A family is subject to the reporting requirements in section 256P.07.
new text end

new text begin (c) If a family reports a change or a change is known to the agency before the family's
regularly scheduled redetermination, the county must act on the change. The commissioner
shall establish standards for verifying a change.
new text end

new text begin (d) A change in income occurs on the day the participant received the first payment
reflecting the change in income.
new text end

new text begin (e) During a family's 12-month eligibility period, if the family's income increases and
remains at or below 85 percent of the state median income, adjusted for family size, there
is no change to the family's eligibility. The county shall not request verification of the
change. The co-payment fee shall not increase during the remaining portion of the family's
12-month eligibility period.
new text end

new text begin (f) During a family's 12-month eligibility period, if the family's income increases and
exceeds 85 percent of the state median income, adjusted for family size, the family is not
eligible for child care assistance. The family must be given 15 calendar days to provide
verification of the change. If the required verification is not returned or confirms ineligibility,
the family's eligibility ends following a subsequent 15-day adverse action notice.
new text end

new text begin (g) Notwithstanding Minnesota Rules, parts 3400.0040, subpart 3, and 3400.0170,
subpart 1, if an applicant or participant reports that employment ended, the agency may
accept a signed statement from the applicant or participant as verification that employment
ended.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraphs (a) and (b) are effective the day following final
enactment. Paragraphs (c) to (g) are effective October 23, 2017.
new text end

Sec. 10.

Minnesota Statutes 2016, section 119B.03, subdivision 3, is amended to read:


Subd. 3.

Eligible participants.

Families that meet the eligibility requirements under
sections deleted text begin119B.07,deleted text end 119B.09deleted text begin,deleted text end and 119B.10, except MFIP participants, diversionary work
program, and transition year families are eligible for child care assistance under the basic
sliding fee program. Families enrolled in the basic sliding fee program shall be continued
until they are no longer eligible. Child care assistance provided through the child care fund
is considered assistance to the parent.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 18, 2017.
new text end

Sec. 11.

Minnesota Statutes 2016, section 119B.05, subdivision 1, is amended to read:


Subdivision 1.

Eligible participants.

Families eligible for child care assistance under
the MFIP child care program are:

(1) MFIP participants who are employed or in job search and meet the requirements of
section 119B.10;

(2) persons who are members of transition year families under section 119B.011,
subdivision 20
, and meet the requirements of section 119B.10;

(3) families who are participating in employment orientation or job search, or other
employment or training activities that are included in an approved employability development
plan under section 256J.95;

(4) MFIP families who are participating in work job search, job support, employment,
or training activities as required in their employment plan, or in appeals, hearings,
assessments, or orientations according to chapter 256J;

(5) MFIP families who are participating in social services activities under chapter 256J
as required in their employment plan approved according to chapter 256J;

(6) families who are participating in services or activities that are included in an approved
family stabilization plan under section 256J.575;

(7) families who are participating in programs as required in tribal contracts under section
119B.02, subdivision 2, or 256.01, subdivision 2;

(8) families who are participating in the transition year extension under section 119B.011,
subdivision 20a; deleted text beginand
deleted text end

(9) student parents as defined under section 119B.011, subdivision 19bdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (10) student parents who turn 21 years of age and who continue to meet the other
requirements under section 119B.011, subdivision 19b. A student parent continues to be
eligible until the student parent is approved for basic sliding fee child care assistance or
until the student parent's redetermination, whichever comes first. At the student parent's
redetermination, if the student parent was not approved for basic sliding fee child care
assistance, a student parent's eligibility ends following a 15-day adverse action notice.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 23, 2017.
new text end

Sec. 12.

Minnesota Statutes 2016, section 119B.09, subdivision 1, is amended to read:


Subdivision 1.

General eligibility requirements deleted text beginfor all applicants for child care
assistance
deleted text end.

(a) Child care services must be available to families who need child care to find
or keep employment or to obtain the training or education necessary to find employment
and who:

(1) have household income less than or equal to 67 percent of the state median income,
adjusted for family size, new text beginat application and redetermination, new text endand meet the requirements of
section 119B.05; receive MFIP assistance; and are participating in employment and training
services under chapter 256J; or

(2) have household income less than or equal to 47 percent of the state median income,
adjusted for family size, at deleted text beginprogram entrydeleted text end new text beginapplication new text endand less than or equal to 67 percent
of the state median income, adjusted for family size, at deleted text beginprogram exitdeleted text endnew text begin redeterminationnew text end.

(b) Child care services must be made available as in-kind services.

(c) All applicants for child care assistance and families currently receiving child care
assistance must be assisted and required to cooperate in establishment of paternity and
enforcement of child support obligations for all children in the family new text beginat application and
redetermination
new text endas a condition of program eligibility. For purposes of this section, a family
is considered to meet the requirement for cooperation when the family complies with the
requirements of section 256.741.

new text begin (d) All applicants for child care assistance and families currently receiving child care
assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition
of eligibility. The co-payment fee may include additional recoupment fees due to a child
care assistance program overpayment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraphs (a) and (c) are effective October 23, 2017. Paragraph
(d) is effective the day following final enactment.
new text end

Sec. 13.

Minnesota Statutes 2016, section 119B.09, subdivision 4, is amended to read:


Subd. 4.

Eligibility; annual income; calculation.

new text begin(a) new text endAnnual 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.

new text begin (b) new text endSelf-employment income must be calculated based on gross receipts less operating
expenses. deleted text beginIncome 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.
deleted text end

new text begin (c) Income changes are processed under section 119B.025, subdivision 4.new text end Included lump
sums counted as income under section 256P.06, subdivision 3, must be annualized over 12
months. 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 23, 2017.
new text end

Sec. 14.

Minnesota Statutes 2016, section 119B.09, subdivision 9a, is amended to read:


Subd. 9a.

Child care centers; assistance.

(a) deleted text beginFor the purposes of this subdivision,
"qualifying child" means a child who is not a child or dependent of an employee of the child
care provider.
deleted text endnew text begin A child care center may receive authorizations for 25 or fewer children who
are dependents of the center's employees. If a child care center is authorized for more than
25 children who are dependents of center employees, the county cannot authorize additional
dependents of an employee until the number of children falls below 25.
new text end

deleted text begin (b) Funds distributed under this chapter must not be paid for child care services that are
provided for a child or dependent of an employee under paragraph (a) unless at all times at
least 50 percent of the children for whom the child care provider is providing care are
qualifying children under paragraph (a).
deleted text end

deleted text begin (c) If a child care provider satisfies the requirements for payment under paragraph (b),
but the percentage of qualifying children under paragraph (a) for whom the provider is
providing care falls below 50 percent, the provider shall have four weeks to raise the
percentage of qualifying children for whom the provider is providing care to at least 50
percent before payments to the provider are discontinued for child care services provided
for a child who is not a qualifying child.
deleted text end

deleted text begin (d) This subdivision shall be implemented as follows:
deleted text end

deleted text begin (1) no later than August 1, 2014, the commissioner shall issue a notice to providers who
have been identified as ineligible for funds distributed under this chapter as described in
paragraph (b); and
deleted text end

deleted text begin (2) no later than January 5, 2015, payments to providers who do not comply with
paragraph (c) will be discontinued for child care services provided for children who are not
qualifying children.
deleted text end

deleted text begin (e) If a child's authorization for child care assistance is terminated under this subdivision,
the county shall send a notice of adverse action to the provider and to the child's parent or
guardian, including information on the right to appeal, under Minnesota Rules, part
3400.0185.
deleted text end

deleted text begin (f)deleted text endnew text begin (b)new text end Funds paid to providers during the period of time deleted text beginbetween the issuance of a notice
under paragraph (d), clause (1), and discontinuation of payments under paragraph (d), clause
(2),
deleted text endnew text begin when a center is authorized for more than 25 children who are dependents of center
employees
new text end must not be treated as overpayments under section 119B.11, subdivision 2a, due
to noncompliance with this subdivision.

deleted text begin (g)deleted text endnew text begin (c)new text end Nothing in this subdivision precludes the commissioner from conducting fraud
investigations relating to child care assistance, imposing sanctions, and obtaining monetary
recovery as otherwise provided by law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 23, 2018.
new text end

Sec. 15.

new text begin [119B.095] CHILD CARE AUTHORIZATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin General authorization requirements. new text end

new text begin (a) When authorizing the amount
of child care, the county agency must consider the amount of time the parent reports on the
application or redetermination form that the child attends preschool, a Head Start program,
or school while the parent is participating in an authorized activity.
new text end

new text begin (b) Care must be authorized and scheduled with a provider based on the applicant's or
participant's verified activity schedule when:
new text end

new text begin (1) the family requests care from more than one provider per child;
new text end

new text begin (2) the family requests care from a legal nonlicensed provider; or
new text end

new text begin (3) an applicant or participant is employed by any child care center that is licensed by
the Department of Human Services or has been identified as a high-risk Medicaid-enrolled
provider.
new text end

new text begin (c) If the family remains eligible at redetermination, a new authorization with fewer
hours, the same hours, or increased hours may be determined.
new text end

new text begin Subd. 2. new text end

new text begin Maintain steady child care authorizations. new text end

new text begin (a) Notwithstanding Minnesota
Rules, chapter 3400, the amount of child care authorized under section 119B.10 for
employment, education, or an MFIP or DWP employment plan shall continue at the same
number of hours or more hours until redetermination, including:
new text end

new text begin (1) when the other parent moves in and is employed or has an education plan under
section 119B.10, subdivision 3, or has an MFIP or DWP employment plan; or
new text end

new text begin (2) when the participant's work hours are reduced or a participant temporarily stops
working or attending an approved education program. Temporary changes include, but are
not limited to, a medical leave, seasonal employment fluctuations, or a school break between
semesters.
new text end

new text begin (b) The county may increase the amount of child care authorized at any time if the
participant verifies the need for increased hours for authorized activities.
new text end

new text begin (c) The county may reduce the amount of child care authorized if a parent requests a
reduction or because of a change in:
new text end

new text begin (1) the child's school schedule;
new text end

new text begin (2) the custody schedule; or
new text end

new text begin (3) the provider's availability.
new text end

new text begin (d) The amount of child care authorized for a family subject to subdivision 1, paragraph
(b), must change when the participant's activity schedule changes. Paragraph (a) does not
apply to a family subject to subdivision 1, paragraph (b).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 18, 2017.
new text end

Sec. 16.

new text begin [119B.097] AUTHORIZATION WITH A SECONDARY PROVIDER.
new text end

new text begin (a) If a child uses any combination of the following providers paid by child care
assistance, a parent must choose one primary provider and one secondary provider per child
that can be paid by child care assistance:
new text end

new text begin (1) an individual or child care center licensed under chapter 245A;
new text end

new text begin (2) an individual or child care center or facility holding a valid child care license issued
by another state or tribe; or
new text end

new text begin (3) a child care center exempt from licensing under section 245A.03.
new text end

new text begin (b) The amount of child care authorized with the secondary provider cannot exceed 20
hours per two-week service period, per child, and the amount of care paid to a child's
secondary provider is limited under section 119B.13, subdivision 1. The total amount of
child care authorized with both the primary and secondary provider cannot exceed the
amount of child care allowed based on the parents' eligible activity schedule, the child's
school schedule, and any other factors relevant to the family's child care needs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 23, 2018.
new text end

Sec. 17.

Minnesota Statutes 2016, section 119B.10, subdivision 1, is amended to read:


Subdivision 1.

Assistance for persons seeking and retaining employment.

(a) Persons
who are seeking employment and who are eligible for assistance under this section are
eligible to receive up to 240 hours of child care assistance per calendar year.

(b) new text beginAt application and redetermination, new text endemployed persons who work at least an average
of 20 hours and full-time students who work at least an average of ten hours a week and
receive at least a minimum wage for all hours worked are eligible for deleted text begincontinueddeleted text end child care
assistance for employment. For purposes of this section, work-study programs must be
counted as employment. new text beginAn employed person with an MFIP or DWP employment plan
shall receive child care assistance as specified in the person's employment plan.
new text endChild care
assistance during employment must be authorized as provided in paragraphs (c) and (d).

(c) When the person works for an hourly wage and the hourly wage is equal to or greater
than the applicable minimum wage, child care assistance shall be provided for the deleted text beginactualdeleted text end
hours of employment, break, and mealtime during the employment and travel time up to
two hours per day.

(d) When the person does not work for an hourly wage, child care assistance must be
provided for the lesser of:

(1) the amount of child care determined by dividing gross earned income by the applicable
minimum wage, up to one hour every eight hours for meals and break time, plus up to two
hours per day for travel time; or

(2) the amount of child care equal to the actual amount of child care used during
employment, including break and mealtime during employment, and travel time up to two
hours per day.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 18, 2017.
new text end

Sec. 18.

Minnesota Statutes 2016, section 119B.10, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin Assistance for persons attending an approved education or training
program.
new text end

new text begin (a) Money for an eligible person according to sections 119B.03, subdivision 3,
and 119B.05, subdivision 1, shall be used to reduce child care costs for a student. The county
shall not limit the duration of child care subsidies for a person in an employment or
educational program unless the person is ineligible for child care funds. Any other limitation
must be based on county policies included in the approved child care fund plan.
new text end

new text begin (b) To be eligible, the student must be in good standing and be making satisfactory
progress toward the degree. The maximum length of time a student is eligible for child care
assistance under the child care fund for education and training is no more than the time
necessary to complete the credit requirements for an associate's or baccalaureate degree as
determined by the educational institution. Time limitations for child care assistance do not
apply to basic or remedial educational programs needed for postsecondary education or
employment. Basic or remedial educational programs include high school, general
equivalency diploma, and English as a second language programs. A program exempt from
this time limit must not run concurrently with a postsecondary program.
new text end

new text begin (c) If a student meets the conditions of paragraphs (a) and (b), child care assistance must
be authorized for all hours of class time and credit hours, including independent study and
internships, and up to two hours of travel time per day. A postsecondary student shall receive
four hours of child care assistance per credit hour for study time and academic appointments
per service period.
new text end

new text begin (d) For an MFIP or DWP participant, child care assistance must be authorized according
to the person's approved employment plan. If an MFIP or DWP participant receiving MFIP
or DWP child care assistance under this chapter moves to another county, continues to
participate in an authorized educational or training program, and remains eligible for MFIP
or DWP child care assistance, the participant must receive continued child care assistance
from the county responsible for the person's current employment plan under section 256G.07.
new text end

new text begin (e) If a person with an approved education program under section 119B.03, subdivision
3, or 119B.05, subdivision 1, begins receiving MFIP or DWP assistance, the person continues
to receive child care assistance for the approved education program until the person's
education is included in an approved MFIP or DWP employment plan or until
redetermination, whichever occurs first.
new text end

new text begin (f) If a person's MFIP or DWP assistance ends and the approved MFIP or DWP
employment plan included education, the person continues to be eligible for child care
assistance for education under transition year child care assistance until the person's education
is included in an approved education plan or until redetermination.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 18, 2017.
new text end

Sec. 19.

new text begin [119B.105] EXTENDED ELIGIBILITY AND AUTHORIZATION.
new text end

new text begin Subdivision 1. new text end

new text begin Three-month extended eligibility period. new text end

new text begin (a) A family in a situation
under paragraph (b) continues to be eligible for up to three months or until the family's
redetermination, whichever occurs first, rather than losing eligibility or having the family's
eligibility suspended. During extended eligibility, the amount of child care authorized shall
continue at the same number or more hours. The family must continue to meet all other
eligibility requirements under this chapter.
new text end

new text begin (b) The family's three-month extended eligibility period applies when:
new text end

new text begin (1) a participant's employment or education program ends permanently;
new text end

new text begin (2) the other parent moves in and does not participate in an authorized activity;
new text end

new text begin (3) a participant's MFIP assistance ends and the participant is not participating in an
authorized activity or the participant's participation in an authorized activity is unknown;
new text end

new text begin (4) a student parent under section 119B.011, subdivision 19b, stops attending school;
or
new text end

new text begin (5) a participant receiving basic sliding fee child care assistance or transition year child
care assistance applied for MFIP assistance and is not participating in an authorized activity
or the participant's participation in an authorized activity is unknown.
new text end

new text begin Subd. 2. new text end

new text begin Extended eligibility and redetermination. new text end

new text begin (a) If the family received three
months of extended eligibility and redetermination is not due, to continue receiving child
care assistance the participant must be employed or have an education plan that meets the
requirements of section 119B.10, subdivision 3, or have an MFIP or DWP employment
plan. If child care assistance continues, the amount of child care authorized shall continue
at the same number or more hours until redetermination, unless a condition in section
119B.095, subdivision 2, paragraph (c), applies. A family subject to section 119B.095,
subdivision 1, paragraph (b), shall have child care authorized based on a verified activity
schedule.
new text end

new text begin (b) If the family's redetermination occurs before the end of the three-month extended
eligibility period to continue receiving child care assistance, the participant must verify that
the participant meets eligibility and activity requirements for child care assistance under
this chapter. If child care assistance continues, the amount of child care authorized is based
on section 119B.10. A family subject to section 119B.095, subdivision 1, paragraph (b),
shall have child care authorized based on a verified activity schedule.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 18, 2017.
new text end

Sec. 20.

Minnesota Statutes 2016, section 119B.12, subdivision 2, is amended to read:


Subd. 2.

Parent fee.

A family must be assessed a parent fee for each service period. A
family's parent fee must be a fixed percentage of its annual gross income. Parent fees must
apply to families eligible for child care assistance under sections 119B.03 and 119B.05.
Income must be as defined in section 119B.011, subdivision 15. The fixed deleted text beginpercentdeleted text end new text beginpercentage
new text end is based on the relationship of the family's annual gross income to 100 percent of the annual
state median income. Parent fees must begin at 75 percent of the poverty level. The minimum
parent fees for families between 75 percent and 100 percent of poverty level must be $2 per
biweekly period. Parent fees must provide for graduated movement to full payment. new text begin At
initial application, the parent fee is established for the family's 12-month eligibility period.
At redetermination, if the family remains eligible, the parent fee is recalculated and is
established for the next 12-month eligibility period. A parent fee shall not increase during
the 12-month eligibility period.
new text endPayment of part or all of a family's parent fee directly to
the family's child care provider on behalf of the family by a source other than the family
shall not affect the family's eligibility for child care assistance, and the amount paid shall
be excluded from the family's income. Child care providers who accept third-party payments
must maintain family specific documentation of payment source, amount, and time period
covered by the payment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 23, 2017.
new text end

Sec. 21.

Minnesota Statutes 2016, section 119B.13, subdivision 1, is amended to read:


Subdivision 1.

Subsidy restrictions.

(a) Beginning February 3, 2014, the maximum
rate paid for child care assistance in any county or county price cluster under the child care
fund shall be the greater of the 25th percentile of the 2011 child care provider rate survey
or the maximum rate effective November 28, 2011.new text begin For a child care provider located within
the boundaries of a city located in two or more of the counties of Benton, Sherburne, and
Stearns, the maximum rate paid for child care assistance shall be equal to the maximum
rate paid in the county with the highest maximum reimbursement rates or the provider's
charge, whichever is less.
new text end The commissioner may: (1) assign a county with no reported
provider prices to a similar price cluster; and (2) consider county level access when
determining final price clusters.

(b) A rate which includes a special needs rate paid under subdivision 3 may be in excess
of the maximum rate allowed under this subdivision.

(c) The department shall monitor the effect of this paragraph on provider rates. The
county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care on
an hourly, full-day, and weekly basis, including special needs and disability care.

new text begin (d) If a child uses one provider,new text end the maximum payment deleted text beginto a providerdeleted text end for one day of care
must not exceed the daily rate. The maximum payment deleted text beginto a providerdeleted text end for one week of care
must not exceed the weekly rate.

new text begin (e) If a child uses two providers under section 119B.097, the maximum payment must
not exceed:
new text end

new text begin (1) the daily rate for one day of care;
new text end

new text begin (2) the weekly rate for one week of care by the child's primary provider; and
new text end

new text begin (3) two daily rates during two weeks of care by a child's secondary provider.
new text end

deleted text begin (d)deleted text endnew text begin (f)new text end Child care providers receiving reimbursement under this chapter must not be paid
activity fees or an additional amount above the maximum rates for care provided during
nonstandard hours for families receiving assistance.

deleted text begin (e) Whendeleted text end new text begin(g) Ifnew text end the provider charge is greater than the maximum provider rate allowed,
the parent is responsible for payment of the difference in the rates in addition to any family
co-payment fee.

deleted text begin (f)deleted text endnew text begin (h)new text end All maximum provider rates changes shall be implemented on the Monday
following the effective date of the maximum provider rate.

deleted text begin (g)deleted text endnew text begin (i)new text end Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum
registration fees in effect on January 1, 2013, shall remain in effect.

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective July 1, 2018. Paragraphs (d) to (i) are
effective April 23, 2018.
new text end

Sec. 22.

Minnesota Statutes 2016, 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. deleted text beginIf bills are submitted within ten days of the end
of the service period,
deleted text end Payments under the child care fund shall be made within deleted text begin30deleted text end new text begin21 new text enddays
of receiving a new text begincomplete new text endbill 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 or the commissioner 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 or the commissioner finds by a preponderance of the evidence that the
provider intentionally gave the county materially false information on the provider's billing
forms, or provided false attendance records to a county or the commissioner;

(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:

(i) an order of suspension of the provider's license issued by the commissioner;

(ii) an order of revocation of the provider's license; or

(iii) a final order of conditional license issued by the commissioner for as long as the
conditional license is in effect;

(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.

(e) For purposes of paragraph (d), clauses (3), (5), and (6), the county or the commissioner
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.

(f) 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 25, 2017.
new text end

Sec. 23.

Minnesota Statutes 2016, section 245.814, is amended by adding a subdivision
to read:


new text begin Subd. 5. new text end

new text begin Foster care parent liability insurance. new text end

new text begin The commissioner may use federal
reimbursement money earned on an expenditure for foster care parent liability insurance
premiums to offset the costs of the premiums.
new text end

Sec. 24.

Minnesota Statutes 2016, section 245A.50, subdivision 5, is amended to read:


Subd. 5.

Sudden unexpected infant death and abusive head trauma training.

(a)
License holders must document that before staff persons, caregivers, and helpers assist in
the care of infants, they are instructed on the standards in section 245A.1435 and receive
training on reducing the risk of sudden unexpected infant death. In addition, license holders
must document that before staff persons, caregivers, and helpers assist in the care of infants
and children under school age, they receive training on reducing the risk of abusive head
trauma from shaking infants and young children. The training in this subdivision may be
provided as initial training under subdivision 1 or ongoing annual training under subdivision
7.

(b) Sudden unexpected infant death reduction training required under this subdivision
must, at a minimum, address the risk factors related to sudden unexpected infant death,
means of reducing the risk of sudden unexpected infant death in child care, and license
holder communication with parents regarding reducing the risk of sudden unexpected infant
death.

(c) Abusive head trauma training required under this subdivision must, at a minimum,
address the risk factors related to shaking infants and young children, means of reducing
the risk of abusive head trauma in child care, and license holder communication with parents
regarding reducing the risk of abusive head trauma.

(d) Training for family and group family child care providers must be developed by the
commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved
by the Minnesota Center for Professional Development. Sudden unexpected infant death
reduction training and abusive head trauma training may be provided in a single course of
no more than two hours in length.

(e) Sudden unexpected infant death reduction training and abusive head trauma training
required under this subdivision must be completed in person or as allowed under subdivision
10, clause (1) or (2), at least once every two years. On the years when the license holder is
not receiving training in person or as allowed under subdivision 10, clause (1) or (2), the
license holder must receive sudden unexpected infant death reduction training and abusive
head trauma training through a video of no more than one hour in length. The video must
be developed or approved by the commissioner.

new text begin (f) An individual who is related to the license holder as defined in section 245A.02,
subdivision 13, and who is involved only in the care of the license holder's own infant or
child under school age and who is not designated to be a caregiver, helper, or substitute, as
defined in Minnesota Rules, part 9502.0315, for the licensed program, is exempt from the
sudden unexpected infant death and abusive head trauma training.
new text end

Sec. 25.

Minnesota Statutes 2016, 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 begin2.23deleted text end new text begin1.94 new text endpercent of adjusted gross income at 275 percent
of federal poverty guidelines and increases to deleted text begin6.08deleted text end new text begin5.29 new text endpercent 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 6.08deleted text end new text begin5.29 new text endpercent 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 begin6.08deleted text end new text begin5.29 new text endpercent of adjusted gross income at 675 percent of federal
poverty guidelines and increases to deleted text begin8.1deleted text end new text begin7.05 new text endpercent 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 begin10.13deleted text end new text begin8.81 new text endpercent 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 26.

Minnesota Statutes 2016, section 256E.30, subdivision 2, is amended to read:


Subd. 2.

Allocation of money.

(a) State money appropriated and community service
block grant money allotted to the state and all money transferred to the community service
block grant from other block grants shall be allocated annually to community action agencies
and Indian reservation governments under clauses (b) and (c), and to migrant and seasonal
farmworker organizations under clause (d).

(b) The available annual money will provide base funding to all community action
agencies and the Indian reservations. Base funding amounts per agency are as follows: for
agencies with low income populations up to deleted text begin3,999deleted text endnew text begin 1,999new text end, $25,000; deleted text begin4,000deleted text endnew text begin 2,000new text end to 23,999,
$50,000; and 24,000 or more, $100,000.

(c) All remaining money of the annual money available after the base funding has been
determined must be allocated to each agency and reservation in proportion to the size of
the poverty level population in the agency's service area compared to the size of the poverty
level population in the state.

(d) Allocation of money to migrant and seasonal farmworker organizations must not
exceed three percent of the total annual money available. Base funding allocations must be
made for all community action agencies and Indian reservations that received money under
this subdivision, in fiscal year 1984, and for community action agencies designated under
this section with a service area population of 35,000 or greater.

Sec. 27.

Minnesota Statutes 2016, section 256J.45, subdivision 2, is amended to read:


Subd. 2.

General information.

The MFIP orientation must consist of a presentation
that informs caregivers of:

(1) the necessity to obtain immediate employment;

(2) the work incentives under MFIP, including the availability of the federal earned
income tax credit and the Minnesota working family tax credit;

(3) the requirement to comply with the employment plan and other requirements of the
employment and training services component of MFIP, including a description of the range
of work and training activities that are allowable under MFIP to meet the individual needs
of participants;

(4) the consequences for failing to comply with the employment plan and other program
requirements, and that the county agency may not impose a sanction when failure to comply
is due to the unavailability of child care or other circumstances where the participant has
good cause under subdivision 3;

(5) the rights, responsibilities, and obligations of participants;

(6) the types and locations of child care services available through the county agency;

(7) the availability and the benefits of the early childhood health and developmental
screening under sections 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10;

(8) the caregiver's eligibility for transition year child care assistance under section
119B.05;

(9) the availability of all health care programs, including transitional medical assistance;

(10) the caregiver's option to choose an employment and training provider and information
about each provider, including but not limited to, services offered, program components,
job placement rates, job placement wages, and job retention rates;

(11) the caregiver's option to request approval of an education and training plan according
to section 256J.53;

(12) the work study programs available under the higher education system; deleted text beginand
deleted text end

(13) information about the 60-month time limit exemptions under the family violence
waiver and referral information about shelters and programs for victims of family violencedeleted text begin.deleted text endnew text begin;
and
new text end

new text begin (14) information about the income exclusions under section 256P.06, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2018.
new text end

Sec. 28.

new text begin [256N.261] SUPPORT FOR ADOPTIVE, FOSTER, AND KINSHIP
FAMILIES.
new text end

new text begin Subdivision 1. new text end

new text begin Program established. new text end

new text begin The commissioner shall design and implement a
coordinated program to reduce the need for placement changes or out-of-home placements
of children and youth in foster care, adoptive placements, and permanent physical and legal
custody kinship placements, and to improve the functioning and stability of these families.
To the extent federal funds are available, the commissioner shall provide the following
adoption and foster care-competent services and ensure that placements are trauma-informed
and child and family-centered:
new text end

new text begin (1) a program providing information, referrals, a parent-to-parent support network, peer
support for youth, family activities, respite care, crisis services, educational support, and
mental health services for children and youth in adoption, foster care, and kinship placements
and adoptive, foster, and kinship families in Minnesota;
new text end

new text begin (2) training offered statewide in Minnesota for adoptive and kinship families, and training
for foster families, and the professionals who serve the families, on the effects of trauma,
common disabilities of adopted children and children in foster care, and kinship placements,
and challenges in adoption, foster care, and kinship placements; and
new text end

new text begin (3) periodic evaluation of these services to ensure program effectiveness in preserving
and improving the success of adoptive, foster, and kinship placements.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "Child and family-centered" means individualized services that respond to a child's
or youth's strengths, interests, and current developmental stage, including social, cognitive,
emotional, physical, cultural, racial, and spiritual needs, and offer support to the entire
adoptive, foster, or kinship family.
new text end

new text begin (c) "Trauma-informed" means care that acknowledges the effect trauma has on children
and the children's families; modifies services to respond to the effects of trauma; emphasizes
skill and strength-building rather than symptom management; and focuses on the physical
and psychological safety of the child and family.
new text end

Sec. 29.

Minnesota Statutes 2016, section 256P.06, subdivision 2, is amended to read:


Subd. 2.

Exempted individuals.

new text begin(a) new text endThe 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:

(1) children under six years old;

(2) caregivers under 20 years of age enrolled at least half-time in school; and

(3) minors enrolled in school full time.

new text begin (b) The following members of an assistance unit are exempt from having their earned
and unearned income count towards the income of an assistance unit for 12 consecutive
calendar months, beginning the month following the marriage date, for benefits under chapter
256J if the household income does not exceed 275 percent of the federal poverty guideline:
new text end

new text begin (1) a new spouse to a caretaker in an existing assistance unit; and
new text end

new text begin (2) the spouse designated by a newly married couple, both of whom were already
members of an assistance unit under chapter 256J.
new text end

new text begin (c) If members identified in paragraph (b) also receive assistance under section 119B.05,
they are exempt from having their earned and unearned income count towards the income
of the assistance unit if the household income prior to the exemption does not exceed 67
percent of the state median income for recipients for 26 consecutive biweekly periods
beginning the second biweekly period after the marriage date.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2018.
new text end

Sec. 30.

Minnesota Statutes 2016, section 256P.07, subdivision 3, is amended to read:


Subd. 3.

Changes that must be reported.

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:

(1) a change in earned income of $100 per month or greaternew text begin with the exception of a
program under chapter 119B
new text end;

(2) a change in unearned income of $50 per month or greaternew text begin with the exception of a
program under chapter 119B
new text end;

(3) a change in employment status and hoursnew text begin with the exception of a program under
chapter 119B
new text end;

(4) a change in address or residence;

(5) a change in household composition with the exception of programs under chapter
256I;

(6) a receipt of a lump-sum paymentnew text begin with the exception of a program under chapter
119B
new text end;

(7) an increase in assets if over $9,000 with the exception of programs under chapter
119B;

(8) a change in citizenship or immigration status;

(9) a change in family status with the exception of programs under chapter 256I;

(10) a change in disability status of a unit member, with the exception of programs under
chapter 119B;

(11) a new rent subsidy or a change in rent subsidynew text begin with the exception of a program
under chapter 119B
new text end; and

(12) a sale, purchase, or transfer of real propertynew text begin with the exception of a program under
chapter 119B
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 18, 2017.
new text end

Sec. 31.

Minnesota Statutes 2016, section 256P.07, subdivision 6, is amended to read:


Subd. 6.

Child care assistance programs-specific reporting.

new text begin(a) new text endIn addition to
subdivision 3, an assistance unit under chapter 119B, within ten days of the change, must
report:

(1) a change in a parentally responsible individual's deleted text beginvisitation schedule ordeleted text end custody
deleted text begin arrangementdeleted text end new text beginschedule new text endfor any child receiving child care assistance program benefits; deleted text beginand
deleted text end

(2) a deleted text beginchange indeleted text endnew text begin permanent end in a parentally responsible individual'snew text end authorized activity
deleted text begin status.deleted text endnew text begin; and
new text end

new text begin (3) if the unit's family's annual included income exceeds 85 percent of the state median
income, adjusted for family size.
new text end

new text begin (b) An assistance unit subject to section 119B.095, subdivision 1, paragraph (b), must
report a change in the unit's authorized activity status.
new text end

new text begin (c) An assistance unit must notify the county when the unit wants to reduce the number
of authorized hours for children in the unit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 18, 2017.
new text end

Sec. 32.

Minnesota Statutes 2016, section 260C.451, subdivision 6, is amended to read:


Subd. 6.

Reentering foster care and accessing services after 18 years of age and up
to 21 years of age.

(a) Upon request of an individual 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 (c), clause (12), 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 responsible social
services agency shall provide foster care as required to implement the plan. The responsible
social services 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 18 years of age may ask to reenter foster care after age 18 anddeleted text begin, to the extent
funds are available,
deleted text end the responsible social services agency that had responsibility for planning
for the individual before discharge from foster care deleted text beginmaydeleted text endnew text begin shallnew text end 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 birthdaynew text begin,
or left foster care within six months prior to the person's 18th birthday,
new text end 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 anddeleted text begin,deleted text end
deleted text begin to the extent funds are available,deleted text end provide foster care as required to implement the plan. The
responsible social services agency shall enter into a voluntary placement agreement with
the individual if the plan includes foster care.

(d) A child who left foster care while under guardianship of the commissioner of human
services retains eligibility for foster care for placement at any time prior to 21 years of age.

Sec. 33. new text beginMINNESOTA BIRTH TO AGE EIGHT PILOT PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Authorization. new text end

new text begin The commissioner of human services shall award a grant
to Dakota County to develop and implement pilots that will evaluate the impact of a
coordinated systems and service delivery approach on key developmental milestones and
outcomes that ultimately lead to reading proficiency by age eight within the target population.
The pilot program is from July 1, 2017, to June 30, 2021.
new text end

new text begin Subd. 2. new text end

new text begin Pilot design and goals. new text end

new text begin The pilot will establish five key developmental milestone
markers from birth to age eight. Enrollees in the pilot will be developmentally assessed and
tracked by a technology solution that tracks developmental milestones along the established
developmental continuum. If a child's progress falls below established milestones and the
weighted scoring, the coordinated service system will focus on identified areas of concern,
mobilize appropriate supportive services, and offer services to identified children and their
families.
new text end

new text begin Subd. 3. new text end

new text begin Program participants in phase 1 target population. new text end

new text begin Pilot program participants
must:
new text end

new text begin (1) be enrolled in a Women's Infant & Children (WIC) program;
new text end

new text begin (2) be participating in a family home visiting program, or nurse family practice, or
Healthy Families America (HFA);
new text end

new text begin (3) be children and families qualifying for and participating in early language learners
(ELL) in the school district in which they reside; and
new text end

new text begin (4) opt in and provide parental consent to participate in the pilot project.
new text end

new text begin Subd. 4. new text end

new text begin Evaluation and report. new text end

new text begin The county or counties shall work with a third-party
evaluator to evaluate the effectiveness of the pilot and report to the legislative committees
with jurisdiction over human services policy and finance each year by February 1 with an
update on the progress of the pilot. The final report on the pilot is due January 1, 2022.
new text end

Sec. 34. new text beginMINNESOTA PATHWAYS TO PROSPERITY AND WELL-BEING PILOT
PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Authorization. new text end

new text begin The commissioner of human services may develop a
pilot project that shall test an alternative financing model for the distribution of publicly
funded benefits. The commissioner may work with interested counties to develop the pilot
and determine the waivers that are necessary to implement the pilot project based on the
pilot design in subdivisions 2 and 3, and outcome measures in subdivision 4.
new text end

new text begin Subd. 2. new text end

new text begin Pilot project goals. new text end

new text begin The goals of the pilot project are to:
new text end

new text begin (1) reduce the historical separation among the state programs and systems affecting
families who are receiving public assistance;
new text end

new text begin (2) eliminate, where possible, funding restrictions to allow a more comprehensive
approach to the needs of the families in the pilot project; and
new text end

new text begin (3) focus on upstream, prevention-oriented supports and interventions.
new text end

new text begin Subd. 3. new text end

new text begin Project participants. new text end

new text begin The pilot project developed by the commissioner may
include requirements that participants:
new text end

new text begin (1) be 26 years of age or younger with a minimum of one child;
new text end

new text begin (2) voluntarily agree to participate in the pilot project;
new text end

new text begin (3) be eligible for, applying for, or receiving public benefits including but not limited
to housing assistance, education supports, employment supports, child care, transportation
supports, medical assistance, earned income tax credit, or the child care tax credit; and
new text end

new text begin (4) be enrolled in an education program that is focused on obtaining a career that will
likely result in a livable wage.
new text end

new text begin Subd. 4. new text end

new text begin Outcomes. new text end

new text begin The outcome measures for the pilot project must include:
new text end

new text begin (1) improvement in the affordability, safety, and permanence of suitable housing;
new text end

new text begin (2) improvement in family functioning and stability, including in the areas of behavioral
health, incarceration, involvement with the child welfare system, or equivalent indicators;
new text end

new text begin (3) improvement in education readiness and outcomes for parents and children from
early childhood through high school, including reduction in absenteeism, preschool readiness
scores, third grade reading competency, graduation, GPA, and standardized test improvement;
new text end

new text begin (4) improvement in attachment to the workforce of one or both parents, including
enhanced job stability; wage gains; career advancement; progress in career preparation; or
an equivalent combination of these or related measures; and
new text end

new text begin (5) improvement in health care access and health outcomes for parents and children.
new text end

Sec. 35. new text beginCHILD CARE CORRECTION ORDER POSTING GUIDELINES.
new text end

new text begin No later than November 1, 2017, the commissioner shall develop guidelines for posting
public licensing data for licensed child care programs. In developing the guidelines, the
commissioner shall consult with stakeholders, including licensed child care center providers,
family child care providers, and county agencies.
new text end

Sec. 36. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2016, section 13.468, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2016, section 119B.07, new text end new text begin is repealed effective December 18, 2017.
new text end

ARTICLE 8

CHEMICAL AND MENTAL HEALTH SERVICES

Section 1.

Minnesota Statutes 2016, section 245.462, subdivision 9, is amended to read:


Subd. 9.

Diagnostic assessment.

new text begin(a) new text end"Diagnostic assessment" deleted text beginmeans a written summary
of the history, diagnosis, strengths, vulnerabilities, and general service needs of an adult
with a mental illness using diagnostic, interview, and other relevant mental health techniques
provided by a mental health professional used in developing an individual treatment plan
or individual community support plan.
deleted text endnew text begin has the meaning given in Minnesota Rules, part
9505.0370, subpart 11, and is delivered as provided in Minnesota Rules, part 9505.0372,
subpart 1, items A, B, C, and E. Diagnostic assessment includes a standard, extended, or
brief diagnostic assessment, or an adult update.
new text end

new text begin (b) A brief diagnostic assessment must include a face-to-face interview with the client
and a written evaluation of the client by a mental health professional or a clinical trainee,
as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or
clinical trainee must gather initial components of a standard diagnostic assessment, including
the client's:
new text end

new text begin (1) age;
new text end

new text begin (2) description of symptoms, including reason for referral;
new text end

new text begin (3) history of mental health treatment;
new text end

new text begin (4) cultural influences and their impact on the client; and
new text end

new text begin (5) mental status examination.
new text end

new text begin (c) On the basis of the initial components, the professional or clinical trainee must draw
a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's
immediate needs or presenting problem.
new text end

new text begin (d) Treatment sessions conducted under authorization of a brief assessment may be used
to gather additional information necessary to complete a standard diagnostic assessment or
an extended diagnostic assessment.
new text end

new text begin (e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible
for psychological testing as part of the diagnostic process.
new text end

new text begin (f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction
with the diagnostic assessment process, a client is eligible for up to three individual or family
psychotherapy sessions or family psychoeducation sessions or a combination of the above
sessions not to exceed three sessions.
new text end

new text begin (g) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item B, subitem (3),
unit (a), a brief diagnostic assessment may be used for a client's family who requires a
language interpreter to participate in the assessment.
new text end

Sec. 2.

new text begin [245.4662] GRANT PROGRAM; MENTAL HEALTH INNOVATION.
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) "Community partnership" means a project involving the collaboration of two or more
eligible applicants.
new text end

new text begin (c) "Eligible applicant" means an eligible county, Indian tribe, mental health service
provider, hospital, or community partnership. Eligible applicant does not include a
state-operated direct care and treatment facility or program under chapter 246.
new text end

new text begin (d) "Intensive residential treatment services" has the meaning given in section 256B.0622,
subdivision 2.
new text end

new text begin (e) "Metropolitan area" means the seven-county metropolitan area, as defined in section
473.121, subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Grants authorized. new text end

new text begin The commissioner of human services shall, in consultation
with stakeholders, award grants to eligible applicants to plan, establish, or operate programs
to improve accessibility and quality of community-based, outpatient mental health services
and reduce the number of clients admitted to regional treatment centers and community
behavioral health hospitals. The commissioner shall award half of all grant funds to eligible
applicants in the metropolitan area and half of all grant funds to eligible applicants outside
the metropolitan area. An applicant may apply for and the commissioner may award grants
for two-year periods. The commissioner may reallocate underspending among grantees
within the same grant period. The mental health innovation account is established under
section 246.18 for ongoing funding.
new text end

new text begin Subd. 3. new text end

new text begin Allocation of grants. new text end

new text begin (a) An application must be on a form and contain
information as specified by the commissioner but at a minimum must contain:
new text end

new text begin (1) a description of the purpose or project for which grant funds will be used;
new text end

new text begin (2) a description of the specific problem the grant funds will address;
new text end

new text begin (3) a letter of support from the local mental health authority;
new text end

new text begin (4) a description of achievable objectives, a work plan, and a timeline for implementation
and completion of processes or projects enabled by the grant; and
new text end

new text begin (5) a process for documenting and evaluating results of the grant.
new text end

new text begin (b) The commissioner shall review each application to determine whether the application
is complete and whether the applicant and the project are eligible for a grant. In evaluating
applications according to paragraph (c), the commissioner shall establish criteria including,
but not limited to: the eligibility of the project; the applicant's thoroughness and clarity in
describing the problem grant funds are intended to address; a description of the applicant's
proposed project; a description of the population demographics and service area of the
proposed project; the manner in which the applicant will demonstrate the effectiveness of
any projects undertaken; the proposed project's longevity and demonstrated financial
sustainability after the initial grant period; and evidence of efficiencies and effectiveness
gained through collaborative efforts. The commissioner may also consider other relevant
factors. In evaluating applications, the commissioner may request additional information
regarding a proposed project, including information on project cost. An applicant's failure
to provide the information requested disqualifies an applicant. The commissioner shall
determine the number of grants awarded.
new text end

new text begin (c) Eligible applicants may receive grants under this section for purposes including, but
not limited to, the following:
new text end

new text begin (1) intensive residential treatment services providing time-limited mental health services
in a residential setting;
new text end

new text begin (2) the creation of stand-alone urgent care centers for mental health and psychiatric
consultation services, crisis residential services, or collaboration between crisis teams and
critical access hospitals;
new text end

new text begin (3) establishing new community mental health services or expanding the capacity of
existing services, including supportive housing; and
new text end

new text begin (4) other innovative projects that improve options for mental health services in community
settings and reduce the number of clients who remain in regional treatment centers and
community behavioral health hospitals beyond when discharge is determined to be clinically
appropriate.
new text end

new text begin Subd. 4. new text end

new text begin Report to legislature. new text end

new text begin By December 1, 2019, the commissioner of human
services shall deliver a report to the chairs and ranking minority members of the legislative
committees with jurisdiction over mental health issues on the outcomes of the projects
funded under this section. The report shall, at a minimum, include the amount of funding
awarded for each project, a description of the programs and services funded, plans for the
long-term sustainability of the projects, and data on outcomes for the programs and services
funded. Grantees must provide information and data requested by the commissioner to
support the development of this report.
new text end

Sec. 3.

Minnesota Statutes 2016, section 245.467, subdivision 2, is amended to read:


Subd. 2.

Diagnostic assessment.

All providers of residential, acute care hospital inpatient,
and regional treatment centers must complete a diagnostic assessment for each of their
clients within five days of admission. Providers of deleted text beginoutpatient anddeleted text end day treatment services
must complete a diagnostic assessment within five days after the adult's second visit or
within 30 days after intake, whichever occurs first. In cases where a diagnostic assessment
is available and has been completed within three years preceding admission, only an adult
diagnostic assessment update is necessary. An "adult diagnostic assessment update" means
a written summary by a mental health professional of the adult's current mental health status
and service needs and includes a face-to-face interview with the adult. If the adult's mental
health status has changed markedly since the adult's most recent diagnostic assessment, a
new diagnostic assessment is required. Compliance with the provisions of this subdivision
does not ensure eligibility for medical assistance reimbursement under chapter 256B.

Sec. 4.

Minnesota Statutes 2016, section 245.4871, is amended by adding a subdivision
to read:


new text begin Subd. 11a. new text end

new text begin Diagnostic assessment. new text end

new text begin (a) "Diagnostic assessment" has the meaning given
in Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota
Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a
standard, extended, or brief diagnostic assessment, or an adult update.
new text end

new text begin (b) A brief diagnostic assessment must include a face-to-face interview with the client
and a written evaluation of the client by a mental health professional or a clinical trainee,
as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or
clinical trainee must gather initial components of a standard diagnostic assessment, including
the client's:
new text end

new text begin (1) age;
new text end

new text begin (2) description of symptoms, including reason for referral;
new text end

new text begin (3) history of mental health treatment;
new text end

new text begin (4) cultural influences and their impact on the client; and
new text end

new text begin (5) mental status examination.
new text end

new text begin (c) On the basis of the brief components, the professional or clinical trainee must draw
a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's
immediate needs or presenting problem.
new text end

new text begin (d) Treatment sessions conducted under authorization of a brief assessment may be used
to gather additional information necessary to complete a standard diagnostic assessment or
an extended diagnostic assessment.
new text end

new text begin (e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible
for psychological testing as part of the diagnostic process.
new text end

new text begin (f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction
with the diagnostic assessment process, a client is eligible for up to three individual or family
psychotherapy sessions or family psychoeducation sessions or a combination of the above
sessions not to exceed three sessions.
new text end

Sec. 5.

Minnesota Statutes 2016, section 245.4871, is amended by adding a subdivision
to read:


new text begin Subd. 18a. new text end

new text begin Functional assessment. new text end

new text begin "Functional assessment" means an assessment by
the case manager of the child's:
new text end

new text begin (1) mental health symptoms as presented in the child's diagnostic assessment;
new text end

new text begin (2) mental health needs as presented in the child's diagnostic assessment;
new text end

new text begin (3) use of drugs and alcohol;
new text end

new text begin (4) vocational and educational functioning;
new text end

new text begin (5) social functioning, including the use of leisure time;
new text end

new text begin (6) interpersonal functioning, including relationships with the child's family;
new text end

new text begin (7) self-care and independent living capacity;
new text end

new text begin (8) medical and dental health;
new text end

new text begin (9) financial assistance needs;
new text end

new text begin (10) housing and transportation needs; and
new text end

new text begin (11) other needs and problems.
new text end

Sec. 6.

Minnesota Statutes 2016, section 245.4876, subdivision 2, is amended to read:


Subd. 2.

Diagnostic assessment.

All residential treatment facilities and acute care
hospital inpatient treatment facilities that provide mental health services for children must
complete a diagnostic assessment for each of their child clients within five working days
of admission. Providers of deleted text beginoutpatient anddeleted text end day treatment services for children must complete
a diagnostic assessment within five days after the child's second visit or 30 days after intake,
whichever occurs first. In cases where a diagnostic assessment is available and has been
completed within 180 days preceding admission, only updating is necessary. "Updating"
means a written summary by a mental health professional of the child's current mental health
status and service needs. If the child's mental health status has changed markedly since the
child's most recent diagnostic assessment, a new diagnostic assessment is required.
Compliance with the provisions of this subdivision does not ensure eligibility for medical
assistance reimbursement under chapter 256B.

Sec. 7.

Minnesota Statutes 2016, 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.

(b) The following services are eligible for grants under this section:

(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;

(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;

(3) respite care services for children with severe emotional disturbances who are at risk
of out-of-home placement;

(4) children's mental health crisis services;

(5) mental health services for people from cultural and ethnic minorities;

(6) children's mental health screening and follow-up diagnostic assessment and treatment;

(7) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;

(8) school-linked mental health servicesnew text begin, including transportation for children receiving
school-linked mental health services when school is not in session
new text end;

(9) building evidence-based mental health intervention capacity for children birth to age
five;

(10) suicide prevention and counseling services that use text messaging statewide;

(11) mental health first aid training;

(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;

(13) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;

(14) early childhood mental health consultation;

(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; deleted text beginand
deleted text end

(16) psychiatric consultation for primary care practitionersdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (17) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grants.
new text end

(c) Services under paragraph (b) 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 new text beginthis new text endparagraph deleted text begin(b)deleted text end must
be designed to foster independent living in the community.

new text begin EFFECTIVE DATE. new text end

new text begin Clause (17) is effective the day following final enactment.
new text end

Sec. 8.

Minnesota Statutes 2016, section 245.91, subdivision 4, is amended to read:


Subd. 4.

Facility or program.

"Facility" or "program" means a nonresidential or
residential program as defined in section 245A.02, subdivisions 10 and 14, deleted text beginthat is required
to be licensed by the commissioner of human services,
deleted text endnew text begin and any agency, facility, or program
that provides services or treatment for mental illness, developmental disabilities, chemical
dependency, or emotional disturbance that is required to be licensed, certified, or registered
by the commissioner of human services, health, or education;
new text end and an acute care inpatient
facility that provides services or treatment for mental illness, developmental disabilities,
chemical dependency, or emotional disturbance.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2016, section 245.91, subdivision 6, is amended to read:


Subd. 6.

Serious injury.

"Serious injury" means:

(1) fractures;

(2) dislocations;

(3) evidence of internal injuries;

(4) head injuries with loss of consciousnessnew text begin or potential for a closed head injury or
concussion without loss of consciousness requiring a medical assessment by a health care
professional, whether or not further medical attention was sought
new text end;

(5) lacerations involving injuries to tendons or organs, and those for which complications
are present;

(6) extensive second-degree or third-degree burns, and other burns for which
complications are present;

(7) extensive second-degree or third-degree frostbite, and others for which complications
are present;

(8) irreversible mobility or avulsion of teeth;

(9) injuries to the eyeball;

(10) ingestion of foreign substances and objects that are harmful;

(11) near drowning;

(12) heat exhaustion or sunstroke; deleted text beginand
deleted text end

(13)new text begin attempted suicide; and
new text end

new text begin (14)new text end all other injuries new text beginand incidents new text endconsidered serious new text beginafter an assessment new text endby a deleted text beginphysiciandeleted text endnew text begin
health care professional, including but not limited to self-injurious behavior, a medication
error requiring medical treatment, a suspected delay of medical treatment, a complication
of a previous injury, or a complication of medical treatment for an injury
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. 10.

Minnesota Statutes 2016, section 245.94, subdivision 1, is amended to read:


Subdivision 1.

Powers.

(a) The ombudsman may prescribe the methods by which
complaints to the office are to be made, reviewed, and acted upon. The ombudsman may
not levy a complaint fee.

(b)new text begin The ombudsman is a health oversight agency as defined in Code of Federal
Regulations, title 45, section 164.501. The ombudsman may access patient records according
to Code of Federal Regulations, title 42, section 2.53. For purposes of this paragraph,
"records" has the meaning given in Code of Federal Regulations, title 42, section
2.53(a)(1)(i).
new text end

new text begin (c)new text end The ombudsman may mediate or advocate on behalf of a client.

deleted text begin (c)deleted text endnew text begin (d)new text end The ombudsman may investigate the quality of services provided to clients and
determine the extent to which quality assurance mechanisms within state and county
government work to promote the health, safety, and welfare of clientsdeleted text begin, other than clients in
acute care facilities who are receiving services not paid for by public funds. The ombudsman
is a health oversight agency as defined in Code of Federal Regulations, title 45, section
164.501
deleted text end.

deleted text begin (d)deleted text endnew text begin (e)new text end At the request of a client, or upon receiving a complaint or other information
affording reasonable grounds to believe that the rights of deleted text begina clientdeleted text endnew text begin one or more clientsnew text end who
deleted text begin isdeleted text endnew text begin maynew text end not new text beginbe new text endcapable of requesting assistance have been adversely affected, the ombudsman
may gather information and data about and analyze, on behalf of the client, the actions of
an agency, facility, or program.

deleted text begin (e)deleted text endnew text begin (f)new text end The ombudsman may gather, on behalf of deleted text begina clientdeleted text endnew text begin one or more clientsnew text end, records of
an agency, facility, or program, or records related to clinical drug trials from the University
of Minnesota Department of Psychiatry, if the records relate to a matter that is within the
scope of the ombudsman's authority. If the records are private and the client is capable of
providing consent, the ombudsman shall first obtain the client's consent. The ombudsman
is not required to obtain consent for access to private data on clients with developmental
disabilitiesnew text begin and individuals served by the Minnesota sex offender program. The ombudsman
may also take photographic or videographic evidence while reviewing the actions of an
agency, facility, or program, with the consent of the client
new text end. The ombudsman is not required
to obtain consent for access to private data on decedents who were receiving services for
mental illness, developmental disabilities,new text begin chemical dependency,new text end or emotional disturbance.
All data collected, created, received, or maintained by the ombudsman are governed by
chapter 13 and other applicable law.

deleted text begin (f)deleted text endnew text begin (g)new text end Notwithstanding any law to the contrary, the ombudsman may subpoena a person
to appear, give testimony, or produce documents or other evidence that the ombudsman
considers relevant to a matter under inquiry. The ombudsman may petition the appropriate
court in Ramsey County to enforce the subpoena. A witness who is at a hearing or is part
of an investigation possesses the same privileges that a witness possesses in the courts or
under the law of this state. Data obtained from a person under this paragraph are private
data as defined in section 13.02, subdivision 12.

deleted text begin (g)deleted text endnew text begin (h)new text end The ombudsman may, at reasonable times in the course of conducting a review,
enter and view premises within the control of an agency, facility, or program.

deleted text begin (h)deleted text endnew text begin (i)new text end The ombudsman may attend Department of Human Services Review Board and
Special Review Board proceedings; proceedings regarding the transfer of clients, as defined
in section 246.50, subdivision 4, between institutions operated by the Department of Human
Services; and, subject to the consent of the affected client, other proceedings affecting the
rights of clients. The ombudsman is not required to obtain consent to attend meetings or
proceedings and have access to private data on clients with developmental disabilitiesnew text begin and
individuals served by the Minnesota sex offender program
new text end.

deleted text begin (i)deleted text endnew text begin (j)new text end The ombudsman shall gather data of agencies, facilities, or programs classified
as private or confidential as defined in section 13.02, subdivisions 3 and 12, regarding
services provided to clients with developmental disabilitiesnew text begin and individuals served by the
Minnesota sex offender program
new text end.

deleted text begin (j)deleted text endnew text begin (k)new text end To avoid duplication and preserve evidence, the ombudsman shall inform relevant
licensing or regulatory officials before undertaking a review of an action of the facility or
program.

new text begin (l) The Office of Ombudsman shall provide the services of the Civil Commitment
Training and Resource Center.
new text end

deleted text begin (k)deleted text endnew text begin (m)new text end The ombudsman shall monitor the treatment of individuals participating in a
University of Minnesota Department of Psychiatry clinical drug trial and ensure that all
protections for human subjects required by federal law and the Institutional Review Board
are provided.

deleted text begin (l)deleted text endnew text begin (n)new text end Sections 245.91 to 245.97 are in addition to other provisions of law under which
any other remedy or right is provided.

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 2016, section 245.97, subdivision 6, is amended to read:


Subd. 6.

Terms, compensation, and removal.

The membership terms, compensation,
and removal of members of the committee and the filling of membership vacancies are
governed by section deleted text begin15.0575deleted text endnew text begin 15.0597new 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. 12.

Minnesota Statutes 2016, section 245A.03, subdivision 2, is amended to read:


Subd. 2.

Exclusion from licensure.

(a) This chapter does not apply to:

(1) residential or nonresidential programs that are provided to a person by an individual
who is related unless the residential program is a child foster care placement made by a
local social services agency or a licensed child-placing agency, except as provided in
subdivision 2a;

(2) nonresidential programs that are provided by an unrelated individual to persons from
a single related family;

(3) residential or nonresidential programs that are provided to adults who do not deleted text beginabuse
chemicals or who do not have a chemical dependency
deleted text endnew text begin misuse substances or have a substance
use disorder
new text end, a mental illness, a developmental disability, a functional impairment, or a
physical disability;

(4) sheltered workshops or work activity programs that are certified by the commissioner
of employment and economic development;

(5) programs operated by a public school for children 33 months or older;

(6) nonresidential programs primarily for children that provide care or supervision for
periods of less than three hours a day while the child's parent or legal guardian is in the
same building as the nonresidential program or present within another building that is
directly contiguous to the building in which the nonresidential program is located;

(7) nursing homes or hospitals licensed by the commissioner of health except as specified
under section 245A.02;

(8) board and lodge facilities licensed by the commissioner of health that do not provide
children's residential services under Minnesota Rules, chapter 2960, mental health or chemical
dependency treatment;

(9) homes providing programs for persons placed by a county or a licensed agency for
legal adoption, unless the adoption is not completed within two years;

(10) programs licensed by the commissioner of corrections;

(11) recreation programs for children or adults that are operated or approved by a park
and recreation board whose primary purpose is to provide social and recreational activities;

(12) programs operated by a school as defined in section 120A.22, subdivision 4; YMCA
as defined in section 315.44; YWCA as defined in section 315.44; or JCC as defined in
section 315.51, whose primary purpose is to provide child care or services to school-age
children;

(13) Head Start nonresidential programs which operate for less than 45 days in each
calendar year;

(14) noncertified boarding care homes unless they provide services for five or more
persons whose primary diagnosis is mental illness or a developmental disability;

(15) programs for children such as scouting, boys clubs, girls clubs, and sports and art
programs, and nonresidential programs for children provided for a cumulative total of less
than 30 days in any 12-month period;

(16) residential programs for persons with mental illness, that are located in hospitals;

(17) the religious instruction of school-age children; Sabbath or Sunday schools; or the
congregate care of children by a church, congregation, or religious society during the period
used by the church, congregation, or religious society for its regular worship;

(18) camps licensed by the commissioner of health under Minnesota Rules, chapter
4630;

(19) mental health outpatient services for adults with mental illness or children with
emotional disturbance;

(20) residential programs serving school-age children whose sole purpose is cultural or
educational exchange, until the commissioner adopts appropriate rules;

(21) community support services programs as defined in section 245.462, subdivision
6
, and family community support services as defined in section 245.4871, subdivision 17;

(22) the placement of a child by a birth parent or legal guardian in a preadoptive home
for purposes of adoption as authorized by section 259.47;

(23) settings registered under chapter 144D which provide home care services licensed
by the commissioner of health to fewer than seven adults;

(24) deleted text beginchemical dependency ordeleted text end substance deleted text beginabusedeleted text endnew text begin use disordernew text end treatment activities of licensed
professionals in private practice as defined in deleted text beginMinnesota Rules, part 9530.6405, subpart 15,
when the treatment activities are not paid for by the consolidated chemical dependency
treatment fund
deleted text endnew text begin section 245G.01, subdivision 17new text end;

(25) consumer-directed community support service funded under the Medicaid waiver
for persons with developmental disabilities when the individual who provided the service
is:

(i) the same individual who is the direct payee of these specific waiver funds or paid by
a fiscal agent, fiscal intermediary, or employer of record; and

(ii) not otherwise under the control of a residential or nonresidential program that is
required to be licensed under this chapter when providing the service;

(26) a program serving only children who are age 33 months or older, that is operated
by a nonpublic school, for no more than four hours per day per child, with no more than 20
children at any one time, and that is accredited by:

(i) an accrediting agency that is formally recognized by the commissioner of education
as a nonpublic school accrediting organization; or

(ii) an accrediting agency that requires background studies and that receives and
investigates complaints about the services provided.

A program that asserts its exemption from licensure under item (ii) shall, upon request
from the commissioner, provide the commissioner with documentation from the accrediting
agency that verifies: that the accreditation is current; that the accrediting agency investigates
complaints about services; and that the accrediting agency's standards require background
studies on all people providing direct contact services; deleted text beginor
deleted text end

(27) a program operated by a nonprofit organization incorporated in Minnesota or another
state that serves youth in kindergarten through grade 12; provides structured, supervised
youth development activities; and has learning opportunities take place before or after
school, on weekends, or during the summer or other seasonal breaks in the school calendar.
A program exempt under this clause is not eligible for child care assistance under chapter
119B. A program exempt under this clause must:

(i) have a director or supervisor on site who is responsible for overseeing written policies
relating to the management and control of the daily activities of the program, ensuring the
health and safety of program participants, and supervising staff and volunteers;

(ii) have obtained written consent from a parent or legal guardian for each youth
participating in activities at the site; and

(iii) have provided written notice to a parent or legal guardian for each youth at the site
that the program is not licensed or supervised by the state of Minnesota and is not eligible
to receive child care assistance paymentsdeleted text begin.deleted text endnew text begin;
new text end

new text begin (28) a county that is an eligible vendor under section 254B.05 to provide care coordination
and comprehensive assessment services; or
new text end

new text begin (29) a recovery community organization that is an eligible vendor under section 254B.05
to provide peer recovery support services.
new text end

(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
building in which a nonresidential program is located if it shares a common wall with the
building in which the nonresidential program is located or is attached to that building by
skyway, tunnel, atrium, or common roof.

(c) Except for the home and community-based services identified in section 245D.03,
subdivision 1
, nothing in this chapter shall be construed to require licensure for any services
provided and funded according to an approved federal waiver plan where licensure is
specifically identified as not being a condition for the services and funding.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 13.

Minnesota Statutes 2016, section 245A.191, is amended to read:


245A.191 PROVIDER ELIGIBILITY FOR PAYMENTS FROM THE CHEMICAL
DEPENDENCY CONSOLIDATED TREATMENT FUND.

(a) When a deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end treatment provider licensed
under new text beginthis chapter, and governed by the standards of chapter 245G or new text endMinnesota Rules,
parts 2960.0430 to 2960.0490 deleted text beginor 9530.6405 to 9530.6505deleted text end, agrees to meet the applicable
requirements under section 254B.05, subdivision 5, deleted text beginparagraphs (b), clauses (1) to (4) and
(6), (c), and (e),
deleted text end to be eligible for enhanced funding from the chemical dependency
consolidated treatment fund, the applicable requirements under section 254B.05 are also
licensing requirements that may be monitored for compliance through licensing investigations
and licensing inspections.

(b) Noncompliance with the requirements identified under paragraph (a) may result in:

(1) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;

(2) nonpayment of claims submitted by the license holder for public program
reimbursement;

(3) recovery of payments made for the service;

(4) disenrollment in the public payment program; or

(5) other administrative, civil, or criminal penalties as provided by law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 14.

new text begin [245G.01] 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.
new text end

new text begin Subd. 2. new text end

new text begin Administration of medication. new text end

new text begin "Administration of medication" means providing
a medication to a client, and includes the following tasks, performed in the following order:
new text end

new text begin (1) checking the client'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 client;
new text end

new text begin (4) documenting the administration of the medication, or the reason for not administering
a medication as prescribed; and
new text end

new text begin (5) reporting information to a licensed practitioner or a nurse regarding a problem with
the administration of medication or the client's refusal to take the medication, if applicable.
new text end

new text begin Subd. 3. new text end

new text begin Adolescent. new text end

new text begin "Adolescent" means an individual under 18 years of age.
new text end

new text begin Subd. 4. new text end

new text begin Alcohol and drug counselor. new text end

new text begin "Alcohol and drug counselor" has the meaning
given in section 148F.01, subdivision 5.
new text end

new text begin Subd. 5. new text end

new text begin Applicant. new text end

new text begin "Applicant" has the meaning given in section 245A.02, subdivision
3.
new text end

new text begin Subd. 6. new text end

new text begin Capacity management system. new text end

new text begin "Capacity management system" means a
database maintained by the department to compile and make information available to the
public about the waiting list status and current admission capability of each opioid treatment
program.
new text end

new text begin Subd. 7. new text end

new text begin Central registry. new text end

new text begin "Central registry" means a database maintained by the
department to collect identifying information from two or more programs about an individual
applying for maintenance treatment or detoxification treatment for opioid addiction to
prevent an individual's concurrent enrollment in more than one program.
new text end

new text begin Subd. 8. new text end

new text begin Client. new text end

new text begin "Client" means an individual accepted by a license holder for assessment
or treatment of a substance use disorder. An individual remains a client until the license
holder no longer provides or intends to provide the individual with treatment service.
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 Co-occurring disorders. new text end

new text begin "Co-occurring disorders" means a diagnosis of both
a substance use disorder and a mental health disorder.
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 Direct contact. new text end

new text begin "Direct contact" has the meaning given for "direct contact"
in section 245C.02, subdivision 11.
new text end

new text begin Subd. 13. new text end

new text begin Face-to-face. new text end

new text begin "Face-to-face" means two-way, real-time, interactive and visual
communication between a client and a treatment service provider and includes services
delivered in person or via telemedicine.
new text end

new text begin Subd. 14. new text end

new text begin License. new text end

new text begin "License" has the meaning given in section 245A.02, subdivision 8.
new text end

new text begin Subd. 15. new text end

new text begin License holder. new text end

new text begin "License holder" has the meaning given in section 245A.02,
subdivision 9.
new text end

new text begin Subd. 16. new text end

new text begin Licensed practitioner. new text end

new text begin "Licensed practitioner" means an individual who is
authorized to prescribe medication as defined in section 151.01, subdivision 23.
new text end

new text begin Subd. 17. new text end

new text begin Licensed professional in private practice. new text end

new text begin "Licensed professional in private
practice" means an individual who:
new text end

new text begin (1) is licensed under chapter 148F, or is exempt from licensure under that chapter but
is otherwise licensed to provide alcohol and drug counseling services;
new text end

new text begin (2) practices solely within the permissible scope of the individual's license as defined
in the law authorizing licensure; and
new text end

new text begin (3) does not affiliate with other licensed or unlicensed professionals to provide alcohol
and drug counseling services. Affiliation does not include conferring with another
professional or making a client referral.
new text end

new text begin Subd. 18. new text end

new text begin Nurse. new text end

new text begin "Nurse" means an individual licensed and currently registered to
practice professional or practical nursing as defined in section 148.171, subdivisions 14 and
15.
new text end

new text begin Subd. 19. new text end

new text begin Opioid treatment program or OTP. new text end

new text begin "Opioid treatment program" or "OTP"
means a program or practitioner engaged in opioid treatment of an individual that provides
dispensing of an opioid agonist treatment medication, along with a comprehensive range
of medical and rehabilitative services, when clinically necessary, to an individual to alleviate
the adverse medical, psychological, or physical effects of an opioid addiction. OTP includes
detoxification treatment, short-term detoxification treatment, long-term detoxification
treatment, maintenance treatment, comprehensive maintenance treatment, and interim
maintenance treatment.
new text end

new text begin Subd. 20. new text end

new text begin Paraprofessional. new text end

new text begin "Paraprofessional" means an employee, agent, or
independent contractor of the license holder who performs tasks to support treatment service.
A paraprofessional may be referred to by a variety of titles including but not limited to
technician, case aide, or counselor assistant. If currently a client of the license holder, the
client cannot be a paraprofessional for the license holder.
new text end

new text begin Subd. 21. new text end

new text begin Student intern. new text end

new text begin "Student intern" means an individual who is authorized by a
licensing board to provide services under supervision of a licensed professional.
new text end

new text begin Subd. 22. new text end

new text begin Substance. new text end

new text begin "Substance" 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. 23. new text end

new text begin Substance use disorder. new text end

new text begin "Substance use disorder" has the meaning given in
the current Diagnostic and Statistical Manual of Mental Disorders.
new text end

new text begin Subd. 24. new text end

new text begin Substance use disorder treatment. new text end

new text begin "Substance use disorder treatment" means
treatment of a substance use disorder, including the process of assessment of a client's needs,
development of planned methods, including interventions or services to address a client's
needs, provision of services, facilitation of services provided by other service providers,
and ongoing reassessment by a qualified professional when indicated. The goal of substance
use disorder treatment is to assist or support the client's efforts to recover from a substance
use disorder.
new text end

new text begin Subd. 25. new text end

new text begin Target population. new text end

new text begin "Target population" means individuals with a substance
use disorder and the specified characteristics that a license holder proposes to serve.
new text end

new text begin Subd. 26. new text end

new text begin Telemedicine. new text end

new text begin "Telemedicine" means the delivery of a substance use disorder
treatment service while the client is at an originating site and the licensed health care provider
is at a distant site as specified in section 254B.05, subdivision 5, paragraph (f).
new text end

new text begin Subd. 27. new text end

new text begin Treatment director. new text end

new text begin "Treatment director" means an individual who meets
the qualifications specified in section 245G.11, subdivisions 1 and 3, and is designated by
the license holder to be responsible for all aspects of the delivery of treatment service.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 15.

new text begin [245G.02] APPLICABILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin Except as provided in subdivisions 2 and 3, no person,
corporation, partnership, voluntary association, controlling individual, or other organization
may provide a substance use disorder treatment service to an individual with a substance
use disorder unless licensed by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Exemption from license requirement. new text end

new text begin This chapter does not apply to a county
or recovery community organization that is providing a service for which the county or
recovery community organization is an eligible vendor under section 254B.05. This chapter
does not apply to an organization whose primary functions are information, referral,
diagnosis, case management, and assessment for the purposes of client placement, education,
support group services, or self-help programs. This chapter does not apply to the activities
of a licensed professional in private practice.
new text end

new text begin Subd. 3. new text end

new text begin Excluded hospitals. new text end

new text begin This chapter does not apply to substance use disorder
treatment provided by a hospital licensed under chapter 62J, or under sections 144.50 to
144.56, unless the hospital accepts funds for substance use disorder treatment from the
consolidated chemical dependency treatment fund under chapter 254B, medical assistance
under chapter 256B, or MinnesotaCare or health care cost containment under chapter 256L,
or general assistance medical care formerly codified in chapter 256D.
new text end

new text begin Subd. 4. new text end

new text begin Applicability of Minnesota Rules, chapter 2960. new text end

new text begin A residential adolescent
substance use disorder treatment program serving an individual younger than 16 years of
age must be licensed according to Minnesota Rules, chapter 2960.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 16.

new text begin [245G.03] LICENSING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin License requirements. new text end

new text begin (a) An applicant for a license to provide substance
use disorder treatment must comply with the general requirements in chapters 245A and
245C, sections 626.556 and 626.557, and Minnesota Rules, chapter 9544.
new text end

new text begin (b) The commissioner may grant variances to the requirements in this chapter that do
not affect the client's health or safety if the conditions in section 245A.04, subdivision 9,
are met.
new text end

new text begin Subd. 2. new text end

new text begin Application. new text end

new text begin Before the commissioner issues a license, an applicant must
submit, on forms provided by the commissioner, any documents the commissioner requires.
new text end

new text begin Subd. 3. new text end

new text begin Change in license terms. new text end

new text begin (a) The commissioner must determine whether a
new license is needed when a change in clauses (1) to (4) occurs. A license holder must
notify the commissioner before a change in one of the following occurs:
new text end

new text begin (1) the Department of Health's licensure of the program;
new text end

new text begin (2) whether the license holder provides services specified in sections 245G.18 to 245G.22;
new text end

new text begin (3) location; or
new text end

new text begin (4) capacity if the license holder meets the requirements of section 245G.21.
new text end

new text begin (b) A license holder must notify the commissioner and must apply for a new license if
there is a change in program ownership.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 17.

new text begin [245G.04] INITIAL SERVICES PLAN.
new text end

new text begin (a) The license holder must complete an initial services plan on the day of service
initiation. The plan must address the client's immediate health and safety concerns, identify
the needs to be addressed in the first treatment session, and make treatment suggestions for
the client during the time between intake and completion of the individual treatment plan.
new text end

new text begin (b) The initial services plan must include a determination of whether a client is a
vulnerable adult as defined in section 626.5572, subdivision 21. An adult client of a
residential program is a vulnerable adult. An individual abuse prevention plan, according
to sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph
(b), is required for a client who meets the definition of vulnerable adult.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 18.

new text begin [245G.05] COMPREHENSIVE ASSESSMENT AND ASSESSMENT
SUMMARY.
new text end

new text begin Subdivision 1. new text end

new text begin Comprehensive assessment. new text end

new text begin (a) A comprehensive assessment of the
client's substance use disorder must be administered face-to-face by an alcohol and drug
counselor within three calendar days after service initiation for a residential program or
during the initial session for all other programs. If the comprehensive assessment is not
completed during the initial session, the client-centered reason for the delay must be
documented in the client's file and the planned completion date. If the client received a
comprehensive assessment that authorized the treatment service, an alcohol and drug
counselor must review the assessment to determine compliance with this subdivision,
including applicable timelines. If available, the alcohol and drug counselor may use current
information provided by a referring agency or other source as a supplement. Information
gathered more than 45 days before the date of admission is not considered current. The
comprehensive assessment must include sufficient information to complete the assessment
summary according to subdivision 2 and the individual treatment plan according to section
245G.06. The comprehensive assessment must include information about the client's needs
that relate to substance use and personal strengths that support recovery, including:
new text end

new text begin (1) age, sex, cultural background, sexual orientation, living situation, economic status,
and level of education;
new text end

new text begin (2) circumstances of service initiation;
new text end

new text begin (3) previous attempts at treatment for substance misuse or substance use disorder,
compulsive gambling, or mental illness;
new text end

new text begin (4) substance use history including amounts and types of substances used, frequency
and duration of use, periods of abstinence, and circumstances of relapse, if any. For each
substance used within the previous 30 days, the information must include the date of the
most recent use and previous withdrawal symptoms;
new text end

new text begin (5) specific problem behaviors exhibited by the client when under the influence of
substances;
new text end

new text begin (6) family status, family history, including history or presence of physical or sexual
abuse, level of family support, and substance misuse or substance use disorder of a family
member or significant other;
new text end

new text begin (7) physical concerns or diagnoses, the severity of the concerns, and whether the concerns
are being addressed by a health care professional;
new text end

new text begin (8) mental health history and psychiatric status, including symptoms, disability, current
treatment supports, and psychotropic medication needed to maintain stability; the assessment
must utilize screening tools approved by the commissioner pursuant to section 245.4863 to
identify whether the client screens positive for co-occurring disorders;
new text end

new text begin (9) arrests and legal interventions related to substance use;
new text end

new text begin (10) ability to function appropriately in work and educational settings;
new text end

new text begin (11) ability to understand written treatment materials, including rules and the client's
rights;
new text end

new text begin (12) risk-taking behavior, including behavior that puts the client at risk of exposure to
blood-borne or sexually transmitted diseases;
new text end

new text begin (13) social network in relation to expected support for recovery and leisure time activities
that are associated with substance use;
new text end

new text begin (14) whether the client is pregnant and, if so, the health of the unborn child and the
client's current involvement in prenatal care;
new text end

new text begin (15) whether the client recognizes problems related to substance use and is willing to
follow treatment recommendations; and
new text end

new text begin (16) collateral information. If the assessor gathered sufficient information from the
referral source or the client to apply the criteria in parts 9530.6620 and 9530.6622, a collateral
contact is not required.
new text end

new text begin (b) If the client is identified as having opioid use disorder or seeking treatment for opioid
use disorder, the program must provide educational information to the client concerning:
new text end

new text begin (1) risks for opioid use disorder and dependence;
new text end

new text begin (2) treatment options, including the use of a medication for opioid use disorder;
new text end

new text begin (3) the risk of and recognizing opioid overdose; and
new text end

new text begin (4) the use, availability, and administration of naloxone to respond to opioid overdose.
new text end

new text begin (c) The commissioner shall develop educational materials that are supported by research
and updated periodically. The license holder must use the educational materials that are
approved by the commissioner to comply with this requirement.
new text end

new text begin (d) If the comprehensive assessment is completed to authorize treatment service for the
client, at the earliest opportunity during the assessment interview the assessor shall determine
if:
new text end

new text begin (1) the client is in severe withdrawal and likely to be a danger to self or others;
new text end

new text begin (2) the client has severe medical problems that require immediate attention; or
new text end

new text begin (3) the client has severe emotional or behavioral symptoms that place the client or others
at risk of harm.
new text end

new text begin If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the
assessment interview and follow the procedures in the program's medical services plan
under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The
assessment interview may resume when the condition is resolved.
new text end

new text begin Subd. 2. new text end

new text begin Assessment summary. new text end

new text begin (a) An alcohol and drug counselor must complete an
assessment summary within three calendar days after service initiation for a residential
program and within three sessions for all other programs. If the comprehensive assessment
is used to authorize the treatment service, the alcohol and drug counselor must prepare an
assessment summary on the same date the comprehensive assessment is completed. If the
comprehensive assessment and assessment summary are to authorize treatment services,
the assessor must determine appropriate services for the client using the dimensions in
Minnesota Rules, part 9530.6622, and document the recommendations.
new text end

new text begin (b) An assessment summary must include:
new text end

new text begin (1) a risk description according to section 245G.05 for each dimension listed in paragraph
(c);
new text end

new text begin (2) a narrative summary supporting the risk descriptions; and
new text end

new text begin (3) a determination of whether the client has a substance use disorder.
new text end

new text begin (c) An assessment summary must contain information relevant to treatment service
planning and recorded in the dimensions in clauses (1) to (6). The license holder must
consider:
new text end

new text begin (1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with
withdrawal symptoms and current state of intoxication;
new text end

new text begin (2) Dimension 2, biomedical conditions and complications; the degree to which any
physical disorder of the client would interfere with treatment for substance use, and the
client's ability to tolerate any related discomfort. The license holder must determine the
impact of continued chemical use on the unborn child, if the client is pregnant;
new text end

new text begin (3) Dimension 3, emotional, behavioral, and cognitive conditions and complications;
the degree to which any condition or complication is likely to interfere with treatment for
substance use or with functioning in significant life areas and the likelihood of harm to self
or others;
new text end

new text begin (4) Dimension 4, readiness for change; the support necessary to keep the client involved
in treatment service;
new text end

new text begin (5) Dimension 5, relapse, continued use, and continued problem potential; the degree
to which the client recognizes relapse issues and has the skills to prevent relapse of either
substance use or mental health problems; and
new text end

new text begin (6) Dimension 6, recovery environment; whether the areas of the client's life are
supportive of or antagonistic to treatment participation and recovery.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 19.

new text begin [245G.06] INDIVIDUAL TREATMENT PLAN.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin Each client must have an individual treatment plan developed
by an alcohol and drug counselor within seven days of service initiation for a residential
program and within three sessions for all other programs. The client must have active, direct
involvement in selecting the anticipated outcomes of the treatment process and developing
the treatment plan. The individual treatment plan must be signed by the client and the alcohol
and drug counselor and document the client's involvement in the development of the plan.
The plan may be a continuation of the initial services plan required in section 245G.04.
Treatment planning must include ongoing assessment of client needs. An individual treatment
plan must be updated based on new information gathered about the client's condition and
on whether methods identified have the intended effect. A change to the plan must be signed
by the client and the alcohol and drug counselor. The plan must provide for the involvement
of the client's family and people selected by the client as important to the success of treatment
at the earliest opportunity, consistent with the client's treatment needs and written consent.
new text end

new text begin Subd. 2. new text end

new text begin Plan contents. new text end

new text begin An individual treatment plan must be recorded in the six
dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue
identified in the assessment summary, prioritized according to the client's needs and focus,
and must include:
new text end

new text begin (1) specific methods to address each identified need, including amount, frequency, and
anticipated duration of treatment service. The methods must be appropriate to the client's
language, reading skills, cultural background, and strengths;
new text end

new text begin (2) resources to refer the client to when the client's needs are to be addressed concurrently
by another provider; and
new text end

new text begin (3) goals the client must reach to complete treatment and terminate services.
new text end

new text begin Subd. 3. new text end

new text begin Documentation of treatment services; treatment plan review. new text end

new text begin (a) A review
of all treatment services must be documented weekly and include a review of:
new text end

new text begin (1) care coordination activities;
new text end

new text begin (2) medical and other appointments the client attended;
new text end

new text begin (3) issues related to medications that are not documented in the medication administration
record; and
new text end

new text begin (4) issues related to attendance for treatment services, including the reason for any client
absence from a treatment service.
new text end

new text begin (b) A note must be entered immediately following any significant event. A significant
event is an event that impacts the client's relationship with other clients, staff, the client's
family, or the client's treatment plan.
new text end

new text begin (c) A treatment plan review must be entered in a client's file weekly or after each treatment
service, whichever is less frequent, by the staff member providing the service. The review
must indicate the span of time covered by the review and each of the six dimensions listed
in section 245G.05, subdivision 2, paragraph (c). The review must:
new text end

new text begin (1) indicate the date, type, and amount of each treatment service provided and the client's
response to each service;
new text end

new text begin (2) address each goal in the treatment plan and whether the methods to address the goals
are effective;
new text end

new text begin (3) include monitoring of any physical and mental health problems;
new text end

new text begin (4) document the participation of others;
new text end

new text begin (5) document staff recommendations for changes in the methods identified in the treatment
plan and whether the client agrees with the change; and
new text end

new text begin (6) include a review and evaluation of the individual abuse prevention plan according
to section 245A.65.
new text end

new text begin (d) Each entry in a client's record must be accurate, legible, signed, and dated. A late
entry must be clearly labeled "late entry." A correction to an entry must be made in a way
in which the original entry can still be read.
new text end

new text begin Subd. 4. new text end

new text begin Service discharge summary. new text end

new text begin (a) An alcohol and drug counselor must write a
discharge summary for each client. The summary must be completed within five days of
the client's service termination or within five days from the client's or program's decision
to terminate services, whichever is earlier.
new text end

new text begin (b) The service discharge summary must be recorded in the six dimensions listed in
section 245G.05, subdivision 2, paragraph (c), and include the following information:
new text end

new text begin (1) the client's issues, strengths, and needs while participating in treatment, including
services provided;
new text end

new text begin (2) the client's progress toward achieving each goal identified in the individual treatment
plan;
new text end

new text begin (3) a risk description according to section 245G.05; and
new text end

new text begin (4) the reasons for and circumstances of service termination. If a program discharges a
client at staff request, the reason for discharge and the procedure followed for the decision
to discharge must be documented and comply with the program's policies on staff-initiated
client discharge. If a client is discharged at staff request, the program must give the client
crisis and other referrals appropriate for the client's needs and offer assistance to the client
to access the services.
new text end

new text begin (c) For a client who successfully completes treatment, the summary must also include:
new text end

new text begin (1) the client's living arrangements at service termination;
new text end

new text begin (2) continuing care recommendations, including transitions between more or less intense
services, or more frequent to less frequent services, and referrals made with specific attention
to continuity of care for mental health, as needed;
new text end

new text begin (3) service termination diagnosis; and
new text end

new text begin (4) the client's prognosis.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 20.

new text begin [245G.07] TREATMENT SERVICE.
new text end

new text begin Subdivision 1. new text end

new text begin Treatment service. new text end

new text begin (a) A license holder must offer the following treatment
services, unless clinically inappropriate and the justifying clinical rationale is documented:
new text end

new text begin (1) individual and group counseling to help the client identify and address needs related
to substance use and develop strategies to avoid harmful substance use after discharge and
to help the client obtain the services necessary to establish a lifestyle free of the harmful
effects of substance use disorder;
new text end

new text begin (2) client education strategies to avoid inappropriate substance use and health problems
related to substance use and the necessary lifestyle changes to regain and maintain health.
Client education must include information on tuberculosis education on a form approved
by the commissioner, the human immunodeficiency virus according to section 245A.19,
other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis.
A licensed alcohol and drug counselor must be present during an educational group;
new text end

new text begin (3) a service to help the client integrate gains made during treatment into daily living
and to reduce the client's reliance on a staff member for support;
new text end

new text begin (4) a service to address issues related to co-occurring disorders, including client education
on symptoms of mental illness, the possibility of comorbidity, and the need for continued
medication compliance while recovering from substance use disorder. A group must address
co-occurring disorders, as needed. When treatment for mental health problems is indicated,
the treatment must be integrated into the client's individual treatment plan;
new text end

new text begin (5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support
services provided one-to-one by an individual in recovery. Peer support services include
education, advocacy, mentoring through self-disclosure of personal recovery experiences,
attending recovery and other support groups with a client, accompanying the client to
appointments that support recovery, assistance accessing resources to obtain housing,
employment, education, and advocacy services, and nonclinical recovery support to assist
the transition from treatment into the recovery community; and
new text end

new text begin (6) on July 1, 2018, or upon federal approval, whichever is later, care coordination
provided by an individual who meets the staff qualifications in section 245G.11, subdivision
7. Care coordination services include:
new text end

new text begin (i) assistance in coordination with significant others to help in the treatment planning
process whenever possible;
new text end

new text begin (ii) assistance in coordination with and follow up for medical services as identified in
the treatment plan;
new text end

new text begin (iii) facilitation of referrals to substance use disorder services as indicated by a client's
medical provider, comprehensive assessment, or treatment plan;
new text end

new text begin (iv) facilitation of referrals to mental health services as identified by a client's
comprehensive assessment or treatment plan;
new text end

new text begin (v) assistance with referrals to economic assistance, social services, housing resources,
and prenatal care according to the client's needs;
new text end

new text begin (vi) life skills advocacy and support accessing treatment follow-up, disease management,
and education services, including referral and linkages to long-term services and supports
as needed; and
new text end

new text begin (vii) documentation of the provision of care coordination services in the client's file.
new text end

new text begin (b) A treatment service provided to a client must be provided according to the individual
treatment plan and must consider cultural differences and special needs of a client.
new text end

new text begin Subd. 2. new text end

new text begin Additional treatment service. new text end

new text begin A license holder may provide or arrange the
following additional treatment service as a part of the client's individual treatment plan:
new text end

new text begin (1) relationship counseling provided by a qualified professional to help the client identify
the impact of the client's substance use disorder on others and to help the client and persons
in the client's support structure identify and change behaviors that contribute to the client's
substance use disorder;
new text end

new text begin (2) therapeutic recreation to allow the client to participate in recreational activities
without the use of mood-altering chemicals and to plan and select leisure activities that do
not involve the inappropriate use of chemicals;
new text end

new text begin (3) stress management and physical well-being to help the client reach and maintain an
appropriate level of health, physical fitness, and well-being;
new text end

new text begin (4) living skills development to help the client learn basic skills necessary for independent
living;
new text end

new text begin (5) employment or educational services to help the client become financially independent;
new text end

new text begin (6) socialization skills development to help the client live and interact with others in a
positive and productive manner; and
new text end

new text begin (7) room, board, and supervision at the treatment site to provide the client with a safe
and appropriate environment to gain and practice new skills.
new text end

new text begin Subd. 3. new text end

new text begin Counselors. new text end

new text begin A treatment service, including therapeutic recreation, must be
provided by an alcohol and drug counselor according to section 245G.11, unless the
individual providing the service is specifically qualified according to the accepted credential
required to provide the service. Therapeutic recreation does not include planned leisure
activities.
new text end

new text begin Subd. 4. new text end

new text begin Location of service provision. new text end

new text begin The license holder may provide services at any
of the license holder's licensed locations or at another suitable location including a school,
government building, medical or behavioral health facility, or social service organization,
upon notification and approval of the commissioner. If services are provided off site from
the licensed site, the reason for the provision of services remotely must be documented.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 21.

new text begin [245G.08] MEDICAL SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Health care services. new text end

new text begin An applicant or license holder must maintain a
complete description of the health care services, nursing services, dietary services, and
emergency physician services offered by the applicant or license holder.
new text end

new text begin Subd. 2. new text end

new text begin Procedures. new text end

new text begin The applicant or license holder must have written procedures for
obtaining a medical intervention for a client, that are approved in writing by a physician
who is licensed under chapter 147, unless:
new text end

new text begin (1) the license holder does not provide a service under section 245G.21; and
new text end

new text begin (2) a medical intervention is referred to 911, the emergency telephone number, or the
client's physician.
new text end

new text begin Subd. 3. new text end

new text begin Standing order protocol. new text end

new text begin A license holder that maintains a supply of naloxone
available for emergency treatment of opioid overdose must have a written standing order
protocol by a physician who is licensed under chapter 147, that permits the license holder
to maintain a supply of naloxone on site, and must require staff to undergo specific training
in administration of naloxone.
new text end

new text begin Subd. 4. new text end

new text begin Consultation services. new text end

new text begin The license holder must have access to and document
the availability of a licensed mental health professional to provide diagnostic assessment
and treatment planning assistance.
new text end

new text begin Subd. 5. new text end

new text begin Administration of medication and assistance with self-medication. new text end

new text begin (a) A
license holder must meet the requirements in this subdivision if a service provided includes
the administration of medication.
new text end

new text begin (b) A staff member, other than a licensed practitioner or nurse, who is delegated by a
licensed practitioner or a registered nurse the task of administration of medication or assisting
with self-medication, must:
new text end

new text begin (1) successfully complete a medication administration training program for unlicensed
personnel through an accredited Minnesota postsecondary educational institution. A staff
member's completion of the course must be documented in writing and placed in the staff
member's personnel file;
new text end

new text begin (2) be trained according to a formalized training program that is taught by a registered
nurse and offered by the license holder. The training must include the process for
administration of naloxone, if naloxone is kept on site. A staff member's completion of the
training must be documented in writing and placed in the staff member's personnel records;
or
new text end

new text begin (3) demonstrate to a registered nurse competency to perform the delegated activity. A
registered nurse must be employed or contracted to develop the policies and procedures for
administration of medication or assisting with self-administration of medication, or both.
new text end

new text begin (c) A registered nurse must provide supervision as defined in section 148.171, subdivision
23. The registered nurse's supervision must include, at a minimum, monthly on-site
supervision or more often if warranted by a client's health needs. The policies and procedures
must include:
new text end

new text begin (1) a provision that a delegation of administration of medication is limited to the
administration of a medication that is administered orally, topically, or as a suppository, an
eye drop, an ear drop, or an inhalant;
new text end

new text begin (2) a provision that each client's file must include documentation indicating whether
staff must conduct the administration of medication or the client must self-administer
medication, or both;
new text end

new text begin (3) a provision that a client may carry emergency medication such as nitroglycerin as
instructed by the client's physician;
new text end

new text begin (4) a provision for the client to self-administer medication when a client is scheduled to
be away from the facility;
new text end

new text begin (5) a provision that if a client self-administers medication when the client is present in
the facility, the client must self-administer medication under the observation of a trained
staff member;
new text end

new text begin (6) a provision that when a license holder serves a client who is a parent with a child,
the parent may only administer medication to the child under a staff member's supervision;
new text end

new text begin (7) requirements for recording the client's use of medication, including staff signatures
with date and time;
new text end

new text begin (8) guidelines for when to inform a nurse of problems with self-administration of
medication, including a client's failure to administer, refusal of a medication, adverse
reaction, or error; and
new text end

new text begin (9) procedures for acceptance, documentation, and implementation of a prescription,
whether written, verbal, telephonic, or electronic.
new text end

new text begin Subd. 6. new text end

new text begin Control of drugs. new text end

new text begin A license holder must have and implement written policies
and procedures developed by a registered nurse that contain:
new text end

new text begin (1) a requirement that each drug must be stored in a locked compartment. A Schedule
II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked
compartment, permanently affixed to the physical plant or medication cart;
new text end

new text begin (2) a system which accounts for all scheduled drugs each shift;
new text end

new text begin (3) a procedure for recording the client's use of medication, including the signature of
the staff member who completed the administration of the medication with the time and
date;
new text end

new text begin (4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
new text end

new text begin (5) a statement that only authorized personnel are permitted access to the keys to a locked
compartment;
new text end

new text begin (6) a statement that no legend drug supply for one client shall be given to another client;
and
new text end

new text begin (7) a procedure for monitoring the available supply of naloxone on site, replenishing
the naloxone supply when needed, and destroying naloxone according to clause (4).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 22.

new text begin [245G.09] CLIENT RECORDS.
new text end

new text begin Subdivision 1. new text end

new text begin Client records required. new text end

new text begin (a) A license holder must maintain a file of
current and accurate client records on the premises where the treatment service is provided
or coordinated. For services provided off site, client records must be available at the program
and adhere to the same clinical and administrative policies and procedures as services
provided on site. The content and format of client records must be uniform and entries in
each record must be signed and dated by the staff member making the entry. Client records
must be protected against loss, tampering, or unauthorized disclosure according to section
254A.09, chapter 13, and Code of Federal Regulations, title 42, chapter 1, part 2, subpart
B, sections 2.1 to 2.67, and title 45, parts 160 to 164.
new text end

new text begin (b) The program must have a policy and procedure that identifies how the program will
track and record client attendance at treatment activities, including the date, duration, and
nature of each treatment service provided to the client.
new text end

new text begin Subd. 2. new text end

new text begin Record retention. new text end

new text begin The client records of a discharged client must be retained
by a license holder for seven years. A license holder that ceases to provide treatment service
must retain client records for seven years from the date of facility closure and must notify
the commissioner of the location of the client records and the name of the individual
responsible for maintaining the client's records.
new text end

new text begin Subd. 3. new text end

new text begin Contents. new text end

new text begin Client records must contain the following:
new text end

new text begin (1) documentation that the client was given information on client rights and
responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
an orientation to the program abuse prevention plan required under section 245A.65,
subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record
must contain documentation that the client was provided educational information according
to section 245G.05, subdivision 1, paragraph (b);
new text end

new text begin (2) an initial services plan completed according to section 245G.04;
new text end

new text begin (3) a comprehensive assessment completed according to section 245G.05;
new text end

new text begin (4) an assessment summary completed according to section 245G.05, subdivision 2;
new text end

new text begin (5) an individual abuse prevention plan according to sections 245A.65, subdivision 2,
and 626.557, subdivision 14, when applicable;
new text end

new text begin (6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;
new text end

new text begin (7) documentation of treatment services and treatment plan review according to section
245G.06, subdivision 3; and
new text end

new text begin (8) a summary at the time of service termination according to section 245G.06,
subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 23.

new text begin [245G.10] STAFF REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Treatment director. new text end

new text begin A license holder must have a treatment director.
new text end

new text begin Subd. 2. new text end

new text begin Alcohol and drug counselor supervisor. new text end

new text begin A license holder must employ an
alcohol and drug counselor supervisor who meets the requirements of section 245G.11,
subdivision 4. An individual may be simultaneously employed as a treatment director,
alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual
meets the qualifications for each position. If an alcohol and drug counselor is simultaneously
employed as an alcohol and drug counselor supervisor or treatment director, that individual
must be considered a 0.5 full-time equivalent alcohol and drug counselor for staff
requirements under subdivision 4.
new text end

new text begin Subd. 3. new text end

new text begin Responsible staff member. new text end

new text begin A treatment director must designate a staff member
who, when present in the facility, is responsible for the delivery of treatment service. A
license holder must have a designated staff member during all hours of operation. A license
holder providing room and board and treatment at the same site must have a responsible
staff member on duty 24 hours a day. The designated staff member must know and understand
the implications of this chapter and sections 245A.65, 626.556, 626.557, and 626.5572.
new text end

new text begin Subd. 4. new text end

new text begin Staff requirement. new text end

new text begin It is the responsibility of the license holder to determine
an acceptable group size based on each client's needs except that treatment services provided
in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not
supervise more than 50 clients. The license holder must maintain a record that documents
compliance with this subdivision.
new text end

new text begin Subd. 5. new text end

new text begin Medical emergency. new text end

new text begin When a client is present, a license holder must have at
least one staff member on the premises who has a current American Red Cross standard
first aid certificate or an equivalent certificate and at least one staff member on the premises
who has a current American Red Cross community, American Heart Association, or
equivalent CPR certificate. A single staff member with both certifications satisfies this
requirement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 24.

