Minnesota Legislature
SF 2452
2nd Engrossment - 91st Legislature (2019 - 2020) Posted on 04/30/2019 09:23am
Current Version - 2nd Engrossment
3.46 3.47
3.48 3.49 3.50 3.51 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8
5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31
6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17
6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 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 8.33 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
10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14
11.15
11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33
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
14.1 14.2 14.3 14.4
14.5 14.6 14.7 14.8 14.9 14.10
14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 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 15.33 15.34 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15
17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27
17.28 17.29 17.30 17.31 17.32 17.33 17.34 18.1 18.2 18.3
18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 18.34 19.1 19.2 19.3 19.4
19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12
19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 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 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32
22.33 22.34
23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11
24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15
25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32
26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 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 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 30.30 30.31 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8
31.9 31.10 31.11 31.12 31.13 31.14
31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25
31.26 31.27 31.28 31.29 31.30 31.31 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
33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12
33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 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
36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32
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 38.32 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 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20
41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 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 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 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9
45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 47.34 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 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 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 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13
52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 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
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 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 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
58.1 58.2 58.3 58.4
58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 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
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 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 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 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 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10
67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20
67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 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 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 71.32 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 72.34 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 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 74.34 74.35 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33 75.34 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 76.34 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15
77.16
77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24
77.25
77.26 77.27 77.28 77.29 77.30 77.31 77.32 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 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
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 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 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
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 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 87.34 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20
88.21
88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 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
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 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 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 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 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 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9
97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 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 99.1 99.2
99.3 99.4 99.5 99.6 99.7 99.8
99.9 99.10 99.11 99.12
99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 100.1 100.2 100.3 100.4 100.5 100.6 100.7
100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 101.33 102.1 102.2 102.3 102.4 102.5 102.6
102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 103.34 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 105.1 105.2 105.3
105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25
105.26 105.27 105.28 105.29 105.30 105.31 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19
106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24
107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 107.34
108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 109.1 109.2 109.3 109.4 109.5
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
109.26 109.27 109.28 109.29 109.30 109.31 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 110.34 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25
111.26
111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22
112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 113.33 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 115.1 115.2 115.3 115.4 115.5 115.6 115.7
115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15
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
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
118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32
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
121.1 121.2 121.3 121.4 121.5 121.6 121.7
121.8
121.9 121.10 121.11 121.12 121.13 121.14 121.15
121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 121.33 122.1 122.2 122.3 122.4 122.5
122.6 122.7
122.8 122.9 122.10 122.11 122.12
122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11
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
124.25 124.26 124.27 124.28 124.29 124.30 124.31 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19
125.20 125.21 125.22
125.23 125.24 125.25 125.26
125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2
126.3
126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 126.34 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15
127.16
127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31
127.32
128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17
128.18
128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20
129.21
129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 130.1 130.2
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
131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15
132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27
132.28 132.29 132.30 132.31 132.32 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9
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
133.26 133.27 133.28 133.29 133.30 133.31 133.32 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8
134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 135.1 135.2 135.3 135.4 135.5 135.6 135.7
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
135.24 135.25 135.26 135.27 135.28 135.29 135.30 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19
136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26
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
139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18
140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16
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
142.29 142.30 142.31 142.32 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29
144.30 144.31 144.32 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17
145.18 145.19
145.20 145.21
145.22
145.23 145.24
145.25 145.26
145.27
146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11
146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18
147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 148.1 148.2 148.3 148.4 148.5 148.6
148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16
148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 151.1 151.2
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
152.24 152.25 152.26 152.27 152.28 152.29 152.30 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32
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
154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 156.34 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 157.33 157.34 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24
158.25 158.26 158.27
158.28 158.29 158.30 158.31 158.32 158.33 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25
160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11
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
164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 164.34 165.1 165.2 165.3
165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14
165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28
166.29 166.30 166.31 166.32 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 168.1 168.2 168.3 168.4 168.5 168.6 168.7
168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 169.1 169.2
169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13
169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8
171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 171.33 171.34 171.35 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8
172.9 172.10 172.11 172.12
172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20
173.21 173.22 173.23 173.24
173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33 174.1 174.2
174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 174.34
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
177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24
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
180.27 180.28 180.29 180.30 180.31 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 182.1 182.2 182.3 182.4
182.5
182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9
184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 184.32 184.33 184.34 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11
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
189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11
189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29
189.30 189.31 189.32 189.33 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26
190.27 190.28 190.29 190.30 190.31 190.32 191.1 191.2 191.3 191.4
191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32
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
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
194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 196.1 196.2 196.3
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
196.31 196.32 196.33 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 199.1 199.2 199.3
199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13
200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21
206.22 206.23 206.24 206.25
206.26 206.27 206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15
208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16
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
211.29 211.30 211.31 211.32 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22
213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11
216.12
216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16
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
219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 219.32 219.33 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19
220.20 220.21 220.22
220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30
221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24
221.25 221.26 221.27 221.28 221.29 221.30 221.31 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14
222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18
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
225.28 225.29 225.30 225.31 226.1 226.2
226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31
227.1 227.2 227.3 227.4 227.5 227.6 227.7
227.8 227.9 227.10 227.11
227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24
227.25
227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18
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
229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 232.1 232.2 232.3 232.4 232.5
232.6 232.7 232.8 232.9
232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8
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
233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 234.1 234.2 234.3
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
235.1 235.2 235.3 235.4 235.5 235.6 235.7
235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19
235.20 235.21 235.22 235.23
235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 235.33 236.1 236.2
236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21
236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 236.34 237.1 237.2
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
238.1 238.2
238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 238.33
239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8
239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19
239.20
239.21 239.22
239.23 239.24
239.25 239.26 239.27 239.28 239.29 239.30 240.1 240.2 240.3 240.4 240.5 240.6 240.7
240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 241.33 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18
242.19
242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 243.1 243.2 243.3 243.4
243.5
243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 244.33 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24
245.25
245.26 245.27 245.28 245.29 245.30 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 247.33 247.34
248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8
248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19
249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30
250.31 250.32 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 251.34 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8
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
253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 254.33 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 255.32 255.33 255.34 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9
256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22
256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 256.32 256.33 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17
257.18 257.19 257.20 257.21 257.22 257.23
257.24
257.25 257.26 257.27
257.28
258.1 258.2
258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 258.32 258.33
259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22
259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32 259.33 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20
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
262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 262.32 262.33 262.34 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24
263.25 263.26
263.27 263.28 263.29 263.30 263.31 263.32 263.33 264.1 264.2
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
264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12
266.13 266.14 266.15 266.16 266.17
266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33 267.34 268.1 268.2 268.3 268.4 268.5 268.6 268.7
268.8 268.9 268.10
268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 268.33 268.34 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 269.34 269.35 269.36 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31 270.32 270.33 270.34 270.35 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34 271.35 272.1 272.2 272.3 272.4 272.5 272.6
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
275.1 275.2 275.3 275.4 275.5
275.6 275.7 275.8
275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26
275.27
275.28 275.29 275.30 275.31 275.32 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24
277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16
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
280.1 280.2 280.3
280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19
280.20 280.21 280.22 280.23 280.24 280.25 280.26
280.27 280.28 280.29 280.30 280.31 280.32 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11
281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22
281.23
281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23
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
283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 283.31
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
284.26 284.27 284.28 284.29 284.30 284.31 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 289.1 289.2 289.3 289.4 289.5 289.6 289.7
289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17
289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 290.1 290.2 290.3 290.4 290.5
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
291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 291.33 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30
293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22
293.23
293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 293.32 294.1 294.2 294.3 294.4 294.5 294.6 294.7
294.8
294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 296.34 296.35 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 297.33 297.34 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10
302.11 302.12
302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11
304.12
304.13 304.14 304.15 304.16 304.17 304.18
304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26
304.27
304.28 304.29 304.30 304.31 305.1 305.2 305.3
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
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
308.1
308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 310.1 310.2 310.3 310.4 310.5
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
311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19
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
313.26 313.27 313.28 313.29 313.30 313.31 313.32 313.33 313.34 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23
314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 314.32 314.33 314.34 315.1 315.2 315.3 315.4 315.5 315.6
315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16
315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12 317.13 317.14 317.15 317.16
317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 318.32 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19 319.20 319.21 319.22 319.23 319.24 319.25 319.26
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
320.24 320.25 320.26 320.27 320.28 320.29 320.30 320.31 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20
321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30
322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23
323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21
324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32 324.33 325.1 325.2 325.3
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
325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 326.1 326.2
326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13
326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17
327.18 327.19 327.20 327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 327.32 327.33 328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25
329.26 329.27 329.28 329.29 329.30 329.31 329.32 330.1 330.2 330.3
330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 331.1 331.2 331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10
331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21
331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 332.1 332.2 332.3 332.4 332.5 332.6
332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 333.33 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16
334.17 334.18 334.19 334.20
334.21
334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17
336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26 336.27 336.28 336.29 337.1 337.2 337.3
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
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
339.31 339.32 339.33 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 341.33 342.1 342.2 342.3
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
342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8
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
343.26 343.27 343.28 343.29 343.30 344.1 344.2 344.3 344.4
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
344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9
345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12
347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29
348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13
348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14
349.15 349.16 349.17 349.18 349.19
349.20 349.21 349.22 349.23 349.24 349.25
349.26 349.27 349.28 349.29 349.30 350.1 350.2 350.3 350.4 350.5 350.6
350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 351.1 351.2 351.3
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
352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 353.32 353.33 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 354.34 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32 355.33 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19
356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30
357.1 357.2 357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15
357.16
357.17 357.18
357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11
358.12 358.13
358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 358.33 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15
359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29
360.30 360.31
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
362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 362.33 362.34 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29
363.30 363.31 363.32 364.1 364.2
364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31 365.32
366.1 366.2
366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13
366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 366.33 366.34 367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13
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