new text begin [245G.11] STAFF QUALIFICATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin General qualifications. new text end

new text begin (a) All staff members who have direct contact
must be 18 years of age or older. At the time of employment, each staff member must meet
the qualifications in this subdivision. For purposes of this subdivision, "problematic substance
use" means a behavior or incident listed by the license holder in the personnel policies and
procedures according to section 245G.13, subdivision 1, clause (5).
new text end

new text begin (b) A treatment director, supervisor, nurse, counselor, student intern, or other professional
must be free of problematic substance use for at least the two years immediately preceding
employment and must sign a statement attesting to that fact.
new text end

new text begin (c) A paraprofessional, recovery peer, or any other staff member with direct contact
must be free of problematic substance use for at least one year immediately preceding
employment and must sign a statement attesting to that fact.
new text end

new text begin Subd. 2. new text end

new text begin Employment; prohibition on problematic substance use. new text end

new text begin A staff member
with direct contact must be free from problematic substance use as a condition of
employment, but is not required to sign additional statements. A staff member with direct
contact who is not free from problematic substance use must be removed from any
responsibilities that include direct contact for the time period specified in subdivision 1.
The time period begins to run on the date of the last incident of problematic substance use
as described in the facility's policies and procedures according to section 245G.13,
subdivision 1, clause (5).
new text end

new text begin Subd. 3. new text end

new text begin Treatment directors. new text end

new text begin A treatment director must:
new text end

new text begin (1) have at least one year of work experience in direct service to an individual with
substance use disorder or one year of work experience in the management or administration
of direct service to an individual with substance use disorder;
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 implications of this chapter, chapter 245A, and sections
626.556, 626.557, and 626.5572. Demonstration of the treatment director's knowledge must
be documented in the personnel record.
new text end

new text begin Subd. 4. new text end

new text begin Alcohol and drug counselor supervisors. new text end

new text begin An alcohol and drug counselor
supervisor must:
new text end

new text begin (1) meet the qualification requirements in subdivision 5;
new text end

new text begin (2) have three or more years of experience providing individual and group counseling
to individuals with substance use disorder; and
new text end

new text begin (3) know and understand the implications of this chapter and sections 245A.65, 626.556,
626.557, and 626.5572.
new text end

new text begin Subd. 5. new text end

new text begin Alcohol and drug counselor qualifications. new text end

new text begin (a) An alcohol and drug counselor
must either be licensed or exempt from licensure under chapter 148F.
new text end

new text begin (b) An individual who is exempt from licensure under chapter 148F, must meet one of
the following additional requirements:
new text end

new text begin (1) completion of at least a baccalaureate degree with a major or concentration in social
work, nursing, sociology, human services, or psychology, or licensure as a registered nurse;
successful completion of a minimum of 120 hours of classroom instruction in which each
of the core functions listed in chapter 148F is covered; and successful completion of 440
hours of supervised experience as an alcohol and drug counselor, either as a student or a
staff member;
new text end

new text begin (2) completion of at least 270 hours of drug counselor training in which each of the core
functions listed in chapter 148F is covered, and successful completion of 880 hours of
supervised experience as an alcohol and drug counselor, either as a student or as a staff
member;
new text end

new text begin (3) current certification as an alcohol and drug counselor or alcohol and drug counselor
reciprocal, through the evaluation process established by the International Certification and
Reciprocity Consortium Alcohol and Other Drug Abuse, Inc.;
new text end

new text begin (4) completion of a bachelor's degree including 480 hours of alcohol and drug counseling
education from an accredited school or educational program and 880 hours of alcohol and
drug counseling practicum; or
new text end

new text begin (5) employment in a program formerly licensed under Minnesota Rules, parts 9530.5000
to 9530.6400, and successful completion of 6,000 hours of supervised work experience in
a licensed program as an alcohol and drug counselor prior to January 1, 2005.
new text end

new text begin (c) An alcohol and drug counselor may not provide a treatment service that requires
professional licensure unless the individual possesses the necessary license. For the purposes
of enforcing this section, the commissioner has the authority to monitor a service provider's
compliance with the relevant standards of the service provider's profession and may issue
licensing actions against the license holder according to sections 245A.05, 245A.06, and
245A.07, based on the commissioner's determination of noncompliance.
new text end

new text begin Subd. 6. new text end

new text begin Paraprofessionals. new text end

new text begin A paraprofessional must have knowledge of client rights,
according to section 148F.165, and staff member responsibilities. A paraprofessional may
not admit, transfer, or discharge a client but may be responsible for the delivery of treatment
service according to section 245G.10, subdivision 3.
new text end

new text begin Subd. 7. new text end

new text begin Care coordination provider qualifications. new text end

new text begin (a) Care coordination must be
provided by qualified staff. An individual is qualified to provide care coordination if the
individual:
new text end

new text begin (1) is skilled in the process of identifying and assessing a wide range of client needs;
new text end

new text begin (2) is knowledgeable about local community resources and how to use those resources
for the benefit of the client;
new text end

new text begin (3) has successfully completed 30 hours of classroom instruction on care coordination
for an individual with substance use disorder;
new text end

new text begin (4) has either:
new text end

new text begin (i) a bachelor's degree in one of the behavioral sciences or related fields; or
new text end

new text begin (ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest
Indian Council on Addictive Disorders; and
new text end

new text begin (5) has at least 2,000 hours of supervised experience working with individuals with
substance use disorder.
new text end

new text begin (b) A care coordinator must receive at least one hour of supervision regarding individual
service delivery from an alcohol and drug counselor weekly.
new text end

new text begin Subd. 8. new text end

new text begin Recovery peer qualifications. new text end

new text begin A recovery peer must:
new text end

new text begin (1) 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) hold a current credential from a certification body approved by the commissioner
that demonstrates 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 ongoing supervision in areas specific to the domains of the recovery peer's
role by an alcohol and drug counselor or an individual with a certification approved by the
commissioner.
new text end

new text begin Subd. 9. new text end

new text begin Volunteers. new text end

new text begin A volunteer may provide treatment service when the volunteer is
supervised and can be seen or heard by a staff member meeting the criteria in subdivision
4 or 5, but may not practice alcohol and drug counseling unless qualified under subdivision
5.
new text end

new text begin Subd. 10. new text end

new text begin Student interns. new text end

new text begin A qualified staff member must supervise and be responsible
for a treatment service performed by a student intern and must review and sign each
assessment, progress note, and individual treatment plan prepared by a student intern. A
student intern must receive the orientation and training required in section 245G.13,
subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment staff may be
students or licensing candidates with time documented to be directly related to the provision
of treatment services for which the staff are authorized.
new text end

new text begin Subd. 11. new text end

new text begin Individuals with temporary permit. new text end

new text begin An individual with a temporary permit
from the Board of Behavioral Health and Therapy may provide chemical dependency
treatment service according to this subdivision if they meet the requirements of either
paragraph (a) or (b).
new text end

new text begin (a) An individual with a temporary permit must be supervised by a licensed alcohol and
drug counselor assigned by the license holder. The supervising licensed alcohol and drug
counselor must document the amount and type of supervision provided at least on a weekly
basis. The supervision must relate to the clinical practice.
new text end

new text begin (b) An individual with a temporary permit must be supervised by a clinical supervisor
approved by the Board of Behavioral Health and Therapy. The supervision must be
documented and meet the requirements of section 148F.04, subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 25.

new text begin [245G.12] PROVIDER POLICIES AND PROCEDURES.
new text end

new text begin A license holder must develop a written policies and procedures manual, indexed
according to section 245A.04, subdivision 14, paragraph (c), that provides staff members
immediate access to all policies and procedures and provides a client and other authorized
parties access to all policies and procedures. The manual must contain the following
materials:
new text end

new text begin (1) assessment and treatment planning policies, including screening for mental health
concerns and treatment objectives related to the client's identified mental health concerns
in the client's treatment plan;
new text end

new text begin (2) policies and procedures regarding HIV according to section 245A.19;
new text end

new text begin (3) the license holder's methods and resources to provide information on tuberculosis
and tuberculosis screening to each client and to report a known tuberculosis infection
according to section 144.4804;
new text end

new text begin (4) personnel policies according to section 245G.13;
new text end

new text begin (5) policies and procedures that protect a client's rights according to section 245G.15;
new text end

new text begin (6) a medical services plan according to section 245G.08;
new text end

new text begin (7) emergency procedures according to section 245G.16;
new text end

new text begin (8) policies and procedures for maintaining client records according to section 245G.09;
new text end

new text begin (9) procedures for reporting the maltreatment of minors according to section 626.556,
and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
new text end

new text begin (10) a description of treatment services, including the amount and type of services
provided;
new text end

new text begin (11) the methods used to achieve desired client outcomes;
new text end

new text begin (12) the hours of operation; and
new text end

new text begin (13) the target population served.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 26.

new text begin [245G.13] PROVIDER PERSONNEL POLICIES.
new text end

new text begin Subdivision 1. new text end

new text begin Personnel policy requirements. new text end

new text begin A license holder must have written
personnel policies that are available to each staff member. The personnel policies must:
new text end

new text begin (1) ensure that staff member retention, promotion, job assignment, or pay are not affected
by a good faith communication between a staff member and the department, the Department
of Health, the ombudsman for mental health and developmental disabilities, law enforcement,
or a local agency for the investigation of a complaint regarding a client's rights, health, or
safety;
new text end

new text begin (2) contain a job description for each staff member position specifying responsibilities,
degree of authority to execute job responsibilities, and qualification requirements;
new text end

new text begin (3) provide for a job performance evaluation based on standards of job performance
conducted on a regular and continuing basis, including a written annual review;
new text end

new text begin (4) describe behavior that constitutes grounds for disciplinary action, suspension, or
dismissal, including policies that address staff member problematic substance use and the
requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement
with a client in violation of chapter 604, and policies prohibiting client abuse described in
sections 245A.65, 626.556, 626.557, and 626.5572;
new text end

new text begin (5) identify how the program will identify whether behaviors or incidents are problematic
substance use, including a description of how the facility must address:
new text end

new text begin (i) receiving treatment for substance use within the period specified for the position in
the staff qualification requirements, including medication-assisted treatment;
new text end

new text begin (ii) substance use that negatively impacts the staff member's job performance;
new text end

new text begin (iii) chemical use that affects the credibility of treatment services with a client, referral
source, or other member of the community;
new text end

new text begin (iv) symptoms of intoxication or withdrawal on the job; and
new text end

new text begin (v) the circumstances under which an individual who participates in monitoring by the
health professional services program for a substance use or mental health disorder is able
to provide services to the program's clients;
new text end

new text begin (6) include a chart or description of the organizational structure indicating lines of
authority and responsibilities;
new text end

new text begin (7) include orientation within 24 working hours of starting for each new staff member
based on a written plan that, at a minimum, must provide training related to the staff member's
specific job responsibilities, policies and procedures, client confidentiality, HIV minimum
standards, and client needs; and
new text end

new text begin (8) include policies outlining the license holder's response to a staff member with a
behavior problem that interferes with the provision of treatment service.
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
has the training described in this subdivision.
new text end

new text begin (b) Each staff member must be trained every two years in:
new text end

new text begin (1) client confidentiality rules and regulations and client ethical boundaries; and
new text end

new text begin (2) emergency procedures and client rights as specified in sections 144.651, 148F.165,
and 253B.03.
new text end

new text begin (c) Annually each staff member with direct contact must be trained on mandatory
reporting as specified in sections 245A.65, 626.556, 626.5561, 626.557, and 626.5572,
including specific training covering the license holder's policies for obtaining a release of
client information.
new text end

new text begin (d) Upon employment and annually thereafter, each staff member with direct contact
must receive training on HIV minimum standards according to section 245A.19.
new text end

new text begin (e) A treatment director, supervisor, nurse, or counselor must have a minimum of 12
hours of training in co-occurring disorders that includes competencies related to philosophy,
trauma-informed care, screening, assessment, diagnosis and person-centered treatment
planning, documentation, programming, medication, collaboration, mental health
consultation, and discharge planning. A new staff member who has not obtained the training
must complete the training within six months of employment. A staff member may request,
and the license holder may grant, credit for relevant training obtained before employment,
which must be documented in the staff member's personnel file.
new text end

new text begin Subd. 3. new text end

new text begin Personnel files. new text end

new text begin The license holder must maintain a separate personnel file for
each staff member. At a minimum, the personnel file must conform to the requirements of
this chapter. A personnel file must contain the following:
new text end

new text begin (1) a completed application for employment signed by the staff member and containing
the staff member's qualifications for employment;
new text end

new text begin (2) documentation related to the staff member's background study data, according to
chapter 245C;
new text end

new text begin (3) for a staff member who provides psychotherapy services, employer names and
addresses for the past five years for which the staff member provided psychotherapy services,
and documentation of an inquiry required by sections 604.20 to 604.205 made to the staff
member's former employer regarding substantiated sexual contact with a client;
new text end

new text begin (4) documentation that the staff member completed orientation and training;
new text end

new text begin (5) documentation that the staff member meets the requirements in section 245G.11;
new text end

new text begin (6) documentation demonstrating the staff member's compliance with section 245G.08,
subdivision 3, for a staff member who conducts administration of medication; and
new text end

new text begin (7) documentation demonstrating the staff member's compliance with section 245G.18,
subdivision 2, for a staff member that treats an adolescent client.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 27.

new text begin [245G.14] SERVICE INITIATION AND TERMINATION POLICIES.
new text end

new text begin Subdivision 1. new text end

new text begin Service initiation policy. new text end

new text begin A license holder must have a written service
initiation policy containing service initiation preferences that comply with this section and
Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria.
The license holder must not initiate services for an individual who does not meet the service
initiation criteria. The service initiation criteria must be either posted in the area of the
facility where services for a client are initiated, or given to each interested person upon
request. Titles of each staff member authorized to initiate services for a client must be listed
in the services initiation and termination policies.
new text end

new text begin Subd. 2. new text end

new text begin License holder responsibilities. new text end

new text begin (a) The license holder must have and comply
with a written protocol for (1) assisting a client in need of care not provided by the license
holder, and (2) a client who poses a substantial likelihood of harm to the client or others, if
the behavior is beyond the behavior management capabilities of the staff members.
new text end

new text begin (b) A service termination and denial of service initiation that poses an immediate threat
to the health of any individual or requires immediate medical intervention must be referred
to a medical facility capable of admitting the client.
new text end

new text begin (c) A service termination policy and a denial of service initiation that involves the
commission of a crime against a license holder's staff member or on a license holder's
premises, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and
title 45, parts 160 to 164, must be reported to a law enforcement agency with jurisdiction.
new text end

new text begin Subd. 3. new text end

new text begin Service termination policies. new text end

new text begin A license holder must have a written policy
specifying the conditions when a client must be terminated from service. The service
termination policy must include:
new text end

new text begin (1) procedures for a client whose services were terminated under subdivision 2;
new text end

new text begin (2) a description of client behavior that constitutes reason for a staff-requested service
termination and a process for providing this information to a client;
new text end

new text begin (3) a requirement that before discharging a client from a residential setting, for not
reaching treatment plan goals, the license holder must confer with other interested persons
to review the issues involved in the decision. The documentation requirements for a
staff-requested service termination must describe why the decision to discharge is warranted,
the reasons for the discharge, and the alternatives considered or attempted before discharging
the client;
new text end

new text begin (4) procedures consistent with section 253B.16, subdivision 2, that staff members must
follow when a client admitted under chapter 253B is to have services terminated;
new text end

new text begin (5) procedures a staff member must follow when a client leaves against staff or medical
advice and when the client may be dangerous to the client or others, including a policy that
requires a staff member to assist the client with assessing needs of care or other resources;
new text end

new text begin (6) procedures for communicating staff-approved service termination criteria to a client,
including the expectations in the client's individual treatment plan according to section
245G.06; and
new text end

new text begin (7) titles of each staff member authorized to terminate a client's service must be listed
in the service initiation and service termination policies.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 28.

new text begin [245G.15] CLIENT RIGHTS PROTECTION.
new text end

new text begin Subdivision 1. new text end

new text begin Explanation. new text end

new text begin A client has the rights identified in sections 144.651,
148F.165, 253B.03, and 254B.02, subdivision 2, as applicable. The license holder must
give each client at service initiation a written statement of the client's rights and
responsibilities. A staff member must review the statement with a client at that time.
new text end

new text begin Subd. 2. new text end

new text begin Grievance procedure. new text end

new text begin At service initiation, the license holder must explain
the grievance procedure to the client or the client's representative. The grievance procedure
must be posted in a place visible to clients, and made available upon a client's or former
client's request. The grievance procedure must require that:
new text end

new text begin (1) a staff member helps the client develop and process a grievance;
new text end

new text begin (2) current telephone numbers and addresses of the Department of Human Services,
Licensing Division; the Office of Ombudsman for Mental Health and Developmental
Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board
of Behavioral Health and Therapy, when applicable, be made available to a client; and
new text end

new text begin (3) a license holder responds to the client's grievance within three days of a staff member's
receipt of the grievance, and the client may bring the grievance to the highest level of
authority in the program if not resolved by another staff member.
new text end

new text begin Subd. 3. new text end

new text begin Photographs of client. new text end

new text begin (a) A photograph, video, or motion picture of a client
taken in the provision of treatment service is considered client records. A photograph for
identification and a recording by video or audio technology to enhance either therapy or
staff member supervision may be required of a client, but may only be available for use as
communications within a program. A client must be informed when the client's actions are
being recorded by camera or other technology, and the client must have the right to refuse
any recording or photography, except as authorized by this subdivision.
new text end

new text begin (b) A license holder must have a written policy regarding the use of any personal
electronic device that can record, transmit, or make images of another client. A license
holder must inform each client of this policy and the client's right to refuse being
photographed or recorded.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 29.

new text begin [245G.16] BEHAVIORAL EMERGENCY PROCEDURES.
new text end

new text begin (a) A license holder or applicant must have written behavioral emergency procedures
that staff must follow when responding to a client who exhibits behavior that is threatening
to the safety of the client or others. Programs must incorporate person-centered planning
and trauma-informed care in the program's behavioral emergency procedure policies. The
procedures must include:
new text end

new text begin (1) a plan designed to prevent a client from hurting themselves or others;
new text end

new text begin (2) contact information for emergency resources that staff must consult when a client's
behavior cannot be controlled by the behavioral emergency procedures;
new text end

new text begin (3) types of procedures that may be used;
new text end

new text begin (4) circumstances under which behavioral emergency procedures may be used; and
new text end

new text begin (5) staff members authorized to implement behavioral emergency procedures.
new text end

new text begin (b) Behavioral emergency procedures must not be used to enforce facility rules or for
the convenience of staff. Behavioral emergency procedures must not be part of any client's
treatment plan, or used at any time for any reason except in response to specific current
behavior that threatens the safety of the client or others. Behavioral emergency procedures
may not include the use of seclusion or restraint.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 30.

new text begin [245G.17] EVALUATION.
new text end

new text begin A license holder must participate in the drug and alcohol abuse normative evaluation
system by submitting information about each client to the commissioner in a manner
prescribed by the commissioner. A license holder must submit additional information
requested by the commissioner that is necessary to meet statutory or federal funding
requirements.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 31.

new text begin [245G.18] LICENSE HOLDERS SERVING ADOLESCENTS.
new text end

new text begin Subdivision 1. new text end

new text begin License. new text end

new text begin A residential treatment program that serves an adolescent younger
than 16 years of age must be licensed as a residential program for a child in out-of-home
placement by the department unless the license holder is exempt under section 245A.03,
subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Alcohol and drug counselor qualifications. new text end

new text begin In addition to the requirements
specified in section 245G.11, subdivisions 1 and 5, an alcohol and drug counselor providing
treatment service to an adolescent must have:
new text end

new text begin (1) an additional 30 hours of classroom instruction or one three-credit semester college
course in adolescent development. This training need only be completed one time; and
new text end

new text begin (2) at least 150 hours of supervised experience as an adolescent counselor, either as a
student or as a staff member.
new text end

new text begin Subd. 3. new text end

new text begin Staff ratios. new text end

new text begin At least 25 percent of a counselor's scheduled work hours must
be allocated to indirect services, including documentation of client services, coordination
of services with others, treatment team meetings, and other duties. A counseling group
consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of
the license holder to determine an acceptable group size based on the needs of the clients.
new text end

new text begin Subd. 4. new text end

new text begin Academic program requirements. new text end

new text begin A client who is required to attend school
must be enrolled and attending an educational program that was approved by the Department
of Education.
new text end

new text begin Subd. 5. new text end

new text begin Program requirements. new text end

new text begin In addition to the requirements specified in the client's
treatment plan under section 245G.06, programs serving an adolescent must include:
new text end

new text begin (1) coordination with the school system to address the client's academic needs;
new text end

new text begin (2) when appropriate, a plan that addresses the client's leisure activities without chemical
use; and
new text end

new text begin (3) a plan that addresses family involvement in the adolescent's treatment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 32.

new text begin [245G.19] LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.
new text end

new text begin Subdivision 1. new text end

new text begin Health license requirements. new text end

new text begin In addition to the requirements of sections
245G.01 to 245G.17, a license holder that offers supervision of a child of a client is subject
to the requirements of this section. A license holder providing room and board for a client
and the client's child must have an appropriate facility license from the Department of
Health.
new text end

new text begin Subd. 2. new text end

new text begin Supervision of a child. new text end

new text begin "Supervision of a child" means a caregiver is within
sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can
intervene to protect the child's health and safety. For a school-age child it means a caregiver
is available to help and care for the child to protect the child's health and safety.
new text end

new text begin Subd. 3. new text end

new text begin Policy and schedule required. new text end

new text begin A license holder must meet the following
requirements:
new text end

new text begin (1) have a policy and schedule delineating the times and circumstances when the license
holder is responsible for supervision of a child in the program and when the child's parents
are responsible for supervision of a child. The policy must explain how the program will
communicate its policy about supervision of a child responsibility to the parent; and
new text end

new text begin (2) have written procedures addressing the actions a staff member must take if a child
is neglected or abused, including while the child is under the supervision of the child's
parent.
new text end

new text begin Subd. 4. new text end

new text begin Additional licensing requirements. new text end

new text begin During the times the license holder is
responsible for the supervision of a child, the license holder must meet the following
standards:
new text end

new text begin (1) child and adult ratios in Minnesota Rules, part 9502.0367;
new text end

new text begin (2) day care training in section 245A.50;
new text end

new text begin (3) behavior guidance in Minnesota Rules, part 9502.0395;
new text end

new text begin (4) activities and equipment in Minnesota Rules, part 9502.0415;
new text end

new text begin (5) physical environment in Minnesota Rules, part 9502.0425; and
new text end

new text begin (6) water, food, and nutrition in Minnesota Rules, part 9502.0445, unless the license
holder has a license from the Department of Health.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 33.

new text begin [245G.20] LICENSE HOLDERS SERVING PERSONS WITH
CO-OCCURRING DISORDERS.
new text end

new text begin A license holder specializing in the treatment of a person with co-occurring disorders
must:
new text end

new text begin (1) demonstrate that staff levels are appropriate for treating a client with a co-occurring
disorder, and that there are adequate staff members with mental health training;
new text end

new text begin (2) have continuing access to a medical provider with appropriate expertise in prescribing
psychotropic medication;
new text end

new text begin (3) have a mental health professional available for staff member supervision and
consultation;
new text end

new text begin (4) determine group size, structure, and content considering the special needs of a client
with a co-occurring disorder;
new text end

new text begin (5) have documentation of active interventions to stabilize mental health symptoms
present in the individual treatment plans and progress notes;
new text end

new text begin (6) have continuing documentation of collaboration with continuing care mental health
providers, and involvement of the providers in treatment planning meetings;
new text end

new text begin (7) have available program materials adapted to a client with a mental health problem;
new text end

new text begin (8) have policies that provide flexibility for a client who may lapse in treatment or may
have difficulty adhering to established treatment rules as a result of a mental illness, with
the goal of helping a client successfully complete treatment; and
new text end

new text begin (9) have individual psychotherapy and case management available during treatment
service.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 34.

new text begin [245G.21] REQUIREMENTS FOR LICENSED RESIDENTIAL
TREATMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin A license holder who provides supervised room and board
at the licensed program site as a treatment component is defined as a residential program
according to section 245A.02, subdivision 14, and is subject to this section.
new text end

new text begin Subd. 2. new text end

new text begin Visitors. new text end

new text begin A client must be allowed to receive visitors at times prescribed by
the license holder. The license holder must set and post a notice of visiting rules and hours,
including both day and evening times. A client's right to receive visitors other than a personal
physician, religious adviser, county case manager, parole or probation officer, or attorney
may be subject to visiting hours established by the license holder for all clients. The treatment
director or designee may impose limitations as necessary for the welfare of a client provided
the limitation and the reasons for the limitation are documented in the client's file. A client
must be allowed to receive visits at all reasonable times from the client's personal physician,
religious adviser, county case manager, parole or probation officer, and attorney.
new text end

new text begin Subd. 3. new text end

new text begin Client property management. new text end

new text begin A license holder who provides room and board
and treatment services to a client in the same facility, and any license holder that accepts
client property must meet the requirements for handling client funds and property in section
245A.04, subdivision 13. License holders:
new text end

new text begin (1) may establish policies regarding the use of personal property to ensure that treatment
activities and the rights of other clients are not infringed upon;
new text end

new text begin (2) may take temporary custody of a client's property for violation of a facility policy;
new text end

new text begin (3) must retain the client's property for a minimum of seven days after the client's service
termination if the client does not reclaim property upon service termination, or for a minimum
of 30 days if the client does not reclaim property upon service termination and has received
room and board services from the license holder; and
new text end

new text begin (4) must return all property held in trust to the client at service termination regardless
of the client's service termination status, except that:
new text end

new text begin (i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section
609.5316, must be given to the custody of a local law enforcement agency. If giving the
property to the custody of a local law enforcement agency violates Code of Federal
Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug
paraphernalia, or drug container must be destroyed by a staff member designated by the
program director; and
new text end

new text begin (ii) a weapon, explosive, and other property that can cause serious harm to the client or
others must be given to the custody of a local law enforcement agency, and the client must
be notified of the transfer and of the client's right to reclaim any lawful property transferred;
and
new text end

new text begin (iii) a medication that was determined by a physician to be harmful after examining the
client must be destroyed, except when the client's personal physician approves the medication
for continued use.
new text end

new text begin Subd. 4. new text end

new text begin Health facility license. new text end

new text begin A license holder who provides room and board and
treatment services in the same facility must have the appropriate license from the Department
of Health.
new text end

new text begin Subd. 5. new text end

new text begin Facility abuse prevention plan. new text end

new text begin A license holder must establish and enforce
an ongoing facility abuse prevention plan consistent with sections 245A.65 and 626.557,
subdivision 14.
new text end

new text begin Subd. 6. new text end

new text begin Individual abuse prevention plan. new text end

new text begin A license holder must prepare an individual
abuse prevention plan for each client as specified under sections 245A.65, subdivision 2,
and 626.557, subdivision 14.
new text end

new text begin Subd. 7. new text end

new text begin Health services. new text end

new text begin A license holder must have written procedures for assessing
and monitoring a client's health, including a standardized data collection tool for collecting
health-related information about each client. The policies and procedures must be approved
and signed by a registered nurse.
new text end

new text begin Subd. 8. new text end

new text begin Administration of medication. new text end

new text begin A license holder must meet the administration
of medications requirements of section 245G.08, subdivision 5, if services include medication
administration.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 35.

new text begin [245G.22] OPIOID TREATMENT PROGRAMS.
new text end

new text begin Subdivision 1. new text end

new text begin Additional requirements. new text end

new text begin (a) An opioid treatment program licensed
under this chapter must also comply with the requirements of this section and Code of
Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on
federal standards or requirements also required under this section, the federal guidance or
interpretations shall apply.
new text end

new text begin (b) Where a standard in this section differs from a standard in an otherwise applicable
administrative rule or statute, the standard of this section applies.
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) "Diversion" means the use of a medication for the treatment of opioid addiction being
diverted from intended use of the medication.
new text end

new text begin (c) "Guest dose" means administration of a medication used for the treatment of opioid
addiction to a person who is not a client of the program that is administering or dispensing
the medication.
new text end

new text begin (d) "Medical director" means a physician licensed to practice medicine in the jurisdiction
that the opioid treatment program is located who assumes responsibility for administering
all medical services performed by the program, either by performing the services directly
or by delegating specific responsibility to authorized program physicians and health care
professionals functioning under the medical director's direct supervision.
new text end

new text begin (e) "Medication used for the treatment of opioid use disorder" means a medication
approved by the Food and Drug Administration for the treatment of opioid use disorder.
new text end

new text begin (f) "Minnesota health care programs" has the meaning given in section 256B.0636.
new text end

new text begin (g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,
title 42, section 8.12, and includes programs licensed under this chapter.
new text end

new text begin (h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605,
subpart 21a.
new text end

new text begin (i) "Unsupervised use" means the use of a medication for the treatment of opioid use
disorder dispensed for use by a client outside of the program setting.
new text end

new text begin Subd. 3. new text end

new text begin Medication orders. new text end

new text begin Before the program may administer or dispense a medication
used for the treatment of opioid use disorder:
new text end

new text begin (1) a client-specific order must be received from an appropriately credentialed physician
who is enrolled as a Minnesota health care programs provider and meets all applicable
provider standards;
new text end

new text begin (2) the signed order must be documented in the client's record; and
new text end

new text begin (3) if the physician that issued the order is not able to sign the order when issued, the
unsigned order must be entered in the client record at the time it was received, and the
physician must review the documentation and sign the order in the client's record within 72
hours of the medication being ordered. The license holder must report to the commissioner
any medication error that endangers a client's health, as determined by the medical director.
new text end

new text begin Subd. 4. new text end

new text begin High dose requirements. new text end

new text begin A client being administered or dispensed a dose
beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams
of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase,
must meet face-to-face with a prescribing physician. The meeting must occur before the
administration or dispensing of the increased medication dose.
new text end

new text begin Subd. 5. new text end

new text begin Drug testing. new text end

new text begin Each client enrolled in the program must receive a minimum of
eight random drug abuse tests per 12 months of treatment. Drug abuse tests must be
reasonably disbursed over the 12-month period. A license holder may elect to conduct more
drug abuse tests.
new text end

new text begin Subd. 6. new text end

new text begin Criteria for unsupervised use. new text end

new text begin (a) To limit the potential for diversion of
medication used for the treatment of opioid use disorder to the illicit market, medication
dispensed to a client for unsupervised use shall be subject to the following requirements:
new text end

new text begin (1) any client in an opioid treatment program may receive a single unsupervised use
dose for a day that the clinic is closed for business, including Sundays and state and federal
holidays; and
new text end

new text begin (2) other treatment program decisions on dispensing medications used for the treatment
of opioid use disorder to a client for unsupervised use shall be determined by the medical
director.
new text end

new text begin (b) In determining whether a client may be permitted unsupervised use of medications,
a physician with authority to prescribe must consider the criteria in this paragraph. The
criteria in this paragraph must also be considered when determining whether dispensing
medication for a client's unsupervised use is appropriate to increase or to extend the amount
of time between visits to the program. The criteria are:
new text end

new text begin (1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics,
and alcohol;
new text end

new text begin (2) regularity of program attendance;
new text end

new text begin (3) absence of serious behavioral problems at the program;
new text end

new text begin (4) absence of known recent criminal activity such as drug dealing;
new text end

new text begin (5) stability of the client's home environment and social relationships;
new text end

new text begin (6) length of time in comprehensive maintenance treatment;
new text end

new text begin (7) reasonable assurance that unsupervised use medication will be safely stored within
the client's home; and
new text end

new text begin (8) whether the rehabilitative benefit the client derived from decreasing the frequency
of program attendance outweighs the potential risks of diversion or unsupervised use.
new text end

new text begin (c) The determination, including the basis of the determination must be documented in
the client's medical record.
new text end

new text begin Subd. 7. new text end

new text begin Restrictions for unsupervised use of methadone hydrochloride. new text end

new text begin (a) If a
physician with authority to prescribe determines that a client meets the criteria in subdivision
6 and may be dispensed a medication used for the treatment of opioid addiction, the
restrictions in this subdivision must be followed when the medication to be dispensed is
methadone hydrochloride.
new text end

new text begin (b) During the first 90 days of treatment, the unsupervised use medication supply must
be limited to a maximum of a single dose each week and the client shall ingest all other
doses under direct supervision.
new text end

new text begin (c) In the second 90 days of treatment, the unsupervised use medication supply must be
limited to two doses per week.
new text end

new text begin (d) In the third 90 days of treatment, the unsupervised use medication supply must not
exceed three doses per week.
new text end

new text begin (e) In the remaining months of the first year, a client may be given a maximum six-day
unsupervised use medication supply.
new text end

new text begin (f) After one year of continuous treatment, a client may be given a maximum two-week
unsupervised use medication supply.
new text end

new text begin (g) After two years of continuous treatment, a client may be given a maximum one-month
unsupervised use medication supply, but must make monthly visits to the program.
new text end

new text begin Subd. 8. new text end

new text begin Restriction exceptions. new text end

new text begin When a license holder has reason to accelerate the
number of unsupervised use doses of methadone hydrochloride, the license holder must
comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the
criteria for unsupervised use and must use the exception process provided by the federal
Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the
purposes of enforcement of this subdivision, the commissioner has the authority to monitor
a program for compliance with federal regulations and may issue licensing actions according
to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of
noncompliance.
new text end

new text begin Subd. 9. new text end

new text begin Guest dose. new text end

new text begin To receive a guest dose, the client must be enrolled in an opioid
treatment program elsewhere in the state or country and be receiving the medication on a
temporary basis because the client is not able to receive the medication at the program in
which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any
one program and must not be for the convenience or benefit of either program. A guest dose
may also occur when the client's primary clinic is not open and the client is not receiving
unsupervised use doses.
new text end

new text begin Subd. 10. new text end

new text begin Capacity management and waiting list system compliance. new text end

new text begin An opioid
treatment program must notify the department within seven days of the program reaching
both 90 and 100 percent of the program's capacity to care for clients. Each week, the program
must report its capacity, currently enrolled dosing clients, and any waiting list. A program
reporting 90 percent of capacity must also notify the department when the program's census
increases or decreases from the 90 percent level.
new text end

new text begin Subd. 11. new text end

new text begin Waiting list. new text end

new text begin An opioid treatment program must have a waiting list system.
If the person seeking admission cannot be admitted within 14 days of the date of application,
each person seeking admission must be placed on the waiting list, unless the person seeking
admission is assessed by the program and found ineligible for admission according to this
chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and
title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each
person seeking treatment while awaiting admission. A person seeking admission on a waiting
list who receives no services under section 245G.07, subdivision 1, must not be considered
a client as defined in section 245G.01, subdivision 9.
new text end

new text begin Subd. 12. new text end

new text begin Client referral. new text end

new text begin An opioid treatment program must consult the capacity
management system to ensure that a person on a waiting list is admitted at the earliest time
to a program providing appropriate treatment within a reasonable geographic area. If the
client was referred through a public payment system and if the program is not able to serve
the client within 14 days of the date of application for admission, the program must contact
and inform the referring agency of any available treatment capacity listed in the state capacity
management system.
new text end

new text begin Subd. 13. new text end

new text begin Outreach. new text end

new text begin An opioid treatment program must carry out activities to encourage
an individual in need of treatment to undergo treatment. The program's outreach model
must:
new text end

new text begin (1) select, train, and supervise outreach workers;
new text end

new text begin (2) contact, communicate, and follow up with individuals with high-risk substance
misuse, individuals with high-risk substance misuse associates, and neighborhood residents
within the constraints of federal and state confidentiality requirements;
new text end

new text begin (3) promote awareness among individuals who engage in substance misuse by injection
about the relationship between injecting substances and communicable diseases such as
HIV; and
new text end

new text begin (4) recommend steps to prevent HIV transmission.
new text end

new text begin Subd. 14. new text end

new text begin Central registry. new text end

new text begin (a) A license holder must comply with requirements to
submit information and necessary consents to the state central registry for each client
admitted, as specified by the commissioner. The license holder must submit data concerning
medication used for the treatment of opioid use disorder. The data must be submitted in a
method determined by the commissioner and the original information must be kept in the
client's record. The information must be submitted for each client at admission and discharge.
The program must document the date the information was submitted. The client's failure to
provide the information shall prohibit participation in an opioid treatment program. The
information submitted must include the client's:
new text end

new text begin (1) full name and all aliases;
new text end

new text begin (2) date of admission;
new text end

new text begin (3) date of birth;
new text end

new text begin (4) Social Security number or Alien Registration Number, if any;
new text end

new text begin (5) current or previous enrollment status in another opioid treatment program;
new text end

new text begin (6) government-issued photo identification card number; and
new text end

new text begin (7) driver's license number, if any.
new text end

new text begin (b) The requirements in paragraph (a) are effective upon the commissioner's
implementation of changes to the drug and alcohol abuse normative evaluation system or
development of an electronic system by which to submit the data.
new text end

new text begin Subd. 15. new text end

new text begin Nonmedication treatment services; documentation. new text end

new text begin (a) The program must
offer at least 50 consecutive minutes of individual or group therapy treatment services as
defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first
ten weeks following admission, and at least 50 consecutive minutes per month thereafter.
As clinically appropriate, the program may offer these services cumulatively and not
consecutively in increments of no less than 15 minutes over the required time period, and
for a total of 60 minutes of treatment services over the time period, and must document the
reason for providing services cumulatively in the client's record. The program may offer
additional levels of service when deemed clinically necessary.
new text end

new text begin (b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
the assessment must be completed within 21 days of service initiation.
new text end

new text begin (c) Notwithstanding the requirements of individual treatment plans set forth in section
245G.06:
new text end

new text begin (1) treatment plan contents for a maintenance client are not required to include goals
the client must reach to complete treatment and have services terminated;
new text end

new text begin (2) treatment plans for a client in a taper or detox status must include goals the client
must reach to complete treatment and have services terminated;
new text end

new text begin (3) for the initial ten weeks after admission for all new admissions, readmissions, and
transfers, progress notes must be entered in a client's file at least weekly and be recorded
in each of the six dimensions upon the development of the treatment plan and thereafter.
Subsequently, the counselor must document progress in the six dimensions at least once
monthly or, when clinical need warrants, more frequently; and
new text end

new text begin (4) upon the development of the treatment plan and thereafter, treatment plan reviews
must occur weekly, or after each treatment service, whichever is less frequent, for the first
ten weeks after the treatment plan is developed. Following the first ten weeks of treatment
plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent
revisions or documentation.
new text end

new text begin Subd. 16. new text end

new text begin Prescription monitoring program. new text end

new text begin (a) The program must develop and
maintain a policy and procedure that requires the ongoing monitoring of the data from the
prescription monitoring program (PMP) for each client. The policy and procedure must
include how the program meets the requirements in paragraph (b).
new text end

new text begin (b) If a medication used for the treatment of substance use disorder is administered or
dispensed to a client, the license holder shall be subject to the following requirements:
new text end

new text begin (1) upon admission to a methadone clinic outpatient treatment program, a client must
be notified in writing that the commissioner of human services and the medical director
must monitor the PMP to review the prescribed controlled drugs a client received;
new text end

new text begin (2) the medical director or the medical director's delegate must review the data from the
PMP described in section 152.126 before the client is ordered any controlled substance, as
defined under section 152.126, subdivision 1, paragraph (c), including medications used
for the treatment of opioid addiction, and the medical director's or the medical director's
delegate's subsequent reviews of the PMP data must occur at least every 90 days;
new text end

new text begin (3) a copy of the PMP data reviewed must be maintained in the client's file;
new text end

new text begin (4) when the PMP data contains a recent history of multiple prescribers or multiple
prescriptions for controlled substances, the physician's review of the data and subsequent
actions must be documented in the client's file within 72 hours and must contain the medical
director's determination of whether or not the prescriptions place the client at risk of harm
and the actions to be taken in response to the PMP findings. The provider must conduct
subsequent reviews of the PMP on a monthly basis; and
new text end

new text begin (5) if at any time the medical director believes the use of the controlled substances places
the client at risk of harm, the program must seek the client's consent to discuss the client's
opioid treatment with other prescribers and must seek the client's consent for the other
prescriber to disclose to the opioid treatment program's medical director the client's condition
that formed the basis of the other prescriptions. If the information is not obtained within
seven days, the medical director must document whether or not changes to the client's
medication dose or number of unsupervised use doses are necessary until the information
is obtained.
new text end

new text begin (c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop
and implement an electronic system for the commissioner to routinely access the PMP data
to determine whether any client enrolled in an opioid addiction treatment program licensed
according to this section was prescribed or dispensed a controlled substance in addition to
that administered or dispensed by the opioid addiction treatment program. When the
commissioner determines there have been multiple prescribers or multiple prescriptions of
controlled substances for a client, the commissioner shall:
new text end

new text begin (1) inform the medical director of the opioid treatment program only that the
commissioner determined the existence of multiple prescribers or multiple prescriptions of
controlled substances; and
new text end

new text begin (2) direct the medical director of the opioid treatment program to access the data directly,
review the effect of the multiple prescribers or multiple prescriptions, and document the
review.
new text end

new text begin (d) If determined necessary, the commissioner shall seek a federal waiver of, or exception
to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), before
implementing this subdivision.
new text end

new text begin Subd. 17. new text end

new text begin Policies and procedures. new text end

new text begin (a) A license holder must develop and maintain the
policies and procedures required in this subdivision.
new text end

new text begin (b) For a program that is not open every day of the year, the license holder must maintain
a policy and procedure that permits a client to receive a single unsupervised use of medication
used for the treatment of opioid use disorder for days that the program is closed for business,
including, but not limited to, Sundays and state and federal holidays as required under
subdivision 6, paragraph (a), clause (1).
new text end

new text begin (c) The license holder must maintain a policy and procedure that includes specific
measures to reduce the possibility of diversion. The policy and procedure must:
new text end

new text begin (1) specifically identify and define the responsibilities of the medical and administrative
staff for performing diversion control measures; and
new text end

new text begin (2) include a process for contacting no less than five percent of clients who have
unsupervised use of medication, excluding clients approved solely under subdivision 6,
paragraph (a), clause (1), to require clients to physically return to the program each month.
The system must require clients to return to the program within a stipulated time frame and
turn in all unused medication containers related to opioid use disorder treatment. The license
holder must document all related contacts on a central log and the outcome of the contact
for each client in the client's record.
new text end

new text begin (d) Medication used for the treatment of opioid use disorder must be ordered,
administered, and dispensed according to applicable state and federal regulations and the
standards set by applicable accreditation entities. If a medication order requires assessment
by the person administering or dispensing the medication to determine the amount to be
administered or dispensed, the assessment must be completed by an individual whose
professional scope of practice permits an assessment. For the purposes of enforcement of
this paragraph, the commissioner has the authority to monitor the person administering or
dispensing the medication for compliance with state and federal regulations and the relevant
standards of the license holder's accreditation agency and may issue licensing actions
according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's
determination of noncompliance.
new text end

new text begin Subd. 18. new text end

new text begin Quality improvement plan. new text end

new text begin The license holder must develop and maintain
a quality improvement plan that:
new text end

new text begin (1) includes evaluation of the services provided to clients to identify issues that may
improve service delivery and client outcomes;
new text end

new text begin (2) includes goals for the program to accomplish based on the evaluation;
new text end

new text begin (3) is reviewed annually by the management of the program to determine whether the
goals were met and, if not, whether additional action is required;
new text end

new text begin (4) is updated at least annually to include new or continued goals based on an updated
evaluation of services; and
new text end

new text begin (5) identifies two specific goal areas, in addition to others identified by the program,
including:
new text end

new text begin (i) a goal concerning oversight and monitoring of the premises around and near the
exterior of the program to reduce the possibility of medication used for the treatment of
opioid use disorder being inappropriately used by a client, including but not limited to the
sale or transfer of the medication to others; and
new text end

new text begin (ii) a goal concerning community outreach, including but not limited to communications
with local law enforcement and county human services agencies, to increase coordination
of services and identification of areas of concern to be addressed in the plan.
new text end

new text begin Subd. 19. new text end

new text begin Placing authorities. new text end

new text begin A program must provide certain notification and
client-specific updates to placing authorities for a client who is enrolled in Minnesota health
care programs. At the request of the placing authority, the program must provide
client-specific updates, including but not limited to informing the placing authority of
positive drug screenings and changes in medications used for the treatment of opioid use
disorder ordered for the client.
new text end

new text begin Subd. 20. new text end

new text begin Duty to report suspected drug diversion. new text end

new text begin (a) To the fullest extent permitted
under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to
law enforcement any credible evidence that the program or its personnel knows, or reasonably
should know, that is directly related to a diversion crime on the premises of the program,
or a threat to commit a diversion crime.
new text end

new text begin (b) "Diversion crime," for the purposes of this section, means diverting, attempting to
divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02,
on the program's premises.
new text end

new text begin (c) The program must document the program's compliance with the requirement in
paragraph (a) in either a client's record or an incident report. A program's failure to comply
with paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 36.

Minnesota Statutes 2016, section 246.18, subdivision 4, is amended to read:


Subd. 4.

Collections deposited in the general fund.

Except as provided in subdivisions
5, 6, and 7, all receipts from collection efforts for the regional treatment centers, state nursing
homesdeleted text begin,deleted text end and other state facilities as defined in section 246.50, subdivision 3, must be deposited
in the general fundnew text begin. From that amount, receipts from collection efforts for the Anoka-Metro
Regional Treatment Center and community behavioral health hospitals must be deposited
in accordance with subdivision 4a
new text end. The commissioner shall ensure that the departmental
financial reporting systems and internal accounting procedures comply with federal standards
for reimbursement for program and administrative expenditures and fulfill the purpose of
this deleted text beginparagraphdeleted text endnew text begin subdivisionnew text end.

Sec. 37.

Minnesota Statutes 2016, section 246.18, is amended by adding a subdivision to
read:


new text begin Subd. 4a. new text end

new text begin Mental health innovation account. new text end

new text begin The mental health innovation account is
established in the special revenue fund. Beginning in fiscal year 2018, $1,000,000 of the
revenue generated by collection efforts from the Anoka-Metro Regional Treatment Center
and community behavioral health hospitals under section 246.54 must annually be deposited
into the mental health innovation account. Money deposited in the mental health innovation
account is appropriated to the commissioner of human services for the mental health
innovation grant program under section 245.4662.
new text end

Sec. 38.

Minnesota Statutes 2016, section 254A.01, is amended to read:


254A.01 PUBLIC POLICY.

It is hereby declared to be the public policy of this state that new text beginscientific evidence shows
that addiction to alcohol or other drugs is a chronic brain disorder with potential for
recurrence, and as with many other chronic conditions, people with substance use disorders
can be effectively treated and can enter recovery.
new text endThe interests of society are best served
by new text beginreducing the stigma of substance use disorder and new text endproviding persons who are dependent
upon alcohol or other drugs with a comprehensive range of rehabilitative and social servicesnew text begin
that span intensity levels and are not restricted to a particular point in time
new text end. Further, it is
declared that treatment under these services shall be voluntary when possible: treatment
shall not be denied on the basis of prior treatment; treatment shall be based on an individual
treatment plan for each person undergoing treatment; treatment shall include a continuum
of services available for a person leaving a program of treatment; treatment shall include
all family members at the earliest possible phase of the treatment process.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 39.

Minnesota Statutes 2016, section 254A.02, subdivision 2, is amended to read:


Subd. 2.

Approved treatment program.

"Approved treatment program" means care
and treatment services provided by any individual, organization or association to deleted text begindrug
dependent
deleted text end personsnew text begin with a substance use disordernew text end, which meets the standards established by
the commissioner of human services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 40.

Minnesota Statutes 2016, section 254A.02, subdivision 3, is amended to read:


Subd. 3.

Comprehensive program.

"Comprehensive program" means the range of
services which are to be made available for the purpose of prevention, care and treatment
of deleted text beginalcohol and drug abusedeleted text endnew text begin substance misuse and substance use disordernew text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 41.

Minnesota Statutes 2016, section 254A.02, subdivision 5, is amended to read:


Subd. 5.

Drug dependent person.

"Drug dependent person" means any deleted text begininebriate person
or any
deleted text end person incapable of self-management or management of personal affairs or unable
to function physically or mentally in an effective manner because of the abuse of a drug,
including alcohol.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 42.

Minnesota Statutes 2016, section 254A.02, subdivision 6, is amended to read:


Subd. 6.

Facility.

"Facility" means any treatment facility administered under an approved
treatment program deleted text beginestablished under Laws 1973, chapter 572deleted text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 43.

Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Substance misuse. new text end

new text begin "Substance misuse" means the use of any psychoactive
or mood-altering substance, without compelling medical reason, in a manner that results in
mental, emotional, or physical impairment and causes socially dysfunctional or socially
disordering behavior and that results in psychological dependence or physiological addiction
as a function of continued use. Substance misuse has the same meaning as drug abuse or
abuse of drugs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 44.

Minnesota Statutes 2016, section 254A.02, subdivision 8, is amended to read:


Subd. 8.

Other drugs.

"Other drugs" means any psychoactive deleted text beginchemicaldeleted text endnew text begin substancenew text end other
than alcohol.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 45.

Minnesota Statutes 2016, section 254A.02, subdivision 10, is amended to read:


Subd. 10.

State authority.

"State authority" is a division established within the
Department of Human Services for the purpose of relating the authority of state government
in the area of deleted text beginalcohol and drug abusedeleted text endnew text begin substance misuse and substance use disordernew text end to the
deleted text begin alcohol and drug abusedeleted text endnew text begin substance misuse and substance use disorder-relatednew text end activities within
the state.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 46.

Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision
to read:


new text begin Subd. 10a. new text end

new text begin Substance use disorder. new text end

new text begin "Substance use disorder" has the meaning given
in the current Diagnostic and Statistical Manual of Mental Disorders.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 47.

Minnesota Statutes 2016, section 254A.03, is amended to read:


254A.03 STATE AUTHORITY ON ALCOHOL AND DRUG ABUSE.

Subdivision 1.

Alcohol and Other Drug Abuse Section.

There is hereby created an
Alcohol and Other Drug Abuse Section in the Department of Human Services. This section
shall be headed by a director. The commissioner may place the director's position in the
unclassified service if the position meets the criteria established in section 43A.08,
subdivision 1a
. The section shall:

(1) conduct and foster basic research relating to the cause, prevention and methods of
diagnosis, treatment and rehabilitation of deleted text beginalcoholic and other drug dependentdeleted text end personsnew text begin with
substance misuse and substance use disorder
new text end;

(2) coordinate and review all activities and programs of all the various state departments
as they relate to deleted text beginalcohol and other drug dependency and abusedeleted text end problemsnew text begin associated with
substance misuse and substance use disorder
new text end;

(3) develop, demonstrate, and disseminate new methods and techniques for deleted text beginthedeleted text end prevention,
new text begin early intervention, new text endtreatment and deleted text beginrehabilitation of alcohol and other drug abuse and
dependency problems
deleted text endnew text begin recovery support for substance misuse and substance use disordernew text end;

(4) gather facts and information about deleted text beginalcoholism and other drug dependency and abusedeleted text endnew text begin
substance misuse and substance use disorder
new text end, and about the efficiency and effectiveness of
prevention, treatment, and deleted text beginrehabilitationdeleted text endnew text begin recovery support servicesnew text end from all comprehensive
programs, including programs approved or licensed by the commissioner of human services
or the commissioner of health or accredited by the Joint Commission on Accreditation of
Hospitals. The state authority is authorized to require information from comprehensive
programs which is reasonable and necessary to fulfill these duties. When required information
has been previously furnished to a state or local governmental agency, the state authority
shall collect the information from the governmental agency. The state authority shall
disseminate facts and summary information about deleted text beginalcohol and other drug abuse dependencydeleted text end
problemsnew text begin associated with substance misuse and substance use disordernew text end to public and private
agencies, local governments, local and regional planning agencies, and the courts for guidance
to and assistance in prevention, treatment and deleted text beginrehabilitationdeleted text endnew text begin recovery supportnew text end;

(5) inform and educate the general public on deleted text beginalcohol and other drug dependency and
abuse problems
deleted text endnew text begin substance misuse and substance use disordernew text end;

(6) serve as the state authority concerning deleted text beginalcohol and other drug dependency and abusedeleted text endnew text begin
substance misuse and substance use disorder
new text end by monitoring the conduct of diagnosis and
referral services, research and comprehensive programs. The state authority shall submit a
biennial report to the governor and the legislature containing a description of public services
delivery and recommendations concerning increase of coordination and quality of services,
and decrease of service duplication and cost;

(7) establish a state plan which shall set forth goals and priorities for a comprehensive
deleted text begin alcohol and other drug dependency and abuse programdeleted text endnew text begin continuum of care for substance
misuse and substance use disorder
new text end for Minnesota. All state agencies operating deleted text beginalcohol and
other drug abuse or dependency
deleted text endnew text begin substance misuse or substance use disordernew text end programs or
administering state or federal funds for such programs shall annually set their program goals
and priorities in accordance with the state plan. Each state agency shall annually submit its
plans and budgets to the state authority for review. The state authority shall certify whether
proposed services comply with the comprehensive state plan and advise each state agency
of review findings;

(8) make contracts with and grants to public and private agencies and organizations,
both profit and nonprofit, and individuals, using federal funds, and state funds as authorized
to pay for costs of state administration, including evaluation, statewide programs and services,
research and demonstration projects, and American Indian programs;

(9) receive and administer deleted text beginmoniesdeleted text endnew text begin moneynew text end available for deleted text beginalcohol and drug abusedeleted text endnew text begin substance
misuse and substance use disorder
new text end programs under the alcohol, drug abuse, and mental
health services block grant, United States Code, title 42, sections 300X to 300X-9;

(10) solicit and accept any gift of money or property for purposes of Laws 1973, chapter
572, and any grant of money, services, or property from the federal government, the state,
any political subdivision thereof, or any private source;

(11) with respect to deleted text beginalcohol and other drug abusedeleted text endnew text begin substance misuse and substance use
disorder
new text end programs serving the American Indian community, establish guidelines for the
employment of personnel with considerable practical experience in deleted text beginalcohol and other drug
abuse problems
deleted text endnew text begin substance misuse and substance use disordernew text end, and understanding of social
and cultural problems related to deleted text beginalcohol and other drug abusedeleted text endnew text begin substance misuse and substance
use disorder
new text end, in the American Indian community.

Subd. 2.

American Indian programs.

There is hereby created a section of American
Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human
Services, to be headed by a special assistant for American Indian programs on deleted text beginalcoholism
and drug abuse
deleted text endnew text begin substance misuse and substance use disordernew text end and two assistants to that
position. The section shall be staffed with all personnel necessary to fully administer
programming for deleted text beginalcohol and drug abusedeleted text endnew text begin substance misuse and substance use disorder
services
new text end for American Indians in the state. The special assistant position shall be filled by
a person with considerable practical experience in and understanding of deleted text beginalcohol and other
drug abuse problems
deleted text endnew text begin substance misuse and substance use disordernew text end in the American Indian
community, who shall be responsible to the director of the Alcohol and Drug Abuse Section
created in subdivision 1 and shall be in the unclassified service. The special assistant shall
meet and consult with the American Indian Advisory Council as described in section
254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report
on the status of deleted text beginalcohol and other drug abusedeleted text endnew text begin substance misuse and substance use disordernew text end
among American Indians in the state of Minnesota. The special assistant with the approval
of the director shall:

(1) administer funds appropriated for American Indian groups, organizations and
reservations within the state for American Indian deleted text beginalcoholism and drug abusedeleted text endnew text begin substance
misuse and substance use disorder
new text end programs;

(2) establish policies and procedures for such American Indian programs with the
assistance of the American Indian Advisory Board; and

(3) hire and supervise staff to assist in the administration of the American Indian program
section within the Alcohol and Drug Abuse Section of the Department of Human Services.

Subd. 3.

Rules for deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end care.

new text begin(a) new text endThe
commissioner of human services shall establish by rule criteria to be used in determining
the appropriate level of chemical dependency care for each recipient of public assistance
seeking treatment for deleted text beginalcohol or other drug dependency and abuse problems.deleted text endnew text begin substance
misuse or substance use disorder. Upon federal approval of a comprehensive assessment
as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding the criteria
in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of comprehensive
assessments under section 254B.05 may determine and approve the appropriate level of
substance use disorder treatment for a recipient of public assistance. The process for
determining an individual's financial eligibility for the consolidated chemical dependency
treatment fund or determining an individual's enrollment in or eligibility for a publicly
subsidized health plan is not affected by the individual's choice to access a comprehensive
assessment for placement.
new text end

new text begin (b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 48.

Minnesota Statutes 2016, section 254A.035, subdivision 1, is amended to read:


Subdivision 1.

Establishment.

There is created an American Indian Advisory Council
to assist the state authority on deleted text beginalcohol and drug abusedeleted text endnew text begin substance misuse and substance use
disorder
new text end in proposal review and formulating policies and procedures relating to deleted text beginchemical
dependency and the abuse of alcohol and other drugs
deleted text endnew text begin substance misuse and substance use
disorder
new text end by American Indians.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 49.

Minnesota Statutes 2016, section 254A.04, is amended to read:


254A.04 CITIZENS ADVISORY COUNCIL.

There is hereby created an Alcohol and Other Drug Abuse Advisory Council to advise
the Department of Human Services concerning the problems of deleted text beginalcohol and other drug
dependency and abuse
deleted text endnew text begin substance misuse and substance use disordernew text end, composed of ten
members. Five members shall be individuals whose interests or training are in the field of
deleted text begin alcohol dependencydeleted text endnew text begin alcohol-specific substance use disordernew text end and deleted text beginabusedeleted text endnew text begin alcohol misusenew text end; and
five members whose interests or training are in the field of deleted text begindependencydeleted text endnew text begin substance use
disorder
new text end and deleted text beginabuse of drugsdeleted text endnew text begin misuse of substancesnew text end other than alcohol. The terms, compensation
and removal of members shall be as provided in section 15.059. The council expires June
30, 2018. The commissioner of human services shall appoint members whose terms end in
even-numbered years. The commissioner of health shall appoint members whose terms end
in odd-numbered years.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 50.

Minnesota Statutes 2016, section 254A.08, is amended to read:


254A.08 DETOXIFICATION CENTERS.

Subdivision 1.

Detoxification services.

Every county board shall provide detoxification
services for deleted text begindrug dependent personsdeleted text endnew text begin any person incapable of self-management or management
of personal affairs or unable to function physically or mentally in an effective manner
because of the use of a drug, including alcohol
new text end. The board may utilize existing treatment
programs and other agencies to meet this responsibility.

Subd. 2.

Program requirements.

For the purpose of this section, a detoxification
program means a social rehabilitation program new text beginlicensed by the Department of Human
Services under chapter 245A, and governed by the standards of Minnesota Rules, parts
9530.6510 to 9530.6590, and
new text endestablished for the purpose of facilitating access into care and
treatment by detoxifying and evaluating the person and providing entrance into a
comprehensive program. Evaluation of the person shall include verification by a professional,
after preliminary examination, that the person is intoxicated or has symptoms of deleted text beginchemical
dependency
deleted text endnew text begin substance misuse or substance use disordernew text end and appears to be in imminent
danger of harming self or others. A detoxification program shall have available the services
of a licensed physician for medical emergencies and routine medical surveillance. A
detoxification program licensed by the Department of Human Services to serve both adults
and minors at the same site must provide for separate sleeping areas for adults and minors.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 51.

Minnesota Statutes 2016, section 254A.09, is amended to read:


254A.09 CONFIDENTIALITY OF RECORDS.

The Department of Human Services shall assure confidentiality to individuals who are
the subject of research by the state authority or are recipients of deleted text beginalcohol or drug abusedeleted text endnew text begin
substance misuse or substance use disorder
new text end information, assessment, or treatment from a
licensed or approved program. The commissioner shall withhold from all persons not
connected with the conduct of the research the names or other identifying characteristics
of a subject of research unless the individual gives written permission that information
relative to treatment and recovery may be released. Persons authorized to protect the privacy
of subjects of research may not be compelled in any federal, state or local, civil, criminal,
administrative or other proceeding to identify or disclose other confidential information
about the individuals. Identifying information and other confidential information related to
deleted text begin alcohol or drug abusedeleted text endnew text begin substance misuse or substance use disordernew text end information, assessment,
treatment, or aftercare services may be ordered to be released by the court for the purpose
of civil or criminal investigations or proceedings if, after review of the records considered
for disclosure, the court determines that the information is relevant to the purpose for which
disclosure is requested. The court shall order disclosure of only that information which is
determined relevant. In determining whether to compel disclosure, the court shall weigh
the public interest and the need for disclosure against the injury to the patient, to the treatment
relationship in the program affected and in other programs similarly situated, and the actual
or potential harm to the ability of programs to attract and retain patients if disclosure occurs.
This section does not exempt any person from the reporting obligations under section
626.556, nor limit the use of information reported in any proceeding arising out of the abuse
or neglect of a child. Identifying information and other confidential information related to
deleted text begin alcohol or drug abuse informationdeleted text endnew text begin substance misuse or substance use disordernew text end, assessment,
treatment, or aftercare services may be ordered to be released by the court for the purpose
of civil or criminal investigations or proceedings. No information may be released pursuant
to this section that would not be released pursuant to section 595.02, subdivision 2.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 52.

Minnesota Statutes 2016, section 254A.19, subdivision 3, is amended to read:


Subd. 3.

Financial conflicts of interest.

(a) Except as provided in paragraph (b) deleted text beginordeleted text endnew text begin,new text end (c),new text begin
or (d),
new text end an assessor conducting a chemical use assessment under Minnesota Rules, parts
9530.6600 to 9530.6655, may not have any direct or shared financial interest or referral
relationship resulting in shared financial gain with a treatment provider.

(b) A county may contract with an assessor having a conflict described in paragraph (a)
if the county documents that:

(1) the assessor is employed by a culturally specific service provider or a service provider
with a program designed to treat individuals of a specific age, sex, or sexual preference;

(2) the county does not employ a sufficient number of qualified assessors and the only
qualified assessors available in the county have a direct or shared financial interest or a
referral relationship resulting in shared financial gain with a treatment provider; or

(3) the county social service agency has an existing relationship with an assessor or
service provider and elects to enter into a contract with that assessor to provide both
assessment and treatment under circumstances specified in the county's contract, provided
the county retains responsibility for making placement decisions.

(c) The county may contract with a hospital to conduct chemical assessments if the
requirements in subdivision 1a are met.

An assessor under this paragraph may not place clients in treatment. The assessor shall
gather required information and provide it to the county along with any required
documentation. The county shall make all placement decisions for clients assessed by
assessors under this paragraph.

new text begin (d) An eligible vendor under section 254B.05 conducting a comprehensive assessment
for an individual seeking treatment shall approve the nature, intensity level, and duration
of treatment service if a need for services is indicated, but the individual assessed can access
any enrolled provider that is licensed to provide the level of service authorized, including
the provider or program that completed the assessment. If an individual is enrolled in a
prepaid health plan, the individual must comply with any provider network requirements
or limitations.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 53.

Minnesota Statutes 2016, section 254B.01, subdivision 3, is amended to read:


Subd. 3.

deleted text beginChemical dependencydeleted text endnew text begin Substance use disorder treatmentnew text end services.

"deleted text beginChemical
dependency
deleted text endnew text begin Substance use disorder treatmentnew text end services" means a planned program of care
for the treatment of deleted text beginchemical dependencydeleted text endnew text begin substance misusenew text end or deleted text beginchemical abusedeleted text endnew text begin substance
use disorder
new text end to minimize or prevent further deleted text beginchemical abusedeleted text endnew text begin substance misusenew text end by the person.
Diagnostic, evaluation, prevention, referral, detoxification, and aftercare services that are
not part of a program of care licensable as a residential or nonresidential deleted text beginchemical dependencydeleted text endnew text begin
substance use disorder
new text end treatment program are not deleted text beginchemical dependencydeleted text endnew text begin substance use
disorder
new text end services for purposes of this section. For pregnant and postpartum women, deleted text beginchemical
dependency
deleted text endnew text begin substance use disordernew text end services include halfway house services, aftercare
services, psychological services, and case management.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 54.

Minnesota Statutes 2016, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Recovery community organization. new text end

new text begin "Recovery community organization"
means an independent organization led and governed by representatives of local communities
of recovery. A recovery community organization mobilizes resources within and outside
of the recovery community to increase the prevalence and quality of long-term recovery
from alcohol and other drug addiction. Recovery community organizations provide
peer-based recovery support activities such as training of recovery peers. Recovery
community organizations provide mentorship and ongoing support to individuals dealing
with a substance use disorder and connect them with the resources that can support each
person's recovery. A recovery community organization also promotes a recovery-focused
orientation in community education and outreach programming, and organize
recovery-focused policy advocacy activities to foster healthy communities and reduce the
stigma of substance use disorder.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 55.

Minnesota Statutes 2016, section 254B.03, subdivision 2, is amended to read:


Subd. 2.

Chemical dependency fund payment.

(a) Payment from the chemical
dependency fund is limited to payments for services other than detoxification new text beginlicensed under
Minnesota Rules, parts 9530.6510 to 9530.6590,
new text endthat, if located outside of federally
recognized tribal lands, would be required to be licensed by the commissioner as a chemical
dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and
services other than detoxification provided in another state that would be required to be
licensed as a chemical dependency program if the program were in the state. Out of state
vendors must also provide the commissioner with assurances that the program complies
substantially with state licensing requirements and possesses all licenses and certifications
required by the host state to provide chemical dependency treatment. deleted text beginExcept for chemical
dependency transitional rehabilitation programs,
deleted text end Vendors receiving payments from the
chemical dependency fund must not require co-payment from a recipient of benefits for
services provided under this subdivision. new text beginThe vendor is prohibited from using the client's
public benefits to offset the cost of services paid under this section. The vendor shall not
require the client to use public benefits for room or board costs. This includes but is not
limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP benefits.
Retention of SNAP benefits is a right of a client receiving services through the consolidated
chemical dependency treatment fund or through state contracted managed care entities.
new text end
Payment from the chemical dependency fund shall be made for necessary room and board
costs provided by vendors certified according to section 254B.05, or in a community hospital
licensed by the commissioner of health according to sections 144.50 to 144.56 to a client
who is:

(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and

(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.

(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.

(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 56.

Minnesota Statutes 2016, section 254B.04, subdivision 1, is amended to read:


Subdivision 1.

Eligibility.

deleted text begin(a)deleted text end Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, and persons eligible for medical assistance benefits under
sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, or who meet the
income standards of section 256B.056, subdivision 4, are entitled to chemical dependency
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.

Persons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county shall
pay for out-of-home placement costs, if applicable.

deleted text begin (b) A person not entitled to services under paragraph (a), but with family income that
is less than 215 percent of the federal poverty guidelines for the applicable family size, shall
be eligible to receive chemical dependency fund services within the limit of funds
appropriated for this group for the fiscal year. If notified by the state agency of limited
funds, a county must give preferential treatment to persons with dependent children who
are in need of chemical dependency treatment pursuant to an assessment under section
626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212.
A county may spend money from its own sources to serve persons under this paragraph.
State money appropriated for this paragraph must be placed in a separate account established
for this purpose.
deleted text end

deleted text begin (c) Persons whose income is between 215 percent and 412 percent of the federal poverty
guidelines for the applicable family size shall be eligible for chemical dependency services
on a sliding fee basis, within the limit of funds appropriated for this group for the fiscal
year. Persons eligible under this paragraph must contribute to the cost of services according
to the sliding fee scale established under subdivision 3. A county may spend money from
its own sources to provide services to persons under this paragraph. State money appropriated
for this paragraph must be placed in a separate account established for this purpose.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 57.

Minnesota Statutes 2016, section 254B.04, subdivision 2b, is amended to read:


Subd. 2b.

Eligibility for placement in opioid treatment programs.

deleted text begin (a) Notwithstanding
provisions of Minnesota Rules, part 9530.6622, subpart 5, related to a placement authority's
requirement to authorize services or service coordination in a program that complies with
Minnesota Rules, part 9530.6500, or Code of Federal Regulations, title 42, part 8, and after
taking into account an individual's preference for placement in an opioid
deleted text end deleted text begin treatment program,
a placement authority may, but is not required to, authorize services or service coordination
or otherwise place an individual in an opioid treatment program. Prior to making a
determination of placement for an individual, the placing authority must consult with the
current treatment provider, if any.
deleted text end

deleted text begin (b)deleted text end Prior to placement of an individual who is determined by the assessor to require
treatment for opioid addiction, the assessor must provide educational information concerning
treatment options for opioid addiction, including the use of a medication for the use of
opioid addiction. The commissioner shall develop educational materials supported by
research and updated periodically that must be used by assessors to comply with this
requirement.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 58.

Minnesota Statutes 2016, section 254B.05, subdivision 1, is amended to read:


Subdivision 1.

Licensure required.

new text begin(a) new text endPrograms licensed by the commissioner are
eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
notwithstanding the provisions of section 245A.03. American Indian programs that provide
deleted text begin chemical dependency primarydeleted text endnew text begin substance use disordernew text end treatment, extended care, transitional
residence, or outpatient treatment services, and are licensed by tribal government are eligible
vendors.

new text begin (b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional
in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4,
is an eligible vendor of a comprehensive assessment and assessment summary provided
according to section 245G.05, and treatment services provided according to sections 245G.06
and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2.
new text end

new text begin (c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible
vendor for a comprehensive assessment and assessment summary when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and
completed according to the requirements of section 245G.05. A county is an eligible vendor
of care coordination services when provided by an individual who meets the staffing
credentials of section 245G.11, subdivisions 1 and 7, and provided according to the
requirements of section 245G.07, subdivision 1, clause (7).
new text end

new text begin (d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community
organization that meets certification requirements identified by the commissioner is an
eligible vendor of peer support services.
new text end

new text begin (e) new text endDetoxification programs new text beginlicensed under Minnesota Rules, parts 9530.6510 to
9530.6590,
new text endare not eligible vendors. Programs that are not licensed as a deleted text beginchemical dependencydeleted text end
residential or nonresidential new text beginsubstance use disorder new text endtreatment new text beginor withdrawal management
new text end program by the commissioner or by tribal government or do not meet the requirements of
subdivisions 1a and 1b are not eligible vendors.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 59.

Minnesota Statutes 2016, section 254B.05, subdivision 1a, is amended to read:


Subd. 1a.

Room and board provider requirements.

(a) Effective January 1, 2000,
vendors of room and board are eligible for chemical dependency fund payment if the vendor:

(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;

(2) is determined to meet applicable health and safety requirements;

(3) is not a jail or prison;

(4) is not concurrently receiving funds under chapter 256I for the recipient;

(5) admits individuals who are 18 years of age or older;

(6) is registered as a board and lodging or lodging establishment according to section
157.17;

(7) has awake staff on site 24 hours per day;

(8) has staff who are at least 18 years of age and meet the requirements of deleted text beginMinnesota
Rules, part 9530.6450, subpart 1, item A
deleted text endnew text begin section 245G.11, subdivision 1, paragraph (a)new text end;

(9) has emergency behavioral procedures that meet the requirements of deleted text beginMinnesota Rules,
part 9530.6475
deleted text endnew text begin section 245G.16new text end;

(10) meets the requirements of deleted text beginMinnesota Rules, part 9530.6435, subparts 3 and 4, items
A and B
deleted text endnew text begin section 245G.08, subdivision 5new text end, if administering medications to clients;

(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;

(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;

(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;

(14) has a grievance procedure that meets the requirements of deleted text beginMinnesota Rules, part
9530.6470, subpart 2
deleted text endnew text begin section 245G.15, subdivision 2new text end; and

(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.

(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 60.

Minnesota Statutes 2016, section 254B.05, subdivision 5, is amended to read:


Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for deleted text beginchemical
dependency
deleted text end new text beginsubstance use disorder new text endservices and service enhancements funded under this
chapter.

(b) Eligible deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end treatment services include:

(1) outpatient treatment services that are licensed according to deleted text beginMinnesota Rules, parts
9530.6405 to 9530.6480
deleted text endnew text begin sections 245G.01 to 245G.17new text end, or applicable tribal license;

new text begin (2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive
assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and
Minnesota Rules, part 9530.6422;
new text end

new text begin (3) on July 1, 2018, or upon federal approval, whichever is later, care coordination
services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6);
new text end

new text begin (4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support
services provided according to section 245G.07, subdivision 1, paragraph (a), clause (5);
new text end

new text begin (5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;
new text end

deleted text begin (2)deleted text endnew text begin (6)new text end medication-assisted therapy services that are licensed according to deleted text beginMinnesota
Rules, parts 9530.6405 to 9530.6480 and 9530.6500
deleted text endnew text begin section 245G.07, subdivision 1new text end, or
applicable tribal license;

deleted text begin (3)deleted text endnew text begin (7)new text end medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause deleted text begin(2)deleted text endnew text begin (6)new text end and provide nine hours of clinical services each week;

deleted text begin (4)deleted text endnew text begin (8)new text end high, medium, and low intensity residential treatment services that are licensed
according to deleted text beginMinnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505,deleted text endnew text begin sections
245G.01 to 245G.17 and 245G.21
new text end or applicable tribal license which provide, respectively,
30, 15, and five hours of clinical services each week;

deleted text begin (5)deleted text endnew text begin (9)new text end hospital-based treatment services that are licensed according to deleted text beginMinnesota Rules,
parts 9530.6405 to 9530.6480,
deleted text end new text beginsections 245G.01 to 245G.17 new text endor applicable tribal license and
licensed as a hospital under sections 144.50 to 144.56;

deleted text begin (6)deleted text endnew text begin (10)new text end adolescent treatment programs that are licensed as outpatient treatment programs
according to deleted text beginMinnesota Rules, parts 9530.6405 to 9530.6485,deleted text endnew text begin sections 245G.01 to 245G.18new text end
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 (7)deleted text endnew text begin (11)new text end high-intensity residential treatment services that are licensed according to
deleted text begin Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505,deleted text endnew text begin sections 245G.01 to 245G.17
and 245G.21
new text end 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

deleted text begin (8)deleted text endnew text begin (12)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 one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under deleted text beginMinnesota Rules, part 9530.6490, subpart
4
deleted text endnew text begin section 245G.19, subdivision 4new text end; 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, or
programs or subprograms serving special populations, if the program or subprogram meets
the following requirements:

(i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;

(ii) is governed with significant input from individuals of that specific background; and

(iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;

(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 deleted text beginMinnesota Rules, part 9530.6495deleted text endnew text begin
section 245G.20
new text end;

(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 shall 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 deleted text beginMinnesota Rules, part
9530.6490
deleted text endnew text begin section 245G.19new text end.

(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).

(f) Subject to federal approval, chemical dependency services that are otherwise covered
as direct face-to-face services may be provided via two-way interactive video. The use of
two-way interactive video must be medically appropriate to the condition and needs of the
person being served. Reimbursement shall be at the same rates and under the same conditions
that would otherwise apply to direct face-to-face services. The interactive video equipment
and connection must comply with Medicare standards in effect at the time the service is
provided.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 61.

Minnesota Statutes 2016, section 254B.051, is amended to read:


254B.051 SUBSTANCE deleted text beginABUSEdeleted text endnew text begin USE DISORDERnew text end TREATMENT
EFFECTIVENESS.

In addition to the substance deleted text beginabusedeleted text endnew text begin use disordernew text end treatment program performance outcome
measures that the commissioner of human services collects annually from treatment providers,
the commissioner shall request additional data from programs that receive appropriations
from the consolidated chemical dependency treatment fund. This data shall include number
of client readmissions six months after release from inpatient treatment, and the cost of
treatment per person for each program receiving consolidated chemical dependency treatment
funds. The commissioner may post this data on the department Web site.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 62.

Minnesota Statutes 2016, section 254B.07, is amended to read:


254B.07 THIRD-PARTY LIABILITY.

The state agency provision and payment of, or liability for, deleted text beginchemical dependencydeleted text endnew text begin
substance use disorder
new text end medical care is the same as in section 256B.042.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 63.

Minnesota Statutes 2016, section 254B.08, is amended to read:


254B.08 FEDERAL WAIVERS.

The commissioner shall apply for any federal waivers necessary to secure, to the extent
allowed by law, federal financial participation for the provision of services to persons who
need deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end services. The commissioner may seek
amendments to the waivers or apply for additional waivers to contain costs. The
commissioner shall ensure that payment for the cost of providing deleted text beginchemical dependencydeleted text endnew text begin
substance use disorder
new text end services under the federal waiver plan does not exceed the cost of
deleted text begin chemical dependencydeleted text endnew text begin substance use disordernew text end services that would have been provided without
the waivered services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 64.

Minnesota Statutes 2016, section 254B.09, is amended to read:


254B.09 INDIAN RESERVATION ALLOCATION OF CHEMICAL
DEPENDENCY FUND.

Subdivision 1.

Vendor payments.

The commissioner shall pay eligible vendors for
deleted text begin chemical dependencydeleted text endnew text begin substance use disordernew text end services to American Indians on the same
basis as other payments, except that no local match is required when an invoice is submitted
by the governing authority of a federally recognized American Indian tribal body or a county
if the tribal governing body has not entered into an agreement under subdivision 2 on behalf
of a current resident of the reservation under this section.

Subd. 2.

American Indian agreements.

The commissioner may enter into agreements
with federally recognized tribal units to pay for deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end
treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The agreements
must clarify how the governing body of the tribal unit fulfills local agency responsibilities
regarding:

(1) the form and manner of invoicing; and

(2) provide that only invoices for eligible vendors according to section 254B.05 will be
included in invoices sent to the commissioner for payment, to the extent that money allocated
under subdivisions 4 and 5 is used.

Subd. 6.

American Indian tribal placements.

After entering into an agreement under
subdivision 2, the governing authority of each reservation may submit invoices to the state
for the cost of providing deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end services to residents
of the reservation according to the placement rules governing county placements, except
that local match requirements are waived. The governing body may designate an agency to
act on its behalf to provide placement services and manage invoices by written notice to
the commissioner and evidence of agreement by the agency designated.

Subd. 8.

Payments to improve services to American Indians.

The commissioner may
set rates for deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end services to American Indians
according to the American Indian Health Improvement Act, Public Law 94-437, for eligible
vendors. These rates shall supersede rates set in county purchase of service agreements
when payments are made on behalf of clients eligible according to Public Law 94-437.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 65.

Minnesota Statutes 2016, section 254B.12, subdivision 2, is amended to read:


Subd. 2.

Payment methodology for highly specialized vendors.

Notwithstanding
subdivision 1, the commissioner shall seek federal authority to develop separate payment
methodologies for deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 66.

Minnesota Statutes 2016, section 254B.12, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin 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, 2017,
payment rates shall be increased by one percent over the rates in effect on January 1, 2017,
for vendors who meet the requirements of section 254B.05.
new text end

Sec. 67.

Minnesota Statutes 2016, section 254B.13, subdivision 2a, is amended to read:


Subd. 2a.

Eligibility for navigator pilot program.

(a) To be considered for participation
in a navigator pilot program, an individual must:

(1) be a resident of a county with an approved navigator program;

(2) be eligible for consolidated chemical dependency treatment fund services;

(3) be a voluntary participant in the navigator program;

(4) satisfy one of the following items:

(i) have at least one severity rating of three or above in dimension four, five, or six in a
comprehensive assessment under deleted text beginMinnesota Rules, part 9530.6422deleted text endnew text begin section 245G.05,
paragraph (c), clauses (4) to (6)
new text end; or

(ii) have at least one severity rating of two or above in dimension four, five, or six in a
comprehensive assessment under deleted text beginMinnesota Rules, part 9530.6422,deleted text endnew text begin section 245G.05,
paragraph (c), clauses (4) to (6),
new text end and be currently participating in a Rule 31 treatment program
under deleted text beginMinnesota Rules, parts 9530.6405 to 9530.6505,deleted text endnew text begin chapter 245Gnew text end or be within 60 days
following discharge after participation in a Rule 31 treatment program; and

(5) have had at least two treatment episodes in the past two years, not limited to episodes
reimbursed by the consolidated chemical dependency treatment funds. An admission to an
emergency room, a detoxification program, or a hospital may be substituted for one treatment
episode if it resulted from the individual's substance use disorder.

(b) New eligibility criteria may be added as mutually agreed upon by the commissioner
and participating navigator programs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 68.

Minnesota Statutes 2016, section 256B.0625, subdivision 45a, is amended to
read:


Subd. 45a.

Psychiatric residential treatment facility services for persons under 21
years of age.

(a) Medical assistance covers psychiatric residential treatment facility servicesnew text begin,
according to section 256B.0941,
new text end for persons deleted text beginunderdeleted text endnew text begin younger thannew text end 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.

(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.

(c) deleted text beginThe commissioner shall develop admissions and discharge procedures and establish
rates consistent with guidelines from the federal Centers for Medicare and Medicaid Services.
deleted text end

deleted text begin (d)deleted text end 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 begin EFFECTIVE DATE. new text end

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

Sec. 69.

new text begin [256B.0941] PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY
FOR PERSONS UNDER 21 YEARS OF AGE.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin (a) An individual who is eligible for mental health treatment
services in a psychiatric residential treatment facility must meet all of the following criteria:
new text end

new text begin (1) before admission, services are determined to be medically necessary by the state's
medical review agent according to Code of Federal Regulations, title 42, section 441.152;
new text end

new text begin (2) is younger than 21 years of age at the time of admission. Services may continue until
the individual meets criteria for discharge or reaches 22 years of age, whichever occurs
first;
new text end

new text begin (3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic
and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression,
or a finding that the individual is a risk to self or others;
new text end

new text begin (4) has functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; an inability to adequately care for
one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill
the individual's needs;
new text end

new text begin (5) requires psychiatric residential treatment under the direction of a physician to improve
the individual's condition or prevent further regression so that services will no longer be
needed;
new text end

new text begin (6) utilized and exhausted other community-based mental health services, or clinical
evidence indicates that such services cannot provide the level of care needed; and
new text end

new text begin (7) was referred for treatment in a psychiatric residential treatment facility by a qualified
mental health professional licensed as defined in section 245.4871, subdivision 27, clauses
(1) to (6).
new text end

new text begin (b) A mental health professional making a referral shall submit documentation to the
state's medical review agent containing all information necessary to determine medical
necessity, including a standard diagnostic assessment completed within 180 days of the
individual's admission. Documentation shall include evidence of family participation in the
individual's treatment planning and signed consent for services.
new text end

new text begin Subd. 2. new text end

new text begin Services. new text end

new text begin Psychiatric residential treatment facility service providers must offer
and have the capacity to provide the following services:
new text end

new text begin (1) development of the individual plan of care, review of the individual plan of care
every 30 days, and discharge planning by required members of the treatment team according
to Code of Federal Regulations, title 42, sections 441.155 to 441.156;
new text end

new text begin (2) any services provided by a psychiatrist or physician for development of an individual
plan of care, conducting a review of the individual plan of care every 30 days, and discharge
planning by required members of the treatment team according to Code of Federal
Regulations, title 42, sections 441.155 to 441.156;
new text end

new text begin (3) active treatment seven days per week that may include individual, family, or group
therapy as determined by the individual care plan;
new text end

new text begin (4) individual therapy, provided a minimum of twice per week;
new text end

new text begin (5) family engagement activities, provided a minimum of once per week;
new text end

new text begin (6) consultation with other professionals, including case managers, primary care
professionals, community-based mental health providers, school staff, or other support
planners;
new text end

new text begin (7) coordination of educational services between local and resident school districts and
the facility;
new text end

new text begin (8) 24-hour nursing; and
new text end

new text begin (9) direct care and supervision, supportive services for daily living and safety, and
positive behavior management.
new text end

new text begin Subd. 3. new text end

new text begin Per diem rate. new text end

new text begin (a) The commissioner shall establish a statewide per diem rate
for psychiatric residential treatment facility services for individuals 21 years of age or
younger. The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers. Payment must not be made to more than one entity for each
individual for services provided under this section on a given day. The commissioner shall
set rates prospectively for the annual rate period. The commissioner shall require providers
to submit annual cost reports on a uniform cost reporting form and shall use submitted cost
reports to inform the rate-setting process. The cost reporting shall be done according to
federal requirements for Medicare cost reports.
new text end

new text begin (b) The following are included in the rate:
new text end

new text begin (1) costs necessary for licensure and accreditation, meeting all staffing standards for
participation, meeting all service standards for participation, meeting all requirements for
active treatment, maintaining medical records, conducting utilization review, meeting
inspection of care, and discharge planning. The direct services costs must be determined
using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
and service-related transportation; and
new text end

new text begin (2) payment for room and board provided by facilities meeting all accreditation and
licensing requirements for participation.
new text end

new text begin (c) A facility may submit a claim for payment outside of the per diem for professional
services arranged by and provided at the facility by an appropriately licensed professional
who is enrolled as a provider with Minnesota health care programs. Arranged services must
be billed by the facility on a separate claim, and the facility shall be responsible for payment
to the provider. These services must be included in the individual plan of care and are subject
to prior authorization by the state's medical review agent.
new text end

new text begin (d) Medicaid shall reimburse for concurrent services as approved by the commissioner
to support continuity of care and successful discharge from the facility. "Concurrent services"
means services provided by another entity or provider while the individual is admitted to a
psychiatric residential treatment facility. Payment for concurrent services may be limited
and these services are subject to prior authorization by the state's medical review agent.
Concurrent services may include targeted case management, assertive community treatment,
clinical care consultation, team consultation, and treatment planning.
new text end

new text begin (e) Payment rates under this subdivision shall not include the costs of providing the
following services:
new text end

new text begin (1) educational services;
new text end

new text begin (2) acute medical care or specialty services for other medical conditions;
new text end

new text begin (3) dental services; and
new text end

new text begin (4) pharmacy drug costs.
new text end

new text begin (f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
reasonable, and consistent with federal reimbursement requirements in Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
Management and Budget Circular Number A-122, relating to nonprofit entities.
new text end

new text begin Subd. 4. new text end

new text begin Leave days. new text end

new text begin (a) Medical assistance covers therapeutic and hospital leave days,
provided the recipient was not discharged from the psychiatric residential treatment facility
and is expected to return to the psychiatric residential treatment facility. A reserved bed
must be held for a recipient on hospital leave or therapeutic leave.
new text end

new text begin (b) A therapeutic leave day to home shall be used to prepare for discharge and
reintegration and shall be included in the individual plan of care. The state shall reimburse
75 percent of the per diem rate for a reserve bed day while the recipient is on therapeutic
leave. A therapeutic leave visit may not exceed three days without prior authorization.
new text end

new text begin (c) A hospital leave day shall be a day for which a recipient has been admitted to a
hospital for medical or acute psychiatric care and is temporarily absent from the psychiatric
residential treatment facility. The state shall reimburse 50 percent of the per diem rate for
a reserve bed day while the recipient is receiving medical or psychiatric care in a hospital.
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. 70.

Minnesota Statutes 2016, section 256B.0943, subdivision 13, is amended to read:


Subd. 13.

Exception to excluded services.

Notwithstanding subdivision 12, up to 15
hours of children's therapeutic services and supports provided within a six-month period to
a child with severe emotional disturbance who is residing in a hospital; deleted text begina group home as
defined in Minnesota Rules, parts 2960.0130 to 2960.0220;
deleted text end a residential treatment facility
licensed under Minnesota Rules, parts 2960.0580 to 2960.0690; new text begina psychiatric residential
treatment facility under section 256B.0625, subdivision 45a;
new text enda regional treatment center;
or other institutional group setting or who is participating in a program of partial
hospitalization are eligible for medical assistance payment if part of the discharge plan.

new text begin EFFECTIVE DATE. new text end

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

Sec. 71.

Minnesota Statutes 2016, section 256B.0945, subdivision 2, is amended to read:


Subd. 2.

Covered services.

All services must be included in a child's individualized
treatment or multiagency plan of care as defined in chapter 245.

For facilities that are not institutions for mental diseases according to federal statute and
regulation, medical assistance covers mental health-related services that are required to be
provided by a residential facility under section 245.4882 and administrative rules promulgated
thereunder, except for room and board.new text begin For residential facilities determined by the federal
Centers for Medicare and Medicaid Services to be an institution for mental diseases, medical
assistance covers medically necessary mental health services provided by the facility
according to section 256B.055, subdivision 13, except for room and board.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for services provided on July 1, 2017,
through April 30, 2019, and expires May 1, 2019.
new text end

Sec. 72.

Minnesota Statutes 2016, section 256B.0945, subdivision 4, is amended to read:


Subd. 4.

Payment rates.

(a) Notwithstanding sections 256B.19 and 256B.041, payments
to counties for residential services provided new text beginunder this section new text endby a residential facility shallnew text begin:
new text end

new text begin (1) for services provided by a residential facility that is not an institution for mental
diseases,
new text endonly be made of federal earnings for services provided deleted text beginunder this sectiondeleted text end, and the
nonfederal share of costs for services provided under this section shall be paid by the county
from sources other than federal funds or funds used to match other federal funds. Payment
to counties for services provided according to this section shall be a proportion of the per
day contract rate that relates to rehabilitative mental health services and shall not include
payment for costs or services that are billed to the IV-E program as room and boarddeleted text begin.deleted text endnew text begin; and
new text end

new text begin (2) for services provided by a residential facility that is determined to be an institution
for mental diseases, be equivalent to the federal share of the payment that would have been
made if the residential facility were not an institution for mental diseases. The portion of
the payment representing what would be the nonfederal shares shall be paid by the county.
Payment to counties for services provided according to this section shall be a proportion of
the per day contract rate that relates to rehabilitative mental health services and shall not
include payment for costs or services that are billed to the IV-E program as room and board.
new text end

(b) Per diem rates paid to providers under this section by prepaid plans shall be the
proportion of the per-day contract rate that relates to rehabilitative mental health services
and shall not include payment for group foster care costs or services that are billed to the
county of financial responsibility. Services provided in facilities located in bordering states
are eligible for reimbursement on a fee-for-service basis only as described in paragraph (a)
and are not covered under prepaid health plans.

(c) Payment for mental health rehabilitative services provided under this section by or
under contract with an American Indian tribe or tribal organization or by agencies operated
by or under contract with an American Indian tribe or tribal organization must be made
according to section 256B.0625, subdivision 34, or other relevant federally approved
rate-setting methodology.

(d) The commissioner shall set aside a portion not to exceed five percent of the federal
funds earned for county expenditures under this section to cover the state costs of
administering this section. Any unexpended funds from the set-aside shall be distributed to
the counties in proportion to their earnings under this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for services provided on July 1, 2017,
through April 30, 2019, and expires May 1, 2019.
new text end

Sec. 73.

Minnesota Statutes 2016, section 256B.763, is amended to read:


256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.

(a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment
rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:

(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;

(2) community mental health centers under section 256B.0625, subdivision 5; and

(3) mental health clinics and centers certified under Minnesota Rules, parts 9520.0750
to 9520.0870, or hospital outpatient psychiatric departments that are designated as essential
community providers under section 62Q.19.

(b) This increase applies to group skills training when provided as a component of
children's therapeutic services and support, psychotherapy, medication management,
evaluation and management, diagnostic assessment, explanation of findings, psychological
testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.

(c) This increase does not apply to rates that are governed by section 256B.0625,
subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated
with the county, rates that are established by the federal government, or rates that increased
between January 1, 2004, and January 1, 2005.

(d) The commissioner shall adjust rates paid to prepaid health plans under contract with
the commissioner to reflect the rate increases provided in paragraphs (a), (e), and (f). The
prepaid health plan must pass this rate increase to the providers identified in paragraphs (a),
(e), (f), and (g).

(e) Payment rates shall be increased by 23.7 percent over the rates in effect on December
31, 2007, for:

(1) medication education services provided on or after January 1, 2008, by adult
rehabilitative mental health services providers certified under section 256B.0623; and

(2) mental health behavioral aide services provided on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943.

(f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943 and
not already included in paragraph (a), payment rates shall be increased by 23.7 percent over
the rates in effect on December 31, 2007.

(g) Payment rates shall be increased by 2.3 percent over the rates in effect on December
31, 2007, for individual and family skills training provided on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943.

new text begin (h) For services described in paragraphs (b), (e), and (g) and rendered on or after July
1, 2017, payment rates for mental health clinics and centers certified under Minnesota Rules,
parts 9520.0750 to 9520.0870, that are not designated as essential community providers
under section 62Q.19 shall be equal to payment rates for mental health clinics and centers
certified under Minnesota Rules, parts 9520.0750 to 9520.0870, that are designated as
essential community providers under section 62Q.19. In order to receive increased payment
rates under this paragraph, a provider must demonstrate a commitment to serve low-income
and underserved populations by:
new text end

new text begin (1) charging for services on a sliding-fee schedule based on current poverty income
guidelines; and
new text end

new text begin (2) not restricting access or services because of a client's financial limitation.
new text end

Sec. 74. new text beginCHILDREN'S MENTAL HEALTH REPORT AND RECOMMENDATIONS.
new text end

new text begin The commissioner of human services shall conduct a comprehensive analysis of
Minnesota's continuum of intensive mental health services and shall develop
recommendations for a sustainable and community-driven continuum of care for children
with serious mental health needs, including children currently being served in residential
treatment. The commissioner's analysis shall include, but not be limited to:
new text end

new text begin (1) data related to access, utilization, efficacy, and outcomes for Minnesota's current
system of residential mental health treatment for a child with a severe emotional disturbance;
new text end

new text begin (2) potential expansion of the state's psychiatric residential treatment facility (PRTF)
capacity, including increasing the number of PRTF beds and conversion of existing children's
mental health residential treatment programs into PRTFs;
new text end

new text begin (3) the capacity need for PRTF and other group settings within the state if adequate
community-based alternatives are accessible, equitable, and effective statewide;
new text end

new text begin (4) recommendations for expanding alternative community-based service models to
meet the needs of a child with a serious mental health disorder who would otherwise require
residential treatment and potential service models that could be utilized, including data
related to access, utilization, efficacy, and outcomes;
new text end

new text begin (5) models of care used in other states; and
new text end

new text begin (6) analysis and specific recommendations for the design and implementation of new
service models, including analysis to inform rate setting as necessary.
new text end

new text begin The analysis shall be supported and informed by extensive stakeholder engagement.
Stakeholders include individuals who receive services, family members of individuals who
receive services, providers, counties, health plans, advocates, and others. Stakeholder
engagement shall include interviews with key stakeholders, intentional outreach to individuals
who receive services and the individual's family members, and regional listening sessions.
new text end

new text begin The commissioner shall provide a report with specific recommendations and timelines
for implementation to the legislative committees with jurisdiction over children's mental
health policy and finance by November 15, 2018.
new text end

Sec. 75. new text beginRESIDENTIAL TREATMENT AND PAYMENT RATE REFORM.
new text end

new text begin The commissioner shall contract with an outside expert to identify recommendations
for the development of a substance use disorder residential treatment program model and
payment structure that is not subject to the federal institutions for mental diseases exclusion
and that is financially sustainable for providers, while incentivizing best practices and
improved treatment outcomes. The analysis must include recommendations and a timeline
for supporting providers to transition to the new models of care delivery. No later than
December 15, 2018, the commissioner shall deliver a report with recommendations to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health and human services policy and finance.
new text end

Sec. 76. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin In Minnesota Statutes and Minnesota Rules, the revisor of statutes, in consultation with
the with the Department of Human Services, shall make necessary cross-reference changes
that are needed as a result of the enactment of sections 12 to 35 and 75. The revisor shall
make any necessary technical and grammatical changes to preserve the meaning of the text.
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. 77. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2016, sections 245A.1915; 245A.192; and 254A.02, subdivision
4,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11,
12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 20, and 21; 9530.6410; 9530.6415;
9530.6420; 9530.6422; 9530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445;
9530.6450; 9530.6455; 9530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480;
9530.6485; 9530.6490; 9530.6495; 9530.6500; and 9530.6505,
new text end new text begin are repealed.
new text end

new text begin (c) new text end new text begin Minnesota Statutes 2016, section 256B.7631, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraphs (a) and (b) are effective January 1, 2018. Paragraph
(c) is effective the day following final enactment.
new text end

ARTICLE 9

OPERATIONS

Section 1.

Minnesota Statutes 2016, section 245A.02, subdivision 2b, is amended to read:


Subd. 2b.

Annual or annually.

new text beginWith the exception of subdivision 2c, new text end"annual" or
"annually" means prior to or within the same month of the subsequent calendar year.

Sec. 2.

Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 2c. new text end

new text begin Annual or annually; family child care training requirements. new text end

new text begin For the
purposes of section 245A.50, subdivisions 1 to 9, "annual" or "annually" means the 12-month
period beginning on the license effective date or the annual anniversary of the effective date
and ending on the day prior to the annual anniversary of the license effective date.
new text end

Sec. 3.

Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:


Subd. 4.

Inspections; waiver.

(a) Before issuing an initial license, the commissioner
shall conduct an inspection of the program. The inspection must include but is not limited
to:

(1) an inspection of the physical plant;

(2) an inspection of records and documents;

(3) an evaluation of the program by consumers of the program; and

(4) observation of the program in operation.

For the purposes of this subdivision, "consumer" means a person who receives the
services of a licensed program, the person's legal guardian, or the parent or individual having
legal custody of a child who receives the services of a licensed program.

(b) The evaluation required in paragraph (a), clause (3)new text begin,new text end or the observation in paragraph
(a), clause (4)new text begin,new text end is not required prior to issuing an initial license under subdivision 7. If the
commissioner issues an initial license under subdivision 7, these requirements must be
completed within one year after the issuance of an initial license.

new text begin (c) Before completing a licensing inspection in a family child care program or child care
center, the licensing agency must offer the license holder an exit interview to discuss
violations of law or rule observed during the inspection and offer technical assistance on
how to comply with applicable laws and rules. Nothing in this paragraph limits the ability
of the commissioner to issue a correction order or negative action for violations of law or
rule not discussed in an exit interview or in the event that a license holder chooses not to
participate in an exit interview.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 4.

Minnesota Statutes 2016, section 245A.06, subdivision 2, is amended to read:


Subd. 2.

Reconsideration of correction orders.

new text begin(a) new text endIf the applicant or license holder
believes that the contents of the commissioner's correction order are in error, the applicant
or license holder may ask the Department of Human Services to reconsider the parts of the
correction order that are alleged to be in error. The request for reconsideration must be made
in writing and must be postmarked and sent to the commissioner within 20 calendar days
after receipt of the correction order by the applicant or license holder, and:

(1) specify the parts of the correction order that are alleged to be in error;

(2) explain why they are in error; and

(3) include documentation to support the allegation of error.

A request for reconsideration does not stay any provisions or requirements of the
correction order. The commissioner's disposition of a request for reconsideration is final
and not subject to appeal under chapter 14.

new text begin (b) This paragraph applies only to licensed family child care providers. A licensed family
child care provider who requests reconsideration of a correction order under paragraph (a)
may also request, on a form and in the manner prescribed by the commissioner, that the
commissioner expedite the review if:
new text end

new text begin (1) the provider is challenging a violation and provides a description of how complying
with the corrective action for that violation would require the substantial expenditure of
funds or a significant change to their program; and
new text end

new text begin (2) describes what actions the provider will take in lieu of the corrective action ordered
to ensure the health and safety of children in care pending the commissioner's review of the
correction order.
new text end

Sec. 5.

Minnesota Statutes 2016, section 245A.06, subdivision 8, is amended to read:


Subd. 8.

Requirement to post correction order.

new text begin(a) new text endFor licensed family child care
providers and child care centers, upon receipt of any correction order or order of conditional
license issued by the commissioner under this section, and notwithstanding a pending request
for reconsideration of the correction order or order of conditional license by the license
holder, the license holder shall post the correction order or order of conditional license in
a place that is conspicuous to the people receiving services and all visitors to the facility
for two years. When the correction order or order of conditional license is accompanied by
a maltreatment investigation memorandum prepared under section 626.556 or 626.557, the
investigation memoranda must be posted with the correction order or order of conditional
license.

new text begin (b) If the commissioner reverses or rescinds a violation in a correction order upon
reconsideration under subdivision 2, the commissioner shall issue an amended correction
order and the license holder shall post the amended order according to paragraph (a).
new text end

new text begin (c) If the correction order is rescinded or reversed in full upon reconsideration under
subdivision 2, the license holder shall remove the original correction order posted according
to paragraph (a).
new text end

Sec. 6.

Minnesota Statutes 2016, section 245A.06, is amended by adding a subdivision to
read:


new text begin Subd. 9. new text end

new text begin Child care correction order quotas prohibited. new text end

new text begin The commissioner and county
licensing agencies shall not order, mandate, require, or suggest to any person responsible
for licensing or inspecting a licensed family child care provider or child care center a quota
for the issuance of correction orders on a daily, weekly, monthly, quarterly, or yearly basis.
new text end

Sec. 7.

new text begin [245A.065] CHILD CARE FIX-IT TICKET.
new text end

new text begin (a) In lieu of a correction order under section 245A.06, the commissioner shall issue a
fix-it ticket to a family child care or child care center license holder if the commissioner
finds that:
new text end

new text begin (1) the license holder has failed to comply with a requirement in this chapter or Minnesota
Rules, chapter 9502 or 9503, that the commissioner determines to be eligible for a fix-it
ticket;
new text end

new text begin (2) the violation does not imminently endanger the health, safety, or rights of the persons
served by the program;
new text end

new text begin (3) the license holder did not receive a fix-it ticket or correction order for the violation
at the license holder's last licensing inspection;
new text end

new text begin (4) the violation can be corrected at the time of inspection or within 48 hours, excluding
Saturdays, Sundays, and holidays; and
new text end

new text begin (5) the license holder corrects the violation at the time of inspection or agrees to correct
the violation within 48 hours, excluding Saturdays, Sundays, and holidays.
new text end

new text begin (b) The fix-it ticket must state:
new text end

new text begin (1) the conditions that constitute a violation of the law or rule;
new text end

new text begin (2) the specific law or rule violated; and
new text end

new text begin (3) that the violation was corrected at the time of inspection or must be corrected within
48 hours, excluding Saturdays, Sundays, and holidays.
new text end

new text begin (c) The commissioner shall not publicly publish a fix-it ticket on the department's Web
site.
new text end

new text begin (d) Within 48 hours, excluding Saturdays, Sundays, and holidays, of receiving a fix-it
ticket, the license holder must correct the violation and within one week submit evidence
to the licensing agency that the violation was corrected.
new text end

new text begin (e) If the violation is not corrected at the time of inspection or within 48 hours, excluding
Saturdays, Sundays, and holidays, or the evidence submitted is insufficient to establish that
the license holder corrected the violation, the commissioner must issue a correction order
for the violation of Minnesota law or rule identified in the fix-it ticket according to section
245A.06.
new text end

new text begin (f) The commissioner shall, following consultation with family child care license holders,
child care center license holders, and county agencies, issue a report by October 1, 2017,
that identifies the violations of this chapter and Minnesota Rules, chapters 9502 and 9503,
that are eligible for a fix-it ticket. The commissioner shall provide the report to county
agencies and the chairs and ranking minority members of the legislative committees with
jurisdiction over child care, and shall post the report to the department's Web site.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 8.

Minnesota Statutes 2016, section 245A.07, subdivision 3, is amended to read:


Subd. 3.

License suspension, revocation, or fine.

(a) The commissioner may suspend
or revoke a license, or impose a fine if:

(1) a license holder fails to comply fully with applicable laws or rules;

(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
a disqualification which has not been set aside under section 245C.22;

(3) a license holder knowingly withholds relevant information from or gives false or
misleading information to the commissioner in connection with an application for a license,
in connection with the background study status of an individual, during an investigation,
or regarding compliance with applicable laws or rules; or

(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to
submit the information required of an applicant under section 245A.04, subdivision 1,
paragraph (f) or (g).

A license holder who has had a license suspended, revoked, or has been ordered to pay
a fine must be given notice of the action by certified mail or personal service. If mailed, the
notice must be mailed to the address shown on the application or the last known address of
the license holder. The notice must state the reasons the license was suspended, revoked,
or a fine was ordered.

(b) If the license was suspended or revoked, the notice must inform the license holder
of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
a license. The appeal of an order suspending or revoking a license must be made in writing
by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
the commissioner within ten calendar days after the license holder receives notice that the
license has been suspended or revoked. If a request is made by personal service, it must be
received by the commissioner within ten calendar days after the license holder received the
order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a
timely appeal of an order suspending or revoking a license, the license holder may continue
to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and
(h), until the commissioner issues a final order on the suspension or revocation.

(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
holder of the responsibility for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
order to pay a fine must be made in writing by certified mail or personal service. If mailed,
the appeal must be postmarked and sent to the commissioner within ten calendar days after
the license holder receives notice that the fine has been ordered. If a request is made by
personal service, it must be received by the commissioner within ten calendar days after
the license holder received the order.

(2) The license holder shall pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies. If the license holder
receives state funds, the state, county, or municipal agencies or departments responsible for
administering the funds shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.

(3) A license holder shall promptly notify the commissioner of human services, in writing,
when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected as indicated by the order
to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
the license holder by certified mail or personal service that a second fine has been assessed.
The license holder may appeal the second fine as provided under this subdivision.

(4) Fines shall be assessed as follows:

new text begin (i)new text end the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c);

new text begin (ii) if the commissioner determines that a determination of maltreatment for which the
license holder is responsible is the result of maltreatment that meets the definition of serious
maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
$5,000;
new text end

new text begin (iii) for a program that operates out of the license holder's home and a program licensed
under Minnesota Rules, parts 9502.0300 to 9502.0495, the fine assessed against the license
holder shall not exceed $1,000 for each determination of maltreatment;
new text end

new text begin (iv)new text end the license holder shall forfeit $200 for each occurrence of a violation of law or rule
governing matters of health, safety, or supervision, including but not limited to the provision
of adequate staff-to-child or adult ratios, and failure to comply with background study
requirements under chapter 245C; and

new text begin (v)new text end the license holder shall forfeit $100 for each occurrence of a violation of law or rule
other than those subject to a new text begin$5,000, new text end$1,000new text begin,new text end or $200 fine deleted text beginabovedeleted text endnew text begin in items (i) to (iv)new text end.

For purposes of this section, "occurrence" means each violation identified in the
commissioner's fine order. Fines assessed against a license holder that holds a license to
provide home and community-based services, as identified in section 245D.03, subdivision
1
, and a community residential setting or day services facility license under chapter 245D
where the services are provided, may be assessed against both licenses for the same
occurrence, but the combined amount of the fines shall not exceed the amount specified in
this clause for that occurrence.

(5) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the case of a corporation, each
controlling individual is personally and jointly liable for payment.

(d) Except for background study violations involving the failure to comply with an order
to immediately remove an individual or an order to provide continuous, direct supervision,
the commissioner shall not issue a fine under paragraph (c) relating to a background study
violation to a license holder who self-corrects a background study violation before the
commissioner discovers the violation. A license holder who has previously exercised the
provisions of this paragraph to avoid a fine for a background study violation may not avoid
a fine for a subsequent background study violation unless at least 365 days have passed
since the license holder self-corrected the earlier background study violation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 9.

new text begin [245A.1434] INFORMATION FOR CHILD CARE LICENSE HOLDERS.
new text end

new text begin The commissioner shall inform family child care and child care center license holders
on a timely basis of changes to state and federal statute, rule, regulation, and policy relating
to the provision of licensed child care, the child care assistance program under chapter 119B,
the quality rating and improvement system under section 124D.142, and child care licensing
functions delegated to counties. Communications under this section shall include information
to promote license holder compliance with identified changes. Communications under this
section may be accomplished by electronic means and shall be made available to the public
online.
new text end

Sec. 10.

new text begin [245A.153] REPORT TO LEGISLATURE ON THE STATUS OF CHILD
CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Reporting requirements. new text end

new text begin Beginning on February 1, 2018, and no later
than February 1 of each year thereafter, the commissioner of human services shall provide
a report on the status of child care in Minnesota to the chairs and ranking minority members
of the legislative committees with jurisdiction over child care.
new text end

new text begin Subd. 2. new text end

new text begin Contents of report. new text end

new text begin (a) The report must include the following:
new text end

new text begin (1) summary data on trends in child care center and family child care capacity and
availability throughout the state, including the number of centers and programs that have
opened and closed and the geographic locations of those centers and programs;
new text end

new text begin (2) a description of any changes to statutes, administrative rules, or agency policies and
procedures that were implemented in the year preceding the report;
new text end

new text begin (3) a description of the actions the department has taken to address or implement the
recommendations from the Legislative Task Force on Access to Affordable Child Care
Report dated January 15, 2017, including but not limited to actions taken in the areas of:
new text end

new text begin (i) encouraging uniformity in implementing and interpreting statutes, administrative
rules, and agency policies and procedures relating to child care licensing and access;
new text end

new text begin (ii) improving communication with county licensors and child care providers regarding
changes to statutes, administrative rules, and agency policies and procedures, ensuring that
information is directly and regularly transmitted;
new text end

new text begin (iii) providing notice to child care providers before issuing correction orders or negative
actions relating to recent changes to statutes, administrative rules, and agency policies and
procedures;
new text end

new text begin (iv) implementing confidential, anonymous communication processes for child care
providers to ask questions and receive prompt, clear answers from the department;
new text end

new text begin (v) streamlining processes to reduce duplication or overlap in paperwork and training
requirements for child care providers; and
new text end

new text begin (vi) compiling and distributing information detailing trends in the violations for which
correction orders and negative actions are issued;
new text end

new text begin (4) a description of the department's efforts to cooperate with counties while addressing
and implementing the task force recommendations;
new text end

new text begin (5) summary data on child care assistance programs including but not limited to state
funding and numbers of families served; and
new text end

new text begin (6) summary data on family child care correction orders, including:
new text end

new text begin (i) the number of licensed family child care provider appeals or requests for
reconsideration of correction orders to the Department of Human Services;
new text end

new text begin (ii) the number of family child care correction order appeals or requests for
reconsideration that the Department of Human Services grants; and
new text end

new text begin (iii) the number of family child care correction order appeals or requests for
reconsideration that the Department of Human Services denies.
new text end

new text begin (b) The commissioner may offer recommendations for legislative action.
new text end

new text begin Subd. 3. new text end

new text begin Sunset. new text end

new text begin This section expires February 2, 2020.
new text end

Sec. 11.

Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:


Subd. 3c.

Local welfare agency, Department of Human Services or Department of
Health responsible for assessing or investigating reports of maltreatment.

(a) The deleted text begincountydeleted text end
local welfare agency is the agency responsible for assessing or investigating allegations of
maltreatment in child foster care, family child care, legally deleted text beginunlicenseddeleted text endnew text begin nonlicensednew text end child
care, deleted text beginjuvenile correctional facilities licensed under section 241.021 located in the local
welfare agency's county,
deleted text end and reports involving children served by an unlicensed personal
care provider organization under section 256B.0659. Copies of findings related to personal
care provider organizations under section 256B.0659 must be forwarded to the Department
of Human Services provider enrollment.

(b) The Department of Human Services is the agency responsible for assessing or
investigating allegations of maltreatment in new text beginjuvenile correctional facilities listed under
section 241.021 located in the local welfare agency's county and in
new text endfacilities licensednew text begin or
certified
new text end under chapters 245A and 245D, except for child foster care and family child care.

(c) The Department of Health is the agency responsible for assessing or investigating
allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and
144A.43 to 144A.482.

ARTICLE 10

HEALTH DEPARTMENT

Section 1.

Minnesota Statutes 2016, section 103I.005, subdivision 2, is amended to read:


Subd. 2.

Boring.

"Boring" means a hole or excavation that is not used to extract water
and includes exploratory borings, deleted text beginenvironmental bore holes,deleted text end bored geothermal heat
exchangers, and elevator deleted text beginshaftsdeleted text endnew text begin boringsnew text end.

Sec. 2.

Minnesota Statutes 2016, section 103I.005, subdivision 2a, is amended to read:


Subd. 2a.

Certified representative.

"Certified representative" means a person certified
by the commissioner to represent a well contractor, limited well/boring contractor, deleted text beginmonitoringdeleted text endnew text begin
environmental
new text end well contractor, or elevator boring contractor.

Sec. 3.

Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision
to read:


new text begin Subd. 8a. new text end

new text begin Environmental well. new text end

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

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

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

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

new text begin (i) measure groundwater levels, including a piezometer;
new text end

new text begin (ii) determine groundwater flow direction or velocity;
new text end

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

new text begin (iv) obtain samples of geologic materials for testing or classification; or
new text end

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

Sec. 4.

Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision
to read:


new text begin Subd. 8b. new text end

new text begin Environmental well contractor. new text end

new text begin "Environmental well contractor" means a
person with an environmental well contractor's license issued by the commissioner.
new text end

Sec. 5.

Minnesota Statutes 2016, section 103I.005, subdivision 12, is amended to read:


Subd. 12.

Limited well/boring contractor.

"Limited well/boring contractor" means a
person with a limited well/boring contractor's license issued by the commissioner. Limited
well/boring contractor's licenses are issued fornew text begin:
new text end

new text begin (1)new text end constructing, repairing, and sealing bored geothermal heat exchangers;

new text begin (2)new text end installing, repairing, and modifying pitless units and pitless adaptors, well casings
above the pitless unit or pitless adaptor, well screens, deleted text beginordeleted text end well diametersdeleted text begin; constructing,
repairing, and sealing drive point wells or dug wells
deleted text endnew text begin, and well pumps and pumping
equipment
new text end;

new text begin (3)new text end constructing, repairing, and sealing dewatering wells;new text begin and
new text end

new text begin (4)new text end sealing wellsdeleted text begin; and installing well pumps or pumping equipmentdeleted text endnew text begin and boringsnew text end.

Sec. 6.

Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision
to read:


new text begin Subd. 17a. new text end

new text begin Temporary environmental well. new text end

new text begin "Temporary environmental well" means
an environmental well as defined in section 103I.005, subdivision 8a, that is sealed within
72 hours of the time construction on the well begins.
new text end

Sec. 7.

Minnesota Statutes 2016, section 103I.005, subdivision 20a, is amended to read:


Subd. 20a.

Water supply well.

"Water supply well" means a well that is not a dewatering
well or deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end well and includes wells used:

(1) for potable water supply;

(2) for irrigation;

(3) for agricultural, commercial, or industrial water supply;

(4) for heating or cooling;new text begin and
new text end

(5) deleted text beginas a remedial well; and
deleted text end

deleted text begin (6)deleted text end for testing water yield for irrigation, commercial or industrial uses, residential supply,
or public water supply.

Sec. 8.

Minnesota Statutes 2016, section 103I.005, subdivision 21, is amended to read:


Subd. 21.

Well.

"Well" means an excavation that is drilled, cored, bored, washed, driven,
dug, jetted, or otherwise constructed if the excavation is intended for the location, diversion,
artificial recharge, new text beginmonitoring, testing, remediation, new text endor acquisition of groundwater. Well
includes deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end wells, drive point wells, and dewatering wells. "Well"
does not include:

(1) an excavation by backhoe, or otherwise for temporary dewatering of groundwater
for nonpotable use during construction, if the depth of the excavation is 25 feet or less;

(2) an excavation made to obtain or prospect for oil, natural gas, minerals, or products
of mining or quarrying;

(3) an excavation to insert media to repressure oil or natural gas bearing formations or
to store petroleum, natural gas, or other products;

(4) an excavation for nonpotable use for wildfire suppression activities; or

(5) borings.

Sec. 9.

Minnesota Statutes 2016, section 103I.101, subdivision 2, is amended to read:


Subd. 2.

Duties.

The commissioner shall:

(1) regulate the drilling, construction, modification, repair, and sealing of wells and
borings;

(2) examine and licensenew text begin:
new text end

new text begin (i)new text end well contractors;

new text begin (ii)new text end persons constructing, repairing, and sealing bored geothermal heat exchangers;

new text begin (iii)new text end persons modifying or repairing well casingsnew text begin above the pitless unit or adaptornew text end, well
screens, deleted text beginordeleted text end well diametersdeleted text begin; persons constructing, repairing, and sealing drive point wells or
dug wells
deleted text endnew text begin, and installing well pumps or pumping equipmentnew text end;

new text begin (iv)new text end persons constructing, repairing, and sealing dewatering wells;

new text begin (v)new text end persons sealing wellsdeleted text begin; persons installing well pumps or pumping equipmentdeleted text endnew text begin or
borings
new text end; and

new text begin (vi)new text end persons excavating or drilling holes for the installation of elevator borings deleted text beginor
hydraulic cylinders
deleted text end;

(3) deleted text beginregisterdeleted text endnew text begin examinenew text end and deleted text beginexamine monitoringdeleted text endnew text begin license environmentalnew text end well contractors;

(4) license explorers engaged in exploratory boring and examine individuals who
supervise or oversee exploratory boring;

(5) after consultation with the commissioner of natural resources and the Pollution
Control Agency, establish standards for the design, location, construction, repair, and sealing
of wells and borings within the state; and

(6) issue permits for wells, groundwater thermal devices, bored geothermal heat
exchangers, and elevator borings.

Sec. 10.

Minnesota Statutes 2016, section 103I.101, subdivision 5, is amended to read:


Subd. 5.

Commissioner to adopt rules.

The commissioner shall adopt rules including:

(1) issuance of licenses for:

(i) qualified well contractorsdeleted text begin, persons modifying or repairing well casings, well screens,
or well diameters
deleted text end;

(ii) deleted text beginpersons constructing, repairing, and sealing drive point wells or dug wells;
deleted text end

deleted text begin (iii)deleted text end persons constructing, repairing, and sealing dewatering wells;

deleted text begin (iv)deleted text endnew text begin (iii)new text end persons sealing wellsnew text begin or boringsnew text end;

deleted text begin (v)deleted text endnew text begin (iv)new text end persons installingnew text begin, modifying, or repairing well casings, well screens, well
diameters, and
new text end well pumps or pumping equipment;

deleted text begin (vi)deleted text endnew text begin (v)new text end persons constructing, repairing, and sealing bored geothermal heat exchangers;
deleted text begin and
deleted text end

deleted text begin (vii)deleted text endnew text begin (vi)new text end persons constructing, repairing, and sealing elevator borings;new text begin and
new text end

new text begin (vii) persons constructing, repairing, and sealing environmental wells;
new text end

(2) deleted text beginissuance of registration for monitoring well contractors;
deleted text end

deleted text begin (3)deleted text end establishment of conditions for examination and review of applications for license
and deleted text beginregistrationdeleted text endnew text begin certificationnew text end;

deleted text begin (4)deleted text endnew text begin (3)new text end establishment of conditions for revocation and suspension of license and
deleted text begin registrationdeleted text endnew text begin certificationnew text end;

deleted text begin (5)deleted text endnew text begin (4)new text end establishment of minimum standards for design, location, construction, repair,
and sealing of wells and borings to implement the purpose and intent of this chapter;

deleted text begin (6)deleted text endnew text begin (5)new text end establishment of a system for reporting on wells and borings drilled and sealed;

deleted text begin (7)deleted text endnew text begin (6)new text end establishment of standards for the construction, maintenance, sealing, and water
quality monitoring of wells in areas of known or suspected contamination;

deleted text begin (8)deleted text endnew text begin (7)new text end establishment of wellhead protection measures for wells serving public water
supplies;

deleted text begin (9)deleted text endnew text begin (8)new text end establishment of procedures to coordinate collection of well and boring data with
other state and local governmental agencies;

deleted text begin (10)deleted text endnew text begin (9)new text end establishment of criteria and procedures for submission of well and boring logs,
formation samples or well or boring cuttings, water samples, or other special information
required for and water resource mapping; and

deleted text begin (11)deleted text endnew text begin (10)new text end establishment of minimum standards for design, location, construction,
maintenance, repair, sealing, safety, and resource conservation related to borings, including
exploratory borings as defined in section 103I.005, subdivision 9.

Sec. 11.

Minnesota Statutes 2016, section 103I.101, subdivision 6, is amended to read:


Subd. 6.

Fees for variances.

The commissioner shall charge a nonrefundable application
fee of deleted text begin$235deleted text endnew text begin $275new text end to cover the administrative cost of processing a request for a variance or
modification of rules adopted by the commissioner under this chapter.

Sec. 12.

Minnesota Statutes 2016, section 103I.105, is amended to read:


103I.105 ADVISORY COUNCIL ON WELLS AND BORINGS.

(a) The Advisory Council on Wells and Borings is established as an advisory council
to the commissioner. The advisory council shall consist of 18 voting members. Of the 18
voting members:

(1) one member must be from the Department of Health, appointed by the commissioner
of health;

(2) one member must be from the Department of Natural Resources, appointed by the
commissioner of natural resources;

(3) one member must be a member of the Minnesota Geological Survey of the University
of Minnesota, appointed by the director;

(4) one member must be a responsible individual for a licensed explorer;

(5) one member must be a certified representative of a licensed elevator boring contractor;

(6) two members must be members of the public who are not connected with the boring
or well drilling industry;

(7) one member must be from the Pollution Control Agency, appointed by the
commissioner of the Pollution Control Agency;

(8) one member must be from the Department of Transportation, appointed by the
commissioner of transportation;

(9) one member must be from the Board of Water and Soil Resources appointed by its
chair;

(10) one member must be a certified representative of deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end
well contractor;

(11) six members must be residents of this state appointed by the commissioner, who
are certified representatives of licensed well contractors, with not more than two from the
seven-county metropolitan area and at least four from other areas of the state who represent
different geographical regions; and

(12) one member must be a certified representative of a licensed bored geothermal heat
exchanger contractor.

(b) An appointee of the well drilling industry may not serve more than two consecutive
terms.

(c) The appointees to the advisory council from the well drilling industry must:

(1) have been residents of this state for at least three years before appointment; and

(2) have at least five years' experience in the well drilling business.

(d) The terms of the appointed members and the compensation and removal of all
members are governed by section 15.059.

Sec. 13.

Minnesota Statutes 2016, section 103I.111, subdivision 6, is amended to read:


Subd. 6.

Unsealed wells new text beginand borings new text endare public health nuisances.

A well new text beginor boring
new text end that is required to be sealed under section 103I.301 but is not sealed is a public health
nuisance. A county may abate the unsealed well new text beginor boring new text endwith the same authority of a
community health board to abate a public health nuisance under section 145A.04, subdivision
8
.

Sec. 14.

Minnesota Statutes 2016, section 103I.111, subdivision 8, is amended to read:


Subd. 8.

Municipal regulation of drilling.

A municipality may regulate all drilling,
except well, elevator deleted text beginshaftdeleted text endnew text begin boringnew text end, and exploratory drilling that is subject to the provisions
of this chapter, above, in, through, and adjacent to subsurface areas designated for mined
underground space development and existing mined underground space. The regulations
may prohibit, restrict, control, and require permits for the drilling.

Sec. 15.

Minnesota Statutes 2016, section 103I.205, subdivision 1, is amended to read:


Subdivision 1.

Notification required.

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

(b) The property owner, the property owner's agent, or the deleted text beginwelldeleted text endnew text begin licensednew text end contractor where
a well is to be located must file the well notification with the commissioner.

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

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

deleted text begin (e) A person may not construct a monitoring well until a permit is issued by the
commissioner for the construction. If after obtaining a permit an attempt to construct a well
is unsuccessful, a new permit is not required as long as the initial permit is modified to
indicate the location of the successful well.
deleted text end

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

(1) the location of the well;

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

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

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

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

Sec. 16.

Minnesota Statutes 2016, section 103I.205, subdivision 2, is amended to read:


Subd. 2.

Emergency permit and notification exemptions.

The commissioner may
adopt rules that modify the procedures for filing a well notification or well new text beginor boring new text endpermit
if conditions occur that:

(1) endanger the public health and welfare or cause a need to protect the groundwater;
or

(2) require the deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end well contractor, limited well/boring contractor,
or well contractor to begin constructing a well new text beginor boring new text endbefore obtaining a permit or
notification.

Sec. 17.

Minnesota Statutes 2016, section 103I.205, subdivision 3, is amended to read:


Subd. 3.

Maintenance permit.

(a) Except as provided under paragraph (b), a well that
is not in use must be sealed or have a maintenance permit.

(b) If deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well or a dewatering well is not sealed by 14 months
after completion of construction, the owner of the property on which the well is located
must obtain and annually renew a maintenance permit from the commissioner.

Sec. 18.

Minnesota Statutes 2016, section 103I.205, subdivision 4, is amended to read:


Subd. 4.

License required.

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

(b) A person may construct, repair, and seal deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well if the
person:

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

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

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

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

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

A person must deleted text beginregister withdeleted text endnew text begin be licensed bynew text end the commissioner as deleted text begina monitoringdeleted text endnew text begin an
environmental
new text end well contractor on forms provided by the commissioner.

(c) A person may do the following work with a limited well/boring contractor's license
in possession. A separate license is required for each of the deleted text beginsixdeleted text endnew text begin fournew text end activities:

(1) installing deleted text beginordeleted text endnew text begin,new text end repairingnew text begin, and modifyingnew text end well screens deleted text beginordeleted text endnew text begin,new text end pitless units deleted text beginordeleted text endnew text begin andnew text end pitless
adaptorsnew text begin, well pumps and pumping equipment,new text end and well casings from the pitless adaptor or
pitless unit to the upper termination of the well casing;

(2) deleted text beginconstructing, repairing, and sealing drive point wells or dug wells;
deleted text end

deleted text begin (3) installing well pumps or pumping equipment;
deleted text end

deleted text begin (4)deleted text end sealing wellsnew text begin and boringsnew text end;

deleted text begin (5)deleted text endnew text begin (3)new text end constructing, repairing, deleted text beginordeleted text endnew text begin andnew text end sealing dewatering wells; or

deleted text begin (6)deleted text endnew text begin (4)new text end constructing, repairing, deleted text beginordeleted text endnew text begin andnew text end sealing bored geothermal heat exchangers.

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

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

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

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

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

Sec. 19.

Minnesota Statutes 2016, section 103I.205, subdivision 5, is amended to read:


Subd. 5.

At-grade deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end wells.

At-grade deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end
wells are authorized without variance and may be installed for the purpose of evaluating
groundwater conditions or for use as a leak detection device. An at-grade deleted text beginmonitoringdeleted text endnew text begin
environmental
new text end well must be installed in accordance with the rules of the commissioner. The
at-grade deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end wells must be installed with an impermeable double
locking cap approved by the commissioner and must be labeled new text beginenvironmental or new text endmonitoring
wells.

Sec. 20.

Minnesota Statutes 2016, section 103I.205, subdivision 6, is amended to read:


Subd. 6.

Distance requirements for sources of contaminationnew text begin, buildings, gas pipes,
liquid propane tanks, and electric lines
new text end.

(a) A person may not place, construct, or install
an actual or potential source of contaminationnew text begin, building, gas pipe, liquid propane tank, or
electric line
new text end any closer to a well new text beginor boring new text endthan the isolation distances prescribed by the
commissioner by rule unless a variance has been prescribed by rule.

(b) The commissioner shall establish by rule reduced isolation distances for facilities
which have safeguards in accordance with sections 18B.01, subdivision 26, and 18C.005,
subdivision 29
.

Sec. 21.

Minnesota Statutes 2016, section 103I.208, subdivision 1, is amended to read:


Subdivision 1.

Well notification fee.

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

(1) for new text beginconstruction of new text enda deleted text beginnewdeleted text end water supply well, deleted text begin$235deleted text endnew text begin $275new text end, which includes the state
core function fee;

(2) for a well sealing, deleted text begin$65deleted text endnew text begin $75new text end for each well, which includes the state core function fee,
except that new text begina single fee of $75 is required new text endfor deleted text beginmonitoringdeleted text endnew text begin all temporary environmentalnew text end wells
deleted text begin constructed ondeleted text endnew text begin recorded on the sealing notification fornew text end a single property, having depths
within a 25 foot range, and sealed within deleted text begin48deleted text endnew text begin 72new text end hours of start of constructiondeleted text begin, a single fee
of $65
deleted text end; deleted text beginand
deleted text end

(3) for construction of a dewatering well, deleted text begin$235deleted text endnew text begin $275new text end, which includes the state core
function fee, for each dewatering well except a dewatering project comprising five or more
dewatering wells shall be assessed a single fee of deleted text begin$1,175deleted text endnew text begin $1,375new text end for the dewatering wells
recorded on the notificationdeleted text begin.deleted text endnew text begin; and
new text end

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

Sec. 22.

Minnesota Statutes 2016, section 103I.208, subdivision 2, is amended to read:


Subd. 2.

Permit fee.

The permit fee to be paid by a property owner is:

(1) for a water supply well that is not in use under a maintenance permit, $175 annually;

(2) deleted text beginfor construction of a monitoring well, $235, which includes the state core function
fee;
deleted text end

deleted text begin (3)deleted text end for deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well that is unsealed under a maintenance permit,
$175 annuallynew text begin except no fee is required for an environmental well owned by a federal
agency, state agency, or local unit of government that is unsealed under a maintenance
permit. "Local unit of government" means a statutory or home rule charter city, town, county,
or soil and water conservation district, watershed district, an organization formed for the
joint exercise of powers under section 471.59, a community health board, or other special
purpose district or authority with local jurisdiction in water and related land resources
management
new text end;

deleted text begin (4) for a monitoring well owned by a federal agency, state agency, or local unit of
government that is unsealed under a maintenance permit, $50 annually. "Local unit of
government" means a statutory or home rule charter city, town, county, or soil and water
conservation district, watershed district, an organization formed for the joint exercise of
powers under section 471.59, a community health board, or other special purpose district
or authority with local jurisdiction in water and related land resources management;
deleted text end

deleted text begin (5)deleted text endnew text begin (3)new text end for deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end wells deleted text beginused as a leak detection device at a single
motor fuel retail outlet, a single petroleum bulk storage site excluding tank farms, or a single
agricultural chemical facility site, the construction permit fee is $235, which includes the
state core function fee, per site regardless of the number of wells constructed on the site,
and the annual fee for
deleted text endnew text begin that are unsealed undernew text end a maintenance permit deleted text beginfor unsealed monitoring
wells is
deleted text endnew text begin,new text end $175 new text beginannually new text endper site regardless of the number of deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end wells
located on site;

deleted text begin (6)deleted text endnew text begin (4)new text end for a groundwater thermal exchange device, in addition to the notification fee
for water supply wells, deleted text begin$235deleted text endnew text begin $275new text end, which includes the state core function fee;

deleted text begin (7)deleted text endnew text begin (5)new text end for a bored geothermal heat exchanger with less than ten tons of heating/cooling
capacity, deleted text begin$235deleted text endnew text begin $275new text end;

deleted text begin (8)deleted text endnew text begin (6)new text end for a bored geothermal heat exchanger with ten to 50 tons of heating/cooling
capacity, deleted text begin$475deleted text endnew text begin $515new text end;

deleted text begin (9)deleted text endnew text begin (7)new text end for a bored geothermal heat exchanger with greater than 50 tons of heating/cooling
capacity, deleted text begin$700deleted text endnew text begin $740new text end;

deleted text begin (10)deleted text endnew text begin (8)new text end for a dewatering well that is unsealed under a maintenance permit, $175 annually
for each dewatering well, except a dewatering project comprising more than five dewatering
wells shall be issued a single permit for $875 annually for dewatering wells recorded on
the permit; and

deleted text begin (11)deleted text endnew text begin (9)new text end for an elevator boring, deleted text begin$235deleted text endnew text begin $275new text end for each boring.

Sec. 23.

Minnesota Statutes 2016, section 103I.235, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin Temporary environmental well and unsuccessful well exemption. new text end

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

Sec. 24.

Minnesota Statutes 2016, section 103I.301, subdivision 1, is amended to read:


Subdivision 1.

Wells and borings.

(a) A property owner must have a well or boring
sealed if:

(1) the well or boring is contaminated or may contribute to the spread of contamination;

(2) the well or boring was attempted to be sealed but was not sealed according to the
provisions of this chapter; or

(3) the well or boring is located, constructed, or maintained in a manner that its continued
use or existence endangers groundwater quality or is a safety or health hazard.

(b) A well new text beginor boring new text endthat is not in use must be sealed unless the property owner has a
maintenance permit for the well.

(c) The property owner must have a well or boring sealed by a deleted text beginregistered ordeleted text end licensed
person authorized to seal the well or boring, consistent with provisions of this chapter.

Sec. 25.

Minnesota Statutes 2016, section 103I.301, subdivision 2, is amended to read:


Subd. 2.

deleted text beginMonitoringdeleted text end new text beginEnvironmental new text endwells.

The owner of the property where deleted text begina
monitoring
deleted text endnew text begin an environmentalnew text end well is located must have the deleted text beginmonitoringdeleted text endnew text begin environmentalnew text end well
sealed when the well is no longer in use. The owner must have a well contractor, limited
well/boring sealing contractor, or deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well contractor seal the
deleted text begin monitoringdeleted text endnew text begin environmentalnew text end well.

Sec. 26.

Minnesota Statutes 2016, section 103I.315, subdivision 1, is amended to read:


Subdivision 1.

Order to seal well or boring.

The commissioner may order a property
owner to seal a well or boring if:

(1) the commissioner determines that without being sealed the well or boring is an
imminent threat to public health or public safety;

(2) the well or boring is required to be sealed under section 103I.301; or

(3) a well is deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well or dewatering well and by 14 months
after construction of the well, the owner has not obtained a maintenance permit, or after a
maintenance permit has been issued the owner has not renewed a maintenance permit.

Sec. 27.

Minnesota Statutes 2016, section 103I.501, is amended to read:


103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.

(a) The commissioner shall regulate and license:

(1) drilling, constructing, and repair of wells;

(2) sealing of wells;

(3) installing of well pumps and pumping equipment;

(4) excavating, drilling, repairing, and sealing of elevator borings;

(5) construction, repair, and sealing of environmental deleted text beginbore holesdeleted text endnew text begin wellsnew text end; and

(6) construction, repair, and sealing of bored geothermal heat exchangers.

(b) The commissioner shall examine and license well contractors, limited well/boring
contractors, deleted text beginanddeleted text end elevator boring contractors, and deleted text beginexamine and register monitoringdeleted text endnew text begin
environmental
new text end well contractors.

(c) The commissioner shall license explorers engaged in exploratory boring and shall
examine persons who supervise or oversee exploratory boring.

Sec. 28.

Minnesota Statutes 2016, section 103I.505, subdivision 1, is amended to read:


Subdivision 1.

Reciprocity authorized.

The commissioner may issue a license or deleted text beginregisterdeleted text endnew text begin
certify
new text end a person under this chapter, without giving an examination, if the person is licensed
or deleted text beginregistereddeleted text endnew text begin certifiednew text end in another state and:

(1) the requirements for licensing or deleted text beginregistrationdeleted text endnew text begin certificationnew text end under which the well or
boring contractor was licensed or deleted text beginregistereddeleted text endnew text begin person was certifiednew text end do not conflict with this
chapter;

(2) the requirements are of a standard not lower than that specified by the rules adopted
under this chapter; and

(3) equal reciprocal privileges are granted to licensees or deleted text beginregistrantsdeleted text endnew text begin certified personsnew text end
of this state.

Sec. 29.

Minnesota Statutes 2016, section 103I.505, subdivision 2, is amended to read:


Subd. 2.

Fees required.

A well or boring contractor new text beginor certified person new text endmust apply for
the license or deleted text beginregistrationdeleted text endnew text begin certificationnew text end and pay the fees under the provisions of this chapter
to receive a license or deleted text beginregistrationdeleted text endnew text begin certificationnew text end under this section.

Sec. 30.

Minnesota Statutes 2016, section 103I.515, is amended to read:


103I.515 LICENSES NOT TRANSFERABLE.

A license or deleted text beginregistrationdeleted text endnew text begin certificationnew text end issued under this chapter is not transferable.

Sec. 31.

Minnesota Statutes 2016, section 103I.525, subdivision 1, is amended to read:


Subdivision 1.

Certification application.

(a) A person must file an application and
application fee with the commissioner to represent a well contractor.

(b) The application must state the applicant's qualifications for certification as a
representative, and other information required by the commissioner. The application must
be on forms prescribed by the commissioner.

deleted text begin (c) A person may apply as an individual if the person:
deleted text end

deleted text begin (1) is not representing a firm, sole proprietorship, partnership, association, corporation,
or other entity including the United States government, any interstate body, the state, and
an agency, department, or political subdivision of the state; and
deleted text end

deleted text begin (2) meets the well contractor certification and license requirements under this chapter.
deleted text end

Sec. 32.

Minnesota Statutes 2016, section 103I.525, subdivision 2, is amended to read:


Subd. 2.

Certification fee.

(a) The application fee for certification as a representative
of a well contractor is $75. The commissioner may not act on an application until the
application fee is paid.

(b) The renewal fee for certification as a representative of a well contractor is $75. The
commissioner may not renew a certification until the renewal fee is paid.

new text begin (c) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
new text end

Sec. 33.

Minnesota Statutes 2016, section 103I.525, subdivision 5, is amended to read:


Subd. 5.

Bond.

(a) As a condition of being issued a well contractor's license, the applicantdeleted text begin,
except a person applying for an individual well contractor's license,
deleted text end must submit a corporate
surety bond for $25,000 approved by the commissioner. The bond must be conditioned to
pay the state on performance of work in this state that is not in compliance with this chapter
or rules adopted under this chapter. The bond is in lieu of other license bonds required by
a political subdivision of the state.

(b) From proceeds of the bond, the commissioner may compensate persons injured or
suffering financial loss because of a failure of the applicant to perform work or duties in
compliance with this chapter or rules adopted under this chapter.

Sec. 34.

Minnesota Statutes 2016, section 103I.525, subdivision 6, is amended to read:


Subd. 6.

License fee.

The fee for a well contractor's license is $250deleted text begin, except the fee for
an individual well contractor's license is $75
deleted text end.

Sec. 35.

Minnesota Statutes 2016, section 103I.525, subdivision 8, is amended to read:


Subd. 8.

Renewal.

(a) A licensee must file an application and a renewal application fee
to renew the license by the date stated in the license.

(b) The renewal application fee for a well contractor's license is $250deleted text begin, except the fee for
an individual well contractor's license is $75
deleted text end.

(c) The renewal application must include information that the certified representative
of the applicant has met continuing education requirements established by the commissioner
by rule.

(d) At the time of the renewal, the commissioner must have on file all properly completed
well and boring construction reports, well and boring sealing reports, reports of elevator
borings, water sample analysis reports, well and boring permits, and well notifications for
work conducted by the licensee since the last license renewal.

Sec. 36.

Minnesota Statutes 2016, section 103I.531, subdivision 2, is amended to read:


Subd. 2.

Certification fee.

(a) The application fee for certification as a representative
of a limited well/boring contractor is $75. The commissioner may not act on an application
until the application fee is paid.

(b) The renewal fee for certification as a representative of a limited well/boring contractor
is $75. The commissioner may not renew a certification until the renewal fee is paid.

new text begin (c) The fee for three or more limited well/boring contractor certifications is $225.
new text end

new text begin (d) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
new text end

Sec. 37.

Minnesota Statutes 2016, section 103I.531, subdivision 5, is amended to read:


Subd. 5.

Bond.

(a) As a condition of being issued a limited well/boring contractor's
license for deleted text beginconstructing, repairing, and sealing drive point wells or dug wells,deleted text end sealing wells
deleted text begin ordeleted text endnew text begin andnew text end borings, constructing, repairing, and sealing dewatering wells, or constructing,
repairing, and sealing bored geothermal heat exchangers, the applicant must submit a
corporate surety bond for $10,000 approved by the commissioner. As a condition of being
issued a limited well/boring contractor's license for installing deleted text beginordeleted text endnew text begin,new text end repairingnew text begin, and modifying
well pumps and pumping equipment,
new text end well screens deleted text beginordeleted text endnew text begin,new text end pitless units deleted text beginordeleted text endnew text begin andnew text end pitless adaptorsnew text begin,new text end
and well casings from the pitless adaptor or pitless unit to the upper termination of the well
casing, deleted text beginor installing well pumps or pumping equipment,deleted text end the applicant must submit a corporate
surety bond for $2,000 approved by the commissioner. The bonds required in this paragraph
must be conditioned to pay the state on performance of work in this state that is not in
compliance with this chapter or rules adopted under this chapter. The bonds are in lieu of
other license bonds required by a political subdivision of the state.

(b) From proceeds of a bond required in paragraph (a), the commissioner may compensate
persons injured or suffering financial loss because of a failure of the applicant to perform
work or duties in compliance with this chapter or rules adopted under this chapter.

Sec. 38.

Minnesota Statutes 2016, section 103I.535, subdivision 2, is amended to read:


Subd. 2.

Certification fee.

(a) The application fee for certification as a representative
of an elevator boring contractor is $75. The commissioner may not act on an application
until the application fee is paid.

(b) The renewal fee for certification as a representative of an elevator boring contractor
is $75. The commissioner may not renew a certification until the renewal fee is paid.

new text begin (c) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
new text end

Sec. 39.

Minnesota Statutes 2016, section 103I.535, subdivision 6, is amended to read:


Subd. 6.

License fee.

The fee for an elevator deleted text beginshaftdeleted text endnew text begin boringnew text end contractor's license is $75.

Sec. 40.

Minnesota Statutes 2016, section 103I.541, subdivision 1, is amended to read:


Subdivision 1.

deleted text beginRegistrationdeleted text endnew text begin Certificationnew text end.

A person seeking deleted text beginregistration as a monitoringdeleted text endnew text begin
certification to represent an environmental
new text end well contractor must meet examination and
experience requirements adopted by the commissioner by rule.

Sec. 41.

Minnesota Statutes 2016, section 103I.541, subdivision 2, is amended to read:


Subd. 2.

Validity.

deleted text beginA monitoringdeleted text endnew text begin An environmentalnew text end well contractor's deleted text beginregistrationdeleted text endnew text begin
certification
new text end is valid until the date prescribed in the deleted text beginregistrationdeleted text endnew text begin certificationnew text end by the
commissioner.

Sec. 42.

Minnesota Statutes 2016, section 103I.541, subdivision 2a, is amended to read:


Subd. 2a.

Certification application.

(a) An individual must submit an application and
application fee to the commissioner to apply for certification as a representative of deleted text begina
monitoring
deleted text endnew text begin an environmentalnew text end well contractor.

(b) The application must be on forms prescribed by the commissioner. The application
must state the applicant's qualifications for the certification, and other information required
by the commissioner.

Sec. 43.

Minnesota Statutes 2016, section 103I.541, subdivision 2b, is amended to read:


Subd. 2b.

Issuance of deleted text beginregistrationdeleted text endnew text begin licensenew text end.

If a person employs a certified representative,
submits the bond under subdivision 3, and pays the deleted text beginregistrationdeleted text endnew text begin licensenew text end fee of $75 for deleted text begina
monitoring
deleted text endnew text begin an environmentalnew text end well contractor deleted text beginregistrationdeleted text endnew text begin licensenew text end, the commissioner shall
issue deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well contractor deleted text beginregistrationdeleted text endnew text begin licensenew text end to the applicant.
The fee for an individual registration is $75. The commissioner may not act on an application
until the application fee is paid.

Sec. 44.

Minnesota Statutes 2016, section 103I.541, subdivision 2c, is amended to read:


Subd. 2c.

Certification fee.

(a) The application fee for certification as a representative
of deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well contractor is $75. The commissioner may not act on
an application until the application fee is paid.

(b) The renewal fee for certification as a representative of deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end
well contractor is $75. The commissioner may not renew a certification until the renewal
fee is paid.

new text begin (c) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
new text end

Sec. 45.

Minnesota Statutes 2016, section 103I.541, subdivision 2e, is amended to read:


Subd. 2e.

Issuance of certification.

If the applicant meets the experience requirements
established by rule and passes the examination as determined by the commissioner, the
commissioner shall issue the applicant a certification to represent deleted text begina monitoringdeleted text endnew text begin an
environmental
new text end well contractor.

Sec. 46.

Minnesota Statutes 2016, section 103I.541, subdivision 3, is amended to read:


Subd. 3.

Bond.

(a) As a condition of being issued deleted text begina monitoringdeleted text endnew text begin an environmentalnew text end well
contractor's deleted text beginregistrationdeleted text endnew text begin licensenew text end, the applicant must submit a corporate surety bond for
$10,000 approved by the commissioner. The bond must be conditioned to pay the state on
performance of work in this state that is not in compliance with this chapter or rules adopted
under this chapter. The bond is in lieu of other license bonds required by a political
subdivision of the state.

(b) From proceeds of the bond, the commissioner may compensate persons injured or
suffering financial loss because of a failure of the applicant to perform work or duties in
compliance with this chapter or rules adopted under this chapter.

Sec. 47.

Minnesota Statutes 2016, section 103I.541, subdivision 4, is amended to read:


Subd. 4.

new text beginLicense new text endrenewal.

(a) A person must file an application and a renewal application
fee to renew the deleted text beginregistrationdeleted text endnew text begin licensenew text end by the date stated in the deleted text beginregistrationdeleted text endnew text begin licensenew text end.

(b) The renewal application fee for deleted text begina monitoringdeleted text endnew text begin an environmental new text end well contractor's
deleted text begin registrationdeleted text endnew text begin licensenew text end is $75.

(c) The renewal application must include information that the certified representative
of the applicant has met continuing education requirements established by the commissioner
by rule.

(d) At the time of the renewal, the commissioner must have on file all well and boring
construction reports, well and boring sealing reports, well permits, and notifications for
work conducted by the deleted text beginregistereddeleted text endnew text begin licensednew text end person since the last deleted text beginregistrationdeleted text endnew text begin licensenew text end renewal.

Sec. 48.

Minnesota Statutes 2016, section 103I.541, subdivision 5, is amended to read:


Subd. 5.

Incomplete or late renewal.

If a deleted text beginregistereddeleted text endnew text begin licensednew text end person submits a renewal
application after the required renewal date:

(1) the deleted text beginregistereddeleted text endnew text begin licensednew text end person must include a late fee of $75; and

(2) the deleted text beginregistereddeleted text endnew text begin licensednew text end person may not conduct activities authorized by the deleted text beginmonitoringdeleted text endnew text begin
environmental
new text end well contractor's deleted text beginregistrationdeleted text endnew text begin licensenew text end until the renewal application, renewal
application fee, late fee, and all other information required in subdivision 4 are submitted.

Sec. 49.

Minnesota Statutes 2016, section 103I.545, is amended to read:


103I.545 REGISTRATION OF DRILLING MACHINES AND HOISTS
REQUIRED.

Subdivision 1.

Drilling machine.

(a) A person may not use a drilling machine such as
a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license
deleted text begin or registrationdeleted text end under this chapter unless the drilling machine is registered with the
commissioner.

(b) A person must apply for the registration on forms prescribed by the commissioner
and submit a $75 registration fee.

(c) A registration is valid for one year.

Subd. 2.

Hoist.

(a) A person may not use a machine such as a hoist for an activity
requiring a license deleted text beginor registrationdeleted text end under this chapter to repair wells or borings, seal wells
or borings, or install pumps unless the machine is registered with the commissioner.

(b) A person must apply for the registration on forms prescribed by the commissioner
and submit a $75 registration fee.

(c) A registration is valid for one year.

Sec. 50.

new text begin [103I.550] LIMITED PUMP, PITLESS, OR DUG WELL/DRIVE POINT
CONTRACTOR.
new text end

new text begin Subdivision 1. new text end

new text begin Limited pump or pitless license or certification. new text end

new text begin A person with a limited
well/boring contractor's license or certification to install well pumps and pumping equipment;
or a person with a limited well/boring contractor's license or certification to install, repair,
and modify pitless units and pitless adapters, well casings above the pitless unit or pitless
adapter, and well screens and well diameters, will be issued a combined license or
certification to: (1) install well pumps and pumping equipment; and (2) install, repair, and
modify pitless units and pitless adapters, well casings above the pitless unit or pitless adapter,
well screens, and well diameters.
new text end

new text begin Subd. 2. new text end

new text begin Limited dug well/drive point license or certification. new text end

new text begin A person with a limited
well/boring contractor's license or certification to construct, repair, and seal drive point
wells and dug wells will be issued a well contractor's license or certification.
new text end

Sec. 51.

Minnesota Statutes 2016, section 103I.601, subdivision 2, is amended to read:


Subd. 2.

License required to make borings.

(a) Except as provided in paragraph (d),
a person must not make an exploratory boring without an explorer's license. The fee for an
explorer's license is $75. The explorer's license is valid until the date prescribed in the license
by the commissioner.

(b) A person must file an application and renewal application fee to renew the explorer's
license by the date stated in the license. The renewal application fee is $75.

(c) If the licensee submits an application fee after the required renewal date, the licensee:

(1) must include a late fee of $75; and

(2) may not conduct activities authorized by an explorer's license until the renewal
application, renewal application fee, late fee, and sealing reports required in subdivision 9
are submitted.

(d) An explorer must designate a responsible individual to supervise and oversee the
making of exploratory borings.

new text begin (1)new text end Before an individual supervises or oversees an exploratory boring, the individual
must file an application and application fee of $75 to qualify as a new text begincertified new text endresponsible
individual.

new text begin (2)new text end The individual must take and pass an examination relating to construction, location,
and sealing of exploratory borings. A professional engineer or geoscientist licensed under
sections 326.02 to 326.15 or a professional geologist certified by the American Institute of
Professional Geologists is not required to take the examination required in this subdivision,
but must be certified as a responsible individual to supervise an exploratory boring.

new text begin (3) The individual must file an application and a renewal fee of $75 to renew the
responsible individual's certification by the date stated in the certification. If the certified
responsible individual submits an application fee after the renewal date, the certified
responsible individual must include a late fee of $75 and may not supervise or oversee
exploratory borings until the renewal application, application fee, and late fee are submitted.
new text end

Sec. 52.

Minnesota Statutes 2016, section 103I.601, subdivision 4, is amended to read:


Subd. 4.

new text beginNotification and new text endmap of borings.

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

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

Sec. 53.

Minnesota Statutes 2016, section 103I.711, subdivision 1, is amended to read:


Subdivision 1.

Impoundment.

The commissioner may apply to district court for a
warrant authorizing seizure and impoundment of all drilling machines or hoists owned or
used by a person. The court shall issue an impoundment order upon the commissioner's
showing that a person is constructing, repairing, or sealing wells or borings or installing
pumps or pumping equipment or excavating holes for installing elevator deleted text beginshaftsdeleted text endnew text begin boringsnew text end
without a license deleted text beginor registrationdeleted text end as required under this chapter. A sheriff on receipt of the
warrant must seize and impound all drilling machines and hoists owned or used by the
person. A person from whom equipment is seized under this subdivision may file an action
in district court for the purpose of establishing that the equipment was wrongfully seized.

Sec. 54.

Minnesota Statutes 2016, section 103I.715, subdivision 2, is amended to read:


Subd. 2.

Gross misdemeanors.

A person is guilty of a gross misdemeanor who:

(1) willfully violates a provision of this chapter or order of the commissioner;

(2) engages in the business of drilling or making wells, sealing wells, installing pumps
or pumping equipment, or constructing elevator deleted text beginshaftsdeleted text endnew text begin boringsnew text end without a license required
by this chapter; or

(3) engages in the business of exploratory boring without an exploratory borer's license
under this chapter.

Sec. 55.

new text begin [137.67] MINNESOTA BIOMEDICINE AND BIOETHICS INNOVATION
GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Grants. new text end

new text begin (a) The steering committee of the University of Minnesota and
Mayo Foundation partnership shall award grants to entities that apply for a grant under this
subdivision to fund innovations and research in biomedicine and bioethics. Grant funds
must be used to fund biomedical and bioethical research, and related clinical translation
and commercialization activities in this state. Entities must apply for a grant in a form and
manner specified by the steering committee. The steering committee shall use the following
criteria to award grants under this subdivision:
new text end

new text begin (1) the likelihood that the research will lead to a new discovery;
new text end

new text begin (2) the prospects for commercialization of the research;
new text end

new text begin (3) the likelihood that the research will strengthen Minnesota's economy through the
creation of new businesses, increased public or private funding for research in Minnesota,
or attracting additional clinicians and researchers to Minnesota; and
new text end

new text begin (4) whether the proposed research includes a bioethics research plan to ensure the research
is conducted using ethical research practices.
new text end

new text begin (b) Projects that include the acquisition or use of human fetal tissue are not eligible for
grants under this subdivision. For purposes of this paragraph, "human fetal tissue" has the
meaning given in United States Code, title 42, section 289g-1(f).
new text end

new text begin Subd. 2. new text end

new text begin Consultation. new text end

new text begin In awarding grants under subdivision 1, the steering committee
may consult with interested parties who are able to provide technical information, advice,
and recommendations on grant projects and awards. Interested parties with whom the steering
committee may consult include but are not limited to representatives of private industries
with expertise in biomedical research, bioethical research, clinical translation,
commercialization, and medical venture financing.
new text end

Sec. 56.

new text begin [144.0572] CRIMINAL HISTORY BACKGROUND CHECKS ON
APPLICANTS, LICENSEES, AND OTHER OCCUPATIONS REGULATED BY
COMMISSIONER OF HEALTH.
new text end

new text begin Subdivision 1. new text end

new text begin Criminal history background check requirements. new text end

new text begin (a) Beginning
January 1, 2018, an applicant for initial licensure, temporary licensure, or relicensure after
a lapse in licensure as an audiologist or speech-language pathologist, or an applicant for
initial certification as a hearing instrument dispenser, must submit to a criminal history
records check of state data completed by the Bureau of Criminal Apprehension (BCA) and
a national criminal history records check, including a search of the records of the Federal
Bureau of Investigation (FBI).
new text end

new text begin (b) Beginning January 1, 2020, an applicant for a renewal license or certificate as an
audiologist, speech-language pathologist, or hearing instrument dispenser who was licensed
or obtained a certificate before January 1, 2018, must submit to a criminal history records
check of state data completed by the BCA and a national criminal history records check,
including a search of the records of the FBI.
new text end

new text begin (c) An applicant must submit to a background study under chapter 245C.
new text end

new text begin (d) The criminal history records check must be structured so that any new crimes that
an applicant or licensee or certificate holder commits after the initial background check are
flagged in the BCA's or FBI's database and reported back to the commissioner of human
services.
new text end

new text begin Subd. 2. new text end

new text begin Procedures. new text end

new text begin (a) The commissioner shall contract with the Department of Human
Services to process the criminal history background check requirements through NETStudy
2.0, as defined in section 245C.02.
new text end

new text begin (b) The Department of Human Services shall conduct the criminal history background
checks according to section 144.057, except that:
new text end

new text begin (1) all applicants must submit to a fingerprint-based criminal history records check of
state data completed by the BCA and a national criminal history records check, including
a search of the records of the FBI;
new text end

new text begin (2) the Department of Human Services shall complete the check and the study and notify
the commissioner of health if the applicant, licensee, or certificate holder has a criminal
history as defined in section 245C.15; and
new text end

new text begin (3) the Department of Human Services shall simultaneously conduct a background study
on each applicant according to chapter 245C.
new text end

new text begin (c) When making a determination whether to issue a license, deny a license, or issue a
conditional license or other credential to practice an occupation regulated by the Department
of Health, the commissioner or the commissioner's designee shall evaluate a criminal
conviction, guilty plea, Alford plea, judicial determination, or preponderance of evidence
to determine an applicant's risk of harm using the criteria in section 364.03.
new text end

new text begin (d) Before taking disciplinary action against an applicant or a licensee based on a criminal
conviction, judicial determination, admission in court, Alford plea, or preponderance of
evidence, the commissioner of health shall provide the applicant or licensee an opportunity
to complete or challenge the accuracy of the criminal history information. The applicant or
licensee shall have 30 calendar days following notice from the commissioner of the intent
to deny licensure or take disciplinary action to request an opportunity to correct or complete
the record prior to the commissioner taking disciplinary action. The commissioner shall
provide the applicant up to 180 days to challenge the accuracy or completeness of the report
with the agency responsible for the record. This subdivision does not affect the right of the
subject of the data to contest the accuracy or completeness under section 13.04, subdivision
4.
new text end

new text begin (e) The checks and studies must be structured so that any new crimes that an applicant
or licensee commits after the initial background check are flagged in the BCA's or FBI's
database and reported back to the commissioner of human services.
new text end

new text begin Subd. 3. new text end

new text begin Applicant, licensee, or other regulated individual's responsibilities. new text end

new text begin (a)
Applicants, licensees, and individuals seeking a credential to practice one of the public
health occupations listed in subdivision 1 must submit a complete criminal history records
check consent form, a complete background study consent form, and a full set of fingerprints
as required by the Department of Human Services in section 245C.05.
new text end

new text begin (b) The applicant or license holder is responsible for paying to the Department of Human
Services all fees associated with the preparation of the fingerprints, the criminal records
check consent form, and the criminal background check.
new text end

Sec. 57.

new text begin [144.059] PALLIATIVE CARE ADVISORY COUNCIL.
new text end

new text begin Subdivision 1. new text end

new text begin Membership. new text end

new text begin The Palliative Care Advisory Council shall consist of 18
public members.
new text end

new text begin Subd. 2. new text end

new text begin Public members. new text end

new text begin (a) The commissioner shall appoint, in the manner provided
in section 15.0597, 18 public members, including the following:
new text end

new text begin (1) two physicians, of which one is certified by the American Board of Hospice and
Palliative Medicine;
new text end

new text begin (2) two registered nurses or advanced practice registered nurses, of which one is certified
by the National Board for Certification of Hospice and Palliative Nurses;
new text end

new text begin (3) one care coordinator experienced in working with people with serious or chronic
illness and their families;
new text end

new text begin (4) one spiritual counselor experienced in working with people with serious or chronic
illness and their families;
new text end

new text begin (5) three licensed health professionals, such as complementary and alternative health
care practitioners, dietitians or nutritionists, pharmacists, or physical therapists, who are
neither physicians nor nurses, but who have experience as members of a palliative care
interdisciplinary team working with people with serious or chronic illness and their families;
new text end

new text begin (6) one licensed social worker experienced in working with people with serious or chronic
illness and their families;
new text end

new text begin (7) four patients or personal caregivers experienced with serious or chronic illness;
new text end

new text begin (8) one representative of a health plan company;
new text end

new text begin (9) one physician assistant that is a member of the American Academy of Hospice and
Palliative Medicine; and
new text end

new text begin (10) two members from any of the categories described in clauses (1) to (9).
new text end

new text begin (b) Council membership must include, where possible, representation that is racially,
culturally, linguistically, geographically, and economically diverse.
new text end

new text begin (c) The council must include at least six members who reside outside Anoka, Carver,
Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Ramsey, Scott, Sherburne, Sibley, Stearns,
Washington, or Wright Counties.
new text end

new text begin (d) To the extent possible, council membership must include persons who have experience
in palliative care research, palliative care instruction in a medical or nursing school setting,
palliative care services for veterans as a provider or recipient, or pediatric care.
new text end

new text begin (e) Council membership must include health professionals who have palliative care work
experience or expertise in palliative care delivery models in a variety of inpatient, outpatient,
and community settings, including acute care, long-term care, or hospice, with a variety of
populations, including pediatric, youth, and adult patients.
new text end

new text begin Subd. 3. new text end

new text begin Term. new text end

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

new text begin Subd. 4. new text end

new text begin Administration. new text end

new text begin The commissioner or the commissioner's designee shall
provide meeting space and administrative services for the council.
new text end

new text begin Subd. 5. new text end

new text begin Chairs. new text end

new text begin At the council's first meeting, and biannually thereafter, the members
shall elect a chair and a vice-chair whose duties shall be established by the council.
new text end

new text begin Subd. 6. new text end

new text begin Meeting. new text end

new text begin The council shall meet at least twice yearly.
new text end

new text begin Subd. 7. new text end

new text begin No compensation. new text end

new text begin Public members of the council serve without compensation
or reimbursement for expenses.
new text end

new text begin Subd. 8. new text end

new text begin Duties. new text end

new text begin (a) The council shall consult with and advise the commissioner on
matters related to the establishment, maintenance, operation, and outcomes evaluation of
palliative care initiatives in the state.
new text end

new text begin (b) By February 15 of each year, the council shall submit to the chairs and ranking
minority members of the committees of the senate and the house of representatives with
primary jurisdiction over health care a report containing:
new text end

new text begin (1) the advisory council's assessment of the availability of palliative care in the state;
new text end

new text begin (2) the advisory council's analysis of barriers to greater access to palliative care; and
new text end

new text begin (3) recommendations for legislative action, with draft legislation to implement the
recommendations.
new text end

new text begin (c) The Department of Health shall publish the report each year on the department's Web
site.
new text end

new text begin Subd. 9. new text end

new text begin Open meetings. new text end

new text begin The council is subject to the requirements of chapter 13D.
new text end

new text begin Subd. 10. new text end

new text begin Sunset. new text end

new text begin The council shall sunset January 1, 2025.
new text end

Sec. 58.

new text begin [144.1215] AUTHORIZATION TO USE HANDHELD DENTAL X-RAY
EQUIPMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Definition; handheld dental x-ray equipment. new text end

new text begin For purposes of this
section, "handheld dental x-ray equipment" means x-ray equipment that is used to take
dental radiographs, is designed to be handheld during operation, and is operated by an
individual authorized to take dental radiographs under chapter 150A.
new text end

new text begin Subd. 2. new text end

new text begin Use authorized. new text end

new text begin (a) Handheld dental x-ray equipment may be used if the
equipment:
new text end

new text begin (1) has been approved for human use by the United States Food and Drug Administration
and is being used in a manner consistent with that approval; and
new text end

new text begin (2) utilizes a backscatter shield that:
new text end

new text begin (i) is composed of a leaded polymer or a substance with a substantially equivalent
protective capacity;
new text end

new text begin (ii) has at least 0.25 millimeters of lead or lead-shielding equivalent; and
new text end

new text begin (iii) is permanently affixed to the handheld dental x-ray equipment.
new text end

new text begin (b) The use of handheld dental x-ray equipment is prohibited if the equipment's
backscatter shield is broken or not permanently affixed to the system.
new text end

new text begin (c) The use of handheld dental x-ray equipment shall not be limited to situations in which
it is impractical to transfer the patient to a stationary x-ray system.
new text end

new text begin (d) Handheld dental x-ray equipment must be stored when not in use, by being secured
in a restricted, locked area of the facility.
new text end

new text begin (e) Handheld dental x-ray equipment must be calibrated initially and at intervals that
must not exceed 24 months. Calibration must include the test specified in Minnesota Rules,
part 4732.1100, subpart 11.
new text end

new text begin (f) Notwithstanding Minnesota Rules, part 4732.0880, subpart 2, item C, the tube housing
and the position-indicating device of handheld dental x-ray equipment may be handheld
during an exposure.
new text end

new text begin Subd. 3. new text end

new text begin Exemptions from certain shielding requirements. new text end

new text begin Handheld dental x-ray
equipment used according to this section and according to manufacturer instructions is
exempt from the following requirements for the equipment:
new text end

new text begin (1) shielding requirements in Minnesota Rules, part 4732.0365, item B; and
new text end

new text begin (2) requirements for the location of the x-ray control console or utilization of a protective
barrier in Minnesota Rules, part 4732.0800, subpart 2, item B, subitems (2) and (3), provided
the equipment utilizes a backscatter shield that satisfies the requirements in subdivision 2,
paragraph (a), clause (2).
new text end

new text begin Subd. 4. new text end

new text begin Compliance with rules. new text end

new text begin A registrant using handheld dental x-ray equipment
shall otherwise comply with Minnesota Rules, chapter 4732.
new text end

Sec. 59.

Minnesota Statutes 2016, section 144.122, is amended to read:


144.122 LICENSE, PERMIT, AND SURVEY FEES.

(a) The state commissioner of health, by rule, may prescribe procedures and fees for
filing with the commissioner as prescribed by statute and for the issuance of original and
renewal permits, licenses, registrations, and certifications issued under authority of the
commissioner. The expiration dates of the various licenses, permits, registrations, and
certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
application and examination fees and a penalty fee for renewal applications submitted after
the expiration date of the previously issued permit, license, registration, and certification.
The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
registrations, and certifications when the application therefor is submitted during the last
three months of the permit, license, registration, or certification period. Fees proposed to
be prescribed in the rules shall be first approved by the Department of Management and
Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
in an amount so that the total fees collected by the commissioner will, where practical,
approximate the cost to the commissioner in administering the program. All fees collected
shall be deposited in the state treasury and credited to the state government special revenue
fund unless otherwise specifically appropriated by law for specific purposes.

(b) The commissioner may charge a fee for voluntary certification of medical laboratories
and environmental laboratories, and for environmental and medical laboratory services
provided by the department, without complying with paragraph (a) or chapter 14. Fees
charged for environment and medical laboratory services provided by the department must
be approximately equal to the costs of providing the services.

(c) The commissioner may develop a schedule of fees for diagnostic evaluations
conducted at clinics held by the services for children with disabilities program. All receipts
generated by the program are annually appropriated to the commissioner for use in the
maternal and child health program.

(d) The commissioner shall set license fees for hospitals and nursing homes that are not
boarding care homes at the following levels:

Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) and
American Osteopathic Association (AOA)
hospitals
$7,655 plus $16 per bed
Non-JCAHO and non-AOA hospitals
$5,280 plus $250 per bed
Nursing home
$183 plus $91 per bednew text begin until June 30, 2018.
$183 plus $100 per bed between July 1, 2018,
and June 30, 2020. $183 plus $105 per bed
beginning July 1, 2020.
new text end

The commissioner shall set license fees for outpatient surgical centers, boarding care
homes, and supervised living facilities at the following levels:

Outpatient surgical centers
$3,712
Boarding care homes
$183 plus $91 per bed
Supervised living facilities
$183 plus $91 per bed.

new text begin Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
or later.
new text end

(e) Unless prohibited by federal law, the commissioner of health shall charge applicants
the following fees to cover the cost of any initial certification surveys required to determine
a provider's eligibility to participate in the Medicare or Medicaid program:

Prospective payment surveys for hospitals
$
900
Swing bed surveys for nursing homes
$
1,200
Psychiatric hospitals
$
1,400
Rural health facilities
$
1,100
Portable x-ray providers
$
500
Home health agencies
$
1,800
Outpatient therapy agencies
$
800
End stage renal dialysis providers
$
2,100
Independent therapists
$
800
Comprehensive rehabilitation outpatient facilities
$
1,200
Hospice providers
$
1,700
Ambulatory surgical providers
$
1,800
Hospitals
$
4,200
Other provider categories or additional
resurveys required to complete initial
certification
Actual surveyor costs: average
surveyor cost x number of hours for
the survey process.

These fees shall be submitted at the time of the application for federal certification and
shall not be refunded. All fees collected after the date that the imposition of fees is not
prohibited by federal law shall be deposited in the state treasury and credited to the state
government special revenue fund.

Sec. 60.

Minnesota Statutes 2016, section 144.1501, subdivision 2, is amended to read:


Subd. 2.

Creation of account.

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

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

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

(3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care
facility for persons with developmental disability; deleted text beginordeleted text end 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; new text begina housing with services establishment as defined in section
144D.01, subdivision 4; or for a home care provider as defined in section 144A.43,
subdivision 4;
new text endor agree to teach at least 12 credit hours, or 720 hours per year in the nursing
field in a postsecondary program at the undergraduate level or the equivalent at the graduate
level;

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

(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
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. 61.

new text begin [144.1505] HEALTH PROFESSIONALS CLINICAL TRAINING
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 advanced practice registered nurse program" means a program that is located
in Minnesota and is currently accredited as a master's, doctoral, or postgraduate level
advanced practice registered nurse program by the Commission on Collegiate Nursing
Education or by the Accreditation Commission for Education in Nursing, or is a candidate
for accreditation;
new text end

new text begin (2) "eligible dental therapy program" means a dental therapy education program or
advanced dental therapy education program that is located in Minnesota and is either:
new text end

new text begin (i) approved by the Board of Dentistry; or
new text end

new text begin (ii) currently accredited by the Commission on Dental Accreditation;
new text end

new text begin (3) "eligible mental health professional program" means a program that is located in
Minnesota and is listed as a mental health professional program by the appropriate accrediting
body for clinical social work, psychology, marriage and family therapy, or licensed
professional clinical counseling, or is a candidate for accreditation;
new text end

new text begin (4) "eligible pharmacy program" means a program that is located in Minnesota and is
currently accredited as a doctor of pharmacy program by the Accreditation Council on
Pharmacy Education;
new text end

new text begin (5) "eligible physician assistant program" means a program that is located in Minnesota
and is currently accredited as a physician assistant program by the Accreditation Review
Commission on Education for the Physician Assistant, or is a candidate for accreditation;
new text end

new text begin (6) "mental health professional" means an individual providing clinical services in the
treatment of mental illness who meets one of the qualifications under section 245.462,
subdivision 18; and
new text end

new text begin (7) "project" means a project to establish or expand clinical training for physician
assistants, advanced practice registered nurses, pharmacists, dental therapists, advanced
dental therapists, or mental health professionals in Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Program. new text end

new text begin (a) The commissioner of health shall award health professional
training site grants to eligible physician assistant, advanced practice registered nurse,
pharmacy, dental therapy, and mental health professional programs to plan and implement
expanded clinical training. A planning grant shall not exceed $75,000, and a training grant
shall not exceed $150,000 for the first year, $100,000 for the second year, and $50,000 for
the third year per program.
new text end

new text begin (b) Funds may be used for:
new text end

new text begin (1) establishing or expanding clinical training for physician assistants, advanced practice
registered nurses, pharmacists, dental therapists, advanced dental therapists, and mental
health professionals in Minnesota;
new text end

new text begin (2) recruitment, training, and retention of students and faculty;
new text end

new text begin (3) connecting students with appropriate clinical training sites, internships, practicums,
or externship activities;
new text end

new text begin (4) travel and lodging for students;
new text end

new text begin (5) faculty, student, and preceptor salaries, incentives, or other financial support;
new text end

new text begin (6) development and implementation of cultural competency training;
new text end

new text begin (7) evaluations;
new text end

new text begin (8) training site improvements, fees, equipment, and supplies required to establish,
maintain, or expand a physician assistant, advanced practice registered nurse, pharmacy,
dental therapy, or mental health professional training program; and
new text end

new text begin (9) 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. new text end

new text begin Eligible physician assistant, advanced practice registered nurse,
pharmacy, dental therapy, and mental health professional programs seeking a grant shall
apply to the commissioner. Applications must include a description of the number of
additional students who will be trained using grant funds; attestation that funding will be
used to support an increase in the number of clinical training slots; a description of the
problem that the proposed project will address; a description of the project, including all
costs associated with the project, sources of funds for the project, detailed uses of all funds
for the project, and the results expected; and a plan to maintain or operate any component
included in the project 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 applications. new text end

new text begin The commissioner shall review each application
to determine whether or not the application is complete and whether the program and the
project are eligible for a grant. In evaluating applications, the commissioner shall score each
application based on factors including, but not limited to, the applicant's clarity and
thoroughness in describing the project and the problems to be addressed, the extent to which
the applicant has demonstrated that the applicant has made adequate provisions to ensure
proper and efficient operation of the training program once the grant project is completed,
the extent to which the proposed project is consistent with the goal of increasing access to
primary care and mental health services for rural and underserved urban communities, the
extent to which the proposed project incorporates team-based primary care, and project
costs and use of funds.
new text end

new text begin Subd. 5. new text end

new text begin Program oversight. new text end

new text begin The commissioner shall determine the amount of a grant
to be given to an eligible program based on the relative score of each eligible program's
application, other relevant factors discussed during the review, and the funds available to
the commissioner. Appropriations made to the program do not cancel and are available until
expended. During the grant period, the commissioner may require and collect from programs
receiving grants any information necessary to evaluate the program.
new text end

Sec. 62.

new text begin [144.4199] PUBLIC HEALTH RESPONSE CONTINGENCY ACCOUNT.
new text end

new text begin Subdivision 1. new text end

new text begin Public health response contingency account. new text end

new text begin A public health response
contingency account is created in the special revenue fund in the state treasury. Money in
the public health response contingency account does not cancel and is appropriated to the
commissioner of health for the purposes specified in subdivision 4 when the determination
criteria in subdivision 3 and the requirements in subdivisions 5, paragraph (a), and 7, are
satisfied.
new text end

new text begin Subd. 2. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "public health response" means
immediate public health activities required to protect the health and safety of the public due
to pandemic influenza or an outbreak of a communicable or infectious disease.
new text end

new text begin Subd. 3. new text end

new text begin Determination criteria. new text end

new text begin The commissioner may make expenditures from the
public health response contingency account only if:
new text end

new text begin (1) the commissioner determines the pandemic influenza or outbreak of a communicable
or infectious disease requires a public health response;
new text end

new text begin (2) the commissioner determines that the public health response is reasonably expected
to require supplies, equipment, personnel, and other resources in excess of the resources
available for public health response and preparedness activities in the affected jurisdictions;
and
new text end

new text begin (3) the commissioner has notified the relevant federal agency that the pandemic influenza
or communicable or infectious disease:
new text end

new text begin (i) is reasonably expected to require the evacuation of the impacted population, relocation
of seriously ill or injured persons to temporary care facilities, or the provision of replacement
essential community services;
new text end

new text begin (ii) poses a probability of a large number of deaths, serious injuries, or long-term
disabilities in the affected population;
new text end

new text begin (iii) involves widespread exposure to an infectious agent that poses a significant risk of
substantial future harm to a large number of people in the affected area; or
new text end

new text begin (iv) poses a significant risk of harm to a large number of people or a high rate of morbidity
or mortality in the affected population.
new text end

new text begin Subd. 4. new text end

new text begin Uses of funds. new text end

new text begin (a) When the determination criteria in subdivision 3 are satisfied
and the commissioner has complied with subdivisions 5, paragraph (a), and 7, the
commissioner may make expenditures from the public health response contingency account
for the following purposes attributable to a public health response:
new text end

new text begin (1) staffing;
new text end

new text begin (2) information technology;
new text end

new text begin (3) supplies, equipment, and services to protect people in the affected area or population,
health care providers, and public safety workers;
new text end

new text begin (4) training for and coordination with local public health departments and health care
providers;
new text end

new text begin (5) communication with and outreach to affected areas or populations;
new text end

new text begin (6) to provide a state match for federal assistance obtained for the public health response;
new text end

new text begin (7) laboratory testing, including enhancements to laboratory capacity necessary to conduct
testing related to the event, and supplies, equipment, shipping, and security;
new text end

new text begin (8) the purchase of vaccines, antibiotics, antivirals, and other medical resources to prevent
the spread of the pandemic influenza or communicable or infectious disease or to treat
related medical conditions;
new text end

new text begin (9) reimbursement to community health boards or other local units of government for
incurred costs for the goods and services listed in clauses (1) to (8) that are attributable to
the public health response;
new text end

new text begin (10) reimbursement to health care organizations and health care providers for incurred
costs that are attributable to the public health response; and
new text end

new text begin (11) funding to support other state agencies for costs incurred by those agencies that are
attributable to the public health response.
new text end

new text begin (b) Money in the account must not be used to increase the total number of full-time
equivalent permanent employees at the Department of Health, unless expressly authorized
by law. Money in the account shall be used only for public health response activities to
protect the health and safety of the public.
new text end

new text begin Subd. 5. new text end

new text begin Assistance from other sources. new text end

new text begin (a) As a condition of making expenditures
from the public health response contingency account, the commissioner must seek any
appropriate assistance from other available sources, including the federal government, to
assist with costs attributable to the public health response.
new text end

new text begin (b) If the commissioner recovers eligible costs for the public health response from a
nonstate source after making expenditures from the public health response contingency
account, the commissioner shall reimburse the public health response contingency account
for those costs, up to the amount recovered for eligible costs from the nonstate source.
new text end

new text begin Subd. 6. new text end

new text begin Emergency management authority. new text end

new text begin Nothing in this section shall be construed
to limit the emergency management authority of the governor or any local or county
organization for emergency management under chapter 12 or other law.
new text end

new text begin Subd. 7. new text end

new text begin Notice and expenditure review. new text end

new text begin (a) For pandemic influenza or an outbreak of
a communicable or infectious disease that begins on or after July 1, 2017, if the commissioner
determines that a public health response to pandemic influenza or an outbreak of a
communicable or infectious disease may require the diversion of Department of Health staff
or resources, the commissioner shall provide written notice to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance with information on the event requiring the public health response, the
public health response that may be required, and estimates of the staff hours and resources
that the commissioner may need to divert to provide the public health response. For pandemic
influenza or an outbreak of a communicable or infectious disease that begins prior to July
1, 2017, the commissioner must provide the notice required by this paragraph no later than
July 10, 2017.
new text end

new text begin (b) Prior to authorizing expenditures from the public health response contingency account,
the commissioner shall seek review and recommendation from the Legislative Advisory
Commission according to the procedures in section 3.3005, subdivision 5, that would
otherwise apply if the funds were federal funds. The commissioner is prohibited from seeking
review and recommendation for any expenditures for public health response activities that
were made before the commissioner provided the notice required in paragraph (a).
new text end

new text begin Subd. 8. new text end

new text begin Report. new text end

new text begin By January 15 of each year, the commissioner shall submit a report to
the chairs and ranking minority members of the house of representatives Ways and Means
Committee, the senate Finance Committee, and the house of representatives and senate
committees with jurisdiction over health and human services finance, detailing expenditures
made in the previous calendar year from the public health response contingency account.
new text end

Sec. 63.

Minnesota Statutes 2016, section 144.4961, subdivision 3, is amended to read:


Subd. 3.

Rulemaking.

The commissioner of health shall adopt rules establishing licensure
requirements and work standards 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 begin Rules adopted by the commissioner under this subdivision
are effective beginning January 1, 2019.
new text end

Sec. 64.

Minnesota Statutes 2016, section 144.4961, subdivision 4, is amended to read:


Subd. 4.

System tag.

All radon mitigation systems installed in Minnesota on or after
January 1, deleted text begin2018deleted text endnew text begin 2019new text end, 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.

Sec. 65.

Minnesota Statutes 2016, section 144.4961, subdivision 5, is amended to read:


Subd. 5.

License required annually.

Effective January 1, deleted text begin2018deleted text endnew text begin 2019new text end, a license is required
annually for every person, firm, or corporation that 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.

Sec. 66.

Minnesota Statutes 2016, 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 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;

(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 complete; deleted text beginor
deleted text end

(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;

(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

(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 begin; or
new text end

new text begin (27) a project involving the addition of 21 new beds in an existing psychiatric hospital
in Hennepin County that is exclusively for patients who are under 21 years of age on the
date of admission
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. 67.

Minnesota Statutes 2016, section 144.99, subdivision 1, is amended to read:


Subdivision 1.

Remedies available.

The provisions of chapters 103I and 157 and sections
115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14),
and (15)
; 144.1201 to 144.1204; 144.121;new text begin 144.1215;new text end 144.1222; 144.35; 144.381 to 144.385;
144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98;
144.992; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders,
stipulation agreements, settlements, compliance agreements, licenses, registrations,
certificates, and permits adopted or issued by the department or under any other law now
in force or later enacted for the preservation of public health may, in addition to provisions
in other statutes, be enforced under this section.

Sec. 68.

Minnesota Statutes 2016, section 144A.472, subdivision 7, is amended to read:


Subd. 7.

Fees; application, change of ownership, and renewal.

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

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

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

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

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

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

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

License Renewal Fee

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

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

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

new text begin License Renewal Fee
new text end

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

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

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

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

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

deleted text begin (h) The license renewal fee schedule in this subdivision is effective July 1, 2016.
deleted text end

Sec. 69.

Minnesota Statutes 2016, section 144A.474, subdivision 11, is amended to read:


Subd. 11.

Fines.

(a) Fines and enforcement actions under this subdivision may be assessed
based on the level and scope of the violations described in paragraph (c) as follows:

(1) Level 1, no fines or enforcement;

(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
mechanisms authorized in section 144A.475 for widespread violations;

(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement
mechanisms authorized in section 144A.475; and

(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the enforcement
mechanisms authorized in section 144A.475.

(b) Correction orders for violations are categorized by both level and scope and fines
shall be assessed as follows:

(1) level of violation:

(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
the client and does not affect health or safety;

(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
to have harmed a client's health or safety, but was not likely to cause serious injury,
impairment, or death;

(iii) Level 3 is a violation that harmed a client's health or safety, not including serious
injury, impairment, or death, or a violation that has the potential to lead to serious injury,
impairment, or death; and

(iv) Level 4 is a violation that results in serious injury, impairment, or death.

(2) scope of violation:

(i) isolated, when one or a limited number of clients are affected or one or a limited
number of staff are involved or the situation has occurred only occasionally;

(ii) pattern, when more than a limited number of clients are affected, more than a limited
number of staff are involved, or the situation has occurred repeatedly but is not found to be
pervasive; and

(iii) widespread, when problems are pervasive or represent a systemic failure that has
affected or has the potential to affect a large portion or all of the clients.

(c) If the commissioner finds that the applicant or a home care provider required to be
licensed under sections 144A.43 to 144A.482 has not corrected violations by the date
specified in the correction order or conditional license resulting from a survey or complaint
investigation, the commissioner may impose a fine. A notice of noncompliance with a
correction order must be mailed to the applicant's or provider's last known address. The
noncompliance notice must list the violations not corrected.

(d) The license holder must pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies by paying the fine. A
timely appeal shall stay payment of the fine until the commissioner issues a final order.

(e) A license holder shall promptly notify the commissioner in writing when a violation
specified in the order is corrected. If upon reinspection the commissioner determines that
a violation has not been corrected as indicated by the order, the commissioner may issue a
second fine. The commissioner shall notify the license holder by mail to the last known
address in the licensing record that a second fine has been assessed. The license holder may
appeal the second fine as provided under this subdivision.

(f) A home care provider that has been assessed a fine under this subdivision has a right
to a reconsideration or a hearing under this section and chapter 14.

(g) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder shall be liable for payment of the fine.

(h) In addition to any fine imposed under this section, the commissioner may assess
costs related to an investigation that results in a final order assessing a fine or other
enforcement action authorized by this chapter.

(i) Fines collected under this subdivision shall be deposited in the state government
special revenue fund and credited to an account separate from the revenue collected under
section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines
collected deleted text beginmaydeleted text endnew text begin mustnew text end be used by the commissioner for special projects to improve home care
in Minnesota as recommended by the advisory council established in section 144A.4799.

Sec. 70.

Minnesota Statutes 2016, section 144A.4799, subdivision 3, is amended to read:


Subd. 3.

Duties.

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

(1) community standards for home care practices;

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

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

(4) training standards;

(5) identifying emerging issues and opportunities in the home care field, including the
use of technology in home and telehealth capabilities;

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

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

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

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

Sec. 71.

Minnesota Statutes 2016, section 144A.70, is amended by adding a subdivision
to read:


new text begin Subd. 4a. new text end

new text begin Nurse. new text end

new text begin "Nurse" means a licensed practical nurse as defined in section 148.171,
subdivision 8, or a registered nurse as defined in section 148.171, subdivision 20.
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. 72.

Minnesota Statutes 2016, 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, new text beginand new text endorderliesdeleted text begin, and other licensed health professionalsdeleted 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 under
section 144A.471 that only provides staff to other home care providers.

new text begin EFFECTIVE DATE. new text end

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

Sec. 73.

Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:


Subd. 2.

Contents of contract.

A housing with services contract, which need not be
entitled as such to comply with this section, shall include at least the following elements in
itself or through supporting documents or attachments:

(1) the name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners is not a natural person, identification of the type of business entity of
the owner or owners;

(3) the name and mailing address of the managing agent, through management agreement
or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept service
of process on behalf of the owner or owners and managing agent;

(5) a statement describing the registration and licensure status of the establishment and
any provider providing health-related or supportive services under an arrangement with the
establishment;

(6) the term of the contract;

(7) a description of the services to be provided to the resident in the base rate to be paid
by resident, including a delineation of the portion of the base rate that constitutes rent and
a delineation of charges for each service included in the base rate;

(8) a description of any additional services, including home care services, available for
an additional fee from the establishment directly or through arrangements with the
establishment, and a schedule of fees charged for these services;

(9) a deleted text begindescriptiondeleted text endnew text begin conspicuous notice informing the tenantnew text end of the new text beginpolicy concerning the
conditions under which and the
new text endprocess through which the contract may be modified,
amended, or terminated, including whether a move to a different room or sharing a room
would be required in the event that the tenant can no longer pay the current rent;

(10) a description of the establishment's complaint resolution process available to residents
including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;

(11) the resident's designated representative, if any;

(12) the establishment's referral procedures if the contract is terminated;

(13) requirements of residency used by the establishment to determine who may reside
or continue to reside in the housing with services establishment;

(14) billing and payment procedures and requirements;

(15) a statement regarding the ability of residents to receive services from service
providers with whom the establishment does not have an arrangement;

(16) a statement regarding the availability of public funds for payment for residence or
services in the establishment; and

(17) a statement regarding the availability of and contact information for long-term care
consultation services under section 256B.0911 in the county in which the establishment is
located.

Sec. 74.

Minnesota Statutes 2016, section 144D.06, is amended to read:


144D.06 OTHER LAWS.

new text begin In addition to registration under this chapter, new text enda housing with services establishment new text beginmust
comply with chapter 504B and the provisions of section 325F.72, and
new text endshall obtain and
maintain all other licenses, permits, registrations, or other governmental approvals required
of it deleted text beginin addition to registration under this chapterdeleted text end. A housing with services establishment is
deleted text begin subject to the provisions of section 325F.72 and chapter 504Bdeleted text endnew text begin not required to obtain a
lodging license under chapter 157 and related rules
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 75.

new text begin [144H.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin The terms defined in this section apply to this chapter.
new text end

new text begin Subd. 2. new text end

new text begin Basic services. new text end

new text begin "Basic services" includes but is not limited to:
new text end

new text begin (1) the development, implementation, and monitoring of a comprehensive protocol of
care that is developed in conjunction with the parent or guardian of a medically complex
or technologically dependent child and that specifies the medical, nursing, psychosocial,
and developmental therapies required by the medically complex or technologically dependent
child; and
new text end

new text begin (2) the caregiver training needs of the child's parent or guardian.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health.
new text end

new text begin Subd. 4. new text end

new text begin Licensee. new text end

new text begin "Licensee" means an owner of a prescribed pediatric extended care
(PPEC) center licensed under this chapter.
new text end

new text begin Subd. 5. new text end

new text begin Medically complex or technologically dependent child. new text end

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

new text begin Subd. 6. new text end

new text begin Owner. new text end

new text begin "Owner" means an individual whose ownership interest provides
sufficient authority or control to affect or change decisions regarding the operation of the
PPEC center. An owner includes a sole proprietor, a general partner, or any other individual
whose ownership interest has the ability to affect the management and direction of the PPEC
center's policies.
new text end

new text begin Subd. 7. new text end

new text begin Prescribed pediatric extended care center, PPEC center, or center.
new text end

new text begin "Prescribed pediatric extended care center," "PPEC center," or "center" means any facility
that provides nonresidential basic services to three or more medically complex or
technologically dependent children who require such services and who are not related to
the owner by blood, marriage, or adoption.
new text end

new text begin Subd. 8. new text end

new text begin Supportive services or contracted services. new text end

new text begin "Supportive services or contracted
services" include but are not limited to speech therapy, occupational therapy, physical
therapy, social work services, developmental services, child life services, and psychology
services.
new text end

Sec. 76.

new text begin [144H.02] LICENSURE REQUIRED.
new text end

new text begin A person may not own or operate a prescribed pediatric extended care center in this state
unless the person holds a temporary or current license issued under this chapter. A separate
license must be obtained for each PPEC center maintained on separate premises, even if
the same management operates the PPEC centers. Separate licenses are not required for
separate buildings on the same grounds. A center shall not be operated on the same grounds
as a child care center licensed under Minnesota Rules, chapter 9503.
new text end

Sec. 77.

new text begin [144H.03] EXEMPTIONS.
new text end

new text begin This chapter does not apply to:
new text end

new text begin (1) a facility operated by the United States government or a federal agency; or
new text end

new text begin (2) a health care facility licensed under chapter 144 or 144A.
new text end

Sec. 78.

new text begin [144H.04] LICENSE APPLICATION AND RENEWAL.
new text end

new text begin Subdivision 1. new text end

new text begin Licenses. new text end

new text begin A person seeking licensure for a PPEC center must submit a
completed application for licensure to the commissioner, in a form and manner determined
by the commissioner. The applicant must also submit the application fee, in the amount
specified in section 144H.05, subdivision 1. Effective January 1, 2018, the commissioner
shall issue a license for a PPEC center if the commissioner determines that the applicant
and center meet the requirements of this chapter and rules that apply to PPEC centers. A
license issued under this subdivision is valid for two years.
new text end

new text begin Subd. 2. new text end

new text begin License renewal. new text end

new text begin A license issued under subdivision 1 may be renewed for a
period of two years if the licensee:
new text end

new text begin (1) submits an application for renewal in a form and manner determined by the
commissioner, at least 30 days before the license expires. An application for renewal
submitted after the renewal deadline date must be accompanied by a late fee in the amount
specified in section 144H.05, subdivision 3;
new text end

new text begin (2) submits the renewal fee in the amount specified in section 144H.05, subdivision 2;
new text end

new text begin (3) demonstrates that the licensee has provided basic services at the PPEC center within
the past two years;
new text end

new text begin (4) provides evidence that the applicant meets the requirements for licensure; and
new text end

new text begin (5) provides other information required by the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin License not transferable. new text end

new text begin A PPEC center license issued under this section is
not transferable to another party. Before acquiring ownership of a PPEC center, a prospective
applicant must apply to the commissioner for a new license.
new text end

Sec. 79.

new text begin [144H.05] FEES.
new text end

new text begin Subdivision 1. new text end

new text begin Initial application fee. new text end

new text begin The initial application fee for PPEC center
licensure is $3,820.
new text end

new text begin Subd. 2. new text end

new text begin License renewal. new text end

new text begin The fee for renewal of a PPEC center license is $1,800.
new text end

new text begin Subd. 3. new text end

new text begin Late fee. new text end

new text begin The fee for late submission of an application to renew a PPEC center
license is $25.
new text end

new text begin Subd. 4. new text end

new text begin Change of ownership. new text end

new text begin The fee for change of ownership of a PPEC center is
$4,200.
new text end

new text begin Subd. 5. new text end

new text begin Nonrefundable; state government special revenue fund. new text end

new text begin All fees collected
under this chapter are nonrefundable and must be deposited in the state treasury and credited
to the state government special revenue fund.
new text end

Sec. 80.

new text begin [144H.06] APPLICATION OF RULES FOR HOSPICE SERVICES AND
RESIDENTIAL HOSPICE FACILITIES.
new text end

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

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

new text begin (2) Minnesota Rules, part 4664.0008;
new text end

new text begin (3) Minnesota Rules, part 4664.0010, subparts 3; 4, items A, subitem (6), and B; and 8;
new text end

new text begin (4) Minnesota Rules, part 4664.0020, subpart 13;
new text end

new text begin (5) Minnesota Rules, part 4664.0370, subpart 1;
new text end

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

new text begin (7) Minnesota Rules, part 4664.0420;
new text end

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

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

new text begin (10) Minnesota Rules, part 4664.0490; and
new text end

new text begin (11) Minnesota Rules, part 4664.0520.
new text end

Sec. 81.

new text begin [144H.07] SERVICES; LIMITATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Services. new text end

new text begin A PPEC center must provide basic services to medically complex
or technologically dependent children, based on a protocol of care established for each child.
A PPEC center may provide services up to 14 hours a day and up to six days a week.
new text end

new text begin Subd. 2. new text end

new text begin Limitations. new text end

new text begin A PPEC center must comply with the following standards related
to services:
new text end

new text begin (1) a child is prohibited from attending a PPEC center for more than 14 hours within a
24-hour period;
new text end

new text begin (2) a PPEC center is prohibited from providing services other than those provided to
medically complex or technologically dependent children; and
new text end

new text begin (3) the maximum capacity for medically complex or technologically dependent children
at a center shall not exceed 45 children.
new text end

Sec. 82.

new text begin [144H.08] ADMINISTRATION AND MANAGEMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Duties of owner. new text end

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

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

new text begin Subd. 2. new text end

new text begin Duties of administrator. new text end

new text begin The center administrator is responsible and accountable
for overall management of the center. The administrator must:
new text end

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

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

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

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

new text begin (iii) copies of all current agreements with providers of supportive services or contracted
services;
new text end

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

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

new text begin (3) develop and maintain a current job description for each employee;
new text end

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

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

Sec. 83.

new text begin [144H.09] ADMISSION, TRANSFER, AND DISCHARGE POLICIES;
CONSENT FORM.
new text end

new text begin Subdivision 1. new text end

new text begin Written policies. new text end

new text begin A PPEC center must have written policies and
procedures governing the admission, transfer, and discharge of children.
new text end

new text begin Subd. 2. new text end

new text begin Notice of discharge. new text end

new text begin At least ten days prior to a child's discharge from a PPEC
center, the PPEC center shall provide notice of the discharge to the child's parent or guardian.
new text end

new text begin Subd. 3. new text end

new text begin Consent form. new text end

new text begin A parent or guardian must sign a consent form outlining the
purpose of a PPEC center, specifying family responsibilities, authorizing treatment and
services, providing appropriate liability releases, and specifying emergency disposition
plans, before the child's admission to the center. The center must provide the child's parents
or guardians with a copy of the consent form and must maintain the consent form in the
child's medical record.
new text end

Sec. 84.

new text begin [144H.10] MEDICAL DIRECTOR.
new text end

new text begin A PPEC center must have a medical director who is a physician licensed in Minnesota
and certified by the American Board of Pediatrics.
new text end

Sec. 85.

new text begin [144H.11] NURSING SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Nursing director. new text end

new text begin A PPEC center must have a nursing director who is
a registered nurse licensed in Minnesota, holds a current certification in cardiopulmonary
resuscitation, and has at least four years of general pediatric nursing experience, at least
one year of which must have been spent caring for medically fragile infants or children in
a pediatric intensive care, neonatal intensive care, PPEC center, or home care setting during
the previous five years. The nursing director is responsible for the daily operation of the
PPEC center.
new text end

new text begin Subd. 2. new text end

new text begin Registered nurses. new text end

new text begin A registered nurse employed by a PPEC center must be a
registered nurse licensed in Minnesota, hold a current certification in cardiopulmonary
resuscitation, and have experience in the previous 24 months in being responsible for the
care of acutely ill or chronically ill children.
new text end

new text begin Subd. 3. new text end

new text begin Licensed practical nurses. new text end

new text begin A licensed practical nurse employed by a PPEC
center must be supervised by a registered nurse and must be a licensed practical nurse
licensed in Minnesota, have at least two years of experience in pediatrics, and hold a current
certification in cardiopulmonary resuscitation.
new text end

new text begin Subd. 4. new text end

new text begin Other direct care personnel. new text end

new text begin (a) Direct care personnel governed by this
subdivision include nursing assistants and individuals with training and experience in the
field of education, social services, or child care.
new text end

new text begin (b) All direct care personnel employed by a PPEC center must work under the supervision
of a registered nurse and are responsible for providing direct care to children at the center.
Direct care personnel must have extensive, documented education and skills training in
providing care to infants and toddlers, provide employment references documenting skill
in the care of infants and children, and hold a current certification in cardiopulmonary
resuscitation.
new text end

Sec. 86.

new text begin [144H.12] TOTAL STAFFING FOR NURSING SERVICES AND DIRECT
CARE PERSONNEL.
new text end

new text begin A PPEC center must provide total staffing for nursing services and direct care personnel
at a ratio of one staff person for every three children at the center. The staffing ratio required
in this section is the minimum staffing permitted.
new text end

Sec. 87.

new text begin [144H.13] MEDICAL RECORD; PROTOCOL OF CARE.
new text end

new text begin A medical record and an individualized nursing protocol of care must be developed for
each child admitted to a PPEC center, must be maintained for each child, and must be signed
by authorized personnel.
new text end

Sec. 88.

new text begin [144H.14] QUALITY ASSURANCE PROGRAM.
new text end

new text begin A PPEC center must have a quality assurance program, in which quarterly reviews are
conducted of the PPEC center's medical records and protocols of care for at least half of
the children served by the PPEC center. The quarterly review sample must be randomly
selected so each child at the center has an equal opportunity to be included in the review.
The committee conducting quality assurance reviews must include the medical director,
administrator, nursing director, and three other committee members determined by the PPEC
center.
new text end

Sec. 89.

new text begin [144H.15] INSPECTIONS.
new text end

new text begin (a) The commissioner may inspect a PPEC center, including records held at the center,
at reasonable times as necessary to ensure compliance with this chapter and the rules that
apply to PPEC centers. During an inspection, a center must provide the commissioner with
access to all center records.
new text end

new text begin (b) The commissioner must inspect a PPEC center before issuing or renewing a license
under this chapter.
new text end

Sec. 90.

new text begin [144H.16] COMPLIANCE WITH OTHER LAWS.
new text end

new text begin Subdivision 1. new text end

new text begin Reporting of maltreatment of minors. new text end

new text begin A PPEC center must develop
policies and procedures for reporting suspected child maltreatment that fulfill the
requirements of section 626.556. The policies and procedures must include the telephone
numbers of the local county child protection agency for reporting suspected maltreatment.
The policies and procedures specified in this subdivision must be provided to the parents
or guardians of all children at the time of admission to the PPEC center and must be available
upon request.
new text end

new text begin Subd. 2. new text end

new text begin Crib safety requirements. new text end

new text begin A PPEC center must comply with the crib safety
requirements in section 245A.146, to the extent they are applicable.
new text end

Sec. 91.

new text begin [144H.17] DENIAL, SUSPENSION, REVOCATION, REFUSAL TO RENEW
A LICENSE.
new text end

new text begin (a) The commissioner may deny, suspend, revoke, or refuse to renew a license issued
under this chapter for:
new text end

new text begin (1) a violation of this chapter or rules adopted that apply to PPEC centers; or
new text end

new text begin (2) an intentional or negligent act by an employee or contractor at the center that
detrimentally affects the health or safety of children at the PPEC center.
new text end

new text begin (b) Prior to any suspension, revocation, or refusal to renew a license, a licensee shall be
entitled to a hearing and review as provided in sections 14.57 to 14.69.
new text end

Sec. 92.

new text begin [144H.18] FINES; CORRECTIVE ACTION PLANS.
new text end

new text begin Subdivision 1. new text end

new text begin Corrective action plans. new text end

new text begin If the commissioner determines that a PPEC
center is not in compliance with this chapter or rules that apply to PPEC centers, the
commissioner may require the center to submit a corrective action plan that demonstrates
a good-faith effort to remedy each violation by a specific date, subject to approval by the
commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Fines. new text end

new text begin The commissioner may issue a fine to a PPEC center, employee, or
contractor if the commissioner determines the center, employee, or contractor violated this
chapter or rules that apply to PPEC centers. The fine amount shall not exceed an amount
for each violation and an aggregate amount established by the commissioner. The failure
to correct a violation by the date set by the commissioner, or a failure to comply with an
approved corrective action plan, constitutes a separate violation for each day the failure
continues, unless the commissioner approves an extension to a specific date. In determining
if a fine is to be imposed and establishing the amount of the fine, the commissioner shall
consider:
new text end

new text begin (1) the gravity of the violation, including the probability that death or serious physical
or emotional harm to a child will result or has resulted, the severity of the actual or potential
harm, and the extent to which the applicable laws were violated;
new text end

new text begin (2) actions taken by the owner or administrator to correct violations;
new text end

new text begin (3) any previous violations; and
new text end

new text begin (4) the financial benefit to the PPEC center of committing or continuing the violation.
new text end

new text begin Subd. 3. new text end

new text begin Fines for violations of other statutes. new text end

new text begin The commissioner shall impose a fine
of $250 on a PPEC center, employee, or contractor for each violation by that PPEC center,
employee, or contractor of section 144H.16, subdivision 2, or 626.556.
new text end

Sec. 93.

new text begin [144H.19] CLOSING A PPEC CENTER.
new text end

new text begin When a PPEC center voluntarily closes, it must, at least 30 days before closure, inform
each child's parents or guardians of the closure and when the closure will occur.
new text end

Sec. 94.

new text begin [144H.20] PHYSICAL ENVIRONMENT.
new text end

new text begin Subdivision 1. new text end

new text begin General requirements. new text end

new text begin A PPEC center shall conform with or exceed
the physical environment requirements in this section and the physical environment
requirements for day care facilities in Minnesota Rules, part 9502.0425. If the physical
environment requirements in this section differ from the physical environment requirements
for day care facilities in Minnesota Rules, part 9502.0425, the requirements in this section
shall prevail. A PPEC center must have sufficient indoor and outdoor space to accommodate
at least six medically complex or technologically dependent children.
new text end

new text begin Subd. 2. new text end

new text begin Specific requirements. new text end

new text begin (a) The entrance to a PPEC center must be barrier-free,
have a wheelchair ramp, provide for traffic flow with a driveway area for entering and
exiting, and have storage space for supplies from home.
new text end

new text begin (b) A PPEC center must have a treatment room with a medication preparation area. The
medication preparation area must contain a work counter, refrigerator, sink with hot and
cold running water, and locked storage for biologicals and prescription drugs.
new text end

new text begin (c) A PPEC center must develop isolation procedures to prevent cross-infections and
must have an isolation room with at least one glass area for observation of a child in the
isolation room. The isolation room must be at least 100 square feet in size.
new text end

new text begin (d) A PPEC center must have:
new text end

new text begin (1) an outdoor play space adjacent to the center of at least 35 square feet per child in
attendance at the center, for regular use; or
new text end

new text begin (2) a park, playground, or play space within 1,500 feet of the center.
new text end

new text begin (e) A PPEC center must have at least 50 square feet of usable indoor space per child in
attendance at the center.
new text end

new text begin (f) Notwithstanding the Minnesota State Building Code and the Minnesota State Fire
Code, a new construction PPEC center or an existing building converted into a PPEC center
must meet the requirements of the International Building Code in Minnesota Rules, chapter
1305, for:
new text end

new text begin (1) Group R, Division 4 occupancy, if serving 12 or fewer children; or
new text end

new text begin (2) Group E, Division 4 occupancy or Group I, Division 4 occupancy, if serving 13 or
more children.
new text end

Sec. 95.