368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 368.32 368.33 368.34 368.35 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 370.32 370.33 370.34 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 371.32 371.33 371.34 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 372.33 372.34 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 373.33 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 374.33 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 375.32 375.33 375.34 375.35 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 376.32 376.33 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 377.32 377.33 377.34 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16 378.17 378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 378.29 378.30 378.31 378.32 378.33 378.34 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29 379.30 379.31 379.32 379.33 379.34 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 380.34 380.35 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29 381.30 381.31 381.32 381.33 381.34 381.35 382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19 382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 382.31 382.32 382.33 382.34 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11 383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24 383.25 383.26 383.27 383.28 383.29 383.30 383.31 383.32 383.33 383.34 383.35 384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31 384.32 384.33 384.34 384.35 385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 385.31 385.32 385.33 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29 386.30 386.31 386.32 386.33 386.34 386.35 387.1 387.2 387.3 387.4 387.5 387.6 387.7 387.8 387.9 387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21 387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 387.32 387.33 387.34 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 388.32 388.33 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9
389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18 389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 389.31 389.32 389.33 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14 390.15 390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31 390.32 390.33 390.34 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 391.31 391.32 391.33 391.34 392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14 392.15 392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 392.31 392.32 392.33 392.34 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14 393.15 393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28 393.29 393.30 393.31 393.32 393.33 393.34 393.35 394.1 394.2 394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24
394.25 394.26 394.27 394.28 394.29 394.30 394.31 394.32 394.33 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28 395.29 395.30 395.31 395.32 395.33 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29 396.30 396.31 396.32 396.33 396.34 397.1 397.2 397.3 397.4 397.5 397.6 397.7
397.8 397.9 397.10 397.11 397.12 397.13 397.14 397.15 397.16 397.17 397.18 397.19 397.20 397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29 397.30 397.31 397.32 397.33 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9
398.10
398.11 398.12 398.13 398.14 398.15 398.16 398.17 398.18
398.19
398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27 398.28 398.29 398.30 398.31 398.32 398.33 398.34 399.1 399.2 399.3 399.4 399.5 399.6
399.7
399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17
399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 399.30 399.31 399.32 399.33 399.34 400.1 400.2
400.3 400.4 400.5
400.6 400.7 400.8
400.9 400.10
A bill for an act
relating to health and human services; establishing the health and human services
budget; modifying provisions governing health care, health insurance, Department
of Human Services operations, Department of Health, and MNsure; requiring care
coordination; modifying medical cannabis requirements; permitting licensed hemp
growers to sell hemp to medical cannabis manufacturers; permitting electronic
monitoring in health care facilities; requiring hospital charges disclosure; modifying
public interest review; authorizing statewide tobacco cessation services; modifying
requirements for PPEC centers; modifying benefits for MnCare and MA for adults;
requiring physicians to allow the opportunity to view ultrasound imaging prior to
an abortion; prohibiting abortions after 20 weeks post fertilization; requiring health
care facilities to post the women's right to know information on their website;
modifying the positive alternatives grant eligibility; modifying the SHIP program;
requiring coverage of 3D mammograms as a preventive service; exempting certain
seasonal food stands from licensure; adjusting license fees for social workers and
optometrists; modifying provisions governing program integrity, children and
family services, chemical and mental health, continuing care for older adults,
disability services, direct care and treatment, operations, and health care; modifying
penalties; establishing asset limits; establishing electronic visit verification system;
eliminating TEFRA fees; repealing MFIP child care assistance program and basic
sliding fee child care assistance program; directing the commissioner of human
services to propose a redesigned child care assistance program; directing closure
of a MSOCS residential facility; repealing statutes relating to the state-operated
services account; establishing a background study set-aside for individuals working
in the substance use disorder treatment field; establishing the officer-involved
community-based care coordination grant program to provide mental health services
to individuals arrested by law enforcement; modifying medical assistance coverage
for community-based care coordination to include tribes; eliminating county share
for cost of officer-involved community-based care coordination; establishing a
shelter-linked youth mental health grant program to provide mental health services
to youth experiencing homelessness or sexual exploitation; establishing the
Community Competency Restoration Task Force; establishing a pilot project for
enhanced community supervision of individuals on probation, parole, supervised
release, or pretrial status who are struggling with mental illness and at heightened
risk to recidivate; directing the commissioner of human services to facilitate
person-centered innovation in health and human services through a statewide
expansion of telepresence platform access and collaboration; modifying human
services licensing provisions; directing the commissioner of human services to
develop a plain-language handbook for family child care providers; requiring
county licensors to seek clarification from Department of Human Services before
issuing correction orders in certain circumstances; reforming child care provider
licensing inspections; establishing an abbreviated inspection process for qualifying
child care providers; establishing risk-based violation levels and corresponding
enforcement actions; directing the commissioner of human services to assign rules
and statutory provisions to violation risk levels; directing the commissioner of
human services to develop key indicators that predict full compliance for use in
abbreviated inspections; authorizing additional special family child care home
licenses; modifying requirements for drinking water in child care centers; modifying
family child care program training requirements; directing the commissioner of
human services to develop an annual refresher training course for family child
care providers; clarifying and extending child care training timelines; exempting
certain individuals from child care training requirements; modifying family child
care emergency preparedness plan requirements; creating the Office of
Ombudsperson for Child Care Providers; providing appointments; increasing time
a child care substitute can provide care; establishing Family Child Care Task Force;
directing commissioner of human services to streamline child care licensing and
background study record requirements; directing the revisor of statutes to codify
certain rules and propose legislation re-codifying chapter 245A; classifying certain
licensing violation data as private and nonpublic data after seven years; expanding
the definition of child care assistance program payment data; requiring the
commissioner of human services to publicly display results of child care licensing
reports for no longer than the minimum time required by federal law; requiring
reports; making technical changes; appropriating money; amending Minnesota
Statutes 2018, sections 13.46, subdivisions 2, 4; 13.461, subdivision 28; 13.69,
subdivision 1; 13.851, by adding a subdivision; 15C.02; 16A.055, subdivision 1a;
18K.03; 62A.30, by adding a subdivision; 62D.12, by adding a subdivision;
62J.495, subdivisions 1, 3; 62K.07; 62Q.01, by adding a subdivision; 62Q.47;
62V.05, subdivisions 2, 5, 10; 62V.08; 119B.02, subdivision 6; 119B.09,
subdivisions 1, 4, 7, 9, 9a; 119B.125, subdivision 6, by adding subdivisions;
119B.13, subdivisions 6, 7; 144.057, subdivision 3; 144.1506, subdivision 2;
144.3831, subdivision 1; 144.552; 144.586, by adding a subdivision; 144.966,
subdivision 2; 144A.073, by adding a subdivision; 144A.479, by adding a
subdivision; 144H.01, subdivision 5; 144H.04, subdivision 1, by adding a
subdivision; 144H.06; 144H.07, subdivisions 1, 2; 144H.08, subdivision 2;
144H.11, subdivisions 2, 3, 4; 145.4131, subdivision 1; 145.4235, subdivision 2;
145.4242; 145.4244; 145.908, subdivision 1; 145.928, subdivisions 1, 7; 145.986,
subdivisions 1, 1a, 4, 5, 6; 148.59; 148E.180; 150A.06, subdivision 3, by adding
subdivisions; 150A.091, by adding subdivisions; 151.01, subdivision 23; 151.06,
by adding a subdivision; 151.211, subdivision 2, by adding a subdivision; 152.126,
subdivision 6; 152.22, subdivision 6, by adding a subdivision; 152.25, subdivision
4; 152.28, subdivision 1; 152.29, subdivisions 1, 2, 3, 3a; 152.31; 157.22; 245.095;
245.4889, subdivision 1; 245A.03, subdivisions 2, 7; 245A.04, subdivisions 4, 7,
by adding subdivisions; 245A.06, subdivision 1, by adding a subdivision; 245A.065;
245A.11, subdivision 2a; 245A.14, subdivision 4, by adding a subdivision; 245A.16,
subdivision 1; 245A.50, subdivisions 1, 2, 3, 4, 5, 6, 7, 9, by adding subdivisions;
245A.51, subdivision 3; 245C.02, by adding a subdivision; 245C.22, subdivisions
4, 5; 245D.03, subdivision 1; 245D.071, subdivision 5; 245D.09, subdivisions 5,
5a; 245D.091, subdivisions 2, 3, 4; 245E.02, by adding a subdivision; 246.54, by
adding a subdivision; 252.27, subdivision 2a; 252.275, subdivision 3; 254A.03,
subdivision 3; 254A.19, by adding a subdivision; 254B.02, subdivision 1; 254B.03,
subdivisions 2, 4; 254B.04, subdivision 1; 254B.05, subdivision 1a; 254B.06,
subdivisions 1, 2; 256.9365; 256.98, subdivisions 1, 8; 256.987, subdivisions 1,
2; 256B.02, subdivision 7, by adding a subdivision; 256B.04, subdivisions 14, 21;
256B.056, subdivisions 1, 3, 4, 5c, 7a; 256B.0625, subdivisions 9, 12, 13, 13e,
13f, 17, 18d, 18h, 19a, 24, 43, 56a, by adding subdivisions; 256B.064, subdivisions
1a, 1b, 2, by adding a subdivision; 256B.0651, subdivision 17; 256B.0652,
subdivision 6; 256B.0658; 256B.0659, subdivisions 3, 3a, 11, 12, 13, 14, 19, 21,
24, 28, by adding a subdivision; 256B.0757, subdivisions 1, 2, 4, by adding
subdivisions; 256B.0911, subdivisions 1a, 3a, 3f, 5, by adding a subdivision;
256B.0915, subdivisions 6, 10, by adding a subdivision; 256B.092, subdivision
1b, by adding a subdivision; 256B.0921; 256B.14, subdivision 2; 256B.27,
subdivision 3; 256B.49, subdivisions 13, 14, by adding a subdivision; 256B.4912,
by adding subdivisions; 256B.4914, subdivisions 2, 3, 5, 6, 7, 8, 9, 10, 10a;
256B.493, subdivision 1; 256B.5013, subdivisions 1, 6; 256B.5014; 256B.5015,
subdivision 2; 256B.69, subdivisions 4, 31; 256B.85, subdivisions 3, 8, 10;
256C.23, by adding a subdivision; 256C.261; 256D.024, subdivision 3; 256D.0515;
256D.0516, subdivision 2; 256I.03, subdivision 8; 256I.04, subdivisions 1, 2b, 2f,
by adding subdivisions; 256I.05, subdivision 1r; 256I.06, subdivision 8; 256J.08,
subdivision 47; 256J.21, subdivision 2; 256J.26, subdivision 3; 256K.45,
subdivision 2; 256L.01, subdivision 5; 256L.03, subdivision 5, by adding a
subdivision; 256M.41, subdivision 3, by adding a subdivision; 256P.04, subdivision
4; 256P.06, subdivision 3; 256R.25; 518A.32, subdivision 3; 518A.51; 525A.11;
641.15, subdivision 3a; Laws 2015, chapter 71, article 12, section 8; Laws 2017,
First Special Session chapter 6, article 1, sections 44; 45; article 3, section 49;
article 8, sections 71; 72; article 18, section 7; proposing coding for new law in
Minnesota Statutes, chapters 8; 62J; 62Q; 144; 145; 214; 245; 245A; 254A; 256;
256B; 256D; 256J; 256K; 256R; 260C; 268A; proposing coding for new law as
Minnesota Statutes, chapter 245I; repealing Minnesota Statutes 2018, sections
16A.724, subdivision 2; 119B.011, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 10a,
11, 12, 13, 13a, 14, 15, 16, 17, 18, 19, 19a, 19b, 20, 20a, 21, 22; 119B.02;
119B.025, subdivisions 1, 2, 3, 4; 119B.03, subdivisions 1, 2, 3, 4, 5, 6, 6a, 6b, 8,
9, 10; 119B.035; 119B.04; 119B.05, subdivisions 1, 4, 5; 119B.06, subdivisions
1, 2, 3; 119B.08, subdivisions 1, 2, 3; 119B.09, subdivisions 1, 3, 4, 4a, 5, 6, 7, 8,
9, 9a, 10, 11, 12, 13; 119B.095; 119B.097; 119B.10, subdivisions 1, 2, 3; 119B.105;
119B.11, subdivisions 1, 2a, 3, 4; 119B.12, subdivisions 1, 2; 119B.125; 119B.13,
subdivisions 1, 1a, 3, 3a, 3b, 3c, 4, 5, 6, 7; 119B.14; 119B.15; 119B.16; 144.1464;
144.1911; 245G.11, subdivisions 1, 4, 7; 246.18, subdivisions 8, 9; 254B.03,
subdivision 4a; 256B.0625, subdivision 31c; 256B.0705; 256I.05, subdivision 3;
256R.53, subdivision 2; Laws 2017, First Special Session chapter 6, article 7,
section 34; Minnesota Rules, parts 3400.0010; 3400.0020, subparts 1, 4, 5, 8, 9a,
10a, 12, 17a, 18, 18a, 20, 24, 25, 26, 28, 29a, 31b, 32b, 33, 34a, 35, 37, 38, 38a,
38b, 39, 40, 40a, 44; 3400.0030; 3400.0035; 3400.0040, subparts 1, 3, 4, 5, 5a,
6a, 6b, 6c, 7, 8, 9, 10, 11, 12, 13, 14, 15, 15a, 17, 18; 3400.0060, subparts 2, 4, 5,
6, 6a, 7, 8, 9, 10; 3400.0080, subparts 1, 1a, 1b, 8; 3400.0090, subparts 1, 2, 3, 4;
3400.0100, subparts 2a, 2b, 2c, 5; 3400.0110, subparts 1, 1a, 2, 2a, 3, 4a, 7, 8, 9,
10, 11; 3400.0120, subparts 1, 1a, 2, 2a, 3, 5; 3400.0130, subparts 1, 1a, 2, 3, 3a,
3b, 5, 5a, 7; 3400.0140, subparts 1, 2, 4, 5, 6, 7, 8, 9, 9a, 10, 14; 3400.0150;
3400.0170, subparts 1, 3, 4, 6a, 7, 8, 9, 10, 11; 3400.0180; 3400.0183, subparts 1,
2, 5; 3400.0185; 3400.0187, subparts 1, 2, 3, 4, 6; 3400.0200; 3400.0220;
3400.0230, subpart 3; 3400.0235, subparts 1, 2, 3, 4, 5, 6; 9530.6800; 9530.6810.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
PROGRAM INTEGRITY
Section 1.
Minnesota Statutes 2018, section 15C.02, is amended to read:
15C.02 LIABILITY FOR CERTAIN ACTS.
(a) A person who commits any act described in clauses (1) to (7) is liable to the state or
the political subdivision for a civil penalty deleted text begin of not less than $5,500 and not more than $11,000
per false or fraudulent claimdeleted text end new text begin in the amounts set forth in the federal False Claims Act, United
States Code, title 31, section 3729, and as modified by the federal Civil Penalties Inflation
Adjustment Act Improvements Act of 2015new text end , plus three times the amount of damages that
the state or the political subdivision sustains because of the act of that person, except as
otherwise provided in paragraph (b):
(1) knowingly presents, or causes to be presented, a false or fraudulent claim for payment
or approval;
(2) knowingly makes or uses, or causes to be made or used, a false record or statement
material to a false or fraudulent claim;
(3) knowingly conspires to commit a violation of clause (1), (2), (4), (5), (6), or (7);
(4) has possession, custody, or control of property or money used, or to be used, by the
state or a political subdivision and knowingly delivers or causes to be delivered less than
all of that money or property;
(5) is authorized to make or deliver a document certifying receipt for money or property
used, or to be used, by the state or a political subdivision and, intending to defraud the state
or a political subdivision, makes or delivers the receipt without completely knowing that
the information on the receipt is true;
(6) knowingly buys, or receives as a pledge of an obligation or debt, public property
from an officer or employee of the state or a political subdivision who lawfully may not
sell or pledge the property; or
(7) knowingly makes or uses, or causes to be made or used, a false record or statement
material to an obligation to pay or transmit money or property to the state or a political
subdivision, or knowingly conceals or knowingly and improperly avoids or decreases an
obligation to pay or transmit money or property to the state or a political subdivision.
(b) Notwithstanding paragraph (a), the court may assess not less than two times the
amount of damages that the state or the political subdivision sustains because of the act of
the person if:
(1) the person committing a violation under paragraph (a) furnished an officer or
employee of the state or the political subdivision responsible for investigating the false or
fraudulent claim violation with all information known to the person about the violation
within 30 days after the date on which the person first obtained the information;
(2) the person fully cooperated with any investigation by the state or the political
subdivision of the violation; and
(3) at the time the person furnished the state or the political subdivision with information
about the violation, no criminal prosecution, civil action, or administrative action had been
commenced under this chapter with respect to the violation and the person did not have
actual knowledge of the existence of an investigation into the violation.
(c) A person violating this section is also liable to the state or the political subdivision
for the costs of a civil action brought to recover any penalty or damages.
(d) A person is not liable under this section for mere negligence, inadvertence, or mistake
with respect to activities involving a false or fraudulent claim.
Sec. 2.
Minnesota Statutes 2018, section 119B.09, subdivision 1, is amended to read:
Subdivision 1.
General eligibility requirements.
(a) Child care services must be
available to families new text begin with financial resources, excluding vehicles, of less than $100,000,
new text end 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, at application and redetermination, and 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 application and less than or equal to 67 percent of the state
median income, adjusted for family size, at redetermination.
(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 at application and
redetermination as 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.
(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.
Sec. 3.
Minnesota Statutes 2018, section 119B.09, subdivision 4, is amended to read:
Subd. 4.
Eligibility; annual income; calculation.
(a) Annual income of the applicant
family is the current monthly income of the family multiplied by 12 or the income for the
12-month period immediately preceding the date of application, or income calculated by
the method which provides the most accurate assessment of income available to the family.
(b) Self-employment income must be calculated based on gross receipts less operating
expensesnew text begin authorized by the Internal Revenue Servicenew text end .
(c) Income changes are processed under section 119B.025, subdivision 4. Included lump
sums counted as income under section 256P.06, subdivision 3, must be annualized over 12
months. new text begin Income includes all deposits into accounts owned or controlled by the applicant,
including amounts spent on personal expenses including rent, mortgage, automobile-related
expenses, utilities, and food and amounts received as salary or draws from business accounts.
Income does not include a deposit specifically identified by the applicant as a loan or gift,
for which the applicant provides the source, date, amount, and repayment terms. new text end Income
new text begin and assets new text end must be verified with documentary evidence. If the applicant does not have
sufficient evidence of incomenew text begin or assetsnew text end , verification must be obtained from the source of
the incomenew text begin or assetsnew text end .
Sec. 4.
Minnesota Statutes 2018, section 119B.09, subdivision 7, is amended to read:
Subd. 7.
Date of eligibility for assistance.
(a) The date of eligibility for child care
assistance under this chapter is the later of the date the application was received by the
county; the beginning date of employment, education, or training; the date the infant is born
for applicants to the at-home infant care program; or the date a determination has been made
that the applicant is a participant in employment and training services under Minnesota
Rules, part 3400.0080, or chapter 256J.
(b) Payment ceases for a family under the at-home infant child care program when a
family has used a total of 12 months of assistance as specified under section 119B.035.
Payment of child care assistance for employed persons on MFIP is effective the date of
employment or the date of MFIP eligibility, whichever is later. Payment of child care
assistance for MFIP or DWP participants in employment and training services is effective
the date of commencement of the services or the date of MFIP or DWP eligibility, whichever
is later. Payment of child care assistance for transition year child care must be made
retroactive to the date of eligibility for transition year child care.
(c) Notwithstanding paragraph (b), payment of child care assistance for participants
eligible under section 119B.05 may only be made retroactive for a maximum of deleted text begin sixdeleted text end new text begin zeronew text end
months from the date of application for child care assistance.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for applications processed on or after
July 1, 2019.
new text end
Sec. 5.
Minnesota Statutes 2018, section 119B.09, subdivision 9, is amended to read:
Subd. 9.
Licensed and legal nonlicensed family child care providers; assistance.
This
subdivision applies to any provider providing care in a setting other than a new text begin licensed or
license-exempt new text end child care center. Licensed and legal nonlicensed family child care providers
and their employees are not eligible to receive child care assistance subsidies under this
chapter for their own children or children in their family during the hours they are providing
child care or being paid to provide child care. Child care providers and their employees are
eligible to receive child care assistance subsidies for their children when they are engaged
in other activities that meet the requirements of this chapter and for which child care
assistance can be paid. The hours for which the provider or their employee receives a child
care subsidy for their own children must not overlap with the hours the provider provides
child care services.
Sec. 6.