Minnesota Statutes 2016, 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;

(11) the medical specialty of the physician performing the abortion; deleted text beginand
deleted text end

new text begin (12) if the abortion was performed via telemedicine, the facility code for the patient and
the facility code for the physician; and
new text end

deleted text begin (12)deleted text endnew text begin (13)new text end whether the abortion resulted in a born alive infant, as defined in section
145.423, subdivision 4, and:

(i) any medical actions taken to preserve the life of the born alive infant;

(ii) whether the born alive infant survived; and

(iii) the status of the born alive infant, should the infant survive, if known.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 96.

Minnesota Statutes 2016, section 145.4716, subdivision 2, is amended to read:


Subd. 2.

Duties of director.

The director of child sex trafficking prevention is responsible
for the following:

(1) developing and providing comprehensive training on sexual exploitation of youth
for social service professionals, medical professionals, public health workers, and criminal
justice professionals;

(2) collecting, organizing, maintaining, and disseminating information on sexual
exploitation and services across the state, including maintaining a list of resources on the
Department of Health Web site;

(3) monitoring and applying for federal funding for antitrafficking efforts that may
benefit victims in the state;

(4) managing grant programs established under sections 145.4716 to 145.4718deleted text begin, anddeleted text endnew text begin;new text end
609.3241, paragraph (c), clause (3);new text begin and 609.5315, subdivision 5c, clause (3);
new text end

(5) managing the request for proposals for grants for comprehensive services, including
trauma-informed, culturally specific services;

(6) identifying best practices in serving sexually exploited youth, as defined in section
260C.007, subdivision 31;

(7) providing oversight of and technical support to regional navigators pursuant to section
145.4717;

(8) conducting a comprehensive evaluation of the statewide program for safe harbor of
sexually exploited youth; and

(9) developing a policy consistent with the requirements of chapter 13 for sharing data
related to sexually exploited youth, as defined in section 260C.007, subdivision 31, among
regional navigators and community-based advocates.

Sec. 97.

Minnesota Statutes 2016, section 145.928, subdivision 13, is amended to read:


Subd. 13.

Reports.

(a) 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.

(b) The commissioner shall new text beginrelease an annual report to the public and new text endsubmit deleted text beginandeleted text end new text beginthe
new text end 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 organizationnew text begin,
an itemized list submitted to the commissioner by each agency or organization awarded a
grant specifying all uses of grant funds and the amount expended for each use
new text end, 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.

Sec. 98.

Minnesota Statutes 2016, 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.

(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 begin (i) Beginning July 1, 2017, the commissioner shall offer grant recipients the option of
using a grant awarded under this subdivision to confront the opioid addiction and overdose
epidemic, and shall award at least two of the grants awarded on or after July 1, 2017, for
these purposes. The grants awarded under this paragraph must meet all other requirements
of this section. The commissioner shall coordinate grant planning activities with the
commissioner of human services. Each grant shall include selected outcomes and evaluation
measures related to addressing the opioid epidemic.
new text end

Sec. 99.

Minnesota Statutes 2016, section 146B.02, subdivision 2, is amended to read:


Subd. 2.

Requirementsnew text begin and term of licensenew text end.

(a) Each application for an initial mobile
or fixed-site establishment license and for renewal must be submitted to the commissioner
on a form provided by the commissioner accompanied with the applicable fee required
under section 146B.10. The application must contain:

(1) the name(s) of the owner(s) and operator(s) of the establishment;

(2) the location of the establishment;

(3) verification of compliance with all applicable local and state codes;

(4) a description of the general nature of the business; and

(5) any other relevant information deemed necessary by the commissioner.

(b) new text beginIf the information submitted is complete and complies with the requirements of this
chapter,
new text endthe commissioner shall issue a provisional establishment licensenew text begin. The provisional
license is
new text end effective until the commissioner determinesnew text begin,new text end after inspectionnew text begin,new text end that the applicant
has met the requirements of this chapter. Upon approval, the commissioner shall issue a
body art establishment license deleted text begineffective for three yearsdeleted text end.

new text begin (c) An establishment license must be renewed every two years.
new text end

Sec. 100.

Minnesota Statutes 2016, section 146B.02, subdivision 3, is amended to read:


Subd. 3.

Inspection.

(a) deleted text beginWithin the period of the provisional establishment license, and deleted text endnew text begin
The commissioner must inspect an establishment issued a provisional license within one
year of the date the license was issued.
new text endThereafter at least one time during each deleted text beginthree-yeardeleted text endnew text begin
two-year
new text end licensure period, the commissioner shall conduct an inspection of the body art
establishment and a review of any records necessary to ensure that the standards required
under this chapter are met.

(b) The commissioner shall have the authority to enter a premises to make an inspection.
Refusal to permit an inspection constitutes valid grounds for licensure denial or revocation.

(c) If the establishment seeking licensure is new construction or if a licensed establishment
is remodeling, the establishment must meet all local building and zoning codes.

Sec. 101.

Minnesota Statutes 2016, section 146B.02, subdivision 5, is amended to read:


Subd. 5.

Transfer new text beginof ownership, relocation, new text endand display of license.

new text begin(a) new text endA body art
establishment license must be issued to a specific person and location and is not transferable.
A license must be prominently displayed in a public area of the establishment.

new text begin (b) An owner who has purchased a body art establishment licensed under the previous
owner must submit an application to license the establishment within two weeks of the date
of sale. Notwithstanding subdivision 1, the new owner may continue to operate for 60 days
after the sale while waiting for a new license to be issued.
new text end

new text begin (c) An owner of a licensed body art establishment who is relocating the establishment
must submit an application for the new location. The owner may request that the new
application become effective at a specified date in the future. If the relocation is not
accomplished by the date expected, and the license at the existing location expires, the
owner may apply for a temporary event permit to continue to operate at the old location.
The owner may apply for no more than four temporary event permits to continue operating
at the old location.
new text end

Sec. 102.

Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision
to read:


new text begin Subd. 7a. new text end

new text begin Supervisors. new text end

new text begin (a) Only a technician who has been licensed as a body artist for
at least two years in Minnesota or in a jurisdiction with which Minnesota has reciprocity
may supervise a temporary technician.
new text end

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

new text begin (c) The commissioner may refuse to approve as a supervisor a technician who has been
disciplined in Minnesota or in another jurisdiction after considering the criteria described
in subdivision 10, paragraph (b).
new text end

Sec. 103.

Minnesota Statutes 2016, section 146B.02, subdivision 8, is amended to read:


Subd. 8.

Temporary deleted text begineventsdeleted text endnew text begin eventnew text end permit.

(a) An deleted text beginowner or operator of adeleted text endnew text begin applicant for
a permit to hold a
new text end temporary body art deleted text beginestablishmentdeleted text endnew text begin eventnew text end shall submit an application deleted text beginfor a
temporary events permit
deleted text end to the commissionernew text begin. The application must be receivednew text end at least 14
days before the start of the event. The application must include the specific days and hours
of operation. deleted text beginThe owner or operatordeleted text endnew text begin An applicant issued a temporary event permitnew text end shall
comply with the requirements of this chapter.

(b) Applications received less than 14 days prior to the start of the event may be processed
if the commissioner determines it is possible to conduct deleted text beginthedeleted text endnew text begin allnew text end required new text beginwork, including an
new text end inspection.

(c) The temporary deleted text begineventsdeleted text endnew text begin eventnew text end permit must be prominently displayed in a public area
at the location.

(d) The temporary deleted text begineventsdeleted text endnew text begin eventnew text end permit, if approved, is valid for the specified dates and
hours listed on the application. No temporary events permit shall be issued for longer than
a 21-day period, and may not be extended.

new text begin (e) No individual who does not hold a current body art establishment license may be
issued a temporary event permit more than four times within the same calendar year.
new text end

new text begin (f) No individual who has been disciplined for a serious violation of this chapter within
three years preceding the intended start date of a temporary event may be issued a license
for a temporary event. Violations that preclude issuance of a temporary event permit include
unlicensed practice; practice in an unlicensed location; any of the conditions listed in section
146B.05, clauses (1) to (8), (12), or (13); 146B.08, subdivision 3, clauses (4), (5), and (10)
to (12); or any other violation that places the health or safety of a client at risk.
new text end

Sec. 104.

Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision
to read:


new text begin Subd. 10. new text end

new text begin Licensure precluded. new text end

new text begin (a) The commissioner may choose to deny a body art
establishment license to an applicant who has been disciplined for a serious violation under
this chapter. Violations that constitute grounds for denial of license are any of the conditions
listed in section 146B.05, subdivision 1, clauses (1) to (8), (12), or (13); 146B.08, subdivision
3, clauses (4), (5), or (10) to (12); or any other violation that places the health or safety of
a client at risk.
new text end

new text begin (b) In considering whether to grant a license to an applicant who has been disciplined
for a violation described in this subdivision, the commissioner shall consider evidence of
rehabilitation, including the nature and seriousness of the violation, circumstances relative
to the violation, the length of time elapsed since the violation, and evidence that demonstrates
that the applicant has maintained safe, ethical, and responsible body art practice since the
time of the most recent violation.
new text end

Sec. 105.

Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Penalties. new text end

new text begin Any person who violates the provisions of subdivision 1 or who
performs body art in an unlicensed location is guilty of a gross misdemeanor.
new text end

Sec. 106.

Minnesota Statutes 2016, section 146B.03, subdivision 6, is amended to read:


Subd. 6.

Licensure term; renewal.

(a) A technician's license is valid for two years from
the date of issuance and may be renewed upon payment of the renewal fee established under
section 146B.10.

(b) At renewal, a licensee must submit proof of continuing education approved by the
commissioner in the areas identified in subdivision 4.

(c) The commissioner shall notify the technician of the pending expiration of a technician
license at least 60 days prior to license expiration.

new text begin (d) A technician previously licensed in Minnesota whose license has lapsed for less than
six years may apply to renew. A technician previously licensed in Minnesota whose license
has lapsed for less than ten years and who was licensed in another jurisdiction or jurisdictions
during the entire time of lapse may apply to renew, but must submit proof of licensure in
good standing in all other jurisdictions in which the technician was licensed as a body artist
during the time of lapse. A technician previously licensed in Minnesota whose license has
lapsed for more than six years and who was not continuously licensed in another jurisdiction
during the period of Minnesota lapse must reapply for licensure under subdivision 4.
new text end

Sec. 107.

Minnesota Statutes 2016, section 146B.03, subdivision 7, as amended by Laws
2017, chapter 40, article 1, section 34, is amended to read:


Subd. 7.

Temporary licensure.

(a) The commissioner may issue a temporary license
to an applicant who submits to the commissioner on a form provided by the commissioner:

(1) proof that the applicant is over the age of 18;

(2) all fees required under section 146B.10; and

(3) a letter from a licensed technician who has agreed to provide the supervision to meet
the supervised experience requirement under subdivision 4.

(b) Upon completion of the required supervised experience, the temporary licensee shall
submit documentation of satisfactorily completing the requirements under subdivision 4,
and the applicable fee under section 146B.10. The commissioner shall issue a new license
in accordance with subdivision 4.

(c) A temporary license issued under this subdivision is valid for one year and may be
renewed deleted text beginfor one additional yeardeleted text endnew text begin twicenew text end.

Sec. 108.

Minnesota Statutes 2016, section 146B.07, subdivision 2, is amended to read:


Subd. 2.

Parent or legal guardian consent; prohibitions.

(a) A technician may perform
body piercings on an individual under the age of 18 if:

(1) the individual's parent or legal guardian is present;

(2) the individual's parent or legal guardian provides personal identification by using
one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), and provides
documentation that reasonably establishes that the individual is the parent or legal guardian
of the individual who is seeking the body piercing;

(3) the individual seeking the body piercing provides proof of identification by using
one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), a current
student identification, or another official source that includes the name and a photograph
of the individual;

(4) a consent form and the authorization form under subdivision 1, paragraph (b) is
signed by the parent or legal guardian in the presence of the technician; and

(5) the piercing is not prohibited under paragraph (c).

(b) deleted text beginNo technician shall tattoo anydeleted text endnew text begin Tattooing annew text end individual under the age of 18 new text beginis a gross
misdemeanor,
new text endregardless of parental or guardian consent.

(c) No nipple or genital piercing, branding, scarification, suspension, subdermal
implantation, microdermal, or tongue bifurcation shall be performed by any technician on
any individual under the age of 18 regardless of parental or guardian consent.

(d) No technician shall perform body art procedures on any individual who appears to
be under the influence of alcohol, controlled substances as defined in section 152.01,
subdivision 4, or hazardous substances as defined in rules adopted under chapter 182.

(e) No technician shall perform body art procedures while under the influence of alcohol,
controlled substances as defined under section 152.01, subdivision 4, or hazardous substances
as defined in the rules adopted under chapter 182.

(f) No technician shall administer anesthetic injections or other medications.

Sec. 109.

Minnesota Statutes 2016, section 146B.10, subdivision 1, is amended to read:


Subdivision 1.

Licensing fees.

(a) The fee for the initial technician licensure and biennial
licensure renewal is deleted text begin$100deleted text endnew text begin $420new text end.

(b) The fee for temporary technician licensure is deleted text begin$100deleted text endnew text begin $240new text end.

(c) The fee for the temporary guest artist license is deleted text begin$50deleted text endnew text begin $140new text end.

(d) The fee for a dual body art technician license is deleted text begin$100deleted text endnew text begin $420new text end.

(e) The fee for a provisional establishment license is deleted text begin$1,000deleted text endnew text begin $1,500new text end.

(f) The fee for an initial establishment license and the deleted text beginthree-yeardeleted text endnew text begin two-yearnew text end license renewal
period required in section 146B.02, subdivision 2, paragraph (b), is deleted text begin$1,000deleted text endnew text begin $1,500new text end.

(g) The fee for a temporary body art establishmentnew text begin eventnew text end permit is deleted text begin$75deleted text endnew text begin $200new text end.

(h) The commissioner shall prorate the initial two-year technician license fee deleted text beginand the
initial three-year body art establishment license fee
deleted text end based on the number of months in the
initial licensure period.new text begin The commissioner shall prorate the first renewal fee for the
establishment license based on the number of months from issuance of the provisional
license to the first renewal.
new text end

new text begin (i) The fee for verification of licensure to other states is $25.
new text end

new text begin (j) The fee to reissue a provisional establishment license that relocates prior to inspection
and removal of provisional status is $350. The expiration date of the provisional license
does not change.
new text end

new text begin (k) The fee to change an establishment name or establishment type, such as tattoo,
piercing, or dual, is $50.
new text end

Sec. 110.

Minnesota Statutes 2016, section 146B.10, subdivision 2, is amended to read:


Subd. 2.

deleted text beginPenalty fordeleted text end Late deleted text beginrenewalsdeleted text endnew text begin renewal feenew text end.

new text begin(a) new text endThe deleted text beginpenaltydeleted text end fee for late submission
deleted text begin fordeleted text end new text beginof a technician new text endrenewal deleted text beginapplicationsdeleted text endnew text begin applicationnew text end is deleted text begin$75deleted text endnew text begin $150new text end.

new text begin (b) The fee for late submission of an establishment renewal application is $300.
new text end

Sec. 111.

Minnesota Statutes 2016, section 146B.10, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Technical violation fee for practice after lapse. new text end

new text begin (a) The technical violation
fee for practicing body art after a body art license has expired and before it is renewed is
$200 for any part of the first month, plus $200 for any part of any subsequent month up to
one year. Continued practice or operation after one year becomes a disciplinary violation.
new text end

new text begin (b) The technical violation fee for practicing body art after a temporary body art license
has expired and before it is renewed is $100 for any part of the first month, plus $100 for
any part of any subsequent month up to six months. Continued practice or operation after
six months becomes a disciplinary violation.
new text end

new text begin (c) The technical violation fee for operating a body art establishment after the license
has expired and before it is renewed is $300 for any part of the first month, plus $300 for
any part of any subsequent month up to six months. Continued practice or operation after
six months becomes a disciplinary violation.
new text end

Sec. 112.

Minnesota Statutes 2016, section 148.514, subdivision 1, is amended to read:


Subdivision 1.

General licensure procedures.

An applicant for licensure must:

(1) submit an application as required under section 148.519, subdivision 1; deleted text beginand
deleted text end

(2) submit all fees required under section 148.5194deleted text begin.deleted text endnew text begin; and
new text end

new text begin (3) consent to a fingerprint-based background check as required under section 148.519.
new text end

Sec. 113.

Minnesota Statutes 2016, section 148.519, subdivision 1, is amended to read:


Subdivision 1.

Applications for licensure.

(a) An applicant for licensure must:

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

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

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

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

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

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

(b) In addition, an applicant must:

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

(2) submit with the application all fees required by section 148.5194; deleted text beginand
deleted text end

(3) sign a waiver authorizing the commissioner to obtain access to the applicant's records
in this or any other state in which the applicant has engaged in the practice of speech-language
pathology or audiologydeleted text begin.deleted text endnew text begin; and
new text end

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

Sec. 114.

Minnesota Statutes 2016, section 148.519, subdivision 2, is amended to read:


Subd. 2.

Action on applications for licensure.

(a) The commissioner shall act on an
application for licensure according to paragraphs (b) to deleted text begin(d)deleted text endnew text begin (e)new text end.

(b) The commissioner shall determine if the applicant meets the requirements for
licensure. The commissioner or advisory council may investigate information provided by
an applicant to determine whether the information is accurate and complete.

new text begin (c) The commissioner shall not issue a license to an applicant who refuses to consent to
a background study within 90 days after submission of an application or fails to submit
fingerprints to the Department of Human Services. Any fees paid by the applicant to the
Department of Health shall be forfeited if the applicant refuses to consent to the background
study.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end The commissioner shall notify an applicant, via certified mail, of action taken on
the application and of the grounds for denying licensure if licensure is denied.

deleted text begin (d)deleted text endnew text begin (e)new text end An applicant denied licensure may make a written request to the commissioner,
within 30 days of the date of notification to the applicant, for reconsideration of the denial.
Individuals requesting reconsideration may submit information that the applicant wants
considered in the reconsideration. After reconsideration of the commissioner's determination
to deny licensure, the commissioner shall determine whether the original determination
should be affirmed or modified. An applicant may make only one request in any one biennial
license period for reconsideration of the commissioner's determination to deny licensure.

Sec. 115.

Minnesota Statutes 2016, section 148.5194, subdivision 2, is amended to read:


Subd. 2.

Speech-language pathologist deleted text beginbiennialdeleted text end licensure deleted text beginfeedeleted text endnew text begin feesnew text end.

new text begin(a) new text endThe fee for initial
licensure deleted text beginand biennial licensure, clinical fellowship licensure, temporary licensure, or
renewal
deleted text end for a speech-language pathologist is deleted text begin$200deleted text endnew text begin $210.50new text end.

new text begin (b) The fee for clinical fellowship licensure, doctoral externship, temporary license, or
renewal for a speech-language pathologist is $200.
new text end

Sec. 116.

Minnesota Statutes 2016, section 148.5194, subdivision 3, is amended to read:


Subd. 3.

deleted text beginBiennialdeleted text end Licensure deleted text beginfeedeleted text endnew text begin feesnew text end for dual licensure as a speech-language
pathologist and audiologist.

new text begin(a) new text endThe fee for initialnew text begin dualnew text end licensure deleted text beginand biennial licensure,
clinical fellowship licensure, doctoral externship, temporary license, or renewal
deleted text endnew text begin as a
speech-language pathologist and audiologist
new text end is deleted text begin$435deleted text endnew text begin $523new text end.

new text begin (b) The fee for clinical fellowship licensure, doctoral externship, temporary license, or
renewal for dual licensure as a speech-language pathologist and audiologist is $510.
new text end

Sec. 117.

Minnesota Statutes 2016, section 148.5194, subdivision 4, is amended to read:


Subd. 4.

Penalty fee for late renewals.

The penalty fee for late submission of a renewal
application is deleted text begin$45deleted text endnew text begin $60new text end.

Sec. 118.

Minnesota Statutes 2016, section 148.5194, subdivision 7, is amended to read:


Subd. 7.

Audiologist biennial licensure fee.

deleted text begin(a)deleted text endnew text begin The licensure fee for initial applicants
is $523.
new text end The biennial licensure fee for audiologists for clinical fellowship, doctoral externship,
temporary, deleted text begininitial applicants,deleted text end and renewal deleted text beginlicenseesdeleted text endnew text begin licensesnew text end is deleted text begin$435deleted text endnew text begin $510new text end.

deleted text begin (b) The audiologist fee is for practical examination costs greater than audiologist exam
fee receipts and for complaint investigation, enforcement action, and consumer information
and assistance expenditures related to hearing instrument dispensing.
deleted text end

Sec. 119.

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


new text begin Subd. 7a. new text end

new text begin Surcharge. new text end

new text begin Speech-language pathologists who were licensed prior to January
1, 2018, shall pay a onetime surcharge of $10.50 to renew when their license first expires
after January 1, 2020. Audiologists who were licensed before January 1, 2018, shall pay a
onetime surcharge of $13 to renew when their license first expires after January 1, 2020.
The surcharge shall cover the commissioner's costs associated with criminal background
checks.
new text end

Sec. 120.

Minnesota Statutes 2016, section 148.5195, subdivision 2, is amended to read:


Subd. 2.

Rights of applicants and licensees.

The rights of an applicant denied licensure
are stated in section 148.519, subdivision 2, paragraph deleted text begin(d)deleted text endnew text begin (e)new text end. A licensee shall not be
subjected to disciplinary action under this section without first having an opportunity for a
contested case hearing under chapter 14.

Sec. 121.

Minnesota Statutes 2016, section 148.997, subdivision 1, is amended to read:


Subdivision 1.

Fees.

(a) The application fee is deleted text begin$130deleted text endnew text begin $185new text end.

(b) The criminal background check fee is deleted text begin$6deleted text endnew text begin $15new text end.

Sec. 122.

Minnesota Statutes 2016, section 152.25, subdivision 1, is amended to read:


Subdivision 1.

Medical cannabis manufacturer registration.

(a) The commissioner
shall register two in-state manufacturers for the production of all medical cannabis within
the state deleted text beginby December 1, 2014, unless the commissioner obtains an adequate supply of
federally sourced medical cannabis by August 1, 2014
deleted text end. The commissioner shall register
new manufacturers or reregister the existing manufacturers by December 1 every two years,
using the factors described in deleted text beginparagraph (c)deleted text endnew text begin this subdivisionnew text end. The commissioner shall deleted text begincontinue
to
deleted text end accept applications after December 1, 2014, deleted text beginif two manufacturers that meet the
qualifications set forth in this subdivision do not apply before December 1, 2014
deleted text endnew text begin if one of
the manufacturers registered before December 1, 2014, ceases to be registered as a
manufacturer
new text end. The commissioner's determination that no manufacturer exists to fulfill the
duties under sections 152.22 to 152.37 is subject to judicial review in Ramsey County
District Court. Data submitted during the application process are private data on individuals
or nonpublic data as defined in section 13.02 until the manufacturer is registered under this
section. Data on a manufacturer that is registered are public data, unless the data are trade
secret or security information under section 13.37.

(b) As a condition for registration, a manufacturer must agree to:

(1) begin supplying medical cannabis to patients by July 1, 2015; and

(2) comply with all requirements under sections 152.22 to 152.37.

(c) The commissioner shall consider the following factors when determining which
manufacturer to register:

(1) the technical expertise of the manufacturer in cultivating medical cannabis and
converting the medical cannabis into an acceptable delivery method under section 152.22,
subdivision 6;

(2) the qualifications of the manufacturer's employees;

(3) the long-term financial stability of the manufacturer;

(4) the ability to provide appropriate security measures on the premises of the
manufacturer;

(5) whether the manufacturer has demonstrated an ability to meet the medical cannabis
production needs required by sections 152.22 to 152.37; and

(6) the manufacturer's projection and ongoing assessment of fees on patients with a
qualifying medical condition.

new text begin (d) If an officer, director, or controlling person of the manufacturer pleads or is found
guilty of intentionally diverting medical cannabis to a person other than allowed by law
under section 152.33, subdivision 1, the commissioner may decide not to renew the
registration of the manufacturer, provided the violation occurred while the person was an
officer, director, or controlling person of the manufacturer.
new text end

deleted text begin (d)deleted text endnew text begin (e)new text end The commissioner shall require each medical cannabis manufacturer to contract
with an independent laboratory to test medical cannabis produced by the manufacturer. The
commissioner shall approve the laboratory chosen by each manufacturer and require that
the laboratory report testing results to the manufacturer in a manner determined by the
commissioner.

new text begin EFFECTIVE DATE. new text end

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

Sec. 123.

Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Revocation, nonrenewal, or denial of consent to transfer a medical cannabis
manufacturer registration.
new text end

new text begin If the commissioner intends to revoke, not renew, or deny
consent to transfer a registration issued under this section, the commissioner must first notify
in writing the manufacturer against whom the action is to be taken and provide the
manufacturer with an opportunity to request a hearing under the contested case provisions
of chapter 14. If the manufacturer does not request a hearing by notifying the commissioner
in writing within 20 days after receipt of the notice of proposed action, the commissioner
may proceed with the action without a hearing. For revocations, the registration of a
manufacturer is considered revoked on the date specified in the commissioner's written
notice of revocation.
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. 124.

Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision
to read:


new text begin Subd. 1b. new text end

new text begin Temporary suspension proceedings. new text end

new text begin The commissioner may institute
proceedings to temporarily suspend the registration of a medical cannabis manufacturer for
a period of up to 90 days by notifying the manufacturer in writing if any action by an
employee, agent, officer, director, or controlling person of the manufacturer:
new text end

new text begin (1) violates any of the requirements of sections 152.21 to 152.37 or the rules adopted
thereunder;
new text end

new text begin (2) permits, aids, or abets the commission of any violation of state law at the
manufacturer's location for cultivation, harvesting, manufacturing, packaging, and processing
or at any site for distribution of medical cannabis;
new text end

new text begin (3) performs any act contrary to the welfare of a registered patient or registered designated
caregiver; or
new text end

new text begin (4) obtains, or attempts to obtain, a registration by fraudulent means or misrepresentation.
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. 125.

Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision
to read:


new text begin Subd. 1c. new text end

new text begin Notice to patients. new text end

new text begin Upon the revocation or nonrenewal of a manufacturer's
registration under subdivision 1a or implementation of an enforcement action under
subdivision 1b that may affect the ability of a registered patient, registered designated
caregiver, or a registered patient's parent or legal guardian to obtain medical cannabis from
the manufacturer subject to the enforcement action, the commissioner shall notify in writing
each registered patient and the patient's registered designated caregiver or registered patient's
parent or legal guardian about the outcome of the proceeding and information regarding
alternative registered manufacturers. This notice must be provided two or more business
days prior to the effective date of the revocation, nonrenewal, or other enforcement action.
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.

Minnesota Statutes 2016, section 152.28, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin Advertising restrictions. new text end

new text begin (a) A health care practitioner shall not publish or
cause to be published any advertisement that:
new text end

new text begin (1) contains false or misleading statements about medical cannabis or about the medical
cannabis registry program;
new text end

new text begin (2) uses colloquial terms to refer to medical cannabis, such as pot, weed, or grass;
new text end

new text begin (3) states or implies the health care practitioner is endorsed by the Department of Health
or by the medical cannabis registry program;
new text end

new text begin (4) includes images of cannabis in its plant or leaf form or of cannabis-smoking
paraphernalia; or
new text end

new text begin (5) contains medical symbols that could reasonably be confused with symbols of
established medical associations or groups.
new text end

new text begin (b) A health care practitioner found by the commissioner to have violated this subdivision
is prohibited from certifying that patients have a qualifying medical condition for purposes
of patient participation in the registry program. The commissioner's decision that a health
care practitioner has violated this subdivision is a final decision of the commissioner and
is not subject to the contested case procedures in chapter 14.
new text end

Sec. 127.

Minnesota Statutes 2016, section 152.33, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Intentional diversion outside the state; penalties. new text end

new text begin (a) In addition to any other
applicable penalty in law, the commissioner may levy a fine of $250,000 against a
manufacturer and may immediately initiate proceedings to revoke the manufacturer's
registration, using the procedure in section 152.25, if:
new text end

new text begin (1) an officer, director, or controlling person of the manufacturer pleads or is found
guilty under subdivision 1 of intentionally transferring medical cannabis, while the person
was an officer, director, or controlling person of the manufacturer, to a person other than
allowed by law; and
new text end

new text begin (2) in intentionally transferring medical cannabis to a person other than allowed by law,
the officer, director, or controlling person transported or directed the transport of medical
cannabis outside of Minnesota.
new text end

new text begin (b) All fines collected under this subdivision shall be deposited in the state government
special revenue fund.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment, and
applies to crimes committed on or after that date.
new text end

Sec. 128.

Minnesota Statutes 2016, section 153A.14, subdivision 1, is amended to read:


Subdivision 1.

Application for certificate.

An applicant must:

(1) be 21 years of age or older;

(2) apply to the commissioner for a certificate to dispense hearing instruments on
application forms provided by the commissioner;

(3) at a minimum, provide the applicant's name, Social Security number, business address
and phone number, employer, and information about the applicant's education, training,
and experience in testing human hearing and fitting hearing instruments;

(4) include with the application a statement that the statements in the application are
true and correct to the best of the applicant's knowledge and belief;

(5) include with the application a written and signed authorization that authorizes the
commissioner to make inquiries to appropriate regulatory agencies in this or any other state
where the applicant has sold hearing instruments;

(6) submit certification to the commissioner that the applicant's audiometric equipment
has been calibrated to meet current ANSI standards within 12 months of the date of the
application;

(7) submit evidence of continuing education credits, if required; deleted text beginand
deleted text end

(8) submit all fees as required under section 153A.17deleted text begin.deleted text endnew text begin; and
new text end

new text begin (9) consent to a fingerprint-based criminal history records check required under section
144.0572, pay all required fees, and cooperate with all requests for information. An applicant
must complete a new criminal background check if more than one year has elapsed since
the applicant last applied for a license.
new text end

Sec. 129.

Minnesota Statutes 2016, section 153A.14, subdivision 2, is amended to read:


Subd. 2.

Issuance of certificate.

new text begin(a) new text endThe commissioner shall issue a certificate to each
dispenser of hearing instruments who applies under subdivision 1 if the commissioner
determines that the applicant is in compliance with this chapter, has passed an examination
administered by the commissioner, has met the continuing education requirements, if
required, and has paid the fee set by the commissioner. The commissioner may reject or
deny an application for a certificate if there is evidence of a violation or failure to comply
with this chapter.

new text begin (b) The commissioner shall not issue a certificate to an applicant who refuses to consent
to a criminal history background check as required by section 144.0572 within 90 days after
submission of an application or fails to submit fingerprints to the Department of Human
Services. Any fees paid by the applicant to the Department of Health shall be forfeited if
the applicant refuses to consent to the background study.
new text end

Sec. 130.

Minnesota Statutes 2016, section 153A.17, is amended to read:


153A.17 EXPENSES; FEES.

(a) The expenses for administering the certification requirements, including the complaint
handling system for hearing aid dispensers in sections 153A.14 and 153A.15, and the
Consumer Information Center under section 153A.18, must be paid from initial application
and examination fees, renewal fees, penalties, and fines. The commissioner shall only use
fees collected under this section for the purposes of administering this chapter. The legislature
must not transfer money generated by these fees from the state government special revenue
fund to the general fund. Surcharges collected by the commissioner of health under section
16E.22 are not subject to this paragraph.

(b) The fees are as follows:

(1) the initial deleted text beginand annual renewaldeleted text end certification application fee is deleted text begin$600deleted text endnew text begin $772.50new text end;

(2) deleted text beginthe initial examination fee for the written portion is $500, and for each time it is
taken, thereafter
deleted text endnew text begin the annual renewal certification application fee is $750new text end;

(3) the initial examination fee for the practical portion is $1,200, and $600 for each time
it is taken, thereafter; for individuals meeting the requirements of section 148.515, subdivision
2, the fee for the practical portion of the hearing instrument dispensing examination is deleted text begin$250deleted text endnew text begin
$600
new text end each time it is taken;

(4) the trainee application fee is deleted text begin$200deleted text endnew text begin $230new text end;

(5) the penalty fee for late submission of a renewal application is deleted text begin$200deleted text endnew text begin $260new text end; and

(6) the fee for verification of certification to other jurisdictions or entities is $25.

(c) The commissioner may prorate the certification fee for new applicants based on the
number of quarters remaining in the annual certification period.

(d) All fees are nonrefundable. All fees, penalties, and fines received must be deposited
in the state government special revenue fund.

(e) deleted text beginBeginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid at the
time of initial certification application or renewal to recover the commissioner's accumulated
direct expenditures for administering the requirements of this chapter.
deleted text endnew text begin Hearing instrument
dispensers who were certified before January 1, 2018, shall pay a onetime surcharge of
$22.50 to renew their certification when it expires after October 31, 2020. The surcharge
shall cover the commissioner's costs associated with criminal background checks.
new text end

Sec. 131.

Minnesota Statutes 2016, section 157.16, subdivision 1, is amended to read:


Subdivision 1.

License required annually.

A license is required annually for every
person, firm, or corporation engaged in the business of conducting a food and beverage
service establishment, youth camp, hotel, motel, lodging establishment, public pool, or
resort. Any person wishing to operate a place of business licensed in this section shall first
make application, pay the required fee specified in this section, and receive approval for
operation, including plan review approval. Special event food stands are not required to
submit plans. Nonprofit organizations operating a special event food stand with multiple
locations at an annual one-day event shall be issued only one license. Application shall be
made on forms provided by the commissioner and shall require the applicant to state the
full name and address of the owner of the building, structure, or enclosure, the lessee and
manager of the food and beverage service establishment, hotel, motel, lodging establishment,
public pool, or resort; the name under which the business is to be conducted; and any other
information as may be required by the commissioner to complete the application for license.new text begin
All fees collected under this section shall be deposited in the state government special
revenue fund.
new text end

Sec. 132.

Minnesota Statutes 2016, section 157.16, subdivision 3, is amended to read:


Subd. 3.

Establishment fees; definitions.

(a) The following fees are required for food
and beverage service establishments, youth camps, hotels, motels, lodging establishments,
public pools, and resorts licensed under this chapter. Food and beverage service
establishments must pay the highest applicable fee under paragraph (d), clause (1), (2), (3),
or (4)deleted text begin, and establishments serving alcohol must pay the highest applicable fee under paragraph
(d), clause (6) or (7)
deleted text end. The license fee for new operators previously licensed under this chapter
for the same calendar year is one-half of the appropriate annual license fee, plus any penalty
that may be required. The license fee for operators opening on or after October 1 is one-half
of the appropriate annual license fee, plus any penalty that may be required.

(b) All food and beverage service establishments, except special event food stands, and
all hotels, motels, lodging establishments, public pools, and resorts shall pay an annual base
fee of deleted text begin$150deleted text endnew text begin $165new text end.

(c) A special event food stand shall pay a flat fee of deleted text begin$50deleted text endnew text begin $55new text end annually. "Special event
food stand" means a fee category where food is prepared or served in conjunction with
celebrations, county fairs, or special events from a special event food stand as defined in
section 157.15.

(d) In addition to the base fee in paragraph (b), each food and beverage service
establishment, other than a special event food stand and a school concession stand, and each
hotel, motel, lodging establishment, public pool, and resort shall pay an additional annual
fee for each fee category, additional food service, or required additional inspection specified
in this paragraph:

(1) deleted text beginLimited food menu selection, $60. "Limited food menu selection"deleted text endnew text begin Category 1
establishment, $110. "Category 1 establishment"
new text end means a fee category that provides one or
more of the followingnew text begin items or is one of the listed establishments or facilitiesnew text end:

(i) new text beginserves new text endprepackaged food that deleted text beginreceives heat treatment anddeleted text end is served in the package;

(ii) deleted text beginfrozen pizza that is heated and served;
deleted text end

deleted text begin (iii)deleted text endnew text begin servesnew text end a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;

deleted text begin (iv)deleted text endnew text begin (iii) servesnew text end soft drinks, coffee, or nonalcoholic beverages; deleted text beginor
deleted text end

deleted text begin (v)deleted text endnew text begin (iv) providesnew text end cleaning for eating, drinking, or cooking utensils, when the only food
served is prepared off sitedeleted text begin.deleted text endnew text begin;
new text end

new text begin (v) a food establishment where the method of food preparation meets the definition of
a low-risk establishment in section 157.20; or
new text end

new text begin (vi) operates as a child care facility licensed under section 245A.03 and Minnesota Rules,
chapter 9503.
new text end

deleted text begin (2) Small establishment, including boarding establishments, $120. "Small establishment"
means a fee category that has no salad bar and meets one or more of the following:
deleted text end

deleted text begin (i) possesses food service equipment that consists of no more than a deep fat fryer, a
grill, two hot holding containers, and one or more microwave ovens;
deleted text end

deleted text begin (ii) serves dipped ice cream or soft serve frozen desserts;
deleted text end

deleted text begin (iii) serves breakfast in an owner-occupied bed and breakfast establishment;
deleted text end

deleted text begin (iv) is a boarding establishment; or
deleted text end

deleted text begin (v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum patron
seating capacity of not more than 50.
deleted text end

deleted text begin (3) Medium establishment, $310. "Medium establishment"deleted text endnew text begin (2) Category 2 establishment,
$245. "Category 2 establishment"
new text end means deleted text begina fee category that meets one or more of the
following
deleted text endnew text begin an establishment that is not a Category 1 establishment and is eithernew text end:

(i) deleted text beginpossesses food service equipment that includes a range, oven, steam table, salad bar,
or salad preparation area;
deleted text endnew text begin a food establishment where the method of food preparation meets
the definition of a medium-risk establishment in section 157.20; or
new text end

(ii) deleted text beginpossesses food service equipment that includes more than one deep fat fryer, one
grill, or two hot holding containers; or
deleted text endnew text begin an elementary or secondary school as defined in
section 120A.05.
new text end

deleted text begin (iii) is an establishment where food is prepared at one location and served at one or more
separate locations.
deleted text end

deleted text begin Establishments meeting criteria in clause (2), item (v), are not included in this fee
category.
deleted text end

deleted text begin (4) Large establishment, $540. "Large establishment"deleted text endnew text begin (3) Category 3 establishment,
$385. "Category 3 establishment"
new text end means new text beginan establishment that is not a Category 1 or Category
2 establishment and is
new text endeither:

(i) deleted text begina fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a medium
establishment, (B) seats more than 175 people, and (C) offers the full menu selection an
average of five or more days a week during the weeks of operation
deleted text endnew text begin a food establishment
where the method of food preparation meets the definition of a high-risk establishment in
section 157.20
new text end; or

(ii) deleted text begina fee category that (A) meets the criteria in clause (3), item (iii), for a medium
establishment, and (B) prepares and serves 500 or more meals per day.
deleted text endnew text begin an establishment
where 500 or more meals are prepared per day and served at one or more separate locations.
new text end

deleted text begin (5)deleted text endnew text begin (4)new text end Other food and beverage service, including food carts, mobile food units, seasonal
temporary food stands, and seasonal permanent food stands, deleted text begin$60deleted text endnew text begin $85new text end.

deleted text begin (6) Beer or wine table service, $60. "Beer or wine table service" means a fee category
where the only alcoholic beverage service is beer or wine, served to customers seated at
tables.
deleted text end

deleted text begin (7) Alcoholic beverage service, other than beer or wine table service, $165.
deleted text end

deleted text begin "Alcohol beverage service, other than beer or wine table service" means a fee category
where alcoholic mixed drinks are served or where beer or wine are served from a bar.
deleted text end

deleted text begin (8)deleted text endnew text begin (5)new text end Lodging per sleeping accommodation unit, deleted text begin$10deleted text endnew text begin $11new text end, including hotels, motels,
lodging establishments, and resorts, up to a maximum of deleted text begin$1,000deleted text endnew text begin $1,100new text end. "Lodging per
sleeping accommodation unit" means a fee category including the number of guest rooms,
cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the
number of beds in a dormitory.

deleted text begin (9)deleted text endnew text begin (6)new text end First public pool, deleted text begin$325deleted text endnew text begin $355new text end; each additional public pool, deleted text begin$175deleted text endnew text begin $200new text end. "Public
pool" means a fee category that has the meaning given in section 144.1222, subdivision 4.

deleted text begin (10)deleted text endnew text begin (7)new text end First spa, deleted text begin$175deleted text endnew text begin $200new text end; each additional spa, deleted text begin$100deleted text endnew text begin $110new text end. "Spa pool" means a fee
category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.

deleted text begin (11)deleted text endnew text begin (8)new text end Private sewer or water, $60. "Individual private water" means a fee category
with a water supply other than a community public water supply as defined in Minnesota
Rules, chapter 4720. "Individual private sewer" means a fee category with an individual
sewage treatment system which uses subsurface treatment and disposal.

deleted text begin (12)deleted text endnew text begin (9)new text end Additional food service, deleted text begin$150deleted text endnew text begin $175new text end. "Additional food service" means a location
at a food service establishment, other than the primary food preparation and service area,
used to prepare or serve new text beginbeverages or new text endfood to the public. Additional food service does not
apply to school concession stands.

deleted text begin (13)deleted text endnew text begin (10)new text end Additional inspection fee, deleted text begin$360deleted text endnew text begin $250new text end. "Additional inspection fee" means a fee
to conduct the second inspection each year for elementary and secondary education facility
school lunch programs when required by the Richard B. Russell National School Lunch
Act.

new text begin (11) HACCP verification, $175. "HACCP verification" means an annual fee category
for a business that performs one or more specialized process that requires an HACCP plan
as required in chapter 31 and Minnesota Rules, chapter 4626.
new text end

(e) A fee for review of construction plans must accompany the initial license application
for restaurants, hotels, motels, lodging establishments, resorts, seasonal food stands, and
mobile food units. new text beginA fee for review of an HACCP plan for specialized processing must be
submitted and approved prior to preparing and serving the specialized processed food for
human consumption.
new text endThe deleted text beginfeedeleted text endnew text begin feesnew text end for deleted text beginthisdeleted text end construction plan deleted text beginreview isdeleted text endnew text begin reviews and HACCP
plan reviews are
new text end as follows:

Service Area
Type
Fee
Food
deleted text begin limited food menu
deleted text end
deleted text begin $275
deleted text end
deleted text begin smalldeleted text endnew text begin category 1new text end establishment
$400
deleted text begin mediumdeleted text endnew text begin category 2new text end establishment
$450
deleted text begin largedeleted text endnew text begin category 3new text end food establishment
$500
additional food service
deleted text begin $150
deleted text end new text begin $250
new text end
new text begin HACCP Plan Review
new text end
new text begin $500
new text end
Transient food service
food cart
$250
seasonal permanent food stand
$250
seasonal temporary food stand
$250
mobile food unit
$350
deleted text begin Alcohol
deleted text end
deleted text begin beer or wine table service
deleted text end
deleted text begin $150
deleted text end
deleted text begin alcohol service from bar
deleted text end
deleted text begin $250
deleted text end
Lodging
less than 25 rooms
$375
25 to less than 100 rooms
$400
100 rooms or more
$500
less than five cabins
$350
five to less than ten cabins
$400
ten cabins or more
$450

(f) When existing food and beverage service establishments, hotels, motels, lodging
establishments, resorts, seasonal food stands, and mobile food units are extensively
remodeled, a fee must be submitted with the remodeling plans. The fee for this construction
plan review is as follows:

Service Area
Type
Fee
Food
deleted text begin limited food menu
deleted text end
deleted text begin $250
deleted text end
deleted text begin smalldeleted text endnew text begin category 1new text end establishment
$300
deleted text begin mediumdeleted text endnew text begin category 2new text end establishment
$350
deleted text begin large fooddeleted text endnew text begin category 3new text end establishment
$400
additional food service
deleted text begin $150
deleted text end new text begin $250
new text end
Transient food service
food cart
$250
seasonal permanent food stand
$250
seasonal temporary food stand
$250
mobile food unit
$250
deleted text begin Alcohol
deleted text end
deleted text begin beer or wine table service
deleted text end
deleted text begin $150
deleted text end
deleted text begin alcohol service from bar
deleted text end
deleted text begin $250
deleted text end
Lodging
less than 25 rooms
$250
25 to less than 100 rooms
$300
100 rooms or more
$450
less than five cabins
$250
five to less than ten cabins
$350
ten cabins or more
$400

(g) Special event food stands are not required to submit construction or remodeling plans
for review.

(h) Youth camps shall pay an annual single fee for food and lodging as follows:

(1) camps with up to 99 campers, $325;

(2) camps with 100 to 199 campers, $550; and

(3) camps with 200 or more campers, $750.

(i) A youth camp which pays fees under paragraph (d) is not required to pay fees under
paragraph (h).

Sec. 133.

Minnesota Statutes 2016, section 157.16, subdivision 3a, is amended to read:


Subd. 3a.

Statewide hospitality fee.

Every person, firm, or corporation that operates a
licensed boarding establishment, food and beverage service establishment, seasonal temporary
or permanent food stand, special event food stand, mobile food unit, food cart, resort, hotel,
motel, or lodging establishment in Minnesota must submit to the commissioner a deleted text begin$35deleted text endnew text begin $40new text end
annual statewide hospitality fee for each licensed activity. The fee for establishments licensed
by the Department of Health is required at the same time the licensure fee is due. For
establishments licensed by local governments, the fee is due by July 1 of each year.

Sec. 134.

Minnesota Statutes 2016, section 245C.10, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Occupations regulated by commissioner of health. new text end

new text begin The commissioner shall
set fees to recover the cost of combined background studies and criminal background checks
initiated by applicants, licensees, and certified practitioners regulated under sections 148.511
to 148.5198 and chapter 153A. The fees collected under this subdivision shall be deposited
in the special revenue fund and are appropriated to the commissioner for the purpose of
conducting background studies and criminal background checks.
new text end

Sec. 135.

Minnesota Statutes 2016, section 327.15, subdivision 3, is amended to read:


Subd. 3.

Fees, manufactured home parks and recreational camping areas.

(a) The
following fees are required for manufactured home parks and recreational camping areas
licensed under this chapter. new text beginFees collected under this section shall be deposited in the state
government special revenue fund.
new text endRecreational camping areas and manufactured home
parks shall pay the highest applicable base fee under paragraph (b). The license fee for new
operators of a manufactured home park or recreational camping area previously licensed
under this chapter for the same calendar year is one-half of the appropriate annual license
fee, plus any penalty that may be required. The license fee for operators opening on or after
October 1 is one-half of the appropriate annual license fee, plus any penalty that may be
required.

(b) All manufactured home parks and recreational camping areas shall pay the following
annual base fee:

(1) a manufactured home park, deleted text begin$150deleted text endnew text begin $165new text end; and

(2) a recreational camping area with:

(i) 24 or less sites, deleted text begin$50deleted text endnew text begin $55new text end;

(ii) 25 to 99 sites, deleted text begin$212deleted text endnew text begin $230new text end; and

(iii) 100 or more sites, deleted text begin$300deleted text endnew text begin $330new text end.

In addition to the base fee, manufactured home parks and recreational camping areas shall
pay deleted text begin$4deleted text endnew text begin $5new text end for each licensed site. This paragraph does not apply to special event recreational
camping areas. Operators of a manufactured home park or a recreational camping area also
licensed under section 157.16 for the same location shall pay only one base fee, whichever
is the highest of the base fees found in this section or section 157.16.

(c) In addition to the fee in paragraph (b), each manufactured home park or recreational
camping area shall pay an additional annual fee for each fee category specified in this
paragraph:

(1) Manufactured home parks and recreational camping areas with public swimming
pools and spas shall pay the appropriate fees specified in section 157.16.

(2) Individual private sewer or water, $60. "Individual private water" means a fee category
with a water supply other than a community public water supply as defined in Minnesota
Rules, chapter 4720. "Individual private sewer" means a fee category with a subsurface
sewage treatment system which uses subsurface treatment and disposal.

(d) The following fees must accompany a plan review application for initial construction
of a manufactured home park or recreational camping area:

(1) for initial construction of less than 25 sites, $375;

(2) for initial construction of 25 to 99 sites, $400; and

(3) for initial construction of 100 or more sites, $500.

(e) The following fees must accompany a plan review application when an existing
manufactured home park or recreational camping area is expanded:

(1) for expansion of less than 25 sites, $250;

(2) for expansion of 25 to 99 sites, $300; and

(3) for expansion of 100 or more sites, $450.

Sec. 136.

Minnesota Statutes 2016, section 364.09, is amended to read:


364.09 EXCEPTIONS.

(a) This chapter does not apply to the licensing process for peace officers; to law
enforcement agencies as defined in section 626.84, subdivision 1, paragraph (f); to fire
protection agencies; to eligibility for a private detective or protective agent license; to the
licensing and background study process under chapters 245A and 245C; to the licensing
and background investigation process under chapter 240; to eligibility for school bus driver
endorsements; to eligibility for special transportation service endorsements; to eligibility
for a commercial driver training instructor license, which is governed by section 171.35
and rules adopted under that section; to emergency medical services personnel, or to the
licensing by political subdivisions of taxicab drivers, if the applicant for the license has
been discharged from sentence for a conviction within the ten years immediately preceding
application of a violation of any of the following:

(1) sections 609.185 to 609.2114, 609.221 to 609.223, 609.342 to 609.3451, or 617.23,
subdivision 2 or 3; or Minnesota Statutes 2012, section 609.21;

(2) any provision of chapter 152 that is punishable by a maximum sentence of 15 years
or more; or

(3) a violation of chapter 169 or 169A involving driving under the influence, leaving
the scene of an accident, or reckless or careless driving.

This chapter also shall not apply to eligibility for juvenile corrections employment, where
the offense involved child physical or sexual abuse or criminal sexual conduct.

(b) This chapter does not apply to a school district or to eligibility for a license issued
or renewed by the Board of Teaching or the commissioner of education.

(c) Nothing in this section precludes the Minnesota Police and Peace Officers Training
Board or the state fire marshal from recommending policies set forth in this chapter to the
attorney general for adoption in the attorney general's discretion to apply to law enforcement
or fire protection agencies.

(d) This chapter does not apply to a license to practice medicine that has been denied or
revoked by the Board of Medical Practice pursuant to section 147.091, subdivision 1a.

(e) This chapter does not apply to any person who has been denied a license to practice
chiropractic or whose license to practice chiropractic has been revoked by the board in
accordance with section 148.10, subdivision 7.

(f) This chapter does not apply to any license, registration, or permit that has been denied
or revoked by the Board of Nursing in accordance with section 148.261, subdivision 1a.

new text begin (g) This chapter does not apply to any license, registration, permit, or certificate that has
been denied or revoked by the commissioner of health according to section 148.5195,
subdivision 5; or 153A.15, subdivision 2.
new text end

deleted text begin (g)deleted text end new text begin(h) new text endThis chapter does not supersede a requirement under law to conduct a criminal
history background investigation or consider criminal history records in hiring for particular
types of employment.

Sec. 137.

Minnesota Statutes 2016, section 609.5315, subdivision 5c, is amended to read:


Subd. 5c.

Disposition of money; prostitution.

Money forfeited under section 609.5312,
subdivision 1
, paragraph (b), must be distributed as follows:

(1) 40 percent must be forwarded to the appropriate agency for deposit as a supplement
to the agency's operating fund or similar fund for use in law enforcement;

(2) 20 percent must be forwarded to the prosecuting authority that handled the forfeiture
for deposit as a supplement to its operating fund or similar fund for prosecutorial purposes;
and

(3) the remaining 40 percent must be forwarded to the commissioner of deleted text beginpublic safetydeleted text endnew text begin
health
new text end to be deposited in the safe harbor for youth account in the special revenue fund and
is appropriated to the commissioner for distribution to crime victims services organizations
that provide services to sexually exploited youth, as defined in section 260C.007, subdivision
31
.

Sec. 138.

Minnesota Statutes 2016, 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) "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.

(b) "Commissioner" means the commissioner of human services.

(c) "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 new text begin144H or new text end245D;

(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E;
or

(3) a nonlicensed personal care provider organization as defined in section 256B.0625,
subdivision 19a
.

(d) "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 allege sexual abuse or 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.

(e) "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
involve sexual abuse or 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 section 120A.05, subdivisions 9, 11, and 13,
and chapter 124E; or in a nonlicensed personal care provider association as defined in section
256B.0625, subdivision 19a.

(f) "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.

(g) "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.

(h) "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.

(i) "Operator" means an operator or agency as defined in section 245A.02.

(j) "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.

(k) "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:

(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;

(8) striking a child who is at least age one but under age four on the face or head, which
results in an injury;

(9) 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;

(10) unreasonable physical confinement or restraint not permitted under section 609.379,
including but not limited to tying, caging, or chaining; or

(11) 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.

(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) "Report" means any communication received by the local welfare agency, police
department, county sheriff, or agency responsible for child protection pursuant to this section
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
known.

(n) "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. Effective May 29, 2017, sexual abuse includes all reports
of known or suspected child sex trafficking involving a child who is identified as a victim
of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321,
subdivisions 7a
and 7b. 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).

(o) "Substantial child endangerment" means a person responsible for a child's care, by
act or omission, 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) abandonment under section 260C.301, subdivision 2;

(3) neglect as defined in paragraph (g), 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;

(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;

(5) manslaughter in the first or second degree under section 609.20 or 609.205;

(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;

(7) solicitation, inducement, and promotion of prostitution under section 609.322;

(8) criminal sexual conduct under sections 609.342 to 609.3451;

(9) solicitation of children to engage in sexual conduct under section 609.352;

(10) malicious punishment or neglect or endangerment of a child under section 609.377
or 609.378;

(11) use of a minor in sexual performance under section 617.246; or

(12) parental behavior, status, or condition which mandates that the county attorney file
a termination of parental rights petition under section 260C.503, subdivision 2.

(p) "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 (j), 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 (q) from the Department of Human
Services.

(q) 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 (p), 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.

(r) 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.

Sec. 139.

Minnesota Statutes 2016, section 626.556, subdivision 3, is amended to read:


Subd. 3.

Persons mandated to report; persons voluntarily reporting.

(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,
county sheriff, tribal social services agency, or tribal police department 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).

(b) Any person may voluntarily report to the local welfare agency, agency responsible
for assessing or investigating the report, police department, county sheriff, tribal social
services agency, or tribal police department 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.

(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 new text begin144H
or
new text end245D; or a nonlicensed personal care provider organization as defined in section
256B.0625, subdivision deleted text begin19deleted text endnew text begin 19anew text end. 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) Notification requirements under subdivision 10 apply to all reports received under
this section.

(e) For purposes of this section, "immediately" means as soon as possible but in no event
longer than 24 hours.

Sec. 140.

Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:


Subd. 3c.

Local welfare agency, Department of Human Services or Department of
Health responsible for assessing or investigating reports of maltreatment.

(a) The county
local welfare agency is the agency responsible for assessing or investigating allegations of
maltreatment in child foster care, family child care, legally unlicensed child care, juvenile
correctional facilities licensed under section 241.021 located in the local welfare agency's
county, and reports involving children served by an unlicensed personal care provider
organization under section 256B.0659. Copies of findings related to personal care provider
organizations under section 256B.0659 must be forwarded to the Department of Human
Services provider enrollment.

(b) The Department of Human Services is the agency responsible for assessing or
investigating allegations of maltreatment in facilities licensed under chapters 245A and
245D, except for child foster care and family child care.

(c) The Department of Health is the agency responsible for assessing or investigating
allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and
144A.43 to 144A.482new text begin or chapter 144Hnew text end.

Sec. 141.

Minnesota Statutes 2016, section 626.556, subdivision 10d, is amended to read:


Subd. 10d.

Notification of neglect or abuse in facility.

(a) When a report is received
that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the
care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed according to sections 144.50
to 144.58; 241.021; or 245A.01 to 245A.16; or chapter new text begin144H or new text end245D, or a school as defined
in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed personal
care provider organization as defined in section 256B.0625, subdivision 19a, the
commissioner of the agency responsible for assessing or investigating the report or local
welfare agency investigating the report shall provide the following information to the parent,
guardian, or legal custodian of a child alleged to have been neglected, physically abused,
sexually abused, or the victim of maltreatment of a child in the facility: the name of the
facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or maltreatment
of a child in the facility has been received; the nature of the alleged neglect, physical abuse,
sexual abuse, or maltreatment of a child in the facility; that the agency is conducting an
assessment or investigation; any protective or corrective measures being taken pending the
outcome of the investigation; and that a written memorandum will be provided when the
investigation is completed.

(b) The commissioner of the agency responsible for assessing or investigating the report
or local welfare agency may also provide the information in paragraph (a) to the parent,
guardian, or legal custodian of any other child in the facility if the investigative agency
knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or
maltreatment of a child in the facility has occurred. In determining whether to exercise this
authority, the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency shall consider the seriousness of the alleged neglect, physical
abuse, sexual abuse, or maltreatment of a child in the facility; the number of children
allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a
child in the facility; the number of alleged perpetrators; and the length of the investigation.
The facility shall be notified whenever this discretion is exercised.

(c) When the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency has completed its investigation, every parent, guardian, or
legal custodian previously notified of the investigation by the commissioner or local welfare
agency shall be provided with the following information in a written memorandum: the
name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual
abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the
investigation findings; a statement whether maltreatment was found; and the protective or
corrective measures that are being or will be taken. The memorandum shall be written in a
manner that protects the identity of the reporter and the child and shall not contain the name,
or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed
during the investigation. If maltreatment is determined to exist, the commissioner or local
welfare agency shall also provide the written memorandum to the parent, guardian, or legal
custodian of each child in the facility who had contact with the individual responsible for
the maltreatment. When the facility is the responsible party for maltreatment, the
commissioner or local welfare agency shall also provide the written memorandum to the
parent, guardian, or legal custodian of each child who received services in the population
of the facility where the maltreatment occurred. This notification must be provided to the
parent, guardian, or legal custodian of each child receiving services from the time the
maltreatment occurred until either the individual responsible for maltreatment is no longer
in contact with a child or children in the facility or the conclusion of the investigation. In
the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions
9, 11, and 13
, and chapter 124E, the commissioner of education need not provide notification
to parents, guardians, or legal custodians of each child in the facility, but shall, within ten
days after the investigation is completed, provide written notification to the parent, guardian,
or legal custodian of any student alleged to have been maltreated. The commissioner of
education may notify the parent, guardian, or legal custodian of any student involved as a
witness to alleged maltreatment.

Sec. 142. new text beginRECOMMENDATIONS FOR SAFETY AND QUALITY IMPROVEMENT
PRACTICES FOR LONG-TERM CARE SERVICES AND SUPPORTS.
new text end

new text begin The commissioner of health shall consult with interested stakeholders to consider:
new text end

new text begin (1) systems improvements in processes used by the Office of Health Facility Complaints
to investigate reports of maltreatment of vulnerable adults received by the office and
processes used to report maltreatment to the office; and
new text end

new text begin (2) options for implementing prevention strategies, alternative reporting approaches,
and proven patient safety and quality improvement practices and infrastructure for long-term
care services and supports.
new text end

Sec. 143. new text beginSTUDY AND REPORT ON HOME CARE NURSING WORKFORCE
SHORTAGE.
new text end

new text begin (a) The chair and ranking minority member of the senate Human Services Reform
Finance and Policy Committee and the chair and ranking minority member of the house of
representatives Health and Human Services Finance Committee shall convene a working
group to study and report on the shortage of registered nurses and licensed practical nurses
available to provide low-complexity regular home care services to clients in need of such
services, especially clients covered by medical assistance, and to provide recommendations
for ways to address the workforce shortage. The working group shall consist of 14 members
appointed as follows:
new text end

new text begin (1) the chair of the senate Human Services Reform Finance and Policy Committee or a
designee;
new text end

new text begin (2) the ranking minority member of the senate Human Services Reform Finance and
Policy Committee or a designee;
new text end

new text begin (3) the chair of the house of representatives Health and Human Services Finance
Committee or a designee;
new text end

new text begin (4) the ranking minority member of the house of representatives Health and Human
Services Finance Committee or a designee;
new text end

new text begin (5) the commissioner of human services or a designee;
new text end

new text begin (6) the commissioner of health or a designee;
new text end

new text begin (7) one representative appointed by the Professional Home Care Coalition;
new text end

new text begin (8) one representative appointed by the Minnesota Home Care Association;
new text end

new text begin (9) one representative appointed by the Minnesota Board of Nursing;
new text end

new text begin (10) one representative appointed by the Minnesota Nurses Association;
new text end

new text begin (11) one representative appointed by the Minnesota Licensed Practical Nurses
Association;
new text end

new text begin (12) one representative appointed by the Minnesota Society of Medical Assistants;
new text end

new text begin (13) one client who receives regular home care nursing services and is covered by medical
assistance appointed by the commissioner of human services after consulting with the
appointing authorities identified in clauses (7) to (12); and
new text end

new text begin (14) one assessor appointed by the commissioner of human services. The assessor must
be certified under Minnesota Statutes, section 256B.0911, and must be a registered nurse.
new text end

new text begin (b) The appointing authorities must appoint members by August 1, 2017.
new text end

new text begin (c) The convening authorities shall convene the first meeting of the working group no
later than August 15, 2017, and caucus staff shall provide support and meeting space for
the working group. The Department of Health and the Department of Human Services shall
provide technical assistance to the working group by providing existing data and analysis
documenting the current and projected workforce shortages in the area of regular home care
nursing. The home care and assisted living program advisory council established under
Minnesota Statutes, section 144A.4799, shall provide advice and recommendations to the
working group. Working group members shall serve without compensation and shall not
be reimbursed for expenses.
new text end

new text begin (d) The working group shall:
new text end

new text begin (1) quantify the number of low-complexity regular home care nursing hours that are
authorized but not provided to clients covered by medical assistance, due to the shortage
of registered nurses and licensed practical nurses available to provide these home care
services;
new text end

new text begin (2) quantify the current and projected workforce shortages of registered nurses and
licensed practical nurses available to provide low-complexity regular home care nursing
services to clients, especially clients covered by medical assistance;
new text end

new text begin (3) develop recommendations for actions to take in the next two years to address the
regular home care nursing workforce shortage, including identifying other health care
professionals who may be able to provide low-complexity regular home care nursing services
with additional training; what additional training may be necessary for these health care
professionals; and how to address scope of practice and licensing issues;
new text end

new text begin (4) compile reimbursement rates for regular home care nursing from other states and
determine Minnesota's national ranking with respect to reimbursement for regular home
care nursing;
new text end

new text begin (5) determine whether reimbursement rates for regular home care nursing fully reimburse
providers for the cost of providing the service and whether the discrepancy, if any, between
rates and costs contributes to lack of access to regular home care nursing; and
new text end

new text begin (6) by January 15, 2018, report on the findings and recommendations of the working
group to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance. The working group's report
shall include draft legislation.
new text end

new text begin (e) The working group shall elect a chair from among its members at its first meeting.
new text end

new text begin (f) The meetings of the working group shall be open to the public.
new text end

new text begin (g) This section expires January 16, 2018, or the day after submitting the report required
by this section, whichever is earlier.
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. 144. new text beginOPIOID ABUSE PREVENTION PILOT PROJECTS.
new text end

new text begin (a) The commissioner of health shall establish opioid abuse prevention pilot projects in
geographic areas throughout the state based on the most recently available data on opioid
overdose and abuse rates, to reduce opioid abuse through the use of controlled substance
care teams and community-wide coordination of abuse-prevention initiatives. The
commissioner shall award grants to health care providers, health plan companies, local units
of government, tribal governments, or other entities to establish pilot projects.
new text end

new text begin (b) Each pilot project must:
new text end

new text begin (1) be designed to reduce emergency room and other health care provider visits resulting
from opioid use or abuse, and reduce rates of opioid addiction in the community;
new text end

new text begin (2) establish multidisciplinary controlled substance care teams, that may consist of
physicians, pharmacists, social workers, nurse care coordinators, and mental health
professionals;
new text end

new text begin (3) deliver health care services and care coordination, through controlled substance care
teams, to reduce the inappropriate use of opioids by patients and rates of opioid addiction;
new text end

new text begin (4) address any unmet social service needs that create barriers to managing pain
effectively and obtaining optimal health outcomes;
new text end

new text begin (5) provide prescriber and dispenser education and assistance to reduce the inappropriate
prescribing and dispensing of opioids;
new text end

new text begin (6) promote the adoption of best practices related to opioid disposal and reducing
opportunities for illegal access to opioids; and
new text end

new text begin (7) engage partners outside of the health care system, including schools, law enforcement,
and social services, to address root causes of opioid abuse and addiction at the community
level.
new text end

new text begin (c) The commissioner shall contract with an accountable community for health that
operates an opioid abuse prevention project, and can document success in reducing opioid
use through the use of controlled substance care teams, to assist the commissioner in
administering this section, and to provide technical assistance to the commissioner and to
entities selected to operate a pilot project.
new text end

new text begin (d) The contract under paragraph (c) shall require the accountable community for health
to evaluate the extent to which the pilot projects were successful in reducing the inappropriate
use of opioids. The evaluation must analyze changes in the number of opioid prescriptions,
the number of emergency room visits related to opioid use, and other relevant measures.
The accountable community for health shall report evaluation results to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services policy and finance and public safety by December 15, 2019.
new text end

new text begin (e) The commissioner may award one grant that, in addition to the other requirements
of this section, allows a root cause approach to reduce opioid abuse in an American Indian
community.
new text end

Sec. 145. new text beginSAFE HARBOR FOR ALL; STATEWIDE SEX TRAFFICKING VICTIMS
STRATEGIC PLAN.
new text end

new text begin (a) By October 1, 2018, the commissioner of health, in consultation with the
commissioners of public safety and human services, shall adopt a comprehensive strategic
plan to address the needs of sex trafficking victims statewide.
new text end

new text begin (b) The commissioner of health shall issue a request for proposals to select an organization
to develop the comprehensive strategic plan. The selected organization shall seek
recommendations from professionals, community members, and stakeholders from across
the state, with an emphasis on the communities most impacted by sex trafficking. At a
minimum, the selected organization must seek input from the following groups: sex
trafficking survivors and their family members, statewide crime victim services coalitions,
victim services providers, nonprofit organizations, task forces, prosecutors, public defenders,
tribal governments, public safety and corrections professionals, public health professionals,
human services professionals, and impacted community members. The strategic plan shall
include recommendations regarding the expansion of Minnesota's Safe Harbor Law to adult
victims of sex trafficking.
new text end

new text begin (c) By January 15, 2019, the commissioner of health shall report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services and criminal justice finance and policy on developing the statewide strategic plan,
including recommendations for additional legislation and funding.
new text end

new text begin (d) As used in this section, "sex trafficking victim" has the meaning given in Minnesota
Statutes, section 609.321, subdivision 7b.
new text end

Sec. 146. new text beginDIRECTION TO THE COMMISSIONER OF HEALTH.
new text end

new text begin The commissioner of health shall work with interested stakeholders to evaluate whether
existing laws, including laws governing housing with services establishments, board and
lodging establishments with special services, assisted living designations, and home care
providers, as well as building code requirements and landlord tenancy laws, sufficiently
protect the health and safety of persons diagnosed with Alzheimer's disease or a related
dementia.
new text end

Sec. 147. new text beginPALLIATIVE CARE ADVISORY COUNCIL.
new text end

new text begin The appointing authorities shall appoint the first members of the Palliative Care Advisory
Council under Minnesota Statutes, section 144.059, by October 1, 2017. The commissioner
of health shall convene the first meeting by November 15, 2017, and the commissioner or
the commissioner's designee shall act as chair until the council elects a chair at its first
meeting.
new text end

Sec. 148. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2016, sections 103I.005, subdivisions 8, 14, and 15; 103I.451; and
144.0571,
new text end new text begin are repealed.
new text end

ARTICLE 11

HEALTH LICENSING BOARDS

Section 1.

Minnesota Statutes 2016, section 147.01, subdivision 7, is amended to read:


Subd. 7.

Physician application deleted text beginfeedeleted text endnew text begin and license feesnew text end.

new text begin(a) new text endThe board may charge deleted text beginadeleted text endnew text begin the
following nonrefundable application and license fees processed pursuant to sections 147.02,
147.03, 147.037, 147.0375, and 147.38:
new text end

new text begin (1) new text endphysician application fee deleted text beginofdeleted text endnew text begin,new text end $200deleted text begin.deleted text endnew text begin;
new text end

new text begin (2) physician annual registration renewal fee, $192;
new text end

new text begin (3) physician endorsement to other states, $40;
new text end

new text begin (4) physician emeritus license, $50;
new text end

new text begin (5) physician temporary licenses, $60;
new text end

new text begin (6) physician late fee, $60;
new text end

new text begin (7) duplicate license fee, $20;
new text end

new text begin (8) certification letter fee, $25;
new text end

new text begin (9) education or training program approval fee, $100;
new text end

new text begin (10) report creation and generation fee, $60;
new text end

new text begin (11) examination administration fee (half day), $50;
new text end

new text begin (12) examination administration fee (full day), $80; and
new text end

new text begin (13) fees developed by the Interstate Commission for determining physician qualification
to register and participate in the interstate medical licensure compact, as established in rules
authorized in and pursuant to section 147.38, not to exceed $1,000.
new text end

new text begin (b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal.
new text endThe revenue generated from the fee must be deposited
in an account in the state government special revenue fund.

Sec. 2.

Minnesota Statutes 2016, section 147.02, subdivision 1, is amended to read:


Subdivision 1.

United States or Canadian medical school graduates.

The board shall
issue a license to practice medicine to a person not currently licensed in another state or
Canada and who meets the requirements in paragraphs (a) to (i).

(a) An applicant for a license shall file a written application on forms provided by the
board, showing to the board's satisfaction that the applicant is of good moral character and
satisfies the requirements of this section.

(b) The applicant shall present evidence satisfactory to the board of being a graduate of
a medical or osteopathic medical school located in the United States, its territories or Canada,
and approved by the board based upon its faculty, curriculum, facilities, accreditation by a
recognized national accrediting organization approved by the board, and other relevant data,
or is currently enrolled in the final year of study at the school.

(c) The applicant must have passed an examination as described in clause (1) or (2).

(1) The applicant must have passed a comprehensive examination for initial licensure
prepared and graded by the National Board of Medical Examiners, the Federation of State
Medical Boards, the Medical Council of Canada, the National Board of Osteopathic
Examiners, or the appropriate state board that the board determines acceptable. The board
shall by rule determine what constitutes a passing score in the examination.

(2) The applicant taking the United States Medical Licensing Examination (USMLE)
or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) must
have passed steps or levels one, two, and three. Step or level three must be passed within
five years of passing step or level two, or before the end of residency training. The applicant
must pass each of steps or levels one, two, and three with passing scores as recommended
by the USMLE program or National Board of Osteopathic Medical Examiners within three
attempts. The applicant taking combinations of Federation of State Medical Boards, National
Board of Medical Examiners, and USMLE may be accepted only if the combination is
approved by the board as comparable to existing comparable examination sequences and
all examinations are completed prior to the year 2000.

(d) The applicant shall present evidence satisfactory to the board of the completion of
one year of graduate, clinical medical training in a program accredited by a national
accrediting organization approved by the board or other graduate training approved in
advance by the board as meeting standards similar to those of a national accrediting
organization.

(e) The applicant may make arrangements with the executive director to appear in person
before the board or its designated representative to show that the applicant satisfies the
requirements of this section. The board may establish as internal operating procedures the
procedures or requirements for the applicant's personal presentation.

(f) The applicant shall pay a new text beginnonrefundable new text endfee established by the board deleted text beginby ruledeleted text end. deleted text beginThe
fee may not be refunded.
deleted text end Upon application or notice of license renewal, the board must
provide notice to the applicant and to the person whose license is scheduled to be issued or
renewed of any additional fees, surcharges, or other costs which the person is obligated to
pay as a condition of licensure. The notice must:

(1) state the dollar amount of the additional costs; and

(2) clearly identify to the applicant the payment schedule of additional costs.

(g) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(h) The applicant must not have engaged in conduct warranting disciplinary action
against a licensee, or have been subject to disciplinary action other than as specified in
paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph,
the board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions and limitations the board considers appropriate.

(i) If the examination in paragraph (c) was passed more than ten years ago, the applicant
must either:

(1) pass the special purpose examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(2) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada.

Sec. 3.

Minnesota Statutes 2016, section 147.03, subdivision 1, is amended to read:


Subdivision 1.

Endorsement; reciprocity.

(a) The board may issue a license to practice
medicine to any person who satisfies the requirements in paragraphs (b) to deleted text begin(f)deleted text endnew text begin(e)new text end.

(b) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1
, paragraphs (a), (b), (d), (e), and (f).

(c) The applicant shall:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the National Board of Medical Examiners, or the United States Medical Licensing
Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph
(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council
of Canada; and

(2) have a current license from the equivalent licensing agency in another state or Canada
and, if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
three of the USMLE within the required three attempts, the applicant may be granted a
license provided the applicant:

(i) has passed each of steps one, two, and three with passing scores as recommended by
the USMLE program within no more than four attempts for any of the three steps;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association Bureau of Professional Education, the
Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians
of Canada.

deleted text begin (d) The applicant shall pay a fee established by the board by rule. The fee may not be
refunded.
deleted text end

deleted text begin (e)deleted text endnew text begin (d)new text end The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

deleted text begin (f)deleted text endnew text begin (e)new text end The applicant must not have engaged in conduct warranting disciplinary action
against a licensee, or have been subject to disciplinary action other than as specified in
paragraph deleted text begin(e)deleted text endnew text begin (d)new text end. If an applicant does not satisfy the requirements stated in this paragraph,
the board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions or limitations the board considers appropriate.

deleted text begin (g)deleted text endnew text begin (f)new text end Upon the request of an applicant, the board may conduct the final interview of
the applicant by teleconference.

Sec. 4.

new text begin [147A.28] PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.
new text end

new text begin (a) The board may charge the following nonrefundable fees:
new text end

new text begin (1) physician assistant application fee, $120;
new text end

new text begin (2) physician assistant annual registration renewal fee (prescribing authority), $135;
new text end

new text begin (3) physician assistant annual registration renewal fee (no prescribing authority), $115;
new text end

new text begin (4) physician assistant temporary registration, $115;
new text end

new text begin (5) physician assistant temporary permit, $60;
new text end

new text begin (6) physician assistant locum tenens permit, $25;
new text end

new text begin (7) physician assistant late fee, $50;
new text end

new text begin (8) duplicate license fee, $20;
new text end

new text begin (9) certification letter fee, $25;
new text end

new text begin (10) education or training program approval fee, $100; and
new text end

new text begin (11) report creation and generation fee, $60.
new text end

new text begin (b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fees must be deposited
in an account in the state government special revenue fund.
new text end

Sec. 5.

Minnesota Statutes 2016, section 147B.08, is amended by adding a subdivision to
read:


new text begin Subd. 4. new text end

new text begin Acupuncturist application and license fees. new text end

new text begin (a) The board may charge the
following nonrefundable fees:
new text end

new text begin (1) acupuncturist application fee, $150;
new text end

new text begin (2) acupuncturist annual registration renewal fee, $150;
new text end

new text begin (3) acupuncturist temporary registration fee, $60;
new text end

new text begin (4) acupuncturist inactive status fee, $50;
new text end

new text begin (5) acupuncturist late fee, $50;
new text end

new text begin (6) duplicate license fee, $20;
new text end

new text begin (7) certification letter fee, $25;
new text end

new text begin (8) education or training program approval fee, $100; and
new text end

new text begin (9) report creation and generation fee, $60.
new text end

new text begin (b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fees must be deposited
in an account in the state government special revenue fund.
new text end

Sec. 6.

Minnesota Statutes 2016, section 147C.40, is amended by adding a subdivision to
read:


new text begin Subd. 5. new text end

new text begin Respiratory therapist application and license fees. new text end

new text begin (a) The board may charge
the following nonrefundable fees:
new text end

new text begin (1) respiratory therapist application fee, $100;
new text end

new text begin (2) respiratory therapist annual registration renewal fee, $90;
new text end

new text begin (3) respiratory therapist inactive status fee, $50;
new text end

new text begin (4) respiratory therapist temporary registration fee, $90;
new text end

new text begin (5) respiratory therapist temporary permit, $60;
new text end

new text begin (6) respiratory therapist late fee, $50;
new text end

new text begin (7) duplicate license fee, $20;
new text end

new text begin (8) certification letter fee, $25;
new text end

new text begin (9) education or training program approval fee, $100; and
new text end

new text begin (10) report creation and generation fee, $60.
new text end

new text begin (b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fees must be deposited
in an account in the state government special revenue fund.
new text end

Sec. 7.

Minnesota Statutes 2016, section 148.6402, subdivision 4, is amended to read:


Subd. 4.

deleted text beginCommissionerdeleted text endnew text begin Boardnew text end.

"deleted text beginCommissionerdeleted text endnew text begin Boardnew text end" means the deleted text begincommissioner of
health or a designee
deleted text endnew text begin Board of Occupational Therapy Practice established in section 148.6449new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 8.

Minnesota Statutes 2016, section 148.6405, is amended to read:


148.6405 LICENSURE APPLICATION REQUIREMENTS: PROCEDURES AND
QUALIFICATIONS.

(a) An applicant for licensure must comply with the application requirements in section
148.6420. To qualify for licensure, an applicant must satisfy one of the requirements in
paragraphs (b) to (f) and not be subject to denial of licensure under section 148.6448.

(b) A person who applies for licensure as an occupational therapist and who has not
been credentialed by the National Board for Certification in Occupational Therapy or another
jurisdiction must meet the requirements in section 148.6408.

(c) A person who applies for licensure as an occupational therapy assistant and who has
not been credentialed by the National Board for Certification in Occupational Therapy or
another jurisdiction must meet the requirements in section 148.6410.

(d) A person who is certified by the National Board for Certification in Occupational
Therapy may apply for licensure by equivalency and must meet the requirements in section
148.6412.

(e) A person who is credentialed in another jurisdiction may apply for licensure by
reciprocity and must meet the requirements in section 148.6415.

(f) A person who applies for temporary licensure must meet the requirements in section
148.6418.

(g) A person who applies for licensure under paragraph (b), (c), or (f) more than two
and less than four years after meeting the requirements in section 148.6408 or 148.6410
must submit the following:

(1) a completed and signed application for licensure on forms provided by the
deleted text begin commissionerdeleted text endnew text begin boardnew text end;

(2) the license application fee required under section 148.6445;

(3) if applying for occupational therapist licensure, proof of having met a minimum of
24 contact hours of continuing education in the two years preceding licensure application,
or if applying for occupational therapy assistant licensure, proof of having met a minimum
of 18 contact hours of continuing education in the two years preceding licensure application;

(4) verified documentation of successful completion of 160 hours of supervised practice
approved by the deleted text begincommissionerdeleted text endnew text begin boardnew text end under a limited license specified in section 148.6425,
subdivision 3
, paragraph (c); and

(5) additional information as requested by the deleted text begincommissionerdeleted text endnew text begin boardnew text end to clarify information
in the application, including information to determine whether the individual has engaged
in conduct warranting disciplinary action under section 148.6448. The information must be
submitted within 30 days after the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end request.

(h) A person who applied for licensure under paragraph (b), (c), or (f) four years or more
after meeting the requirements in section 148.6408 or 148.6410 must meet all the
requirements in paragraph (g) except clauses (3) and (4), submit documentation of having
retaken and passed the credentialing examination for occupational therapist or occupational
therapy assistant, or of having completed an occupational therapy refresher program that
contains both a theoretical and clinical component approved by the deleted text begincommissionerdeleted text endnew text begin boardnew text end,
and verified documentation of successful completion of 480 hours of supervised practice
approved by the deleted text begincommissionerdeleted text endnew text begin boardnew text end under a limited license specified in section 148.6425,
subdivision 3
, paragraph (c). The 480 hours of supervised practice must be completed in
six months and may be completed at the applicant's place of work. Only refresher courses
completed within one year prior to the date of application qualify for approval.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 9.

Minnesota Statutes 2016, section 148.6408, subdivision 2, is amended to read:


Subd. 2.

Qualifying examination score required.

(a) An applicant must achieve a
qualifying score on the credentialing examination for occupational therapist.

(b) The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall determine the qualifying score for the credentialing
examination for occupational therapist. In determining the qualifying score, the deleted text begincommissionerdeleted text endnew text begin
board
new text end shall consider the cut score recommended by the National Board for Certification in
Occupational Therapy, or other national credentialing organization approved by the
deleted text begin commissionerdeleted text endnew text begin boardnew text end, using the modified Angoff method for determining cut score or another
method for determining cut score that is recognized as appropriate and acceptable by industry
standards.

(c) The applicant is responsible for:

(1) making arrangements to take the credentialing examination for occupational therapist;

(2) bearing all expenses associated with taking the examination; and

(3) having the examination scores sent directly to the deleted text begincommissionerdeleted text endnew text begin boardnew text end from the
testing service that administers the examination.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 10.

Minnesota Statutes 2016, section 148.6410, subdivision 2, is amended to read:


Subd. 2.

Qualifying examination score required.

(a) An applicant for licensure must
achieve a qualifying score on the credentialing examination for occupational therapy
assistants.

(b) The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall determine the qualifying score for the credentialing
examination for occupational therapy assistants. In determining the qualifying score, the
deleted text begin commissionerdeleted text endnew text begin boardnew text end shall consider the cut score recommended by the National Board for
Certification in Occupational Therapy, or other national credentialing organization approved
by the deleted text begincommissionerdeleted text endnew text begin boardnew text end, using the modified Angoff method for determining cut score
or another method for determining cut score that is recognized as appropriate and acceptable
by industry standards.

(c) The applicant is responsible for:

(1) making all arrangements to take the credentialing examination for occupational
therapy assistants;

(2) bearing all expense associated with taking the examination; and

(3) having the examination scores sent directly to the deleted text begincommissionerdeleted text endnew text begin boardnew text end from the
testing service that administers the examination.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 11.

Minnesota Statutes 2016, section 148.6412, subdivision 2, is amended to read:


Subd. 2.

Persons certified by National Board for Certification in Occupational
Therapy after June 17, 1996.

The deleted text begincommissionerdeleted text endnew text begin boardnew text end may license any person certified
by the National Board for Certification in Occupational Therapy as an occupational therapist
after June 17, 1996, if the deleted text begincommissionerdeleted text endnew text begin boardnew text end determines the requirements for certification
are equivalent to or exceed the requirements for licensure as an occupational therapist under
section 148.6408. The deleted text begincommissionerdeleted text endnew text begin boardnew text end may license any person certified by the National
Board for Certification in Occupational Therapy as an occupational therapy assistant after
June 17, 1996, if the deleted text begincommissionerdeleted text endnew text begin boardnew text end determines the requirements for certification are
equivalent to or exceed the requirements for licensure as an occupational therapy assistant
under section 148.6410. Nothing in this section limits the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end authority
to deny licensure based upon the grounds for discipline in sections 148.6401 to deleted text begin148.6450deleted text endnew text begin
148.6449
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 12.

Minnesota Statutes 2016, section 148.6415, is amended to read:


148.6415 LICENSURE BY RECIPROCITY.

A person who holds a current credential as an occupational therapist in the District of
Columbia or a state or territory of the United States whose standards for credentialing are
determined by the deleted text begincommissionerdeleted text endnew text begin boardnew text end to be equivalent to or exceed the requirements for
licensure under section 148.6408 may be eligible for licensure by reciprocity as an
occupational therapist. A person who holds a current credential as an occupational therapy
assistant in the District of Columbia or a state or territory of the United States whose
standards for credentialing are determined by the deleted text begincommissionerdeleted text endnew text begin boardnew text end to be equivalent to
or exceed the requirements for licensure under section 148.6410 may be eligible for licensure
by reciprocity as an occupational therapy assistant. Nothing in this section limits the
deleted text begin commissioner'sdeleted text endnew text begin board'snew text end authority to deny licensure based upon the grounds for discipline
in sections 148.6401 to deleted text begin148.6450deleted text endnew text begin 148.6449new text end. An applicant must provide:

(1) the application materials as required by section 148.6420, subdivisions 1, 3, and 4;

(2) the fees required by section 148.6445;

(3) a copy of a current and unrestricted credential for the practice of occupational therapy
as either an occupational therapist or occupational therapy assistant;

(4) a letter from the jurisdiction that issued the credential describing the applicant's
qualifications that entitled the applicant to receive the credential; and

(5) other information necessary to determine whether the credentialing standards of the
jurisdiction that issued the credential are equivalent to or exceed the requirements for
licensure under sections 148.6401 to deleted text begin148.6450deleted text endnew text begin 148.6449new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 13.

Minnesota Statutes 2016, section 148.6418, subdivision 1, is amended to read:


Subdivision 1.

Application.

The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall issue temporary licensure
as an occupational therapist or occupational therapy assistant to applicants who are not the
subject of a disciplinary action or past disciplinary action, nor disqualified on the basis of
items listed in section 148.6448, subdivision 1.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 14.

Minnesota Statutes 2016, section 148.6418, subdivision 2, is amended to read:


Subd. 2.

Procedures.

To be eligible for temporary licensure, an applicant must submit
a completed application for temporary licensure on forms provided by the deleted text begincommissionerdeleted text endnew text begin
board
new text end, the fees required by section 148.6445, and one of the following:

(1) evidence of successful completion of the requirements in section 148.6408,
subdivision 1
, or 148.6410, subdivision 1;

(2) a copy of a current and unrestricted credential for the practice of occupational therapy
as either an occupational therapist or occupational therapy assistant in another jurisdiction;
or

(3) a copy of a current and unrestricted certificate from the National Board for
Certification in Occupational Therapy stating that the applicant is certified as an occupational
therapist or occupational therapy assistant.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 15.

Minnesota Statutes 2016, section 148.6418, subdivision 4, is amended to read:


Subd. 4.

Supervision required.

An applicant who has graduated from an accredited
occupational therapy program, as required by section 148.6408, subdivision 1, or 148.6410,
subdivision 1
, and who has not passed the examination required by section 148.6408,
subdivision 2
, or 148.6410, subdivision 2, must practice under the supervision of a licensed
occupational therapist. The supervising therapist must, at a minimum, supervise the person
working under temporary licensure in the performance of the initial evaluation, determination
of the appropriate treatment plan, and periodic review and modification of the treatment
plan. The supervising therapist must observe the person working under temporary licensure
in order to assure service competency in carrying out evaluation, treatment planning, and
treatment implementation. The frequency of face-to-face collaboration between the person
working under temporary licensure and the supervising therapist must be based on the
condition of each patient or client, the complexity of treatment and evaluation procedures,
and the proficiencies of the person practicing under temporary licensure. The occupational
therapist or occupational therapy assistant working under temporary licensure must provide
verification of supervision on the application form provided by the deleted text begincommissionerdeleted text endnew text begin boardnew text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 16.

Minnesota Statutes 2016, section 148.6418, subdivision 5, is amended to read:


Subd. 5.

Expiration of temporary licensure.

A temporary license issued to a person
pursuant to subdivision 2, clause (1), expires six months from the date of issuance for
occupational therapists and occupational therapy assistants or on the date the deleted text begincommissionerdeleted text endnew text begin
board
new text end grants or denies licensure, whichever occurs first. A temporary license issued to a
person pursuant to subdivision 2, clause (2) or (3), expires 90 days after it is issued. Upon
application for renewal, a temporary license shall be renewed once to persons who have
not met the examination requirement under section 148.6408, subdivision 2, or 148.6410,
subdivision 2
, within the initial temporary licensure period and who are not the subject of
a disciplinary action nor disqualified on the basis of items in section 148.6448, subdivision
1
. Upon application for renewal, a temporary license shall be renewed once to persons who
are able to demonstrate good cause for failure to meet the requirements for licensure under
section 148.6412 or 148.6415 within the initial temporary licensure period and who are not
the subject of a disciplinary action nor disqualified on the basis of items in section 148.6448,
subdivision 1
.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 17.

Minnesota Statutes 2016, section 148.6420, subdivision 1, is amended to read:


Subdivision 1.

Applications for licensure.

An applicant for licensure must:

(1) submit a completed application for licensure on forms provided by the deleted text begincommissionerdeleted text endnew text begin
board
new text end and must supply the information requested on the application, including:

(i) the applicant's name, business address and business telephone number, business
setting, and daytime telephone number;

(ii) the name and location of the occupational therapy program the applicant completed;

(iii) a description of the applicant's education and training, including a list of degrees
received from educational institutions;

(iv) the applicant's work history for the six years preceding the application, including
the number of hours worked;

(v) a list of all credentials currently and previously held in Minnesota and other
jurisdictions;

(vi) a description of any jurisdiction's refusal to credential the applicant;

(vii) a description of all professional disciplinary actions initiated against the applicant
in any jurisdiction;

(viii) information on any physical or mental condition or chemical dependency that
impairs the person's ability to engage in the practice of occupational therapy with reasonable
judgment or safety;

(ix) a description of any misdemeanor or felony conviction that relates to honesty or to
the practice of occupational therapy;

(x) a description of any state or federal court order, including a conciliation court
judgment or a disciplinary order, related to the individual's occupational therapy practice;
and

(xi) a statement indicating the physical agent modalities the applicant will use and
whether the applicant will use the modalities as an occupational therapist or an occupational
therapy assistant under direct supervision;

(2) submit with the application all fees required by section 148.6445;

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

(4) sign a waiver authorizing the deleted text begincommissionerdeleted text endnew text begin boardnew text end to obtain access to the applicant's
records in this or any other state in which the applicant holds or previously held a credential
for the practice of an occupation, has completed an accredited occupational therapy education
program, or engaged in the practice of occupational therapy;

(5) submit additional information as requested by the deleted text begincommissionerdeleted text endnew text begin boardnew text end; and

(6) submit the additional information required for licensure by equivalency, licensure
by reciprocity, and temporary licensure as specified in sections 148.6408 to 148.6418.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 18.

Minnesota Statutes 2016, section 148.6420, subdivision 3, is amended to read:


Subd. 3.

Applicants certified by National Board for Certification in Occupational
Therapy.

An applicant who is certified by the National Board for Certification in
Occupational Therapy must provide the materials required in subdivision 1 and the following:

(1) verified documentation from the National Board for Certification in Occupational
Therapy stating that the applicant is certified as an occupational therapist, registered or
certified occupational therapy assistant, the date certification was granted, and the applicant's
certification number. The document must also include a statement regarding disciplinary
actions. The applicant is responsible for obtaining this documentation by sending a form
provided by the deleted text begincommissionerdeleted text endnew text begin boardnew text end to the National Board for Certification in Occupational
Therapy; and

(2) a waiver authorizing the deleted text begincommissionerdeleted text endnew text begin boardnew text end to obtain access to the applicant's
records maintained by the National Board for Certification in Occupational Therapy.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 19.

Minnesota Statutes 2016, section 148.6420, subdivision 5, is amended to read:


Subd. 5.

Action on applications for licensure.

(a) The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall
approve, approve with conditions, or deny licensure. The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall act on
an application for licensure according to paragraphs (b) to (d).

(b) The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall determine if the applicant meets the requirements for
licensure. The deleted text begincommissionerdeleted text endnew text begin boardnew text end, or the advisory council at the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end
request, may investigate information provided by an applicant to determine whether the
information is accurate and complete.

(c) The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall notify an applicant of action taken on the application
and, if licensure is denied or approved with conditions, the grounds for the deleted text begincommissioner'sdeleted text endnew text begin
board's
new text end determination.

(d) An applicant denied licensure or granted licensure with conditions may make a
written request to the deleted text begincommissionerdeleted text endnew text begin boardnew text end, within 30 days of the date of the deleted text begincommissioner'sdeleted text endnew text begin
board's
new text end determination, for reconsideration of the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end determination.
Individuals requesting reconsideration may submit information which the applicant wants
considered in the reconsideration. After reconsideration of the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end
determination to deny licensure or grant licensure with conditions, the deleted text begincommissionerdeleted text endnew text begin boardnew text end
shall determine whether the original determination should be affirmed or modified. An
applicant is allowed no more than one request in any one biennial licensure period for
reconsideration of the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end determination to deny licensure or approve
licensure with conditions.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 20.

Minnesota Statutes 2016, section 148.6423, is amended to read:


148.6423 LICENSURE RENEWAL.

Subdivision 1.

Renewal requirements.

To be eligible for licensure renewal, a licensee
must:

(1) submit a completed and signed application for licensure renewal on forms provided
by the deleted text begincommissionerdeleted text endnew text begin boardnew text end;

(2) submit the renewal fee required under section 148.6445;

(3) submit proof of having met the continuing education requirement of section 148.6443
on forms provided by the deleted text begincommissionerdeleted text endnew text begin boardnew text end; and

(4) submit additional information as requested by the deleted text begincommissionerdeleted text endnew text begin boardnew text end to clarify
information presented in the renewal application. The information must be submitted within
30 days after the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end request.

Subd. 2.

Renewal deadline.

(a) Except as provided in paragraph (c), licenses must be
renewed every two years. Licensees must comply with the following procedures in paragraphs
(b) to (e):

(b) Each license must state an expiration date. An application for licensure renewal must
be received by the deleted text beginDepartment of Healthdeleted text endnew text begin boardnew text end or postmarked at least 30 calendar days
before the expiration date. If the postmark is illegible, the application shall be considered
timely if received at least 21 calendar days before the expiration date.

(c) If the deleted text begincommissionerdeleted text endnew text begin boardnew text end changes the renewal schedule and the expiration date is
less than two years, the fee and the continuing education contact hours to be reported at the
next renewal must be prorated.

(d) An application for licensure renewal not received within the time required under
paragraph (b), but received on or before the expiration date, must be accompanied by a late
fee in addition to the renewal fee specified by section 148.6445.

(e) Licensure renewals received after the expiration date shall not be accepted and persons
seeking licensed status must comply with the requirements of section 148.6425.

Subd. 3.

Licensure renewal notice.