Minnesota Statutes 2018, section 119B.09, subdivision 9a, is amended to read:
Subd. 9a.
Child care deleted text begin centersdeleted text end new text begin authorizationsnew text end ; deleted text begin assistancedeleted text end new text begin dependents of employees
and controlling individualsnew text end .
(a) A new text begin licensed or license-exempt new text end child care center deleted text begin maydeleted text end new text begin must
notnew text end receive authorizations for deleted text begin 25 or fewer childrendeleted text end new text begin more than seven childrennew text end who are
dependents of the center's employeesnew text begin or controlling individualsnew text end . deleted text begin 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.
deleted text end
deleted text begin
(b) Funds paid to providers during the period of time when a center is authorized for
more than 25 children who are dependents of center employees must not be treated as
overpayments under section 119B.11, subdivision 2a, due to noncompliance with this
subdivision.
deleted text end
deleted text begin (c)deleted text end new text begin (b)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.
Sec. 7.
Minnesota Statutes 2018, section 119B.125, subdivision 6, is amended to read:
Subd. 6.
Record-keeping requirement.
new text begin (a) As a condition of payment, new text end all providers
receiving child care assistance payments must keep new text begin accurate and legible new text end daily attendance
records at the site where services are delivered for children receiving child care assistance
and must make those records available immediately to the county or the commissioner upon
request. The attendance records must be completed daily and include the date, the first and
last name of each child in attendance, and the times when each child is dropped off and
picked up. To the extent possible, the times that the child was dropped off to and picked up
from the child care provider must be entered by the person dropping off or picking up the
child. The daily attendance records must be retained at the site where services are delivered
for six years after the date of service.
new text begin
(b) Records that are not produced immediately under paragraph (a), unless a delay is
agreed upon by the commissioner and provider, shall not be valid for purposes of establishing
a child's attendance and shall result in an overpayment under paragraph (d).
new text end
new text begin (c) new text end A county or the commissioner may deny new text begin or revoke a provider's new text end authorization deleted text begin as a
child care provider to any applicant, rescind authorization of any provider,deleted text end new text begin to receive child
care assistance payments under section 119B.13, subdivision 6, paragraph (d), pursue a
fraud disqualification under section 256.98, take an action against the provider under chapter
245E,new text end or establish an new text begin attendance record new text end overpayment deleted text begin claim in the systemdeleted text end new text begin under paragraph
(d) new text end against a current or former provider, when the county or the commissioner knows or
has reason to believe that the provider has not complied with the record-keeping requirement
in this subdivision. deleted text begin A provider's failure to produce attendance records as requested on more
than one occasion constitutes grounds for disqualification as a provider.
deleted text end
new text begin
(d) To calculate an attendance record overpayment under this subdivision, the
commissioner or county agency subtracts the maximum daily rate from the total amount
paid to a provider for each day that a child's attendance record is missing, unavailable,
incomplete, illegible, inaccurate, or otherwise inadequate.
new text end
new text begin
(e) The commissioner shall develop criteria to direct a county when the county must
establish an attendance overpayment under this subdivision.
new text end
Sec. 8.
Minnesota Statutes 2018, section 119B.125, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Proof of surety bond coverage. new text end
new text begin
All licensed child care centers authorized
for reimbursement under this chapter that received child care assistance program revenue
equal to or greater than $250,000 in the previous calendar year must provide to the
commissioner at least once per year proof of surety bond coverage of $100,000 in a format
determined by the commissioner. The surety bond must be in a form approved by the
commissioner, be renewed annually, and allow for recovery of costs and fees in pursuing
a claim on the bond.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 9.
Minnesota Statutes 2018, section 119B.125, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Financial misconduct. new text end
new text begin
(a) County agencies may conduct investigations of
financial misconduct by child care providers as described in section 245E.02, subdivisions
1 and 2, only after receiving verification that the department is not investigating a provider
under chapter 245E.
new text end
new text begin
(b) If, upon investigation, a preponderance of evidence shows financial misconduct by
a provider, the county may immediately suspend the provider's authorization to receive
child care assistance payments under section 119B.13, subdivision 6, paragraph (d), prior
to pursuing other available remedies.
new text end
new text begin
(c) The county shall give immediate notice in writing to a provider and any affected
families of any suspension of the provider's child care authorization under paragraph (b).
The notice shall state:
new text end
new text begin
(1) the factual basis for the county's determination;
new text end
new text begin
(2) the date of the suspension;
new text end
new text begin
(3) the length of the suspension;
new text end
new text begin
(4) the requirements and procedures for reinstatement;
new text end
new text begin
(5) the right to dispute the county's determination and to provide evidence; and
new text end
new text begin
(6) the right to appeal the county's determination.
new text end
new text begin
(d) The county's determination under paragraph (b) is subject to the fair hearing
requirements under section 119B.16, subdivisions 1a, 1b, and 2. A provider that requests a
fair hearing is entitled to a hearing within ten days of the request.
new text end
Sec. 10.
Minnesota Statutes 2018, section 119B.13, subdivision 6, is amended to read:
Subd. 6.
Provider payments.
(a) new text begin A provider shall bill only for services documented
according to section 119B.125, subdivision 6. new text end The provider shall bill for services provided
within ten days of the end of the service period. Payments under the child care fund shall
be made within 21 days of receiving a complete bill from the provider. Counties or the state
may establish policies that make payments on a more frequent basis.
(b) If a provider has received an authorization of care and been issued a billing form for
an eligible family, the bill must be submitted within 60 days of the last date of service on
the bill. A bill submitted more than 60 days after the last date of service must be paid if the
county determines that the provider has shown good cause why the bill was not submitted
within 60 days. Good cause must be defined in the county's child care fund plan under
section 119B.08, subdivision 3, and the definition of good cause must include county error.
Any bill submitted more than a year after the last date of service on the bill must not be
paid.
(c) If a provider provided care for a time period without receiving an authorization of
care and a billing form for an eligible family, payment of child care assistance may only be
made retroactively for a maximum of six months from the date the provider is issued an
authorization of care and billing form.
(d) A county 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; deleted text begin or
deleted text end
(6) the provider gives false child care price informationdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(7) the provider fails to report decreases in a child's attendance, as required under section
119B.125, subdivision 9.
new text end
(e) For purposes of paragraph (d), clauses (3), (5), deleted text begin anddeleted text end (6), new text begin and (7), new text end 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 July 1, 2019.
new text end
Sec. 11.
Minnesota Statutes 2018, section 119B.13, subdivision 7, is amended to read:
Subd. 7.
Absent days.
(a) Licensed child care providers and license-exempt centers
must not be reimbursed for more than 25 full-day absent days per child, excluding holidays,
in a deleted text begin fiscaldeleted text end new text begin calendarnew text end year, or for more than ten consecutive full-day absent days. new text begin "Absent
day" means any day that the child is authorized and scheduled to be in care with a licensed
provider or license exempt center and the child is absent from the care for the entire day.
new text end Legal nonlicensed family child care providers must not be reimbursed for absent days. If a
child attends for part of the time authorized to be in care in a day, but is absent for part of
the time authorized to be in care in that same day, the absent time must be reimbursed but
the time must not count toward the absent days limit. Child care providers must only be
reimbursed for absent days if the provider has a written policy for child absences and charges
all other families in care for similar absences.
(b) Notwithstanding paragraph (a), children with documented medical conditions that
cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
full-day absent days limit. Absences due to a documented medical condition of a parent or
sibling who lives in the same residence as the child receiving child care assistance do not
count against the absent days limit in a deleted text begin fiscaldeleted text end new text begin calendarnew text end year. Documentation of medical
conditions must be on the forms and submitted according to the timelines established by
the commissioner. A public health nurse or school nurse may verify the illness in lieu of a
medical practitioner. If a provider sends a child home early due to a medical reason,
including, but not limited to, fever or contagious illness, the child care center director or
lead teacher may verify the illness in lieu of a medical practitioner.
(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit
if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or
commissioner of education-selected high school equivalency certification; and (3) is a
student in a school district or another similar program that provides or arranges for child
care, parenting support, social services, career and employment supports, and academic
support to achieve high school graduation, upon request of the program and approval of the
county. If a child attends part of an authorized day, payment to the provider must be for the
full amount of care authorized for that day.
(d) Child care providers must be reimbursed for up to ten federal or state holidays or
designated holidays per year when the provider charges all families for these days and the
holiday or designated holiday falls on a day when the child is authorized to be in attendance.
Parents may substitute other cultural or religious holidays for the ten recognized state and
federal holidays. Holidays do not count toward the absent days limit.
(e) A family or child care provider must not be assessed an overpayment for an absent
day payment unless (1) there was an error in the amount of care authorized for the family,
(2) all of the allowed full-day absent payments for the child have been paid, or (3) the family
or provider did not timely report a change as required under law.
(f) The provider and family shall receive notification of the number of absent days used
upon initial provider authorization for a family and ongoing notification of the number of
absent days used as of the date of the notification.
(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days
per child, excluding holidays, in a deleted text begin fiscaldeleted text end new text begin calendarnew text end year; and ten consecutive full-day absent
days.
new text begin
(h) For purposes of this subdivision, "holidays limit" means ten full-day holidays per
child, excluding absent days, in a calendar year.
new text end
new text begin
(i) If a day meets the criteria of an absent day or a holiday under this subdivision, the
provider must bill that day as an absent day or holiday. A provider's failure to properly bill
an absent day or a holiday results in an overpayment, regardless of whether the child reached,
or is exempt from, the absent days limit or holidays limit for the calendar year.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 12.
Minnesota Statutes 2018, section 144A.479, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Labor market reporting. new text end
new text begin
A home care provider shall comply with the labor
market reporting requirements described in section 256B.4912, subdivision 1a.
new text end
Sec. 13.
Minnesota Statutes 2018, section 245.095, is amended to read:
245.095 LIMITS ON RECEIVING PUBLIC FUNDS.
Subdivision 1.
Prohibition.
new text begin (a) new text end If a provider, vendor, or individual enrolled, licensed,
deleted text begin ordeleted text end receiving funds under a grant contractnew text begin , or registerednew text end in any program administered by the
commissionernew text begin , including under the commissioner's powers and authorities in section 256.01,new text end
is excluded from deleted text begin anydeleted text end new text begin thatnew text end program deleted text begin administered by the commissioner, including under the
commissioner's powers and authorities in section 256.01deleted text end , the commissioner shallnew text begin :
new text end
new text begin (1)new text end prohibit the excluded provider, vendor, or individual from enrolling deleted text begin ordeleted text end new text begin ,new text end becoming
licensednew text begin , receiving grant funds, or registeringnew text end in any other program administered by the
commissionerdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider,
vendor, or individual in any other program administered by the commissioner.
new text end
new text begin (b) new text end The duration of this prohibitionnew text begin , disenrollment, revocation, suspension,
disqualification, or debarmentnew text end must last for the longest applicable sanction or disqualifying
period in effect for the provider, vendor, or individual permitted by state or federal law.
Subd. 2.
Definitions.
(a) For purposes of this section, the following definitions have the
meanings given them.
(b) "Excluded" means disenrolled, deleted text begin subject to license revocation or suspension,
disqualified, or subject to vendor debarmentdeleted text end new text begin disqualified, has a license that has been revoked
or suspended under chapter 245A, has been debarred or suspended new text end under Minnesota Rules,
part 1230.1150new text begin , or terminated from participation in medical assistance under section
256B.064new text end .
(c) "Individual" means a natural person providing products or services as a provider or
vendor.
(d) "Provider" means an owner, controlling individual, license holder, director, or
managerial official.
Sec. 14.
new text begin
[245A.24] MANDATORY REPORTING.
new text end
new text begin
All licensors employed by a county or the Department of Human Services must
immediately report any suspected fraud to county human services investigators or the
Department of Human Services Office of the Inspector General.
new text end
Sec. 15.
Minnesota Statutes 2018, section 245E.02, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Provider definitions. new text end
new text begin
For the purposes of this section, "provider" includes:
new text end
new text begin
(1) individuals or entities meeting the definition of provider in section 245E.01,
subdivision 12; and
new text end
new text begin
(2) owners and controlling individuals of entities identified in clause (1).
new text end
Sec. 16.
Minnesota Statutes 2018, section 256.98, subdivision 1, is amended to read:
Subdivision 1.
Wrongfully obtaining assistance.
A person who commits any of the
following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897,
the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program
formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, new text begin 256I, new text end 256J, 256K, or
256L, child care assistance programs, and emergency assistance programs under section
256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses
(1) to (5):
(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willfully false statement or representation, by intentional concealment of any material fact,
or by impersonation or other fraudulent device, assistance or the continued receipt of
assistance, to include child care assistance or vouchers produced according to sections
145.891 to 145.897 and MinnesotaCare services according to sections 256.9365, 256.94,
and 256L.01 to 256L.15, to which the person is not entitled or assistance greater than that
to which the person is entitled;
(2) knowingly aids or abets in buying or in any way disposing of the property of a
recipient or applicant of assistance without the consent of the county agency; or
(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments
to which the individual is not entitled as a provider of subsidized child care, or by furnishing
or concurring in a willfully false claim for child care assistance.
The continued receipt of assistance to which the person is not entitled or greater than
that to which the person is entitled as a result of any of the acts, failure to act, or concealment
described in this subdivision shall be deemed to be continuing offenses from the date that
the first act or failure to act occurred.
Sec. 17.
Minnesota Statutes 2018, section 256.98, subdivision 8, is amended to read:
Subd. 8.
Disqualification from program.
(a) Any person found to be guilty of
wrongfully obtaining assistance by a federal or state court or by an administrative hearing
determination, or waiver thereof, through a disqualification consent agreement, or as part
of any approved diversion plan under section 401.065, or any court-ordered stay which
carries with it any probationary or other conditions, in the Minnesota family investment
program and any affiliated program to include the diversionary work program and the work
participation cash benefit program, the food stamp or food support program, the general
assistance program, housing support under chapter 256I, or the Minnesota supplemental
aid program shall be disqualified from that program. new text begin The disqualification based on a finding
or action by a federal or state court is a permanent disqualification. The disqualification
based on an administrative hearing, or waiver thereof, through a disqualification consent
agreement, or as part of any approved diversion plan under section 401.065, or any
court-ordered stay which carries with it any probationary or other conditions must be for a
period of two years for the first offense and a permanent disqualification for the second
offense. new text end In addition, any person disqualified from the Minnesota family investment program
shall also be disqualified from the food stamp or food support program. The needs of that
individual shall not be taken into consideration in determining the grant level for that
assistance unitdeleted text begin :deleted text end new text begin .
new text end
deleted text begin
(1) for one year after the first offense;
deleted text end
deleted text begin
(2) for two years after the second offense; and
deleted text end
deleted text begin
(3) permanently after the third or subsequent offense.
deleted text end
The period of program disqualification shall begin on the date stipulated on the advance
notice of disqualification without possibility of postponement for administrative stay or
administrative hearing and shall continue through completion unless and until the findings
upon which the sanctions were imposed are reversed by a court of competent jurisdiction.
The period for which sanctions are imposed is not subject to review. The sanctions provided
under this subdivision are in addition to, and not in substitution for, any other sanctions that
may be provided for by law for the offense involved. A disqualification established through
hearing or waiver shall result in the disqualification period beginning immediately unless
the person has become otherwise ineligible for assistance. If the person is ineligible for
assistance, the disqualification period begins when the person again meets the eligibility
criteria of the program from which they were disqualified and makes application for that
program.
(b) A family receiving assistance through child care assistance programs under chapter
119B with a family member who is found to be guilty of wrongfully obtaining child care
assistance by a federal court, state court, or an administrative hearing determination or
waiver, through a disqualification consent agreement, as part of an approved diversion plan
under section 401.065, or a court-ordered stay with probationary or other conditions, is
disqualified from child care assistance programs. The disqualifications deleted text begin must be for periods
of one year and two years for the first and second offenses, respectively. Subsequent
violations must result indeleted text end new text begin based on a finding or action by a federal or state court is a new text end permanent
disqualification. new text begin The disqualification based on an administrative hearing determination or
waiver, through a disqualification consent agreement, as part of an approved diversion plan
under section 401.065, or a court-ordered stay with probationary or other conditions must
be for a period of two years for the first offense and a permanent disqualification for the
second offense. new text end During the disqualification period, disqualification from any child care
program must extend to all child care programs and must be immediately applied.
(c) A provider caring for children receiving assistance through child care assistance
programs under chapter 119B is disqualified from receiving payment for child care services
from the child care assistance program under chapter 119B when the provider is found to
have wrongfully obtained child care assistance by a federal court, state court, or an
administrative hearing determination or waiver under section 256.046, through a
disqualification consent agreement, as part of an approved diversion plan under section
401.065, or a court-ordered stay with probationary or other conditions. The disqualification
deleted text begin must be for a period of one year for the first offense and two years for the second offense.
Any subsequent violation must result indeleted text end new text begin based on a finding or action by a federal or state
court is anew text end permanent disqualification. new text begin The disqualification based on an administrative hearing
determination or waiver under section 256.045, as part of an approved diversion plan under
section 401.065, or a court-ordered stay with probationary or other conditions must be for
a period of two years for the first offense and a permanent disqualification for the second
offense. new text end The disqualification period must be imposed immediately after a determination is
made under this paragraph. During the disqualification period, the provider is disqualified
from receiving payment from any child care program under chapter 119B.
(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults
without children and upon federal approval, all categories of medical assistance and
remaining categories of MinnesotaCare, except for children through age 18, by a federal or
state court or by an administrative hearing determination, or waiver thereof, through a
disqualification consent agreement, or as part of any approved diversion plan under section
401.065, or any court-ordered stay which carries with it any probationary or other conditions,
is disqualified from that program. The period of disqualification is one year after the first
offense, two years after the second offense, and permanently after the third or subsequent
offense. The period of program disqualification shall begin on the date stipulated on the
advance notice of disqualification without possibility of postponement for administrative
stay or administrative hearing and shall continue through completion unless and until the
findings upon which the sanctions were imposed are reversed by a court of competent
jurisdiction. The period for which sanctions are imposed is not subject to review. The
sanctions provided under this subdivision are in addition to, and not in substitution for, any
other sanctions that may be provided for by law for the offense involved.
Sec. 18.
Minnesota Statutes 2018, section 256.987, subdivision 1, is amended to read:
Subdivision 1.
Electronic benefit transfer (EBT) card.
Cash benefits for the general
assistance and Minnesota supplemental aid programs under chapter 256D and programs
under chapter 256J must be issued on an EBT card deleted text begin withdeleted text end new text begin .new text end The name new text begin and photograph new text end of the
head of household new text begin and a list of family members authorized to use the EBT card must be
new text end printed on the card. new text begin The cardholder must show identification before making a purchase.
new text end The card must include the following statement: "It is unlawful to use this card to purchase
tobacco products or alcoholic beverages." This card must be issued within 30 calendar days
of an eligibility determination. During the initial 30 calendar days of eligibility, a recipient
may have cash benefits issued on an EBT card without a name printed on the card. This
card may be the same card on which food support benefits are issued and does not need to
meet the requirements of this section.
Sec. 19.
Minnesota Statutes 2018, section 256.987, subdivision 2, is amended to read:
Subd. 2.
Prohibited purchasesnew text begin and returnsnew text end .
new text begin (a) new text end An individual with an EBT card issued
for one of the programs listed under subdivision 1 is prohibited from using the EBT debit
card to purchase tobacco products and alcoholic beverages, as defined in section 340A.101,
subdivision 2. Any prohibited purchases made under this subdivision shall constitute unlawful
use and result in disqualification of the cardholder from the program as provided in
subdivision 4.
new text begin
(b) An item purchased with an EBT card that is returned must be credited back to the
EBT card. It is prohibited to give the EBT cardholder cash for returned items purchased
with an EBT card.
new text end
Sec. 20.
Minnesota Statutes 2018, section 256B.02, subdivision 7, is amended to read:
Subd. 7.
Vendor of medical care.
(a) "Vendor of medical care" means any person or
persons furnishing, within the scope of the vendor's respective license, any or all of the
following goods or services: medical, surgical, hospital, ambulatory surgical center services,
optical, visual, dental and nursing services; drugs and medical supplies; appliances;
laboratory, diagnostic, and therapeutic services; nursing home and convalescent care;
screening and health assessment services provided by public health nurses as defined in
section 145A.02, subdivision 18; health care services provided at the residence of the patient
if the services are performed by a public health nurse and the nurse indicates in a statement
submitted under oath that the services were actually provided; and such other medical
services or supplies provided or prescribed by persons authorized by state law to give such
services and suppliesnew text begin , including services under section 256B.4912. For purposes of this
chapter, the term includes a person or entity that furnishes a good or service eligible for
medical assistance or federally approved waiver plan payments under this chapternew text end . The term
includes, but is not limited to, directors and officers of corporations or members of
partnerships who, either individually or jointly with another or others, have the legal control,
supervision, or responsibility of submitting claims for reimbursement to the medical
assistance program. The term only includes directors and officers of corporations who
personally receive a portion of the distributed assets upon liquidation or dissolution, and
their liability is limited to the portion of the claim that bears the same proportion to the total
claim as their share of the distributed assets bears to the total distributed assets.
(b) "Vendor of medical care" also includes any person who is credentialed as a health
professional under standards set by the governing body of a federally recognized Indian
tribe authorized under an agreement with the federal government according to United States
Code, title 25, section 450f, to provide health services to its members, and who through a
tribal facility provides covered services to American Indian people within a contract health
service delivery area of a Minnesota reservation, as defined under Code of Federal
Regulations, title 42, section 36.22.
(c) A federally recognized Indian tribe that intends to implement standards for
credentialing health professionals must submit the standards to the commissioner of human
services, along with evidence of meeting, exceeding, or being exempt from corresponding
state standards. The commissioner shall maintain a copy of the standards and supporting
evidence, and shall use those standards to enroll tribal-approved health professionals as
medical assistance providers. For purposes of this section, "Indian" and "Indian tribe" mean
persons or entities that meet the definition in United States Code, title 25, section 450b.
Sec. 21.
Minnesota Statutes 2018, section 256B.02, is amended by adding a subdivision
to read:
new text begin Subd. 20. new text end
new text begin Income. new text end
new text begin
Income is calculated using the adjusted gross income methodology
under the Affordable Care Act. Income includes funds in personal or business accounts
used to pay personal expenses including rent, mortgage, automobile-related expenses,
utilities, food, and other personal expenses not directly related to the business, unless the
funds are directly attributable to an exception to the income requirement specifically
identified by the applicant.
new text end
Sec. 22.
Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
Subd. 21.
Provider enrollment.
(a)new text begin The commissioner shall enroll providers and conduct
screening activities as required by Code of Federal Regulations, title 42, section 455, subpart
E, including database checks, unannounced pre- and post-enrollment site visits, fingerprinting,
and criminal background studies. A provider providing services from multiple licensed
locations must enroll each licensed location separately. The commissioner may deny a
provider's incomplete application for enrollment if a provider fails to respond to the
commissioner's request for additional information within 60 days of the request.
new text end
new text begin
(b) The commissioner must revalidate each provider under this subdivision at least once
every five years. The commissioner may revalidate a personal care assistance agency under
this subdivision once every three years. The commissioner shall conduct revalidation as
follows:
new text end
new text begin
(1) provide 30-day notice of revalidation due date to include instructions for revalidation
and a list of materials the provider must submit to revalidate;
new text end
new text begin
(2) notify the provider that fails to completely respond within 30 days of any deficiencies
and allow an additional 30 days to comply; and
new text end
new text begin
(3) give 60-day notice of termination and immediately suspend a provider's ability to
bill for failure to remedy any deficiencies within the 30-day time period. The commissioner's
decision to suspend the provider's ability to bill is not subject to an administrative appeal.
new text end
new text begin
(c) The commissioner shall require that an individual rendering care to a recipient for
the following covered services enroll as an individual provider and be identified on claims:
new text end
new text begin
(1) consumer directed community supports; and
new text end
new text begin
(2) qualified professionals supervising personal care assistant services according to
section 256B.0659.
new text end
new text begin
(d) The commissioner may suspend a provider's ability to bill for a failure to comply
with any individual provider requirements or conditions of participation until the provider
comes into compliance. The commissioner's decision to suspend the provider's ability to
bill is not subject to an administrative appeal.
new text end
new text begin
(e) Notwithstanding any other provision to the contrary, all correspondence and
notifications, including notifications of termination and other actions, shall be delivered
electronically to a provider's MN-ITS mailbox. For a provider that does not have a MN-ITS
account and mailbox, notice shall be sent by first class mail.
new text end
new text begin (f)new text end If the commissioner or the Centers for Medicare and Medicaid Services determines
that a provider is designated "high-risk," the commissioner may withhold payment from
providers within that category upon initial enrollment for a 90-day period. The withholding
for each provider must begin on the date of the first submission of a claim.
deleted text begin (b)deleted text end new text begin (g)new text end An enrolled provider that is also licensed by the commissioner under chapter
245A, or is licensed as a home care provider by the Department of Health under chapter
144A and has a home and community-based services designation on the home care license
under section 144A.484, must designate an individual as the entity's compliance officer.
The compliance officer must:
(1) develop policies and procedures to assure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;
(2) train the employees of the provider entity, and any agents or subcontractors of the
provider entity including billers, on the policies and procedures under clause (1);
(3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services, and implement action to remediate any resulting problems;
(4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;
(5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and
(6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.
The commissioner may require, as a condition of enrollment in medical assistance, that a
provider within a particular industry sector or category establish a compliance program that
contains the core elements established by the Centers for Medicare and Medicaid Services.
deleted text begin (c)deleted text end new text begin (h)new text end The commissioner may revoke the enrollment of an ordering or rendering provider
for a period of not more than one year, if the provider fails to maintain and, upon request
from the commissioner, provide access to documentation relating to written orders or requests
for payment for durable medical equipment, certifications for home health services, or
referrals for other items or services written or ordered by such provider, when the
commissioner has identified a pattern of a lack of documentation. A pattern means a failure
to maintain documentation or provide access to documentation on more than one occasion.
Nothing in this paragraph limits the authority of the commissioner to sanction a provider
under the provisions of section 256B.064.
deleted text begin (d)deleted text end new text begin (i)new text end The commissioner shall terminate or deny the enrollment of any individual or
entity if the individual or entity has been terminated from participation in Medicare or under
the Medicaid program or Children's Health Insurance Program of any other state.
deleted text begin (e)deleted text end new text begin (j)new text end As a condition of enrollment in medical assistance, the commissioner shall require
that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
Services, its agents, or its designated contractors and the state agency, its agents, or its
designated contractors to conduct unannounced on-site inspections of any provider location.
The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
and standards used to designate Medicare providers in Code of Federal Regulations, title
42, section 424.518. The list and criteria are not subject to the requirements of chapter 14.
The commissioner's designations are not subject to administrative appeal.
deleted text begin (f)deleted text end new text begin (k)new text end As a condition of enrollment in medical assistance, the commissioner shall require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
high-risk for fraud, waste, or abuse.
deleted text begin (g)deleted text end new text begin (l)new text end (1) Upon initial enrollment, reenrollment, and notification of revalidation, all
durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
meeting the durable medical equipment provider and supplier definition in clause (3),
operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
annually renewed and designates the Minnesota Department of Human Services as the
obligee, and must be submitted in a form approved by the commissioner. For purposes of
this clause, the following medical suppliers are not required to obtain a surety bond: a
federally qualified health center, a home health agency, the Indian Health Service, a
pharmacy, and a rural health clinic.
(2) At the time of initial enrollment or reenrollment, durable medical equipment providers
and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond mustnew text begin be in a form approved by the
commissioner, renewed annually, and mustnew text end allow for recovery of costs and fees in pursuing
a claim on the bond.
(3) "Durable medical equipment provider or supplier" means a medical supplier that can
purchase medical equipment or supplies for sale or rental to the general public and is able
to perform or arrange for necessary repairs to and maintenance of equipment offered for
sale or rental.
deleted text begin (h)deleted text end new text begin (m)new text end The Department of Human Services may require a provider to purchase a surety
bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
if: (1) the provider fails to demonstrate financial viability, (2) the department determines
there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
provider or category of providers is designated high-risk pursuant to paragraph deleted text begin (a)deleted text end new text begin (e)new text end and
as per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in
an amount of $100,000 or ten percent of the provider's payments from Medicaid during the
immediately preceding 12 months, whichever is greater. The surety bond must name the
Department of Human Services as an obligee and must allow for recovery of costs and fees
in pursuing a claim on the bond. This paragraph does not apply if the provider currently
maintains a surety bond under the requirements in section 256B.0659 or 256B.85.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019, with the exception that the
amendments to paragraph (l), clause (2), are effective January 1, 2020.
new text end
Sec. 23.
Minnesota Statutes 2018, section 256B.056, subdivision 3, is amended to read:
Subd. 3.
Asset limitations for certain individuals.
(a) To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or if a member
of a household with two family members, husband and wife, or parent and child, the
household must not own more than $6,000 in assets, plus $200 for each additional legal
dependent. 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 accumulation of the clothing and personal needs allowance
according to section 256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not considered in determining
eligibility for medical assistance is the value of those assets excluded under the Supplemental
Security Income program for aged, blind, and disabled persons, with the following
exceptions:
(1) household goods and personal effects are not considered;
(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considerednew text begin . A bank account
that contains personal income or assets or is used to pay personal expenses is not a capital
or operating asset of a trade or businessnew text end ;
(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security
Income program;
(4) assets designated as burial expenses are excluded to the same extent excluded by the
Supplemental Security Income program. Burial expenses funded by annuity contracts or
life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;
(5) for a person who no longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical assistance under section 256B.057,
subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility
as an employed person with a disability, to the extent that the person's total assets remain
within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
(6) when a person enrolled in medical assistance under section 256B.057, subdivision
9, is age 65 or older and has been enrolled during each of the 24 consecutive months before
the person's 65th birthday, the assets owned by the person and the person's spouse must be
disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when
determining eligibility for medical assistance under section 256B.055, subdivision 7. The
income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions
in section 256B.059; and
(7) 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.
(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.
Sec. 24.
Minnesota Statutes 2018, section 256B.056, subdivision 4, is amended to read:
Subd. 4.
Income.