At least 60 calendar days before the expiration date
in subdivision 2, the deleted text begincommissionerdeleted text endnew text begin boardnew text end shall mail a renewal notice to the licensee's last
known address on file with the deleted text begincommissionerdeleted text endnew text begin boardnew text end. The notice must include an application
for licensure renewal and notice of fees required for renewal. The licensee's failure to receive
notice does not relieve the licensee of the obligation to meet the renewal deadline and other
requirements for licensure renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 21.

Minnesota Statutes 2016, section 148.6425, subdivision 2, is amended to read:


Subd. 2.

Licensure renewal after licensure expiration date.

An individual whose
application for licensure renewal is received after the licensure expiration date must submit
the following:

(1) a completed and signed application for licensure following lapse in licensed status
on forms provided by the deleted text begincommissionerdeleted text endnew text begin boardnew text end;

(2) the renewal fee and the late fee required under section 148.6445;

(3) proof of having met the continuing education requirements in section 148.6443,
subdivision 1
; and

(4) additional information as requested by the deleted text begincommissionerdeleted text endnew text begin boardnew text end to clarify information
in the application, including information to determine whether the individual has engaged
in conduct warranting disciplinary action as set forth in section 148.6448. The information
must be submitted within 30 days after the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end request.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 22.

Minnesota Statutes 2016, section 148.6425, subdivision 3, is amended to read:


Subd. 3.

Licensure renewal four years or more after licensure expiration date.

(a)
An individual who requests licensure renewal four years or more after the licensure expiration
date must submit the following:

(1) a completed and signed application for licensure on forms provided by the
deleted text begin commissionerdeleted text endnew text begin boardnew text end;

(2) the renewal fee and the late fee required under section 148.6445 if renewal application
is based on paragraph (b), clause (1), (2), or (3), or the renewal fee required under section
148.6445 if renewal application is based on paragraph (b), clause (4);

(3) proof of having met the continuing education requirement in section 148.6443,
subdivision 1
, except the continuing education must be obtained in the two years immediately
preceding application renewal; and

(4) at the time of the next licensure renewal, proof of having met the continuing education
requirement, which shall be prorated based on the number of months licensed during the
two-year licensure period.

(b) In addition to the requirements in paragraph (a), the applicant must submit proof of
one of the following:

(1) verified documentation of successful completion of 160 hours of supervised practice
approved by the deleted text begincommissionerdeleted text endnew text begin boardnew text end as described in paragraph (c);

(2) verified documentation of having achieved a qualifying score on the credentialing
examination for occupational therapists or the credentialing examination for occupational
therapy assistants administered within the past year;

(3) documentation of having completed a combination of occupational therapy courses
or an occupational therapy refresher program that contains both a theoretical and clinical
component approved by the deleted text begincommissionerdeleted text endnew text begin boardnew text end. Only courses completed within one year
preceding the date of the application or one year after the date of the application qualify for
approval; or

(4) evidence that the applicant holds a current and unrestricted credential for the practice
of occupational therapy in another jurisdiction and that the applicant's credential from that
jurisdiction has been held in good standing during the period of lapse.

(c) To participate in a supervised practice as described in paragraph (b), clause (1), the
applicant shall obtain limited licensure. To apply for limited licensure, the applicant shall
submit the completed limited licensure application, fees, and agreement for supervision of
an occupational therapist or occupational therapy assistant practicing under limited licensure
signed by the supervising therapist and the applicant. The supervising occupational therapist
shall state the proposed level of supervision on the supervision agreement form provided
by the deleted text begincommissionerdeleted text endnew text begin boardnew text end. The supervising therapist shall determine the frequency and
manner of supervision based on the condition of the patient or client, the complexity of the
procedure, and the proficiencies of the supervised occupational therapist. At a minimum, a
supervising occupational therapist shall be on the premises at all times that the person
practicing under limited licensure is working; be in the room ten percent of the hours worked
each week by the person practicing under limited licensure; and provide daily face-to-face
collaboration for the purpose of observing service competency of the occupational therapist
or occupational therapy assistant, discussing treatment procedures and each client's response
to treatment, and reviewing and modifying, as necessary, each treatment plan. The supervising
therapist shall document the supervision provided. The occupational therapist participating
in a supervised practice is responsible for obtaining the supervision required under this
paragraph and must comply with the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end requirements for supervision
during the entire 160 hours of supervised practice. The supervised practice must be completed
in two months and may be completed at the applicant's place of work.

(d) In addition to the requirements in paragraphs (a) and (b), the applicant must submit
additional information as requested by the deleted text begincommissionerdeleted text endnew text begin boardnew text end to clarify information in the
application, including information to determine whether the applicant has engaged in conduct
warranting disciplinary action as set forth in section 148.6448. The information must be
submitted within 30 days after the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end request.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 23.

Minnesota Statutes 2016, section 148.6428, is amended to read:


148.6428 CHANGE OF NAME, ADDRESS, OR EMPLOYMENT.

A licensee who changes a name, address, or employment must inform the deleted text begincommissionerdeleted text endnew text begin
board
new text end, in writing, of the change of name, address, employment, business address, or business
telephone number within 30 days. A change in name must be accompanied by a copy of a
marriage certificate or court order. All notices or other correspondence mailed to or served
on a licensee by the deleted text begincommissionerdeleted text endnew text begin boardnew text end at the licensee's address on file with the
deleted text begin commissionerdeleted text endnew text begin boardnew text end shall be considered as having been received by the licensee.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 24.

Minnesota Statutes 2016, section 148.6443, subdivision 5, is amended to read:


Subd. 5.

Reporting continuing education contact hours.

Within one month following
licensure expiration, each licensee shall submit verification that the licensee has met the
continuing education requirements of this section on the continuing education report form
provided by the deleted text begincommissionerdeleted text endnew text begin boardnew text end. The continuing education report form may require
the following information:

(1) title of continuing education activity;

(2) brief description of the continuing education activity;

(3) sponsor, presenter, or author;

(4) location and attendance dates;

(5) number of contact hours; and

(6) licensee's notarized affirmation that the information is true and correct.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 25.

Minnesota Statutes 2016, section 148.6443, subdivision 6, is amended to read:


Subd. 6.

Auditing continuing education reports.

(a) The deleted text begincommissionerdeleted text endnew text begin boardnew text end may
audit a percentage of the continuing education reports based on random selection. A licensee
shall maintain all documentation required by this section for two years after the last day of
the biennial licensure period in which the contact hours were earned.

(b) All renewal applications that are received after the expiration date may be subject
to a continuing education report audit.

(c) Any licensee against whom a complaint is filed may be subject to a continuing
education report audit.

(d) The licensee shall make the following information available to the deleted text begincommissionerdeleted text endnew text begin
board
new text end for auditing purposes:

(1) a copy of the completed continuing education report form for the continuing education
reporting period that is the subject of the audit including all supporting documentation
required by subdivision 5;

(2) a description of the continuing education activity prepared by the presenter or sponsor
that includes the course title or subject matter, date, place, number of program contact hours,
presenters, and sponsors;

(3) documentation of self-study programs by materials prepared by the presenter or
sponsor that includes the course title, course description, name of sponsor or author, and
the number of hours required to complete the program;

(4) documentation of university, college, or vocational school courses by a course
syllabus, listing in a course bulletin, or equivalent documentation that includes the course
title, instructor's name, course dates, number of contact hours, and course content, objectives,
or goals; and

(5) verification of attendance by:

(i) a signature of the presenter or a designee at the continuing education activity on the
continuing education report form or a certificate of attendance with the course name, course
date, and licensee's name;

(ii) a summary or outline of the educational content of an audio or video educational
activity to verify the licensee's participation in the activity if a designee is not available to
sign the continuing education report form;

(iii) verification of self-study programs by a certificate of completion or other
documentation indicating that the individual has demonstrated knowledge and has
successfully completed the program; or

(iv) verification of attendance at a university, college, or vocational course by an official
transcript.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 26.

Minnesota Statutes 2016, section 148.6443, subdivision 7, is amended to read:


Subd. 7.

Waiver of continuing education requirements.

The deleted text begincommissionerdeleted text endnew text begin boardnew text end may
grant a waiver of the requirements of this section in cases where the requirements would
impose an extreme hardship on the licensee. The request for a waiver must be in writing,
state the circumstances that constitute extreme hardship, state the period of time the licensee
wishes to have the continuing education requirement waived, and state the alternative
measures that will be taken if a waiver is granted. The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall set forth,
in writing, the reasons for granting or denying the waiver. Waivers granted by the
deleted text begin commissionerdeleted text endnew text begin boardnew text end shall specify, in writing, the time limitation and required alternative
measures to be taken by the licensee. A request for waiver shall be denied if the deleted text begincommissionerdeleted text endnew text begin
board
new text end finds that the circumstances stated by the licensee do not support a claim of extreme
hardship, the requested time period for waiver is unreasonable, the alternative measures
proposed by the licensee are not equivalent to the continuing education activity being waived,
or the request for waiver is not submitted to the deleted text begincommissionerdeleted text endnew text begin boardnew text end within 60 days after
the expiration date.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 27.

Minnesota Statutes 2016, section 148.6443, subdivision 8, is amended to read:


Subd. 8.

Penalties for noncompliance.

The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall refuse to renew
or grant, or shall suspend, condition, limit, or qualify the license of any person who the
deleted text begin commissionerdeleted text endnew text begin boardnew text end determines has failed to comply with the continuing education
requirements of this section. A licensee may request reconsideration of the deleted text begincommissioner'sdeleted text endnew text begin
board's
new text end determination of noncompliance or the penalty imposed under this section by making
a written request to the deleted text begincommissionerdeleted text endnew text begin boardnew text end within 30 days of the date of notification to the
applicant. Individuals requesting reconsideration may submit information that the licensee
wants considered in the reconsideration.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 28.

Minnesota Statutes 2016, section 148.6445, subdivision 1, is amended to read:


Subdivision 1.

Initial licensure fee.

The initial licensure fee for occupational therapists
is $145. The initial licensure fee for occupational therapy assistants is $80. The deleted text begincommissionerdeleted text endnew text begin
board
new text end shall prorate fees based on the number of quarters remaining in the biennial licensure
period.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 29.

Minnesota Statutes 2016, section 148.6445, subdivision 10, is amended to read:


Subd. 10.

Use of fees.

All fees are nonrefundable. The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall only
use fees collected under this section for the purposes of administering this chapter. The
legislature must not transfer money generated by these fees from the state government
special revenue fund to the general fund. deleted text beginSurcharges collected by the commissioner of health
under section 16E.22 are not subject to this subdivision.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 30.

Minnesota Statutes 2016, section 148.6448, is amended to read:


148.6448 GROUNDS FOR DENIAL OF LICENSURE OR DISCIPLINE;
INVESTIGATION PROCEDURES; DISCIPLINARY ACTIONS.

Subdivision 1.

Grounds for denial of licensure or discipline.

The deleted text begincommissionerdeleted text endnew text begin boardnew text end
may deny an application for licensure, may approve licensure with conditions, or may
discipline a licensee using any disciplinary actions listed in subdivision 3 on proof that the
individual has:

(1) intentionally submitted false or misleading information to the deleted text begincommissionerdeleted text endnew text begin boardnew text end
or the advisory council;

(2) failed, within 30 days, to provide information in response to a written request by the
deleted text begin commissionerdeleted text endnew text begin boardnew text end or advisory council;

(3) performed services of an occupational therapist or occupational therapy assistant in
an incompetent manner or in a manner that falls below the community standard of care;

(4) failed to satisfactorily perform occupational therapy services during a period of
temporary licensure;

(5) violated sections 148.6401 to deleted text begin148.6450deleted text endnew text begin 148.6449new text end;

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

(7) been convicted of violating any state or federal law, rule, or regulation which directly
relates to the practice of occupational therapy;

(8) aided or abetted another person in violating any provision of sections 148.6401 to
deleted text begin 148.6450deleted text endnew text begin 148.6449new text end;

(9) been disciplined for conduct in the practice of an occupation by the state of Minnesota,
another jurisdiction, or a national professional association, if any of the grounds for discipline
are the same or substantially equivalent to those in sections 148.6401 to deleted text begin148.6450deleted text endnew text begin 148.6449new text end;

(10) not cooperated with the deleted text begincommissioner or advisory councildeleted text endnew text begin boardnew text end in an investigation
conducted according to subdivision 2;

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

(12) engaged in dishonest, unethical, or unprofessional conduct in connection with the
practice of occupational therapy that is likely to deceive, defraud, or harm the public;

(13) demonstrated a willful or careless disregard for the health, welfare, or safety of a
client;

(14) performed medical diagnosis or provided treatment, other than occupational therapy,
without being licensed to do so under the laws of this state;

(15) paid or promised to pay a commission or part of a fee to any person who contacts
the occupational therapist for consultation or sends patients to the occupational therapist
for treatment;

(16) engaged in an incentive payment arrangement, other than that prohibited by clause
(15), that promotes occupational therapy overutilization, whereby the referring person or
person who controls the availability of occupational therapy services to a client profits
unreasonably as a result of client treatment;

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

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

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

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

(21) engaged in conduct with a client that is sexual or may reasonably be interpreted by
the client as sexual, or in any verbal behavior that is seductive or sexually demeaning to a
patient;

(22) violated a federal or state court order, including a conciliation court judgment, or
a disciplinary order issued by the deleted text begincommissionerdeleted text endnew text begin boardnew text end, related to the person's occupational
therapy practice; or

(23) any other just cause related to the practice of occupational therapy.

Subd. 2.

Investigation of complaints.

The deleted text begincommissioner, or the advisory council when
authorized by the commissioner,
deleted text endnew text begin boardnew text end may initiate an investigation upon receiving a
complaint or other oral or written communication that alleges or implies that a person has
violated sections 148.6401 to deleted text begin148.6450deleted text endnew text begin 148.6449new text end. In the receipt, investigation, and hearing
of a complaint that alleges or implies a person has violated sections 148.6401 to deleted text begin148.6450deleted text endnew text begin
148.6449
new text end, the deleted text begincommissionerdeleted text endnew text begin boardnew text end shall follow the procedures in section 214.10.

Subd. 3.

Disciplinary actions.

If the deleted text begincommissionerdeleted text endnew text begin boardnew text end finds that an occupational
therapist or occupational therapy assistant should be disciplined according to subdivision
1, the deleted text begincommissionerdeleted text endnew text begin boardnew text end may take any one or more of the following actions:

(1) refuse to grant or renew licensure;

(2) approve licensure with conditions;

(3) revoke licensure;

(4) suspend licensure;

(5) any reasonable lesser action including, but not limited to, reprimand or restriction
on licensure; or

(6) any action authorized by statute.

Subd. 4.

Effect of specific disciplinary action on use of title.

Upon notice from the
deleted text begin commissionerdeleted text endnew text begin boardnew text end denying licensure renewal or upon notice that disciplinary actions have
been imposed and the person is no longer entitled to practice occupational therapy and use
the occupational therapy and licensed titles, the person shall cease to practice occupational
therapy, to use titles protected by sections 148.6401 to deleted text begin148.6450deleted text endnew text begin 148.6449new text end, and to represent
to the public that the person is licensed by the deleted text begincommissionerdeleted text endnew text begin boardnew text end.

Subd. 5.

Reinstatement requirements after disciplinary action.

A person who has
had licensure suspended may request and provide justification for reinstatement following
the period of suspension specified by the deleted text begincommissionerdeleted text endnew text begin boardnew text end. The requirements of sections
148.6423 and 148.6425 for renewing licensure and any other conditions imposed with the
suspension must be met before licensure may be reinstated.

Subd. 6.

Authority to contract.

The deleted text begincommissionerdeleted text endnew text begin boardnew text end shall contract with the health
professionals services program as authorized by sections 214.31 to 214.37 to provide these
services to practitioners under this chapter. The health professionals services program does
not affect the deleted text begincommissioner'sdeleted text endnew text begin board'snew text end authority to discipline violations of sections 148.6401
to deleted text begin148.6450deleted text endnew text begin 148.6449new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 31.

new text begin [148.6449] BOARD OF OCCUPATIONAL THERAPY PRACTICE.
new text end

new text begin Subdivision 1. new text end

new text begin Creation. new text end

new text begin The Board of Occupational Therapy Practice consists of 11
members appointed by the governor. The members are:
new text end

new text begin (1) five occupational therapists licensed under sections 148.6401 to 148.6449;
new text end

new text begin (2) three occupational therapy assistants licensed under sections 148.6401 to 148.6449;
and
new text end

new text begin (3) three public members, including two members who have received occupational
therapy services or have a family member who has received occupational therapy services,
and one member who is a health care professional or health care provider licensed in
Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Qualifications of board members. new text end

new text begin (a) The occupational therapy practitioners
appointed to the board must represent a variety of practice areas and settings.
new text end

new text begin (b) At least two occupational therapy practitioners must be employed outside the
seven-county metropolitan area.
new text end

new text begin (c) Board members shall serve for not more than two consecutive terms.
new text end

new text begin Subd. 3. new text end

new text begin Recommendations for appointment. new text end

new text begin Prior to the end of the term of a member
of the board, or within 60 days after a position on the board becomes vacant, the Minnesota
Occupational Therapy Association and other interested persons and organizations may
recommend to the governor members qualified to serve on the board. The governor may
appoint members to the board from the list of persons recommended or from among other
qualified candidates.
new text end

new text begin Subd. 4. new text end

new text begin Officers. new text end

new text begin The board shall biennially elect from its membership a chair, vice-chair,
and secretary-treasurer. Each officer shall serve until a successor is elected.
new text end

new text begin Subd. 5. new text end

new text begin Executive director. new text end

new text begin The board shall appoint and employ an executive director
who is not a member of the board. The employment of the executive director shall be subject
to the terms described in section 214.04, subdivision 2a.
new text end

new text begin Subd. 6. new text end

new text begin Terms; compensation; removal of members. new text end

new text begin Membership terms, compensation
of members, removal of members, the filling of membership vacancies, and fiscal year and
reporting requirements shall be as provided in chapter 214. The provision of staff,
administrative services, and office space; the review and processing of complaints; the
setting of board fees; and other activities relating to board operations shall be conducted
according to chapter 214.
new text end

new text begin Subd. 7. new text end

new text begin Duties of the Board of Occupational Therapy Practice. new text end

new text begin (a) The board shall:
new text end

new text begin (1) adopt and enforce rules and laws necessary for licensing occupational therapy
practitioners;
new text end

new text begin (2) adopt and enforce rules for regulating the professional conduct of the practice of
occupational therapy;
new text end

new text begin (3) issue licenses to qualified individuals in accordance with sections 148.6401 to
148.6449;
new text end

new text begin (4) assess and collect fees for the issuance and renewal of licenses;
new text end

new text begin (5) educate the public about the requirements for licensing occupational therapy
practitioners, educate occupational therapy practitioners about the rules of conduct, and
enable the public to file complaints against applicants and licensees who may have violated
sections 148.6401 to 148.6449; and
new text end

new text begin (6) investigate individuals engaging in practices that violate sections 148.6401 to
148.6449 and take necessary disciplinary, corrective, or other action according to section
148.6448.
new text end

new text begin (b) The board may adopt rules necessary to define standards or carry out the provisions
of sections 148.6401 to 148.6449. Rules shall be adopted according to chapter 14.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 32.

Minnesota Statutes 2016, section 148.881, is amended to read:


148.881 DECLARATION OF POLICY.

The practice of psychology in Minnesota affects the public health, safety, and welfare.
The regulations in deleted text beginsections 148.88 to 148.98deleted text endnew text begin the Minnesota Psychology Practice Act as
enforced by the Board of Psychology
new text end protect the public deleted text beginfrom the practice of psychology by
unqualified persons and from unethical or unprofessional conduct by persons licensed to
practice psychology
deleted text endnew text begin through licensure and regulation to promote access to safe, ethical, and
competent psychological services
new text end.

Sec. 33.

Minnesota Statutes 2016, section 148.89, is amended to read:


148.89 DEFINITIONS.

Subdivision 1.

Applicability.

For the purposes of sections 148.88 to 148.98, the following
terms have the meanings given them.

Subd. 2.

Board of Psychology or board.

"Board of Psychology" or "board" means the
board established under section 148.90.

Subd. 2a.

Client.

"Client" means deleted text begineach individual or legal, religious, academic,
organizational, business, governmental, or other entity that receives, received, or should
have received, or arranged for another individual or entity to receive services from an
individual regulated under sections 148.88 to 148.98. Client also means an individual's
legally authorized representative, such as a parent or guardian. For the purposes of sections
148.88 to 148.98, "client" may include patient, resident, counselee, evaluatee, and, as limited
in the rules of conduct, student, supervisee, or research subject. In the case of dual clients,
the licensee or applicant for licensure must be aware of the responsibilities to each client,
and of the potential for divergent interests of each client
deleted text endnew text begin a direct recipient of psychological
services within the context of a professional relationship that may include a child, adolescent,
adult, couple, family, group, organization, community, or other entity. The client may be
the person requesting the psychological services or the direct recipient of the services
new text end.

Subd. 2b.

Credentialed.

"Credentialed" means having a license, certificate, charter,
registration, or similar authority to practice in an occupation regulated by a governmental
board or agency.

Subd. 2c.

Designated supervisor.

"Designated supervisor" means a qualified individual
who is deleted text begindesignateddeleted text endnew text begin identified and assignednew text end by the primary supervisor to provide additional
supervision and training deleted text beginto a licensed psychological practitioner ordeleted text end to an individual who is
obtaining required predegree supervised professional experience or postdegree supervised
new text begin psychological new text endemployment.

new text begin Subd. 2d. new text end

new text begin Direct services. new text end

new text begin "Direct services" means the delivery of preventive, diagnostic,
assessment, or therapeutic intervention services where the primary purpose is to benefit a
client who is the direct recipient of the service.
new text end

new text begin Subd. 2e. new text end

new text begin Full-time employment. new text end

new text begin "Full-time employment" means a minimum of 35
clock hours per week.
new text end

Subd. 3.

Independent practice.

"Independent practice" means the practice of psychology
without supervision.

new text begin Subd. 3a. new text end

new text begin Jurisdiction. new text end

new text begin "Jurisdiction" means the United States, United States territories,
or Canadian provinces or territories.
new text end

Subd. 4.

Licensee.

"Licensee" means a person who is licensed by the board deleted text beginas a licensed
psychologist or as a licensed psychological practitioner
deleted text end.

Subd. 4a.

Provider or provider of services.

"Provider" or "provider of services" means
any individual who is regulated by the boarddeleted text begin, and includes a licensed psychologist, a licensed
psychological practitioner, a licensee, or an applicant
deleted text end.

Subd. 4b.

Primary supervisor.

"Primary supervisor" means a psychologist licensed in
Minnesota or other qualified individual who provides the principal supervision deleted text beginto a licensed
psychological practitioner or
deleted text end to an individual who is obtaining required predegree supervised
professional experience or postdegree supervised new text beginpsychological new text endemployment.

Subd. 5.

Practice of psychology.

"Practice of psychology" means the observation,
description, evaluation, interpretation, deleted text beginordeleted text endnew text begin prediction, ornew text end modification of human behavior by
the application of psychological principles, methods, or procedures for deleted text beginany reason, including
to prevent, eliminate, or manage
deleted text endnew text begin the purpose of preventing, eliminating, evaluating, assessing,
or predicting
new text end symptomatic, maladaptive, or undesired behaviornew text begin; applying psychological
principles in legal settings;
new text end and deleted text beginto enhancedeleted text endnew text begin enhancingnew text end interpersonal relationships, work, life
and developmental adjustment, personal and organizational effectiveness, behavioral health,
and mental health. The practice of psychology includes, but is not limited to, the following
services, regardless of whether the provider receives payment for the services:

(1) psychological research and teaching of psychologynew text begin subject to the exemptions in
section 148.9075
new text end;

(2) deleted text beginassessment, including psychological testing and other means of evaluating personal
characteristics such as intelligence, personality, abilities, interests, aptitudes, and
neuropsychological functioning
deleted text endnew text begin psychological testing and the evaluation or assessment of
personal characteristics, such as intelligence, personality, cognitive, physical and emotional
abilities, skills, interests, aptitudes, and neuropsychological functioning
new text end;

(3) deleted text begina psychological report, whether written or oral, including testimony of a provider as
an expert witness, concerning the characteristics of an individual or entity
deleted text endnew text begin counseling,
psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy
new text end;

deleted text begin (4) psychotherapy, including but not limited to, categories such as behavioral, cognitive,
emotive, systems, psychophysiological, or insight-oriented therapies; counseling; hypnosis;
and diagnosis and treatment of:
deleted text end

deleted text begin (i) mental and emotional disorder or disability;
deleted text end

deleted text begin (ii) alcohol and substance dependence or abuse;
deleted text end

deleted text begin (iii) disorders of habit or conduct;
deleted text end

deleted text begin (iv) the psychological aspects of physical illness or condition, accident, injury, or
disability, including the psychological impact of medications;
deleted text end

deleted text begin (v) life adjustment issues, including work-related and bereavement issues; and
deleted text end

deleted text begin (vi) child, family, or relationship issues
deleted text end

new text begin (4) diagnosis, treatment, and management of mental or emotional disorders or disabilities,
substance use disorders, disorders of habit or conduct, and the psychological aspects of
physical illness, accident, injury, or disability
new text end;

(5) deleted text beginpsychoeducational services and treatmentdeleted text endnew text begin psychoeducational evaluation, therapy,
and remediation
new text end; deleted text beginand
deleted text end

(6) consultation deleted text beginand supervisiondeleted text endnew text begin with physicians, other health care professionals, and
clients regarding available treatment options, including medication, with respect to the
provision of care for a specific client;
new text end

new text begin (7) provision of direct services to individuals or groups for the purpose of enhancing
individual and organizational effectiveness, using psychological principles, methods, and
procedures to assess and evaluate individuals on personal characteristics for individual
development or behavior change or for making decisions about the individual; and
new text end

new text begin (8) supervision and consultation related to any of the services described in this
subdivision
new text end.

new text begin Subd. 6. new text end

new text begin Telesupervision. new text end

new text begin "Telesupervision" means the clinical supervision of
psychological services through a synchronous audio and video format where the supervisor
is not physically in the same facility as the supervisee.
new text end

Sec. 34.

Minnesota Statutes 2016, section 148.90, subdivision 1, is amended to read:


Subdivision 1.

Board of Psychology.

(a) The Board of Psychology is created with the
powers and duties described in this section. The board has 11 members who consist of:

(1) deleted text beginthreedeleted text endnew text begin fournew text end individuals licensed as licensed psychologists who have doctoral degrees
in psychology;

(2) two individuals licensed as licensed psychologists who have master's degrees in
psychology;

(3) two psychologists, not necessarily licensed, deleted text beginone with adeleted text endnew text begin who havenew text end doctoral deleted text begindegreedeleted text endnew text begin
degrees
new text end in psychology deleted text beginand one with either a doctoral or master's degree in psychologydeleted text end
representing different training programs in psychology;

deleted text begin (4) one individual licensed or qualified to be licensed as: (i) through December 31, 2010,
a licensed psychological practitioner; and (ii) after December 31, 2010, a licensed
psychologist;
deleted text end and

deleted text begin (5)deleted text endnew text begin (4)new text end three public members.

(b) After the date on which fewer than 30 percent of the individuals licensed by the
board as licensed psychologists qualify for licensure under section 148.907, subdivision 3,
paragraph (b), vacancies filled under paragraph (a), clause (2), shall be filled by an individual
with either a master's or doctoral degree in psychology licensed or qualified to be licensed
as a licensed psychologist.

(c) After the date on which fewer than 15 percent of the individuals licensed by the board
as licensed psychologists qualify for licensure under section 148.907, subdivision 3,
paragraph (b), vacancies under paragraph (a), clause (2), shall be filled by an individual
with either a master's or doctoral degree in psychology licensed or qualified to be licensed
as a licensed psychologist.

Sec. 35.

Minnesota Statutes 2016, section 148.90, subdivision 2, is amended to read:


Subd. 2.

Members.

(a) The members of the board shall:

(1) be appointed by the governor;

(2) be residents of the state;

(3) serve for not more than two consecutive terms;

(4) designate the officers of the board; and

(5) administer oaths pertaining to the business of the board.

(b) A public member of the board shall represent the public interest and shall not:

(1) be a psychologistdeleted text begin, psychological practitioner,deleted text end or have engaged in the practice of
psychology;

(2) be an applicant or former applicant for licensure;

(3) be a member of another health professionnew text begin and be licensed by a health-related licensing
board as defined under section 214.01, subdivision 2; the commissioner of health; or licensed,
certified, or registered by another jurisdiction
new text end;

(4) be a member of a household that includes a psychologist deleted text beginor psychological practitionerdeleted text end;
or

(5) have conflicts of interest or the appearance of conflicts with duties as a board member.

Sec. 36.

Minnesota Statutes 2016, section 148.905, subdivision 1, is amended to read:


Subdivision 1.

General.

The board shall:

(1) adopt and enforce rules for licensing psychologists deleted text beginand psychological practitionersdeleted text end
and for regulating their professional conduct;

(2) adopt and enforce rules of conduct governing the practice of psychology;

(3) adopt and implement rules for examinations which shall be held at least once a year
to assess applicants' knowledge and skills. The examinations may be written or oral or both,
and may be administered by the board or by institutions or individuals designated by the
boarddeleted text begin;deleted text endnew text begin. Before the adoption and implementation of a new national examination, the board
must consider whether the examination:
new text end

new text begin (i) demonstrates reasonable reliability and external validity;
new text end

new text begin (ii) is normed on a reasonable representative and diverse national sample; and
new text end

new text begin (iii) is intended to assess an applicant's education, training, and experience for the purpose
of public protection;
new text end

(4) issue licenses to individuals qualified under sections 148.907 deleted text beginand 148.908deleted text endnew text begin, 148.909,
148.915, and 148.916
new text end, according to the procedures for licensing in Minnesota Rules;

(5) issue copies of the rules for licensing to all applicants;

(6) establish and maintain annually a register of current licenses;

(7) establish and collect fees for the issuance and renewal of licenses and other services
by the board. Fees shall be set to defray the cost of administering the provisions of sections
148.88 to 148.98 including costs for applications, examinations, enforcement, materials,
and the operations of the board;

(8) educate the public deleted text beginaboutdeleted text endnew text begin onnew text end the requirements for deleted text beginlicensing of psychologists and of
psychological practitioners
deleted text end new text beginlicenses issued by the board new text endand deleted text beginaboutdeleted text endnew text begin onnew text end the rules of conductdeleted text begin,
to
deleted text endnew text begin;
new text end

new text begin (9)new text end enable the public to file complaints against applicants or licensees who may have
violated the Psychology Practice Act; deleted text beginand
deleted text end

deleted text begin (9)deleted text endnew text begin (10)new text end adopt and implement requirements for continuing educationnew text begin;new text end and

new text begin (11) new text endestablish or approve programs that qualify for professional psychology continuing
educational credit. The board may hire consultants, agencies, or professional psychological
associations to establish and approve continuing education courses.

Sec. 37.

Minnesota Statutes 2016, section 148.907, subdivision 1, is amended to read:


Subdivision 1.

Effective date.

deleted text beginAfter August 1, 1991,deleted text end No person shall engage in the
independent practice of psychology unless that person is licensed as a licensed psychologistnew text begin
or is exempt under section 148.9075
new text end.

Sec. 38.

Minnesota Statutes 2016, section 148.907, subdivision 2, is amended to read:


Subd. 2.

Requirements for licensure as licensed psychologist.

To become licensed
by the board as a licensed psychologist, an applicant shall comply with the following
requirements:

(1) pass an examination in psychology;

(2) pass a professional responsibility examination on the practice of psychology;

(3) pass any other examinations as required by board rules;

(4) pay nonrefundable fees to the board for applications, processing, testing, renewals,
and materials;

(5) deleted text beginhavedeleted text end attained the age of majority, be of good moral character, and have no unresolved
disciplinary action or complaints pending in the state of Minnesota or any other jurisdiction;

(6) deleted text beginhavedeleted text end earned a doctoral degree with a major in psychology from a regionally accredited
educational institution meeting the standards the board has established by rule; and

(7) deleted text beginhavedeleted text end completed at least one full year or the equivalent in part time of postdoctoral
supervised psychological employmentnew text begin in no less than 12 months and no more than 60
months. If the postdoctoral supervised psychological employment goes beyond 60 months,
the board may grant a variance to this requirement
new text end.

Sec. 39.

new text begin [148.9075] EXEMPTIONS TO LICENSE REQUIREMENT.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin (a) Nothing in sections 148.88 to 148.98 shall prevent members
of other professions or occupations from performing functions for which they are competent
and properly authorized by law. The following individuals are exempt from the licensure
requirements of the Minnesota Psychology Practice Act, provided they operate in compliance
with the stated exemption:
new text end

new text begin (1) individuals licensed by a health-related licensing board as defined under section
214.01, subdivision 2, or by the commissioner of health;
new text end

new text begin (2) individuals authorized as mental health practitioners as defined under section 245.462,
subdivision 17; and
new text end

new text begin (3) individuals authorized as mental health professionals under section 245.462,
subdivision 18.
new text end

new text begin (b) Any of these individuals must not hold themselves out to the public by any title or
description stating or implying they are licensed to engage in the practice of psychology
unless they are licensed under sections 148.88 to 148.98 or are using a title in compliance
with section 148.96.
new text end

new text begin Subd. 2. new text end

new text begin Business or industrial organization. new text end

new text begin Nothing in sections 148.88 to 148.98
shall prevent the use of psychological techniques by a business or industrial organization
for its own personnel purposes or by an employment agency or state vocational rehabilitation
agency for the evaluation of the agency's clients prior to a recommendation for employment.
However, a representative of an industrial or business firm or corporation may not sell,
offer, or provide psychological services as specified in section 148.89, unless the services
are performed or supervised by an individual licensed under sections 148.88 to 148.98.
new text end

new text begin Subd. 3. new text end

new text begin School psychologist. new text end

new text begin (a) Nothing in sections 148.88 to 148.98 shall be construed
to prevent a person who holds a license or certificate issued by the State Board of Teaching
in accordance with chapters 122A and 129 from practicing school psychology within the
scope of employment if authorized by a board of education or by a private school that meets
the standards prescribed by the State Board of Teaching, or from practicing as a school
psychologist within the scope of employment in a program for children with disabilities.
new text end

new text begin (b) Any person exempted under this subdivision shall not offer psychological services
to any other individual, organization, or group for remuneration, monetary or otherwise,
unless the person is licensed by the Board of Psychology under sections 148.88 to 148.98.
new text end

new text begin Subd. 4. new text end

new text begin Clergy or religious officials. new text end

new text begin Nothing in sections 148.88 to 148.98 shall be
construed to prevent recognized religious officials, including ministers, priests, rabbis,
imams, Christian Science practitioners, and other persons recognized by the board, from
conducting counseling activities that are within the scope of the performance of their regular
recognizable religious denomination or sect, as defined in current federal tax regulations,
if the religious official does not refer to the official's self as a psychologist and the official
remains accountable to the established authority of the religious denomination or sect.
new text end

new text begin Subd. 5. new text end

new text begin Teaching and research. new text end

new text begin Nothing in sections 148.88 to 148.98 shall be construed
to prevent a person employed in a secondary, postsecondary, or graduate institution from
teaching and conducting research in psychology within an educational institution that is
recognized by a regional accrediting organization or by a federal, state, county, or local
government institution, agency, or research facility, so long as:
new text end

new text begin (1) the institution, agency, or facility provides appropriate oversight mechanisms to
ensure public protections; and
new text end

new text begin (2) the person is not providing direct clinical services to a client or clients as defined in
sections 148.88 to 148.98.
new text end

new text begin Subd. 6. new text end

new text begin Psychologist in disaster or emergency relief. new text end

new text begin Nothing in sections 148.88 to
148.98 shall be construed to prevent a psychologist sent to this state for the sole purpose of
responding to a disaster or emergency relief effort of the state government, the federal
government, the American Red Cross, or other disaster or emergency relief organization as
long as the psychologist is not practicing in Minnesota longer than 30 days and the sponsoring
organization can certify the psychologist's assignment to this state. The board or its designee,
at its discretion, may grant an extension to the 30-day time limitation of this subdivision.
new text end

new text begin Subd. 7. new text end

new text begin Psychological consultant. new text end

new text begin A license under sections 148.88 to 148.98 is not
required by a nonresident of the state, serving as an expert witness, organizational consultant,
presenter, or educator on a limited basis provided the person is appropriately trained,
educated, or has been issued a license, certificate, or registration by another jurisdiction.
new text end

new text begin Subd. 8. new text end

new text begin Students. new text end

new text begin Nothing in sections 148.88 to 148.98 shall prohibit the practice of
psychology under qualified supervision by a practicum psychology student, a predoctoral
psychology intern, or an individual who has earned a doctoral degree in psychology and is
in the process of completing their postdoctoral supervised psychological employment. A
student trainee or intern shall use the titles as required under section 148.96, subdivision 3.
new text end

new text begin Subd. 9. new text end

new text begin Other professions. new text end

new text begin Nothing in sections 148.88 to 148.98 shall be construed to
authorize a person licensed under sections 148.88 to 148.98 to engage in the practice of any
profession regulated under Minnesota law, unless the individual is duly licensed or registered
in that profession.
new text end

Sec. 40.

new text begin [148.9077] RELICENSURE.
new text end

new text begin A former licensee may apply to the board for licensure after complying with all laws
and rules required for applicants for licensure that were in effect on the date the initial
Minnesota license was granted. The former licensee must verify to the board that the former
licensee has not engaged in the practice of psychology in this state since the last date of
active licensure, except as permitted under statutory licensure exemption, and must submit
a fee for relicensure.
new text end

Sec. 41.

Minnesota Statutes 2016, section 148.9105, subdivision 1, is amended to read:


Subdivision 1.

Application.

Retired providers who are licensed or were formerly licensed
to practice psychology in the state according to the Minnesota Psychology Practice Act may
apply to the board for psychologist emeritus registration deleted text beginor psychological practitioner
emeritus registration
deleted text end if they declare that they are retired from the practice of psychology in
Minnesota, have not been the subject of disciplinary action in any jurisdiction, and have no
unresolved complaints in any jurisdiction. Retired providers shall complete the necessary
forms provided by the board and pay a onetime, nonrefundable fee of $150 at the time of
application.

Sec. 42.

Minnesota Statutes 2016, section 148.9105, subdivision 4, is amended to read:


Subd. 4.

Documentation of status.

A provider granted emeritus registration shall receive
a document certifying that emeritus status has been granted by the board and that the
registrant has completed the registrant's active career as a psychologist deleted text beginor psychological
practitioner
deleted text end licensed in good standing with the board.

Sec. 43.

Minnesota Statutes 2016, section 148.9105, subdivision 5, is amended to read:


Subd. 5.

Representation to public.

In addition to the descriptions allowed in section
148.96, subdivision 3, paragraph (e), former licensees who have been granted emeritus
registration may represent themselves as "psychologist emeritus" deleted text beginor "psychological
practitioner emeritus,"
deleted text end but shall not represent themselves or allow themselves to be
represented to the public as "licensed" or otherwise as current licensees of the board.

Sec. 44.

Minnesota Statutes 2016, section 148.916, subdivision 1, is amended to read:


Subdivision 1.

Generally.

deleted text beginIfdeleted text end new text begin(a) new text endA nonresident of the state of Minnesotadeleted text begin,deleted text end who is not
seeking licensure in this statedeleted text begin,deleted text end and who has been issued a license, certificate, or registration
by another jurisdiction to practice psychology deleted text beginat the doctoral level, wishesdeleted text endnew text begin and who intendsnew text end
to practice in Minnesota for more than deleted text beginseven calendardeleted text endnew text begin 30new text end daysdeleted text begin, the persondeleted text end shall apply to the
board for guest licensuredeleted text begin, provided thatdeleted text endnew text begin.new text end The psychologist's practice in Minnesota is limited
to no more than nine consecutive months per calendar year. Application under this section
shall be made no less than 30 days prior to the expected date of practice in Minnesota and
shall be subject to approval by the board or its designee. deleted text beginThe board shall charge a
nonrefundable fee for guest licensure. The board shall adopt rules to implement this section.
deleted text end

new text begin (b) To be eligible for licensure under this section, the applicant must:
new text end

new text begin (1) have a license, certification, or registration to practice psychology from another
jurisdiction;
new text end

new text begin (2) have a doctoral degree in psychology from a regionally accredited institution;
new text end

new text begin (3) be of good moral character;
new text end

new text begin (4) have no pending complaints or active disciplinary or corrective actions in any
jurisdiction;
new text end

new text begin (5) pass a professional responsibility examination designated by the board; and
new text end

new text begin (6) pay a fee to the board.
new text end

Sec. 45.

Minnesota Statutes 2016, section 148.916, subdivision 1a, is amended to read:


Subd. 1a.

Applicants for licensure.

(a) An applicant who is seeking licensure in this
state, and who, at the time of application, is licensed, certified, or registered to practice
psychology in another jurisdiction at the doctoral level may apply to the board for guest
licensure in order to begin practicing psychology in this state while their application is being
processed if the applicant is of good moral character and has no complaints, corrective, or
disciplinary action pending in any jurisdiction.

new text begin (b)new text end Application under this deleted text beginsectiondeleted text endnew text begin subdivisionnew text end shall be made no less than 30 days prior
to the expected date of practice in this state, and must be made concurrently or after
submission of an application for licensure as a licensed psychologistnew text begin if applicablenew text end.
Applications under this deleted text beginsectiondeleted text endnew text begin subdivisionnew text end are subject to approval by the board or its
designee.new text begin The board shall charge a fee for guest licensure under this subdivision.
new text end

deleted text begin (b) The board shall charge a nonrefundable fee for guest licensure under this subdivision.
deleted text end

(c) A guest license issued under this subdivision shall be valid for one year from the
date of issuance, or until the board has either issued a license or has denied the applicant's
application for licensure, whichever is earlier. Guest licenses issued under this deleted text beginsectiondeleted text endnew text begin
subdivision
new text end may be renewed annually until the board has denied the applicant's application
for licensure.

Sec. 46.

Minnesota Statutes 2016, section 148.925, is amended to read:


148.925 SUPERVISION.

Subdivision 1.

Supervision.

For the purpose of meeting the requirements of deleted text beginthis sectiondeleted text endnew text begin
the Minnesota Psychology Practice Act
new text end, supervision means documented in-person
consultationdeleted text begin, which may include interactive, visual electronic communication, between
either: (1) a primary supervisor and a licensed psychological practitioner; or (2) a
deleted text end new text beginthat
employs a collaborative relationship that has both facilitative and evaluative components
with the goal of enhancing the professional competence and science, and practice-informed
professional work of the supervisee. Supervision may include telesupervision between
new text end primary or designated deleted text beginsupervisordeleted text end new text beginsupervisors new text endand deleted text beginan applicant for licensure as a licensed
psychologist
deleted text endnew text begin the superviseenew text end. The supervision shall be adequate to assure the quality and
competence of the activities supervised. Supervisory consultation shall include discussions
on the nature and content of the practice of the supervisee, including, but not limited to, a
review of a representative sample of psychological services in the supervisee's practice.

Subd. 2.

Postdegree supervised new text beginpsychological new text endemployment.

Postdegree supervised
new text begin psychological new text endemployment means required paid or volunteer work experience and postdegree
training of an individual seeking to be licensed as a licensed psychologist that involves the
professional oversight by a primary supervisor and satisfies the supervision requirements
in deleted text beginsubdivisions 3 and 5deleted text endnew text begin the Minnesota Psychology Practice Actnew text end.

Subd. 3.

Individuals qualified to provide supervision.

deleted text begin (a) Supervision of a master's
level applicant for licensure as a licensed psychologist shall be provided by an individual:
deleted text end

deleted text begin (1) who is a psychologist licensed in Minnesota with competence both in supervision
in the practice of psychology and in the activities being supervised;
deleted text end

deleted text begin (2) who has a doctoral degree with a major in psychology, who is employed by a
regionally accredited educational institution or employed by a federal, state, county, or local
government institution, agency, or research facility, and who has competence both in
supervision in the practice of psychology and in the activities being supervised, provided
the supervision is being provided and the activities being supervised occur within that
regionally accredited educational institution or federal, state, county, or local government
institution, agency, or research facility;
deleted text end

deleted text begin (3) who is licensed or certified as a psychologist in another jurisdiction and who has
competence both in supervision in the practice of psychology and in the activities being
supervised; or
deleted text end

deleted text begin (4) who, in the case of a designated supervisor, is a master's or doctorally prepared
mental health professional.
deleted text end

deleted text begin (b)deleted text end Supervision of deleted text begina doctoral leveldeleted text endnew text begin annew text end applicant for licensure as a licensed psychologist
shall be provided by an individual:

(1) who is a psychologist licensed in Minnesota with a doctoral degree and competence
both in supervision in the practice of psychology and in the activities being supervised;

(2) who has a doctoral degree with a major in psychology, who is employed by a
regionally accredited educational institution or is employed by a federal, state, county, or
local government institution, agency, or research facility, and who has competence both in
supervision in the practice of psychology and in the activities being supervised, provided
the supervision is being provided and the activities being supervised occur within that
regionally accredited educational institution or federal, state, county, or local government
institution, agency, or research facility;

(3) who is licensed or certified as a psychologist in another jurisdiction and who has
competence both in supervision in the practice of psychology and in the activities being
supervised;

(4) who is a psychologist licensed in Minnesota who was licensed before August 1,
1991, with competence both in supervision in the practice of psychology and in the activities
being supervised; or

(5) who, in the case of a designated supervisor, is a master's or doctorally prepared
mental health professional.

deleted text begin Subd. 4. deleted text end

deleted text begin Supervisory consultation for a licensed psychological practitioner.
deleted text end

deleted text begin Supervisory consultation between a supervising licensed psychologist and a supervised
licensed psychological practitioner shall be at least one hour in duration and shall occur on
an individual, in-person basis. A minimum of one hour of supervision per month is required
for the initial 20 or fewer hours of psychological services delivered per month. For each
additional 20 hours of psychological services delivered per month, an additional hour of
supervision per month is required. When more than 20 hours of psychological services are
provided in a week, no more than one hour of supervision is required per week.
deleted text end

Subd. 5.

Supervisory consultation for an applicant for licensure as a licensed
psychologist.

Supervision of an applicant for licensure as a licensed psychologist shall
include at least two hours of regularly scheduled in-person consultations per week for
full-time employment, one hour of which shall be with the supervisor on an individual basis.
The remaining hour may be with a designated supervisor. The board may approve an
exception to the weekly supervision requirement for a week when the supervisor was ill or
otherwise unable to provide supervision. The board may prorate the two hours per week of
supervision for individuals preparing for licensure on a part-time basis. Supervised
psychological employment does not qualify for licensure when the supervisory consultation
is not adequate as described in subdivision 1, or in the board rules.

Subd. 6.

Supervisee duties.

deleted text beginIndividualsdeleted text endnew text begin Applicantsnew text end preparing for licensure as a licensed
psychologist during their postdegree supervised new text beginpsychological new text endemployment may perform
as part of their training any deleted text beginfunctionsdeleted text end new text beginof the services new text endspecified in section 148.89, subdivision
5
, but only under qualified supervision.

deleted text begin Subd. 7. deleted text end

deleted text begin Variance from supervision requirements. deleted text end

deleted text begin (a) An applicant for licensure as
a licensed psychologist who entered supervised employment before August 1, 1991, may
request a variance from the board from the supervision requirements in this section in order
to continue supervision under the board rules in effect before August 1, 1991.
deleted text end

deleted text begin (b) After a licensed psychological practitioner has completed two full years, or the
equivalent, of supervised post-master's degree employment meeting the requirements of
subdivision 5 as it relates to preparation for licensure as a licensed psychologist, the board
shall grant a variance from the supervision requirements of subdivision 4 or 5 if the licensed
psychological practitioner presents evidence of:
deleted text end

deleted text begin (1) endorsement for specific areas of competency by the licensed psychologist who
provided the two years of supervision;
deleted text end

deleted text begin (2) employment by a hospital or by a community mental health center or nonprofit mental
health clinic or social service agency providing services as a part of the mental health service
plan required by the Comprehensive Mental Health Act;
deleted text end

deleted text begin (3) the employer's acceptance of clinical responsibility for the care provided by the
licensed psychological practitioner; and
deleted text end

deleted text begin (4) a plan for supervision that includes at least one hour of regularly scheduled individual
in-person consultations per week for full-time employment. The board may approve an
exception to the weekly supervision requirement for a week when the supervisor was ill or
otherwise unable to provide supervision.
deleted text end

deleted text begin (c) Following the granting of a variance under paragraph (b), and completion of two
additional full years or the equivalent of supervision and post-master's degree employment
meeting the requirements of paragraph (b), the board shall grant a variance to a licensed
psychological practitioner who presents evidence of:
deleted text end

deleted text begin (1) endorsement for specific areas of competency by the licensed psychologist who
provided the two years of supervision under paragraph (b);
deleted text end

deleted text begin (2) employment by a hospital or by a community mental health center or nonprofit mental
health clinic or social service agency providing services as a part of the mental health service
plan required by the Comprehensive Mental Health Act;
deleted text end

deleted text begin (3) the employer's acceptance of clinical responsibility for the care provided by the
licensed psychological practitioner; and
deleted text end

deleted text begin (4) a plan for supervision which includes at least one hour of regularly scheduled
individual in-person supervision per month.
deleted text end

deleted text begin (d) The variance allowed under this section must be deemed to have been granted to an
individual who previously received a variance under paragraph (b) or (c) and is seeking a
new variance because of a change of employment to a different employer or employment
setting. The deemed variance continues until the board either grants or denies the variance.
An individual who has been denied a variance under this section is entitled to seek
reconsideration by the board.
deleted text end

Sec. 47.

Minnesota Statutes 2016, section 148.96, subdivision 3, is amended to read:


Subd. 3.

Requirements for representations to public.

(a) Unless licensed under sections
148.88 to 148.98, except as provided in paragraphs (b) through (e), persons shall not represent
themselves or permit themselves to be represented to the public by:

(1) using any title or description of services incorporating the words "psychology,"
"psychological," "psychological practitioner," or "psychologist"; or

(2) representing that the person has expert qualifications in an area of psychology.

(b) Psychologically trained individuals who are employed by an educational institution
recognized by a regional accrediting organization, by a federal, state, county, or local
government institution, agency, or research facility, may represent themselves by the title
designated by that organization provided that the title does not indicate that the individual
is credentialed by the board.

(c) A psychologically trained individual from an institution described in paragraph (b)
may offer lecture services and is exempt from the provisions of this section.

(d) A person who is preparing for the practice of psychology under supervision in
accordance with board statutes and rules may be designated as a "psychological intern,"
new text begin "psychology fellow," new text end"psychological trainee," or by other terms clearly describing the
person's training status.

(e) Former licensees who are completely retired from the practice of psychology may
represent themselves using the descriptions in paragraph (a), clauses (1) and (2), but shall
not represent themselves or allow themselves to be represented as current licensees of the
board.

deleted text begin (f) Nothing in this section shall be construed to prohibit the practice of school psychology
by a person licensed in accordance with chapters 122A and 129.
deleted text end

Sec. 48.

Minnesota Statutes 2016, section 148B.53, subdivision 1, is amended to read:


Subdivision 1.

General requirements.

(a) To be licensed as a licensed professional
counselor (LPC), an applicant must provide evidence satisfactory to the board that the
applicant:

(1) is at least 18 years of age;

(2) is of good moral character;

(3) has completed a master's or doctoral degree program in counseling or a related field,
as determined by the board based on the criteria in paragraph (b), that includes a minimum
of 48 semester hours or 72 quarter hours and a supervised field experience of not fewer than
700 hours that is counseling in nature;

(4) has submitted to the board a plan for supervision during the first 2,000 hours of
professional practice or has submitted proof of supervised professional practice that is
acceptable to the board; and

(5) has demonstrated competence in professional counseling by passing the National
Counseling Exam (NCE) administered by the National Board for Certified Counselors, Inc.
(NBCC) or an equivalent national examination as determined by the board, and ethical,
oral, and situational examinations if prescribed by the board.

(b) The degree described in paragraph (a), clause (3), must be from a counseling program
recognized by the Council for Accreditation of Counseling and Related Education Programs
(CACREP) or from an institution of higher education that is accredited by a regional
accrediting organization recognized by the Council for Higher Education Accreditation
(CHEA). Specific academic course content and training must include course work in each
of the following subject areas:

(1) the helping relationship, including counseling theory and practice;

(2) human growth and development;

(3) lifestyle and career development;

(4) group dynamics, processes, counseling, and consulting;

(5) assessment and appraisal;

(6) social and cultural foundations, including multicultural issues;

(7) principles of etiology, treatment planning, and prevention of mental and emotional
disorders and dysfunctional behavior;

(8) family counseling and therapy;

(9) research and evaluation; and

(10) professional counseling orientation and ethics.

deleted text begin (c) To be licensed as a professional counselor, a psychological practitioner licensed
under section 148.908 need only show evidence of licensure under that section and is not
required to comply with paragraph (a), clauses (1) to (3) and (5), or paragraph (b).
deleted text end

deleted text begin (d)deleted text endnew text begin (c)new text end To be licensed as a professional counselor, a Minnesota licensed psychologist
need only show evidence of licensure from the Minnesota Board of Psychology and is not
required to comply with paragraph (a) or (b).

Sec. 49.

Minnesota Statutes 2016, section 150A.06, subdivision 3, is amended to read:


Subd. 3.

Waiver of examination.

(a) All or any part of the examination for dentists deleted text beginordeleted text endnew text begin,new text endnew text begin
dental therapists,
new text end dental hygienists, new text beginor dental assistants, new text endexcept that pertaining to the law of
Minnesota relating to dentistry and the rules of the board, may, at the discretion of the board,
be waived for an applicant who presents a certificate of having passed all components of
the National Board Dental Examinations or evidence of having maintained an adequate
scholastic standing as determined by the boarddeleted text begin, in dental school as to dentists, or dental
hygiene school as to dental hygienists
deleted text end.

(b) The board shall waive the clinical examination required for licensure for any dentist
applicant who is a graduate of a dental school accredited by the Commission on Dental
Accreditation, who has passed all components of the National Board Dental Examinations,
and who has satisfactorily completed a Minnesota-based postdoctoral general dentistry
residency program (GPR) or an advanced education in general dentistry (AEGD) program
after January 1, 2004. The postdoctoral program must be accredited by the Commission on
Dental Accreditation, be of at least one year's duration, and include an outcome assessment
evaluation assessing the resident's competence to practice dentistry. The board may require
the applicant to submit any information deemed necessary by the board to determine whether
the waiver is applicable.

Sec. 50.

Minnesota Statutes 2016, section 150A.06, subdivision 8, is amended to read:


Subd. 8.

Licensure by credentials.

(a) Any dental assistant may, upon application and
payment of a fee established by the board, apply for licensure based on an evaluation of the
applicant's education, experience, and performance record in lieu of completing a
board-approved dental assisting program for expanded functions as defined in rule, and
may be interviewed by the board to determine if the applicant:

(1) has graduated from an accredited dental assisting program accredited by the
Commission on Dental Accreditationdeleted text begin, ordeleted text endnew text begin andnew text end is currently certified by the Dental Assisting
National Board;

(2) is not subject to any pending or final disciplinary action in another state or Canadian
province, or if not currently certified or registered, previously had a certification or
registration in another state or Canadian province in good standing that was not subject to
any final or pending disciplinary action at the time of surrender;

(3) is of good moral character and abides by professional ethical conduct requirements;

(4) at board discretion, has passed a board-approved English proficiency test if English
is not the applicant's primary language; and

(5) has met all expanded functions curriculum equivalency requirements of a Minnesota
board-approved dental assisting program.

(b) The board, at its discretion, may waive specific licensure requirements in paragraph
(a).

(c) An applicant who fulfills the conditions of this subdivision and demonstrates the
minimum knowledge in dental subjects required for licensure under subdivision 2a must
be licensed to practice the applicant's profession.

(d) If the applicant does not demonstrate the minimum knowledge in dental subjects
required for licensure under subdivision 2a, the application must be denied. If licensure is
denied, the board may notify the applicant of any specific remedy that the applicant could
take which, when passed, would qualify the applicant for licensure. A denial does not
prohibit the applicant from applying for licensure under subdivision 2a.

(e) A candidate whose application has been denied may appeal the decision to the board
according to subdivision 4a.

Sec. 51.

Minnesota Statutes 2016, section 150A.10, subdivision 4, is amended to read:


Subd. 4.

Restorative procedures.

(a) Notwithstanding subdivisions 1, 1a, and 2, a
licensed dental hygienist or licensed dental assistant may perform the following restorative
procedures:

(1) place, contour, and adjust amalgam restorations;

(2) place, contour, and adjust glass ionomer;

(3) adapt and cement stainless steel crowns;new text begin and
new text end

deleted text begin (4) place, contour, and adjust class I and class V supragingival composite restorations
where the margins are entirely within the enamel; and
deleted text end

deleted text begin (5)deleted text endnew text begin (4)new text end place, contour, and adjust classnew text begin I,new text end IInew text begin,new text end and deleted text beginclassdeleted text end V supragingival composite
restorations on primary deleted text beginteethdeleted text endnew text begin and permanent dentitionnew text end.

(b) The restorative procedures described in paragraph (a) may be performed only if:

(1) the licensed dental hygienist or licensed dental assistant has completed a
board-approved course on the specific procedures;

(2) the board-approved course includes a component that sufficiently prepares the licensed
dental hygienist or licensed dental assistant to adjust the occlusion on the newly placed
restoration;

(3) a licensed dentist or licensed advanced dental therapist has authorized the procedure
to be performed; and

(4) a licensed dentist or licensed advanced dental therapist is available in the clinic while
the procedure is being performed.

(c) The dental faculty who teaches the educators of the board-approved courses specified
in paragraph (b) must have prior experience teaching these procedures in an accredited
dental education program.

Sec. 52.

Minnesota Statutes 2016, section 214.01, subdivision 2, is amended to read:


Subd. 2.

Health-related licensing board.

"Health-related licensing board" means the
Board of Examiners of Nursing Home Administrators established pursuant to section
144A.19, the Office of Unlicensed Complementary and Alternative Health Care Practice
established pursuant to section 146A.02, the Board of Medical Practice created pursuant to
section 147.01, the Board of Nursing created pursuant to section 148.181, the Board of
Chiropractic Examiners established pursuant to section 148.02, the Board of Optometry
established pursuant to section 148.52, new text beginthe Board of Occupational Therapy Practice
established pursuant to section 148.6449,
new text endthe Board of Physical Therapy established pursuant
to section 148.67, the Board of Psychology established pursuant to section 148.90, the Board
of Social Work pursuant to section 148E.025, the Board of Marriage and Family Therapy
pursuant to section 148B.30, the Board of Behavioral Health and Therapy established by
section 148B.51, the Board of Dietetics and Nutrition Practice established under section
148.622, the Board of Dentistry established pursuant to section 150A.02, the Board of
Pharmacy established pursuant to section 151.02, the Board of Podiatric Medicine established
pursuant to section 153.02, and the Board of Veterinary Medicine established pursuant to
section 156.01.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 53. new text beginBOARD OF OCCUPATIONAL THERAPY PRACTICE.
new text end

new text begin The governor shall appoint all members to the Board of Occupational Therapy Practice
under Minnesota Statutes, section 148.6449, by October 1, 2017. The governor shall designate
one member of the board to convene the first meeting of the board by November 1, 2017.
The board shall elect officers at its first meeting.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 54. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall replace references
to Minnesota Statutes, section 148.6450, with Minnesota Statutes, section 148.6449.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 55. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the headnote of Minnesota Statutes, section 147.0375,
to read "LICENSURE OF EMINENT PHYSICIANS."
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. 56. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2016, sections 147A.21; 147B.08, subdivisions 1, 2, and 3;
147C.40, subdivisions 1, 2, 3, and 4; 148.906; 148.907, subdivision 5; 148.908; 148.909,
subdivision 7; and 148.96, subdivisions 4 and 5,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2016, sections 148.6402, subdivision 2; and 148.6450, new text end new text begin are
repealed.
new text end

new text begin (c) new text end new text begin Minnesota Rules, part 5600.2500, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraphs (a) and (c) are effective July 1, 2017. Paragraph (b)
is effective January 1, 2018.
new text end

ARTICLE 12

OPIATE ABUSE PREVENTION

Section 1.

Minnesota Statutes 2016, section 151.212, subdivision 2, is amended to read:


Subd. 2.

Controlled substances.

new text begin(a) new text endIn addition to the requirements of subdivision 1,
when the use of any drug containing a controlled substance, as defined in chapter 152, or
any other drug determined by the board, either alone or in conjunction with alcoholic
beverages, may impair the ability of the user to operate a motor vehicle, the board shall
require by rule that notice be prominently set forth on the label or container. Rules
promulgated by the board shall specify exemptions from this requirement when there is
evidence that the user will not operate a motor vehicle while using the drug.

new text begin (b) In addition to the requirements of subdivision 1, whenever a prescription drug
containing an opiate is dispensed to a patient for outpatient use, the pharmacy or practitioner
dispensing the drug must prominently display on the label or container a notice that states
"Caution: Opioid. Risk of overdose and addiction."
new text end

Sec. 2.

Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to
read:


new text begin Subd. 4. new text end

new text begin Limit on quantity of opiates prescribed for acute dental and ophthalmic
pain.
new text end

new text begin (a) When used for the treatment of acute dental pain or acute pain associated with
refractive surgery, prescriptions for opiate or narcotic pain relievers listed in Schedules II
through IV of section 152.02 shall not exceed a four-day supply. The quantity prescribed
shall be consistent with the dosage listed in the professional labeling for the drug that has
been approved by the United States Food and Drug Administration.
new text end

new text begin (b) For the purposes of this subdivision, "acute pain" means pain resulting from disease,
accidental or intentional trauma, surgery, or another cause, that the practitioner reasonably
expects to last only a short period of time. Acute pain does not include chronic pain or pain
being treated as part of cancer care, palliative care, or hospice or other end-of-life care.
new text end

new text begin (c) Notwithstanding paragraph (a), if in the professional clinical judgment of a practitioner
more than a four-day supply of a prescription listed in Schedules II through IV of section
152.02 is required to treat a patient's acute pain, the practitioner may issue a prescription
for the quantity needed to treat such acute pain.
new text end

Sec. 3. new text beginCHRONIC PAIN REHABILITATION THERAPY DEMONSTRATION
PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services shall award a
two-year grant to a rehabilitation institute located in Minneapolis operated by a nonprofit
foundation to participate in a bundled payment arrangement for chronic pain rehabilitation
therapy for adults who are eligible for fee-for-service medical assistance under Minnesota
Statutes, section 256B.055. The chronic pain rehabilitation therapy demonstration project
must include: nonnarcotic medication management, including opioid tapering;
interdisciplinary care coordination; and group and individual therapy in cognitive behavioral
therapy and physical therapy. The project may include self-management education in
nutrition, stress, mental health, substance use, or other modalities, if clinically appropriate.
The commissioner shall award the grant on a sole-source basis and the program design must
be mutually agreed upon by the commissioner and the grant recipient. Grant funds are
available until expended.
new text end

new text begin Subd. 2. new text end

new text begin Performance measures. new text end

new text begin The commissioner shall develop performance measures
to evaluate the demonstration project. These measures may include:
new text end

new text begin (1) reduction in medications, including opioids, taken for pain;
new text end

new text begin (2) reduction in emergency department and outpatient clinic utilization related to pain;
new text end

new text begin (3) improved ability to return to work, job search, or school;
new text end

new text begin (4) patient functional status and satisfaction; and
new text end

new text begin (5) rate of program completion.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) To be eligible to participate in the demonstration project, an
individual must:
new text end

new text begin (1) be 21 years of age or older;
new text end

new text begin (2) be eligible for fee-for-service medical assistance under Minnesota Statutes, section
256B.055, and not have other health coverage; and
new text end

new text begin (3) meet criteria appropriate for chronic pain rehabilitation.
new text end

new text begin (b) In determining the criteria under paragraph (a), clause (3), the commissioner shall
consider, but is not required to include, the following:
new text end

new text begin (1) moderate to severe pain lasting longer than four months;
new text end

new text begin (2) an impairment in daily functioning, including work or activities of daily living;
new text end

new text begin (3) a referral from a physician or other qualified medical professional indicating that all
reasonable medical and surgical options have been exhausted; and
new text end

new text begin (4) willingness of the patient to engage in chronic pain rehabilitation therapies, including
opioid tapering.
new text end

new text begin Subd. 4. new text end

new text begin Payment for services. new text end

new text begin The bundled payment shall be billed on a per-person,
per-day payment and only for days the patient receives services from the grant recipient.
The grant recipient shall not receive a bundled payment for services provided to the patient
if a nonbundled medical assistance payment for a service that is part of the bundle is received
for the same day of service.
new text end

new text begin Subd. 5. new text end

new text begin Report. new text end

new text begin The rehabilitation institute, for the duration of the demonstration
project, must annually report on cost savings and performance indicators described in
subdivision 2 to the commissioner of human services. One year after the completion of the
demonstration project, the commissioner of human services shall submit a report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health care. The report shall include an evaluation of the demonstration project, based on
the performance measures developed under subdivision 2, and may also include
recommendations to increase individual access to chronic pain rehabilitation therapy through
Minnesota health care programs.
new text end

Sec. 4. new text beginSUBSTANCE USE DISORDER PROVIDER CAPACITY GRANT
PROGRAM.
new text end

new text begin The commissioner of human services shall design and implement a grant program to
assist providers to purchase the first dose of a nonnarcotic injectable or implantable
medication to treat substance use disorder for medical assistance enrollees. Grants shall be
distributed between July 1, 2017, and June 30, 2019. The commissioner shall conduct
outreach to providers regarding the availability of this grant and ensure a simplified grant
application process. The commissioner shall provide technical assistance to assist providers
in building operational capacity to treat substance use disorders with nonnarcotic injectable
or implantable medications. The commissioner, in collaboration with stakeholders, shall
analyze the impact of the grant program under this section and the actual or perceived
barriers for providers to access and be reimbursed for nonnarcotic injectable or implantable
substance use disorder medications and develop recommendations for addressing identified
barriers. The commissioner shall provide a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance by September 1, 2019.
new text end

ARTICLE 13

MISCELLANEOUS

Section 1.

Minnesota Statutes 2016, section 62K.15, is amended to read:


62K.15 ANNUAL OPEN ENROLLMENT PERIODSnew text begin; SPECIAL ENROLLMENT
PERIODS
new text end.

(a) Health carriers offering individual health plans must limit annual enrollment in the
individual market to the annual open enrollment periods for MNsure. Nothing in this section
limits the application of special or limited open enrollment periods as defined under the
Affordable Care Act.

(b) Health carriers offering individual health plans must inform all applicants at the time
of application and enrollees at least annually of the open and special enrollment periods as
defined under the Affordable Care Act.

new text begin (c) Health carriers offering individual health plans must provide a special enrollment
period for enrollment in the individual market by employees of a small employer that offers
a qualified small employer health reimbursement arrangement in accordance with United
States Code, title 26, section 9831(d). The special enrollment period shall be available only
to employees newly hired by a small employer offering a qualified small employer health
reimbursement arrangement, and to employees employed by the small employer at the time
the small employer initially offers a qualified small employer health reimbursement
arrangement. For employees newly hired by the small employer, the special enrollment
period shall last for 30 days after the employee's first day of employment. For employees
employed by the small employer at the time the small employer initially offers a qualified
small employer health reimbursement arrangement, the special enrollment period shall last
for 30 days after the date the arrangement is initially offered to employees.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end The commissioner of commerce shall enforce this section.

Sec. 2.

Minnesota Statutes 2016, section 245A.02, subdivision 5a, is amended to read:


Subd. 5a.

Controlling individual.

new text begin(a) new text end"Controlling individual" means deleted text begina public body,
governmental agency, business entity, officer, owner, or managerial official whose
responsibilities include the direction of the management or policies of a program. For
purposes of this subdivision, owner means an individual who has direct or indirect ownership
interest in a corporation, partnership, or other business association issued a license under
this chapter. For purposes of this subdivision, managerial official means those individuals
who have the decision-making authority related to the operation of the program, and the
responsibility for the ongoing management of or direction of the policies, services, or
employees of the program. A site director who has no ownership interest in the program is
not considered to be a managerial official for purposes of this definition. Controlling
individual does not include
deleted text endnew text begin an owner of a program or service provider licensed under this
chapter and the following individuals, if applicable
new text end:

new text begin (1) each officer of the organization, including the chief executive officer and chief
financial officer;
new text end

new text begin (2) the individual designated as the authorized agent under section 245A.04, subdivision
1, paragraph (b);
new text end

new text begin (3) the individual designated as the compliance officer under section 256B.04, subdivision
21, paragraph (b); and
new text end

new text begin (4) each managerial official whose responsibilities include the direction of the
management or policies of a program.
new text end

new text begin (b) Controlling individual does not include:
new text end

(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;

(2) an individual who is a state or federal official, or state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more programs, unless the individual is also an officer,
owner, or managerial official of the program, receives remuneration from the program, or
owns any of the beneficial interests not excluded in this subdivision;

(3) an individual who owns less than five percent of the outstanding common shares of
a corporation:

(i) whose securities are exempt under section 80A.45, clause (6); or

(ii) whose transactions are exempt under section 80A.46, clause (2); deleted text beginor
deleted text end

(4) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the program
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxationdeleted text begin.deleted text endnew text begin; or
new text end

new text begin (5) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual according to paragraph (a).
new text end

new text begin (c) For purposes of this subdivision, "managerial official" means an individual who has
the decision-making authority related to the operation of the program, and the responsibility
for the ongoing management of or direction of the policies, services, or employees of the
program. A site director who has no ownership interest in the program is not considered to
be a managerial official for purposes of this definition.
new text end

Sec. 3.

Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 10b. new text end

new text begin Owner. new text end

new text begin "Owner" means an individual or organization that has a direct or
indirect ownership interest of five percent or more in a program licensed under this chapter.
For purposes of this subdivision, "direct ownership interest" means the possession of equity
in capital, stock, or profits of an organization, and "indirect ownership interest" means a
direct ownership interest in an entity that has a direct or indirect ownership interest in a
licensed program. For purposes of this chapter, "owner of a nonprofit corporation" means
the president and treasurer of the board of directors or, for an entity owned by an employee
stock ownership plan, means the president and treasurer of the entity. A government entity
that is issued a license under this chapter shall be designated the owner.
new text end

ARTICLE 14

NURSING FACILITY TECHNICAL CORRECTIONS

Section 1.

Minnesota Statutes 2016, section 144.0722, subdivision 1, as amended by Laws
2017, chapter 40, article 1, section 18, is amended to read:


Subdivision 1.

Resident reimbursement classifications.

The commissioner of health
shall establish resident reimbursement classifications based upon the assessments of residents
of nursing homes and boarding care homes conducted under section 144.0721, or under
rules established by the commissioner of human services under deleted text beginsections 256B.421 to 256B.48deleted text endnew text begin
chapter 256R
new text end. The reimbursement classifications established by the commissioner must
conform to the rules established by the commissioner of human services.

Sec. 2.

Minnesota Statutes 2016, section 144A.071, subdivision 3, as amended by Laws
2017, chapter 40, article 1, section 22, is amended to read:


Subd. 3.

Exceptions authorizing increase in beds; hardship areas.

(a) The
commissioner of health, in coordination with the commissioner of human services, may
approve the addition of new licensed and Medicare and Medicaid certified nursing home
beds, using the criteria and process set forth in this subdivision.

(b) The commissioner, in cooperation with the commissioner of human services, shall
consider the following criteria when determining that an area of the state is a hardship area
with regard to access to nursing facility services:

(1) a low number of beds per thousand in a specified area using as a standard the beds
per thousand people age 65 and older, in five year age groups, using data from the most
recent census and population projections, weighted by each group's most recent nursing
home utilization, of the county at the 20th percentile, as determined by the commissioner
of human services;

(2) a high level of out-migration for nursing facility services associated with a described
area from the county or counties of residence to other Minnesota counties, as determined
by the commissioner of human services, using as a standard an amount greater than the
out-migration of the county ranked at the 50th percentile;

(3) an adequate level of availability of noninstitutional long-term care services measured
as public spending for home and community-based long-term care services per individual
age 65 and older, in five year age groups, using data from the most recent census and
population projections, weighted by each group's most recent nursing home utilization, as
determined by the commissioner of human services using as a standard an amount greater
than the 50th percentile of counties;

(4) there must be a declaration of hardship resulting from insufficient access to nursing
home beds by local county agencies and area agencies on aging; and

(5) other factors that may demonstrate the need to add new nursing facility beds.

(c) On August 15 of odd-numbered years, the commissioner, in cooperation with the
commissioner of human services, may publish in the State Register a request for information
in which interested parties, using the data provided under section 144A.351, along with any
other relevant data, demonstrate that a specified area is a hardship area with regard to access
to nursing facility services. For a response to be considered, the commissioner must receive
it by November 15. The commissioner shall make responses to the request for information
available to the public and shall allow 30 days for comment. The commissioner shall review
responses and comments and determine if any areas of the state are to be declared hardship
areas.

(d) For each designated hardship area determined in paragraph (c), the commissioner
shall publish a request for proposals in accordance with section 144A.073 and Minnesota
Rules, parts 4655.1070 to 4655.1098. The request for proposals must be published in the
State Register by March 15 following receipt of responses to the request for information.
The request for proposals must specify the number of new beds which may be added in the
designated hardship area, which must not exceed the number which, if added to the existing
number of beds in the area, including beds in layaway status, would have prevented it from
being determined to be a hardship area under paragraph (b), clause (1). Beginning July 1,
2011, the number of new beds approved must not exceed 200 beds statewide per biennium.
After June 30, 2019, the number of new beds that may be approved in a biennium must not
exceed 300 statewide. For a proposal to be considered, the commissioner must receive it
within six months of the publication of the request for proposals. The commissioner shall
review responses to the request for proposals and shall approve or disapprove each proposal
by the following July 15, in accordance with section 144A.073 and Minnesota Rules, parts
4655.1070 to 4655.1098. The commissioner shall base approvals or disapprovals on a
comparison and ranking of proposals using only the criteria in subdivision 4a. Approval of
a proposal expires after 18 months unless the facility has added the new beds using existing
space, subject to approval by the commissioner, or has commenced construction as defined
in section 144A.071, subdivision 1a, paragraph (d). If, after the approved beds have been
added, fewer than 50 percent of the beds in a facility are newly licensed, the operating
payment rates previously in effect shall remain. If, after the approved beds have been added,
50 percent or more of the beds in a facility are newly licensed, operating payment rates shall
be determined according to Minnesota Rules, part 9549.0057, using the limits under deleted text beginchapter
256R
deleted text endnew text begin sections 256R.23, subdivision 5, and 256R.24, subdivision 3new text end. External fixednew text begin costsnew text end
payment rates must be determined according to deleted text beginchapter 256Rdeleted text endnew text begin section 256R.25new text end. Property
payment rates for facilities with beds added under this subdivision must be determined in
the same manner as rate determinations resulting from projects approved and completed
under section 144A.073.

(e) The commissioner may:

(1) certify or license new beds in a new facility that is to be operated by the commissioner
of veterans affairs or when the costs of constructing and operating the new beds are to be
reimbursed by the commissioner of veterans affairs or the United States Veterans
Administration; and

(2) license or certify beds in a facility that has been involuntarily delicensed or decertified
for participation in the medical assistance program, provided that an application for
relicensure or recertification is submitted to the commissioner by an organization that is
not a related organization as defined in section 256R.02, subdivision 43, to the prior licensee
within 120 days after delicensure or decertification.

Sec. 3.

Minnesota Statutes 2016, section 144A.071, subdivision 4a, as amended by Laws
2017, chapter 40, article 1, section 23, 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.434new text begin or chapter 256Rnew text end;

(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 deleted text beginsection 256B.431deleted text endnew text begin
chapter 256R
new text end. Property-related reimbursement rates shall be determined under section
deleted text begin 256B.431deleted text endnew text begin 256R.26new text end, taking into account any federal or state flood-related loans or grants
provided to the facility;

(x) to license and certify to the licensee of a nursing home in Polk County that was
destroyed by flood in 1997 replacement projects with a total of up to 129 beds, with at least
25 beds to be located in Polk County 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. The operating payment rates for
the new nursing facilities shall be determined based on the interim and settle-up payment
provisions of deleted text beginsection 256B.431 or 256B.434, chapter 256R, ordeleted text end Minnesota Rules, parts
9549.0010 to 9549.0080. Property-related reimbursement rates shall be determined under
section deleted text begin256B.431 or 256B.434 or chapter 256Rdeleted text endnew text begin 256R.26new text end. 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
deleted text begin chapter 256Rdeleted text endnew text begin section 256R.50new 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 256R.40;

(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 deleted text beginsection 256B.431deleted text endnew text begin chapter 256Rnew text end. Property-related reimbursement
rates shall be determined under section deleted text begin256B.431deleted text endnew text begin 256R.26new text end, 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 deleted text beginsection deleted text enddeleted text begin256B.431deleted text end new text beginchapter 256R
new text end and Minnesota Rules, parts 9549.0010 to 9549.0080deleted text begin, or section 256B.434 or chapter 256Rdeleted text end;
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. 4.

Minnesota Statutes 2016, section 144A.071, subdivision 4c, as amended by Laws
2017, chapter 40, article 1, section 24, is amended to read:


Subd. 4c.

Exceptions for replacement beds after June 30, 2003.

(a) 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:

(1) to license and certify an 80-bed city-owned facility in Nicollet County to be
constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
attached to a hospital that is also being replaced. The threshold allowed for this project
under section 144A.073 shall be the maximum amount available to pay the additional
medical assistance costs of the new facility;

(2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis
County, provided that the 29 beds must be transferred from active or layaway status at an
existing facility in St. Louis County that had 235 beds on April 1, 2003.

The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
rate at that facility shall not be adjusted as a result of this transfer. The operating payment
rate of the facility adding beds after completion of this project shall be the same as it was
on the day prior to the day the beds are licensed and certified. This project shall not proceed
unless it is approved and financed under the provisions of section 144A.073;

(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new
beds are transferred from a 45-bed facility in Austin under common ownership that is closed
and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common
ownership; (ii) the commissioner of human services is authorized by the 2004 legislature
to negotiate budget-neutral planned nursing facility closures; and (iii) money is available
from planned closures of facilities under common ownership to make implementation of
this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be
reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall
be used for a special care unit for persons with Alzheimer's disease or related dementias;

(4) to license and certify up to 80 beds transferred from an existing state-owned nursing
facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching
campus. The operating cost payment rates for the new facility shall be determined based
on the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and
the reimbursement provisions of deleted text beginsection 256B.431deleted text endnew text begin chapter 256Rnew text end. The property payment
rate for the first three years of operation shall be $35 per day. For subsequent years, the
property payment rate of $35 per day shall be adjusted for inflation as provided in section
256B.434, subdivision 4, paragraph (c), as long as the facility has a contract under section
256B.434;

(5) to initiate a pilot program to license and certify up to 80 beds transferred from an
existing county-owned nursing facility in Steele County relocated to the site of a new acute
care facility as part of the county's Communities for a Lifetime comprehensive plan to create
innovative responses to the aging of its population. Upon relocation to the new site, the
nursing facility shall delicense 28 beds. The payment rate for external fixed costs for the
new facility shall be increased by an amount as calculated according to items (i) to (v):

(i) compute the estimated decrease in medical assistance residents served by the nursing
facility by multiplying the decrease in licensed beds by the historical percentage of medical
assistance resident days;

(ii) compute the annual savings to the medical assistance program from the delicensure
of 28 beds by multiplying the anticipated decrease in medical assistance residents, determined
in item (i), by the existing facility's weighted average payment rate multiplied by 365;

(iii) compute the anticipated annual costs for community-based services by multiplying
the anticipated decrease in medical assistance residents served by the nursing facility,
determined in item (i), by the average monthly elderly waiver service costs for individuals
in Steele County multiplied by 12;

(iv) subtract the amount in item (iii) from the amount in item (ii);

(v) divide the amount in item (iv) by an amount equal to the relocated nursing facility's
occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the
historical percentage of medical assistance resident days; and

(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County
and to integrate these services with other community-based programs and services under a
communities for a lifetime pilot program and comprehensive plan to create innovative
responses to the aging of its population. Two nursing facilities, one for 84 beds and one for
65 beds, in the city of Red Wing licensed on July 1, 2015, shall be consolidated into a newly
renovated 64-bed nursing facility resulting in the delicensure of 85 beds. Notwithstanding
the carryforward of the approval authority in section 144A.073, subdivision 11, the funding
approved in April 2009 by the commissioner of health for a project in Goodhue County
shall not carry forward. The closure of the 85 beds shall not be eligible for a planned closure
rate adjustment under section 256R.40. The construction project permitted in this clause
shall not be eligible for a threshold project rate adjustment under section 256B.434,
subdivision 4f
. The payment rate for external fixed costs for the new facility shall be
increased by an amount as calculated according to items (i) to (vi):

(i) compute the estimated decrease in medical assistance residents served by both nursing
facilities by multiplying the difference between the occupied beds of the two nursing facilities
for the reporting year ending September 30, 2009, and the projected occupancy of the facility
at 95 percent occupancy by the historical percentage of medical assistance resident days;

(ii) compute the annual savings to the medical assistance program from the delicensure
by multiplying the anticipated decrease in the medical assistance residents, determined in
item (i), by the hospital-owned nursing facility weighted average payment rate multiplied
by 365;

(iii) compute the anticipated annual costs for community-based services by multiplying
the anticipated decrease in medical assistance residents served by the facilities, determined
in item (i), by the average monthly elderly waiver service costs for individuals in Goodhue
County multiplied by 12;

(iv) subtract the amount in item (iii) from the amount in item (ii);

(v) multiply the amount in item (iv) by 57.2 percent; and

(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an
amount equal to the relocated nursing facility's occupancy factor under section 256B.431,
subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance
resident days.

(b) Projects approved under this subdivision shall be treated in a manner equivalent to
projects approved under subdivision 4a.

Sec. 5.

Minnesota Statutes 2016, section 144A.10, subdivision 4, as amended by Laws
2017, chapter 40, article 1, section 27, is amended to read:


Subd. 4.

Correction orders.

Whenever a duly authorized representative of the
commissioner of health finds upon inspection of a nursing home, that the facility or a
controlling person or an employee of the facility is not in compliance with sections 144.411
to 144.417, 144.651, 144.6503, 144A.01 to 144A.155, or 626.557 or the rules promulgated
thereunder, a correction order shall be issued to the facility. The correction order shall state
the deficiency, cite the specific rule or statute violated, state the suggested method of
correction, and specify the time allowed for correction. If the commissioner finds that the
nursing home had uncorrected or repeated violations which create a risk to resident care,
safety, or rights, the commissioner shall notify the commissioner of human services deleted text beginwho
shall require the facility to use any incentive payments received under section 256R.38, to
correct the violations and shall require the facility to forfeit incentive payments for failure
to correct the violations. The forfeiture shall not apply to correction orders issued for physical
plant deficiencies
deleted text end.

Sec. 6.

Minnesota Statutes 2016, section 144A.74, is amended to read:


144A.74 MAXIMUM CHARGES.

A supplemental nursing services agency must not bill or receive payments from a nursing
home licensed under this chapter at a rate higher than 150 percent of the sum of the weighted
average wage rate, plus a factor determined by the commissioner to incorporate payroll
taxes as defined in deleted text beginMinnesota Rules, part 9549.0020, subpart 33deleted text endnew text begin section 256R.02, subdivision
37
new text end, for the applicable employee classification for the geographic group to which the nursing
home is assigned under Minnesota Rules, part 9549.0052. The weighted average wage rates
must be determined by the commissioner of human services and reported to the commissioner
of health on an annual basis. Wages are defined as hourly rate of pay and shift differential,
including weekend shift differential and overtime. Facilities shall provide information
necessary to determine weighted average wage rates to the commissioner of human services
in a format requested by the commissioner. The maximum rate must include all charges for
administrative fees, contract fees, or other special charges in addition to the hourly rates for
the temporary nursing pool personnel supplied to a nursing home.

Sec. 7.

Minnesota Statutes 2016, section 256.9657, subdivision 1, is amended to read:


Subdivision 1.

Nursing home license surcharge.

(a) Effective July 1, 1993, each
non-state-operated nursing home licensed under chapter 144A shall pay to the commissioner
an annual surcharge according to the schedule in subdivision 4. The surcharge shall be
calculated as $620 per licensed bed. If the number of licensed beds is reduced, the surcharge
shall be based on the number of remaining licensed beds the second month following the
receipt of timely notice by the commissioner of human services that beds have been
delicensed. The nursing home must notify the commissioner of health in writing when beds
are delicensed. The commissioner of health must notify the commissioner of human services
within ten working days after receiving written notification. If the notification is received
by the commissioner of human services by the 15th of the month, the invoice for the second
following month must be reduced to recognize the delicensing of beds. Beds on layaway
status continue to be subject to the surcharge. The commissioner of human services must
acknowledge a medical care surcharge appeal within 30 days of receipt of the written appeal
from the provider.

(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.

(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased to
$990.

(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased to
$2,815.

(e) The commissioner may reduce, and may subsequently restore, the surcharge under
paragraph (d) based on the commissioner's determination of a permissible surcharge.

deleted text begin (f) Between April 1, 2002, and August 15, 2004, a facility governed by this subdivision
may elect to assume full participation in the medical assistance program by agreeing to
comply with all of the requirements of the medical assistance program, including the rate
equalization law in section 256B.48, subdivision 1, paragraph (a), and all other requirements
established in law or rule, and to begin intake of new medical assistance recipients. Rates
will be determined under Minnesota Rules, parts 9549.0010 to 9549.0080. Rate calculations
will be subject to limits as prescribed in rule and law. Other than the adjustments in sections
256B.431, subdivisions 30 and 32; 256B.437, subdivision 3, paragraph (b), Minnesota
Rules, part 9549.0057, and any other applicable legislation enacted prior to the finalization
of rates, facilities assuming full participation in medical assistance under this paragraph are
not eligible for any rate adjustments until the July 1 following their settle-up period.
deleted text end

Sec. 8.

Minnesota Statutes 2016, 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 9549.0051
to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph
(a). Effective on July 1 of the state fiscal year in which the resident assessment system as
described in section deleted text begin256B.438deleted text endnew text begin 256R.17new text end 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.

(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 deleted text beginsections 256B.431, 256B.434, and 256B.441deleted text endnew text begin
chapter 256R
new text end, 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.

Sec. 9.

Minnesota Statutes 2016, section 256B.35, subdivision 4, as amended by Laws
2017, chapter 40, article 1, section 72, is amended to read:


Subd. 4.

Field audits required.

The commissioner of human services shall conduct
field audits at the same time as cost report audits required under section 256R.13new text begin, subdivision
1
new text end
, and at any other time but at least once every four years, without notice, to determine
whether this section was complied with and that the funds provided residents for their
personal needs were actually expended for that purpose.

Sec. 10.

Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:


Subd. 30.

Bed layaway and delicensure.

(a) For rate years beginning on or after July
1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway
shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph
(c), and calculation of the rental per diem, have those beds given the same effect as if the
beds had been delicensed so long as the beds remain on layaway. At the time of a layaway,
a facility may change its single bed election for use in calculating capacity days under
Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be
effective the first day of the month following the month in which the layaway of the beds
becomes effective under section 144A.071, subdivision 4b.

(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to
the contrary under section 256B.434new text begin or chapter 256Rnew text end, a nursing facility reimbursed under
that sectionnew text begin or chapternew text end which has placed beds on layaway shall, for so long as the beds
remain on layaway, be allowed to:

(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;

(2) retain or change the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and

(3) establish capacity days based on the number of beds immediately prior to the layaway
and the number of beds after the layaway.

The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and
(3). If a facility reimbursed under section 256B.434new text begin or chapter 256Rnew text end completes a moratorium
exception project after its base year, the base year property rate shall be the moratorium
project property rate. The base year rate shall be inflated by the factors in section 256B.434,
subdivision 4
, paragraph (c). The property payment rate increase shall be effective the first
day of the month following the month in which the layaway of the beds becomes effective.

(c) If a nursing facility removes a bed from layaway status in accordance with section
144A.071, subdivision 4b, the commissioner shall establish capacity days based on the
number of licensed and certified beds in the facility not on layaway and shall reduce the
nursing facility's property payment rate in accordance with paragraph (b).

(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision
to the contrary under section 256B.434new text begin or chapter 256Rnew text end, a nursing facility reimbursed under
that sectionnew text begin or chapternew text end, which has delicensed beds after July 1, 2000, by giving notice of
the delicensure to the commissioner of health according to the notice requirements in section
144A.071, subdivision 4b, shall be allowed to:

(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;

(2) retain or change the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and

(3) establish capacity days based on the number of beds immediately prior to the
delicensure and the number of beds after the delicensure.

The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the delicensure of beds and clauses (1), (2),
and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception
project after its base year, the base year property rate shall be the moratorium project property
rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
paragraph (c). The property payment rate increase shall be effective the first day of the
month following the month in which the delicensure of the beds becomes effective.

(e) For nursing facilities reimbursed under this section deleted text beginordeleted text endnew text begin,new text end section 256B.434,new text begin or chapter
256R,
new text end any beds placed on layaway shall not be included in calculating facility occupancy
as it pertains to leave days defined in Minnesota Rules, part 9505.0415.

(f) For nursing facilities reimbursed under this section deleted text beginordeleted text endnew text begin,new text end section 256B.434,new text begin or chapter
256R,
new text end the rental rate calculated after placing beds on layaway may not be less than the rental
rate prior to placing beds on layaway.

(g) A nursing facility receiving a rate adjustment as a result of this section shall comply
with section deleted text begin256B.47, subdivision 2deleted text endnew text begin 256R.06, subdivision 5new text end.

(h) A facility that does not utilize the space made available as a result of bed layaway
or delicensure under this subdivision to reduce the number of beds per room or provide
more common space for nursing facility uses or perform other activities related to the
operation of the nursing facility shall have its property rate increase calculated under this
subdivision reduced by the ratio of the square footage made available that is not used for
these purposes to the total square footage made available as a result of bed layaway or
delicensure.

Sec. 11. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 10 are effective the day following final enactment.
new text end

ARTICLE 15

MANAGED CARE ORGANIZATIONS

Section 1.

Minnesota Statutes 2016, section 256.045, subdivision 3a, is amended to read:


Subd. 3a.

Prepaid health plan appeals.

(a) All prepaid health plans under contract to
the commissioner under chapter 256B must provide for a complaint system according to
section 62D.11. When a prepaid health plan denies, reduces, or terminates a health service
or denies a request to authorize a previously authorized health service, the prepaid health
plan must notify the recipient of the right to file a complaint or an appeal. The notice must
include the name and telephone number of the ombudsman and notice of the recipient's
right to request a hearing under paragraph (b). Recipients may request the assistance of the
ombudsman in the complaint system process. The prepaid health plan must issue a written
resolution of the complaint to the recipient within 30 days after the complaint is filed with
the prepaid health plan. A recipient is deleted text beginnotdeleted text end required to exhaust the complaint system
procedures in order to request a hearing under paragraph (b).

(b) Recipients enrolled in a prepaid health plan under chapter 256B may contest a prepaid
health plan's denial, reduction, or termination of health services, a prepaid health plan's
denial of a request to authorize a previously authorized health service, or the prepaid health
plan's written resolution of a complaint by submitting a written request for a hearing
according to subdivision 3. A state human services judge shall conduct a hearing on the
matter and shall recommend an order to the commissioner of human services. The
commissioner need not grant a hearing if the sole issue raised by a recipient is the
commissioner's authority to require mandatory enrollment in a prepaid health plan in a
county where prepaid health plans are under contract with the commissioner. The state
human services judge may order a second medical opinion from deleted text beginthe prepaid health plan or
may order a second medical opinion from
deleted text end a nonprepaid health plan provider at the expense
of the deleted text beginprepaid health plandeleted text endnew text begin Department of Human Servicesnew text end. Recipients may request the
assistance of the ombudsman in the appeal process.

(c) In the written request for a hearing to appeal from a prepaid health plan's denial,
reduction, or termination of a health service, a prepaid health plan's denial of a request to
authorize a previously authorized service, or the prepaid health plan's written resolution to
a complaint, a recipient may request an expedited hearing. If an expedited appeal is
warranted, the state human services judge shall hear the appeal and render a decision within
a time commensurate with the level of urgency involved, based on the individual
circumstances of the case.

new text begin (d) Beginning January 1, 2018, the requirements of Code of Federal Regulations, part
42, sections 438.400 to 438.424, take precedent over any conflicting provisions in this
subdivision. All other provisions of this section remain in effect.
new text end

Sec. 2.

Minnesota Statutes 2016, section 256B.69, is amended by adding a subdivision to
read:


new text begin Subd. 36. new text end

new text begin Enrollee support system. new text end

new text begin (a) The commissioner shall establish an enrollee
support system that provides support to an enrollee before and during enrollment in a
managed care plan.
new text end

new text begin (b) The enrollee support system must:
new text end

new text begin (1) provide access to counseling for each potential enrollee on choosing a managed care
plan;
new text end

new text begin (2) assist an enrollee in understanding enrollment in a managed care plan;
new text end

new text begin (3) provide an access point for complaints regarding enrollment, covered services, and
other related matters;
new text end

new text begin (4) provide information on an enrollee's grievance and appeal rights within the managed
care organization and the state's fair hearing process, including an enrollee's rights and
responsibilities; and
new text end

new text begin (5) provide assistance to an enrollee, upon request, in navigating the grievance and
appeals process within the managed care organization and in appealing adverse benefit
determinations made by the managed care organization to the state's fair hearing process
after the managed care organization's internal appeals process has been exhausted. Assistance
does not include providing representation to an enrollee at the state's fair hearing, but may
include a referral to appropriate legal representation sources.
new text end

new text begin (c) Outreach to enrollees through the support system must be accessible to an enrollee
through multiple formats, including telephone, Internet, in-person, and, if requested, through
auxiliary aids and services.
new text end

new text begin (d) The commissioner may designate enrollment brokers to assist enrollees on selecting
a managed care organization and providing necessary enrollment information. For purposes
of this subdivision, "enrollment broker" means an individual or entity that performs choice
counseling or enrollment activities in accordance with Code of Federal Regulations, part
42, section 438.810, or both.
new text end

Sec. 3.

Minnesota Statutes 2016, section 256B.69, is amended by adding a subdivision to
read:


new text begin Subd. 37. new text end

new text begin Networks. new text end

new text begin (a) The commissioner shall ensure that a managed care
organization's network providers are enrolled with the commissioner as medical assistance
providers, and that the providers comply with the provider disclosure, screening, and
enrollment requirements in Code of Federal Regulations, part 42, section 455. A provider
that has a network provider contract with the managed care organization is not required to
provide services to a medical assistance or MinnesotaCare recipient who is receiving services
through the fee-for-service system.
new text end

new text begin (b) A managed care organization may enter into a network provider contract with a
provider that is not a medical assistance provider for a period of up to 120 days pending the
outcome of the medical assistance provider enrollment process. A managed care organization
must terminate the contract upon notification that the provider cannot be enrolled as a
medical assistance provider or upon expiration of the 120-day period if notification has not
been received within that period. The managed care organization must notify each affected
enrollee of the provider contract termination.
new text end

new text begin (c) For purposes of this subdivision, "network provider" means any provider, group of
providers, entity with a network provider agreement with the managed care organization,
or subcontractor that receives payments from the managed care organization either directly
or indirectly to provide services under a managed care contract between the commissioner
and the managed care organization.
new text end

Sec. 4.

new text begin [256B.6925] ENROLLEE INFORMATION.
new text end

new text begin Subdivision 1. new text end

new text begin Information provided by the commissioner. new text end

new text begin The commissioner shall
provide to each potential enrollee the following information:
new text end

new text begin (1) basic features of receiving services through managed care;
new text end

new text begin (2) which individuals are excluded from managed care enrollment, subject to mandatory
managed care enrollment, or who may choose to enroll voluntarily;
new text end

new text begin (3) for mandatory and voluntary enrollment, the length of the enrollment period and
information about an enrollee's right to disenroll in accordance with Code of Federal
Regulations, part 42, section 438.56;
new text end

new text begin (4) the service area covered by each managed care organization;
new text end

new text begin (5) covered services, including services provided by the managed care organization and
services provided by the commissioner;
new text end

new text begin (6) the provider directory and drug formulary for each managed care organization;
new text end

new text begin (7) cost-sharing requirements;
new text end

new text begin (8) requirements for adequate access to services, including provider network adequacy
standards;
new text end

new text begin (9) a managed care organization's responsibility for coordination of enrollee care; and
new text end

new text begin (10) quality and performance indicators, including enrollee satisfaction for each managed
care organization, if available.
new text end

new text begin Subd. 2. new text end

new text begin Information provided by the managed care organization. new text end

new text begin The commissioner
shall ensure that managed care organizations provide to each enrollee the following
information:
new text end

new text begin (1) an enrollee handbook within a reasonable time after receiving notice of the enrollee's
enrollment. The handbook must, at a minimum, include information on benefits provided,
how and where to access benefits, cost-sharing requirements, how transportation is provided,
and other information as required by Code of Federal Regulations, part 42, section 438.10,
paragraph (g);
new text end

new text begin (2) a provider directory for the following provider types: physicians, specialists, hospitals,
pharmacies, behavioral health providers, and long-term supports and services providers, as
appropriate. The directory must include the provider's name, group affiliation, street address,
telephone number, Web site, specialty if applicable, whether the provider accepts new
enrollees, the provider's cultural and linguistic capabilities as identified in Code of Federal
Regulations, part 42, section 438.10, paragraph (h), and whether the provider's office
accommodates people with disabilities;
new text end

new text begin (3) a drug formulary that includes both generic and name brand medications that are
covered and each medication tier, if applicable;
new text end

new text begin (4) written notice of termination of a contracted provider. Within 15 calendar days after
receipt or issuance of the termination notice, the managed care organization must make a
good faith effort to provide notice to each enrollee who received primary care from, or was
seen on a regular basis by, the terminated provider; and
new text end

new text begin (5) upon enrollee request, the managed care organization's physician incentive plan.
new text end

new text begin Subd. 3. new text end

new text begin Provision of information. new text end

new text begin (a) All information required to be provided to
enrollees and potential enrollees of a managed care organization, including the provider
directory, enrollee handbook, and drug formulary, must be provided in a manner and format
that is easily understood and readily accessible. The information must be available through
the enrollee support system established under section 256B.69, subdivision 36, the
department's Web site and each managed care organization's Web site. The commissioner
and managed care organization shall inform each enrollee that the information is available
on the department's and the managed care organization's Web sites and shall provide the
potential enrollee or enrollee with the applicable URL to access the information. An enrollee
with a disability who cannot access the information online must be provided, upon request,
with auxiliary aids and services necessary to access the information at no cost to the enrollee.
new text end

new text begin (b) The commissioner and managed care organization shall provide all required
information electronically to potential enrollees and enrollees unless the enrollee requests
the information in paper form. The commissioner and managed care organization shall
inform an enrollee that, upon request, the information is available in paper form without
charge to the enrollee, and shall mail the information to the potential enrollee's or the
enrollee's mailing address within five business days of the request. If the information is
provided to the enrollee through e-mail, the managed care organization must receive the
enrollee's agreement before providing the information by e-mail.
new text end

new text begin (c) The information required to be provided electronically to a potential enrollee or
enrollee must:
new text end

new text begin (1) be readily accessible;
new text end

new text begin (2) be published in a prominent location on the commissioner's and managed care
organization's Web sites in a format that has the capability of being retained and printed;
and
new text end

new text begin (3) satisfy the requirements for content and language requirements in accordance with
Code of Federal Regulations, part 42, section 438.10, paragraph (d).
new text end

new text begin Subd. 4. new text end

new text begin Language and accessibility standards. new text end

new text begin (a) Managed care contracts entered
into under section 256B.69, 256B.692, or 256L.12, must require a managed care organization
to provide language assistance, and auxiliary aids and services, if requested, to ensure access
to a managed care organization's programs and services, as required under United States
Code, title 42, sections 18116 and 2000d, and any other federal regulations or guidance
from the United States Department of Health and Human Services.
new text end

new text begin (b) The commissioner shall establish a methodology to identify the prevalent non-English
languages spoken by enrollees and potential enrollees throughout Minnesota and in each
managed care organization's service area.
new text end

new text begin (c) The commissioner shall ensure that oral interpretation is provided in all languages
and written interpretation is provided in each prevalent non-English language, and that both
are available to enrollees and potential enrollees free of charge. Oral interpretation services
shall include the use of auxiliary aids, TTY/TDY, and American sign language.
new text end

new text begin (d) All written materials that target potential enrollees and are provided to enrollees,
including the provider directory, enrollee handbook, appeals and grievance notices, and
denial and termination notices, must:
new text end

new text begin (1) use at least 12-point font;
new text end

new text begin (2) be written at a 7th grade reading level;
new text end

new text begin (3) be available in alternative formats and through auxiliary aids and services that consider
the special needs of the enrollee, including an enrollee with a disability or limited English
proficiency;
new text end

new text begin (4) use taglines that consist of short statements in each of the prevalent non-English
languages, in an 18-point font, that explain the availability of language interpreter services
free of charge; and
new text end

new text begin (5) explain how to request auxiliary aids and services, including the provision of the
materials in alternative formats and the TTY/TDY telephone number of the managed care
organization's customer service unit and the department's enrollee support system.
new text end

new text begin (e) For purposes of this subdivision, "prevalent non-English language" means a
non-English language that is determined by the commissioner to be spoken by a significant
number or percentage of potential enrollees and enrollees with limited proficiency in English.
new text end

new text begin Subd. 5. new text end

new text begin Enrollee communication. new text end

new text begin (a) The commissioner shall ensure that the managed
care organization:
new text end

new text begin (1) submits all marketing materials to the commissioner for approval before distribution
and that marketing materials are accurate and do not mislead, confuse, or defraud;
new text end

new text begin (2) distributes marketing materials to a managed care organization's entire service area
and as otherwise permitted by contract;
new text end

new text begin (3) complies with the information requirements in Code of Federal Regulations, part 42,
section 438.10;
new text end

new text begin (4) does not seek to influence enrollment with the sale or offering of any private
insurance, with the exception of communications between an enrollee and a managed care
organization that is related to the offering of a qualified health plan as defined under section
62K.03; and
new text end

new text begin (5) does not directly, or indirectly, engage in door-to-door, telephone, e-mail, texting,
or other cold-call marketing activities.
new text end

new text begin (b) For the purposes of this subdivision, "cold-call marketing activities" means any
unsolicited personal contact or communication by a managed care organization with an
individual who is not enrolled in that managed care organization that can be reasonably
interpreted as intended to influence the individual to enroll in a specific managed care
organization or to not enroll in or disenroll from another managed care organization.
new text end

Sec. 5.

new text begin [256B.6926] STATE MONITORING.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin (a) The commissioner shall establish a monitoring system
that addresses all aspects of the managed care program, including the performance of each
managed care organization in the areas identified under Code of Federal Regulations, part
42, section 438.66, paragraph (b).
new text end

new text begin (b) The commissioner shall use data collected from the monitoring activities, including,
at a minimum, the data identified in Code of Federal Regulations, part 42, section 438.66,
paragraph (c), to improve the performance of the managed care program.
new text end

new text begin Subd. 2. new text end

new text begin Readiness review. new text end

new text begin The commissioner shall conduct a readiness review of each
managed care organization that contracts with the commissioner to assess the managed care
organization's ability and capacity to perform satisfactorily in the areas described in Code
of Federal Regulations, part 42, section 438.66, paragraph (d), clauses (1) to (4). The review
must be conducted and approval must be received from the Centers for Medicare and
Medicaid Services prior to the commissioner entering into a contract with the managed care
organization.
new text end

new text begin Subd. 3. new text end

new text begin Report. new text end

new text begin (a) The commissioner shall submit to the Centers for Medicare and
Medicaid Services, no later than 180 days after each contract year, a report on the managed
care program administered by the commissioner, regardless of the authority under which
the program operates, with the initial report being submitted 180 days after the contract
year following the release of the Centers for Medicare and Medicaid Services guidance.
Each report must, at a minimum, assess the managed care program's operation in the areas
identified in Code of Federal Regulations, part 42, section 438.66, paragraph (e), clause
(2), and must be:
new text end

new text begin (1) provided to the Medicaid Citizens' Advisory Committee as required under Code of
Federal Regulations, part 42, section 431.12;
new text end

new text begin (2) provided to the stakeholder consultation group as required under Code of Federal
Regulations, part 42, section 438.70, to the extent the managed care program includes
long-term services and supports; and
new text end

new text begin (3) published on the department's Web site.
new text end

new text begin (b) The report described under this subdivision may be used to meet the commissioner's
reporting obligation under the managed care waiver authority for the managed care program.
new text end

new text begin Subd. 4. new text end

new text begin Conflicts of interest. new text end

new text begin The commissioner shall implement safeguards against
conflicts of interest on behalf of state and local officers and employees and agents of the
state who have responsibilities relating to managed care contracts. The safeguards must be
at least as effective as the safeguards specified in United States Code, title 41, sections 2101
to 2107. The commissioner shall comply with Code of Federal Regulations, part 42, section
438.58, and United States Code, title 42, section 1396a, paragraph (a), clause (4), item (c),
applicable to contracting officers, employees, or independent contractors.
new text end

Sec. 6.

new text begin [256B.6927] QUALITY ASSESSMENT AND PERFORMANCE.
new text end

new text begin Subdivision 1. 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 them.
new text end

new text begin (b) "Access" means the availability and timely use of services to achieve optimal
outcomes as required under Code of Federal Regulations, part 42, sections 438.68 and
438.206.
new text end

new text begin (c) "External quality review" means the analysis and evaluation by an external quality
review organization of the aggregated information on quality, timeliness, and access to the
health care services that a managed care organization or the managed care organization's
contractor provides to enrollees.
new text end

new text begin (d) "External quality review organization" means an organization that meets the
competence and independence requirements under Code of Federal Regulations, part 42,
section 438.354, and performs external quality review and may perform other external
quality review-related activities as required under Code of Federal Regulations, part 42,
section 438.358.
new text end

new text begin (e) "Quality" means the degree that a managed care organization increases the likelihood
of desired outcomes of a managed care organization's enrollees through:
new text end

new text begin (1) a managed care organization's structural and operational characteristics;
new text end

new text begin (2) the provision of services that are consistent with current professional, evidence-based
knowledge; and
new text end

new text begin (3) interventions for performance improvement.
new text end

new text begin (f) "Validation" means the review of information, data, and procedures to determine the
extent that information, data, and procedures are accurate, reliable, free from bias, and
according to standards for data collection and analysis.
new text end

new text begin Subd. 2. new text end

new text begin Quality strategy. new text end

new text begin (a) The commissioner shall implement a written quality
strategy for assessing and improving the quality of health care and other services provided
by managed care organizations. At a minimum, the quality strategy must include:
new text end

new text begin (1) defined network adequacy requirements and availability of services standards for
managed care organizations, including examples of evidence-based clinical practice
guidelines;
new text end

new text begin (2) measurable goals and objectives for continuous quality improvement that consider
the health status of all populations served by the managed care organization;
new text end

new text begin (3) a description of:
new text end

new text begin (i) the quality metrics and performance targets used in measuring the performance and
improvement of each managed care organization; and
new text end

new text begin (ii) performance improvement projects, including a description of any intervention
proposed by the commissioner to improve access, quality, or timeliness of care for enrollees;
new text end

new text begin (4) annual, external independent reviews of quality outcomes, and the timeliness of and
access to services covered by the managed care organization;
new text end

new text begin (5) a description of the managed care organization's transition of care policy;
new text end

new text begin (6) a plan to identify, evaluate, and reduce health disparities based on an enrollee's age,
race, ethnicity, sex, primary language, or disability status, and provide this demographic
information to the managed care organization at the time of enrollment;
new text end

new text begin (7) appropriate use of intermediate sanctions to be imposed on a managed care
organization;
new text end

new text begin (8) the mechanisms implemented to identify enrollees who need long-term services and
supports or enrollees with special health care needs; and
new text end

new text begin (9) information related to nonduplication of the external quality review activities in
accordance with Code of Federal Regulations, part 42, section 438.360, paragraph (c).
new text end

new text begin (b) In developing the initial quality strategy, the commissioner shall:
new text end

new text begin (1) obtain input from the Medicaid Citizens' Advisory Committee, enrollees, and other
interested stakeholders;
new text end

new text begin (2) consult with the tribes according to the tribal consultation policy;
new text end

new text begin (3) consider recommendations from the external quality review organization identified
under subdivision 3, for improving the quality of health care services furnished by the
managed care organization; and
new text end

new text begin (4) make the strategy available for public comment.
new text end

new text begin (c) The commissioner shall submit a copy of the initial quality strategy to the Centers
for Medicare and Medicaid Services for comments and feedback. If significant changes are
made based on the comments and feedback received, the commissioner shall publish the
revised quality strategy on the department's Web site. The commissioner shall make the
final quality strategy available on the department's Web site.
new text end

new text begin (d) The commissioner shall review and update the quality strategy at least every three
years or more frequently, if needed. The review shall include an evaluation of the
effectiveness of the quality strategy conducted within the previous three years. The results
of the review and any updates shall be published on the department's Web site.
new text end

new text begin Subd. 3. new text end

new text begin External quality reviews. new text end

new text begin (a) The commissioner shall contract with an external
quality review organization in accordance with Code of Federal Regulations, part 42, section
438.354, to conduct an annual external quality review of each managed care organization.
The commissioner shall ensure that all necessary information is provided to the external
quality review organization for analysis and inclusion in the external quality review technical
report required under paragraph (g). The information provided must be obtained in
accordance with Code of Federal Regulations, part 42, section 438.352.
new text end

new text begin (b) The commissioner shall follow an open, competitive procurement process according
to state and federal law for any contract with an external quality review organization. The
external quality review organization may use a subcontractor if the subcontractor meets the
requirements for independence. The external quality review organization is accountable for
and must oversee all functions performed by the subcontractor.
new text end

new text begin (c) The following mandatory external quality review related activities must be performed
for each managed care organization:
new text end

new text begin (1) validation of performance improvement projects, performance measures, and meeting
network adequacy requirements for the 12 months preceding the most recently completed
contract period; and
new text end

new text begin (2) review of the managed care organization's compliance with Code of Federal
Regulations, part 42, subpart D, and section 438.330 for the preceding three years.
new text end

new text begin (d) The commissioner may elect to incorporate any of the optional activities listed in
Code of Federal Regulations, part 42, section 438.358, paragraph (c), as part of the external
quality review.
new text end

new text begin (e) To avoid duplication, the commissioner may use information from a Medicare or
private accreditation review to provide information for a managed care organization's annual
external quality review instead of conducting one or more of the mandatory external quality
review activities. The information used must satisfy Code of Federal Regulations, part 42,
section 438.360, paragraph (a).
new text end

new text begin (f) If the conditions in Code of Federal Regulations, part 42, section 438.362, are satisfied,
the commissioner may accept the data, correspondence, information, and findings regarding
the managed care organization's compliance with a Medicare quality review in lieu of
performing an external quality review. For each managed care organization exempt from
an external quality review, the commissioner shall obtain the most recent Medicare review
findings or Medicare information from a private national accrediting organization that the
Centers for Medicare and Medicaid Services approves and recognizes for Medicare
Advantage Organization deeming.
new text end

new text begin (g) The qualified external quality review organization must produce an annual external
quality review technical report in accordance with Code of Federal Regulations, part 42,
section 438.364. The technical report must summarize findings on access and quality of
care. The commissioner may revise the final external quality review technical report if there
is evidence of error or omission. The final external quality review technical report must be
published on the department's Web site by April 30 of each year and copies of the report
must be made available upon request and in alternative formats. Information in the technical
report must not disclose the identity or other protected patient identifying health information.
new text end

Sec. 7.

new text begin [256B.6928] MANAGED CARE RATES AND PAYMENTS.
new text end

new text begin Subdivision 1. 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 them.
new text end

new text begin (b) "Base amount" has the meaning given in Code of Federal Regulations, part 42, section
438.6, paragraph (a).
new text end

new text begin (c) "Budget neutral" has the meaning given in Code of Federal Regulations, part 42,
section 438.5, paragraph (a).
new text end

new text begin (d) "Credibility adjustment" has the meaning given in Code of Federal Regulations, part
42, section 438.8, paragraph (b).
new text end

new text begin (e) "Full credibility" has the meaning given in Code of Federal Regulations, part 42,
section 438.8, paragraph (b).
new text end

new text begin (f) "Incentive arrangement" has the meaning given in Code of Federal Regulations, part
42, section 438.6.
new text end

new text begin (g) "Medical loss ratio" has the meaning given in Code of Federal Regulations, part 42,
section 438.8, paragraph (b).
new text end

new text begin (h) "Medical loss ratio reporting year" has the meaning given in Code of Federal
Regulations, part 42, section 438.8, paragraph (b).
new text end

new text begin (i) "Member months" has the meaning given in Code of Federal Regulations, part 42,
section 438.8, paragraph (b).
new text end

new text begin (j) "No credibility" has the meaning given in Code of Federal Regulations, part 42,
section 438.8, paragraph (b).
new text end

new text begin (k) "Partial credibility" has the meaning given in Code of Federal Regulations, part 42,
section 438.8, paragraph (b).
new text end

new text begin (l) "Pass-through payment" has the meaning given in Code of Federal Regulations, part
42, section 438.6, paragraph (a).
new text end

new text begin (m) "Rate cell" has the meaning given in Code of Federal Regulations, part 42, section
438.2.
new text end

new text begin (n) "Risk adjustment" has the meaning given in Code of Federal Regulations, part 42,
section 438.5, paragraph (a).
new text end

new text begin Subd. 2. new text end

new text begin Actuarial soundness. new text end

new text begin (a) Capitation rates for managed care organizations must
be reviewed and approved by the Centers for Medicare and Medicaid Services as actuarially
sound. The capitation rates must be provided in the format and time frame required by Code
of Federal Regulations, part 42, section 438.7. Capitation rates must:
new text end

new text begin (1) be developed in accordance with the rates standards in Code of Federal Regulations,
part 42, section 438.5, and generally accepted actuarial principles and practices. Any proposed
differences in capitation rates between covered populations must be based on valid rate
development standards and not on the rate of federal financial participation associated with
the covered populations;
new text end

new text begin (2) be appropriate for the populations covered and the services furnished under the
contract;
new text end

new text begin (3) meet the requirements for availability of services, adequate capacity, and coordination
and continuity of care in accordance with Code of Federal Regulations, part 42, sections
438.206, 438.207, and 438.208;
new text end

new text begin (4) be specific to each rate cell under the contract, and must not cross-subsidize or be
cross-subsidized by payments from any other rate cell;
new text end

new text begin (5) meet any special contract provisions in accordance with Code of Federal Regulations,
part 42, section 438.6; and
new text end

new text begin (6) be developed to reasonably achieve a medical loss ratio standard of at least 85 percent
for the rate year, or a higher minimum medical loss ratio if mandated by the commissioner,
as long as the capitation rates are adequate for reasonable, appropriate, and attainable
nonbenefit costs.
new text end

new text begin (b) An independent actuary must certify that the rates were developed in accordance
with Code of Federal Regulations, part 42, section 438.3, paragraph (c), clause (1), item
(ii), paragraph (e).
new text end

new text begin Subd. 3. new text end

new text begin Rate development standards. new text end

new text begin (a) In developing capitation rates, the
commissioner shall:
new text end

new text begin (1) identify and develop base utilization and price data, including validated encounter
data and audited financial reports received from the managed care organizations that
demonstrate experience for the populations served by the managed care organizations, for
the three most recent and complete years before the rating period;
new text end

new text begin (2) develop and apply reasonable trend factors, including cost and utilization, to base
data that are developed from actual experience of the medical assistance population or a
similar population according to generally accepted actuarial practices and principles;
new text end

new text begin (3) develop the nonbenefit component of the rate to account for reasonable expenses
related to the managed care organization's administration; taxes; licensing and regulatory
fees; contribution to reserves; risk margin; cost of capital and other operational costs
associated with the managed care organization's provision of covered services to enrollees;
new text end

new text begin (4) consider the value of cost-sharing for rate development purposes, regardless of
whether the managed care organization imposes the cost-sharing on the enrollee or the
cost-sharing is collected by the provider;
new text end

new text begin (5) make appropriate and reasonable adjustments to account for changes to the base data,
programmatic changes, changes to nonbenefit components, and any other adjustment
necessary to establish actuarially sound rates. Each adjustment must reasonably support the
development of an accurate base data set for purposes of rate setting, reflect the health status
of the enrolled population, and be developed in accordance with generally accepted actuarial
principles and practices;
new text end

new text begin (6) consider the managed care organization's past medical loss ratio in the development
of the capitation rates and consider the projected medical loss ratio; and
new text end

new text begin (7) select a prospective or retrospective risk adjustment methodology that must be
developed in a budget-neutral manner consistent with generally accepted actuarial principles
and practices.
new text end

new text begin (b) The base data must be derived from the medical assistance population or, if data on
the medical assistance population is not available, derived from a similar population and
adjusted to make the utilization and price data comparable to the medical assistance
population. Data must be in accordance with actuarial standards for data quality and an
explanation of why that specific data is used must be provided in the rate certification. If
the commissioner is unable to base the rates on data that are within the three most recent
and complete years before the rating period, the commissioner may request an approval
from the Centers for Medicare and Medicaid Services for an exception. The request must
describe why an exception is necessary and describe the actions that the commissioner
intends to take to comply with the request.
new text end

new text begin Subd. 4. new text end

new text begin Special contract requirements related to payment. new text end

new text begin (a) If the commissioner
uses risk-sharing mechanisms, including reinsurance, risk corridors, or stop-loss limits, the
risk-sharing mechanism must be described in the contract, and must be developed according
to the rate development standards and generally accepted actuarial principles and practices.
new text end

new text begin (b) The commissioner may utilize incentive payment arrangements in managed care
organization contracts. Any incentive arrangement utilized by the commissioner must be
made available to all managed care organizations under contract with the commissioner
under the same terms of performance. The payment must not exceed 105 percent of the
approved capitation payments attributable to the enrollees or services covered by the incentive
arrangement and must be actuarially sound. For all incentive arrangements the contract
must state that the arrangement is:
new text end

new text begin (1) for a fixed period of time and performance is measured during the rating period in
which the incentive arrangement is applied;
new text end

new text begin (2) not renewed automatically; and
new text end

new text begin (3) associated with specified activities, targets, performance measures, or quality-based
outcomes in the quality strategy described under section 256B.6927.
new text end

new text begin The incentive payment arrangement must not condition a managed care organization's
participation in the incentive arrangement upon entering into or adhering to an
intergovernmental transfer agreement.
new text end

new text begin (c) The commissioner may utilize withhold arrangements in managed care organization
contracts. Any withhold arrangement utilized by the commissioner must be applied to all
managed care organizations under contract with the commissioner under the same terms of
performance. Any withhold arrangement must ensure that the capitation payment minus
any portion of the withheld funds that is not reasonably achievable is actuarially sound. The
total amount of the withheld funds, achievable or not, must be reasonable and must take
into consideration each managed care organization's financial operating needs, accounting
for the size and characteristics of the populations covered under the contract, as well as the
managed care organization's capital reserves, as measured by the risk based capital level,
months of claims reserve, or other appropriate measure of reserves. The data, assumptions,
and methodologies used to determine the portion of the withhold that is reasonably achievable
must be submitted as part of the documentation required by Code of Federal Regulations,
part 42, section 438.7, paragraph (b), clause (6). For all withhold arrangements, the contract
must state that the arrangement is:
new text end

new text begin (1) for a fixed period of time and performance is measured during the rating period in
which the withhold arrangement is applied;
new text end

new text begin (2) not renewed automatically; and
new text end

new text begin (3) associated with specified activities, targets, performance measures, or quality-based
outcomes in the state's quality strategy.
new text end

new text begin The withhold payment arrangement must not condition a managed care organization's
participation in the withhold arrangement upon entering into or adhering to an
intergovernmental transfer agreement.
new text end

new text begin Subd. 5. new text end

new text begin Direction of managed care organization expenditures. new text end

new text begin (a) The commissioner
shall not direct managed care organizations expenditures under the managed care contract,
except in the following situations:
new text end

new text begin (1) implementation of a value-based purchasing model for provider reimbursement,
including pay-for-performance arrangements, bundled payments, or other service payments
intended to recognize value or outcomes over volume of services;
new text end

new text begin (2) participation in a multipayer or medical assistance-specific delivery system reform
or performance improvement initiative; or
new text end

new text begin (3) implementation of a minimum or maximum fee schedule, or a uniform dollar or
percentage increase for network providers that provide a particular service. The maximum
fee schedule must allow the managed care organization the ability to reasonably manage
risk and provide discretion in accomplishing the goals of the contract.
new text end

new text begin (b) Any managed care contract that directs managed care organization expenditures as
permitted under paragraph (a), clauses (1) to (3), must be developed in accordance with
Code of Federal Regulations, part 42, sections 438.4 and 438.5; comply with actuarial
soundness and generally accepted actuarial principles and practices; and have written
approval from the Centers for Medicare and Medicaid Services before implementation. To
obtain approval, the commissioner shall demonstrate in writing that the contract arrangement:
new text end

new text begin (1) is based on the utilization and delivery of services;
new text end

new text begin (2) directs expenditures equally, using the same terms of performance for a class of
providers providing service under the contract;
new text end

new text begin (3) is intended to advance at least one of the goals and objectives in the commissioner's
quality strategy;
new text end

new text begin (4) has an evaluation plan that measures the degree to which the arrangement advances
at least one of the goals in the commissioner's quality strategy;
new text end

new text begin (5) does not condition network provider participation on the network provider entering
into or adhering to an intergovernmental transfer agreement; and
new text end

new text begin (6) is not renewed automatically.
new text end

new text begin (c) For contract arrangements identified in paragraph (a), clauses (1) and (2), the
commissioner shall:
new text end

new text begin (1) make participation in the value-based purchasing model, special delivery system
reform, or performance improvement initiative available, using the same terms of
performance, to a class of providers providing services under the contract related to the
model, reform, or initiative; and
new text end

new text begin (2) use a common set of performance measures across all payers and providers.
new text end

new text begin (d) The commissioner shall not set the amount or frequency of the expenditures or recoup
from the managed care organization any unspent funds allocated for these arrangements.
new text end

new text begin Subd. 6. new text end

new text begin Monthly capitation payments for placements in institutions of mental
disease.
new text end

new text begin The commissioner may make a monthly capitation payment to a managed care
organization for an enrollee under the age of 65 receiving treatment for psychiatric or
substance use disorder in an institution for mental diseases in accordance with Code of
Federal Regulations, part 42, section 438.6, paragraph (e).
new text end

new text begin Subd. 7. new text end

new text begin Rate certification submission. new text end

new text begin (a) The commissioner shall submit the rate
certifications to the Centers for Medicare and Medicaid Services for review and approval
at the same time as the managed care contracts. The rate certification must satisfy Code of
Federal Regulations, part 42, section 438.7, paragraph (b), and must include:
new text end

new text begin (1) base data used in the rate setting process;
new text end

new text begin (2) trend, including changes in the utilization and the price of services;
new text end

new text begin (3) the nonbenefit component of the rate;
new text end

new text begin (4) any adjustments;
new text end

new text begin (5) the prospective and retrospective risk adjustment methodology; and
new text end

new text begin (6) any special contract provisions related to payment.
new text end

new text begin (b) The commissioner, through the state's actuary, must certify the final capitation rates
paid per rate cell under each contract and document the underlying data, assumptions and
methodologies.
new text end

new text begin (c) The commissioner may pay a managed care organization a capitation rate under a
managed care contract that is different than the capitation rate paid to another managed care
organization, if each capitation rate per rate cell that is paid is independently developed and
set in accordance with Code of Federal Regulations, part 42, sections 438.4, 438.5, 438.6,
and 438.8. The commissioner may increase or decrease the capitation rate per rate cell in
accordance with Code of Federal Regulations, part 42, sections 438.4, paragraph (b), clause
(4), and 438.7, paragraph (c), up to 1.5 percent without submitting a revised rate certification.
new text end

new text begin (d) If the commissioner determines that a retroactive adjustment to the capitation rate
is necessary, the retroactive adjustment must be supported by a rationale for the adjustment
and the data. Assumptions and methodologies used to develop the adjustment must be
described with enough detail to allow the Centers for Medicare and Medicaid Services or
an actuary to determine the reasonableness of the adjustment. Any retroactive adjustments
must be certified by an actuary in a revised rate certification and submitted to the Centers
for Medicare and Medicaid Services for approval as a contract amendment. All adjustments
are subject to timely federal claim filing requirements.
new text end

new text begin (e) The commissioner shall, upon request from the Centers for Medicare and Medicaid
Services, provide additional information if the Centers for Medicare and Medicaid Services
determines the information is pertinent to certification approval. The commissioner shall
identify whether the additional information shall be provided by the commissioner, the
actuary, or another party.
new text end

new text begin Subd. 8. new text end

new text begin Medical loss ratio. new text end

new text begin (a) The commissioner shall require that each managed care
organization calculate and submit to the commissioner a medical loss ratio report for each
contract year. The calculation of the medical loss ratio in the medical loss ratio reporting
year must be the ratio of the numerator to the denominator. The numerator must be the sum
of the managed care organization's incurred claims, the managed care organization's
expenditures for activities that improve health care quality, and fraud prevention activities.
The denominator must be calculated as the managed care organization's adjusted premium
revenue minus the managed care organization's federal, state, and local taxes and licensing
and regulatory fees identified in Code of Federal Regulations, part 42, section 438.8,
paragraph (f), clause (3). The total amount of the denominator for a managed care
organization that is assumed by another managed care organization must be reported by the
assuming managed care organization for the entire medical loss ratio reporting year. The
managed care organization must aggregate the data for all eligibility groups covered under
the contract, unless the commissioner requires separate reporting and a separate medical
loss ratio calculation for specific populations.
new text end

new text begin (b) Incurred claims must be identified by the expenditures, liabilities, reserves, deductions,
and exclusions in accordance with Code of Federal Regulations, part 42, section 438.8,
paragraph (e), clause (2).
new text end

new text begin (c) Activities that improve health care quality must be in one category in accordance
with Code of Federal Regulations, part 42, section 438.8, paragraph (e), clause (3).
new text end

new text begin (d) Fraud prevention activities, including managed care organization expenditures on
activities related to fraud prevention must be identified in accordance with Code of Federal
Regulations, part 45, section 158.
new text end

new text begin (e) Premium revenue must include capitation payments; onetime payments for specific
life events of enrollees; other payments to the managed care organization in accordance
with Code of Federal Regulations, part 42, section 438.6, paragraph (b), clause (3); unpaid
cost-sharing amounts; and changes to unearned premium reserves, net payments, and receipts
related to risk-sharing mechanisms.
new text end

new text begin (f) When calculating the medical loss ratio, each expense must be included under only
one type of expense, unless a portion of the expense fits under the definition of, or criteria
for, one type of expense and the remainder fits into a different type of expense, in which
case the expense must be prorated between types of expenses. Expenditures that benefit
multiple contracts or populations, or contracts other than those being reported, must be
reported on a pro rata basis. Expenses must be allocated using the methods described in
Code of Federal Regulations, part 42, section 438.8, paragraph (g), clause (2).
new text end

new text begin (g) The commissioner may require the managed care organization to provide a remittance
if the medical loss ratio for the medical loss ratio reporting year does not meet the minimum
medical loss ratio standard of 85 percent, or if applicable, a higher ratio mandated by the
commissioner.
new text end

new text begin Subd. 9. new text end

new text begin Reports. new text end

new text begin (a) The commissioner shall require each managed care organization
to submit a report to the commissioner for each medical loss ratio reporting year that includes
the information identified in Code of Federal Regulations, part 42, section 438.8, paragraph
(k). The report must be submitted within 12 months of the end of each medical loss ratio
reporting year. The managed care organization must require any third-party vendor providing
claims adjudication to provide all underlying data associated with medical loss ratio reporting
to the managed care organization within 180 days of the end of the medical loss ratio
reporting year or within 30 days of being requested by the managed care organization to
calculate and validate the accuracy of medical loss ratio reporting. The managed care
organization must include with the medical loss ratio report an attestation as to the accuracy
of the calculation of the medical loss ratio.
new text end

new text begin (b) The commissioner shall annually submit to the Centers for Medicare and Medicaid
Services a summary description of the reports received from the managed care organizations
in accordance with Code of Federal Regulations, part 42, section 438.8, paragraph (k), along
with the rate certification required under subdivision 7. At a minimum, the summary
description must include for the medical loss ratio report reporting year, the amount of the
numerator, the amount of the denominator, the medical loss ratio percentage achieved, the
number of member months, and any remittances owed. If through the contract the
commissioner requires the managed care organization to pay remittances for not meeting
the minimum medical loss ratio, the commissioner must reimburse the Centers for Medicare
and Medicaid Services the federal share that reflects any differences in the federal matching
rate. If a remittance is owed, the commissioner shall submit with the required report a
separate report describing the methodology used to determine the state and federal shares
of the remittance.
new text end

new text begin (c) If the commissioner makes a retroactive change to the capitation payments for a
medical loss ratio reporting year for which the report was already submitted to the
commissioner, the managed care organization shall recalculate the medical loss ratio for
that year and submit a new report meeting the reporting requirements under paragraph (a).
new text end

new text begin (d) The commissioner may exempt a newly contracted managed care organization from
calculating and reporting the medical loss ratio for the first year of the managed care
organization's operation as required under this subdivision. If a managed care organization
is excluded, the managed care organization must comply with the requirements of this
section during the next medical loss ratio reporting year.
new text end

ARTICLE 16

CHILD CARE DEVELOPMENT BLOCK GRANT COMPLIANCE

Section 1.

Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:


Subd. 4.

Inspections; waiver.

(a) Before issuing an initial license, the commissioner
shall conduct an inspection of the program. The inspection must include but is not limited
to:

(1) an inspection of the physical plant;

(2) an inspection of records and documents;

(3) an evaluation of the program by consumers of the program; deleted text beginand
deleted text end

(4) observation of the program in operationdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) an inspection for the health, safety, and fire standards in licensing requirements for
a child care license holder.
new text end

For the purposes of this subdivision, "consumer" means a person who receives the
services of a licensed program, the person's legal guardian, or the parent or individual having
legal custody of a child who receives the services of a licensed program.

(b) The evaluation required in paragraph (a), clause (3) or the observation in paragraph
(a), clause (4) is not required prior to issuing an initial license under subdivision 7. If the
commissioner issues an initial license under subdivision 7, these requirements must be
completed within one year after the issuance of an initial license.

new text begin (c) The commissioner or the county shall inspect at least annually a child care provider
licensed under this chapter and Minnesota Rules, chapter 9502 or 9503, for compliance
with applicable licensing standards.
new text end

new text begin (d) No later than November 19, 2017, the commissioner shall make publicly available
on the department's Web site the results of inspection reports of all child care providers
licensed under this chapter and under Minnesota Rules, chapter 9502 or 9503, and the
number of deaths, serious injuries, and instances of substantiated child maltreatment that
occurred in licensed child care settings each year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 2.

Minnesota Statutes 2016, section 245A.09, subdivision 7, is amended to read:


Subd. 7.

Regulatory methods.

(a) Where appropriate and feasible the commissioner
shall identify and implement alternative methods of regulation and enforcement to the extent
authorized in this subdivision. These methods shall include:

(1) expansion of the types and categories of licenses that may be granted;

(2) when the standards of another state or federal governmental agency or an independent
accreditation body have been shown to require the same standards, methods, or alternative
methods to achieve substantially the same intended outcomes as the licensing standards,
the commissioner shall consider compliance with the governmental or accreditation standards
to be equivalent to partial compliance with the licensing standards; and

(3) use of an abbreviated inspection that employs key standards that have been shown
to predict full compliance with the rules.

(b) If the commissioner accepts accreditation as documentation of compliance with a
licensing standard under paragraph (a), the commissioner shall continue to investigate
complaints related to noncompliance with all licensing standards. The commissioner may
take a licensing action for noncompliance under this chapter and shall recognize all existing
appeal rights regarding any licensing actions taken under this chapter.

(c) The commissioner shall work with the commissioners of health, public safety,
administration, and education in consolidating duplicative licensing and certification rules
and standards if the commissioner determines that consolidation is administratively feasible,
would significantly reduce the cost of licensing, and would not reduce the protection given
to persons receiving services in licensed programs. Where administratively feasible and
appropriate, the commissioner shall work with the commissioners of health, public safety,
administration, and education in conducting joint agency inspections of programs.

(d) The commissioner shall work with the commissioners of health, public safety,
administration, and education in establishing a single point of application for applicants
who are required to obtain concurrent licensure from more than one of the commissioners
listed in this clause.

(e) Unless otherwise specified in statute, the commissioner may conduct routine
inspections biennially.

new text begin (f) For a licensed child care center, the commissioner shall conduct one unannounced
licensing inspection at least annually.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 3.

Minnesota Statutes 2016, section 245A.10, subdivision 2, is amended to read:


Subd. 2.

County fees for background studies and licensing inspections.

(a) new text beginBefore
the implementation of NETStudy 2.0,
new text endfor purposes of family and group family child care
licensing under this chapter, a county agency may charge a fee to an applicant or license
holder to recover the actual cost of background studies, but in any case not to exceed $100
annually. A county agency may also charge a license fee to an applicant or license holder
not to exceed $50 for a one-year license or $100 for a two-year license.

(b) new text beginBefore the implementation of NETStudy 2.0, new text enda county agency may charge a fee to
a legal nonlicensed child care provider or applicant for authorization to recover the actual
cost of background studies completed under section 119B.125, but in any case not to exceed
$100 annually.

(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area;

(3) for new providers; or

(4) for providers who have attained at least 16 hours of training before seeking initial
licensure.

(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on an
installment basis for up to one year. If the provider is receiving child care assistance payments
from the state, the provider may have the fees under paragraph (a) or (b) deducted from the
child care assistance payments for up to one year and the state shall reimburse the county
for the county fees collected in this manner.

(e) For purposes of adult foster care and child foster care licensing, and licensing the
physical plant of a community residential setting, under this chapter, a county agency may
charge a fee to a corporate applicant or corporate license holder to recover the actual cost
of licensing inspections, not to exceed $500 annually.

(f) Counties may elect to reduce or waive the fees in paragraph (e) under the following
circumstances:

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area; or

(3) for new providers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 4.

Minnesota Statutes 2016, section 245A.14, is amended by adding a subdivision to
read:


new text begin Subd. 15. new text end

new text begin Parental access in child care programs. new text end

new text begin An enrolled child's parent or legal
guardian must be allowed access to the parent's or legal guardian's child any time while the
child is in care.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 5.

Minnesota Statutes 2016, section 245A.16, subdivision 1, is amended to read:


Subdivision 1.

Delegation of authority to agencies.

(a) County agencies and private
agencies that have been designated or licensed by the commissioner to perform licensing
functions and activities under section 245A.04 and background studies for family child care
under chapter 245C; to recommend denial of applicants under section 245A.05; to issue
correction orders, to issue variances, and recommend a conditional license under section
245A.06; or to recommend suspending or revoking a license or issuing a fine under section
245A.07, shall comply with rules and directives of the commissioner governing those
functions and with this section. The following variances are excluded from the delegation
of variance authority and may be issued only by the commissioner:

(1) dual licensure of family child care and child foster care, dual licensure of child and
adult foster care, and adult foster care and family child care;

(2) adult foster care maximum capacity;

(3) adult foster care minimum age requirement;

(4) child foster care maximum age requirement;

(5) variances regarding disqualified individuals except thatnew text begin, before the implementation
of NETStudy 2.0,
new text end county agencies may issue variances under section 245C.30 regarding
disqualified individuals when the county is responsible for conducting a consolidated
reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and
(b), of a county maltreatment determination and a disqualification based on serious or
recurring maltreatment;

(6) the required presence of a caregiver in the adult foster care residence during normal
sleeping hours; and

(7) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder.

Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must
not grant a license holder a variance to exceed the maximum allowable family child care
license capacity of 14 children.

(b) new text beginBefore the implementation of NETStudy 2.0, new text endcounty agencies must report information
about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision
2
, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the
commissioner at least monthly in a format prescribed by the commissioner.

(c) For family deleted text begindaydeleted text endnew text begin childnew text end care programs, the commissioner deleted text beginmay authorizedeleted text endnew text begin shall require
a county agency to conduct one unannounced
new text end licensing deleted text beginreviews every two years after a
licensee has had at least one annual
deleted text end reviewnew text begin at least annuallynew text end.

(d) For family adult day services programs, the commissioner may authorize licensing
reviews every two years after a licensee has had at least one annual review.

(e) A license issued under this section may be issued for up to two years.

(f) During implementation of chapter 245D, the commissioner shall consider:

(1) the role of counties in quality assurance;

(2) the duties of county licensing staff; and

(3) the possible use of joint powers agreements, according to section 471.59, with counties
through which some licensing duties under chapter 245D may be delegated by the
commissioner to the counties.

Any consideration related to this paragraph must meet all of the requirements of the corrective
action plan ordered by the federal Centers for Medicare and Medicaid Services.

(g) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or
successor provisions; and section 245D.061 or successor provisions, for family child foster
care programs providing out-of-home respite, as identified in section 245D.03, subdivision
1, paragraph (b), clause (1), is excluded from the delegation of authority to county and
private agencies.

new text begin (h) A county agency shall report to the commissioner, in a manner prescribed by the
commissioner, the following information for a licensed family child care program:
new text end

new text begin (1) the results of each licensing review completed, including the date of the review, any
licensing correction order issued; and
new text end

new text begin (2) any death, serious injury, or determination of substantiated maltreatment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 6.

Minnesota Statutes 2016, section 245A.16, is amended by adding a subdivision to
read:


new text begin Subd. 7. new text end

new text begin Family child care licensing oversight. new text end

new text begin Only county staff trained by the
commissioner on the family child care licensing standards in this chapter and Minnesota
Rules, chapter 9502, shall perform family child care licensing functions under subdivision
1. Training must occur within 90 days of a staff person's employment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 7.

Minnesota Statutes 2016, section 245A.40, subdivision 1, is amended to read:


Subdivision 1.

Orientation.

The child care center license holder must ensure that every
staff person and volunteer is given orientation training and successfully completes the
training before starting assigned duties. The orientation training in this subdivision applies
to volunteers who will have direct contact with or access to children and who are not under
the direct supervision of a staff person. Completion of the orientation must be documented
in the individual's personnel record. The orientation training must include information about:

(1) the center's philosophy, child care program, and procedures for maintaining health
and safetynew text begin according to section 245A.41 and Minnesota Rules, part 9503.0140,new text end and handling
emergencies and accidentsnew text begin according to Minnesota Rules, part 9503.0110new text end;

(2) specific job responsibilities;

(3) the behavior guidance standards in Minnesota Rules, part 9503.0055; and

(4) the reporting responsibilities in section 626.556, and Minnesota Rules, part 9503.0130.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 8.

Minnesota Statutes 2016, section 245A.40, subdivision 2, is amended to read:


Subd. 2.

Child deleted text begingrowth anddeleted text end developmentnew text begin and learningnew text end training.

(a) For purposes of
child care centers, the director and all staff hired after July 1, 2006, shall complete and
document at least two hours of child deleted text begingrowth anddeleted text end developmentnew text begin and learningnew text end training within
the first deleted text beginyeardeleted text endnew text begin 90 daysnew text end of employment. For purposes of this subdivision, "child deleted text begingrowth anddeleted text end
developmentnew text begin and learningnew text end training" means training in understanding how children deleted text beginacquire
language and
deleted text end develop physically, cognitively, emotionally, and sociallynew text begin and learn as part
of the children's family, culture, and community
new text end. Training completed under this subdivision
may be used to meet deleted text beginthe orientation training requirements under subdivision 1 anddeleted text end the
in-service training requirements under subdivision 7.

(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:

(1) have taken a three-credit college course on early childhood development within the
past five years;

(2) have received a baccalaureate or master's degree in early childhood education or
school-age child care within the past five years;

(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator,
a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood
special education teacher, or an elementary teacher with a kindergarten endorsement; or

(4) have received a baccalaureate degree with a Montessori certificate within the past
five years.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 9.

Minnesota Statutes 2016, section 245A.40, subdivision 3, is amended to read:


Subd. 3.

First aid.

(a) All teachers and assistant teachers in a child care center governed
by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least one staff person during
field trips and when transporting children in care, must satisfactorily complete new text beginpediatric
new text end first aid training within 90 days of the start of work, unless the training has been completed
within the previous deleted text beginthreedeleted text endnew text begin twonew text end years.

(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least
one staff person who has satisfactorily completed new text beginpediatric new text endfirst aid training must be present
at all times in the center, during field trips, and when transporting children in care.

(c) The new text beginpediatric new text endfirst aid training must be repeated at least every deleted text beginthreedeleted text endnew text begin twonew text end years,
documented in the person's personnel record and indicated on the center's staffing chart,
and provided by an individual approved as a first aid instructor. This training may be less
than eight hours.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 10.

Minnesota Statutes 2016, section 245A.40, subdivision 4, is amended to read:


Subd. 4.

Cardiopulmonary resuscitation.

(a) All teachers and assistant teachers in a
child care center governed by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least
one staff person during field trips and when transporting children in care, must satisfactorily
complete training in cardiopulmonary resuscitation (CPR) that includes CPR techniques
for infants and children and in the treatment of obstructed airways. The CPR training must
be completed within 90 days of the start of work, unless the training has been completed
within the previous deleted text beginthreedeleted text endnew text begin twonew text end years. The CPR training must have been provided by an
individual approved to provide CPR instruction, must be repeated at least once every deleted text beginthreedeleted text endnew text begin
two
new text end years, and must be documented in the staff person's records.

(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least
one staff person who has satisfactorily completed cardiopulmonary resuscitation training
must be present at all times in the center, during field trips, and when transporting children
in care.

(c) CPR training may be provided for less than four hours.

(d) Persons providing CPR training must use CPR training that has been developed:

(1) by the American Heart Association or the American Red Cross and incorporates
psychomotor skills to support the instruction; or

(2) using nationally recognized, evidence-based guidelines for CPR and incorporates
psychomotor skills to support the instruction.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 11.

Minnesota Statutes 2016, section 245A.40, subdivision 7, is amended to read:


Subd. 7.

In-service.

(a) A license holder must ensure that deleted text beginan annual in-service training
plan is developed and carried out and that it meets the requirements in clauses (1) to (7).
The in-service training plan must:
deleted text endnew text begin the center director and all staff who have direct contact
with a child complete annual in-service training. In-service training requirements must be
met by a staff person's participation in the following training areas:
new text end

deleted text begin (1) be consistent with the center's child care program plan;
deleted text end

deleted text begin (2) meet the training needs of individual staff persons as specified in each staff person's
annual evaluation report;
deleted text end

deleted text begin (3) provide training, at least one-fourth of which is by a resource not affiliated with the
license holder;
deleted text end

deleted text begin (4) include Minnesota Rules, parts 9503.0005 to 9503.0170, relevant to the staff person's
position and must occur within two weeks of initial employment;
deleted text end

deleted text begin (5) provide that at least one-half of the annual in-service training completed by a staff
person each year pertains to the age of children for which the person is providing care;
deleted text end

deleted text begin (6) provide that no more than four hours of each annual in-service training requirement
relate to administration, finances, and records training for a teacher, assistant teacher, or
aide; and
deleted text end

deleted text begin (7) provide that the remainder of the in-service training requirement be met by
participation in training in child growth and development; learning environment and
curriculum; assessment and planning for individual needs; interactions with children; families
and communities; health, safety, and nutrition; and program planning and evaluation.
deleted text end

new text begin (1) child development and learning;
new text end

new text begin (2) developmentally appropriate learning experiences;
new text end

new text begin (3) relationships with families;
new text end

new text begin (4) assessment, evaluation, and individualization;
new text end

new text begin (5) historical and contemporary development of early childhood education;
new text end

new text begin (6) professionalism; and
new text end

new text begin (7) health, safety, and nutrition.
new text end

(b) For purposes of this subdivision, the following terms have the meanings given them.

(1) "Child deleted text begingrowth anddeleted text end developmentnew text begin and learningnew text end training" has the meaning given it in
subdivision 2, paragraph (a).

deleted text begin (2) "Learning environment and curriculum" means training in establishing an environment
that provides learning experiences to meet each child's needs, capabilities, and interests,
including early childhood education methods or theory, recreation, sports, promoting
creativity in the arts, arts and crafts methods or theory, and early childhood special education
methods or theory.
deleted text end

deleted text begin (3) "Assessment and planning for individual needs" means training in observing and
assessing what children know and can do in order to provide curriculum and instruction
that addresses their developmental and learning needs, including children with special needs.
deleted text end

deleted text begin (4) "Interactions with children" means training in establishing supportive relationships
with children and guiding them as individuals and as part of a group, including child study
techniques and behavior guidance.
deleted text end

deleted text begin (5) "Families and communities" means training in working collaboratively with families,
agencies, and organizations to meet children's needs and to encourage the community's
involvement, including family studies and parent involvement.
deleted text end

deleted text begin (6) "Health, safety, and nutrition" means training in establishing and maintaining an
environment that ensures children's health, safety, and nourishment, including first aid,
cardiopulmonary resuscitation, child nutrition, and child abuse and neglect prevention.
deleted text end

deleted text begin (7) "Program planning and evaluation" means training in establishing, implementing,
evaluating, and enhancing program operations.
deleted text end

new text begin (2) "Developmentally appropriate learning experiences" means creating positive learning
experiences, promoting cognitive development, promoting social and emotional development,
promoting physical development, and promoting creative development.
new text end

new text begin (3) "Relationships with families" means training on building a positive, respectful
relationship with the child's family.
new text end

new text begin (4) "Assessment, evaluation, and individualization" means training in observing,
recording, and assessing development; assessing and using information to plan; and assessing
and using information to enhance and maintain program quality.
new text end

new text begin (5) "Historical and contemporary development of early childhood education" means
training in past and current practices in early childhood education and how current events
and issues affect children, families, and programs.
new text end

new text begin (6) "Professionalism" means training in knowledge, skills, and abilities that promote
ongoing professional development.
new text end

new text begin (7) "Health, safety, and nutrition" means training in establishing health practices, ensuring
safety, and providing healthy nutrition.
new text end

(c) The director and all program staff persons must annually complete a number of hours
of in-service training equal to at least two percent of the hours for which the director or
program staff person is annually paid, unless one of the following is applicable.

(1) A teacher at a child care center must complete one percent of working hours of
in-service training annually if the teacher:

(i) possesses a baccalaureate or master's degree in early childhood education or school-age
care;

(ii) is licensed in Minnesota as a prekindergarten teacher, an early childhood educator,
a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood
special education teacher, or an elementary teacher with a kindergarten endorsement; or

(iii) possesses a baccalaureate degree with a Montessori certificate.

(2) A teacher or assistant teacher at a child care center must complete one and one-half
percent of working hours of in-service training annually if the individual is:

(i) a registered nurse or licensed practical nurse with experience working with infants;

(ii) possesses a Montessori certificate, a technical college certificate in early childhood
development, or a child development associate certificate; or

(iii) possesses an associate of arts degree in early childhood education, a baccalaureate
degree in child development, or a technical college diploma in early childhood development.

(d) The number of required training hours may be prorated for individuals not employed
full time or for an entire year.

(e) The annual in-service training must be completed within the calendar year for which
it was required. In-service training completed by staff persons is transferable upon a staff
person's change in employment to another child care program.

(f) The license holder must ensure that, when a staff person completes in-service training,
the training is documented in the staff person's personnel record. The documentation must
include the date training was completed, the goal of the training and topics covered, trainer's
name and organizational affiliation, trainer's signed statement that training was successfully
completed, and the director's approval of the training.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 12.

Minnesota Statutes 2016, section 245A.40, is amended by adding a subdivision
to read:


new text begin Subd. 9. new text end

new text begin Ongoing health and safety training. new text end

new text begin A staff person's orientation training on
maintaining health and safety and handling emergencies and accidents, as required in
subdivision 1, must be repeated at least once each calendar year by each staff person. The
completion of the annual training must be documented in the staff person's personnel record.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 13.

new text begin [245A.41] CHILD CARE CENTER HEALTH AND SAFETY
REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Allergy prevention and response. new text end

new text begin (a) Before admitting a child for care,
the license holder must obtain documentation of any known allergy from the child's parent
or legal guardian or the child's source of medical care. If a child has a known allergy, the
license holder must maintain current information about the allergy in the child's record and
develop an individual child care program plan as specified in Minnesota Rules, part
9503.0065, subpart 3. The individual child care program plan must include but not be limited
to a description of the allergy, specific triggers, avoidance techniques, symptoms of an
allergic reaction, and procedures for responding to an allergic reaction, including medication,
dosages, and a doctor's contact information.
new text end

new text begin (b) The license holder must ensure that each staff person who is responsible for carrying
out the individual child care program plan review and follow the plan. Documentation of a
staff person's review must be kept on site.
new text end

new text begin (c) At least annually or following any changes made to allergy-related information in
the child's record, the license holder must update the child's individual child care program
plan and inform each staff person who is responsible for carrying out the individual child
care program plan of the change. The license holder must keep on site documentation that
a staff person was informed of a change.
new text end

new text begin (d) A child's allergy information must be available at all times including on site, when
on field trips, or during transportation. A child's food allergy information must be readily
available to a staff person in the area where food is prepared and served to the child.
new text end

new text begin (e) The license holder must contact the child's parent or legal guardian as soon as possible
in any instance of exposure or allergic reaction that requires medication or medical
intervention. The license holder must call emergency medical services when epinephrine
is administered to a child in the license holder's care.
new text end

new text begin Subd. 2. new text end

new text begin Handling and disposal of bodily fluids. new text end

new text begin The licensed child care center must
comply with the following procedures for safely handling and disposing of bodily fluids:
new text end

new text begin (1) surfaces that come in contact with potentially infectious bodily fluids, including
blood and vomit, must be cleaned and disinfected according to Minnesota Rules, part
9503.0005, subpart 11;
new text end

new text begin (2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
new text end

new text begin (3) sharp items used for a child with special care needs must be disposed of in a "sharps
container." The sharps container must be stored out of reach of a child;
new text end

new text begin (4) the license holder must have the following bodily fluid disposal supplies in the center:
disposable gloves, disposal bags, and eye protection; and
new text end

new text begin (5) the license holder must ensure that each staff person is trained on universal precautions
to reduce the risk of spreading infectious disease. A staff person's completion of the training
must be documented in the staff person's personnel record.
new text end

new text begin Subd. 3. new text end

new text begin Emergency preparedness. new text end

new text begin (a) No later than September 30, 2017, a licensed
child care center must have a written emergency plan for emergencies that require evacuation,
sheltering, or other protection of a child, such as fire, natural disaster, intruder, or other
threatening situation that may pose a health or safety hazard to a child. The plan must be
written on a form developed by the commissioner and must include:
new text end

new text begin (1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
new text end

new text begin (2) a designated relocation site and evacuation route;
new text end

new text begin (3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation,
shelter-in-place, or lockdown, including procedures for reunification with families;
new text end

new text begin (4) accommodations for a child with a disability or a chronic medical condition;
new text end

new text begin (5) procedures for storing a child's medically necessary medicine that facilitates easy
removal during an evacuation or relocation;
new text end

new text begin (6) procedures for continuing operations in the period during and after a crisis; and
new text end

new text begin (7) procedures for communicating with local emergency management officials, law
enforcement officials, or other appropriate state or local authorities.
new text end

new text begin (b) The license holder must train staff persons on the emergency plan at orientation,
when changes are made to the plan, and at least once each calendar year. Training must be
documented in each staff person's personnel file.
new text end

new text begin (c) The license holder must conduct drills according to the requirements in Minnesota
Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented.
new text end

new text begin (d) The license holder must review and update the emergency plan annually.
Documentation of the annual emergency plan review shall be maintained in the program's
administrative records.
new text end

new text begin (e) The license holder must include the emergency plan in the program's policies and
procedures as specified under section 245A.04, subdivision 14. The license holder must
provide a physical or electronic copy of the emergency plan to the child's parent or legal
guardian upon enrollment.
new text end

new text begin (f) The relocation site and evacuation route must be posted in a visible place as part of
the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140,
subpart 21.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 14.

Minnesota Statutes 2016, section 245A.50, subdivision 2, is amended to read:


Subd. 2.

Child deleted text begingrowth anddeleted text end developmentnew text begin and learningnew text end and behavior guidance
training.

(a) For purposes of family and group family child care, the license holder and
each adult caregiver who provides care in the licensed setting for more than 30 days in any
12-month period shall complete and document at least four hours of child growth and
deleted text begin developmentdeleted text endnew text begin learningnew text end and behavior guidance training prior to initial licensure, and before
caring for children. For purposes of this subdivision, "child deleted text begingrowth anddeleted text end developmentnew text begin and
learning
new text end training" means training in understanding how children deleted text beginacquire language anddeleted text end
develop physically, cognitively, emotionally, and sociallynew text begin and learn as part of the children's
family, culture, and community
new text end. "Behavior guidance training" means training in the
understanding of the functions of child behavior and strategies for managing challenging
situations. new text beginAt least two hours of new text endchild deleted text begingrowth anddeleted text end development andnew text begin learning ornew text end behavior
guidance training must be repeated annually. Training curriculum shall be developed or
approved by the commissioner of human services deleted text beginby January 1, 2014deleted text end.

(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:

(1) have taken a three-credit course on early childhood development within the past five
years;

(2) have received a baccalaureate or master's degree in early childhood education or
school-age child care within the past five years;

(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator,
a kindergarten to grade 6 teacher with a prekindergarten specialty, an early childhood special
education teacher, or an elementary teacher with a kindergarten endorsement; or

(4) have received a baccalaureate degree with a Montessori certificate within the past
five years.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 15.

Minnesota Statutes 2016, section 245A.50, subdivision 7, is amended to read:


Subd. 7.

Training requirements for family and group family child care.

For purposes
of family and group family child care, the license holder and each primary caregiver must
complete 16 hours of ongoing training each year. For purposes of this subdivision, a primary
caregiver is an adult caregiver who provides services in the licensed setting for more than
30 days in any 12-month period. Repeat of topical training requirements in subdivisions 2
to 8 shall count toward the annual 16-hour training requirement. Additional ongoing training
subjects to meet the annual 16-hour training requirement must be selected from the following
areas:

(1) child deleted text begingrowth anddeleted text end developmentnew text begin and learningnew text end training under subdivision 2, paragraph
(a);

deleted text begin (2) learning environment and curriculum, including training in establishing an
environment and providing activities that provide learning experiences to meet each child's
needs, capabilities, and interests;
deleted text end

deleted text begin (3) assessment and planning for individual needs, including training in observing and
assessing what children know and can do in order to provide curriculum and instruction
that addresses their developmental and learning needs, including children with special needs
and bilingual children or children for whom English is not their primary language;
deleted text end

deleted text begin (4) interactions with children, including training in establishing supportive relationships
with children, guiding them as individuals and as part of a group;
deleted text end

deleted text begin (5) families and communities, including training in working collaboratively with families
and agencies or organizations to meet children's needs and to encourage the community's
involvement;
deleted text end

deleted text begin (6) health, safety, and nutrition, including training in establishing and maintaining an
environment that ensures children's health, safety, and nourishment, including child abuse,
maltreatment, prevention, and reporting; home and fire safety; child injury prevention;
communicable disease prevention and control; first aid; and CPR;
deleted text end

deleted text begin (7) program planning and evaluation, including training in establishing, implementing,
evaluating, and enhancing program operations; and
deleted text end

deleted text begin (8) behavior guidance, including training in the understanding of the functions of child
behavior and strategies for managing behavior.
deleted text end

new text begin (2) developmentally appropriate learning experiences, including training in creating
positive learning experiences, promoting cognitive development, promoting social and
emotional development, promoting physical development, promoting creative development;
and behavior guidance;
new text end

new text begin (3) relationships with families, including training in building a positive, respectful
relationship with the child's family;
new text end

new text begin (4) assessment, evaluation, and individualization, including training in observing,
recording, and assessing development; assessing and using information to plan; and assessing
and using information to enhance and maintain program quality;
new text end

new text begin (5) historical and contemporary development of early childhood education, including
training in past and current practices in early childhood education and how current events
and issues affect children, families, and programs;
new text end

new text begin (6) professionalism, including training in knowledge, skills, and abilities that promote
ongoing professional development; and
new text end

new text begin (7) health, safety, and nutrition, including training in establishing healthy practices;
ensuring safety; and providing healthy nutrition.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 16.

Minnesota Statutes 2016, section 245A.50, subdivision 9, is amended to read:


Subd. 9.

Supervising for safety; training requirement.

deleted text beginEffective July 1, 2014deleted text endnew text begin (a)
Before initial licensure and before caring for a child
new text end, all family child care license holders
and each adult caregiver who provides care in the licensed family child care home for more
than 30 days in any 12-month period shall complete and document deleted text beginat least six hours of
approved training on supervising for safety prior to initial licensure, and before caring for
children. At least two hours of training on supervising for safety must be repeated annually.
For purposes of this subdivision, "supervising for safety" includes supervision basics,
supervision outdoors, equipment and materials, illness, injuries, and disaster preparedness.
The commissioner shall develop the supervising for safety curriculum by January 1, 2014.
deleted text endnew text begin
the completion of the six-hour Supervising for Safety for Family Child Care course developed
by the commissioner.
new text end

new text begin (b) The family child care license holder and each adult caregiver who provides care in
the licensed family child care home for more than 30 days in any 12-month period shall
complete and document:
new text end

new text begin (1) the annual completion of a two-hour active supervision course developed by the
commissioner; and
new text end

new text begin (2) the completion at least once every five years of the two-hour courses Health and
Safety I and Health and Safety II. A license holder's or adult caregiver's completion of either
training in a given year meets the annual active supervision training requirement in clause
(1).
new text end

Sec. 17.

new text begin [245A.51] FAMILY CHILD CARE HEALTH AND SAFETY
REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Allergy prevention and response. new text end

new text begin (a) Before admitting a child for care,
the license holder must obtain information about any known allergy from the child's parent
or legal guardian. The license holder must maintain current allergy information in each
child's record. The allergy information must include a description of the allergy, specific
triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for
responding to an allergic reaction, including medication, dosages, and a doctor's contact
information.
new text end

new text begin (b) The child's allergy information must be documented on a form approved by the
commissioner, readily available to all caregivers, and reviewed annually by the license
holder and each caregiver.
new text end

new text begin Subd. 2. new text end

new text begin Handling and disposal of bodily fluids. new text end

new text begin The licensed family child care provider
must comply with the following procedures for safely handling and disposing of bodily
fluids:
new text end

new text begin (1) surfaces that come in contact with potentially infectious bodily fluids, including
blood and vomit, must be cleaned and disinfected as described in section 245A.148;
new text end

new text begin (2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
new text end

new text begin (3) sharp items used for a child with special care needs must be disposed of in a "sharps
container." The sharps container must be stored out of reach of a child; and
new text end

new text begin (4) the license holder must have the following bodily fluid disposal supplies available:
disposable gloves, disposal bags, and eye protection.
new text end

new text begin Subd. 3. new text end

new text begin Emergency preparedness plan. new text end

new text begin (a) No later than September 30, 2017, a
licensed family child care provider must have a written emergency preparedness plan for
emergencies that require evacuation, sheltering, or other protection of children, such as fire,
natural disaster, intruder, or other threatening situation that may pose a health or safety
hazard to children. The plan must be written on a form developed by the commissioner and
updated at least annually. The plan must include:
new text end

new text begin (1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
new text end

new text begin (2) a designated relocation site and evacuation route;
new text end

new text begin (3) procedures for notifying a child's parent or legal guardian of the evacuation,
shelter-in-place, or lockdown, including procedures for reunification with families;
new text end

new text begin (4) accommodations for a child with a disability or a chronic medical condition;
new text end

new text begin (5) procedures for storing a child's medically necessary medicine that facilitate easy
removal during an evacuation or relocation;
new text end

new text begin (6) procedures for continuing operations in the period during and after a crisis; and
new text end

new text begin (7) procedures for communicating with local emergency management officials, law
enforcement officials, or other appropriate state or local authorities.
new text end

new text begin (b) The license holder must train caregivers before the caregiver provides care and at
least annually on the emergency preparedness plan and document completion of this training.
new text end

new text begin (c) The license holder must conduct drills according to the requirements in Minnesota
Rules, part 9502.0435, subpart 8. The date and time of the drills must be documented.
new text end

new text begin (d) The license holder must have the emergency preparedness plan available for review
and posted in a prominent location. The license holder must provide a physical or electronic
copy of the plan to the child's parent or legal guardian upon enrollment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 18.

Minnesota Statutes 2016, section 245C.02, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Child care staff person. new text end

new text begin "Child care staff person" means an individual other
than an individual who is related to all children for whom child care services are provided
and:
new text end

new text begin (1) who is employed by a child care provider for compensation;
new text end

new text begin (2) whose activities involve the care or supervision of a child for a child care provider
or unsupervised access to a child who is cared for or supervised by a child care provider;
or
new text end

new text begin (3) an individual 13 years of age or older residing in a licensed family child care home
or legal nonlicensed child care program.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 19.

Minnesota Statutes 2016, section 245C.03, subdivision 1, is amended to read:


Subdivision 1.

Licensed programs.

(a) The commissioner shall conduct a background
study on:

(1) the person or persons applying for a license;

(2) an individual age 13 and over living in the household where the licensed program
will be provided who is not receiving licensed services from the program;

(3) current or prospective employees or contractors of the applicant who will have direct
contact with persons served by the facility, agency, or program;

(4) volunteers or student volunteers who will have direct contact with persons served
by the program to provide program services if the contact is not under the continuous, direct
supervision by an individual listed in clause (1) or (3);

(5) an individual age ten to 12 living in the household where the licensed services will
be provided when the commissioner has reasonable cause;

(6) an individual who, without providing direct contact services at a licensed program,
may have unsupervised access to children or vulnerable adults receiving services from a
program, when the commissioner has reasonable cause; deleted text beginand
deleted text end

(7) all deleted text beginmanagerial officialsdeleted text endnew text begin controlling individualsnew text end as defined deleted text beginunderdeleted text endnew text begin innew text end section 245A.02,
subdivision 5a
deleted text begin.deleted text endnew text begin; and
new text end

new text begin (8) child care staff persons as defined in section 245C.02, subdivision 6a.
new text end

new text begin (b) Paragraph (a), clauses (5) and (6), apply to legal nonlicensed child care and certified
license-exempt child care programs.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end For family child foster care settings, a short-term substitute caregiver providing
direct contact services for a child for less than 72 hours of continuous care is not required
to receive a background study under this chapter.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective when the Department of Human Services
implements NETStudy 2.0 or October 1, 2017, whichever is later. The commissioner of
human services shall notify the revisor of statutes when the department implements
NETStudy 2.0.
new text end

Sec. 20.

Minnesota Statutes 2016, section 245C.03, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Legal nonlicensed and certified child care programs. new text end

new text begin The commissioner
shall conduct background studies on an individual required under sections 119B.125 and
245G.10 to complete a background study under this chapter.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 21.

Minnesota Statutes 2016, section 245C.04, subdivision 1, is amended to read:


Subdivision 1.

Licensed programsnew text begin; other child care programsnew text end.

(a) The commissioner
shall conduct a background study of an individual required to be studied under section
245C.03, subdivision 1, at least upon application for initial license for all license types.

(b) The commissioner shall conduct a background study of an individual required to be
studied under section 245C.03, subdivision 1,new text begin including a child care staff person as defined
in section 245C.02, subdivision 6a, in a family child care program, licensed child care center,
certified license-exempt child care center, or legal nonlicensed child care provider, on a
schedule determined by the commissioner. The background study must include submission
of fingerprints for a national criminal history record check and a review of the information
under section 245C.08. A background study for a child care program must be repeated
within five years from the most recent study conducted under this paragraph.
new text end

new text begin (c)new text end At reapplication deleted text beginfor a licensedeleted text end for new text begina new text endfamily child caredeleted text begin.deleted text endnew text begin license:
new text end

new text begin (1) for a background study affiliated with a licensed family child care center or legal
nonlicensed child care provider, the individual shall provide information required under
section 245C.05, subdivision 1, paragraphs (a), (b), and (d), to the county agency, and be
fingerprinted and photographed under section 245C.05, subdivision 5;
new text end

new text begin (2) the county agency shall verify the information received under clause (1) and forward
the information to the commissioner to complete the background study; and
new text end

new text begin (3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end The commissioner is not required to conduct a study of an individual at the time
of reapplication for a license if the individual's background study was completed by the
commissioner of human services and the following conditions are met:

(1) a study of the individual was conducted either at the time of initial licensure or when
the individual became affiliated with the license holder;

(2) the individual has been continuously affiliated with the license holder since the last
study was conducted; and

(3) the last study of the individual was conducted on or after October 1, 1995.

deleted text begin (d)deleted text endnew text begin (e)new text end The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6),
who is newly affiliated with a child foster care license holder. The county or private agency
shall collect and forward to the commissioner the information required under section 245C.05,
subdivisions 1
and 5. The background study conducted by the commissioner of human
services under this paragraph must include a review of the information required under
section 245C.08, subdivisions 1, 3, and 4.

deleted text begin (e)deleted text endnew text begin (f)new text end The commissioner shall conduct a background study of an individual specified
under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated
with an adult foster care or family adult day servicesnew text begin and with a family child carenew text end license
holdernew text begin or a legal nonlicensed child care provider authorized under chapter 119Bnew text end: (1) the
county shall collect and forward to the commissioner the information required under section
245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) deleted text beginanddeleted text endnew text begin,new text end (b),new text begin
and (d),
new text end for background studies conducted by the commissioner for all family adult day
services deleted text beginanddeleted text endnew text begin,new text end for adult foster care when the adult foster care license holder resides in the
adult foster care residencenew text begin, and for family child care and legal nonlicensed child care
authorized under chapter 119B
new text end; (2) the license holder shall collect and forward to the
commissioner the information required under section 245C.05, subdivisions 1, paragraphs
(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the
commissioner for adult foster care when the license holder does not reside in the adult foster
care residence; and (3) the background study conducted by the commissioner under this
paragraph must include a review of the information required under section 245C.08,
subdivision 1
, paragraph (a), and subdivisions 3 and 4.

deleted text begin (f)deleted text endnew text begin (g)new text end Applicants for licensure, license holders, and other entities as provided in this
chapter must submit completed background study requests to the commissioner using the
electronic system known as NETStudy before individuals specified in section 245C.03,
subdivision 1
, begin positions allowing direct contact in any licensed program.

deleted text begin (g)deleted text endnew text begin (h)new text end For an individual who is not on the entity's active roster, the entity must initiate
a new background study through NETStudy when:

(1) an individual returns to a position requiring a background study following an absence
of 120 or more consecutive days; or

(2) a program that discontinued providing licensed direct contact services for 120 or
more consecutive days begins to provide direct contact licensed services again.

The license holder shall maintain a copy of the notification provided to the commissioner
under this paragraph in the program's files. If the individual's disqualification was previously
set aside for the license holder's program and the new background study results in no new
information that indicates the individual may pose a risk of harm to persons receiving
services from the license holder, the previous set-aside shall remain in effect.

deleted text begin (h)deleted text endnew text begin (i)new text end For purposes of this section, a physician licensed under chapter 147 is considered
to be continuously affiliated upon the license holder's receipt from the commissioner of
health or human services of the physician's background study results.

deleted text begin (i)deleted text endnew text begin (j)new text end For purposes of family child care, a substitute caregiver must receive repeat
background studies at the time of each license renewal.

new text begin (k) A repeat background study at the time of license renewal is not required if the family
child care substitute caregiver's background study was completed by the commissioner on
or after October 1, 2017, and the substitute caregiver is on the license holder's active roster
in NETStudy 2.0.
new text end

new text begin (l) Before and after school programs authorized under chapter 119B, are exempt from
the background study requirements under section123B.03, or an employee for whom a
background study under this chapter has been completed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 22.

Minnesota Statutes 2016, section 245C.04, subdivision 8, is amended to read:


Subd. 8.

Current or prospective contractors serving multiple family child care
license holders.

new text begin(a) Before the implementation of NETStudy 2.0, new text endcurrent or prospective
contractors who are required to have a background study under section 245C.03, subdivision
1
, who provide services for multiple family child care license holders in a single county,
and will have direct contact with children served in the family child care setting are required
to have only one background study which is transferable to all family child care programs
in that county if:

(1) the county agency maintains a record of the contractor's background study results
which verify the contractor is approved to have direct contact with children receiving
services;

(2) the license holder contacts the county agency and obtains notice that the current or
prospective contractor is in compliance with background study requirements and approved
to have direct contact; and

(3) the contractor's background study is repeated every two years.

new text begin (b) For a family child care license holder operating under NETStudy 2.0, the license
holder's active roster shall be the system used to document when a background study subject
is affiliated with the license holder.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 23.

Minnesota Statutes 2016, section 245C.05, subdivision 2b, is amended to read:


Subd. 2b.

County agency to collect and forward information to commissioner.

new text begin(a)
new text end For background studies related to all family adult day services and to adult foster care when
the adult foster care license holder resides in the adult foster care residence, the county
agency must collect the information required under subdivision 1 and forward it to the
commissioner.

new text begin (b) Upon implementation of NETStudy 2.0, for background studies related to family
child care and legal nonlicensed child care authorized under chapter 119B, the county agency
must collect the information required under subdivision 1 and provide the information to
the commissioner.
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. 24.

Minnesota Statutes 2016, section 245C.05, subdivision 4, is amended to read:


Subd. 4.

Electronic transmission.

(a) For background studies conducted by the
Department of Human Services, the commissioner shall implement a secure system for the
electronic transmission of:

(1) background study information to the commissioner;

(2) background study results to the license holder;

(3) background study results to county and private agencies for background studies
conducted by the commissioner for child foster care; and

(4) background study results to county agencies for background studies conducted by
the commissioner for adult foster care and family adult day servicesnew text begin and, upon
implementation of NETStudy 2.0, family child care and legal nonlicensed child care
authorized under chapter 119B
new text end.

(b) Unless the commissioner has granted a hardship variance under paragraph (c), a
license holder or an applicant must use the electronic transmission system known as
NETStudy or NETStudy 2.0 to submit all requests for background studies to the
commissioner as required by this chapter.

(c) A license holder or applicant whose program is located in an area in which high-speed
Internet is inaccessible may request the commissioner to grant a variance to the electronic
transmission requirement.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2016, section 245C.05, subdivision 5, is amended to read:


Subd. 5.

Fingerprints and photograph.

(a) Before the implementation of NETStudy
2.0, except as provided in paragraph (c), for any background study completed under this
chapter, when the commissioner has reasonable cause to believe that further pertinent
information may exist on the subject of the background study, the subject shall provide the
commissioner with a set of classifiable fingerprints obtained from an authorized agency.

(b) Before the implementation of NETStudy 2.0, for purposes of requiring fingerprints,
the commissioner has reasonable cause when, but not limited to, the:

(1) information from the Bureau of Criminal Apprehension indicates that the subject is
a multistate offender;

(2) information from the Bureau of Criminal Apprehension indicates that multistate
offender status is undetermined; or

(3) commissioner has received a report from the subject or a third party indicating that
the subject has a criminal history in a jurisdiction other than Minnesota.

(c) Notwithstanding paragraph (d), for background studies conducted by the commissioner
for child foster care, adoptions, or a transfer of permanent legal and physical custody of a
child, the subject of the background study, who is 18 years of age or older, shall provide
the commissioner with a set of classifiable fingerprints obtained from an authorized agencynew text begin
for a national criminal history record check
new text end.

(d) For background studies initiated on or after the implementation of NETStudy 2.0,
every subject of a background study must provide the commissioner with a set of the
background study subject's classifiable fingerprints and photograph. The photograph and
fingerprints must be recorded at the same time by the commissioner's authorized fingerprint
collection vendor and sent to the commissioner through the commissioner's secure data
system described in section 245C.32, subdivision 1a, paragraph (b). The fingerprints shall
not be retained by the Department of Public Safety, Bureau of Criminal Apprehension, or
the commissioner, but will be retained by the Federal Bureau of Investigation. The
commissioner's authorized fingerprint collection vendor shall, for purposes of verifying the
identity of the background study subject, be able to view the identifying information entered
into NETStudy 2.0 by the entity that initiated the background study, but shall not retain the
subject's fingerprints, photograph, or information from NETStudy 2.0. The authorized
fingerprint collection vendor shall retain no more than the name and date and time the
subject's fingerprints were recorded and sent, only as necessary for auditing and billing
activities.

new text begin (e) When specifically required by law, fingerprints collected under this section must be
submitted for a national criminal history record check.
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. 26.

Minnesota Statutes 2016, section 245C.05, subdivision 7, is amended to read:


Subd. 7.

Probation officer and corrections agent.

(a) A probation officer or corrections
agent shall notify the commissioner of an individual's conviction if the individual:

(1) has been affiliated with a program or facility regulated by the Department of Human
Services or Department of Health, a facility serving children or youth licensed by the
Department of Corrections, or any type of home care agency or provider of personal care
assistance services within the preceding year; and

(2) has been convicted of a crime constituting a disqualification under section 245C.14.

(b) For the purpose of this subdivision, "conviction" has the meaning given it in section
609.02, subdivision 5.

(c) The commissioner, in consultation with the commissioner of corrections, shall develop
forms and information necessary to implement this subdivision and shall provide the forms
and information to the commissioner of corrections for distribution to local probation officers
and corrections agents.

(d) The commissioner shall inform individuals subject to a background study that criminal
convictions for disqualifying crimes deleted text beginwilldeleted text endnew text begin shallnew text end be reported to the commissioner by the
corrections system.

(e) A probation officer, corrections agent, or corrections agency is not civilly or criminally
liable for disclosing or failing to disclose the information required by this subdivision.

(f) Upon receipt of disqualifying information, the commissioner shall provide the notice
required under section 245C.17, as appropriate, to agencies on record as having initiated a
background study or making a request for documentation of the background study status
of the individual.

(g) This subdivision does not apply to family child care programsnew text begin or legal nonlicensed
child care programs for individuals whose background study was completed in NETStudy
2.0
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. 27.

Minnesota Statutes 2016, 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 deleted text beginfrom the national crime information
system
deleted text endnew text begin received as a result of submission of fingerprints for a national criminal history
record check,
new text end when the commissioner has reasonable cause as defined under section 245C.05,
subdivision 5, or as required under section 144.057, subdivision 1, clause (2); deleted text beginand
deleted text end

(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,new text begin and for a background study required for family child care, certified
license-exempt child care, child care centers, and legal nonlicensed child care authorized
under chapter 119B,
new text end 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) deleted text begininformation from national crime information databases,deleted text end when the background study
subject is 18 years of age or olderdeleted text begin.deleted text endnew text begin, information received following submission of fingerprints
for a national criminal history record check; and
new text end

new text begin (7) for a background study required for family child care, certified license-exempt child
care centers, licensed child care centers, and legal nonlicensed child care authorized under
chapter 119B, the background study shall also include a name and date-of-birth search of
the National Sex Offender Public Web site.
new text end

(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.

(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 begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 28.

Minnesota Statutes 2016, section 245C.08, subdivision 2, is amended to read:


Subd. 2.

Background studies conducted by a county agencynew text begin for family child carenew text end.

(a) new text beginBefore the implementation of NETStudy 2.0, new text endfor a background study conducted by a
county agency for family child care services, the commissioner shall review:

(1) information from the county agency's record of substantiated maltreatment of adults
and the maltreatment of minors;

(2) information from juvenile courts as required in subdivision 4 for:

(i) individuals listed in section 245C.03, subdivision 1, paragraph (a), who are ages 13
through 23 living in the household where the licensed services will be provided; and

(ii) any other individual listed under section 245C.03, subdivision 1, when there is
reasonable cause; and

(3) information from the Bureau of Criminal Apprehension.

(b) If the individual has resided in the county for less than five years, the study shall
include the records specified under paragraph (a) for the previous county or counties of
residence for the past five years.

(c) Notwithstanding expungement by a court, the county agency may consider information
obtained under paragraph (a), clause (3), unless the commissioner received notice of the
petition for expungement and the court order for expungement is directed specifically to
the commissioner.

new text begin EFFECTIVE DATE. new text end

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

Sec. 29.

Minnesota Statutes 2016, section 245C.08, subdivision 4, is amended to read:


Subd. 4.

Juvenile court records.

(a) For a background study conducted by the
Department of Human Services, the commissioner shall review records from the juvenile
courts for an individual studied under section 245C.03, subdivision 1, paragraph (a), when
the commissioner has reasonable cause.

(b) For a background study conducted by a county agencynew text begin for family child care before
the implementation of NETStudy 2.0
new text end, the commissioner shall review records from the
juvenile courts for individuals listed in section 245C.03, subdivision 1, who are ages 13
through 23 living in the household where the licensed services will be provided. The
commissioner shall also review records from juvenile courts for any other individual listed
under section 245C.03, subdivision 1, when the commissioner has reasonable cause.

(c) The juvenile courts shall help with the study by giving the commissioner existing
juvenile court records relating to delinquency proceedings held on individuals described in
section 245C.03, subdivision 1, paragraph (a), when requested pursuant to this subdivision.

(d) For purposes of this chapter, a finding that a delinquency petition is proven in juvenile
court shall be considered a conviction in state district court.

(e) Juvenile courts shall provide orders of involuntary and voluntary termination of
parental rights under section 260C.301 to the commissioner upon request for purposes of
conducting a background study under this chapter.

new text begin EFFECTIVE DATE. new text end

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

Sec. 30.

Minnesota Statutes 2016, section 245C.09, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin False statement in connection with a background study. new text end

new text begin A child care staff
person shall be disqualified for knowingly making a materially false statement in connection
with a background study.
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 2016, section 245C.10, subdivision 9, is amended to read:


Subd. 9.

Human services licensed programs.

The commissioner shall recover the cost
of background studies required under section 245C.03, subdivision 1, for all programs that
are licensed by the commissioner, except child foster care deleted text beginanddeleted text endnew text begin,new text end family child care,new text begin child care
centers, certified license-exempt child care centers, and legal nonlicensed child care
authorized under chapter 119B,
new text end through a fee of no more than $20 per study charged to the
license holder. The fees collected under this subdivision are appropriated to the commissioner
for the purpose of conducting background studies.

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 2016, section 245C.10, is amended by adding a subdivision
to read:


new text begin Subd. 9a. new text end

new text begin Child care programs. new text end

new text begin The commissioner shall recover the cost of a background
study required for family child care, certified license-exempt child care centers, licensed
child care centers, and legal nonlicensed child care providers authorized under chapter 119B
through a fee of no more than $40 per study charged to the license holder. The fees collected
under this subdivision are appropriated to the commissioner to conduct background studies.
new text end

Sec. 33.

Minnesota Statutes 2016, section 245C.11, subdivision 3, is amended to read:


Subd. 3.

Criminal history data.

County agencies shall have access to the criminal
history data in the same manner as county licensing agencies under this chapter for purposes
of background studies completednew text begin before the implementation of NETStudy 2.0new text end by county
agencies on legal nonlicensed child care providers to determine eligibility for child care
funds under chapter 119B.

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.

Minnesota Statutes 2016, section 245C.15, subdivision 1, is amended to read:


Subdivision 1.

Permanent disqualification.

(a) An individual is disqualified under
section 245C.14 if: (1) regardless of how much time has passed since the discharge of the
sentence imposed, if any, for the offense; and (2) unless otherwise specified, regardless of
the level of the offense, the individual has committed any of the following offenses: sections
243.166 (violation of predatory offender registration law); 609.185 (murder in the first
degree); 609.19 (murder in the second degree); 609.195 (murder in the third degree); 609.20
(manslaughter in the first degree); 609.205 (manslaughter in the second degree); a felony
offense under 609.221 or 609.222 (assault in the first or second degree); a felony offense
under sections 609.2242 and 609.2243 (domestic assault), spousal abuse, child abuse or
neglect, or a crime against children; 609.2247 (domestic assault by strangulation); 609.228
(great bodily harm caused by distribution of drugs); 609.245 (aggravated robbery); 609.25
(kidnapping); 609.2661 (murder of an unborn child in the first degree); 609.2662 (murder
of an unborn child in the second degree); 609.2663 (murder of an unborn child in the third
degree); 609.322 (solicitation, inducement, and promotion of prostitution); 609.324,
subdivision 1
(other prohibited acts); 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); 609.3451
(criminal sexual conduct in the fifth degree); 609.3453 (criminal sexual predatory conduct);
609.352 (solicitation of children to engage in sexual conduct); 609.365 (incest); a felony
offense under 609.377 (malicious punishment of a child); a felony offense under 609.378
(neglect or endangerment of a child); 609.561 (arson in the first degree); 609.66, subdivision
1e
(drive-by shooting); 609.749, subdivision 3, 4, or 5 (felony-level stalking); 609.855,
subdivision 5
(shooting at or in a public transit vehicle or facility); 617.23, subdivision 2,
clause (1), or subdivision 3, clause (1) (indecent exposure involving a minor); 617.246 (use
of minors in sexual performance prohibited); deleted text beginordeleted text end 617.247 (possession of pictorial
representations of minors)new text begin; or, for a child care staff person, conviction of a crime that would
make the individual ineligible for employment under United States Code, title 42, section
9858F, regardless of whether a period of disqualification under subdivisions 2 to 4, would
apply if the individual were not a child care staff person
new text end.

(b) An individual's aiding and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes,
permanently disqualifies the individual under section 245C.14.

(c) An individual's offense in any other state or country, where the elements of the offense
are substantially similar to any of the offenses listed in paragraph (a), permanently disqualifies
the individual under section 245C.14.

(d) When a disqualification is based on a judicial determination other than a conviction,
the disqualification period begins from the date of the court order. When a disqualification
is based on an admission, the disqualification period begins from the date of an admission
in court. When a disqualification is based on an Alford Plea, the disqualification period
begins from the date the Alford Plea is entered in court. When a disqualification is based
on a preponderance of evidence of a disqualifying act, the disqualification date begins from
the date of the dismissal, the date of discharge of the sentence imposed for a conviction for
a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

(e) If the individual studied commits one of the offenses listed in paragraph (a) that is
specified as a felony-level only offense, but the sentence or level of offense is a gross
misdemeanor or misdemeanor, the individual is disqualified, but the disqualification
look-back period for the offense is the period applicable to gross misdemeanor or
misdemeanor offenses.

new text begin (f) A child care staff person shall be disqualified as long as the individual is registered,
or required to be registered, on a state sex offender registry or repository or the National
Sex Offender Registry.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 35.

Minnesota Statutes 2016, section 245C.16, subdivision 1, is amended to read:


Subdivision 1.

Determining immediate risk of harm.

(a) If the commissioner determines
that the individual studied has a disqualifying characteristic, the commissioner shall review
the information immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will have direct
contact with, or access to, people receiving services.

(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:

(1) the recency of the disqualifying characteristic;

(2) the recency of discharge from probation for the crimes;

(3) the number of disqualifying characteristics;

(4) the intrusiveness or violence of the disqualifying characteristic;

(5) the vulnerability of the victim involved in the disqualifying characteristic;

(6) the similarity of the victim to the persons served by the program where the individual
studied will have direct contact;

(7) whether the individual has a disqualification from a previous background study that
has not been set aside; and

(8) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 1,new text begin or the individual is a child care staff
person who has a felony-level conviction for a drug-related offense in the last five years,
new text end
the commissioner may order the immediate removal of the individual from any position
allowing direct contact with, or access to, persons receiving services from the program.

(c) This section does not apply when the subject of a background study is regulated by
a health-related licensing board as defined in chapter 214, and the subject is determined to
be responsible for substantiated maltreatment under section 626.556 or 626.557.

(d) This section does not apply to a background study related to an initial application
for a child foster care license.

(e) Except for paragraph (f), this section does not apply to a background study that is
also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
personal care assistant or a qualified professional as defined in section 256B.0659,
subdivision 1
.

(f) If the commissioner has reason to believe, based on arrest information or an active
maltreatment investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously supervised
or immediately removed pending the conclusion of the maltreatment investigation or criminal
proceedings.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 36.

Minnesota Statutes 2016, section 245C.17, subdivision 6, is amended to read:


Subd. 6.

Notice to county agency.

For studies on individuals related to a license to
provide adult foster care and family adult day servicesnew text begin and, effective upon implementation
of NETStudy 2.0, family child care and legal nonlicensed child care authorized under chapter
119B
new text end, the commissioner shall also provide a notice of the background study results to the
county agency that initiated the background study.

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Minnesota Statutes 2016, section 245C.21, subdivision 1, is amended to read:


Subdivision 1.

Who may request reconsideration.

An individual who is the subject of
a disqualification may request a reconsideration of the disqualificationnew text begin pursuant to this
section
new text end. The individual must submit the request for reconsideration to the commissioner in
writing.

new text begin EFFECTIVE DATE. new text end

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

Sec. 38.

Minnesota Statutes 2016, section 245C.22, subdivision 5, is amended to read:


Subd. 5.

Scope of set-aside.

(a) If the commissioner sets aside a disqualification under
this section, the disqualified individual remains disqualified, but may hold a license and
have direct contact with or access to persons receiving services. Except as provided in
paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the
licensed program, applicant, or agency specified in the set aside notice under section 245C.23.
For personal care provider organizations, the commissioner's set-aside may further be limited
to a specific individual who is receiving services. For new background studies required
under section 245C.04, subdivision 1, paragraph deleted text begin(g)deleted text endnew text begin (h)new text end, if an individual's disqualification
was previously set aside for the license holder's program and the new background study
results in no new information that indicates the individual may pose a risk of harm to persons
receiving services from the license holder, the previous set-aside shall remain in effect.

(b) If the commissioner has previously set aside an individual's disqualification for one
or more programs or agencies, and the individual is the subject of a subsequent background
study for a different program or agency, the commissioner shall determine whether the
disqualification is set aside for the program or agency that initiated the subsequent
background study. A notice of a set-aside under paragraph (c) shall be issued within 15
working days if all of the following criteria are met:

(1) the subsequent background study was initiated in connection with a program licensed
or regulated under the same provisions of law and rule for at least one program for which
the individual's disqualification was previously set aside by the commissioner;

(2) the individual is not disqualified for an offense specified in section 245C.15,
subdivision 1 or 2;

(3) the commissioner has received no new information to indicate that the individual
may pose a risk of harm to any person served by the program; and

(4) the previous set-aside was not limited to a specific person receiving services.

(c) When a disqualification is set aside under paragraph (b), the notice of background
study results issued under section 245C.17, in addition to the requirements under section
245C.17, shall state that the disqualification is set aside for the program or agency that
initiated the subsequent background study. The notice must inform the individual that the
individual may request reconsideration of the disqualification under section 245C.21 on the
basis that the information used to disqualify the individual is incorrect.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 39.

Minnesota Statutes 2016, section 245C.22, subdivision 7, is amended to read:


Subd. 7.

Classification of certain data.

(a) Notwithstanding section 13.46, except as
provided in paragraph (f), upon setting aside a disqualification under this section, the identity
of the disqualified individual who received the set-aside and the individual's disqualifying
characteristics are public data if the set-aside was:

(1) for any disqualifying characteristic under section 245C.15,new text begin except a felony-level
conviction for a drug-related offense within the past five years,
new text end when the set-aside relates
to a child care center or a family child care provider licensed under chapter 245Anew text begin, certified
license-exempt child care center, or legal nonlicensed family child care
new text end; or

(2) for a disqualifying characteristic under section 245C.15, subdivision 2.

(b) Notwithstanding section 13.46, upon granting a variance to a license holder under
section 245C.30, the identity of the disqualified individual who is the subject of the variance,
the individual's disqualifying characteristics under section 245C.15, and the terms of the
variance are public data, new text beginexcept as provided in paragraph (c), clause (6), new text endwhen the variance:

(1) is issued to a child care center or a family child care provider licensed under chapter
245A; or

(2) relates to an individual with a disqualifying characteristic under section 245C.15,
subdivision 2
.

(c) The identity of a disqualified individual and the reason for disqualification remain
private data when:

(1) a disqualification is not set aside and no variance is granted, except as provided under
section 13.46, subdivision 4;

(2) the data are not public under paragraph (a) or (b);

(3) the disqualification is rescinded because the information relied upon to disqualify
the individual is incorrect;

(4) the disqualification relates to a license to provide relative child foster care. As used
in this clause, "relative" has the meaning given it under section 260C.007, subdivision 26b
or 27; deleted text beginor
deleted text end

(5) the disqualified individual is a household member of a licensed foster care provider
and:

(i) the disqualified individual previously received foster care services from this licensed
foster care provider;

(ii) the disqualified individual was subsequently adopted by this licensed foster care
provider; and

(iii) the disqualifying act occurred before the adoptionnew text begin; or
new text end

new text begin (6) a variance is granted to a child care center or family child care license holder for an
individual's disqualification that is based on a felony-level conviction for a drug-related
offense that occurred within the past five years
new text end.

(d) Licensed family child care providers and child care centers must provide notices as
required under section 245C.301.

(e) Notwithstanding paragraphs (a) and (b), the identity of household members who are
the subject of a disqualification related set-aside or variance is not public data if:

(1) the household member resides in the residence where the family child care is provided;

(2) the subject of the set-aside or variance is under the age of 18 years; and

(3) the set-aside or variance only relates to a disqualification under section 245C.15,
subdivision 4, for a misdemeanor-level theft crime as defined in section 609.52.

(f) When the commissioner has reason to know that a disqualified individual has received
an order for expungement for the disqualifying record that does not limit the commissioner's
access to the record, and the record was opened or exchanged with the commissioner for
purposes of a background study under this chapter, the data that would otherwise become
public under paragraph (a) or (b) remain private data.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 40.

Minnesota Statutes 2016, section 245C.23, is amended to read:


245C.23 COMMISSIONER'S RECONSIDERATION NOTICE.

Subdivision 1.

Disqualification that is rescinded or set aside.

(a) If the commissioner
rescinds or sets aside a disqualification, the commissioner shall notify the applicant, license
holder, or other entity in writing or by electronic transmission of the decision.

(b) In the notice from the commissioner that a disqualification has been rescinded, the
commissioner must inform the applicant, license holder, or other entity that the information
relied upon to disqualify the individual was incorrect.

(c) Except as provided in deleted text beginparagraphdeleted text endnew text begin paragraphsnew text end (d)new text begin and (e)new text end, in the notice from the
commissioner that a disqualification has been set aside, the commissioner must inform the
applicant, license holder, or other entity of the reason for the individual's disqualification
and that information about which factors under section 245C.22, subdivision 4, were the
basis of the decision to set aside the disqualification are available to the license holder upon
request without the consent of the background study subject.

(d) When the commissioner has reason to know that a disqualified individual has received
an order for expungement for the disqualifying record that does not limit the commissioner's
access to the record, and the record was opened or exchanged with the commissioner for
purposes of a background study under this chapter, the information provided under paragraph
(c) must only inform the applicant, license holder, or other entity that the disqualifying
criminal record is sealed under a court order.

new text begin (e) The notification requirements in paragraph (c) do not apply when the set aside is
granted to an individual related to a background study for a licensed child care center,
certified license-exempt child care center, or family child care license holder, or for a legal
nonlicensed child care provider authorized under chapter 119B, and the individual is
disqualified for a felony-level conviction for a drug-related offense that occurred within the
past five years. The notice that the individual's disqualification is set aside must inform the
applicant, license holder, or legal nonlicensed child care provider that the disqualifying
criminal record is not public.
new text end

Subd. 2.

Commissioner's notice of disqualification that is not set aside.

(a) The
commissioner shall notify the license holder of the disqualification and order the license
holder to immediately remove the individual from any position allowing direct contact with
persons receiving services from the license holder if:

(1) the individual studied does not submit a timely request for reconsideration under
section 245C.21;

(2) the individual submits a timely request for reconsideration, but the commissioner
does not set aside the disqualification for that license holder under section 245C.22, unless
the individual has a right to request a hearing under section 245C.27, 245C.28, or 256.045;

(3) an individual who has a right to request a hearing under sections 245C.27 and 256.045,
or 245C.28 and chapter 14 for a disqualification that has not been set aside, does not request
a hearing within the specified time; or

(4) an individual submitted a timely request for a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
disqualification under section 245A.08, subdivision 5, or 256.045.

(b) If the commissioner does not set aside the disqualification under section 245C.22,
and the license holder was previously ordered under section 245C.17 to immediately remove
the disqualified individual from direct contact with persons receiving services or to ensure
that the individual is under continuous, direct supervision when providing direct contact
services, the order remains in effect pending the outcome of a hearing under sections 245C.27
and 256.045, or 245C.28 and chapter 14.

(c) If the commissioner does not set aside the disqualification under section 245C.22,
and the license holder was not previously ordered under section 245C.17 to immediately
remove the disqualified individual from direct contact with persons receiving services or
to ensure that the individual is under continuous direct supervision when providing direct
contact services, the commissioner shall order the individual to remain under continuous
direct supervision pending the outcome of a hearing under sections 245C.27 and 256.045,
or 245C.28 and chapter 14.

(d) For background studies related to child foster care, the commissioner shall also notify
the county or private agency that initiated the study of the results of the reconsideration.

(e) For background studies related to new text beginfamily child care, legal nonlicensed child care,
new text end adult foster carenew text begin,new text end and family adult day services, the commissioner shall also notify the county
that initiated the study of the results of the reconsideration.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 41.

Minnesota Statutes 2016, section 245C.25, is amended to read:


245C.25 CONSOLIDATED RECONSIDERATION OF MALTREATMENT
DETERMINATION AND DISQUALIFICATION.

deleted text begin (a)deleted text end If an individual is disqualified on the basis of a determination of maltreatment under
section 626.556 or 626.557, which was serious or recurring, and the individual requests
reconsideration of the maltreatment determination under section 626.556, subdivision 10i,
or 626.557, subdivision 9d, and also requests reconsideration of the disqualification under
section 245C.21, the commissioner shall consolidate the reconsideration of the maltreatment
determination and the disqualification into a single reconsideration.

deleted text begin (b) For maltreatment and disqualification determinations made by county agencies, the
county agency shall conduct the consolidated reconsideration. If the county agency has
disqualified an individual on multiple bases, one of which is a county maltreatment
determination for which the individual has a right to request reconsideration, the county
shall conduct the reconsideration of all disqualifications.
deleted text end

deleted text begin (c) If the county has previously conducted a consolidated reconsideration under paragraph
(b) of a maltreatment determination and a disqualification based on serious or recurring
maltreatment, and the county subsequently disqualifies the individual based on that
determination, the county shall conduct the reconsideration of the subsequent disqualification.
The scope of the subsequent disqualification shall be limited to whether the individual poses
a risk of harm in accordance with section 245C.22, subdivision 4. If the commissioner
subsequently disqualifies the individual in connection with a child foster care license based
on the county's previous maltreatment determination, the commissioner shall conduct the
reconsideration of the subsequent disqualification.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 42.

Minnesota Statutes 2016, section 245C.30, subdivision 2, is amended to read:


Subd. 2.

Disclosure of reason for disqualification.

(a) The commissioner may not grant
a variance for a disqualified individual unless the applicant or license holder requests the
variance and the disqualified individual provides written consent for the commissioner to
disclose to the applicant or license holder the reason for the disqualification.