(a) To be eligible for medical assistance, a person eligible under section
256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of the federal
poverty guidelines. Effective January 1, 2000, and each successive January, recipients of
Supplemental Security Income may have an income up to the Supplemental Security Income
standard in effect on that date.
(b) Effective January 1, 2014, to be eligible for medical assistance, under section
256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133
percent of the federal poverty guidelines for the household size.
(c) To be eligible for medical assistance under section 256B.055, subdivision 15, a
person may have an income up to 133 percent of federal poverty guidelines for the household
size.
(d) To be eligible for medical assistance under section 256B.055, subdivision 16, a child
age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines for
the household size.
(e) To be eligible for medical assistance under section 256B.055, subdivision 3a, a child
under age 19 may have income up to 275 percent of the federal poverty guidelines for the
household size or an equivalent standard when converted using modified adjusted gross
income methodology as required under the Affordable Care Act. Children who are enrolled
in medical assistance as of December 31, 2013, and are determined ineligible for medical
assistance because of the elimination of income disregards under modified adjusted gross
income methodology as defined in subdivision 1a remain eligible for medical assistance
under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law
111-3, until the date of their next regularly scheduled eligibility redetermination as required
in subdivision 7a.
(f) In computing income to determine eligibility of persons under paragraphs (a) to (e)
who are not residents of long-term care facilities, the commissioner shallnew text begin : (1)new text end disregard
increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
Administration unusual medical expense payments are considered income to the recipientdeleted text begin .deleted text end new text begin ;
and (2) include all assets available to the applicant that are considered income according to
the Internal Revenue Service. Income includes all deposits into accounts owned or controlled
by the applicant, including amounts spent on personal expenses, including rent, mortgage,
automobile-related expenses, utilities, and food and amounts received as salary or draws
from business accounts and not otherwise excluded by federal or state laws. Income does
not include a deposit specifically identified by the applicant as a loan or gift, for which the
applicant provides the source, date, amount, and repayment terms.
new text end
Sec. 25.
Minnesota Statutes 2018, section 256B.056, subdivision 7a, is amended to read:
Subd. 7a.
Periodic renewal of eligibility.
(a) The commissioner shall make an annual
redetermination of eligibility deleted text begin based on information contained in the enrollee's case file and
other information available to the agency, including but not limited to information accessed
through an electronic database, without requiring the enrollee to submit any information
when sufficient data is available for the agency to renew eligibilitydeleted text end .
(b) deleted text begin If the commissioner cannot renew eligibility in accordance with paragraph (a),deleted text end The
commissioner must provide the enrollee with a prepopulated renewal form containing
eligibility information available to the agency and deleted text begin permitdeleted text end the enrollee deleted text begin todeleted text end new text begin mustnew text end submit the
form with any corrections or additional information to the agency and sign the renewal form
via any of the modes of submission specified in section 256B.04, subdivision 18.
(c) An enrollee who is terminated for failure to complete the renewal process may
subsequently submit the renewal form and required information within four months after
the date of termination and have coverage reinstated without a lapse, if otherwise eligible
under this chapter.
(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
required to renew eligibility every six months.
Sec. 26.
Minnesota Statutes 2018, 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,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:
(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;
(2) ambulances, as defined in section 144E.001, subdivision 2;
(3) taxicabs that meet the requirements of this subdivision;
(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 8840deleted text begin , and in consultation with the Minnesota Department of
Transportationdeleted text end . new text begin All drivers providing nonemergency medical transportation must be
individually enrolled with the commissioner if the driver is a subcontractor for or employed
by a provider that both has a base of operation located within a metropolitan county listed
in section 473.121, subdivision 4, and is listed in paragraph (b), clause (1) or (3). new text end 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 wheelchairs, child seats, 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 transportation 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.
(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 begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 27.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 17d. new text end
new text begin Transportation services oversight. new text end
new text begin
The commissioner shall contract with
a vendor or dedicate staff for oversight of providers of nonemergency medical transportation
services pursuant to the commissioner's authority in section 256B.04 and Minnesota Rules,
parts 9505.2160 to 9505.2245.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 28.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 17e. new text end
new text begin Transportation provider termination. new text end
new text begin
(a) A terminated nonemergency
medical transportation provider, including all named individuals on the current enrollment
disclosure form and known or discovered affiliates of the nonemergency medical
transportation provider, is not eligible to enroll as a nonemergency medical transportation
provider for five years following the termination.
new text end
new text begin
(b) After the five-year period in paragraph (a), if a provider seeks to reenroll as a
nonemergency medical transportation provider, the nonemergency medical transportation
provider must be placed on a one-year probation period. During a provider's probation
period, the commissioner shall complete unannounced site visits and request documentation
to review compliance with program requirements.
new text end
Sec. 29.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 17f. new text end
new text begin Transportation provider training. new text end
new text begin
The commissioner shall make available
to providers of nonemergency medical transportation and all drivers training materials and
online training opportunities regarding documentation requirements, documentation
procedures, and penalties for failing to meet documentation requirements.
new text end
Sec. 30.
Minnesota Statutes 2018, section 256B.0625, subdivision 18h, is amended to
read:
Subd. 18h.
Managed care.
deleted text begin (a)deleted text end The following subdivisions apply to managed care plans
and county-based purchasing plans:
(1) subdivision 17, paragraphs (a), (b), new text begin (c), new text end (i), and (n);
(2) subdivision 18; and
(3) subdivision 18a.
deleted 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.
deleted text end
Sec. 31.
Minnesota Statutes 2018, section 256B.0625, subdivision 43, is amended to read:
Subd. 43.
Mental health provider travel time.
new text begin (a) new text end Medical assistance covers provider
travel time if a deleted text begin recipient's individual treatment plandeleted text end new text begin recipientnew text end requires the provision of mental
health services outside of the provider's deleted text begin normaldeleted text end new text begin usual new text end place of business. deleted text begin This does not include
any travel time which is included in other billable services, and is only covered when the
mental health service being provided to a recipient is covered under medical assistance.
deleted text end
new text begin
(b) Medical assistance covers under this subdivision the time a provider is in transit to
provide a covered mental health service to a recipient at a location that is not the provider's
usual place of business. A provider must travel the most direct route available. Mental health
provider travel time does not include time for scheduled or unscheduled stops, meal breaks,
or vehicle maintenance or repair, including refueling or vehicle emergencies. Recipient
transportation is not covered under this subdivision.
new text end
new text begin
(c) Mental health provider travel time under this subdivision is only covered when the
mental health service being provided is covered under medical assistance and only when
the covered mental health service is delivered and billed. Mental health provider travel time
is not covered when the mental health service being provided otherwise includes provider
travel time or when the service is site based.
new text end
new text begin
(d) A provider must document each trip for which the provider seeks reimbursement
under this subdivision in a compiled travel record. Required documentation may be collected
and maintained electronically or in paper form but must be made available and produced
upon request by the commissioner. The travel record must be written in English and must
be legible according to the standard of a reasonable person. The recipient's individual
identification number must be on each page of the record. The reason the provider must
travel to provide services must be included in the record, if not otherwise documented in
the recipient's individual treatment plan. Each entry in the record must document:
new text end
new text begin
(1) start and stop time (with a.m. and p.m. notations);
new text end
new text begin
(2) printed name of the recipient;
new text end
new text begin
(3) date the entry is made;
new text end
new text begin
(4) date the service is provided;
new text end
new text begin
(5) origination site and destination site;
new text end
new text begin
(6) who provided the service;
new text end
new text begin
(7) the electronic source used to calculate driving directions and distance between
locations; and
new text end
new text begin
(8) the medically necessary mental health service delivered.
new text end
new text begin
(e) Mental health providers identified by the commissioner to have submitted a fraudulent
report may be excluded from participation in Minnesota health care programs.
new text end
Sec. 32.
Minnesota Statutes 2018, section 256B.064, subdivision 1b, is amended to read:
Subd. 1b.
Sanctions available.
The commissioner may impose the following sanctions
for the conduct described in subdivision 1a: suspension or withholding of payments to a
vendor and suspending or terminating participation in the program, or imposition of a fine
under subdivision 2, paragraph (f). When imposing sanctions under this section, the
commissioner shall consider the nature, chronicity, or severity of the conduct and the effect
of the conduct on the health and safety of persons served by the vendor.new text begin The commissioner
shall suspend a vendor's participation in the program for a minimum of five years if the
vendor is convicted of a crime, received a stay of adjudication, or entered a court-ordered
diversion program for an offense related to a provision of a health service under medical
assistance or health care fraud.new text end Regardless of imposition of sanctions, the commissioner
may make a referral to the appropriate state licensing board.
Sec. 33.
Minnesota Statutes 2018, section 256B.064, subdivision 2, is amended to read:
Subd. 2.
Imposition of monetary recovery and sanctions.
(a) The commissioner shall
determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor
of medical care under this section. Except as provided in paragraphs (b) and (d), neither a
monetary recovery nor a sanction will be imposed by the commissioner without prior notice
and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed
action, provided that the commissioner may suspend or reduce payment to a vendor of
medical care, except a nursing home or convalescent care facility, after notice and prior to
the hearing if in the commissioner's opinion that action is necessary to protect the public
welfare and the interests of the program.
(b) Except when the commissioner finds good cause not to suspend payments under
Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
withhold or reduce payments to a vendor of medical care without providing advance notice
of such withholding or reduction if either of the following occurs:
(1) the vendor is convicted of a crime involving the conduct described in subdivision
1a; or
(2) the commissioner determines there is a credible allegation of fraud for which an
investigation is pending under the program. A credible allegation of fraud is an allegation
which has been verified by the state, from any source, including but not limited to:
(i) fraud hotline complaints;
(ii) claims data mining; and
(iii) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations.
Allegations are considered to be credible when they have an indicia of reliability and
the state agency has reviewed all allegations, facts, and evidence carefully and acts
judiciously on a case-by-case basis.
(c) The commissioner must send notice of the withholding or reduction of payments
under paragraph (b) within five days of taking such action unless requested in writing by a
law enforcement agency to temporarily withhold the notice. The notice must:
(1) state that payments are being withheld according to paragraph (b);
(2) set forth the general allegations as to the nature of the withholding action, but need
not disclose any specific information concerning an ongoing investigation;
(3) except in the case of a conviction for conduct described in subdivision 1a, state that
the withholding is for a temporary period and cite the circumstances under which withholding
will be terminated;
(4) identify the types of claims to which the withholding applies; and
(5) inform the vendor of the right to submit written evidence for consideration by the
commissioner.
The withholding or reduction of payments will not continue after the commissioner
determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
relating to the alleged fraud are completed, unless the commissioner has sent notice of
intention to impose monetary recovery or sanctions under paragraph (a).new text begin Upon conviction
for a crime related to the provision, management, or administration of a health service under
medical assistance, a payment held pursuant to this section by the commissioner or a managed
care organization that contracts with the commissioner under section 256B.035 is forfeited
to the commissioner or managed care organization, regardless of the amount charged in the
criminal complaint or the amount of criminal restitution ordered.
new text end
(d) The commissioner shall suspend or terminate a vendor's participation in the program
without providing advance notice and an opportunity for a hearing when the suspension or
termination is required because of the vendor's exclusion from participation in Medicare.
Within five days of taking such action, the commissioner must send notice of the suspension
or termination. The notice must:
(1) state that suspension or termination is the result of the vendor's exclusion from
Medicare;
(2) identify the effective date of the suspension or termination; and
(3) inform the vendor of the need to be reinstated to Medicare before reapplying for
participation in the program.
(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is
to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision
3, by filing with the commissioner a written request of appeal. The appeal request must be
received by the commissioner no later than 30 days after the date the notification of monetary
recovery or sanction was mailed to the vendor. The appeal request must specify:
(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount
involved for each disputed item;
(2) the computation that the vendor believes is correct;
(3) the authority in statute or rule upon which the vendor relies for each disputed item;
(4) the name and address of the person or entity with whom contacts may be made
regarding the appeal; and
(5) other information required by the commissioner.
(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
services according to standards in this chapter and Minnesota Rules, chapter 9505. The
commissioner may assess fines if specific required components of documentation are
missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is
less.new text begin If the commissioner determines that a vendor repeatedly violated this chapter or
Minnesota Rules, chapter 9505, related to the provision of services to program recipients
and the submission of claims for payment, the commissioner may order a vendor to forfeit
a fine based on the nature, severity, and chronicity of the violations, in an amount of up to
$5,000 or 20 percent of the value of the claims, whichever is greater.
new text end
(g) The vendor shall pay the fine assessed on or before the payment date specified. If
the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
recover the amount of the fine. A timely appeal shall stay payment of the fine until the
commissioner issues a final order.
Sec. 34.
Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Vendor mandates on prohibited hiring. new text end
new text begin
(a) The commissioner shall maintain
and publish a list of each excluded individual and entity that was convicted of a crime related
to the provision, management, or administration of a medical assistance health service, or
where participation in the program was suspended or terminated under subdivision 2. A
vendor that receives funding from medical assistance shall not: (1) employ an individual
or entity who is on the exclusion list; or (2) enter into or maintain a business relationship
with an individual or entity that is on the exclusion list.
new text end
new text begin
(b) Before hiring or entering into a business transaction, a vendor shall check the
exclusion list. The vendor shall check the exclusion list on a monthly basis and document
the date and time with a.m. and p.m. designations that the exclusion list was checked and
the name and title of the person who checked the exclusion list. The vendor shall: (1)
immediately terminate a current employee on the exclusion list; and (2) immediately
terminate a business relationship with an individual or entity on the exclusion list.
new text end
new text begin
(c) A vendor's requirement to check the exclusion list and to terminate an employee on
the exclusion list applies to each employee, even if the named employee is not responsible
for direct patient care or direct submission of a claim to medical assistance. A vendor's
requirement to check the exclusion list and terminate a business relationship with an
individual or entity on the exclusion list applies to each business relationship, even if the
named individual or entity is not responsible for direct patient care or direct submission of
a claim to medical assistance.
new text end
new text begin
(d) A vendor that employs or enters into or maintains a business relationship with an
individual or entity on the exclusion list shall refund any payment related to a service
rendered by an individual or entity on the exclusion list from the date the individual is
employed or the date the individual is placed on the exclusion list, whichever is later, and
a vendor may be subject to:
new text end
new text begin
(1) sanctions under subdivision 2;
new text end
new text begin
(2) a civil monetary penalty of up to $25,000 for each determination by the department
that the vendor employed or contracted with an individual or entity on the exclusion list;
and
new text end
new text begin
(3) other fines or penalties allowed by law.
new text end
Sec. 35.
new text begin
[256B.0646] CORRECTIVE ACTIONS FOR PEOPLE USING PERSONAL
CARE ASSISTANCE SERVICES; MINNESOTA RESTRICTED RECIPIENT
PROGRAM.
new text end
new text begin
(a) When there is abusive or fraudulent billing of personal care assistance services or
community first services and supports under section 256B.85, the commissioner may place
a recipient in the Minnesota restricted recipient program as defined in Minnesota Rules,
part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this
section must:
new text end
new text begin
(1) use a designated traditional personal care assistance provider agency;
new text end
new text begin
(2) obtain a new assessment as described in section 256B.0911, including consultation
with a registered or public health nurse on the long-term care consultation team under section
256B.0911, subdivision 3, paragraph (b), clause (2); and
new text end
new text begin
(3) comply with additional conditions for the use of personal care assistance services or
community first services and supports if the commissioner determines it is necessary to
prevent future misuse of personal care assistance services or abusive or fraudulent billing
related to personal care assistance services. These additional conditions may include, but
are not limited to:
new text end
new text begin
(i) the restriction of service authorizations to a duration of no more than one month; and
new text end
new text begin
(ii) requiring a qualified professional to monitor and report services on a monthly basis.
new text end
new text begin
(b) Placement in the Minnesota restricted recipient program under this section is subject
to appeal according to section 256B.045.
new text end
Sec. 36.
Minnesota Statutes 2018, section 256B.0651, subdivision 17, is amended to read:
Subd. 17.
Recipient protection.
(a) Providers of home care services must provide each
recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days
prior to terminating services to a recipient, if the termination results from provider sanctions
under section 256B.064, such as a payment withhold, a suspension of participation, or a
termination of participation. If a home care provider determines it is unable to continue
providing services to a recipient, the provider must notify the recipient, the recipient's
responsible party, and the commissioner 30 days prior to terminating services to the recipient
because of an action under section 256B.064, and must assist the commissioner and lead
agency in supporting the recipient in transitioning to another home care provider of the
recipient's choice.
(b) In the event of a payment withhold from a home care provider, a suspension of
participation, or a termination of participation of a home care provider under section
256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care
and the lead agencies for all recipients with active service agreements with the provider. At
the commissioner's request, the lead agencies must contact recipients to ensure that the
recipients are continuing to receive needed care, and that the recipients have been given
free choice of provider if they transfer to another home care provider. In addition, the
commissioner or the commissioner's delegate may directly notify recipients who receive
care from the provider that payments have been new text begin or will be new text end withheld or that the provider's
participation in medical assistance has been new text begin or will be new text end suspended or terminated, if the
commissioner determines that notification is necessary to protect the welfare of the recipients.
For purposes of this subdivision, "lead agencies" means counties, tribes, and managed care
organizations.
Sec. 37.
Minnesota Statutes 2018, section 256B.0659, subdivision 3, is amended to read:
Subd. 3.
deleted text begin Noncovereddeleted text end Personal care assistance servicesnew text begin not coverednew text end .
(a) Personal care
assistance services are not eligible for medical assistance payment under this section when
provided:
(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal guardian,
licensed foster provider, except as allowed under section 256B.0652, subdivision 10, or
responsible party;
(2) in order to meet staffing or license requirements in a residential or child care setting;
(3) solely as a child care or babysitting service; deleted text begin or
deleted text end
(4) without authorization by the commissioner or the commissioner's designeedeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(5) on dates not within the frequency requirements of subdivision 14, paragraph (c), and
subdivision 19, paragraph (a).
new text end
(b) The following personal care services are not eligible for medical assistance payment
under this section when provided in residential settings:
(1) when the provider of home care services who is not related by blood, marriage, or
adoption owns or otherwise controls the living arrangement, including licensed or unlicensed
services; or
(2) when personal care assistance services are the responsibility of a residential or
program license holder under the terms of a service agreement and administrative rules.
(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible for
medical assistance reimbursement for personal care assistance services under this section
include:
(1) sterile procedures;
(2) injections of fluids and medications into veins, muscles, or skin;
(3) home maintenance or chore services;
(4) homemaker services not an integral part of assessed personal care assistance services
needed by a recipient;
(5) application of restraints or implementation of procedures under section 245.825;
(6) instrumental activities of daily living for children under the age of 18, except when
immediate attention is needed for health or hygiene reasons integral to the personal care
services and the need is listed in the service plan by the assessor; and
(7) assessments for personal care assistance services by personal care assistance provider
agencies or by independently enrolled registered nurses.
Sec. 38.
Minnesota Statutes 2018, section 256B.0659, subdivision 12, is amended to read:
Subd. 12.
Documentation of personal care assistance services provided.
(a) Personal
care assistance services for a recipient must be documented daily by each personal care
assistant, on a time sheet form approved by the commissioner. All documentation may be
web-based, electronic, or paper documentation. The completed form must be submitted on
a monthly basis to the provider and kept in the recipient's health record.
(b) The activity documentation must correspond to the personal care assistance care plan
and be reviewed by the qualified professional.
(c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:
(1) full name of personal care assistant and individual provider number;
(2) provider name and telephone numbers;
(3) full name of recipientnew text begin and either the recipient's medical assistance identification
number or date of birthnew text end ;
(4) consecutive dates, including month, day, and year, and arrival and departure times
with a.m. or p.m. notations;
(5) signatures of recipient or the responsible party;
(6) personal signature of the personal care assistant;
(7) any shared care provided, if applicable;
(8) a statement that it is a federal crime to provide false information on personal care
service billings for medical assistance payments; and
(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
Sec. 39.
Minnesota Statutes 2018, section 256B.0659, subdivision 13, is amended to read:
Subd. 13.
Qualified professional; qualifications.
(a) The qualified professional must
work for a personal care assistance provider agency deleted text begin anddeleted text end new text begin ,new text end meet the definition new text begin of qualified
professional new text end under section 256B.0625, subdivision 19cnew text begin , and enroll with the department as
a qualified professional after clearing a background studynew text end . Before a qualified professional
provides services, the personal care assistance provider agency must initiate a background
study on the qualified professional under chapter 245C, and the personal care assistance
provider agency must have received a notice from the commissioner that the qualified
professional:
(1) is not disqualified under section 245C.14; or
(2) is disqualified, but the qualified professional has received a set aside of the
disqualification under section 245C.22.
(b) The qualified professional shall perform the duties of training, supervision, and
evaluation of the personal care assistance staff and evaluation of the effectiveness of personal
care assistance services. The qualified professional shall:
(1) develop and monitor with the recipient a personal care assistance care plan based on
the service plan and individualized needs of the recipient;
(2) develop and monitor with the recipient a monthly plan for the use of personal care
assistance services;
(3) review documentation of personal care assistance services provided;
(4) provide training and ensure competency for the personal care assistant in the individual
needs of the recipient; and
(5) document all training, communication, evaluations, and needed actions to improve
performance of the personal care assistants.
(c) Effective July 1, 2011, the qualified professional shall complete the provider training
with basic information about the personal care assistance program approved by the
commissioner. Newly hired qualified professionals must complete the training within six
months of the date hired by a personal care assistance provider agency. Qualified
professionals who have completed the required training as a worker from a personal care
assistance provider agency do not need to repeat the required training if they are hired by
another agency, if they have completed the training within the last three years. The required
training must be available with meaningful access according to title VI of the Civil Rights
Act and federal regulations adopted under that law or any guidance from the United States
Health and Human Services Department. The required training must be available online or
by electronic remote connection. The required training must provide for competency testing
to demonstrate an understanding of the content without attending in-person training. A
qualified professional is allowed to be employed and is not subject to the training requirement
until the training is offered online or through remote electronic connection. A qualified
professional employed by a personal care assistance provider agency certified for
participation in Medicare as a home health agency is exempt from the training required in
this subdivision. When available, the qualified professional working for a Medicare-certified
home health agency must successfully complete the competency test. The commissioner
shall ensure there is a mechanism in place to verify the identity of persons completing the
competency testing electronically.
Sec. 40.
Minnesota Statutes 2018, section 256B.0659, subdivision 14, is amended to read:
Subd. 14.
Qualified professional; duties.
(a) Effective January 1, deleted text begin 2010deleted text end new text begin 2020new text end , all personal
care assistants must be supervised by a qualified professionalnew text begin who is enrolled as an individual
provider with the commissioner under section 256B.04, subdivision 21, paragraph (c)new text end .
(b) Through direct training, observation, return demonstrations, and consultation with
the staff and the recipient, the qualified professional must ensure and document that the
personal care assistant is:
(1) capable of providing the required personal care assistance services;
(2) knowledgeable about the plan of personal care assistance services before services
are performed; and
(3) able to identify conditions that should be immediately brought to the attention of the
qualified professional.
(c) The qualified professional shall evaluate the personal care assistant within the first
14 days of starting to provide regularly scheduled services for a recipient, or sooner as
determined by the qualified professional, except for the personal care assistance choice
option under subdivision 19, paragraph (a), clause (4). For the initial evaluation, the qualified
professional shall evaluate the personal care assistance services for a recipient through direct
observation of a personal care assistant's work. The qualified professional may conduct
additional training and evaluation visits, based upon the needs of the recipient and the
personal care assistant's ability to meet those needs. Subsequent visits to evaluate the personal
care assistance services provided to a recipient do not require direct observation of each
personal care assistant's work and shall occur:
(1) at least every 90 days thereafter for the first year of a recipient's services;
(2) every 120 days after the first year of a recipient's service or whenever needed for
response to a recipient's request for increased supervision of the personal care assistance
staff; and
(3) after the first 180 days of a recipient's service, supervisory visits may alternate
between unscheduled phone or Internet technology and in-person visits, unless the in-person
visits are needed according to the care plan.
(d) Communication with the recipient is a part of the evaluation process of the personal
care assistance staff.
(e) At each supervisory visit, the qualified professional shall evaluate personal care
assistance services including the following information:
(1) satisfaction level of the recipient with personal care assistance services;
(2) review of the month-to-month plan for use of personal care assistance services;
(3) review of documentation of personal care assistance services provided;
(4) whether the personal care assistance services are meeting the goals of the service as
stated in the personal care assistance care plan and service plan;
(5) a written record of the results of the evaluation and actions taken to correct any
deficiencies in the work of a personal care assistant; and
(6) revision of the personal care assistance care plan as necessary in consultation with
the recipient or responsible party, to meet the needs of the recipient.
(f) The qualified professional shall complete the required documentation in the agency
recipient and employee files and the recipient's home, including the following documentation:
(1) the personal care assistance care plan based on the service plan and individualized
needs of the recipient;
(2) a month-to-month plan for use of personal care assistance services;
(3) changes in need of the recipient requiring a change to the level of service and the
personal care assistance care plan;
(4) evaluation results of supervision visits and identified issues with personal care
assistance staff with actions taken;
(5) all communication with the recipient and personal care assistance staff; and
(6) hands-on training or individualized training for the care of the recipient.
(g) The documentation in paragraph (f) must be done on agency templates.
(h) The services that are not eligible for payment as qualified professional services
include:
(1) direct professional nursing tasks that could be assessed and authorized as skilled
nursing tasks;
(2) agency administrative activities;
(3) training other than the individualized training required to provide care for a recipient;
and
(4) any other activity that is not described in this section.
new text begin
(i) The qualified professional shall notify the commissioner on a form prescribed by the
commissioner, within 30 days of when a qualified professional is no longer employed by
or otherwise affiliated with the personal care assistance agency for whom the qualified
professional previously provided qualified professional services.
new text end
Sec. 41.
Minnesota Statutes 2018, section 256B.0659, subdivision 19, is amended to read:
Subd. 19.
Personal care assistance choice option; qualifications; duties.
(a) Under
personal care assistance choice, the recipient or responsible party shall:
(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);
(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;
(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;
(4) effective January 1, 2010, supervise and evaluate the personal care assistant with the
qualified professional, who is required to visit the recipient at least every 180 days;
(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;
(6) engage in an annual face-to-face reassessment to determine continuing eligibility
and service authorization; and
(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being used.
(b) The personal care assistance choice provider agency shall:
(1) meet all personal care assistance provider agency standards;
(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;
(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and
(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.
(c) The duties of the personal care assistance choice provider agency are to:
(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations including, but not limited to, purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation including, but not
limited to, workers' compensation deleted text begin anddeleted text end new text begin ,new text end unemployment insurancenew text begin , and labor market data
required under section 256B.4912, subdivision 1anew text end ;
(2) bill the medical assistance program for personal care assistance services and qualified
professional services;
(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;
(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;
(5) withhold and pay all applicable federal and state taxes;
(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;
(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;
(8) enroll in the medical assistance program as a personal care assistance choice agency;
and
(9) enter into a written agreement as specified in subdivision 20 before services are
provided.
Sec. 42.
Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
Subd. 21.
Requirements for provider enrollment of personal care assistance provider
agencies.
(a) All personal care assistance provider agencies must provide, at the time of
enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
a format determined by the commissioner, information and documentation that includes,
but is not limited to, the following:
(1) the personal care assistance provider agency's current contact information including
address, telephone number, and e-mail address;
(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid
revenue in the previous calendar year is up to and including $300,000, the provider agency
must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is
over $300,000, the provider agency must purchase a surety bond of $100,000. The surety
bond must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
(3) proof of fidelity bond coverage in the amount of $20,000;
(4) proof of workers' compensation insurance coverage;
(5) proof of liability insurance;
(6) a description of the personal care assistance provider agency's organization identifying
the names of all owners, managing employees, staff, board of directors, and the affiliations
of the directors, owners, or staff to other service providers;
(7) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery;
new text begin identification, prevention, detection, and reporting of fraud or any billing, record-keeping,
or other administrative noncompliance; new text end and employee and consumer safety including process
for notification and resolution of consumer grievances, identification and prevention of
communicable diseases, and employee misconduct;
(8) copies of all other forms the personal care assistance provider agency uses in the
course of daily business including, but not limited to:
(i) a copy of the personal care assistance provider agency's time sheet if the time sheet
varies from the standard time sheet for personal care assistance services approved by the
commissioner, and a letter requesting approval of the personal care assistance provider
agency's nonstandard time sheet;
(ii) the personal care assistance provider agency's template for the personal care assistance
care plan; and
(iii) the personal care assistance provider agency's template for the written agreement
in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
(9) a list of all training and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;
(10) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this section;
(11) documentation of the agency's marketing practices;
(12) disclosure of ownership, leasing, or management of all residential properties that
is used or could be used for providing home care services;
(13) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services for
employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
care assistance choice option and 72.5 percent of revenue from other personal care assistance
providers. The revenue generated by the qualified professional and the reasonable costs
associated with the qualified professional shall not be used in making this calculation; deleted text begin and
deleted text end
(14) effective May 15, 2010, documentation that the agency does not burden recipients'
free exercise of their right to choose service providers by requiring personal care assistants
to sign an agreement not to work with any particular personal care assistance recipient or
for another personal care assistance provider agency after leaving the agency and that the
agency is not taking action on any such agreements or requirements regardless of the date
signednew text begin ; and
new text end
new text begin (15) a copy of the personal care assistance provider agency's self-auditing policy and
other materials demonstrating the personal care assistance provider agency's internal program
integrity proceduresnew text end .
(b) new text begin Personal care assistance provider agencies enrolling for the first time must also
provide, at the time of enrollment as a personal care assistance provider agency in a format
determined by the commissioner, information and documentation that includes proof of
sufficient initial operating capital to support the infrastructure necessary to allow for ongoing
compliance with the requirements of this section. Sufficient operating capital can be
demonstrated as follows:
new text end
new text begin
(1) copies of business bank account statements with at least $5,000 in cash reserves;
new text end
new text begin
(2) proof of a cash reserve or business line of credit sufficient to equal three payrolls of
the agency's current or projected business; and
new text end
new text begin
(3) any other manner proscribed by the commissioner.
new text end
new text begin (c) new text end Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider agency
enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
the information specified in paragraph (a) from all personal care assistance providers
beginning July 1, 2009.
deleted text begin (c)deleted text end new text begin (d)new text end All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before enrollment of the agency as a provider. Employees
in management and supervisory positions and owners who are active in the day-to-day
operations of an agency who have completed the required training as an employee with a
personal care assistance provider agency do not need to repeat the required training if they
are hired by another agency, if they have completed the training within the past three years.