(b) This subdivision does not apply to programs licensed to provide family child care
for children, foster care for children in the provider's own home, or foster care or day care
services for adults in the provider's own home. When the commissioner grants a variance
for a disqualified individual in connection with a license to provide the services specified
in this paragraph, the disqualified individual's consent is not required to disclose the reason
for the disqualification to the license holder in the variance issued under subdivision 1new text begin,
provided that the commissioner may not disclose the reason for the disqualification if the
disqualification is based on a felony-level conviction for a drug-related offense within the
past five years
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
new text end

Sec. 43.

new text begin [245G.01] 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 in this
section.
new text end

new text begin Subd. 2. new text end

new text begin Applicant. new text end

new text begin "Applicant" means an individual or organization that is subject to
certification under this chapter and that applied for but is not yet granted certification under
this chapter.
new text end

new text begin Subd. 3. new text end

new text begin Center operator or program operator. new text end

new text begin "Center operator" or "program operator"
means the person exercising supervision or control over the center's or program's operations,
planning, and functioning. There may be more than one designated center operator or
program operator.
new text end

new text begin Subd. 4. new text end

new text begin Certification holder. new text end

new text begin "Certification holder" means the individual or organization
that is legally responsible for the operation of the center, and granted certification by the
commissioner under this chapter.
new text end

new text begin Subd. 5. new text end

new text begin Certified license-exempt child care center. new text end

new text begin "Certified license-exempt child
care center" means the commissioner's written authorization for a child care center excluded
from licensure under section 245A.03, subdivision 2, paragraph (a), clause (5), (11) to (13),
(15), (18), or (26), to register to receive child care assistance payments under chapter 119B.
new text end

new text begin Subd. 6. new text end

new text begin Disinfecting. new text end

new text begin "Disinfecting" means the use of a product capable of destroying
or inactivating harmful germs, except bacterial spores, consistent with label directions on
environmental surfaces including bathroom toilets and floors, diaper-changing surfaces,
and surfaces exposed to blood or other bodily fluids.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 44.

new text begin [245G.02] WHO MUST BE CERTIFIED.
new text end

new text begin A program that is exempt from licensure under section 245A.03, subdivision 2, paragraph
(a), clause (5), (11) to (13), (15), (18), or (26), and is authorized to receive child care
assistance payments under chapter 119B, must be a certified license-exempt child care
center according to this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 45.

new text begin [245G.03] APPLICATION PROCEDURES.
new text end

new text begin Subdivision 1. new text end

new text begin Schedule. new text end

new text begin The certification of license-exempt child care centers shall be
implemented by September 30, 2017. Certification applications shall be received and
processed on a phased-in schedule as determined by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Application submission. new text end

new text begin The commissioner shall provide application
instructions and information about the rules and requirements of other state agencies that
affect the applicant. The certification application must be submitted in a manner prescribed
by the commissioner. The commissioner shall act on the application within 90 working days
of receiving a completed application.
new text end

new text begin Subd. 3. new text end

new text begin Incomplete applications. new text end

new text begin When the commissioner receives an application for
initial certification that is incomplete because the applicant failed to submit required
documents or is deficient because the documents submitted do not meet certification
requirements, the commissioner shall provide the applicant written notice that the application
is incomplete or deficient. In the notice, the commissioner shall identify documents that are
missing or deficient and give the applicant 45 days to resubmit a second application that is
complete. An applicant's failure to submit a complete application after receiving notice from
the commissioner is basis for certification denial.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 46.

new text begin [245G.04] COMMISSIONER'S RIGHT OF ACCESS.
new text end

new text begin (a) When the commissioner is exercising the powers conferred by this chapter, whenever
the center is in operation and the information is relevant to the commissioner's inspection
or investigation, the commissioner must be given access to:
new text end

new text begin (1) the physical facility and grounds where the program is provided;
new text end

new text begin (2) documentation and records, including electronically maintained records;
new text end

new text begin (3) children served by the center; and
new text end

new text begin (4) staff and personnel records of current and former staff.
new text end

new text begin (b) The commissioner must be given access without prior notice and as often as the
commissioner considers necessary if the commissioner is investigating alleged maltreatment
or a violation of a law or rule, or conducting an inspection. When conducting an inspection,
the commissioner may request and shall receive assistance from other state, county, and
municipal governmental agencies and departments. The applicant or certification holder
shall allow the commissioner, at the commissioner's expense, to photocopy, photograph,
and make audio and video recordings during an inspection at the commissioner's expense.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 47.

new text begin [245G.05] MONITORING AND INSPECTIONS.
new text end

new text begin (a) The commissioner must conduct an on-site inspection of a certified license-exempt
child care center at least annually to determine compliance with the health, safety, and fire
standards specific to a certified license-exempt child care center.
new text end

new text begin (b) No later than November 19, 2017, the commissioner shall make publicly available
on the department's Web site the results of inspection reports for all certified centers including
the number of deaths, serious injuries, and instances of substantiated child maltreatment
that occurred in certified centers each year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 48.

new text begin [245G.06] CORRECTION ORDER.
new text end

new text begin Subdivision 1. new text end

new text begin Correction order requirements. new text end

new text begin If the applicant or certification holder
failed to comply with a law or rule, the commissioner may issue a correction order. The
correction order must state:
new text end

new text begin (1) the condition that constitutes a violation of the law or rule;
new text end

new text begin (2) the specific law or rule violated; and
new text end

new text begin (3) the time allowed to correct each violation.
new text end

new text begin Subd. 2. new text end

new text begin Reconsideration request. new text end

new text begin (a) If the applicant or certification holder believes
that the commissioner's correction order is erroneous, the applicant or certification holder
may ask the commissioner to reconsider the part of the correction order that is allegedly
erroneous. A request for reconsideration must be made in writing, postmarked, and sent to
the commissioner within 20 calendar days after the applicant or certification holder received
the correction order, and must:
new text end

new text begin (1) specify the part of the correction order that is allegedly erroneous;
new text end

new text begin (2) explain why the specified part is erroneous; and
new text end

new text begin (3) include documentation to support the allegation of error.
new text end

new text begin (b) A request for reconsideration does not stay any provision or requirement of the
correction order. The commissioner's disposition of a request for reconsideration is final
and not subject to appeal.
new text end

new text begin Subd. 3. new text end

new text begin Decertification following a correction order. new text end

new text begin (a) If the commissioner finds
that the applicant or certification holder failed to correct the violation specified in the
correction order, the commissioner may decertify the license-exempt center pursuant to
section 245G.07.
new text end

new text begin (b) Nothing in this section prohibits the commissioner from decertifying a center
according to section 245G.07.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 49.

new text begin [245G.07] DECERTIFICATION.
new text end

new text begin (a) The commissioner may decertify a center if a certification holder:
new text end

new text begin (1) failed to comply with an applicable law or rule; or
new text end

new text begin (2) knowingly withheld relevant information from or gave false or misleading information
to the commissioner in connection with an application for certification, in connection with
the background study status of an individual, during an investigation, or regarding compliance
with applicable laws or rules.
new text end

new text begin (b) When considering decertification, the commissioner shall consider the nature,
chronicity, or severity of the violation of law or rule.
new text end

new text begin (c) When a center is decertified, the center is ineligible to receive a child care assistance
payment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 50.

new text begin [245G.08] STAFFING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Staffing requirements. new text end

new text begin During hours of operation, a certified center
must have a director or designee on site who is responsible for overseeing implementation
of written policies relating to the management and control of the daily activities of the
program, ensuring the health and safety of program participants, and supervising staff and
volunteers.
new text end

new text begin Subd. 2. new text end

new text begin Director qualifications. new text end

new text begin The director must be 18 years of age or older and have
completed at least 16 hours of training in any of the following topic areas: child development
and learning; developmentally appropriate learning experiences; relationships with families;
assessment, evaluation, and individualization; historical and contemporary development of
early childhood education; professionalism; and health, safety, and nutrition.
new text end

new text begin Subd. 3. new text end

new text begin Staff qualifications. new text end

new text begin A staff person must be 16 years of age or older before
providing direct, unsupervised care to a child.
new text end

new text begin Subd. 4. new text end

new text begin Maximum group size. new text end

new text begin (a) For a child six weeks old through 16 months old,
the maximum group size shall be no more than eight children.
new text end

new text begin (b) For a child 16 months old through 33 months old, the maximum group size shall be
no more than 14 children.
new text end

new text begin (c) For a child 33 months old through prekindergarten, a maximum group size shall be
no more than 20 children.
new text end

new text begin (d) For a child in kindergarten through 13 years old, a maximum group size shall be no
more than 30 children.
new text end

new text begin (e) The maximum group size applies at all times except during group activity coordination
time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and
special activity including a film, guest speaker, indoor large muscle activity, or holiday
program.
new text end

new text begin Subd. 5. new text end

new text begin Ratios. new text end

new text begin (a) The minimally acceptable staff-to-child ratios are:
new text end

new text begin six weeks old through 16 months old
new text end
new text begin 1:4
new text end
new text begin 16 months old through 33 months old
new text end
new text begin 1:7
new text end
new text begin 33 months old through prekindergarten
new text end
new text begin 1:10
new text end
new text begin kindergarten through 13 years old
new text end
new text begin 1:15
new text end

new text begin (b) Kindergarten includes a child of sufficient age to have attended the first day of
kindergarten or who is eligible to enter kindergarten within the next four months.
new text end

new text begin (c) For mixed groups, the ratio for the age group of the youngest child applies.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 51.

new text begin [245G.10] BACKGROUND STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Documentation. new text end

new text begin (a) The applicant or certification holder must submit
and maintain documentation of a completed background study for:
new text end

new text begin (1) each person applying for the certification;
new text end

new text begin (2) each person identified as a center operator or program operator as defined in section
245G.01, subdivision 5;
new text end

new text begin (3) each current or prospective staff person or contractor of the certified center who will
have direct contact with a child served by the center;
new text end

new text begin (4) each volunteer who has direct contact with a child served by the center if the contact
is not under the continuous, direct supervision by an individual listed in clause (1), (2), or
(3); and
new text end

new text begin (5) each managerial staff of the certification holder with oversight and supervision of
the certified center.
new text end

new text begin (b) To be accepted for certification, a background study on every individual in subdivision
1, clause (1), must be completed under chapter 245C and result in a not disqualified
determination under section 245C.14 or a disqualification that was set aside under section
245C.22.
new text end

new text begin Subd. 2. new text end

new text begin Direct contact. new text end

new text begin (a) The subject of the background study may not provide direct
contact services to a child served by a certified center unless the subject is under continuous
direct supervision pending completion of the background study.
new text end

new text begin (b) The certified center must document in the staff person's personnel file the date the
program initiates a background study and the date the subject of the study first had direct
contact with a child served by the center.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 52.

new text begin [245G.11] REPORTING.
new text end

new text begin (a) The certification holder must comply with the reporting requirements for abuse and
neglect specified in section 626.556. A person mandated to report physical or sexual child
abuse or neglect occurring within a certified center shall report the information to the
commissioner.
new text end

new text begin (b) The certification holder must inform the commissioner within 24 hours of:
new text end

new text begin (1) the death of a child in the program; and
new text end

new text begin (2) any injury to a child in the program that required treatment by a physician.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 53.

new text begin [245G.12] FEES.
new text end

new text begin The commissioner shall consult with stakeholders to develop an administrative fee to
implement this chapter. By February 15, 2019, the commissioner shall provide
recommendations on the amount of an administrative fee to the legislative committees with
jurisdiction over health and human services policy and finance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 54.

new text begin [245G.13] HEALTH AND SAFETY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Exclusion of sick children and infectious disease outbreak control.
new text end

new text begin (a) A certified center must supervise and isolate a child from other children in the program
when a child becomes sick and immediately notify the sick child's parent or legal guardian.
new text end

new text begin (b) A certified center must post or give notice to the parent or legal guardian of an
exposed child the same day the program is notified of a child's contagious reportable disease
specified in Minnesota Rules, part 4605.7040, or scabies, impetigo, ringworm, or chicken
pox.
new text end

new text begin Subd. 2. new text end

new text begin Immunizations. new text end

new text begin By a child's date of attendance, the certified center must
maintain or have access to a record detailing the child's current immunizations or applicable
exemption.
new text end

new text begin Subd. 3. new text end

new text begin Administration of medication. new text end

new text begin (a) A certified center that chooses to administer
medicine must meet the requirements in this subdivision.
new text end

new text begin (b) The certified center must obtain written permission from the child's parent or legal
guardian before administering prescription medicine, diapering product, sunscreen lotion,
and insect repellent.
new text end

new text begin (c) The certified center must administer nonprescription medicine, diapering product,
sunscreen lotion, and insect repellent according to the manufacturer's instructions unless
provided written instructions by a licensed health professional to use a product differently.
new text end

new text begin (d) The certified center must obtain and follow written instructions from the prescribing
health professional before administering prescription medicine. Medicine with the child's
first and last name and current prescription information on the label is considered written
instructions.
new text end

new text begin (e) The certified center must ensure all medicine is:
new text end

new text begin (1) kept in the medicine's original container with a legible label stating the child's first
and last name;
new text end

new text begin (2) given only to the child whose name is on the label;
new text end

new text begin (3) not given after an expiration date on the label; and
new text end

new text begin (4) returned to the child's parent or legal guardian or destroyed, if unused.
new text end

new text begin (f) The certified center must document in the child's record the administration of
medication, including the child's first and last name; the name of the medication or
prescription number; the date, time, and dosage; and the name and signature of the person
who administered the medicine. This documentation must be available to the child's parent
or legal guardian.
new text end

new text begin (g) The certified center must store medicines, insect repellents, and diapering products
according to directions on the original container.
new text end

new text begin Subd. 4. new text end

new text begin Preventing and responding to allergies. new text end

new text begin (a) Before admitting a child for care,
the certified center must obtain documentation of any known allergies from the child's parent
or legal guardian. The certified center must maintain current allergy information in each
child's record. The allergy information must include:
new text end

new text begin (1) a description of the allergy, specific triggers, avoidance techniques, and symptoms
of an allergic reaction; and
new text end

new text begin (2) procedures for responding to an allergic reaction, including medication, dosages,
and a doctor's contact information.
new text end

new text begin (b) The certified center must inform staff of each child's current allergy information. At
least annually and when a change is made to allergy-related information in a child's record,
the certified center must inform staff of any change. Documentation that staff were informed
of the child's current allergy information must be kept on site.
new text end

new text begin (c) A child's allergy information must be available at all times including on site, when
on field trips, or during transportation. Food allergy information must be readily available
to staff in the area where food is prepared and served to the child.
new text end

new text begin Subd. 5. new text end

new text begin Building and physical premises; free of hazards. new text end

new text begin (a) The certified center
must document compliance with the State Fire Code by providing documentation of a fire
marshal inspection completed within the previous three years by a state fire marshal or a
local fire code inspector trained by the state fire marshal.
new text end

new text begin (b) The certified center must designate a primary indoor and outdoor space used for
child care on a facility site floor plan.
new text end

new text begin (c) The certified center must ensure the areas used by a child are clean and in good repair,
with structurally sound and functional furniture and equipment that is appropriate to the
age and size of a child who uses the area.
new text end

new text begin (d) The certified center must ensure hazardous items including but not limited to sharp
objects, medicines, cleaning supplies, poisonous plants, and chemicals are out of reach of
a child.
new text end

new text begin (e) The certified center must safely handle and dispose of bodily fluids and other
potentially infectious fluids by using gloves, disinfecting surfaces that come in contact with
potentially infectious bodily fluids, and disposing of bodily fluid in a securely sealed plastic
bag.
new text end

new text begin Subd. 6. new text end

new text begin Transporting children. new text end

new text begin (a) If a certified center chooses to transport a child,
the certified center must ensure that the driver of the vehicle holds a valid driver's license,
appropriate to the vehicle driven.
new text end

new text begin (b) If a certified center chooses to transport a child, the center must comply with all seat
belt and child passenger restraint system requirements under sections 169.685 and 169.686.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 55.

new text begin [245G.14] TRAINING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin First aid and cardiopulmonary resuscitation. new text end

new text begin At least one designated
staff person who completed pediatric first aid training and pediatric cardiopulmonary
resuscitation (CPR) training must be present at all times at the program, during field trips,
and when transporting a child. The designated staff person must repeat pediatric first aid
training and pediatric CPR training at least once every two years.
new text end

new text begin Subd. 2. new text end

new text begin Sudden unexpected infant death. new text end

new text begin A certified center that cares for an infant
who is younger than one year of age must ensure that staff persons and volunteers receive
training according to section 245A.1435 on reducing the risk of sudden unexpected infant
death before assisting in the care of an infant.
new text end

new text begin Subd. 3. new text end

new text begin Abusive head trauma. new text end

new text begin A certified center that cares for a child through four
years of age must ensure that staff persons and volunteers receive training on abusive head
trauma from shaking infants and young children before assisting in the care of a child through
four years of age.
new text end

new text begin Subd. 4. new text end

new text begin Child development. new text end

new text begin The certified center must ensure each staff person completes
at least two hours of child development and learning training within 14 days of employment
and annually thereafter. For purposes of this subdivision, "child development and learning
training" means how a child develops physically, cognitively, emotionally, and socially and
learns as part of the child's family, culture, and community.
new text end

new text begin Subd. 5. new text end

new text begin Orientation. new text end

new text begin The certified center must ensure each staff person is trained at
orientation on health and safety requirements in sections 245G.11, 245G.13, 245G.14, and
245G.15. The certified center must provide staff with an orientation within 14 days of
employment. Before the completion of orientation, a staff person must be supervised while
providing direct care to a child.
new text end

new text begin Subd. 6. new text end

new text begin In service. new text end

new text begin (a) The certified center must ensure each staff person is trained at
least annually on health and safety requirements in sections 245G.11, 245G.13, 245G.14,
and 245G.15.
new text end

new text begin (b) Each staff person must annually complete at least six hours of training. Training
required under paragraph (a) may be used toward the hourly training requirements of this
subdivision.
new text end

new text begin Subd. 7. new text end

new text begin Documentation. new text end

new text begin A certified center must document the date of a completed
training required by this section in the personnel record of each staff person.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 56.

new text begin [245G.15] EMERGENCY PREPAREDNESS.
new text end

new text begin Subdivision 1. new text end

new text begin Written emergency plan. new text end

new text begin (a) A certified center must have a written
emergency plan for emergencies that require evacuation, sheltering, or other protection of
children, such as fire, natural disaster, intruder, or other threatening situation that may pose
a health or safety hazard to children. The plan must be written on a form developed by the
commissioner and reviewed and updated at least once each calendar year. The annual review
of the emergency plan must be documented.
new text end

new text begin (b) The plan must include:
new text end

new text begin (1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
new text end

new text begin (2) a designated relocation site and evacuation route;
new text end

new text begin (3) procedures for notifying a child's parent or legal guardian of the relocation and
reunification with families;
new text end

new text begin (4) accommodations for a child with a disability or a chronic medical condition;
new text end

new text begin (5) procedures for storing a child's medically necessary medicine that facilitates easy
removal during an evacuation or relocation;
new text end

new text begin (6) procedures for continuing operations in the period during and after a crisis; and
new text end

new text begin (7) procedures for communicating with local emergency management officials, law
enforcement officials, or other appropriate state or local authorities.
new text end

new text begin (c) The certification holder must have an emergency plan available for review upon
request by the child's parent or legal guardian.
new text end

new text begin Subd. 2. new text end

new text begin Staff person training. new text end

new text begin The certification holder must train a staff person at
orientation and at least once each calendar year on the emergency plan and document training
in each personnel file. The certified center must conduct at least quarterly one evacuation
drill and one shelter-in-place drill. The date and time of the drills must be documented.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 57.

new text begin [245G.16] PERSONNEL RECORD.
new text end

new text begin The certification holder must maintain a personnel record for each staff person at the
program that must contain:
new text end

new text begin (1) the staff person's name, home address, telephone number, and date of birth;
new text end

new text begin (2) documentation that the staff person completed training required by section 245G.14;
new text end

new text begin (3) documentation of the date the program initiated a background study for the staff
person; and
new text end

new text begin (4) documentation of the date the staff person first had direct contact and access to a
child while supervised, and the date the staff person first had direct contact and access to a
child while unsupervised.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 58.

new text begin [245G.17] CERTIFICATION STANDARDS.
new text end

new text begin The commissioner shall regularly consult with stakeholders for input related to
implementing the standards in this chapter.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 59.

new text begin [245G.18] PARENTAL ACCESS.
new text end

new text begin An enrolled child's parent or legal guardian must be allowed access to the parent's or
legal guardian's child at any time while the child is in care.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 60.

Minnesota Statutes 2016, 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) "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.

(b) "Commissioner" means the commissioner of human services.

(c) "Facility" means:

(1) a licensed or unlicensed day care facility,new text begin certified license-exempt child care center,new text end
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
245Dnew text begin or 245Gnew text end;

(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E;
or

(3) a nonlicensed personal care provider organization as defined in section 256B.0625,
subdivision 19a
.

(d) "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 allege sexual abuse or 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.

(e) "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
involve sexual abuse or substantial child endangerment, and for reports of maltreatment in
facilities required to be licensednew text begin or certifiednew text end under chapter 245A deleted text beginordeleted text endnew text begin,new text end 245Dnew text begin, or 245Gnew text end; under
sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05,
subdivisions 9
, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider
association as defined in section 256B.0625, subdivision 19a.

(f) "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.

(g) "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.

(h) "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.

(i) "Operator" means an operator or agency as defined in section 245A.02.

(j) "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.

(k) "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:

(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;

(8) striking a child who is at least age one but under age four on the face or head, which
results in an injury;

(9) 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;

(10) unreasonable physical confinement or restraint not permitted under section 609.379,
including but not limited to tying, caging, or chaining; or

(11) 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.

(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) "Report" means any communication received by the local welfare agency, police
department, county sheriff, or agency responsible for child protection pursuant to this section
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
known.

(n) "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. Effective May 29, 2017, sexual abuse includes all reports
of known or suspected child sex trafficking involving a child who is identified as a victim
of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321,
subdivisions 7a
and 7b. 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).

(o) "Substantial child endangerment" means a person responsible for a child's care, by
act or omission, 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) abandonment under section 260C.301, subdivision 2;

(3) neglect as defined in paragraph (g), 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;

(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;

(5) manslaughter in the first or second degree under section 609.20 or 609.205;

(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;

(7) solicitation, inducement, and promotion of prostitution under section 609.322;

(8) criminal sexual conduct under sections 609.342 to 609.3451;

(9) solicitation of children to engage in sexual conduct under section 609.352;

(10) malicious punishment or neglect or endangerment of a child under section 609.377
or 609.378;

(11) use of a minor in sexual performance under section 617.246; or

(12) parental behavior, status, or condition which mandates that the county attorney file
a termination of parental rights petition under section 260C.503, subdivision 2.

(p) "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 (j), 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 (q) from the Department of Human
Services.

(q) 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 (p), 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.

(r) 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 61.

Minnesota Statutes 2016, section 626.556, subdivision 3, is amended to read:


Subd. 3.

Persons mandated to report; persons voluntarily reporting.

(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,
county sheriff, tribal social services agency, or tribal police department 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).

(b) Any person may voluntarily report to the local welfare agency, agency responsible
for assessing or investigating the report, police department, county sheriff, tribal social
services agency, or tribal police department 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.

(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 licensingnew text begin
or certifying
new text end the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16;
or chapter 245Dnew text begin or 245Gnew text end; 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) Notification requirements under subdivision 10 apply to all reports received under
this section.

(e) For purposes of this section, "immediately" means as soon as possible but in no event
longer than 24 hours.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 62.

Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:


Subd. 3c.

Local welfare agency, Department of Human Services or Department of
Health responsible for assessing or investigating reports of maltreatment.

(a) The deleted text begincountydeleted text end
local welfare agency is the agency responsible for assessing or investigating allegations of
maltreatment in child foster care, family child care, legally deleted text beginunlicenseddeleted text endnew text begin nonlicensednew text end child
care, deleted text beginjuvenile correctional facilities licensed under section 241.021 located in the local
welfare agency's county,
deleted text end and reports involving children served by an unlicensed personal
care provider organization under section 256B.0659. Copies of findings related to personal
care provider organizations under section 256B.0659 must be forwarded to the Department
of Human Services provider enrollment.

(b) The Department of Human Services is the agency responsible for assessing or
investigating allegations of maltreatment in new text beginjuvenile correctional facilities listed under
section 241.021 located in the local welfare agency's county and in
new text endfacilities licensednew text begin or
certified
new text end under chapters 245A deleted text beginanddeleted text endnew text begin,new text end 245D,new text begin and 245G,new text end except for child foster care and family
child care.

(c) The Department of Health is the agency responsible for assessing or investigating
allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and
144A.43 to 144A.482.

Sec. 63.

Minnesota Statutes 2016, section 626.556, subdivision 4, is amended to read:


Subd. 4.

Immunity from liability.

(a) The following persons are immune from any civil
or criminal liability that otherwise might result from their actions, if they are acting in good
faith:

(1) any person making a voluntary or mandated report under subdivision 3 or under
section 626.5561 or assisting in an assessment under this section or under section 626.5561;

(2) any person with responsibility for performing duties under this section or supervisor
employed by a local welfare agency, the commissioner of an agency responsible for operating
or supervising a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed new text beginor certified new text endunder sections
144.50 to 144.58; 241.021; 245A.01 to 245A.16; or new text beginchapter new text end245Bdeleted text begin,deleted text endnew text begin or 245G;new text end or a school as
defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed
personal care provider organization as defined in section 256B.0625, subdivision 19a,
complying with subdivision 10d; and

(3) any public or private school, facility as defined in subdivision 2, or the employee of
any public or private school or facility who permits access by a local welfare agency, the
Department of Education, or a local law enforcement agency and assists in an investigation
or assessment pursuant to subdivision 10 or under section 626.5561.

(b) A person who is a supervisor or person with responsibility for performing duties
under this section employed by a local welfare agency, the commissioner of human services,
or the commissioner of education complying with subdivisions 10 and 11 or section 626.5561
or any related rule or provision of law is immune from any civil or criminal liability that
might otherwise result from the person's actions, if the person is (1) acting in good faith
and exercising due care, or (2) acting in good faith and following the information collection
procedures established under subdivision 10, paragraphs (h), (i), and (j).

(c) This subdivision does not provide immunity to any person for failure to make a
required report or for committing neglect, physical abuse, or sexual abuse of a child.

(d) If a person who makes a voluntary or mandatory report under subdivision 3 prevails
in a civil action from which the person has been granted immunity under this subdivision,
the court may award the person attorney fees and costs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 64.

Minnesota Statutes 2016, section 626.556, subdivision 10d, is amended to read:


Subd. 10d.

Notification of neglect or abuse in facility.

(a) When a report is received
that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the
care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensednew text begin or certifiednew text end according to
sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245Dnew text begin or 245Gnew text end, or
a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a
nonlicensed personal care provider organization as defined in section 256B.0625, subdivision
19a
, the commissioner of the agency responsible for assessing or investigating the report
or local welfare agency investigating the report shall provide the following information to
the parent, guardian, or legal custodian of a child alleged to have been neglected, physically
abused, sexually abused, or the victim of maltreatment of a child in the facility: the name
of the facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or
maltreatment of a child in the facility has been received; the nature of the alleged neglect,
physical abuse, sexual abuse, or maltreatment of a child in the facility; that the agency is
conducting an assessment or investigation; any protective or corrective measures being
taken pending the outcome of the investigation; and that a written memorandum will be
provided when the investigation is completed.

(b) The commissioner of the agency responsible for assessing or investigating the report
or local welfare agency may also provide the information in paragraph (a) to the parent,
guardian, or legal custodian of any other child in the facility if the investigative agency
knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or
maltreatment of a child in the facility has occurred. In determining whether to exercise this
authority, the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency shall consider the seriousness of the alleged neglect, physical
abuse, sexual abuse, or maltreatment of a child in the facility; the number of children
allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a
child in the facility; the number of alleged perpetrators; and the length of the investigation.
The facility shall be notified whenever this discretion is exercised.

(c) When the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency has completed its investigation, every parent, guardian, or
legal custodian previously notified of the investigation by the commissioner or local welfare
agency shall be provided with the following information in a written memorandum: the
name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual
abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the
investigation findings; a statement whether maltreatment was found; and the protective or
corrective measures that are being or will be taken. The memorandum shall be written in a
manner that protects the identity of the reporter and the child and shall not contain the name,
or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed
during the investigation. If maltreatment is determined to exist, the commissioner or local
welfare agency shall also provide the written memorandum to the parent, guardian, or legal
custodian of each child in the facility who had contact with the individual responsible for
the maltreatment. When the facility is the responsible party for maltreatment, the
commissioner or local welfare agency shall also provide the written memorandum to the
parent, guardian, or legal custodian of each child who received services in the population
of the facility where the maltreatment occurred. This notification must be provided to the
parent, guardian, or legal custodian of each child receiving services from the time the
maltreatment occurred until either the individual responsible for maltreatment is no longer
in contact with a child or children in the facility or the conclusion of the investigation. In
the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions
9, 11, and 13
, and chapter 124E, the commissioner of education need not provide notification
to parents, guardians, or legal custodians of each child in the facility, but shall, within ten
days after the investigation is completed, provide written notification to the parent, guardian,
or legal custodian of any student alleged to have been maltreated. The commissioner of
education may notify the parent, guardian, or legal custodian of any student involved as a
witness to alleged maltreatment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 65.

Minnesota Statutes 2016, 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 (k);

(2) neglect as defined in subdivision 2, paragraph (g);

(3) sexual abuse as defined in subdivision 2, paragraph (n);

(4) mental injury as defined in subdivision 2, paragraph (f); or

(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (c).

(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 licensenew text begin or certificationnew text end 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 licensingnew text begin or certificationnew text end actions under deleted text beginsectionsdeleted text endnew text begin sectionnew text end 245A.06 deleted text beginordeleted text endnew text begin,new text end 245A.07new text begin, 245G.06,
or 245G.07
new text end apply.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 66.

Minnesota Statutes 2016, section 626.556, subdivision 10f, is amended to read:


Subd. 10f.

Notice of determinations.

Within ten working days of the conclusion of a
family assessment, the local welfare agency shall notify the parent or guardian of the child
of the need for services to address child safety concerns or significant risk of subsequent
child maltreatment. The local welfare agency and the family may also jointly agree that
family support and family preservation services are needed. Within ten working days of the
conclusion of an investigation, the local welfare agency or agency responsible for
investigating the report shall notify the parent or guardian of the child, the person determined
to be maltreating the child, and, if applicable, the director of the facility, of the determination
and a summary of the specific reasons for the determination. When the investigation involves
a child foster care setting that is monitored by a private licensing agency under section
245A.16, the local welfare agency responsible for investigating the report shall notify the
private licensing agency of the determination and shall provide a summary of the specific
reasons for the determination. The notice to the private licensing agency must include
identifying private data, but not the identity of the reporter of maltreatment. The notice must
also include a certification that the information collection procedures under subdivision 10,
paragraphs (h), (i), and (j), were followed and a notice of the right of a data subject to obtain
access to other private data on the subject collected, created, or maintained under this section.
In addition, the notice shall include the length of time that the records will be kept under
subdivision 11c. The investigating agency shall notify the parent or guardian of the child
who is the subject of the report, and any person or facility determined to have maltreated a
child, of their appeal or review rights under this section. The notice must also state that a
finding of maltreatment may result in denial of a licensenew text begin or certificationnew text end application or
background study disqualification under chapter 245C related to employment or services
that are licensednew text begin or certifiednew text end by the Department of Human Services under chapter 245Anew text begin or
245G
new text end, the Department of Health under chapter 144 or 144A, the Department of Corrections
under section 241.021, and from providing services related to an unlicensed personal care
provider organization under chapter 256B.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 67.

Minnesota Statutes 2016, section 626.556, subdivision 10i, is amended to read:


Subd. 10i.

Administrative reconsideration; review panel.

(a) Administrative
reconsideration is not applicable in family assessments since no determination concerning
maltreatment is made. For investigations, except as provided under paragraph (e), an
individual or facility that the commissioner of human services, a local social service agency,
or the commissioner of education determines has maltreated a child, an interested person
acting on behalf of the child, regardless of the determination, who contests the investigating
agency's final determination regarding maltreatment, may request the investigating agency
to reconsider its final determination regarding maltreatment. The request for reconsideration
must be submitted in writing to the investigating agency within 15 calendar days after receipt
of notice of the final determination regarding maltreatment or, if the request is made by an
interested person who is not entitled to notice, within 15 days after receipt of the notice by
the parent or guardian of the child. If mailed, the request for reconsideration must be
postmarked and sent to the investigating agency within 15 calendar days of the individual's
or facility's receipt of the final determination. If the request for reconsideration is made by
personal service, it must be received by the investigating agency within 15 calendar days
after the individual's or facility's receipt of the final determination. Effective January 1,
2002, an individual who was determined to have maltreated a child under this section and
who was disqualified on the basis of serious or recurring maltreatment under sections
245C.14 and 245C.15, may request reconsideration of the maltreatment determination and
the disqualification. The request for reconsideration of the maltreatment determination and
the disqualification must be submitted within 30 calendar days of the individual's receipt
of the notice of disqualification under sections 245C.16 and 245C.17. If mailed, the request
for reconsideration of the maltreatment determination and the disqualification must be
postmarked and sent to the investigating agency within 30 calendar days of the individual's
receipt of the maltreatment determination and notice of disqualification. If the request for
reconsideration is made by personal service, it must be received by the investigating agency
within 30 calendar days after the individual's receipt of the notice of disqualification.

(b) Except as provided under paragraphs (e) and (f), if the investigating agency denies
the request or fails to act upon the request within 15 working days after receiving the request
for reconsideration, the person or facility entitled to a fair hearing under section 256.045
may submit to the commissioner of human services or the commissioner of education a
written request for a hearing under that section. Section 256.045 also governs hearings
requested to contest a final determination of the commissioner of education. The investigating
agency shall notify persons who request reconsideration of their rights under this paragraph.
The hearings specified under this section are the only administrative appeal of a decision
issued under paragraph (a). Determinations under this section are not subject to accuracy
and completeness challenges under section 13.04.

(c) If, as a result of a reconsideration or review, the investigating agency changes the
final determination of maltreatment, that agency shall notify the parties specified in
subdivisions 10b, 10d, and 10f.

(d) Except as provided under paragraph (f), if an individual or facility contests the
investigating agency's final determination regarding maltreatment by requesting a fair
hearing under section 256.045, the commissioner of human services shall assure that the
hearing is conducted and a decision is reached within 90 days of receipt of the request for
a hearing. The time for action on the decision may be extended for as many days as the
hearing is postponed or the record is held open for the benefit of either party.

(e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis
of a determination of maltreatment, which was serious or recurring, and the individual has
requested reconsideration of the maltreatment determination under paragraph (a) and
requested reconsideration of the disqualification under sections 245C.21 to 245C.27,
reconsideration of the maltreatment determination and reconsideration of the disqualification
shall be consolidated into a single reconsideration. If reconsideration of the maltreatment
determination is denied and the individual remains disqualified following a reconsideration
decision, the individual may request a fair hearing under section 256.045. If an individual
requests a fair hearing on the maltreatment determination and the disqualification, the scope
of the fair hearing shall include both the maltreatment determination and the disqualification.

(f) If a maltreatment determination or a disqualification based on serious or recurring
maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, the license holder has the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for
under section 245A.08, subdivision 2a, the scope of the contested case hearing shall include
the maltreatment determination, disqualification, and licensing sanction or denial of a license.
In such cases, a fair hearing regarding the maltreatment determination and disqualification
shall not be conducted under section 256.045. Except for family child care and child foster
care, reconsideration of a maltreatment determination as provided under this subdivision,
and reconsideration of a disqualification as provided under section 245C.22, shall also not
be conducted when:

(1) a denial of a license under section 245A.05 or a licensing sanction under section
245A.07, is based on a determination that the license holder is responsible for maltreatment
or the disqualification of a license holder based on serious or recurring maltreatment;

(2) the denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and

(3) the license holder appeals the maltreatment determination or disqualification, and
denial of a license or licensing sanction.

Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
determination or disqualification, but does not appeal the denial of a license or a licensing
sanction, reconsideration of the maltreatment determination shall be conducted under sections
626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
disqualification shall be conducted under section 245C.22. In such cases, a fair hearing shall
also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
626.557, subdivision 9d.

If the disqualified subject is an individual other than the license holder and upon whom
a background study must be conducted under chapter 245C, the hearings of all parties may
be consolidated into a single contested case hearing upon consent of all parties and the
administrative law judge.

(g) For purposes of this subdivision, "interested person acting on behalf of the child"
means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult
stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been
determined to be the perpetrator of the maltreatment.

new text begin (h) If a maltreatment determination is the basis for a correction order under section
245G.06 or decertification under section 245G.07, the certification holder has the right to
request reconsideration under sections 245G.06 and 245G.07. If the certification holder
appeals the maltreatment determination or disqualification, but does not appeal the correction
order or decertification, reconsideration of the maltreatment determination shall be conducted
under section 626.556, subdivision 10i, and reconsideration of the disqualification shall be
conducted under section 245C.22.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
new text end

Sec. 68. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall change all Minnesota Statutes, chapter 245G, references in
this article to chapter 245H.
new text end

ARTICLE 17

HUMAN SERVICES FORECAST ADJUSTMENTS

Section 1. new text beginDEPARTMENT 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 2015, chapter 71, article 14, as amended by Laws 2016, chapter
189, articles 22 and 23, 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 "2017" used in this article means that the
appropriations listed are available for the fiscal year ending June 30, 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 2017
new text end

Sec. 2. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin (342,045,000)
new text end
new text begin Appropriations by Fund
new text end
new text begin 2017
new text end
new text begin General Fund
new text end
new text begin (198,450,000)
new text end
new text begin Health Care Access
new text end
new text begin (146,590,000)
new text end
new text begin TANF
new text end
new text begin 2,995,000
new text end

new text begin Subd. 2. new text end

new text begin Forecasted Programs
new text end

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 (2,111,000)
new text end
new text begin TANF
new text end
new text begin 2,579,000
new text end
new text begin (b) MFIP Child Care Assistance Grants
new text end
new text begin (6,513,000)
new text end
new text begin (c) General Assistance Grants
new text end
new text begin (4,219,000)
new text end
new text begin (d) Minnesota Supplemental Aid Grants
new text end
new text begin (581,000)
new text end
new text begin (e) Group Residential Housing Grants
new text end
new text begin (533,000)
new text end
new text begin (f) Northstar Care for Children
new text end
new text begin 2,613,000
new text end
new text begin (g) MinnesotaCare Grants
new text end
new text begin (145,883,000)
new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin (h) Medical Assistance Grants
new text end
new text begin Appropriations by Fund
new text end
new text begin General Fund
new text end
new text begin (192,744,000)
new text end
new text begin Health Care Access
new text end
new text begin (707,000)
new text end
new text begin (i) Alternative Care Grants
new text end
new text begin -0-
new text end
new text begin (j) CD Entitlement Grants
new text end
new text begin 5,638,000
new text end

new text begin Subd. 3. new text end

new text begin Technical Activities
new text end

new text begin 416,000
new text end

new text begin This appropriation is from the TANF fund.
new text end

Sec. 3. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 and 2 are effective the day following final enactment.
new text end

ARTICLE 18

APPROPRIATIONS

Section 1. new text beginHEALTH 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 "2018" and "2019" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2018, or June 30, 2019, respectively.
"The first year" is fiscal year 2018. "The second year" is fiscal year 2019. "The biennium"
is fiscal years 2018 and 2019.
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 2018
new text end
new text begin 2019
new text end

Sec. 2. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin 7,548,395,000
new text end
new text begin $
new text end
new text begin 7,654,331,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2018
new text end
new text begin 2019
new text end
new text begin General
new text end
new text begin 6,819,523,000
new text end
new text begin 6,880,153,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 4,274,000
new text end
new text begin 4,274,000
new text end
new text begin Health Care Access
new text end
new text begin 446,453,000
new text end
new text begin 501,104,000
new text end
new text begin Federal TANF
new text end
new text begin 276,249,000
new text end
new text begin 266,904,000
new text end
new text begin Lottery Prize
new text end
new text begin 1,896,000
new text end
new text begin 1,896,000
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 TANF Maintenance of Effort
new text end

new text begin (a) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
maintenance of effort (MOE) requirements of
the TANF block grant specified under Code
of Federal Regulations, title 45, section 263.1.
In order to meet these basic TANF/MOE
requirements, the commissioner may report
as TANF/MOE expenditures only nonfederal
money expended for allowable activities listed
in the following clauses:
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;
new text end

new text begin (7) qualifying Minnesota education credit
expenditures under Minnesota Statutes, section
290.0674; and
new text end

new text begin (8) qualifying Head Start expenditures under
Minnesota Statutes, section 119A.50.
new text end

new text begin (b) For the activities listed in paragraph (a),
clauses (2) to (8), the commissioner may
report only 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) The commissioner shall ensure that the
MOE 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 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 (e) For the purposes of paragraph (d), 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.
new text end

new text begin (f) 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 (g) 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 (h) Receipts for Systems Project.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, ISDS, METS, 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 and is available for ongoing
development and operations.
new text end

new text begin (i) Federal SNAP Education and Training
Grants.
Federal funds available during fiscal
years 2017, 2018, and 2019 for Supplemental
Nutrition Assistance Program Education and
Training and SNAP Quality Control
Performance Bonus grants are appropriated
to the commissioner of human services for the
purposes allowable under the terms of the
federal award. This paragraph is effective the
day following final enactment.
new text end

new text begin Subd. 3. new text end

new text begin Central Office; Operations
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 136,778,000
new text end
new text begin 121,009,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 4,149,000
new text end
new text begin 4,149,000
new text end
new text begin Health Care Access
new text end
new text begin 21,019,000
new text end
new text begin 21,019,000
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 (a) 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 (b) Transfer to Office of Legislative
Auditor.
$600,000 in fiscal year 2018 and
$600,000 in fiscal year 2019 are for transfer
to the Office of the Legislative Auditor for
audit activities under Minnesota Statutes,
section 3.972, subdivision 2b.
new text end

new text begin (c) Base Level Adjustment. The general fund
base is $133,378,000 in fiscal year 2020 and
$133,418,000 in fiscal year 2021.
new text end

new text begin Subd. 4. new text end

new text begin Central Office; 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 10,438,000
new text end
new text begin 10,431,000
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 2018 and fiscal year 2019
from the systems 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 Subd. 5. new text end

new text begin Central Office; Health Care
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 20,719,000
new text end
new text begin 21,249,000
new text end
new text begin Health Care Access
new text end
new text begin 23,697,000
new text end
new text begin 23,804,000
new text end

new text begin (a) Integrated Health Partnership Health
Information Exchange.
$125,000 in fiscal
year 2018 and $250,000 in fiscal year 2019
are from the general fund to contract with
state-certified health information exchange
vendors to support providers participating in
an integrated health partnership under
Minnesota Statutes, section 256B.0755, to
connect enrollees with community supports
and social services and improve collaboration
among participating and authorized providers.
new text end

new text begin (b) new text end new text begin Transfer to Legislative Auditor. new text end new text begin 153,000
in fiscal year 2018 and $153,000 in fiscal year
2019 are from the general fund for transfer to
the Office of the Legislative Auditor for the
auditor to establish and maintain a team of
auditors with the training and experience
necessary to fulfill the requirements in
Minnesota Statutes, section 3.972, subdivision
2a.
new text end

new text begin (c) new text beginBase Level Adjustment.new text end The general fund
base is $21,257,000 in fiscal year 2020 and
$21,302,000 in fiscal year 2021.
new text end

new text begin Subd. 6. new text end

new text begin Central Office; Continuing Care for
Older Adults
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 15,359,000
new text end
new text begin 15,113,000
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 (a) Alzheimer's Disease Working Group.
$127,000 in fiscal year 2018 and $110,000 in
fiscal year 2019 are from the general fund for
the Alzheimer's disease working group. This
is a onetime appropriation.
new text end

new text begin (b) new text beginBase Level Adjustment.new text end The general fund
base is $15,053,000 in fiscal year 2020 and
$15,053,000 in fiscal year 2021.
new text end

new text begin Subd. 7. new text end

new text begin Central Office; Community Supports
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 29,546,000
new text end
new text begin 29,381,000
new text end
new text begin Lottery Prize
new text end
new text begin 163,000
new text end
new text begin 163,000
new text end

new text begin (a) new text end new text begin new text beginTransportation Study. new text end$250,000 in fiscal
year 2018 and $250,000 in fiscal year 2019
are for a study to identify opportunities to
increase access to transportation services for
individuals who receive home and
community-based services. This is a onetime
appropriation.
new text end

new text begin (b) new text end new text begin new text beginDeaf and Hard-of-Hearing Services.new text end
$438,000 in fiscal year 2018 and $395,000 in
fiscal year 2019 are from the general fund for
the Deaf and Hard-of-Hearing Services
Division under Minnesota Statutes, section
256C.233. Starting in fiscal year 2019, 20
percent of this appropriation each year must
be used for technology improvements,
technology support, and training for staff on
the use of technology for external facing
services to implement Minnesota Statutes,
section 256C.24, subdivision 2, clause (12).
new text end

new text begin (c) Consumer-Directed Community
Supports Revised Budget Methodology
Report.
$435,000 in fiscal year 2018 and
$65,000 in fiscal year 2019 are from the
general fund to study and develop an
individual budgeting model for disability
waiver recipients and those accessing services
through consumer-directed community
supports. The commissioner shall submit
recommendations to the chairs and ranking
minority members of the legislative
committees with jurisdiction over these
programs by December 15, 2018. This is a
onetime appropriation.
new text end

new text begin (d) new text end new text begin new text beginSubstance Use Disorder System Study.
new text end
$150,000 in fiscal year 2018 and $150,000 in
fiscal year 2019 are for a substance use
disorder system study. This is a onetime
appropriation.
new text end

new text begin (e) Children's Mental Health Report and
Recommendations.
$125,000 in fiscal year
2018 and $125,000 in fiscal year 2019 are for
a comprehensive analysis of Minnesota's
continuum of intensive mental health services
for children with serious mental health needs.
This is a onetime appropriation.
new text end

new text begin (f) Self-Directed Workforce Collective
Bargaining Agreement.
$1,206,000 in fiscal
year 2018 and $1,206,000 in fiscal year 2019
may be used for administration, training,
grants, and reimbursement to implement a
collective bargaining agreement between the
state and the Service Employees International
Union Healthcare Minnesota (SEIU). This
appropriation is not available until the
collective bargaining agreement between the
state and SEIU under Minnesota Statutes,
section 179A.54, is approved under
subdivision 15, paragraph (b), clause (3). The
commissioner may transfer funds between
budget activities with the approval of the
commissioner of management and budget. The
base for this purpose is $293,000 in fiscal year
2020 and $293,000 in fiscal year 2021.
new text end

new text begin (g) Implementation and Operation of an
Electronic Service Delivery Documentation
System.
$170,000 in fiscal year 2018 and
$105,000 in fiscal year 2019 are from the
general fund for the development and
implementation of an electronic service
delivery documentation system. This is a
onetime appropriation.
new text end

new text begin (h) new text beginWaiver Consolidation Study. new text end$110,000
in fiscal year 2018 and $140,000 in fiscal year
2019 are to conduct a study on consolidating
the four disability home and community-based
services waivers into one program. The
commissioner of human services shall submit
recommendations to the chairs and ranking
minority members of the legislative
committees with oversight over health and
human services by January 15, 2019. This is
a onetime appropriation.
new text end

new text begin (i) new text end new text begin new text beginBase Level Adjustment. new text endThe general fund
base is $27,504,000 in fiscal year 2020 and
$27,328,000 in fiscal year 2021.
new text end

new text begin Subd. 8. new text end

new text begin Forecasted Programs; MFIP/DWP
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 88,930,000
new text end
new text begin 98,251,000
new text end
new text begin Federal TANF
new text end
new text begin 92,732,000
new text end
new text begin 83,513,000
new text end

new text begin Subd. 9. new text end

new text begin Forecasted Programs; MFIP Child Care
Assistance
new text end

new text begin 101,293,000
new text end
new text begin 112,078,000
new text end

new text begin Subd. 10. new text end

new text begin Forecasted Programs; General
Assistance
new text end

new text begin 55,536,000
new text end
new text begin 57,221,000
new text end

new text begin (a) 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 (b) Emergency General Assistance Limit.
The amount appropriated for emergency
general assistance is limited to no more than
$6,729,812 in fiscal year 2018 and $6,729,812
in fiscal year 2019. 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 Subd. 11. new text end

new text begin Forecasted Programs; Minnesota
Supplemental Aid
new text end

new text begin 40,484,000
new text end
new text begin 41,634,000
new text end

new text begin Subd. 12. new text end

new text begin Forecasted Programs; Group
Residential Housing
new text end

new text begin 169,312,000
new text end
new text begin 179,643,000
new text end

new text begin new text begin Eliminate Group Residential Housing
Grant.
new text end
The forecasted base funding for the
group residential housing program shall be
reduced by $460,000 in fiscal year 2018 and
$460,000 in fiscal year 2019 to reflect the
elimination of grant funding for facilities
under Minnesota Statutes, section 256I.05,
subdivision 1m. The ongoing base funding
shall be adjusted to reflect the elimination of
this grant.
new text end

new text begin Subd. 13. new text end

new text begin Forecasted Programs; Northstar Care
for Children
new text end

new text begin 80,542,000
new text end
new text begin 96,433,000
new text end

new text begin Subd. 14. new text end

new text begin Forecasted Programs; MinnesotaCare
new text end

new text begin 12,363,000
new text end
new text begin 13,218,000
new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin Subd. 15. new text end

new text begin Forecasted Programs; Medical
Assistance
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 5,174,139,000
new text end
new text begin 5,172,292,000
new text end
new text begin Health Care Access
new text end
new text begin 385,159,000
new text end
new text begin 438,848,000
new text end

new text begin (a) Behavioral Health Services. $1,000,000
in fiscal year 2018 and $1,000,000 in fiscal
year 2019 are 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 (b) Self-Directed Workforce Collective
Bargaining Agreement.
(1) This
appropriation includes money to implement a
collective bargaining agreement between the
state and the Service Employees International
Union Healthcare Minnesota (SEIU). This
appropriation is not available until the
collective bargaining agreement between the
state of Minnesota and the Service Employees
International Union Healthcare Minnesota
under Minnesota Statutes, section 179A.54,
is approved as provided in clause (3).
new text end

new text begin (2) The commissioner of management and
budget is authorized to negotiate and enter
into a collective bargaining agreement with
SEIU under Minnesota Statutes, section
179A.54, subject to clause (1), and subdivision
7, paragraph (f). The economic terms of the
collective bargaining agreement may include
wage floor increases for direct support
workers, paid time off, holiday pay, wage
increases for workers serving people with
complex needs, training stipends, and training
for direct support workers and for
implementation of the registry as outlined in
the collective bargaining agreement.
new text end

new text begin (3) Notwithstanding Minnesota Statutes,
sections 3.855, 179A.22, subdivision 4, and
179A.54, subdivision 5, upon approval of a
negotiated collective bargaining agreement by
the SEIU and the commissioner of
management and budget, the commissioner
of human services is authorized to implement
the negotiated collective bargaining
agreement.
new text end

new text begin Subd. 16. new text end

new text begin Forecasted Programs; Alternative
Care
new text end

new text begin 44,258,000
new text end
new text begin 44,976,000
new text end

new text begin new text begin Alternative Care Transfer.new text end 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 Subd. 17. new text end

new text begin Forecasted Programs; Chemical
Dependency Treatment Fund
new text end

new text begin 117,226,000
new text end
new text begin 136,493,000
new text end

new text begin Subd. 18. new text end

new text begin Grant Programs; 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 8,715,000
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 Subd. 19. new text end

new text begin Grant Programs; Basic Sliding Fee
Child Care Assistance Grants
new text end

new text begin 44,690,000
new text end
new text begin 53,413,000
new text end

new text begin (a) Maximum Rate for Certain Child Care
Providers.
Notwithstanding Minnesota
Statutes, section 119B.03, subdivisions 6 and
6a, $25,000 in fiscal year 2019 is to modify
maximum rates for child care providers in a
city with boundaries located in two or more
of the counties of Benton, Sherburne, and
Stearns. $12,000 of the funding for the
calendar year 2018 allocation and $29,000 of
the funding for the calendar year 2019
allocation shall be allocated proportionally to
the three counties based on county
expenditures in the most recent calendar year.
Allocations in calendar year 2020 and beyond
shall be calculated using the allocation formula
in Minnesota Statutes, section 119B.03,
subdivision 6.
new text end

new text begin new text begin (b) Base Level Adjustment.new text end The general fund
base is $53,583,000 in fiscal year 2020 and
$53,639,000 in fiscal year 2021.
new text end

new text begin Subd. 20. new text end

new text begin Grant Programs; 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 Subd. 21. new text end

new text begin Grant Programs; 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 Subd. 22. new text end

new text begin Grant Programs; 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 39,240,000
new text end
new text begin 39,165,000
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 (a) new text beginTitle IV-E Adoption Assistance.new text end (1) The
commissioner shall allocate funds from the
Title IV-E reimbursement to the state from
the Fostering Connections to Success and
Increasing Adoptions Act for adoptive, foster,
and kinship families as required in Minnesota
Statutes, section 256N.261.
new text end

new text begin (2) 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 for postadoption, foster care,
adoption, and kinship services, including a
parent-to-parent support network.
new text end

new text begin (b) new text end new text begin new text beginAdoption Assistance Incentive Grants.new text end
(1) The commissioner shall allocate federal
funds available for adoption and guardianship
assistance incentive grants for postadoption
services to support adoptive, foster, and
kinship families as required in Minnesota
Statutes, section 256N.261.
new text end

new text begin (2) Federal funds available during fiscal year
2019 for adoption incentive grants must be
used for foster care, adoption, and kinship
services, including a parent-to-parent support
network.
new text end

new text begin (c) new text beginAdoption Support Services.new text end The
commissioner shall allocate 20 percent of
federal funds from title IV-B, subpart 2, of the
Social Security Act, Promoting Safe and
Stable Families, for adoption support services
under Minnesota Statutes, section 256N.261.
new text end

new text begin (d) Anoka County Family Foster Care.
$75,000 in fiscal year 2018 is from the general
fund for a grant to Anoka County to establish
and promote family foster care recruitment
models. The county shall use the grant funds
for the purpose of increasing foster care
providers through administrative
simplification, nontraditional recruitment
models, and family incentive options, and
develop a strategic planning model to recruit
family foster care providers. This is a onetime
appropriation.
new text end

new text begin (e) White Earth Band of Ojibwe Child
Welfare Services.
$500,000 in fiscal year
2018 and $500,000 in fiscal year 2019 are
from the general fund for a grant to the White
Earth Band of Ojibwe to deliver child welfare
services.
new text end

new text begin Subd. 23. new text end

new text begin Grant Programs; Children and
Community Service Grants
new text end

new text begin 58,201,000
new text end
new text begin 58,201,000
new text end

new text begin Subd. 24. new text end

new text begin Grant Programs; Children and
Economic Support Grants
new text end

new text begin 32,930,000
new text end
new text begin 32,940,000
new text end

new text begin (a) Minnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2018 do not
cancel but are available for this purpose in
fiscal year 2019.
new text end

new text begin (b) Long-term Homeless Supportive
Services.
$375,000 in fiscal year 2018 and
$375,000 in fiscal year 2019 are for the
long-term homeless supportive services fund
under Minnesota Statutes, section 256K.26.
This is a onetime appropriation.
new text end

new text begin (c) Community Action Grants. $750,000 in
fiscal year 2018 and $750,000 in fiscal year
2019 are for community action grants under
Minnesota Statutes, sections 256E.30 to
256E.32. This is a onetime appropriation.
new text end

new text begin (d) Transitional Housing. $200,000 in fiscal
year 2018 and $200,000 in fiscal year 2019
are for the transitional housing program under
Minnesota Statutes, section 256E.33. This is
a onetime appropriation.
new text end

new text begin (e) Family Assets for Independence.
$250,000 in fiscal year 2018 and $250,000 in
fiscal year 2019 are for the family assets for
independence program under Minnesota
Statutes, section 256E.35. This is a onetime
appropriation.
new text end

new text begin (f) Safe Harbor for Sexually Exploited
Youth.
(1) $400,000 in fiscal year 2018 and
$400,000 in fiscal year 2019 are for
emergency shelter and transitional and
long-term housing beds for sexually exploited
youth and youth at risk of sexual exploitation.
new text end

new text begin (2) $100,000 in fiscal year 2018 and $100,000
in fiscal year 2019 are 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 (3) Youth 24 years of age or younger are
eligible for shelter, housing beds, and services
under this paragraph. In funding shelter,
housing beds, and outreach workers under this
paragraph, the commissioner shall emphasize
activities that promote capacity-building and
development of resources in greater
Minnesota.
new text end

new text begin (g) Emergency Services Program. $100,000
in fiscal year 2018 and $100,000 in fiscal year
2019 are for the emergency services program,
which provides services and emergency shelter
for homeless Minnesotans under Minnesota
Statutes, section 256E.36. This is a onetime
appropriation.
new text end

new text begin (h) Dakota County Child Data Tracking.
$200,000 in fiscal year 2018 is for the
Minnesota Birth to Eight pilot project for the
development of the information technology
solution that will track the established
developmental milestone progress of each
child participating in the pilot up to age eight.
new text end

new text begin (i) Food Shelf Programs. $375,000 in fiscal
year 2018 and $375,000 in fiscal year 2019
are for food shelf programs under Minnesota
Statutes, section 256E.34. This appropriation
may be used to purchase proteins, fruits,
vegetables, and diapers. This is a onetime
appropriation.
new text end

new text begin (j) Community Living Infrastructure.
$1,400,000 in fiscal year 2018 and $1,400,000
in fiscal year 2019 are for community living
infrastructure grants under article 2, section
17.
new text end

new text begin (k) Housing Web Site Grant. $150,000 in
fiscal year 2018 and $150,000 in fiscal year
2019 are for a grant to a public or private
entity to create and maintain a Web site and
application to track real-time housing openings
for people with disabilities.
new text end

new text begin (l) Housing Benefit Web Site. $130,000 in
fiscal year 2018 and $130,000 in fiscal year
2019 are to operate the housing benefit 101
Web site to help people who need affordable
housing, and supports to maintain that
housing, understand the range of housing
options and support services available.
new text end

new text begin (m) Coparenting Education. $150,000 in
fiscal year 2018 and $150,000 in fiscal year
2019 are for a grant to a health and wellness
center located in North Minneapolis that is a
federally qualified health center. This is a
onetime appropriation. The center must use
the grant money to offer coparent services to
unmarried parents. The center must develop
a process to inform and educate unmarried
parents about the center's coparent services.
The coparent services must include the
following:
new text end

new text begin (1) coparenting workshops for the unmarried
parents;
new text end

new text begin (2) assistance to the unmarried parents in
developing a parenting plan that specifies a
schedule of the time each parent spends with
the child, child support obligations, and a
designation of decision-making responsibilities
regarding the child's education, medical needs,
and religious upbringing;
new text end

new text begin (3) an assessment of social services needs for
each parent; and
new text end

new text begin (4) additional social services support,
including support related to employment,
education, and housing.
new text end

new text begin The parenting plan assistance must include
the option of using private mediation.
new text end

new text begin The coparent workshops must focus at a
minimum on (i) the benefits to the child of
having both parents involved in a child's life,
(ii) promoting both parents' participation in a
child's life, (iii) building coparenting and
communication skills, (iv) information on
establishing paternity, (v) assisting parents in
developing a parenting plan, and (vi) educating
participants on how to foster a nonresident
parent's continued involvement in a child's
life.
new text end

new text begin (n) Base Level Adjustments. The general
fund base is $30,840,000 in fiscal year 2020
and $31,940,000 in fiscal year 2021. The
general fund base includes $453,000 in fiscal
year 2020 and $453,000 in fiscal year 2021
for community living infrastructure grant
allocations under Minnesota Statutes, section
256I.09.
new text end

new text begin Subd. 25. new text end

new text begin Grant Programs; 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 5,519,000
new text end
new text begin 4,111,000
new text end
new text begin Health Care Access
new text end
new text begin 3,465,000
new text end
new text begin 3,465,000
new text end

new text begin (a) Chronic Pain Rehabilitation Therapy
Demonstration Project.
$1,000,000 in fiscal
year 2018 is from the general fund for a
chronic pain rehabilitation therapy
demonstration project with a rehabilitation
institute. The commissioner may use up to
three percent of this appropriation for
administrative costs for the project. This is a
onetime appropriation.
new text end

new text begin (b) Health Care Grants. $400,000 in fiscal
year 2018 and $400,000 in fiscal year 2019
are for the substance use disorder and provider
capacity grant program. This is a onetime
appropriation.
new text end

new text begin (c) Base Level Adjustment. The general fund
base is $3,711,000 in fiscal year 2020 and
$3,711,000 in fiscal year 2021.
new text end

new text begin Subd. 26. new text end

new text begin Grant Programs; Other Long-Term
Care Grants
new text end

new text begin 2,500,000
new text end
new text begin 2,925,000
new text end

new text begin (a) Home and Community-Based Incentive
Pool.
$1,000,000 in fiscal year 2018 and
$1,000,000 in fiscal year 2019 are for
incentive payments under Minnesota Statutes,
section 256B.0921. This is a onetime
appropriation.
new text end

new text begin (b) Base Level Adjustment. The general fund
base is $1,925,000 in fiscal year 2020 and
$1,925,000 in fiscal year 2021.
new text end

new text begin Subd. 27. new text end

new text begin Grant Programs; Aging and Adult
Services Grants
new text end

new text begin 30,786,000
new text end
new text begin 32,437,000
new text end

new text begin (a) Gap Analysis. $217,000 in fiscal year
2018 and $218,000 in fiscal year 2019 are for
analysis of gaps in long-term care services
under Minnesota Statutes, section 144A.351.
new text end

new text begin (b) Advanced In-Home Activity-Monitoring
Systems.
$40,000 in fiscal year 2018 is for a
grant to a local research organization with
expertise in identifying current and potential
support systems and examining the capacity
of those systems to meet the needs of the
growing population of elderly persons to
conduct a comprehensive assessment of
current literature, past research, and an
environmental scan of the field related to
advanced in-home activity-monitoring systems
for elderly persons. The commissioner must
report the results of the assessment by January
15, 2018, to the legislative committees and
divisions with jurisdiction over health and
human services policy and finance. This is a
onetime appropriation.
new text end

new text begin (c) new text end new text begin new text beginBase Level Adjustments. new text endThe general
fund base is $32,811,000 in fiscal year 2020
and $32,995,000 in fiscal year 2021. The
general fund base includes $334,000 in fiscal
year 2020 and $477,000 in fiscal year 2021
for the Minnesota Board on Aging for
self-directed caregiver grants under Minnesota
Statutes, section 256.975, subdivision 12.
new text end

new text begin Subd. 28. new text end

new text begin Grant Programs; Deaf and
Hard-of-Hearing Grants
new text end

new text begin 2,675,000
new text end
new text begin 2,675,000
new text end

new text begin new text begin Expanded Services Grants. new text end$800,000 in
fiscal year 2018 and $800,000 in fiscal year
2019 are for deaf and hard-of-hearing grants.
new text end

new text begin The funds must be used to provide:
new text end

new text begin (1) services to Minnesotans who are deafblind
under Minnesota Statutes, section 256C.261;
new text end

new text begin (2) linguistically and culturally appropriate
mental health services to children who are
deaf, children who are deafblind, and children
who are hard-of-hearing;
new text end

new text begin (3) an increase in the fiscal year 2017 base
level grant amount to provide mentors who
have hearing loss to parents of infants and
children with newly identified hearing loss;
and
new text end

new text begin (4) training each year in ProTactile American
Sign Language or other communication
systems used by people who are deafblind.
Training shall be provided to persons who are
deafblind and to interpreters, support service
providers, and intervenors who work with
persons who are deafblind.
new text end

new text begin The funds may be used to provide culturally
affirmative psychiatric services.
new text end

new text begin Subd. 29. new text end

new text begin Grant Programs; Disabilities Grants
new text end

new text begin 21,175,000
new text end
new text begin 21,176,000
new text end

new text begin (a) Disability Waiver Rate System
Transition Grants.
$30,000 in fiscal year
2018 and $31,000 in fiscal year 2019 are for
grants to home and community-based
disability waiver services providers that are
projected to receive at least a ten percent
decrease in revenues due to transition to rates
calculated under Minnesota Statutes, section
256B.4914.The commissioner shall award
grants to ensure ongoing access for individuals
currently receiving these services and provide
stability to providers as they transition to new
service delivery models. The general fund base
for the grants under this paragraph is $287,000
in fiscal year 2020 and $288,000 in fiscal year
2021.
new text end

new text begin (b) Self-Advocacy Grants. $133,000 in fiscal
year 2018 and $133,000 in fiscal year 2019
are for grants under Minnesota Statutes,
section 256.477, paragraph (a).
new text end

new text begin (c) Services for Persons with Intellectual
and Developmental Disabilities.
$143,000
in fiscal year 2018 and $143,000 in fiscal year
2019 are for a grant to an organization
described under Minnesota Statutes, section
256.477. This is a onetime appropriation.
Grant funds must be used for the following
purposes:
new text end

new text begin (1) to maintain the infrastructure needed to
train and support the activities of a statewide
network of peer-to-peer mentors for persons
with developmental disabilities, focused on
building awareness of service options and
advocacy skills necessary to move toward full
inclusion in community life, including the
development and delivery of the curriculum
to support the peer-to-peer network;
new text end

new text begin (2) to provide outreach activities, including
statewide conferences and disability
networking opportunities focused on
self-advocacy, informed choice, and
community engagement skills;
new text end

new text begin (3) to provide an annual leadership program
for persons with intellectual and
developmental disabilities; and
new text end

new text begin (4) to provide for administrative and general
operating costs associated with managing and
maintaining facilities, program delivery,
evaluation, staff, and technology.
new text end

new text begin (d) Outreach to Persons in Institutional
Settings.
$105,000 in fiscal year 2018 and
$105,000 in fiscal year 2019 are for a grant to
an organization described under Minnesota
Statutes, section 256.477, to be used for
subgrants to organizations in Minnesota to
conduct outreach to persons working and
living in institutional settings to provide
education and information about community
options. This is a onetime appropriation. Grant
funds must be used to deliver peer-led skill
training sessions in six regions of the state to
help persons with intellectual and
developmental disabilities understand
community service options related to:
new text end

new text begin (1) housing;
new text end

new text begin (2) employment;
new text end

new text begin (3) education;
new text end

new text begin (4) transportation;
new text end

new text begin (5) emerging service reform initiatives
contained in the state's Olmstead plan; the
Workforce Innovation and Opportunity Act,
Public Law 113-128; and federal home and
community-based services regulations; and
new text end

new text begin (6) connecting with individuals who can help
persons with intellectual and developmental
disabilities make an informed choice and plan
for a transition in services.
new text end

new text begin (e) Community Living Grants. To the extent
funding is available, the commissioner may
transfer funds from the semi-independent
living services grant to new community living
grants to pay for transitional costs and
facilitate the transition of individuals from
corporate foster care to community living.
new text end

new text begin (f) Life Skills Training for Individuals with
Autism Spectrum Disorder.
$125,000 in
fiscal year 2018 and $125,000 in fiscal year
2019 are for a grant to an organization located
in Richfield that provides life skills training
to young adults with learning disabilities to
meet the needs of individuals with autism
spectrum disorder. This is a onetime
appropriation. This appropriation may be used
to:
new text end

new text begin (1) create a best practices curriculum for
serving individuals with autism spectrum
disorder in residential placements with
therapeutic programming; and
new text end

new text begin (2) expand facilities by adding safety features,
living spaces, and academic areas.
new text end

new text begin (g) Base Level Adjustment. The general fund
base is $21,059,000 in fiscal year 2020 and
$21,060,000 in fiscal year 2021.
new text end

new text begin Subd. 30. new text end

new text begin Grant Programs; 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 81,577,000
new text end
new text begin 81,477,000
new text end
new text begin Health Care Access
new text end
new text begin 750,000
new text end
new text begin 750,000
new text end

new text begin (a) Peer-Run Respite Services in Wadena
County.
$100,000 in fiscal year 2018 is from
the general fund for a grant to Wadena County
for the planning and development of a peer-run
respite center for individuals experiencing
mental health conditions or co-occurring
substance abuse disorder. This is a onetime
appropriation and is available until June 30,
2021. The grant is contingent on Wadena
County providing to the commissioner of
human services a plan to fund, operate, and
sustain the program and services after the
onetime state grant is expended. Wadena
County must outline the proposed funding
stream or mechanism, and any necessary local
funding commitment, which will ensure the
program will result in a sustainable program.
The funding stream may include state funding
for programs and services for which the
individuals served under this paragraph may
be eligible. The commissioner of human
services, in collaboration with Wadena
County, may explore a plan for continued
funding using existing appropriations through
eligibility for group residential housing under
Minnesota Statutes, chapter 256I.
new text end

new text begin The peer-run respite center must:
new text end

new text begin (1) admit individuals who are in need of peer
support and supportive services while
addressing an increase in symptoms or
stressors or exacerbation of their mental health
or substance abuse;
new text end

new text begin (2) admit individuals to reside at the center on
a short-term basis, no longer than five days;
new text end

new text begin (3) be operated by a nonprofit organization;
new text end

new text begin (4) employ individuals who have personal
experience with mental health or co-occurring
substance abuse conditions who meet the
qualifications of a mental health certified peer
specialist under Minnesota Statutes, section
256B.0615, or a recovery peer;
new text end

new text begin (5) provide at least three but no more than six
beds in private rooms; and
new text end

new text begin (6) not provide clinical services.
new text end

new text begin By November 1, 2018, the commissioner of
human services, in consultation with Wadena
County, shall report to the committees in the
senate and house of representatives with
jurisdiction over mental health issues, the
status of planning and development of the
peer-run respite center, and the plan to
financially support the program and services
after the state grant is expended.
new text end

new text begin (b) Housing Options for Persons with
Serious Mental Illness.
$575,000 in fiscal
year 2018 and $575,000 in fiscal year 2019
are from the general fund for adult mental
health grants under Minnesota Statutes, section
245.4661, subdivision 9, paragraph (a), clause
(2), to support increased availability of
housing options with supports for persons with
serious mental illness. This is a onetime
appropriation.
new text end

new text begin (c) Assertive Community Treatment.
$200,000 in fiscal year 2018 and $200,000 in
fiscal year 2019 are from the general fund for
adult mental health grants under Minnesota
Statutes, section 256B.0622, subdivision 12,
to expand assertive community treatment
services. This is a onetime appropriation.
new text end

new text begin (d) Mental Health Crisis Services. $400,000
in fiscal year 2018 and $400,000 in fiscal year
2019 are from the general fund for adult
mental health grants under Minnesota Statutes,
section 245.4661, and children's mental health
grants under Minnesota Statutes, section
245.4889, to expand mental health crisis
services, including:
new text end

new text begin (1) mobile crisis services;
new text end

new text begin (2) residential crisis services;
new text end

new text begin (3) colocation of mobile crisis services in
urgent care clinics and psychiatric emergency
departments; and
new text end

new text begin (4) development of co-responder mental health
crisis response models.
new text end

new text begin This is a onetime appropriation.
new text end

new text begin (e) Housing with Supports. $500,000 in fiscal
year 2018 and $500,000 in fiscal year 2019
are for the housing with supports for adults
with serious mental illness grant under
Minnesota Statutes, section 245.4661,
subdivision 9, paragraph (a), clause (2). This
is a onetime appropriation.
new text end

new text begin (f) Base Level Adjustment. The general fund
base is $79,802,000 in fiscal year 2020 and
$79,802,000 in fiscal year 2021.
new text end

new text begin Subd. 31. new text end

new text begin Grant Programs; Child Mental Health
Grants
new text end

new text begin 21,411,000
new text end
new text begin 21,476,000
new text end

new text begin (a) First Psychotic Episode Funding.
$500,000 in fiscal year 2018 and $500,000 in
fiscal year 2019 are for grants under
Minnesota Statutes, section 245.4889,
subdivision 1, paragraph (b), clause (15). This
is a onetime appropriation. Funding shall be
used to:
new text end

new text begin (1) provide intensive treatment and supports
to adolescents and adults experiencing or at
risk of a first psychotic episode. Intensive
treatment and support includes medication
management, psychoeducation for the
individual and family, case management,
employment supports, education supports,
cognitive behavioral approaches, social skills
training, peer support, crisis planning, and
stress management. Projects must use all
available funding streams;
new text end

new text begin (2) conduct outreach, training, and guidance
to mental health and health care professionals,
including postsecondary health clinics, on
early psychosis symptoms, screening tools,
and best practices; and
new text end

new text begin (3) ensure access to first psychotic episode
psychosis services under this section,
including ensuring access for individuals who
live in rural areas. Funds may be used to pay
for housing or travel or to address other
barriers to individuals and their families
participating in first psychotic episode
services.
new text end

new text begin (b) Respite Care Services. $150,000 in fiscal
year 2018 and $150,000 in fiscal year 2019
are for children's mental health grants under
Minnesota Statutes, section 245.4889,
subdivision 1, paragraph (b), clause (3), to
provide respite care services to families of
children with serious mental illness. This is a
onetime appropriation.
new text end

new text begin (c) Base Level Adjustment. The general fund
base is $20,826,000 in fiscal year 2020 and
$20,826,000 in fiscal year 2021.
new text end

new text begin Subd. 32. new text end

new text begin Grant Programs; Chemical
Dependency Treatment Support Grants
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 2,386,000
new text end
new text begin 2,386,000
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 (a) Minnesota Transitions Charter School.
Notwithstanding any other law to the contrary,
Minnesota Transitions Charter School is
eligible to receive grants under Minnesota
Statutes, section 254A.03, subdivision 1.
new text end

new text begin (b) new text beginProblem Gambling.new text end $225,000 in fiscal
year 2018 and $225,000 in fiscal year 2019
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 (c) Minnesota Organization on Fetal
Alcohol Syndrome.
$250,000 in fiscal year
2018 and $250,000 in fiscal year 2019 are for
a grant to the Minnesota Organization on Fetal
Alcohol Syndrome (MOFAS). This is a
onetime appropriation. Of this amount,
MOFAS shall make grants to eligible regional
collaboratives that fulfill the requirements in
this paragraph. "Eligible regional
collaboratives" means a partnership between
at least one local government and at least one
community-based organization and, where
available, a family home visiting program. For
purposes of this paragraph, a local government
includes a county or multicounty organization,
a tribal government, a county-based
purchasing entity, or a community health
board. Eligible regional collaboratives must
use grant funds to reduce the incidence of fetal
alcohol syndrome disorders and other prenatal
drug-related effects in children in Minnesota
by identifying and serving pregnant women
suspected of or known to use or abuse alcohol
or other drugs. The eligible regional
collaboratives must provide intensive services
to chemically dependent women to increase
positive birth outcomes. MOFAS must make
grants to eligible regional collaboratives from
both rural and urban areas. A grant recipient
must report to the commissioner of human
services annually by January 15 on the
services and programs funded by the
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 (d) Base Level Adjustment. new text end new text begin The general fund
base is $2,136,000 in fiscal year 2020 and
$2,136,000 in fiscal year 2021.
new text end

new text begin Subd. 33. new text end

new text begin Direct Care and Treatment - Generally
new text end

new text begin (a) new text beginTransfer Authority. new text endMoney appropriated
to budget activities under subdivisions 34, 35,
36, 37, and 38 may be transferred between
budget activities and between years of the
biennium with the approval of the
commissioner of management and budget.
new text end

new text begin (b) 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 (2).
new text end

new text begin Subd. 34. new text end

new text begin Direct Care and Treatment - Mental
Health and Substance Abuse
new text end

new text begin 118,545,000
new text end
new text begin 118,631,000
new text end

new text begin (a) Child and Adolescent Behavioral Health
Services.
$405,000 in fiscal year 2018 and
$491,000 in fiscal year 2019 are to continue
to operate the child and adolescent behavioral
health services program under Minnesota
Statutes, section 246.014. This is a onetime
appropriation.
new text end

new text begin (b) new text beginDCT Operating Adjustment (CARE).
new text end
$447,000 in fiscal year 2018 and $447,000 in
fiscal year 2019 are for Community Addiction
Recovery Enterprise (CARE) operating
adjustments. The commissioner must transfer
$447,000 in fiscal year 2018 and $447,000 in
fiscal year 2019 to the enterprise fund for
CARE.
new text end

new text begin (c) new text beginBase Level Adjustment. new text endThe general fund
base is $118,140,000 in fiscal year 2020 and
$118,140,000 in fiscal year 2021.
new text end

new text begin Subd. 35. new text end

new text begin Direct Care and Treatment -
Community-Based Services
new text end

new text begin 25,652,000
new text end
new text begin 20,543,000
new text end

new text begin (a) new text beginDCT Operating Adjustment (MSOCS).
new text end
$2,393,000 in fiscal year 2018 and $2,393,000
in fiscal year 2019 are for Minnesota State
Operated Community Services (MSOCS)
operating adjustments. The commissioner must
transfer $2,393,000 in fiscal year 2018 and
$2,393,000 in fiscal year 2019 to the enterprise
fund for MSOCS.
new text end

new text begin (b) new text beginMSOCS Sustainability. new text end$7,697,000 in
fiscal year 2018 and $2,588,000 in fiscal year
2019 are for the Minnesota State Operated
Community Services program. Of this amount,
the commissioner must transfer $6,697,000 in
fiscal year 2018 and $1,588,000 in fiscal year
2019 to the enterprise fund for Minnesota State
Operated Community Services. $1,000,000 is
available each year of the biennium for
start-up expenses for new residential homes
to be operated by Minnesota State Operated
Community Services.
new text end

new text begin (c) Base Level Adjustment. The general fund
base is $18,955,000 in fiscal year 2021.
new text end

new text begin Subd. 36. new text end

new text begin Direct Care and Treatment - Forensic
Services
new text end

new text begin 102,806,000
new text end
new text begin 106,958,000
new text end

new text begin Base Level Adjustment. The general fund
base is $109,828,000 in fiscal year 2020 and
$112,437,000 in fiscal year 2021.
new text end

new text begin Subd. 37. new text end

new text begin Direct Care and Treatment - Sex
Offender Program
new text end

new text begin 89,217,000
new text end
new text begin 89,225,000
new text end

new text begin new text begin Transfer Authority. new text endMoney 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 Subd. 38. new text end

new text begin Direct Care and Treatment -
Operations
new text end

new text begin 45,151,000
new text end
new text begin 45,708,000
new text end

new text begin Base Level Adjustment. The general fund
base is $45,995,000 in fiscal year 2020 and
$46,256,000 in fiscal year 2021.
new text end

new text begin Subd. 39. new text end

new text begin Technical Activities
new text end

new text begin 84,384,000
new text end
new text begin 84,258,000
new text end

new text begin (a) This appropriation is from the federal
TANF fund.
new text end

new text begin (b) Base Level Adjustment. The TANF fund
base is $86,346,000 in fiscal year 2020 and
$86,355,000 in fiscal year 2021.
new text end

Sec. 3. new text beginCOMMISSIONER OF HEALTH
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin 213,792,000
new text end
new text begin $
new text end
new text begin 207,347,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2018
new text end
new text begin 2019
new text end
new text begin General
new text end
new text begin 111,829,000
new text end
new text begin 105,274,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 53,607,000
new text end
new text begin 54,102,000
new text end
new text begin Health Care Access
new text end
new text begin 36,643,000
new text end
new text begin 36,258,000
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 end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 81,438,000
new text end
new text begin 78,100,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 6,215,000
new text end
new text begin 6,182,000
new text end
new text begin Health Care Access
new text end
new text begin 36,643,000
new text end
new text begin 36,258,000
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 (a) TANF Appropriations. (1) $3,579,000
of the TANF fund each year is 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 (2) $2,000,000 of the TANF fund each year
is for decreasing racial and ethnic disparities
in infant mortality rates under Minnesota
Statutes, section 145.928, subdivision 7.
new text end

new text begin (3) $4,978,000 of the TANF fund each year
is 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 according to Minnesota Statutes,
section 145A.14, subdivision 2a.
new text end

new text begin (4) $1,156,000 of the TANF fund each year
is for family planning grants under Minnesota
Statutes, section 145.925.
new text end

new text begin (5) The commissioner may use up to 6.23
percent of the funds appropriated each 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 (b) TANF Carryforward. 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 (c) new text beginEvidence-Based Home Visiting.new text end
$6,000,000 in fiscal year 2018 and $6,000,000
in fiscal year 2019 are from the general fund
to start up or expand evidence-based home
visiting programs. The commissioner shall
award grants to community health boards,
nonprofits, or tribal nations in urban and rural
areas of the state. Grant funds must be used
to start up or expand evidence-based home
visiting programs in the county, reservation,
or region to serve families, such as parents
with high risk or high needs, parents with a
history of mental illness, domestic abuse, or
substance abuse, or first-time mothers
prenatally until the child is four 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.
Priority for grants to rural areas shall be given
to community health boards, nonprofits, and
tribal nations that expand services within
regional partnerships that provide the
evidence-based home visiting programs. This
funding shall only be used to supplement, not
to replace, funds being used for
evidence-based home visiting services as of
June 30, 2017. Up to seven percent of the
appropriation may be used for training,
technical assistance, evaluation, and other
costs to administer the grants. The general
fund base for this program is $16,500,000 in
fiscal year 2020 and $16,500,000 in fiscal year
2021.
new text end

new text begin (d) Safe Harbor for Sexually Exploited
Youth Services.
$250,000 in fiscal year 2018
and $250,000 in fiscal year 2019 are from the
general fund for trauma-informed, culturally
specific services for sexually exploited youth.
Youth 24 years of age or younger are eligible
for services under this paragraph.
new text end

new text begin (e) Safe Harbor Program Technical
Assistance and Evaluation.
$200,000 in
fiscal year 2018 and $200,000 in fiscal year
2019 are from the general fund for training,
technical assistance, protocol implementation,
and evaluation activities related to the safe
harbor program. Of these amounts:
new text end

new text begin (1) $90,000 each fiscal year is for providing
training and technical assistance to individuals
and organizations that provide safe harbor
services and receive funds for that purpose
from the commissioner of human services or
commissioner of health;
new text end

new text begin (2) $90,000 each fiscal year is for protocol
implementation, which includes providing
technical assistance in establishing best
practices-based systems for effectively
identifying, interacting with, and referring
sexually exploited youth to appropriate
resources; and
new text end

new text begin (3) $20,000 each fiscal year is for program
evaluation activities in compliance with
Minnesota Statutes, section 145.4718.
new text end

new text begin (f) Promoting Safe Harbor Capacity. In
funding services and activities under
paragraphs (d) and (e), the commissioner shall
emphasize activities that promote
capacity-building and development of
resources in greater Minnesota.
new text end

new text begin (g) Administration of Safe Harbor
Program.
$60,000 in fiscal year 2018 and
$60,000 in fiscal year 2019 are for
administration of the safe harbor for sexually
exploited youth program.
new text end

new text begin (h) Palliative Care Advisory Council.
$44,000 in fiscal year 2018 and $44,000 in
fiscal year 2019 are from the general fund for
the Palliative Care Advisory Council under
Minnesota Statutes, section 144.059. This is
a onetime appropriation.
new text end

new text begin (i) Transfer; Minnesota Biomedicine and
Bioethics Innovation Grants.
$2,500,000 in
fiscal year 2018 is from the general fund for
transfer to the Board of Regents of the
University of Minnesota for Minnesota
biomedicine and bioethics innovation grants
under Minnesota Statutes, section 137.67. The
full amount of the appropriation is for grants,
and the University of Minnesota shall not use
any portion for administrative or monitoring
expenses. The steering committee of the
University of Minnesota and Mayo Foundation
partnership must submit a preliminary report
by April 1, 2018, and a final report by April
1, 2019, on all grant activities funded under
Minnesota Statutes, section 137.67, to the
chairs and ranking minority members of the
legislative committees with jurisdiction over
health and human services finance. This is a
onetime appropriation and is available until
June 30, 2021.
new text end

new text begin (j) new text beginStatewide Strategic Plan for Victims of
Sex Trafficking.
new text end
$73,000 in fiscal year 2018
is from the general fund for the development
of a comprehensive statewide strategic plan
and report to address the needs of sex
trafficking victims statewide. This is a onetime
appropriation.
new text end

new text begin (k) Home and Community-Based Services
Employee Scholarship Program.
$500,000
in fiscal year 2018 and $500,000 in fiscal year
2019 are from the general fund for the home
and community-based services employee
scholarship program under Minnesota Statutes,
section 144.1503.
new text end

new text begin (l) Comprehensive Advanced Life Support
Educational Program.
$100,000 in fiscal
year 2018 and $100,000 in fiscal year 2019
are from the general fund for the
comprehensive advanced life support
educational program under Minnesota Statutes,
section 144.6062. This is a onetime
appropriation.
new text end

new text begin (m) Opioid Abuse Prevention. $1,028,000
in fiscal year 2018 is to establish and evaluate
accountable community for health opioid
abuse prevention pilot projects. $28,000 of
this amount is for administration. This is a
onetime appropriation and is available until
June 30, 2021.
new text end

new text begin (n) Advanced Care Planning. $250,000 in
fiscal year 2018 and $250,000 in fiscal year
2019 are from the general fund for a grant to
a statewide advanced 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. Of this
amount, $9,000 each year is for administration.
This is a onetime appropriation.
new text end

new text begin (o) Health Professionals Clinical Training
Expansion Grant Program.
$526,000 in
fiscal year 2018 and $526,000 in fiscal year
2019 are from the general fund for the primary
care and mental health professions clinical
training expansion grant program under
Minnesota Statutes, section 144.1505. Of this
amount, $26,000 each year is for
administration.
new text end

new text begin (p) Federally Qualified Health Centers.
$500,000 in fiscal year 2018 and $500,000 in
fiscal year 2019 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 (q) Base Level Adjustments. The general
fund base is $87,656,000 in fiscal year 2020
and $87,706,000 in fiscal year 2021. The
health care access fund base is $36,858,000
in fiscal year 2020 and $36,258,000 in fiscal
year 2021.
new text end

new text begin Subd. 3. new text end

new text begin Health Protection
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 20,928,000
new text end
new text begin 17,339,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 47,392,000
new text end
new text begin 47,920,000
new text end

new text begin (a) Prescribed Pediatric Extended Care
Center Licensure Activities.
$64,000 in fiscal
year 2018 and $17,000 in fiscal year 2019 are
from the state government special revenue
fund for licensure of prescribed pediatric
extended care centers under Minnesota
Statutes, chapter 144H.
new text end

new text begin (b) Vulnerable Adults in Health Care
Settings.
$1,162,000 in fiscal year 2018 and
$2,030,000 in fiscal year 2019 are from the
general fund for regulating health care and
home care settings. The general fund base for
this purpose is $2,401,000 in fiscal year 2020
and $3,405,000 in fiscal year 2021.
new text end

new text begin (c) Transfer; Public Health Response
Contingency Account.
The commissioner
shall transfer $5,000,000 in fiscal year 2018
from the general fund to the public health
response contingency account established in
Minnesota Statutes, section 144.4199.
new text end

new text begin (d) Base Level Adjustment. The general fund
base is $17,710,000 in fiscal year 2020 and
$18,714,000 in fiscal year 2021. The state
government special revenue fund base is
$47,958,000 in fiscal year 2020 and
$48,295,000 in fiscal year 2021.
new text end

new text begin Subd. 4. new text end

new text begin Health Operations
new text end

new text begin 9,463,000
new text end
new text begin 9,835,000
new text end

Sec. 4. new text beginHEALTH-RELATED BOARDS
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin 24,996,000
new text end
new text begin $
new text end
new text begin 23,189,000
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 end

new text begin 565,000
new text end
new text begin 571,000
new text end

new text begin Base Level Adjustment. The base is $576,000
in fiscal year 2020 and $576,000 in fiscal year
2021.
new text end

new text begin Subd. 3. new text end

new text begin Board of Dentistry
new text end

new text begin 1,396,000
new text end
new text begin 1,408,000
new text end

new text begin Subd. 4. new text end

new text begin Board of Dietetics and Nutrition
Practice
new text end

new text begin 130,000
new text end
new text begin 132,000
new text end

new text begin Subd. 5. new text end

new text begin Board of Marriage and Family Therapy
new text end

new text begin 360,000
new text end
new text begin 357,000
new text end

new text begin Base Level Adjustment. The base is $360,000
in fiscal year 2020 and $361,000 in fiscal year
2021.
new text end

new text begin Subd. 6. new text end

new text begin Board of Medical Practice
new text end

new text begin 5,207,000
new text end
new text begin 5,243,000
new text end

new text begin (a) Health Professional Services Program.
This appropriation includes $955,000 in fiscal
year 2018 and $964,000 in fiscal year 2019
for the health professional services program.
The base for this program is $924,000 in fiscal
year 2020 and $924,000 in fiscal year 2021.
new text end

new text begin (b) Base Level Adjustment. The base is
$5,291,000 in fiscal year 2020 and $5,291,000
in fiscal year 2021.
new text end

new text begin Subd. 7. new text end

new text begin Board of Nursing
new text end

new text begin 6,380,000
new text end
new text begin 4,783,000
new text end

new text begin Subd. 8. new text end

new text begin Board of Nursing Home Administrators
new text end

new text begin 3,397,000
new text end
new text begin 3,202,000
new text end

new text begin (a) Administrative Services Unit - Operating
Costs.
Of this appropriation, $2,260,000 in
fiscal year 2018 and $2,287,000 in fiscal year
2019 are for operating costs of the
administrative services unit. The
administrative services unit may receive and
expend reimbursements for services it
performs for other agencies.
new text end

new text begin (b) Administrative Services Unit - Volunteer
Health Care Provider Program.
Of this
appropriation, $150,000 in fiscal year 2018
and $150,000 in fiscal year 2019 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end

new text begin (c) Administrative Services Unit -
Retirement Costs.
Of this appropriation,
$378,000 in fiscal year 2018 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 retirement costs. Any board that has
an unexpended balance for an amount
transferred under this paragraph shall transfer
the unexpended amount to the administrative
services unit. These funds are available either
year of the biennium.
new text end

new text begin (d) Administrative Services Unit -
Health-Related Licensing Boards Operating
Costs.
Of this appropriation, $194,000 in
fiscal year 2018 and $350,000 in fiscal year
2019 shall be transferred to the health-related
boards funded under this section for operating
costs. The administrative services unit shall
determine transfer amounts in consultation
with the health-related boards funded under
this section.
new text end

new text begin (e) Administrative Services Unit - Contested
Cases and Other Legal Proceedings.
Of this
appropriation, $200,000 in fiscal year 2018
and $200,000 in fiscal year 2019 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 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 end

new text begin 173,000
new text end
new text begin 174,000
new text end

new text begin Subd. 10. new text end

new text begin Board of Pharmacy
new text end

new text begin 3,124,000
new text end
new text begin 3,164,000
new text end

new text begin Base Level Adjustment. The base is
$3,189,000 in fiscal year 2020 and $3,226,000
in fiscal year 2021.
new text end

new text begin Subd. 11. new text end

new text begin Board of Physical Therapy
new text end

new text begin 507,000
new text end
new text begin 508,000
new text end

new text begin Base Level Adjustment. The base is $524,000
in fiscal year 2020 and $526,000 in fiscal year
2021.
new text end

new text begin Subd. 12. new text end

new text begin Board of Podiatric Medicine
new text end

new text begin 198,000
new text end
new text begin 198,000
new text end

new text begin Subd. 13. new text end

new text begin Board of Psychology
new text end

new text begin 1,220,000
new text end
new text begin 1,240,000
new text end

new text begin Base Level Adjustment. The base is
$1,247,000 in fiscal year 2020 and $1,247,000
in fiscal year 2021.
new text end

new text begin Subd. 14. new text end

new text begin Board of Social Work
new text end

new text begin 1,254,000
new text end
new text begin 1,246,000
new text end

new text begin Base Level Adjustment. The base is
$1,248,000 in fiscal year 2020 and $1,250,000
in fiscal year 2021.
new text end

new text begin Subd. 15. new text end

new text begin Board of Veterinary Medicine
new text end

new text begin 314,000
new text end
new text begin 320,000
new text end

new text begin Base Level Adjustment. The base is $327,000
in fiscal year 2020 and $333,000 in fiscal year
2021.
new text end

new text begin Subd. 16. new text end

new text begin Board of Behavioral Health and
Therapy
new text end

new text begin 771,000
new text end
new text begin 643,000
new text end

new text begin Subd. 17. new text end

new text begin Board of Occupational Therapy
Practice
new text end

new text begin 374,000
new text end
new text begin 328,000
new text end

Sec. 5. new text beginEMERGENCY MEDICAL SERVICES
REGULATORY BOARD
new text end

new text begin $
new text end
new text begin 3,667,000
new text end
new text begin $
new text end
new text begin 3,596,000
new text end

new text begin (a) Cooper/Sams Volunteer Ambulance
Program.
$950,000 in fiscal year 2018 and
$950,000 in fiscal year 2019 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.
new text end

new text begin (1) Of this amount, $861,000 in fiscal year
2018 and $861,000 in fiscal year 2019 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.
new text end

new text begin (2) Of this amount, $89,000 in fiscal year 2018
and $89,000 in fiscal year 2019 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 (b) EMSRB Operations. $1,771,000 in fiscal
year 2018 and $1,700,000 in fiscal year 2019
are for board operations. The base for this
program is $1,702,000 in fiscal year 2020 and
$1,702,000 in fiscal year 2021.
new text end

new text begin (c) Regional Grants. $585,000 in fiscal year
2018 and $585,000 in fiscal year 2019 are for
regional emergency medical services
programs, to be distributed equally to the eight
emergency medical service regions under
Minnesota Statutes, section 144E.52.
new text end

new text begin (d) Ambulance Training Grant. $361,000
in fiscal year 2018 and $361,000 in fiscal year
2019 are for training grants under Minnesota
Statutes, section 144E.35.
new text end

new text begin (e) Base Level Adjustment. The base is
$3,598,000 in fiscal year 2020 and $3,598,000
in fiscal year 2021.
new text end

Sec. 6. new text beginCOUNCIL ON DISABILITY
new text end

new text begin $
new text end
new text begin 893,000
new text end
new text begin $
new text end
new text begin 892,000
new text end

new text begin Base Level Adjustment. The base is $856,000
in fiscal year 2020 and $858,000 in fiscal year
2021.
new text end

Sec. 7. new text beginOMBUDSMAN FOR MENTAL
HEALTH AND DEVELOPMENTAL
DISABILITIES
new text end

new text begin $
new text end
new text begin 2,407,000
new text end
new text begin $
new text end
new text begin 2,427,000
new text end

new text begin Department of Psychiatry Monitoring.
$100,000 in fiscal year 2018 and $100,000 in
fiscal year 2019 are for monitoring the
Department of Psychiatry at the University of
Minnesota.
new text end

Sec. 8. new text beginOMBUDSPERSONS FOR FAMILIES
new text end

new text begin $
new text end
new text begin 460,000
new text end
new text begin $
new text end
new text begin 465,000
new text end

Sec. 9.

Laws 2009, chapter 101, article 1, section 12, is amended to read:


Sec. 12. ADMINISTRATION

Subdivision 1.

Total Appropriation

$
19,973,000
$
19,617,000
Appropriations by Fund
2010
2011
General
19,723,000
19,617,000
Special Revenue
Fund
250,000
0

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

Subd. 2.

Government and Citizen Services

18,097,000
17,766,000
Appropriations by Fund
General
17,847,000
17,766,000
Special Revenue
Fund
250,000
0

(a) $802,000 the first year and $802,000 the
second year are for the Minnesota Geospatial
Information Office. Of the total appropriation,
$10,000 per year is intended for preparation
of township acreage data in Laws 2008,
chapter 366, article 17, section 7, subdivision
3.

(b) $74,000 the first year and $74,000 the
second year are for the Council on
Developmental Disabilities.

deleted text begin (c) $127,000 the first year and $127,000 the
second year are for transfer to the
commissioner of human services for a grant
to the Council on Developmental Disabilities
for the purpose of establishing a statewide
self-advocacy network for persons with
intellectual and developmental disabilities
(ID/DD). The self-advocacy network shall:
(1) ensure that persons with ID/DD are
informed of their rights in employment,
housing, transportation, voting, government
policy, and other issues pertinent to the ID/DD
community; (2) provide public education and
awareness of the civil and human rights issues
persons with ID/DD face; (3) provide funds,
technical assistance, and other resources for
self-advocacy groups across the state; and (4)
organize systems of communications to
facilitate an exchange of information between
self-advocacy groups. This appropriation must
be included in the base budget for the
commissioner of human services for the
biennium beginning July 1, 2011.
deleted text end

(d) $250,000 the first year and $170,000 the
second year are to fund activities to prepare
for and promote the 2010 census.

(e) $206,000 the first year and $206,000 the
second year are for the Office of the State
Archaeologist.

(f) $8,388,000 the first year and $8,388,000
the second year are for office space costs of
the legislature and veterans organizations, for
ceremonial space, and for statutorily free
space.

(g) $3,500,000 of the balance in the facilities
repair and replacement account in the special
revenue fund is canceled to the general fund
on July 1, 2009. This is a onetime cancellation.

(h) The requirements imposed on the
commissioner of finance and the commissioner
of administration under Laws 2007, chapter
148, article 1, section 12, subdivision 2,
paragraph (b), relating to the savings
attributable to the real property portfolio
management system are inoperative.

(i) $250,000 is appropriated to the
commissioner of administration from the
information and telecommunications account
in the special revenue fund to continue
planning for data center consolidation,
including beginning a predesign study and
lifecycle cost analysis, and exploring
technologies to reduce energy consumption
and operating costs.

Subd. 3.

Administrative Management Support

1,876,000
1,851,000

$125,000 each year is for the Office of Grant
Management. During the biennium ending
June 30, 2011, the commissioner must recover
this amount through deductions in state grants
subject to the jurisdiction of the office. The
commissioner may not deduct more than 2.5
percent from the amount of any grant. The
amount deducted from appropriations for these
grants must be deposited in the general fund.