By September 1, 2010, the required training must be available with meaningful access
according to title VI of the Civil Rights Act and federal regulations adopted under that law
or any guidance from the United States Health and Human Services Department. The
required training must be available online or by electronic remote connection. The required
training must provide for competency testing. Personal care assistance provider agency
billing staff shall complete training about personal care assistance program financial
management. This training is effective July 1, 2009. Any personal care assistance provider
agency enrolled before that date shall, if it has not already, complete the provider training
within 18 months of July 1, 2009. Any new owners or employees in management and
supervisory positions involved in the day-to-day operations are required to complete
mandatory training as a requisite of working for the agency. Personal care assistance provider
agencies certified for participation in Medicare as home health agencies are exempt from
the training required in this subdivision. When available, Medicare-certified home health
agency owners, supervisors, or managers must successfully complete the competency test.
new text begin
(e) All personal care assistance provider agencies must provide, at the time of revalidation
as a personal care assistance provider agency in a format determined by the commissioner,
information and documentation that includes, but is not limited to, the following:
new text end
new text begin
(1) documentation of the payroll paid for the preceding 12 months or other period as
proscribed by the commissioner; and
new text end
new text begin
(2) financial statements demonstrating compliance with paragraph (a), clause (13).
new text end
Sec. 43.
Minnesota Statutes 2018, section 256B.0659, subdivision 24, is amended to read:
Subd. 24.
Personal care assistance provider agency; general duties.
A personal care
assistance provider agency shall:
(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;
(2) comply with general medical assistance coverage requirements;
(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;
(4) comply with background study requirements;
(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;
(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;
(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;
(8) withhold and pay all applicable federal and state taxes;
(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent
of the revenue generated by the medical assistance rate for personal care assistance services
for employee personal care assistant wages and benefits. The revenue generated by the
qualified professional and the reasonable costs associated with the qualified professional
shall not be used in making this calculation;
(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;
(11) enter into a written agreement under subdivision 20 before services are provided;
(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;
(13) provide the recipient with a copy of the home care bill of rights at start of service;
deleted text begin and
deleted text end
(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissionerdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(15) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a.
new text end
Sec. 44.
Minnesota Statutes 2018, section 256B.27, subdivision 3, is amended to read:
Subd. 3.
Access to medical records.
The commissioner of human services, with the
written consent of the recipient, on file with the local welfare agency, shall be allowed
access to all personal medical records of medical assistance recipients solely for the purposes
of investigating whether or not: (a) a vendor of medical care has submitted a claim for
reimbursement, a cost report or a rate application which is duplicative, erroneous, or false
in whole or in part, or which results in the vendor obtaining greater compensation than the
vendor is legally entitled to; or (b) the medical care was medically necessary. deleted text begin The vendor
of medical care shall receive notification from the commissioner at least 24 hours before
the commissioner gains access to such records.deleted text end new text begin When the commissioner is investigating a
suspected overpayment of Medicaid funds, only after first conferring with the department's
Office of Inspector General, and documenting the evidentiary basis for any decision to
demand immediate access to medical records, the commissioner must be given immediate
access without prior notice to the vendor's office during regular business hours and to
documentation and records related to services provided and submission of claims for services
provided. Denying the commissioner access to records is cause for the vendor's immediate
suspension of payment or termination according to section 256B.064.new text end The determination
of provision of services not medically necessary shall be made by the commissioner.
Notwithstanding any other law to the contrary, a vendor of medical care shall not be subject
to any civil or criminal liability for providing access to medical records to the commissioner
of human services pursuant to this section.
Sec. 45.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Annual labor market reporting. new text end
new text begin
(a) As determined by the commissioner, a
provider of home and community-based services for the elderly under sections 256B.0913
and 256B.0915, home and community-based services for people with developmental
disabilities under section 256B.092, and home and community-based services for people
with disabilities under section 256B.49 shall submit data to the commissioner on the
following:
new text end
new text begin
(1) number of direct-care staff;
new text end
new text begin
(2) wages of direct-care staff;
new text end
new text begin
(3) hours worked by direct-care staff;
new text end
new text begin
(4) overtime wages of direct-care staff;
new text end
new text begin
(5) overtime hours worked by direct-care staff;
new text end
new text begin
(6) benefits paid and accrued by direct-care staff;
new text end
new text begin
(7) direct-care staff retention rates;
new text end
new text begin
(8) direct-care staff job vacancies;
new text end
new text begin
(9) amount of travel time paid;
new text end
new text begin
(10) program vacancy rates; and
new text end
new text begin
(11) other related data requested by the commissioner.
new text end
new text begin
(b) The commissioner may adjust reporting requirements for a self-employed direct-care
staff.
new text end
new text begin
(c) For the purposes of this subdivision, "direct-care staff" means employees, including
self-employed individuals and individuals directly employed by a participant in a
consumer-directed service delivery option, providing direct service provision to people
receiving services under this section. Direct-care staff does not include executive, managerial,
or administrative staff.
new text end
new text begin
(d) This subdivision also applies to a provider of personal care assistance services under
section 256B.0625, subdivision 19a; community first services and supports under section
256B.85; nursing services and home health services under section 256B.0625, subdivision
6a; home care nursing services under section 256B.0625, subdivision 7; or day training and
habilitation services for residents of intermediate care facilities for persons with
developmental disabilities under section 256B.501.
new text end
new text begin
(e) This subdivision also applies to financial management services providers for
participants who directly employ direct-care staff through consumer support grants under
section 256.476; the personal care assistance choice program under section 256B.0657,
subdivisions 18 to 20; community first services and supports under section 256B.85; and
the consumer-directed community supports option available under the alternative care
program, the brain injury waiver, the community alternative care waiver, the community
alternatives for disabled individuals waiver, the developmental disabilities waiver, the
elderly waiver, and the Minnesota senior health option, except financial management services
providers are not required to submit the data listed in paragraph (a), clauses (7) to (11).
new text end
new text begin
(f) The commissioner shall ensure that data submitted under this subdivision is not
duplicative of data submitted under any other section of this chapter or any other chapter.
new text end
new text begin
(g) A provider shall submit the data annually on a date specified by the commissioner.
The commissioner shall give a provider at least 30 calendar days to submit the data. If a
provider fails to submit the requested data by the date specified by the commissioner, the
commissioner may delay medical assistance reimbursement until the requested data is
submitted.
new text end
new text begin
(h) Individually identifiable data submitted to the commissioner in this section are
considered private data on an individual, as defined by section 13.02, subdivision 12.
new text end
new text begin
(i) The commissioner shall analyze data annually for workforce assessments and how
the data impact service access.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 46.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Home and community-based service billing requirements. new text end
new text begin
(a) A home and
community-based service is eligible for reimbursement if:
new text end
new text begin
(1) it is a service provided as specified in a federally approved waiver plan, as authorized
under sections 256B.0913, 256B.0915, 256B.092, and 256B.49;
new text end
new text begin
(2) if applicable, it is provided on days and times during the days and hours of operation
specified on any license that is required under chapter 245A or 245D; or
new text end
new text begin
(3) the home and community-based service provider has met the documentation
requirements under subdivision 12, 13, 14, or 15.
new text end
new text begin
A service that does not meet the criteria in this subdivision may be recovered by the
department according to section 256B.064 and Minnesota Rules, parts 9505.2160 to
9505.2245.
new text end
new text begin
(b) The provider must maintain documentation that all individuals providing service
have attested to reviewing and understanding the following statement upon employment
and annually thereafter.
new text end
new text begin
"It is a federal crime to provide materially false information on service billings for
medical assistance or services provided under a federally approved waiver plan, as authorized
under Minnesota Statutes, sections 256B.0913, 256B.0915, 256B.092, and 256B.49."
new text end
Sec. 47.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Home and community-based service documentation requirements. new text end
new text begin
(a)
Documentation may be collected and maintained electronically or in paper form by providers,
but must be made available and produced upon the request of the commissioner.
Documentation of delivered services that comply with the electronic visit verification
requirements under Laws 2017, First Special Session chapter 6, article 3, section 49, satisfy
the requirements of this subdivision.
new text end
new text begin
(b) Documentation of a delivered service must be in English and must be legible according
to the standard of a reasonable person.
new text end
new text begin
(c) If the service is reimbursed at an hourly or specified minute-based rate, each
documentation of the provision of a service, unless otherwise specified, must include:
new text end
new text begin
(1) the date the documentation occurred;
new text end
new text begin
(2) the day, month, and year when the service was provided;
new text end
new text begin
(3) the start and stop times with a.m. and p.m. designations, except for case management
services as defined under sections 256B.0913, subdivision 7, 256B.0915, subdivision 1a,
256B.092, subdivision 1a, and 256B.49, subdivision 13;
new text end
new text begin
(4) the service name or description of the service provided; and
new text end
new text begin
(5) the name, signature, and title, if any, of the provider of service. If the service is
provided by multiple staff members, the provider may designate a staff member responsible
for verifying services and completing the documentation required by this paragraph.
new text end
new text begin
(d) If the service is reimbursed at a daily rate or does not meet the requirements of
paragraph (c), each documentation of the provision of a service, unless otherwise specified,
must include:
new text end
new text begin
(1) the date the documentation occurred;
new text end
new text begin
(2) the day, month, and year when the service was provided;
new text end
new text begin
(3) the service name or description of the service provided; and
new text end
new text begin
(4) the name, signature, and title, if any, of the person providing the service. If the service
is provided by multiple staff, the provider may designate a staff person responsible for
verifying services and completing the documentation required by this paragraph.
new text end
Sec. 48.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Waiver transportation documentation and billing requirements. new text end
new text begin
(a) A
waiver transportation service must meet the billing requirements under section 256B.4912,
subdivision 11, to be eligible for reimbursement and must:
new text end
new text begin
(1) be a waiver transportation service that is not covered by medical transportation under
the Medicaid state plan; and
new text end
new text begin
(2) be a waiver transportation service that is not included as a component of another
waiver service.
new text end
new text begin
(b) A waiver transportation service provider must meet the documentation requirements
under subdivision 12 and must maintain:
new text end
new text begin
(1) odometer and other records as provided in section 256B.0625, subdivision 17b,
paragraph (b), clause (3), sufficient to distinguish an individual trip with a specific vehicle
and driver for a waiver transportation service that is billed directly by the mile, except if
the provider is a common carrier as defined by Minnesota Rules, part 9505.0315, subpart
1, item B, or a publicly operated transit system; and
new text end
new text begin
(2) documentation demonstrating that a vehicle and a driver meets the standards
determined by the Department of Human Services on vehicle and driver qualifications as
described in section 256B.0625, subdivision 17, paragraph (c).
new text end
Sec. 49.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Equipment and supply documentation requirements. new text end
new text begin
(a) An equipment
and supply services provider must meet the documentation requirements under subdivision
12 and must, for each documentation of the provision of a service, include:
new text end
new text begin
(1) the recipient's assessed need for the equipment or supply and the reason the equipment
or supply is not covered by the Medicaid state plan;
new text end
new text begin
(2) the type and brand name of the equipment or supply delivered to or purchased by
the recipient, including whether the equipment or supply was rented or purchased;
new text end
new text begin
(3) the quantity of the equipment or supplies delivered or purchased; and
new text end
new text begin
(4) the cost of equipment or supplies if the amount paid for the service depends on the
cost.
new text end
new text begin
(b) A provider must maintain a copy of the shipping invoice or a delivery service tracking
log or other documentation showing the date of delivery that proves the equipment or supply
was delivered to the recipient or a receipt if the equipment or supply was purchased by the
recipient.
new text end
Sec. 50.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Adult day service documentation and billing requirements. new text end
new text begin
(a) A service
defined as "adult day care" under section 245A.02, subdivision 2a, and licensed under
Minnesota Rules, parts 9555.9600 to 9555.9730, must meet the documentation requirements
under subdivision 12 and must maintain documentation of:
new text end
new text begin
(1) a needs assessment and current plan of care according to section 245A.143,
subdivisions 4 to 7, or Minnesota Rules, part 9555.9700, if applicable, for each recipient;
new text end
new text begin
(2) attendance records as specified under section 245A.14, subdivision 14, paragraph
(c); the date of attendance must be documented on the attendance record with the day,
month, and year; and the pickup and drop-off time must be noted on the attendance record
in hours and minutes with a.m. and p.m. designations;
new text end
new text begin
(3) the monthly and quarterly program requirements in Minnesota Rules, part 9555.9710,
subparts 1, items E and H, 3, 4, and 6, if applicable;
new text end
new text begin
(4) the names and qualifications of the registered physical therapists, registered nurses,
and registered dietitians who provide services to the adult day care or nonresidential program;
and
new text end
new text begin
(5) the location where the service was provided and, if the location is an alternate location
from the primary place of service, the address, or if an address is not available, a description
of both the origin and destination location, the length of time at the alternate location with
a.m. and p.m. designations, and a list of participants who went to the alternate location.
new text end
new text begin
(b) A provider cannot exceed its licensed capacity; if licensed capacity is exceeded, all
Minnesota health care program payments for that date shall be recovered by the department.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 51.
Minnesota Statutes 2018, section 256B.5014, is amended to read:
256B.5014 deleted text begin FINANCIALdeleted text end REPORTINGnew text begin REQUIREMENTSnew text end .
new text begin Subdivision 1. new text end
new text begin Financial reporting. new text end
All facilities shall maintain financial records and
shall provide annual income and expense reports to the commissioner of human services
on a form prescribed by the commissioner no later than April 30 of each year in order to
receive medical assistance payments. The reports for the reporting year ending December
31 must include:
(1) salaries and related expenses, including program salaries, administrative salaries,
other salaries, payroll taxes, and fringe benefits;
(2) general operating expenses, including supplies, training, repairs, purchased services
and consultants, utilities, food, licenses and fees, real estate taxes, insurance, and working
capital interest;
(3) property related costs, including depreciation, capital debt interest, rent, and leases;
and
(4) total annual resident days.
new text begin Subd. 2. new text end
new text begin Labor market reporting. new text end
new text begin
All intermediate care facilities shall comply with
the labor market reporting requirements described in section 256B.4912, subdivision 1a.
new text end
Sec. 52.
Minnesota Statutes 2018, section 256B.85, subdivision 10, is amended to read:
Subd. 10.
Agency-provider and FMS provider qualifications and duties.
(a)
Agency-providers identified in subdivision 11 and FMS providers identified in subdivision
13a shall:
(1) enroll as a medical assistance Minnesota health care programs provider and meet all
applicable provider standards and requirements;
(2) demonstrate compliance with federal and state laws and policies for CFSS as
determined by the commissioner;
(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results;
(4) verify and maintain records of all services and expenditures by the participant,
including hours worked by support workers;
(5) not engage in any agency-initiated direct contact or marketing in person, by telephone,
or other electronic means to potential participants, guardians, family members, or participants'
representatives;
(6) directly provide services and not use a subcontractor or reporting agent;
(7) meet the financial requirements established by the commissioner for financial
solvency;
(8) have never had a lead agency contract or provider agreement discontinued due to
fraud, or have never had an owner, board member, or manager fail a state or FBI-based
criminal background check while enrolled or seeking enrollment as a Minnesota health care
programs provider; and
(9) have an office located in Minnesota.