$25,000 the first year is for the Office of
Grants Management to study and make
recommendations on improving collaborative
activities between the state, nonprofit entities,
and the private sector, including: (1)
recommendations for expanding successful
initiatives involving not-for-profit
organizations that have demonstrated
measurable, positive results in addressing
high-priority community issues; and (2)
recommendations on grant requirements and
design to encourage programs receiving grants
to become self-sufficient. The office may
appoint an advisory group to assist in the study
and recommendations. The office must report
its recommendations to the legislature by
January 15, 2010.

Sec. 10.

Laws 2012, chapter 247, article 6, section 2, subdivision 2, is amended to read:


Subd. 2.

Central Office Operations

(a) Operations
118,000
356,000

Base Level Adjustment. The general fund
base is increased by $91,000 in fiscal year
2014 and $44,000 in fiscal year 2015.

(b) Health Care
24,000
346,000

This is a onetime appropriation.

Managed Care Audit Activities. In fiscal
year 2014, deleted text beginand in each even-numbered year
thereafter,
deleted text end the commissioner shall transfer
from the health care access fund $1,740,000
to the legislative auditor for managed care
audit services under Minnesota Statutes,
section 256B.69, subdivision 9d. This is a
biennial appropriation. The health care access
fund base is increased by $1,842,000 in fiscal
year 2014. deleted text beginNotwithstanding any contrary
provision in this article, this paragraph does
not expire.
deleted text end

(c) Continuing Care
19,000
375,000

Base Level Adjustment. The general fund
base is decreased by $159,000 in fiscal years
2014 and 2015.

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.

Laws 2013, chapter 108, article 15, section 2, subdivision 2, is amended to read:


Subd. 2.

Central Office

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

(a) Operations
2,909,000
8,957,000

Base Adjustment. The general fund base is
decreased by $8,916,000 in fiscal year 2016
and $8,916,000 in fiscal year 2017.

(b) Children and Families
109,000
206,000
(c) Continuing Care
2,849,000
3,574,000

Base Adjustment. The general fund base is
decreased by $2,000 in fiscal year 2016 and
by $27,000 in fiscal year 2017.

(d) Group Residential Housing
(1,166,000)
(8,602,000)
(e) Medical Assistance
(3,950,000)
(6,420,000)
(f) Alternative Care
(7,386,000)
(6,851,000)
(g) Child and Community Service Grants
3,000,000
3,000,000
(h) Aging and Adult Services Grants
5,365,000
5,936,000

deleted text begin Gaps Analysis. In fiscal year 2014, and in
each even-numbered year thereafter, $435,000
is appropriated to conduct an analysis of gaps
in long-term care services under Minnesota
Statutes, section 144A.351. This is a biennial
appropriation. The base is increased by
$435,000 in fiscal year 2016. Notwithstanding
any contrary provisions in this article, this
provision does not expire.
deleted text end

Base Adjustment. The general fund base is
increased by $498,000 in fiscal year 2016, and
decreased by $124,000 in fiscal year 2017.

(i) Disabilities Grants
414,000
414,000

Sec. 12.

Laws 2015, chapter 71, article 14, section 3, subdivision 2, as amended by Laws
2015, First Special Session chapter 6, section 2, is amended to read:


Subd. 2.

Health Improvement

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

Violence Against Asian Women Working
Group.
$200,000 in fiscal year 2016 from the
general fund is for the working group on
violence against Asian women and children.

MERC Program. $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
.

Poison Information Center Grants.
$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.

Advanced Care Planning. $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.

Early Dental Prevention Initiatives.
$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.

International Medical Graduate Assistance
Program.
(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.

(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.

Federally Qualified Health Centers.
$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.

Organ Donation. $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.

Primary Care Residency. $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.

Somali deleted text beginWomen's Health Pilotdeleted text endnew text begin Autismnew text end
Program.
deleted text begin(a)deleted text end The commissioner of health
shall deleted text beginestablish 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:
deleted text end

deleted 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;
deleted text end

deleted 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
deleted text end

deleted 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.
deleted text end

deleted 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
deleted text endnew text begin award a grant
to Dakota County to partner with a
community-based organization with expertise
in serving Somali children with autism. The
grant must address barriers to accessing health
care and other resources by providing outreach
to Somali families on available support and
training to providers on Somali culture
new text end.

(c) deleted text beginThe pilot program must report the
deleted text enddeleted text begin outcomes to the commissioner by June 30,
deleted text enddeleted text begin 2017.deleted text endnew text begin The grantee shall report to the
commissioner and the chairs and ranking
minority members of the legislative
committees with jurisdiction over health care
policy and finance on the grant funds used and
any notable outcomes achieved by January 15,
2019.
new text end

(d) $110,000 in fiscal year 2016 is for the
deleted text begin Somali women's health pilot programdeleted text endnew text begin grant to
Dakota County
new text end. Of this appropriation, the
commissioner may use up to $10,000 to
administer the deleted text beginprogramdeleted text endnew text begin grant to Dakota
County
new text end. This appropriation is available until
June 30, 2017. This is a onetime appropriation.

Menthol Cigarette Usage in
African-American Community Intervention
Grants.
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.

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.

(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.

Opiate Antagonists. $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.

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).

(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
.

HCBS Employee Scholarships. $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.

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.

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.

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.

Health Care Grants for Uninsured
Individuals.
(a) $62,500 in fiscal year 2016
and $62,500 in fiscal year 2017 are from the
health care access fund for dental provider
grants in Minnesota Statutes, section 145.929,
subdivision 1
.

(b) $218,750 in fiscal year 2016 and $218,750
in fiscal year 2017 are from the health care
access fund for community mental health
program grants in Minnesota Statutes, section
145.929, subdivision 2.

(c) $750,000 in fiscal year 2016 and $750,000
in fiscal year 2017 are from the health care
access fund for the emergency medical
assistance outlier grant program in Minnesota
Statutes, section 145.929, subdivision 3.

(d) $218,750 of the health care access fund
appropriation in fiscal year 2016 and $218,750
in fiscal year 2017 are 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).

(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.

TANF Appropriations. (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.

(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.

(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
.

(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.

(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.

TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.

Health Professional Loan Forgiveness.
$2,631,000 in fiscal year 2016 and $2,631,000
in fiscal year 2017 are from the health care
access 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.

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.

Prevention of Violence in Health Care.
$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.

Health Care Savings Determinations. (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.

(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.

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.

Sec. 13.

Laws 2017, chapter 2, article 1, section 2, subdivision 3, is amended to read:


Subd. 3.

Payments to health carriers.

(a) The commissioner shall make payments to
health carriers on behalf of eligible individuals effectuating coverage for calendar year 2017,
for the months in that year for which the individual has paid the net premium amount to the
health carrier. Payments to health carriers shall be based on the premium subsidy available
to eligible individuals in the individual market, regardless of the cost of coverage purchased.
The commissioner shall not withhold payments because a health carrier cannot prove an
enrollee is an eligible individual.

(b) Health carriers seeking reimbursement from the commissioner must submit an invoice
and supporting information to the commissioner, using a form developed by the
commissioner, in order to be eligible for payment. The commissioner shall finalize the form
by March 1, 2017.

(c) Total state payments to health carriers must be made within the limits of the available
appropriation. The commissioner shall reimburse health carriers at the full requested amount
up to the level of the appropriation. The commissioner, by July 15, 2017, shall determine
whether the available appropriation will be sufficient to provide premium subsidies equal
to 25 percent of the gross premium for the period September 1, 2017, through December
31, 2017. If the commissioner determines that the available appropriation is not sufficient,
the commissioner shall reduce the premium subsidy percentage, beginning September 1,
2017, through the remainder of the calendar year, by an amount sufficient to ensure that the
total amount of premium subsidies provided for the calendar year does not exceed the
available appropriation. The commissioner shall notify health carriers of any reduced
premium subsidy percentage within five days of making a determination. Health carriers
shall provide enrollees with at least 30 days' notice of any reduction in the premium subsidy
percentage.

(d) The commissioner shall consider health carriers as vendors under Minnesota Statutes,
section 16A.124, subdivision 3, and each monthly invoice shall represent the completed
delivery of the service.

new text begin (e) The commissioner, with the November 2017 forecast, shall certify the extent to which
appropriations exceed forecast obligations under this subdivision. Notwithstanding Laws
2017, chapter 2, article 1, section 7, the estimated value of available funds, up to $98,779,000,
shall be canceled to the general fund. The cancellation in this paragraph shall be reduced
by any difference in medical assistance expenditures estimated in the trend calculation under
section 15.
new text end

Sec. 14. new text beginIMPLEMENTATION OF CONTINGENT APPROPRIATIONS.
new text end

new text begin Notwithstanding Laws 2017, chapter 2, article 1, section 7, and upon certification of
excess funds in accordance with Laws 2017, chapter 2, article 1, section 2, subdivision 3,
up to $1,388,000 in fiscal year 2018 and up to $15,102,000 in fiscal year 2019 are
appropriated to the commissioner of human services for central office operations in fiscal
year 2019. This appropriation is onetime.
new text end

Sec. 15. new text beginTREND LIMIT; CALCULATION.
new text end

new text begin Beginning January 1, 2019, and ending June 30, 2021, the commissioner may limit the
trend increase in rates paid to managed care plans and county-based purchasing plans under
Minnesota Statutes, sections 256B.69 and 256B.692, by an amount equal to the value of a
0.5 percent reduction in trend in medical assistance. Managed care rates must meet actuarial
soundness and rate development requirements under Code of Federal Regulations, title 42,
part 438, subpart A.
new text end

new text begin In the November 2017 forecast, the commissioner of human services, in consultation
with the commissioner of management and budget, shall determine the extent to which the
limits in managed care trend growth are forecasted to reduce medical assistance expenditures
in fiscal years 2019 through 2021. Any reduction estimated shall reduce the cancellation in
Laws 2017, chapter 2, article 1, section 2, subdivision 3, paragraph (e), by up to $82,289,000.
new text end

Sec. 16. new text beginTRANSFERS.
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, 2019, within fiscal years among the MFIP, general
assistance, 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 and Policy
Committee, the senate Human Services Reform Finance and Policy Committee, 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 and Policy Committee, the
senate Human Services Reform Finance and Policy Committee, and the house of
representatives Health and Human Services Finance Committee quarterly about transfers
made under this subdivision.
new text end

Sec. 17. new text beginINDIRECT 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. 18. new text beginEXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2019, unless a
different expiration date is explicit.
new text end

Sec. 19. new text beginEFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2017, unless a different effective date is specified.
new text end

APPENDIX

Repealed Minnesota Statutes: 171-S0002-1

13.468 DATA SHARING WITHIN COUNTIES.

County welfare, human services, corrections, public health, and veterans service units within a county may inform each other as to whether an individual or family currently is being served by the county unit, without the consent of the subject of the data. Data that may be shared are limited to the following: the name, telephone number, and last known address of the data subject; and the identification and contact information regarding personnel of the county unit responsible for working with the individual or family. If further information is necessary for the county unit to carry out its duties, each county unit may share additional data if the unit is authorized by state statute or federal law to do so or the individual gives written, informed consent.

103I.005 DEFINITIONS.

Subd. 8.

Environmental bore hole.

"Environmental bore hole" means a hole or excavation in the ground that penetrates a confining layer or is greater than 25 feet in depth and enters or goes through a water bearing layer and is used to monitor or measure physical, chemical, radiological, or biological parameters without extracting water. An environmental bore hole also includes bore holes constructed for vapor recovery or venting systems. An environmental bore hole does not include a well, elevator shaft, exploratory boring, or monitoring well.

Subd. 14.

Monitoring well.

"Monitoring well" means an excavation that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed to extract groundwater for physical, chemical, or biological testing. "Monitoring well" includes a groundwater quality sampling well.

Subd. 15.

Monitoring well contractor.

"Monitoring well contractor" means a person who is registered by the commissioner to construct monitoring wells.

103I.451 ENVIRONMENTAL BORE HOLES.

An environmental bore hole must be constructed, sealed, and reported as prescribed by rule of the commissioner by a well contractor or a monitoring well contractor.

119B.07 USE OF MONEY.

(a) Money for persons listed in sections 119B.03, subdivision 3, and 119B.05, subdivision 1, shall be used to reduce the costs of child care for students, including the costs of child care for students while employed if enrolled in an eligible education program at the same time and making satisfactory progress towards completion of the program. Counties may not limit the duration of child care subsidies for a person in an employment or educational program, except when the person is found to be ineligible under the child care fund eligibility standards. Any limitation must be based on a person's employment plan in the case of an MFIP participant, and county policies included in the child care fund plan. The maximum length of time a student is eligible for child care assistance under the child care fund for education and training is no more than the time necessary to complete the credit requirements for an associate or baccalaureate degree as determined by the educational institution, excluding basic or remedial education programs needed to prepare for postsecondary education or employment.

(b) To be eligible, the student must be in good standing and be making satisfactory progress toward the degree. Time limitations for child care assistance do not apply to basic or remedial educational programs needed to prepare for postsecondary education or employment. These programs include: high school, general equivalency diploma, and English as a second language. Programs exempt from this time limit must not run concurrently with a postsecondary program. If an MFIP participant who is receiving MFIP child care assistance under this chapter moves to another county, continues to participate in educational or training programs authorized in their employment plans, and continues to be eligible for MFIP child care assistance under this chapter, the MFIP participant must receive continued child care assistance from the county responsible for their current employment plan, under section 256G.07.

144.0571 INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO CRIMINAL BACKGROUND CHECKS.

(a) If the Department of Health is not reviewed by the Sunset Advisory Commission according to the schedule in section 3D.21, the commissioner of health, as the regulator for occupational therapy practitioners, speech-language pathologists, audiologists, and hearing instrument dispensers, shall require applicants for licensure or renewal to submit to a criminal history records check as required under section 214.075 for other health-related licensed occupations regulated by the health-related licensing boards.

(b) Any statutory changes necessary to include the commissioner of health to section 214.075 shall be included in the plan required in section 214.075, subdivision 8.

144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: REPORT AND STUDY REQUIRED.

Subd. 2.

Critical access study.

The commissioner of human services shall conduct a onetime study to assess local capacity and availability of home and community-based services for older adults, people with disabilities, and people with mental illnesses. The study must assess critical access at the community level and identify potential strategies to build home and community-based service capacity in critical access areas. The report shall be submitted to the legislature no later than August 15, 2015.

147A.21 RULEMAKING AUTHORITY.

The board shall adopt rules:

(1) setting license fees;

(2) setting renewal fees;

(3) setting fees for temporary licenses; and

(4) establishing renewal dates.

147B.08 FEES.

Subdivision 1.

Annual registration fee.

The board shall establish the fee of $150 for initial licensure and $150 annual licensure renewal. The board may prorate the initial licensure fee.

Subd. 2.

Penalty fee for late renewals.

The penalty fee for late submission for renewal application is $50.

Subd. 3.

Deposit.

Fees collected by the board under this section must be deposited in the state government special revenue fund.

147C.40 FEES.

Subdivision 1.

Fees.

The board shall adopt rules setting:

(1) licensure fees;

(2) renewal fees;

(3) late fees;

(4) inactive status fees; and

(5) fees for temporary permits.

Subd. 2.

Proration of fees.

The board may prorate the initial annual license fee. All licensees are required to pay the full fee upon license renewal.

Subd. 3.

Penalty fee for late renewals.

An application for license renewal submitted after the deadline must be accompanied by a late fee in addition to the required fees.

Subd. 4.

Nonrefundable fees.

All of the fees in subdivision 1 are nonrefundable.

148.6402 DEFINITIONS.

Subd. 2.

Advisory council.

"Advisory council" means the Occupational Therapy Practitioners Advisory Council in section 148.6450.

148.6450 OCCUPATIONAL THERAPY PRACTITIONERS ADVISORY COUNCIL.

Subdivision 1.

Membership.

The commissioner shall appoint seven persons to an Occupational Therapy Practitioners Advisory Council consisting of the following:

(1) two public members, as defined in section 214.02. The public members shall be either persons who have received occupational therapy services or family members of or caregivers to such persons;

(2) two members who are occupational therapists and two occupational therapy assistants licensed under sections 148.6401 to 148.6450, each of whom is employed in a different practice area including, but not limited to, long-term care, school therapy, early intervention, administration, gerontology, industrial rehabilitation, cardiac rehabilitation, physical disability, pediatrics, mental health, home health, and hand therapy. Three of the four occupational therapy practitioners who serve on the advisory council must be currently, and for the three years preceding the appointment, engaged in the practice of occupational therapy or employed as an administrator or an instructor of an occupational therapy program. At least one of the four occupational therapy practitioners who serves on the advisory council must be employed in a rural area; and

(3) one member who is a licensed or registered health care practitioner, or other credentialed practitioner, who works collaboratively with occupational therapy practitioners.

Subd. 2.

Duties.

At the commissioner's request, the advisory council shall:

(1) advise the commissioner regarding the occupational therapy practitioner licensure standards;

(2) advise the commissioner on enforcement of sections 148.6401 to 148.6450;

(3) provide for distribution of information regarding occupational therapy practitioners licensure standards;

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

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

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

148.906 LEVELS OF PRACTICE.

The board may grant licenses for levels of psychological practice to be known as (1) licensed psychologist and (2) licensed psychological practitioner.

148.907 LICENSED PSYCHOLOGIST.

Subd. 5.

Converting from licensed psychological practitioner to licensed psychologist.

Notwithstanding subdivision 3, to convert from licensure as a licensed psychological practitioner to licensure as a licensed psychologist, a licensed psychological practitioner shall have:

(1) completed an application provided by the board for conversion from licensure as a licensed psychological practitioner to licensure as a licensed psychologist;

(2) paid a nonrefundable fee of $500;

(3) documented successful completion of two full years, or the equivalent, of supervised postlicensure employment meeting the requirements of section 148.925, subdivision 5, as it relates to preparation for licensure as a licensed psychologist as follows:

(i) for individuals licensed as licensed psychological practitioners on or before December 31, 2006, the supervised practice must be completed by December 31, 2010; and

(ii) for individuals licensed as licensed psychological practitioners after December 31, 2006, the supervised practice must be completed within four years from the date of licensure; and

(4) no unresolved disciplinary action or complaints pending, or incomplete disciplinary orders or corrective action agreements in Minnesota or any other jurisdiction.

148.908 LICENSED PSYCHOLOGICAL PRACTITIONER.

Subdivision 1.

Scope of practice.

A licensed psychological practitioner shall practice only under supervision that satisfies the requirements of section 148.925 and while employed by either a licensed psychologist or a health care or social service agency which employs or contracts with a supervising licensed psychologist who shares clinical responsibility for the care provided by the licensed psychological practitioner.

Subd. 2.

Requirements for licensure as licensed psychological practitioner.

To become licensed by the board as a licensed psychological practitioner, an applicant shall comply with the following requirements:

(1) have earned a doctoral or master's degree or the equivalent of a master's degree in a doctoral program with a major in psychology from a regionally accredited educational institution meeting the standards the board has established by rule. The degree requirements must be completed by December 31, 2005;

(2) complete an application for admission to the examination for professional practice in psychology and pay the nonrefundable application fee by December 31, 2005;

(3) complete an application for admission to the professional responsibility examination and pay the nonrefundable application fee by December 31, 2005;

(4) pass the examination for professional practice in psychology by December 31, 2006;

(5) pass the professional responsibility examination by December 31, 2006;

(6) complete an application for licensure as a licensed psychological practitioner and pay the nonrefundable application fee by March 1, 2007; and

(7) have attained the age of majority, be of good moral character, and have no unresolved disciplinary action or complaints pending in the state of Minnesota or any other jurisdiction.

Subd. 3.

Termination of licensure.

Effective December 31, 2011, the licensure of all licensed psychological practitioners shall be terminated without further notice and licensure as a licensed psychological practitioner in Minnesota shall be eliminated.

148.909 LICENSURE FOR VOLUNTEER PRACTICE.

Subd. 7.

Continuing education requirements.

A provider licensed under this section is subject to the same continuing education requirements as a licensed psychologist under section 148.911.

148.96 PRESENTATION TO PUBLIC.

Subd. 4.

Persons or techniques not regulated by this board.

(a) Nothing in sections 148.88 to 148.98 shall be construed to limit the occupational pursuits consistent with their training and codes of ethics of professionals such as teachers in recognized public and private schools, members of the clergy, physicians, social workers, school psychologists, alcohol or drug counselors, optometrists, or attorneys. However, in such performance any title used shall be in accordance with section 148.96.

(b) Use of psychological techniques by business and industrial organizations for their own personnel purposes or by employment agencies or state vocational rehabilitation agencies for the evaluation of their own clients prior to recommendation for employment is also specifically allowed. However, no representative of an industrial or business firm or corporation may sell, offer, or provide any psychological services as specified in section 148.89 unless such services are performed or supervised by individuals licensed under sections 148.88 to 148.98.

Subd. 5.

Other professions not authorized.

Nothing in sections 148.88 to 148.98 shall be construed to authorize a person licensed under sections 148.88 to 148.98 to engage in the practice of any profession regulated under Minnesota law unless the person is duly licensed or registered in that profession.

245A.1915 OPIOID ADDICTION TREATMENT EDUCATION REQUIREMENT FOR PROVIDERS LICENSED TO PROVIDE CHEMICAL DEPENDENCY TREATMENT SERVICES.

All programs serving persons with substance use issues licensed by the commissioner must provide educational information concerning: treatment options for opioid addiction, including the use of a medication for the use of opioid addiction; and recognition of and response to opioid overdose and the use and administration of naloxone, to clients identified as having or seeking treatment for opioid addiction. The commissioner shall develop educational materials that are supported by research and updated periodically that must be used by programs to comply with this requirement.

245A.192 PROVIDERS LICENSED TO PROVIDE TREATMENT OF OPIOID ADDICTION.

Subdivision 1.

Scope.

(a) This section applies to services licensed under this chapter to provide treatment for opioid addiction. In addition to the requirements under Minnesota Rules, parts 9530.6405 to 9530.6505, a program licensed to provide treatment of opioid addiction must meet the requirements in this section.

(b) Where a standard in this section differs from a standard in an otherwise applicable administrative rule, the standards of this section apply.

(c) When federal guidance or interpretations have been issued on federal standards or requirements also required under this section, the federal guidance or interpretations shall apply.

Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision have the meanings given them.

(b) "Diversion" means the use of a medication for the treatment of opioid addiction being diverted from its intended use.

(c) "Guest dose or dosing" means the practice of administering a medication used for the treatment of opioid addiction to a person who is not a client of the program that is administering or dispensing the medication.

(d) "Medical director" means a physician, licensed to practice medicine in the jurisdiction in which the opioid treatment program is located, who assumes responsibility for administering all medical services performed by the program, either by performing them directly or by delegating specific responsibility to authorized program physicians and health care professionals functioning under the medical director's direct supervision.

(e) "Medication used for the treatment of opioid addiction" means a medication approved by the Food and Drug Administration for the treatment of opioid addiction.

(f) "Opioid treatment program" has the meaning given in Code of Federal Regulations, title 42, section 8.12, and includes programs licensed under Minnesota Rules, part 9530.6500.

(g) "Program" means an entity that is licensed under Minnesota Rules, part 9530.6500.

(h) "Unsupervised use" means the use of a medication for the treatment of opioid addiction dispensed for use by a client outside of the program setting. This is also referred to as a "take-home" dose.

(i) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, subpart 21a.

(j) "Minnesota health care programs" has the meaning given in section 256B.0636.

Subd. 3.

Medication orders.

Prior to the program administering or dispensing a medication used for the treatment of opioid addiction:

(1) a client-specific order must be received from an appropriately credentialed physician who is enrolled as a Minnesota health care programs provider and meets all applicable provider standards;

(2) the signed order must be documented in the client's record; and

(3) if the physician that issued the order is not able to sign the order when issued, the unsigned order must be entered in the client record at the time it was received, and the physician must review the documentation and sign the order in the client's record within 72 hours of the medication being ordered. The license holder must report to the commissioner any medication error that endangers a patient's health, as determined by the medical director.

Subd. 3a.

High dose requirements.

A client being administered or dispensed a dose beyond that set forth in subdivision 5, paragraph (a), clause (1), that exceeds 150 milligrams of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, must meet face-to-face with a prescribing physician. The meeting must occur before the administering or dispensing of the increased dose.

Subd. 4.

Drug testing.

Each client enrolled in the program must receive a minimum of eight random drug abuse tests per 12 months of treatment. These tests must be reasonably disbursed over the 12-month period. A license holder may elect to conduct more drug abuse tests.

Subd. 5.

Criteria for unsupervised use.

(a) To limit the potential for diversion of medication used for the treatment of opioid addiction to the illicit market, any such medications dispensed to patients for unsupervised use shall be subject to the following requirements:

(1) any patient in an opioid treatment program may receive a single take-home dose for a day that the clinic is closed for business, including Sundays and state and federal holidays; and

(2) treatment program decisions on dispensing medications used to treat opioid addiction to patients for unsupervised use beyond that set forth in clause (1) shall be determined by the medical director.

(b) A physician with authority to prescribe must consider the criteria in this subdivision in determining whether a client may be permitted unsupervised or take-home use of such medications. The criteria must also be considered when determining whether dispensing medication for a client's unsupervised use is appropriate to increase or to extend the amount of time between visits to the program. The criteria include:

(1) absence of recent abuse of drugs including but not limited to opioids, nonnarcotics, and alcohol;

(2) regularity of program attendance;

(3) absence of serious behavioral problems at the program;

(4) absence of known recent criminal activity such as drug dealing;

(5) stability of the client's home environment and social relationships;

(6) length of time in comprehensive maintenance treatment;

(7) reasonable assurance that take-home medication will be safely stored within the client's home; and

(8) whether the rehabilitative benefit the client derived from decreasing the frequency of program attendance outweighs the potential risks of diversion or unsupervised use.

(c) The determination, including the basis of the determination, must be consistent with the criteria in this subdivision and must be documented in the client's medical record.

Subd. 6.

Restrictions for unsupervised or take-home use of methadone hydrochloride.

(a) In cases where it is determined that a client meets the criteria in subdivision 5 and may be dispensed a medication used for the treatment of opioid addiction, the restrictions in paragraphs (b) to (g) must be followed when the medication to be dispensed is methadone hydrochloride.

(b) During the first 90 days of treatment, the take-home supply must be limited to a maximum of a single dose each week and the client shall ingest all other doses under direct supervision.

(c) In the second 90 days of treatment, the take-home supply must be limited to two doses per week.

(d) In the third 90 days of treatment, the take-home supply must not exceed three doses per week.

(e) In the remaining months of the first year, a client may be given a maximum six-day supply of take-home medication.

(f) After one year of continuous treatment, a client may be given a maximum two-week supply of take-home medication.

(g) After two years of continuous treatment, a client may be given a maximum one-month supply of take-home medication, but must make monthly visits.

Subd. 7.

Restriction exceptions.

When a license holder has reason to accelerate the number of unsupervised or take-home doses of methadone hydrochloride, the license holder must comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the criteria for unsupervised use in subdivision 5, and must use the exception process provided by the federal Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the purposes of enforcement of this subdivision, the commissioner has the authority to monitor for compliance with these federal regulations and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance.

Subd. 8.

Guest dosing.

In order to receive a guest dose, the client must be enrolled in an opioid treatment program elsewhere in the state or country and be receiving the medication on a temporary basis because the client is not able to receive the medication at the program in which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any one program and must not be for the convenience or benefit of either program. Guest dosing may also occur when the client's primary clinic is not open and the client is not receiving take-home doses.

Subd. 9.

Data and reporting.

The license holder must submit data concerning medication used for the treatment of opioid addiction to a central registry. The data must be submitted in a method determined by the commissioner and must be submitted for each client at the time of admission and discharge. The program must document the date the information was submitted. This requirement is effective upon implementation of changes to the Drug and Alcohol Abuse Normative Evaluation System (DAANES) or development of an electronic system by which to submit the data.

Subd. 10.

Nonmedication treatment services; documentation.

(a) The program must offer at least 50 consecutive minutes of individual or group therapy treatment services as defined in Minnesota Rules, part 9530.6430, subpart 1, item A, subitem (1), per week, for the first ten weeks following admission, and at least 50 consecutive minutes per month thereafter. As clinically appropriate, the program may offer these services cumulatively and not consecutively in increments of no less than 15 minutes over the required time period, and for a total of 60 minutes of treatment services over the time period, and must document the reason for providing services cumulatively in the client's record. The program may offer additional levels of service when deemed clinically necessary.

(b) Notwithstanding the requirements of comprehensive assessments in Minnesota Rules, part 9530.6422, the assessment must be completed within 21 days of service initiation.

(c) Notwithstanding the requirements of individual treatment plans set forth in Minnesota Rules, part 9530.6425:

(1) treatment plan contents for maintenance clients are not required to include goals the client must reach to complete treatment and have services terminated;

(2) treatment plans for clients in a taper or detox status must include goals the client must reach to complete treatment and have services terminated;

(3) for the initial ten weeks after admission for all new admissions, readmissions, and transfers, progress notes must be entered in a client's file at least weekly and be recorded in each of the six dimensions upon the development of the treatment plan and thereafter. Subsequently, the counselor must document progress no less than one time monthly, recorded in the six dimensions or when clinical need warrants more frequent notations; and

(4) upon the development of the treatment plan and thereafter, treatment plan reviews must occur weekly, or after each treatment service, whichever is less frequent, for the first ten weeks after the treatment plan is developed. Following the first ten weeks of treatment plan reviews, reviews may occur monthly, unless the client has needs that warrant more frequent revisions or documentation.

Subd. 11.

Prescription monitoring program.

(a) The program must develop and maintain a policy and procedure that requires the ongoing monitoring of the data from the prescription monitoring program for each client. The policy and procedure must include how the program will meet the requirements in paragraph (b).

(b) If a medication used for the treatment of opioid addiction is administered or dispensed to a client, the license holder shall be subject to the following requirements:

(1) upon admission to a methadone clinic outpatient treatment program, clients must be notified in writing that the commissioner of human services and the medical director will monitor the prescription monitoring program to review the prescribed controlled drugs the clients have received;

(2) the medical director or the medical director's delegate must review the data from the Minnesota Board of Pharmacy prescription monitoring program (PMP) established under section 152.126 prior to the client being ordered any controlled substance, as defined under section 152.126, subdivision 1, paragraph (c), including medications used for the treatment of opioid addiction, and subsequent reviews of the PMP data must occur at least every 90 days;

(3) a copy of the PMP data reviewed must be maintained in the client file;

(4) when the PMP data contains a recent history of multiple prescribers or multiple prescriptions for controlled substances, the physician's review of the data and subsequent actions must be documented in the client's individual file within 72 hours and must contain the medical director's determination of whether or not the prescriptions place the client at risk of harm and the actions to be taken in response to the PMP findings. In addition, the provider must conduct subsequent reviews of the PMP on a monthly basis; and

(5) if at any time the medical director believes the use of the controlled substances places the client at risk of harm, the program must seek the client's consent to discuss the client's opioid treatment with other prescribers and must seek consent for the other prescriber to disclose to the opioid treatment program's medical director the client's condition that formed the basis of the other prescriptions. If the information is not obtained within seven days, the medical director must document whether or not changes to the client's medication dose or number of take-home doses are necessary until the information is obtained.

(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop and implement an electronic system through which the commissioner shall routinely access the data from the Minnesota Board of Pharmacy prescription monitoring program established under section 152.126 for the purpose of determining whether any client enrolled in an opioid addiction treatment program licensed according to this section has also been prescribed or dispensed a controlled substance in addition to that administered or dispensed by the opioid addiction treatment program. When the commissioner determines there have been multiple prescribers or multiple prescriptions of controlled substances, the commissioner shall:

(1) inform the medical director of the opioid treatment program only that the commissioner determined the existence of multiple prescribers or multiple prescriptions of controlled substances; and

(2) direct the medical director of the opioid treatment program to access the data directly, review the effect of the multiple prescribers or multiple prescriptions, and document the review.

(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), prior to implementing this subdivision.

Subd. 12.

Policies and procedures.

(a) License holders must develop and maintain the policies and procedures required in this subdivision.

(b) For programs that are not open every day of the year, the license holder must maintain a policy and procedure that permits clients to receive a single unsupervised use of medication used for the treatment of opioid addiction for days that the program is closed for business, including, but not limited to, Sundays and state and federal holidays as required under subdivision 5, paragraph (a), clause (1).

(c) The license holder must maintain a policy and procedure that includes specific measures to reduce the possibility of medication used for the treatment of opioid addiction being diverted from its intended treatment use. The policy and procedure must:

(1) specifically identify and define the responsibilities of the medical and administrative staff for carrying out diversion control measures; and

(2) include a process for contacting no less than five percent of clients who have unsupervised use of medication used for the treatment of opioid addiction, excluding those approved solely under subdivision 5, paragraph (a), clause (1), to require them to physically return to the program each month. The system must require clients to return to the program within a stipulated time frame and turn in all unused medication containers related to opioid addiction treatment. The license holder must document all related contacts on a central log and the outcome of the contact for each client in the individual client's record.

(d) Medications used for the treatment of opioid addictions must be ordered, administered, and dispensed according to applicable state and federal regulations and the standards set by applicable accreditation entities. In addition, when an order requires assessment by the person administering or dispensing the medication to determine the amount to be administered or dispensed, the assessment must be completed by an individual whose professional scope of practice permits such assessment. For the purposes of enforcement of this paragraph, the commissioner has the authority to monitor for compliance with these state and federal regulations and the relevant standards of the license holder's accreditation agency and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance.

Subd. 13.

Quality improvement plan.

The license holder must develop and maintain a quality improvement process and plan. The plan must:

(1) include evaluation of the services provided to clients with the goal of identifying issues that may improve service delivery and client outcomes;

(2) include goals for the program to accomplish based on the evaluation;

(3) be reviewed annually by the management of the program to determine whether the goals were met and, if not, whether additional action is required;

(4) be updated at least annually to include new or continued goals based on an updated evaluation of services; and

(5) identify two specific goal areas, in addition to others identified by the program, including:

(i) a goal concerning oversight and monitoring of the premises around and near the exterior of the program to reduce the possibility of medication used for the treatment of opioid addiction being inappropriately used by clients, including but not limited to the sale or transfer of the medication to others; and

(ii) a goal concerning community outreach, including but not limited to communications with local law enforcement and county human services agencies, with the goal of increasing coordination of services and identification of areas of concern to be addressed in the plan.

Subd. 14.

Placing authorities.

Programs must provide certain notification and client-specific updates to placing authorities for clients who are enrolled in Minnesota health care programs. At the request of the placing authority, the program must provide client-specific updates, including but not limited to informing the placing authority of positive drug screenings and changes in medications used for the treatment of opioid addiction ordered for the client.

Subd. 15.

A program's duty to report suspected drug diversion.

(a) To the fullest extent permitted under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to law enforcement any credible evidence that the program or its personnel knows, or reasonably should know, that is directly related to a diversion crime on the premises of the program, or a threat to commit a diversion crime.

(b) "Diversion crime," for the purposes of this section, means diverting, attempting to divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02, on the program's premises.

(c) The program must document its compliance with the requirement in paragraph (a) in either a client's record or an incident report.

(d) Failure to comply with the duty in paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.

Subd. 16.

Variance.

The commissioner may grant a variance to the requirements of this section.

254A.02 DEFINITIONS.

Subd. 4.

Drug abuse or abuse of drugs.

"Drug abuse or abuse of drugs" is the use of any psychoactive or mood altering chemical substance, without compelling medical reason, in such a manner as to induce mental, emotional or physical impairment and cause socially dysfunctional or socially disordering behavior and which results in psychological or physiological dependency as a function of continued use.

256B.19 DIVISION OF COST.

Subd. 1c.

Additional portion of nonfederal share.

(a) Hennepin County shall be responsible for a monthly transfer payment of $1,500,000, due before noon on the 15th of each month and the University of Minnesota shall be responsible for a monthly transfer payment of $500,000 due before noon on the 15th of each month, beginning July 15, 1995. These sums shall be part of the designated governmental unit's portion of the nonfederal share of medical assistance costs.

(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall be $2,066,000 each month.

(c) Beginning July 1, 2001, the commissioner shall increase annual capitation payments to a demonstration provider serving eligible individuals in Hennepin County under section 256B.69 for the prepaid medical assistance program by approximately $6,800,000 to recognize higher than average medical education costs.

(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) and (b) shall be reduced to $566,000, and the University of Minnesota's payment under paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 31, 2010, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $566,000.

(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June 30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally provided under Public Law 111-5, for the six-month period from January 1, 2011, to June 30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.

Subd. 16.

Budget neutrality adjustments.

(a) The commissioner shall use the following adjustments to the rate generated by the framework to assure budget neutrality until the rate information is available to implement paragraph (b). The rate generated by the framework shall be multiplied by the appropriate factor, as designated below:

(1) for residential services: 1.003;

(2) for day services: 1.000;

(3) for unit-based services with programming: 0.941; and

(4) for unit-based services without programming: 0.796.

(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated spending for all home and community-based waiver services under the new payment rates defined in subdivisions 6 to 9 with estimated spending for the same recipients and services under the rates in effect on July 1, 2013. This comparison must distinguish spending under each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and services for one or more service months after the new rates have gone into effect. The commissioner shall consult with the commissioner of management and budget on this analysis to ensure budget neutrality. If estimated spending under the new rates for services under one or more subdivisions differs in this comparison by 0.3 percent or more, the commissioner shall assure aggregate budget neutrality across all service areas by adjusting the budget neutrality factor in paragraph (a) in each subdivision so that total estimated spending for each subdivision under the new rates matches estimated spending under the rates in effect on July 1, 2013.

256B.64 ATTENDANTS TO VENTILATOR-DEPENDENT RECIPIENTS.

A ventilator-dependent recipient of medical assistance who has been receiving the services of a home care nurse or personal care assistant in the recipient's home may continue to have a home care nurse or personal care assistant present upon admission to a hospital licensed under chapter 144. The personal care assistant or home care nurse shall perform only the services of communicator or interpreter for the ventilator-dependent patient during a transition period of up to 120 hours to assure adequate training of the hospital staff to communicate with the patient and to understand the unique comfort, safety, and personal care needs of the patient. The personal care assistant or home care nurse may offer nonbinding advice to the health care professionals in charge of the ventilator-dependent patient's care and treatment on matters pertaining to the comfort and safety of the patient. Within 36 hours of the end of the 120-hour transition period, an assessment may be made by the ventilator-dependent recipient, the attending physician, and the hospital staff caring for the recipient. If the persons making the assessment determine that additional communicator or interpreter services are medically necessary, the hospital must contact the commissioner 24 hours prior to the end of the 120-hour transition period and submit the assessment information to the commissioner. The commissioner shall review the request and determine if it is medically necessary to continue the interpreter services or if the hospital staff has had sufficient opportunity to adequately determine the needs of the patient. The commissioner shall determine if continued service is necessary and appropriate and whether or not payments shall continue. The commissioner may not authorize services beyond the limits of the available appropriations for this section. The commissioner may adopt rules necessary to implement this section. Reimbursement under this section must be at the payment rate and in a manner consistent with the payment rate and manner used in reimbursing these providers for home care services for the ventilator-dependent recipient under the medical assistance program.

256B.7631 CHEMICAL DEPENDENCY PROVIDER RATE INCREASE.

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.

256C.23 DEFINITIONS.

Subd. 3.

Regional service center.

"Regional service center" means a facility designed to provide an entry point for deaf, deafblind, and hard-of-hearing persons of that region in need of education, employment, social, human, or other services.

256C.233 DUTIES OF STATE AGENCIES.

Subd. 4.

State commissioners.

The commissioners of all state agencies shall consult with the Deaf and Hard-of-Hearing Services Division concerning the promulgation of public policies, regulations, and programs necessary to address the needs of deaf, deafblind, and hard-of-hearing Minnesotans. Each state agency shall consult with the Deaf and Hard-of-Hearing Services Division concerning the need to forward legislative initiatives to the governor to address the concerns of deaf, deafblind, and hard-of-hearing Minnesotans.

256C.25 INTERPRETER SERVICES.

Subdivision 1.

Establishment.

The Deaf and Hard-of-Hearing Services Division shall maintain and coordinate statewide interpreting or interpreter referral services for use by any public or private agency or individual in the state. The division shall directly coordinate these services but may contract with an appropriate agency to provide this service. The division may collect a $3 fee per referral for interpreter referral services and the actual costs of interpreter services provided by department staff. Fees and payments collected shall be deposited in the general fund. The $3 referral fee shall not be collected from state agencies or local units of government or deaf or hard-of-hearing consumers or interpreters.

Subd. 2.

Duties.

Interpreting or interpreter referral services must include:

(1) statewide access to interpreter referral and direct interpreting services, coordinated with the regional service centers;

(2) maintenance of a statewide directory of qualified interpreters;

(3) assessment of the present and projected supply and demand for interpreter services statewide; and

(4) coordination with the regional service centers on projects to train interpreters and advocate for and evaluate interpreter services.

Repealed Minnesota Rule: 171-S0002-1

5600.2500 FEES.

The fees charged by the board are fixed at the following rates:

A.

physician application fee, $200;

B.

physician annual license, $192;

C.

physician endorsement to other states, $40;

D.

physician emeritus license, $50;

E.

physician temporary licenses, $60;

F.

physician late fee, $60;

G.

physician assistant application fee, $120;

H.

physician assistant annual registration (prescribing), $135;

I.

physician assistant annual registration (nonprescribing), $115;

J.

physician assistant temporary registration, $115;

K.

physician assistant temporary permit, $60;

L.

physician assistant locum tenens permit, $25;

M.

physician assistant late fee, $50;

N.

acupuncture temporary permit, $60;

O.

acupuncture inactive status fee, $50;

P.

respiratory care annual registration, $90;

Q.

respiratory care application fee, $100;

R.

respiratory care late fee, $50;

S.

respiratory care inactive status, $50;

T.

respiratory care temporary permit, $60;

U.

respiratory care temporary registration, $90;

V.

duplicate license or registration fee, $20;

W.

certification letter, $25;

X.

verification of status, $10;

Y.

education or training program approval fee, $100;

Z.

report creation and generation, $60 per hour billed in quarter-hour increments with a quarter-hour minimum; and

AA.

examination administrative fee:

(1)

half day, $50; and

(2)

full day, $80.

The renewal cycle for physician assistants under items H and I begins July 1. The duration of the permit issued under item L is one year.

9500.1140 APPEALS.

Subp. 3.

Case mix appeals.

A hospital may appeal a payment change that results from a difference in case mix between the base year and rate year. The appeal must be received by the commissioner or postmarked no later than 120 days after the end of the appealed rate year. A case mix appeal will apply to all medical assistance patients who received inpatient hospital services from the hospital for which the hospital received medical assistance payment excluding Medicare crossovers and the appeal is effective for the entire rate year. A case mix appeal excludes medical assistance admissions whose payments have been made according to part 9500.1130, subpart 1b, item E. A case mix appeal excludes medical assistance admissions that have a relative value of zero for its DRG. The results of case mix appeals do not automatically carry forward into later rate years. Separate case mix appeals must be submitted for each rate year based on the change in the mix of cases for that particular rate year. An adjustment will be made only to the extent that the need is attributable to circumstances that are separately identified by the hospital. The hospital must demonstrate that the average acuity or length of stay of patients in each rate year appealed has increased or services have been added or discontinued according to items A to J.

A.

The change must be measured by use of case mix indices derived using all DRG's. Relative values for each DRG will be determined according to part 9500.1110, subpart 1, by substituting DRG terms and data for diagnostic category terms and data. DRG relative values will be determined based on all programs and the rehabilitation distinct part specialty group. Separate DRG relative values will be determined for transfers to the neonatal intensive care unit specialty group. For each program and specialty group, make the determinations in subitems (1) to (6).

(1)

Multiply the hospital's number of rate year admissions within each DRG by the relative value of that DRG.

(2)

Add together each of the products determined in subitem (1).

(3)

Divide the total from subitem (2) by the hospital's number of rate year admissions and round the quotient to five decimal places.

(4)

Complete the functions in subitems (1) to (3) for the hospital's base year admissions determined in part 9500.1110, subpart 1, item C.

(5)

Divide the quotient determined in subitem (3) by the quotient determined in subitem (4).

(6)

Multiply subitem (5) by 100 and round the percentage to five decimal places.

B.

The percentage change, in whole numbers, between the recalculated case mix indices under item A will be reduced by the change in indices as measured using diagnostic categories in part 9500.1100, subparts 20b to 20g. For each program and specialty group, make the determinations in subitems (1) to (8).

(1)

Multiply the hospital's number of rate year admissions within each diagnostic category by the relative value of that diagnostic category as determined in part 9500.1100.

(2)

Add together each of the products determined in subitem (1).

(3)

Divide the total from subitem (2) by the hospital's number of rate year admissions and round the quotient to five decimal places.

(4)

Complete the functions in subitems (1) to (3) for the hospital's base year admissions determined in part 9500.1110, subpart 1, item C.

(5)

Divide the quotient determined in subitem (3) by the quotient determined in subitem (4).

(6)

Multiply subitem (5) by 100 and round the percentage to five decimal places.

(7)

Divide item A, subitem (6), by subitem (6).

(8)

Multiply subitem (7) by 100 and round the percentage change to whole numbers.

C.

Determine the payments made for admissions occurring during the appealed rate year under part 9500.1128 reduced by property payments made under parts 9500.1121, 9500.1122, 9500.1123, and 9500.1124 for each program and specialty group.

D.

Multiply item B, subitem (8), by item C for each program and specialty group.

E.

Subtract item C from item D for each program and specialty group.

F.

Add the differences in item E.

G.

Add the differences in item C.

H.

Divide item F by item G. If the quotient is less than positive 0.05 and more than negative 0.05, there can be no payment adjustment for a change in case mix.

I.

Subtract 0.05 from the quotient in item H if the quotient is positive or add 0.05 if the quotient is negative.

J.

Multiply item G by item I. If the product is positive, there is an underpayment with that amount due the hospital. If the product is negative, there is an overpayment with that amount due the department.

9500.1140 APPEALS.

Subp. 4.

Medicare adjustment appeals.

To appeal a payment rate or payment change that results from Medicare adjustments of base year information, the appeal must be received by the commissioner or postmarked not later than 60 days after the date the medical assistance determination was mailed to the hospital by the department or within 60 days of the date the Medicare determination was mailed to the hospital by Medicare, whichever is later.

9500.1140 APPEALS.

Subp. 5.

Rate and payment appeals.

To appeal a payment rate or payment determination that is not a case mix or Medicare adjustment appeal, the appeal must be received by the commissioner within 60 days of the date the determination was mailed to the hospital.

9500.1140 APPEALS.

Subp. 6.

Resolution of appeals.

The appeal will be heard by an administrative law judge according to parts 1400.5100 to 1400.8401 and Minnesota Statutes, sections 14.57to 14.62, and according to the requirements of items A to D.

A.

The hospital must demonstrate by a preponderance of the evidence that the commissioner's determination is incorrect or not according to law.

B.

Both overpayments and underpayments that result from the submission of appeals will be implemented.

C.

Facts to be considered in any appeal of base year information are limited to those in existence at the time the payment rates of the first rate year were established from the base year information.

D.

Relative values and rates that are based on averages will not be recalculated to reflect the appeal outcome.

9530.6405 DEFINITIONS.

Subpart 1.

Scope.

As used in parts 9530.6405 to 9530.6505, the following terms have the meanings given to them.

9530.6405 DEFINITIONS.

Subp. 1a.

Administration of medications.

"Administration of medications" means performing a task to provide medications to a client, and includes the following tasks, performed in the following order:

A.

checking the client's medication record;

B.

preparing the medication for administration;

C.

administering the medication to the client;

D.

documenting the administration, or the reason for not administering medications as prescribed; and

E.

reporting information to a licensed practitioner or a nurse regarding problems with the administration of the medication or the client's refusal to take the medication.

9530.6405 DEFINITIONS.

Subp. 2.

Adolescent.

"Adolescent" means an individual under 18 years of age.

9530.6405 DEFINITIONS.

Subp. 3.

Alcohol and drug counselor.

"Alcohol and drug counselor" has the meaning given in Minnesota Statutes, section 148C.01, subdivision 2.

9530.6405 DEFINITIONS.

Subp. 4.

Applicant.

"Applicant" means an individual, corporation, partnership, voluntary association, controlling individual, or other organization that has applied for licensure under this chapter.

9530.6405 DEFINITIONS.

Subp. 5.

Capacity management system.

"Capacity management system" means a database operated by the Department of Human Services to compile and make information available to the public about the waiting list status and current admission capability of each program serving intravenous drug abusers.

9530.6405 DEFINITIONS.

Subp. 6.

Central registry.

"Central registry" means a database maintained by the department that collects identifying information from two or more programs about individuals applying for maintenance treatment or detoxification treatment for addiction to opiates for the purpose of avoiding an individual's concurrent enrollment in more than one program.

9530.6405 DEFINITIONS.

Subp. 7.

Chemical.

"Chemical" means alcohol, solvents, controlled substances as defined by Minnesota Statutes, section 152.01, subdivision 4, and other mood altering substances.

9530.6405 DEFINITIONS.

Subp. 7a.

Chemical dependency treatment.

"Chemical dependency treatment" means treatment of a substance use disorder, including the process of assessment of a client's needs, development of planned interventions or services to address those needs, provision of services, facilitation of services provided by other service providers, and reassessment by a qualified professional. The goal of treatment is to assist or support the client's efforts to recover from substance use disorder.

9530.6405 DEFINITIONS.

Subp. 8.

Client.

"Client" means an individual accepted by a license holder for assessment or treatment of a substance use disorder. An individual remains a client until the license holder no longer provides or plans to provide the individual with treatment services.

9530.6405 DEFINITIONS.

Subp. 9.

Commissioner.

"Commissioner" means the commissioner of the Department of Human Services or the commissioner's designee.

9530.6405 DEFINITIONS.

Subp. 10.

Co-occurring or co-occurring client.

"Co-occurring" or "co-occurring client" means a diagnosis that indicates a client suffers from a substance use disorder and a mental health problem.

9530.6405 DEFINITIONS.

Subp. 11.

Department.

"Department" means the Department of Human Services.

9530.6405 DEFINITIONS.

Subp. 12.

Direct client contact.

"Direct client contact" has the meaning given for "direct contact" in Minnesota Statutes, section 245C.02, subdivision 11.

9530.6405 DEFINITIONS.

Subp. 13.

License.

"License" means a certificate issued by the commissioner authorizing the license holder to provide a specific program for a specified period of time in accordance with the terms of the license and the rules of the commissioner.

9530.6405 DEFINITIONS.

Subp. 14.

License holder.

"License holder" means an individual, corporation, partnership, voluntary organization, or other organization that is legally responsible for the operation of the program, has been granted a license by the commissioner under this chapter, and is a controlling individual.

9530.6405 DEFINITIONS.

Subp. 14a.

Licensed practitioner.

"Licensed practitioner" means a person who is authorized to prescribe as defined in Minnesota Statutes, section 151.01, subdivision 23.

9530.6405 DEFINITIONS.

Subp. 15.

Licensed professional in private practice.

"Licensed professional in private practice" means an individual who meets the following criteria:

A.

is licensed under Minnesota Statutes, chapter 148C, or is exempt from licensure under that chapter but is otherwise licensed to provide alcohol and drug counseling services;

B.

practices solely within the permissible scope of the individual's license as defined in the law authorizing licensure; and

C.

does not affiliate with other licensed or unlicensed professionals for the purpose of providing alcohol and drug counseling services. Affiliation does not include conferring with other professionals or making client referrals.

9530.6405 DEFINITIONS.

Subp. 15a.

Nurse.

"Nurse" means a person licensed and currently registered to practice professional or practical nursing as defined in Minnesota Statutes, section 148.171, subdivisions 14 and 15.

9530.6405 DEFINITIONS.

Subp. 16.

Paraprofessional.

"Paraprofessional" means an employee, agent, or independent contractor of the license holder who performs tasks in support of the provision of treatment services. Paraprofessionals may be referred to by a variety of titles including technician, case aide, or counselor assistant. An individual may not be a paraprofessional employed by the license holder if the individual is a client of the license holder.

9530.6405 DEFINITIONS.

Subp. 17.

Program serving intravenous drug abusers.

"Program serving intravenous drug abusers" means a program whose primary purpose is providing agonist medication-assisted therapy to clients who are narcotic dependent, regardless of whether the client's narcotic use was intravenous or by other means.

9530.6405 DEFINITIONS.

Subp. 17a.

Student intern.

"Student intern" means a person who is enrolled in an alcohol and drug counselor education program at an accredited school or educational program and is earning a minimum of nine semester credits per calendar year toward the completion of an associate's, bachelor's, master's, or doctorate degree requirements. Degree requirements must include an additional 18 semester credits or 270 hours of alcohol and drug counseling related course work and 440 hours of practicum.

9530.6405 DEFINITIONS.

Subp. 17b.

Substance.

"Substance" means a "chemical" as defined in subpart 7.

9530.6405 DEFINITIONS.

Subp. 17c.

Substance use disorder.

"Substance use disorder" means a pattern of substance use as defined in the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM), et seq. The DSM-IV-TR is incorporated by reference. The DSM was published by the American Psychiatric Association in 1994, in Washington D.C., and is not subject to frequent change. The DSM-IV-TR is available through the Minitex interlibrary loan system.

9530.6405 DEFINITIONS.

Subp. 18.

Target population.

"Target population" means individuals experiencing problems with a substance use disorder having the specified characteristics that a license holder proposes to serve.

9530.6405 DEFINITIONS.

Subp. 20.

Treatment director.

"Treatment director" means an individual who meets the qualifications specified under part 9530.6450, subparts 1 and 3, and is designated by the license holder to be responsible for all aspects of the delivery of treatment services.

9530.6405 DEFINITIONS.

Subp. 21.

Treatment service.

"Treatment service" means a therapeutic intervention or series of interventions.

9530.6410 APPLICABILITY.

Subpart 1.

Applicability.

Except as provided in subparts 2 and 3, no person, corporation, partnership, voluntary association, controlling individual, or other organization may provide chemical dependency treatment services to an individual who has a substance use disorder unless licensed by the commissioner.

Subp. 2.

Activities exempt from license requirement.

Parts 9530.6405 to 9530.6505 do not apply to organizations whose primary functions are information, referral, diagnosis, case management, and assessment for the purposes of placement, education, support group services, or self-help programs. Parts 9530.6405 to 9530.6505do not apply to the activities of licensed professionals in private practice which are not paid for by the consolidated chemical dependency treatment fund.

Subp. 3.

Certain hospitals excluded from license requirement.

Parts 9530.6405 to 9530.6505 do not apply to chemical dependency treatment provided by hospitals licensed under Minnesota Statutes, chapter 62J, or under Minnesota Statutes, sections 144.50 to 144.56, unless the hospital accepts funds for chemical dependency treatment under the consolidated chemical dependency treatment fund under Minnesota Statutes, chapter 254B, medical assistance under Minnesota Statutes, chapter 256B, MinnesotaCare or health care cost containment under Minnesota Statutes, chapter 256L, or general assistance medical care under Minnesota Statutes, chapter 256D.

Subp. 4.

Applicability of chapter 2960.

Beginning July 1, 2005, residential adolescent chemical dependency treatment programs must be licensed according to chapter 2960.

9530.6415 LICENSING REQUIREMENTS.

Subpart 1.

General application and license requirements.

An applicant for a license to provide treatment must comply with the general requirements in Minnesota Statutes, chapters 245A and 245C, and Minnesota Statutes, sections 626.556 and 626.557.

Subp. 2.

Contents of application.

Prior to issuance of a license, an applicant must submit, on forms provided by the commissioner, any documents the commissioner requires to demonstrate the following:

A.

compliance with parts 9530.6405 to 9530.6505;

B.

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 parts 9530.6405 to 9530.6505;

C.

completion of an assessment of need for a new or expanded program according to part 9530.6800; and

D.

insurance coverage, including bonding, sufficient to cover all client funds, property, and interests.

Subp. 3.

Changes in license terms.

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:

(1)

a change in the Department of Health's licensure of the program;

(2)

a change in whether the license holder provides services specified in parts 9530.6485 to 9530.6505;

(3)

a change in location; or

(4)

a change in capacity if the license holder meets the requirements of part 9530.6505.

B.

A license holder must notify the commissioner and must apply for a new license if there is a change in program ownership.

9530.6420 INITIAL SERVICES PLAN.

The license holder must complete an initial services plan during or immediately following the intake interview. The plan must address the client's immediate health and safety concerns, identify the issues to be addressed in the first treatment sessions, and make treatment suggestions for the client during the time between intake and completion of the treatment plan. The initial services plan must include a determination whether a client is a vulnerable adult as defined in Minnesota Statutes, section 626.5572, subdivision 21. All adult clients of a residential program are vulnerable adults. An individual abuse prevention plan, according to Minnesota Statutes, sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for all clients who meet the definition of "vulnerable adult."

9530.6422 COMPREHENSIVE ASSESSMENT.

Subpart 1.

Comprehensive assessment of substance use disorder.

A comprehensive assessment of the client's substance use disorder must be coordinated by an alcohol and drug counselor and completed within three calendar days after service initiation for a residential program or three sessions of the client's initiation to services for all other programs. The alcohol and drug counselor may rely on current information provided by a referring agency or other sources as a supplement when information is available. Information gathered more than 45 days before the date of admission is not current. If the comprehensive assessment cannot be completed in the time specified, the treatment plan must indicate how and when it will be completed. The assessment must include sufficient information to complete the assessment summary according to subpart 2 and part 9530.6425. The comprehensive assessment must include information about the client's problems that relate to chemical use and personal strengths that support recovery, including:

A.

age, sex, cultural background, sexual orientation, living situation, economic status, and level of education;

B.

circumstances of service initiation;

C.

previous attempts at treatment for chemical use or dependency, compulsive gambling, or mental illness;

D.

chemical use history including amounts and types of chemicals used, frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. For each chemical used within the previous 30 days, the information must include the date and time of the most recent use and any previous experience with withdrawal;

E.

specific problem behaviors exhibited by the client when under the influence of chemicals;

F.

current family status, family history, including history or presence of physical or sexual abuse, level of family support, and chemical use, abuse, or dependency among family members and significant others;

G.

physical concerns or diagnoses, the severity of the concerns, and whether or not the concerns are being addressed by a health care professional;

H.

mental health history and current psychiatric status, including symptoms, disability, current treatment supports, and psychotropic medication needed to maintain stability;

I.

arrests and legal interventions related to chemical use;

J.

ability to function appropriately in work and educational settings;

K.

ability to understand written treatment materials, including rules and client rights;

L.

risk-taking behavior, including behavior that puts the client at risk of exposure to blood borne or sexually transmitted diseases;

M.

social network in relation to expected support for recovery and leisure time activities that have been associated with chemical use;

N.

whether the client is pregnant and if so, the health of the unborn child and current involvement in prenatal care; and

O.

whether the client recognizes problems related to substance use and is willing to follow treatment recommendations.

Subp. 2.

Assessment summary.

An alcohol and drug counselor must prepare an assessment summary within three calendar days for a residential program or within three treatment sessions of service initiation. The narrative summary of the comprehensive assessment results must meet the requirements of items A and B:

A.

An assessment summary must be prepared by an alcohol and drug counselor and include:

(1)

a risk description according to part 9530.6622 for each dimension listed in item B;

(2)

narrative supporting the risk descriptions; and

(3)

a determination of whether the client meets the DSM criteria for a person with a substance use disorder.

B.

Contain information relevant to treatment planning and recorded in the dimensions in subitems (1) to (6):

(1)

Dimension 1, acute intoxication/withdrawal potential. The license holder must consider the client's ability to cope with withdrawal symptoms and current state of intoxication.

(2)

Dimension 2, biomedical conditions and complications. The license holder must consider the degree to which any physical disorder would interfere with treatment for substance abuse, and the client's ability to tolerate any related discomfort. The license holder must determine the impact of continued chemical use on the unborn child if the client is pregnant.

(3)

Dimension 3, emotional, behavioral, and cognitive conditions and complications. The license holder must determine the degree to which any condition or complications are likely to interfere with treatment for substance abuse or with functioning in significant life areas and the likelihood of risk of harm to self or others.

(4)

Dimension 4, readiness for change. The license holder must also consider the amount of support and encouragement necessary to keep the client involved in treatment.

(5)

Dimension 5, relapse, continued use, and continued problem potential. The license holder must consider the degree to which the client recognizes relapse issues and has the skills to prevent relapse of either substance use or mental health problems.

(6)

Dimension 6, recovery environment. The license holder must consider the degree to which key areas of the client's life are supportive of or antagonistic to treatment participation and recovery.

9530.6425 INDIVIDUAL TREATMENT PLANS.

Subpart 1.

General.

Individual treatment plans for clients in treatment must be completed within seven calendar days of completion of the assessment summary. Treatment plans must continually be updated, based on new information gathered about the client's condition and on whether planned treatment interventions have had the intended effect. Treatment planning must include ongoing assessment in each of the six dimensions according to part 9530.6422, subpart 2. The plan must provide for the involvement of the client's family and those people selected by the client as being important to the success of the treatment experience at the earliest opportunity, consistent with the client's treatment needs and written consent. The plan must be developed after completion of the comprehensive assessment and is subject to amendment until services to the client are terminated. The client must have an opportunity to have active, direct involvement in selecting the anticipated outcomes of the treatment process and in developing the individual treatment plan. The individual treatment plan must be signed by the client and the alcohol and drug counselor. The individual treatment plan may be a continuation of the initial services plan required in part 9530.6420.

Subp. 2.

Plan contents.

An individual treatment plan must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and address each problem identified in the assessment summary, and include:

A.

specific methods to be used to address identified problems, including amount, frequency, and anticipated duration of treatment service. The methods must be appropriate to the client's language, reading skills, cultural background, and strengths;

B.

resources to which the client is being referred for problems when problems are to be addressed concurrently by another provider; and

C.

goals the client must reach to complete treatment and have services terminated.

Subp. 3.

Progress notes and plan review.

A.

Progress notes must be entered in a client's file weekly or after each treatment service, whichever is less frequent, by the staff person providing the service. The note must reference the treatment plan. Progress notes must be recorded and address each of the six dimensions listed in part 9530.6422, subpart 2, item B. Progress notes must:

(1)

be entered immediately following any significant event. Significant events include those events which have an impact on the client's relationship with other clients, staff, the client's family, or the client's treatment plan;

(2)

indicate the type and amount of each treatment service the client has received;

(3)

include monitoring of any physical and mental health problems and the participation of others in the treatment plan;

(4)

document the participation of others; and

(5)

document that the client has been notified of each treatment plan change and that the client either does or does not agree with the change.

B.

Treatment plan review must:

(1)

occur weekly or after each treatment service, whichever is less frequent;

(2)

address each goal in the treatment plan that has been worked on since the last review;

(3)

address whether the strategies to address the goals are effective, and if not, must include changes to the treatment plan; and

(4)

include a review and evaluation of the individual abuse prevention plan according to Minnesota Statutes, section 245A.65.

C.

All entries in a client's record must be legible, signed, and dated. Late entries must be clearly labeled "late entry." Corrections to an entry must be made in a way in which the original entry can still be read.

Subp. 3a.

Documentation.

Progress notes and plan review do not require separate documentation if the information in the client file meets the requirements of subpart 3, items A and B.

Subp. 4.

Summary at termination of services.

An alcohol and drug counselor must write a discharge summary for each client. The summary must be completed within five days of the client's service termination or within five days from the client's or program's decision to terminate services, whichever is earlier.

A.

The summary at termination of services must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and include the following information:

(1)

client's problems, strengths, and needs while participating in treatment, including services provided;

(2)

client's progress toward achieving each of the goals identified in the individual treatment plan;

(3)

reasons for and circumstances of service termination; and

(4)

risk description according to part 9530.6622.

B.

For clients who successfully complete treatment, the summary must also include:

(1)

living arrangements upon discharge;

(2)

continuing care recommendations, including referrals made with specific attention to continuity of care for mental health problems, as needed;

(3)

service termination diagnosis; and

(4)

client's prognosis.

9530.6430 TREATMENT SERVICES.

Subpart 1.

Treatment services offered by license holder.

A.

A license holder must offer the following treatment services unless clinically inappropriate and the justifying clinical rationale is documented:

(1)

individual and group counseling to help the client identify and address problems related to chemical use and develop strategies to avoid inappropriate chemical use after discharge;

(2)

client education strategies to avoid inappropriate chemical use and health problems related to chemical use and the necessary changes in lifestyle to regain and maintain health. Client education must include information concerning the human immunodeficiency virus, according to Minnesota Statutes, section 245A.19, other sexually transmitted diseases, drug and alcohol use during pregnancy, hepatitis, and tuberculosis;

(3)

transition services to help the client integrate gains made during treatment into daily living and to reduce reliance on the license holder's staff for support;

(4)

services to address issues related to co-occurring mental illness, including education for clients on basic symptoms of mental illness, the possibility of comorbidity, and the need for continued medication compliance while working on recovery from substance use disorder. Groups must address co-occurring mental illness issues, as needed. When treatment for mental health problems is indicated, it is integrated into the client's treatment plan; and

(5)

service coordination to help the client obtain the services and to support the client's need to establish a lifestyle free of the harmful effects of substance use disorder.

B.

Treatment services provided to individual clients must be provided according to the individual treatment plan and must address cultural differences and special needs of all clients.

Subp. 2.

Additional treatment services.

A license holder may provide or arrange the following additional treatment services as a part of the individual treatment plan:

A.

relationship counseling provided by a qualified professional to help the client identify the impact of the client's substance use disorder on others and to help the client and persons in the client's support structure identify and change behaviors that contribute to the client's substance use disorder;

B.

therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood-altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemicals;

C.

stress management and physical well-being to help the client reach and maintain an acceptable level of health, physical fitness, and well-being;

D.

living skills development to help the client learn basic skills necessary for independent living;

E.

employment or educational services to help the client become financially independent;

F.

socialization skills development to help the client live and interact with others in a positive and productive manner; and

G.

room, board, and supervision provided at the treatment site to give the client a safe and appropriate environment in which to gain and practice new skills.

Subp. 3.

Counselors to provide treatment services.

Treatment services, including therapeutic recreation, must be provided by alcohol and drug counselors qualified according to part 9530.6450, unless the individual providing the service is specifically qualified according to the accepted standards of that profession. Therapeutic recreation does not include planned leisure activities.

Subp. 4.

Location of service provision.

A client of a license holder may only receive services at any of the license holder's licensed locations or at the client's home, except that services under subpart 1, item A, subitems (3) and (5), and subpart 2, items B and E, may be provided in another suitable location.

9530.6435 MEDICAL SERVICES.

Subpart 1.

Health care services description.

An applicant or license holder must maintain a complete description of the health care services, nursing services, dietary services, and emergency physician services offered by the license holder.

Subp. 1a.

Procedures.

The applicant or license holder must have written procedures for obtaining medical interventions when needed for a client, that are approved in writing by a physician who is licensed under Minnesota Statutes, chapter 147, unless:

A.

the license holder does not provide services under part 9530.6505; and

B.

all medical interventions are referred to 911, the emergency telephone number, or the client's physician.

Subp. 2.

Consultation services.

The license holder must have access to and document the availability of a licensed mental health professional to provide diagnostic assessment and treatment planning assistance.

Subp. 3.

Administration of medications and assistance with self-medication.

A license holder must meet the requirements in items A and B if services include medication administration.

A.

A staff member, other than a licensed practitioner or nurse, who is delegated by a licensed practitioner or a registered nurse the task of administration of medication or assistance with self-medication must:

(1)

document that the staff member has successfully completed a medication administration training program for unlicensed personnel through an accredited Minnesota postsecondary educational institution. Completion of the course must be documented in writing and placed in the staff member's personnel file; or

(2)

be trained according to a formalized training program which is taught by a registered nurse and offered by the license holder. Completion of the course must be documented in writing and placed in the staff member's personnel records; or

(3)

demonstrate to a registered nurse competency to perform the delegated activity.

B.

A registered nurse must be employed or contracted to develop the policies and procedures for medication administration or assistance with self-administration of medication or both. A registered nurse must provide supervision as defined in part 6321.0100. The registered nurse supervision must include monthly on-site supervision or more often as warranted by client health needs. The policies and procedures must include:

(1)

a provision that delegations of administration of medication are limited to administration of those medications which are oral, suppository, eye drops, ear drops, inhalant, or topical;

(2)

a provision that each client's file must include documentation indicating whether staff will be administering medication or the client will be doing self-administration or a combination of both;

(3)

a provision that clients may carry emergency medication such as nitroglycerin as instructed by their physician;

(4)

a provision for medication to be self-administered when a client is scheduled not to be at the facility;

(5)

a provision that if medication is to be self-administered at a time when the client is present in the facility, medication will be self-administered under observation of a trained staff person;

(6)

a provision that when a license holder serves clients who are parents with children, the parent may only administer medication to the child under staff supervision;

(7)

requirements for recording the client's use of medication, including staff signatures with date and time;

(8)

guidelines for when to inform a registered nurse of problems with self-administration, including failure to administer, client refusal of a medication, adverse reactions, or errors; and

(9)

procedures for acceptance, documentation, and implementation of prescriptions, whether written, verbal, telephonic, or electronic.

Subp. 4.

Control of drugs.

A license holder must have in place and implement written policies and procedures developed by a registered nurse that contains the following provisions:

A.

a requirement that all drugs must be stored in a locked compartment. Schedule II drugs, as defined by Minnesota Statutes, section 152.02, must be stored in a separately locked compartment, permanently affixed to the physical plant or medication cart;

B.

a system which accounts for all scheduled drugs each shift;

C.

a procedure for recording the client's use of medication, including the signature of the administrator of the medication with the time and date;

D.

a procedure for destruction of discontinued, outdated, or deteriorated medications;

E.

a statement that only authorized personnel are permitted to have access to the keys to the locked drug compartments; and

F.

a statement that no legend drug supply for one client will be given to another client.

9530.6440 CLIENT RECORDS.

Subpart 1.

Client records required.

A license holder must maintain a file of current client records on the premises where the treatment services are provided or coordinated. The content and format of client records must be uniform and entries in each case must be signed and dated by the staff member making the entry. Client records must be protected against loss, tampering, or unauthorized disclosure in compliance with Minnesota Statutes, section 254A.09, Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164, and, if applicable, Minnesota Statutes, chapter 13.

Subp. 2.

Records retention.

Records of discharged clients must be retained by a license holder for seven years. License holders that cease to provide treatment services must retain client records for seven years from the date of facility closure and must notify the commissioner of the location of the records and the name of a person responsible for maintaining the records.

Subp. 3.

Client records, contents.

Client records must contain the following:

A.

documentation that the client was given information on client rights, responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided an orientation to the program abuse prevention plan as required under Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a), clause (4);

B.

an initial services plan completed according to part 9530.6420;

C.

a comprehensive assessment completed according to part 9530.6422;

D.

an assessment summary completed according to part 9530.6422, subpart 2;

E.

an individual abuse prevention plan that complies with Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14, when applicable;

F.

an individual treatment plan, as required under part 9530.6425, subparts 1 and 2;

G.

progress notes, as required in part 9530.6425, subpart 3; and

H.

a summary of termination of services, written according to part 9530.6425, subpart 4.

Subp. 4.

Electronic records.

A license holder who intends to use electronic record keeping or electronic signatures to comply with parts 9530.6405 to 9530.6505 must first obtain written permission from the commissioner. The commissioner must grant permission after the license holder provides documentation demonstrating the license holder's use of a system for ensuring security of electronic records. Use of electronic record keeping or electronic signatures does not alter the license holder's obligations under state or federal law, regulation, or rule.

9530.6445 STAFFING REQUIREMENTS.

Subpart 1.

Treatment director required.

A license holder must have a treatment director.

Subp. 2.

Alcohol and drug counselor supervisor requirements.

A license holder must employ an alcohol and drug counselor supervisor who meets the requirements under part 9530.6450, subpart 4. An individual may be simultaneously employed as a treatment director, alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual meets the qualifications for each position. If an alcohol and drug counselor is simultaneously an alcohol and drug counselor supervisor or treatment director, that individual must be considered a 0.5 full-time equivalent alcohol and drug counselor for purposes of meeting the staffing requirements under subpart 4.

Subp. 3.

Responsible staff person.

A treatment director must designate a staff member who, when present in the facility, is responsible for the delivery of treatment services. A license holder must have a designated staff person during all hours of operation. A license holder providing room and board and treatment at the same site must have a responsible staff person on duty 24 hours a day. The designated staff person must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572.

Subp. 4.

Staffing requirements.

At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group shall not exceed an average of 16 clients during any 30 consecutive calendar days. It is the responsibility of the license holder to determine an acceptable group size based on the client's needs. A counselor in a program treating intravenous drug abusers must not supervise more than 50 clients. The license holder must maintain a record that documents compliance with this subpart.

Subp. 5.

Medical emergencies.

When clients are present, a license holder must have at least one staff person on the premises who has a current American Red Cross standard first aid certificate or an equivalent certificate and at least one staff person on the premises who has a current American Red Cross community, American Heart Association, or equivalent CPR certificate. A single staff person with both certifications satisfies this requirement.

9530.6450 STAFF QUALIFICATIONS.

Subpart 1.

Qualifications of all staff members with direct client contact.

All staff members who have direct client contact must be at least 18 years of age. At the time of hiring, all staff members must meet the qualifications in item A or B. A chemical use problem for purposes of this subpart is a problem listed by the license holder in the personnel policies and procedures according to part 9530.6460, subpart 1, item E.

A.

Treatment directors, supervisors, nurses, counselors, and other professionals must be free of chemical use problems for at least the two years immediately preceding their hiring and must sign a statement attesting to that fact.

B.

Paraprofessionals and all other staff members with direct client contact must be free of chemical use problems for at least one year immediately preceding their hiring and must sign a statement attesting to that fact.

Subp. 2.

Employment; prohibition on chemical use problems.

Staff members with direct client contact must be free from chemical use problems as a condition of employment, but are not required to sign additional statements. Staff members with direct client contact who are not free from chemical use problems must be removed from any responsibilities that include direct client contact for the time period specified in subpart 1. The time period begins to run on the date the employee begins receiving treatment services or the date of the last incident as described in the list developed according to part 9530.6460, subpart 1, item E.

Subp. 3.

Treatment director qualifications.

In addition to meeting the requirements of subpart 1, a treatment director must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, chapter 245A, and sections 626.556, 626.557, and 626.5572. A treatment director must:

A.

have at least one year of work experience in direct service to individuals with chemical use problems or one year of work experience in the management or administration of direct service to individuals with chemical use problems; and

B.

have a baccalaureate degree or three years of work experience in administration or personnel supervision in human services.

Subp. 4.

Alcohol and drug counselor supervisor qualifications.

In addition to meeting the requirements of subpart 1, an alcohol and drug counselor supervisor must meet the following qualifications:

A.

the individual is competent in the areas specified in subpart 5;

B.

the individual has three or more years of experience providing individual and group counseling to chemically dependent clients except that, prior to January 1, 2005, an individual employed in a program formerly licensed under parts 9530.5000 to 9530.6400is required to have one or more years experience; and

C.

the individual knows and understands the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572.

Subp. 5.

Alcohol and drug counselor qualifications.

In addition to meeting the requirements of subpart 1, an alcohol and drug counselor must be either licensed or exempt from licensure under Minnesota Statutes, chapter 148C. An alcohol and drug counselor must document competence in screening for and working with clients with mental health problems, through education, training, and experience.

A.

Alcohol and drug counselors licensed under Minnesota Statutes, chapter 148C, must comply with rules adopted under Minnesota Statutes, chapter 148C.

B.

Counselors exempt under Minnesota Statutes, chapter 148C, must be competent, as evidenced by one of the following:

(1)

completion of at least a baccalaureate degree with a major or concentration in social work, nursing, sociology, human services, or psychology, or licensure as a registered nurse; successful completion of a minimum of 120 hours of classroom instruction in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered; and successful completion of 440 hours of supervised experience as an alcohol and drug counselor, either as a student or as a staff member;

(2)

completion of 270 hours of alcohol and drug counselor training in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered, and successful completion of 880 hours of supervised experience as an alcohol and drug counselor, either as a student, or as a staff member;

(3)

current certification as an alcohol and drug counselor or alcohol and drug counselor reciprocal, through the evaluation process established by the International Certification and Reciprocity Consortium Alcohol and Other Drug Abuse, Inc., and published in the Case Presentation Method Trainer's Manual, copyright 1993. The manual is incorporated by reference. It is available at the State Law Library, Judicial Center, 25 Reverend Dr. Martin Luther King Jr. Blvd., St. Paul, Minnesota 55155;

(4)

completion of a bachelor's degree including 480 hours of alcohol and drug counseling education from an accredited school or educational program and 880 hours of alcohol and drug counseling practicum; or

(5)

employment in a program formerly licensed under parts 9530.5000 to 9530.6400 and successful completion of 6,000 hours of supervised work experience in a licensed program as an alcohol and drug counselor prior to January 1, 2005.

Subp. 6.

Paraprofessional qualifications and duties.

A paraprofessional must comply with subpart 1 and have knowledge of client rights, outlined in Minnesota Statutes, section 148F.165, and of staff responsibilities. A paraprofessional may not admit, transfer, or discharge clients but may be the person responsible for the delivery of treatment services as required in part 9530.6445, subpart 3.

Subp. 7.

Volunteers.

Volunteers may provide treatment services when they are supervised and can be seen or heard by a staff member meeting the criteria in subpart 4 or 5, but may not practice alcohol and drug counseling unless qualified under subpart 5.

Subp. 8.

Student interns.

A qualified staff person must supervise and be responsible for all treatment services performed by student interns and must review and sign all assessments, progress notes, and treatment plans prepared by the intern. Student interns must meet the requirements in subpart 1, item A, and receive the orientation and training required in part 9530.6460, subpart 1, item G, and subpart 2.

Subp. 9.

Individuals with temporary permit.

Individuals with a temporary permit from the Board of Behavioral Health and Therapy may provide chemical dependency treatment services under the conditions in either item A or B.

A.

The individual is supervised by a licensed alcohol and drug counselor assigned by the license holder. The licensed alcohol and drug counselor must document the amount and type of supervision at least weekly. The supervision must relate to clinical practices. One licensed alcohol and drug counselor may not supervise more than three individuals with temporary permits, according to Minnesota Statutes, section 148C.01, subdivision 12a.

B.

The individual is supervised by a clinical supervisor approved by the Board of Behavioral Health and Therapy. The supervision must be documented and meet the requirements of Minnesota Statutes, section 148C.044, subdivision 4.

9530.6455 PROVIDER POLICIES AND PROCEDURES.

License holders must develop a written policy and procedures manual indexed according to Minnesota Statutes, section 245A.04, subdivision 14, paragraph (c), so that staff may have immediate access to all policies and procedures and so that consumers of the services and other authorized parties may have access to all policies and procedures. The manual must contain the following materials:

A.

assessment and treatment planning policies, which include screening for mental health concerns, and the inclusion of treatment objectives related to identified mental health concerns in the client's treatment plan;

B.

policies and procedures regarding HIV that comply with Minnesota Statutes, section 245A.19;

C.

the methods and resources used by the license holder to provide information on tuberculosis and tuberculosis screening to all clients and to report known cases of tuberculosis infection according to Minnesota Statutes, section 144.4804;

D.

personnel policies that comply with part 9530.6460;

E.

policies and procedures that protect client rights as required under part 9530.6470;

F.

a medical services plan that complies with part 9530.6435;

G.

emergency procedures that comply with part 9530.6475;

H.

policies and procedures for maintaining client records under part 9530.6440;

I.

procedures for reporting the maltreatment of minors under Minnesota Statutes, section 626.556, and vulnerable adults under Minnesota Statutes, sections 245A.65, 626.557, and 626.5572;

J.

a description of treatment services including the amount and type of client services provided;

K.

the methods used to achieve desired client outcomes; and

L.

the hours of operation and target population served.

9530.6460 PERSONNEL POLICIES AND PROCEDURES.

Subpart 1.

Policy requirements.

License holders must have written personnel policies and must make them available to each staff member. The policies must:

A.

assure that staff member retention, promotion, job assignment, or pay are not affected by a good faith communication between a staff member and the Department of Health, the Department of Human Services, the ombudsman for mental health and developmental disabilities, law enforcement, or local agencies for the investigation of complaints regarding a client's rights, health, or safety;

B.

contain job descriptions for each position specifying responsibilities, degree of authority to execute job responsibilities, and qualifications;

C.

provide for job performance evaluations based on standards of job performance to be conducted on a regular and continuing basis, including a written annual review;

D.

describe behavior that constitutes grounds for disciplinary action, suspension or dismissal, including policies that address chemical use problems and meet the requirements of part 9530.6450, subpart 1, policies prohibiting personal involvement with clients in violation of Minnesota Statutes, chapter 604, and policies prohibiting client abuse as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572;

E.

list behaviors or incidents that are considered chemical use problems. The list must include:

(1)

receiving treatment for chemical use within the period specified for the position in the staff qualification requirements;

(2)

chemical use that has a negative impact on the staff member's job performance;

(3)

chemical use that affects the credibility of treatment services with clients, referral sources, or other members of the community; and

(4)

symptoms of intoxication or withdrawal on the job;

F.

include a chart or description of the organizational structure indicating lines of authority and responsibilities;

G.

include orientation within 24 working hours of starting for all new staff based on a written plan that, at a minimum, must provide for training related to the specific job functions for which the staff member was hired, policies and procedures, client confidentiality, the human immunodeficiency virus minimum standards, and client needs; and

H.

policies outlining the license holder's response to staff members with behavior problems that interfere with the provision of treatment services.

Subp. 2.

Staff development.

A license holder must ensure that each staff person has the training required in items A to E.

A.

All staff must be trained every two years in client confidentiality rules and regulations and client ethical boundaries.

B.

All staff must be trained every two years in emergency procedures and client rights as specified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03.

C.

All staff with direct client contact must be trained every year on mandatory reporting as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.5561, 626.5563, 626.557, and 626.5572, including specific training covering the facility's policies concerning obtaining client releases of information.

D.

All staff with direct client contact must receive training upon hiring and annually thereafter on the human immunodeficiency virus minimum standards according to Minnesota Statutes, section 245A.19.

E.

Treatment directors, supervisors, nurses, and counselors must obtain 12 hours of training in co-occurring mental health problems and substance use disorder that includes competencies related to philosophy, screening, assessment, diagnosis and treatment planning, documentation, programming, medication, collaboration, mental health consultation, and discharge planning. Staff employed by a license holder on the date this rule is adopted must obtain the training within 12 months of the date of adoption. New staff who have not obtained such training must obtain it within 12 months of the date this rule is adopted or within six months of hire, whichever is later. Staff may request, and the license holder may grant credit for, relevant training obtained prior to January 1, 2005.

Subp. 3.

Personnel files.

The license holder must maintain a separate personnel file for each staff member. At a minimum, the personnel file must be maintained to meet the requirements under parts 9530.6405 to 9530.6505 and contain the following:

A.

a completed application for employment signed by the staff member and containing the staff member's qualifications for employment;

B.

documentation related to the applicant's background study data, as defined in Minnesota Statutes, chapter 245C;

C.

for staff members who will be providing psychotherapy services, employer names and addresses for the past five years for which the staff member provided psychotherapy services, and documentation of an inquiry made to these former employers regarding substantiated sexual contact with a client as required by Minnesota Statutes, chapter 604;

D.

documentation of completed orientation and training;

E.

documentation demonstrating compliance with parts 9530.6450 and 9530.6485, subpart 2; and

F.

documentation demonstrating compliance with part 9530.6435, subpart 3, for staff members who administer medications.

9530.6465 SERVICE INITIATION AND TERMINATION POLICIES.

Subpart 1.

Service initiation policy.

A license holder must have a written service initiation policy containing service initiation preferences which comply with this rule and Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria. The license holder must not initiate services for individuals who do not meet the service initiation criteria. The service initiation criteria must be either posted in the area of the facility where services for clients are initiated, or given to all interested persons upon request. Titles of all staff members authorized to initiate services for clients must be listed in the services initiation and termination policies. A license holder that serves intravenous drug abusers must have a written policy that provides service initiation preference as required by Code of Federal Regulations, title 45, part 96.131.

Subp. 2.

License holder responsibilities; terminating or denying services.

A license holder has specific responsibilities when terminating services or denying treatment service initiation to clients for reasons of health, behavior, or criminal activity.

A.

The license holder must have and comply with a written protocol for assisting clients in need of care not provided by the license holder, and for clients who pose a substantial likelihood of harm to themselves or others, if the behavior is beyond the behavior management capabilities of the staff. All service terminations and denials of service initiation which pose an immediate threat to the health of any individual or require immediate medical intervention must be referred to a medical facility capable of admitting the individual.

B.

All service termination policies and denials of service initiation that involve the commission of a crime against a license holder's staff member or on a license holder's property, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and Code of Federal Regulations, title 45, parts 160 to 164, must be reported to a law enforcement agency with proper jurisdiction.

Subp. 3.

Service termination and transfer policies.

A license holder must have a written policy specifying the conditions under which clients must be discharged. The policy must include:

A.

procedures for individuals whose services have been terminated under subpart 2;

B.

a description of client behavior that constitutes reason for a staff-requested service termination and a process for providing this information to clients;

C.

procedures consistent with Minnesota Statutes, section 253B.16, subdivision 2, that staff must follow when a client admitted under Minnesota Statutes, chapter 253B, is to have services terminated;

D.

procedures staff must follow when a client leaves against staff or medical advice and when the client may be dangerous to self or others;

E.

procedures for communicating staff-approved service termination criteria to clients, including the expectations in the client's individual treatment plan according to part 9530.6425; and

F.

titles of staff members authorized to terminate client services must be listed in the service initiation and termination policies.

9530.6470 POLICIES AND PROCEDURES THAT PROTECT CLIENT RIGHTS.

Subpart 1.

Client rights; explanation.

Clients have the rights identified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03, as applicable. The license holder must give each client upon service initiation a written statement of client's rights and responsibilities. Staff must review the statement with clients at that time.

Subp. 2.

Grievance procedure.

Upon service initiation, the license holder must explain the grievance procedure to the client or their representative. The grievance procedure must be posted in a place visible to clients, and made available upon a client's request. The grievance procedure must also be made available to former clients upon request. The grievance procedure must require that:

A.

staff help the client develop and process a grievance;

B.

telephone numbers and addresses of the Department of Human Services, licensing division; the Office of Ombudsman for Mental Health and Developmental Disabilities; the Minnesota Department of Health, Office of Alcohol and Drug Counselor Licensing Program, and Office of Health Facilities Complaints; when applicable, be made available to clients; and

C.

a license holder be obligated to respond to the client's grievance within three days of a staff member's receipt of the grievance, and the client be permitted to bring the grievance to the highest level of authority in the program if not resolved by other staff members.

Subp. 3.

Photographs of client.

All photographs, video tapes, and motion pictures of clients taken in the provision of treatment services are considered client records. Photographs for identification and recordings by video and audio tape for the purpose of enhancing either therapy or staff supervision may be required of clients, but may only be available for use as communications within a program. Clients must be informed when their actions are being recorded by camera or tape, and have the right to deny any taping or photography, except as authorized by this subpart.

9530.6475 BEHAVIORAL EMERGENCY PROCEDURES.

A.

A license holder or applicant must have written procedures that staff must follow when responding to a client who exhibits behavior that is threatening to the safety of the client or others. The procedures must include:

(1)

a plan designed to prevent the client from hurting themselves or others;

(2)

contact information for emergency resources that staff must consult when a client's behavior cannot be controlled by the procedures established in the plan;

(3)

types of procedures that may be used;

(4)

circumstances under which emergency procedures may be used; and

(5)

staff members authorized to implement emergency procedures.

B.

Behavioral emergency procedures must not be used to enforce facility rules or for the convenience of staff. Behavioral emergency procedures must not be part of any client's treatment plan, or used at any time for any reason except in response to specific current behaviors that threaten the safety of the client or others. Behavioral emergency procedures may not include the use of seclusion or restraint.

9530.6480 EVALUATION.

Subpart 1.

Participation in drug and alcohol abuse normative evaluation system.

License holders must participate in the drug and alcohol abuse normative evaluation system by submitting information about each client to the commissioner in a format specified by the commissioner.

Subp. 2.

Commissioner requests.

A license holder must submit additional information requested by the commissioner that is necessary to meet statutory or federal funding requirements.

9530.6485 LICENSE HOLDERS SERVING ADOLESCENTS.

Subpart 1.

License holders serving adolescents.

A residential treatment program that serves persons under 18 years of age must be licensed as a residential program for children in out-of-home placement by the department unless the license holder is exempt under Minnesota Statutes, section 245A.03, subdivision 2.

Subp. 2.

Alcohol and drug counselor qualifications.

In addition to the requirements specified in part 9530.6450, subparts 1 and 5, an alcohol and drug counselor providing treatment services to adolescents must have:

A.

an additional 30 hours of classroom instruction or one three-credit semester college course in adolescent development. This training need only be completed one time; and

B.

at least 150 hours of supervised experience as an adolescent counselor, either as a student or as a staff member.

Subp. 3.

Staffing ratios.

At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group consisting entirely of adolescents must not exceed 16 clients. It is the responsibility of the license holder to determine an acceptable group size based on the needs of the clients.

Subp. 4.

Academic program requirements.

Clients who are required to attend school must be enrolled and attending an educational program that has been approved by the Minnesota Department of Education.

Subp. 5.

Program requirements.

In addition to the requirements specified in the client's treatment plan under part 9530.6425, programs serving adolescents must include the following:

A.

coordination with the school system to address the client's academic needs;

B.

when appropriate, a plan that addresses the client's leisure activities without chemical use; and

C.

a plan that addresses family involvement in the adolescent's treatment.

9530.6490 LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.

Subpart 1.

Health license requirements.

In addition to the requirements of parts 9530.6405 to 9530.6480, all license holders that offer supervision of children of clients are subject to the requirements of this part. License holders providing room and board for clients and their children must have an appropriate facility license from the Minnesota Department of Health.

Subp. 2.

Supervision of children defined.

"Supervision of children" means a caregiver is within sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can intervene to protect the health and safety of the child. For the school age child it means a caregiver is available to help and care for the child so that the child's health and safety is protected.

Subp. 3.

Policy and schedule required.

License holders must meet the following requirements:

A.

license holders must have a policy and schedule delineating the times and circumstances under which the license holder is responsible for supervision of children in the program and when the child's parents are responsible for child supervision. The policy must explain how the program will communicate its policy about child supervision responsibility to the parents; and

B.

license holders must have written procedures addressing the actions to be taken by staff if children are neglected or abused including while the children are under the supervision of their parents.

Subp. 4.

Additional licensing requirements.

During the times the license holder is responsible for the supervision of children, the license holder must meet the following standards:

A.

child and adult ratios in part 9502.0367;

B.

day care training in Minnesota Statutes, section 245A.50;

C.

behavior guidance in part 9502.0395;

D.

activities and equipment in part 9502.0415;

E.

physical environment in part 9502.0425; and

F.

water, food, and nutrition in part 9502.0445, unless the license holder has a license from the Minnesota Department of Health.

9530.6495 LICENSE HOLDERS SERVING PERSONS WITH SUBSTANCE USE AND MENTAL HEALTH DISORDERS.

In addition to meeting the requirements of parts 9530.6405 to 9530.6490, license holders specializing in the treatment of persons with substance use disorder and mental health problems must:

A.

demonstrate that staffing levels are appropriate for treating clients with substance use disorder and mental health problems, and that there is adequate staff with mental health training;

B.

have continuing access to a medical provider with appropriate expertise in prescribing psychotropic medications;

C.

have a mental health professional available for staff supervision and consultation;

D.

determine group size, structure, and content with consideration for the special needs of those with substance use disorder and mental health disorders;

E.

have documentation of active interventions to stabilize mental health symptoms present in treatment plans and progress notes;

F.

have continuing documentation of collaboration with continuing care mental health providers, and involvement of those providers in treatment planning meetings;

G.

have available program materials adapted to individuals with mental health problems;

H.

have policies that provide flexibility for clients who may lapse in treatment or may have difficulty adhering to established treatment rules as a result of a mental illness, with the goal of helping clients successfully complete treatment; and

I.

have individual psychotherapy and case management available during the treatment process.

9530.6500 PROGRAMS SERVING INTRAVENOUS DRUG ABUSERS.

Subpart 1.

Additional requirements.

In addition to the requirements of parts 9530.6405 to 9530.6505, programs serving intravenous drug abusers must comply with the requirements of this part.

Subp. 2.

Capacity management and waiting list system compliance.

A program serving intravenous drug abusers must notify the department within seven days of when the program reaches both 90 and 100 percent of the program's capacity to care for clients. Each week, the program must report its capacity, current enrolled dosing clients, and any waiting list. A program reporting 90 percent of capacity must also notify the department when its census has increased or decreased from the 90 percent level.

Subp. 3.

Waiting list.

A program serving intravenous drug abusers must have a waiting list system. Each person seeking admission must be placed on the waiting list if the person cannot be admitted within 14 days of the date of application, unless the applicant is assessed by the program and found not to be eligible for admission according to parts 9530.6405 to 9530.6505, and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and Code of Federal Regulations, title 45, parts 160 to 164. The waiting list must assign a unique patient identifier for each intravenous drug abuser seeking treatment while awaiting admission. An applicant on a waiting list who receives no services under part 9530.6430, subpart 1, must not be considered a "client" as defined in part 9530.6405, subpart 8.

Subp. 4.

Client referral.

Programs serving intravenous drug abusers must consult the capacity management system so that persons on waiting lists are admitted at the earliest time to a program providing appropriate treatment within a reasonable geographic area. If the patient has been referred through a public payment system and if the program is not able to serve the client within 14 days of the date of application for admission, the program must contact and inform the referring agency of any available treatment capacity listed in the state capacity management system.

Subp. 5.

Outreach.

Programs serving intravenous drug abusers must carry out activities to encourage individuals in need of treatment to undergo treatment. The program's outreach model must:

A.

select, train, and supervise outreach workers;

B.

contact, communicate, and follow up with high risk substance abusers, their associates, and neighborhood residents within the constraints of federal and state confidentiality requirements, including Code of Federal Regulations, title 42, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164;

C.

promote awareness among injecting drug abusers about the relationship between injecting drug abuse and communicable diseases such as HIV; and

D.

recommend steps that can be taken to ensure that HIV transmission does not occur.

Subp. 6.

Central registry.

Programs serving intravenous drug abusers must comply with requirements to submit information and necessary consents to the state central registry for each client admitted, as specified by the commissioner. The client's failure to provide the information will prohibit involvement in an opiate treatment program. The information submitted must include the client's:

A.

full name and all aliases;

B.

date of admission;

C.

date of birth;

D.

Social Security number or INS number, if any;

E.

enrollment status in other current or last known opiate treatment programs;

F.

government-issued photo-identification card number; and

G.

driver's license number, if any.

The information in items A to G must be submitted in a format prescribed by the commissioner, with the original kept in the client's chart, whenever a client is accepted for treatment, the client's type or dosage of a drug is changed, or the client's treatment is interrupted, resumed, or terminated.

9530.6505 REQUIREMENTS FOR LICENSED RESIDENTIAL TREATMENT.

Subpart 1.

Applicability.

A license holder who provides supervised room and board at the licensed program site as a treatment component is defined as a residential program according to Minnesota Statutes, section 245A.02, subdivision 14, and is subject to this part.

Subp. 2.

Visitors.

Clients must be allowed to receive visitors at times prescribed by the license holder. The license holder must set and post a notice of visiting rules and hours, including both day and evening times. A client's right to receive visitors other than a personal physician, religious advisor, county case manager, parole or probation officer, or attorney may be subject to visiting hours established by the license holder for all clients. The treatment director or designee may impose limitations as necessary for the welfare of a client provided that limitations and the reasons for them are documented in the client's file. Clients must be allowed to receive visits at all reasonable times from their personal physicians, religious advisors, county case managers, parole or probation officers, and attorneys.

Subp. 3.

Client property management.

A license holder who provides room and board and treatment services to clients in the same facility, and any license holder that accepts client property must meet the requirements in Minnesota Statutes, section 245A.04, subdivision 13, for handling resident funds and property. In the course of client property management, license holders:

A.

may establish policies regarding the use of personal property to assure that treatment activities and the rights of other patients are not infringed;

B.

may take temporary custody of property for violation of facility policies;

C.

must retain the client's property for a minimum of seven days after discharge if the client does not reclaim property upon service termination, or for a minimum of 30 days if the client does not reclaim property upon service termination and has received room and board services from the license holder; and

D.

must return all property held in trust to the client upon service termination regardless of the client's service termination status, except:

(1)

drugs, drug paraphernalia, and drug containers that are forfeited under Minnesota Statutes, section 609.5316, must be destroyed by staff or given over to the custody of a local law enforcement agency, according to Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164;

(2)

weapons, explosives, and other property which can cause serious harm to self or others must be given over to the custody of a local law enforcement agency, and the client must be notified of the transfer and of the right to reclaim any lawful property transferred; and

(3)

medications that have been determined by a physician to be harmful after examining the client, except when the client's personal physician approves the medication for continued use.

Subp. 4.

Health facility license.

A license holder who provides room and board and treatment services in the same facility must have the appropriate license from the Department of Health.

Subp. 5.

Facility abuse prevention plan.

A license holder must establish and enforce an ongoing facility abuse prevention plan consistent with Minnesota Statutes, sections 245A.65 and 626.557, subdivision 14.

Subp. 6.

Individual abuse prevention plan.

A license holder must prepare an individual abuse prevention plan for each client as specified under Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14.

Subp. 7.

Health services.

License holders must have written procedures for assessing and monitoring client health, including a standardized data collection tool for collecting health-related information about each client. The policies and procedures must be approved and signed by a registered nurse.

Subp. 8.

Administration of medications.

License holders must meet the administration of medications requirements of part 9530.6435, subpart 3.