(b) In conducting general duties, agency-providers and FMS providers shall:
(1) pay support workers based upon actual hours of services provided;
(2) pay for worker training and development services based upon actual hours of services
provided or the unit cost of the training session purchased;
(3) withhold and pay all applicable federal and state payroll taxes;
(4) make arrangements and pay unemployment insurance, taxes, workers' compensation,
liability insurance, and other benefits, if any;
(5) enter into a written agreement with the participant, participant's representative, or
legal representative that assigns roles and responsibilities to be performed before services,
supports, or goods are provided;
(6) report maltreatment as required under sections 626.556 and 626.557; deleted text begin and
deleted text end
(7) new text begin comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a; and
new text end
new text begin (8) new text end comply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13.
Sec. 53.
Minnesota Statutes 2018, section 256D.024, subdivision 3, is amended to read:
Subd. 3.
Fleeing deleted text begin felonsdeleted text end new text begin offendersnew text end .
An individual who is fleeing to avoid prosecution,
or custody, or confinement after conviction for a crime deleted text begin that is a felonydeleted text end under the laws of
the jurisdiction from which the individual fleesdeleted text begin , or in the case of New Jersey, is a high
misdemeanor,deleted text end is ineligible to receive benefits under this chapter.
Sec. 54.
new text begin
[256D.0245] DRUG TESTING INFORMATION FROM PROBATION
OFFICERS.
new text end
new text begin
The local probation agency shall regularly provide a list of probationers who tested
positive for an illegal controlled substance to the local social services agency, specifically
the welfare fraud division, for purposes of section 256D.024.
new text end
Sec. 55.
Minnesota Statutes 2018, section 256D.0515, is amended to read:
256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
All food stamp households must be determined eligible for the benefit discussed under
section 256.029. Food stamp households must demonstrate thatnew text begin : (1)new text end their gross income is
equal to or less than 165 percent of the federal poverty guidelines for the same family sizenew text begin ;
and (2) they have financial resources, excluding vehicles, of less than $100,000new text end .
Sec. 56.
Minnesota Statutes 2018, section 256D.0516, subdivision 2, is amended to read:
Subd. 2.
Food support reporting requirements.
The commissioner of human services
shall implement simplified reporting as permitted under the Food Stamp Act of 1977, as
amended, and the food stamp regulations in Code of Federal Regulations, title 7, part 273.
Food support recipient households new text begin are new text end required to report deleted text begin periodically shall not be required
to report more often than one timedeleted text end every six monthsnew text begin , and must report any changes in income,
assets, or employment that affects eligibility within ten days of the date the change occursnew text end .
This provision shall not apply to households receiving food benefits under the Minnesota
family investment program waiver.
Sec. 57.
Minnesota Statutes 2018, section 256J.08, subdivision 47, is amended to read:
Subd. 47.
Income.
"Income" means cash or in-kind benefit, whether earned or unearned,
received by or available to an applicant or participant that is not property under section
256P.02.new text begin An applicant must document that the property is not available to the applicant.
new text end
Sec. 58.
Minnesota Statutes 2018, section 256J.21, subdivision 2, is amended to read:
Subd. 2.
Income exclusions.
The following must be excluded in determining a family's
available income:
(1) payments for basic care, difficulty of care, and clothing allowances received for
providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
to 9555.6265, 9560.0521, and 9560.0650 to 9560.0654, payments for family foster care for
children under section 260C.4411 or chapter 256N, and payments received and used for
care and maintenance of a third-party beneficiary who is not a household member;
(2) reimbursements for employment training received through the Workforce Investment
Act of 1998, United States Code, title 20, chapter 73, section 9201;
(3) reimbursement for out-of-pocket expenses incurred while performing volunteer
services, jury duty, employment, or informal carpooling arrangements directly related to
employment;
(4) all educational assistance, except the county agency must count graduate student
teaching assistantships, fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary educational expenses, shall count
scholarships or grants awarded to graduate students that do not require teaching or research
as unearned income;
(5) loans, regardless of purpose, from public or private lending institutions, governmental
lending institutions, or governmental agencies;
(6) loans from private individuals, regardless of purpose, provided an applicant or
participant deleted text begin documents that the lender expects repaymentdeleted text end new text begin provides documentation of the
source of the loan, dates, amount of the loan, and terms of repaymentnew text end ;
(7)(i) state income tax refunds; and
(ii) federal income tax refunds;
(8)(i) federal earned income credits;
(ii) Minnesota working family credits;
(iii) state homeowners and renters credits under chapter 290A; and
(iv) federal or state tax rebates;
(9) funds received for reimbursement, replacement, or rebate of personal or real property
when these payments are made by public agencies, awarded by a court, solicited through
public appeal, or made as a grant by a federal agency, state or local government, or disaster
assistance organizations, subsequent to a presidential declaration of disaster;
(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial
expenses, or to repair or replace insured property;
(11) reimbursements for medical expenses that cannot be paid by medical assistance;
(12) payments by a vocational rehabilitation program administered by the state under
chapter 268A, except those payments that are for current living expenses;
(13) in-kind income, including any payments directly made by a third party to a provider
of goods and servicesnew text begin . In-kind income does not include in-kind payments of living expensesnew text end ;
(14) assistance payments to correct underpayments, but only for the month in which the
payment is received;
(15) payments for short-term emergency needs under section 256J.626, subdivision 2;
(16) funeral and cemetery payments as provided by section 256.935;
(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar
month;
(18) any form of energy assistance payment made through Public Law 97-35,
Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
providers by other public and private agencies, and any form of credit or rebate payment
issued by energy providers;
(19) Supplemental Security Income (SSI), including retroactive SSI payments and other
income of an SSI recipient;
(20) Minnesota supplemental aid, including retroactive payments;
(21) proceeds from the sale of real or personal property;
(22) adoption or kinship assistance payments under chapter 256N or 259A and Minnesota
permanency demonstration title IV-E waiver payments;
(23) state-funded family subsidy program payments made under section 252.32 to help
families care for children with developmental disabilities, consumer support grant funds
under section 256.476, and resources and services for a disabled household member under
one of the home and community-based waiver services programs under chapter 256B;
(24) interest payments and dividends from property that is not excluded from and that
does not exceed the asset limit;
(25) rent rebates;
(26) income earned by a minor caregiver, minor child through age 6, or a minor child
who is at least a half-time student in an approved elementary or secondary education program;
(27) income earned by a caregiver under age 20 who is at least a half-time student in an
approved elementary or secondary education program;
(28) MFIP child care payments under section 119B.05;
(29) all other payments made through MFIP to support a caregiver's pursuit of greater
economic stability;
(30) income a participant receives related to shared living expenses;
(31) reverse mortgages;
(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42,
chapter 13A, sections 1771 to 1790;
(33) benefits provided by the women, infants, and children (WIC) nutrition program,
United States Code, title 42, chapter 13A, section 1786;
(34) benefits from the National School Lunch Act, United States Code, title 42, chapter
13, sections 1751 to 1769e;
(35) relocation assistance for displaced persons under the Uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter
61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12,
chapter 13, sections 1701 to 1750jj;
(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part
2, sections 2271 to 2322;
(37) war reparations payments to Japanese Americans and Aleuts under United States
Code, title 50, sections 1989 to 1989d;
(38) payments to veterans or their dependents as a result of legal settlements regarding
Agent Orange or other chemical exposure under Public Law 101-239, section 10405,
paragraph (a)(2)(E);
(39) income that is otherwise specifically excluded from MFIP consideration in federal
law, state law, or federal regulation;
(40) security and utility deposit refunds;
(41) American Indian tribal land settlements excluded under Public Laws 98-123, 98-124,
and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and
Mille Lacs reservations and payments to members of the White Earth Band, under United
States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
(42) all income of the minor parent's parents and stepparents when determining the grant
for the minor parent in households that include a minor parent living with parents or
stepparents on MFIP with other children;
(43) income of the minor parent's parents and stepparents equal to 200 percent of the
federal poverty guideline for a family size not including the minor parent and the minor
parent's child in households that include a minor parent living with parents or stepparents
not on MFIP when determining the grant for the minor parent. The remainder of income is
deemed as specified in section 256J.37, subdivision 1b;
(44) payments made to children eligible for relative custody assistance under section
257.85;
(45) vendor payments for goods and services made on behalf of a client unless the client
has the option of receiving the payment in cash;
(46) the principal portion of a contract for deed payment;
(47) cash payments to individuals enrolled for full-time service as a volunteer under
AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
National, and AmeriCorps NCCC;
(48) housing assistance grants under section 256J.35, paragraph (a); and
(49) child support payments of up to $100 for an assistance unit with one child and up
to $200 for an assistance unit with two or more children.
Sec. 59.
Minnesota Statutes 2018, section 256J.26, subdivision 3, is amended to read:
Subd. 3.
Fleeing deleted text begin felonsdeleted text end new text begin offendersnew text end .
An individual who is fleeing to avoid prosecution,
or custody, or confinement after conviction for a crime deleted text begin that is a felonydeleted text end under the laws of
the jurisdiction from which the individual fleesdeleted text begin , or in the case of New Jersey, is a high
misdemeanor,deleted text end is disqualified from receiving MFIP.
Sec. 60.
new text begin
[256J.265] DRUG TESTING INFORMATION FROM PROBATION
OFFICERS.
new text end
new text begin
The local probation agency shall regularly provide a list of probationers who tested
positive for an illegal controlled substance to the local social services agency, specifically
the welfare fraud division, for purposes of section 256J.26.
new text end
Sec. 61.
Minnesota Statutes 2018, section 256L.01, subdivision 5, is amended to read:
Subd. 5.
Income.
"Income" has the meaning given for modified adjusted gross income,
as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's
current income, or if income fluctuates month to month, the income for the 12-month
eligibility period.new text begin Income includes amounts deposited into checking and savings accounts
for personal expenses including rent, mortgage, automobile-related expenses, utilities, and
food.
new text end
Sec. 62.
Minnesota Statutes 2018, section 256P.04, subdivision 4, is amended to read:
Subd. 4.
Factors to be verified.
(a) The agency shall verify the following at application:
(1) identity of adults;
(2) age, if necessary to determine eligibility;
(3) immigration status;
(4) income;
(5) spousal support and child support payments made to persons outside the household;
(6) vehicles;
(7) checking and savings accountsdeleted text begin ;deleted text end new text begin . Verification of checking and savings accounts must
include the source of deposits into accounts; identification of any loans, including the date,
source, amount, and terms of repayment; identification of deposits for personal expenses
including rent, mortgage, automobile-related expenses, utilities, and food;
new text end
(8) inconsistent information, if related to eligibility;
(9) residence;
(10) Social Security number; deleted text begin and
deleted text end
(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), item
(ix), for the intended purpose for which it was given and receiveddeleted text begin .deleted text end new text begin ;
new text end
new text begin
(12) loans. Verification of loans must include the source, the full amount, and repayment
terms; and
new text end
new text begin
(13) direct or indirect gifts of money.
new text end
(b) Applicants who are qualified noncitizens and victims of domestic violence as defined
under section 256J.08, subdivision 73, clause (7), are not required to verify the information
in paragraph (a), clause (10). When a Social Security number is not provided to the agency
for verification, this requirement is satisfied when each member of the assistance unit
cooperates with the procedures for verification of Social Security numbers, issuance of
duplicate cards, and issuance of new numbers which have been established jointly between
the Social Security Administration and the commissioner.
Sec. 63.
Minnesota Statutes 2018, section 256P.06, subdivision 3, is amended to read:
Subd. 3.
Income inclusions.
The following must be included in determining the income
of an assistance unit:
(1) earned incomenew text begin :
new text end
new text begin
(i) calculated according to Minnesota Rules, part 3400.0170, subpart 7, for earned income
from self-employment, except if the participant is drawing a salary, taking a draw from the
business, or using the business account to pay personal expenses including rent, mortgage,
automobile-related expenses, utilities, or food, not directly related to the business, the salary
or payment must be treated as earned income; and
new text end
new text begin (ii) excluding expenses listed in Minnesota Rules, part 3400.0170, subpart 8, items A
to I and M to Pnew text end ; and
(2) unearned income, which includes:
(i) interest and dividends from investments and savings;
(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;
(iii) proceeds from rent and contract for deed payments in excess of the principal and
interest portion owed on property;
(iv) income from trusts, excluding special needs and supplemental needs trusts;
(v) interest income from loans made by the participant or household;
(vi) cash prizes and winnings;
(vii) unemployment insurance income;
(viii) retirement, survivors, and disability insurance payments;
(ix) nonrecurring income over $60 per quarter unless earmarked and used for the purpose
for which it is intended. Income and use of this income is subject to verification requirements
under section 256P.04;
(x) retirement benefits;
(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I,
and 256J;
(xii) tribal per capita payments unless excluded by federal and state law;
(xiii) income and payments from service and rehabilitation programs that meet or exceed
the state's minimum wage rate;
(xiv) income from members of the United States armed forces unless excluded from
income taxes according to federal or state law;
(xv) all child support payments for programs under chapters 119B, 256D, and 256I;
(xvi) the amount of child support received that exceeds $100 for assistance units with
one child and $200 for assistance units with two or more children for programs under chapter
256J; and
(xvii) spousal support.
Sec. 64.
Laws 2017, First Special Session chapter 6, article 3, section 49, is amended to
read:
Sec. 49. ELECTRONIC deleted text begin SERVICE DELIVERY DOCUMENTATION SYSTEMdeleted text end new text begin
VISIT VERIFICATIONnew text end .
Subdivision 1.
Documentation; establishment.
The commissioner of human services
shall establish implementation requirements and standards for deleted text begin andeleted text end electronic deleted text begin service delivery
documentation systemdeleted text end new text begin visit verificationnew text end 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.
Subd. 2.
Definitions.
(a) For purposes of this section, the terms in this subdivision have
the meanings given them.
(b) "Electronic deleted text begin service delivery documentationdeleted text end new text begin visit verificationnew text end " means the electronic
documentation of the:
(1) type of service performed;
(2) individual receiving the service;
(3) date of the service;
(4) location of the service delivery;
(5) individual providing the service; and
(6) time the service begins and ends.
(c) "Electronic deleted text begin service delivery documentationdeleted text end new text begin visit verificationnew text end system" means a system
that provides electronic deleted text begin service delivery documentationdeleted text end new text begin verification of servicesnew text end that complies
with the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision
3.
(d) "Service" means one of the following:
(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625,
subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; deleted text begin or
deleted text end
(2) community first services and supports under Minnesota Statutes, section 256B.85new text begin ;
new text end
new text begin
(3) home health services under Minnesota Statutes, section 256B.0625, subdivision 6a;
or
new text end
new text begin (4) other medical supplies and equipment or home and community-based services that
are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255new text end .
Subd. 3.
new text begin Systemnew text end requirements.
(a) In developing implementation requirements for deleted text begin andeleted text end
electronic deleted text begin service delivery documentation systemdeleted text end new text begin visit verificationnew text end , the commissioner shall
deleted text begin 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, todeleted text end ensure
that the requirements:
(1) are minimally administratively and financially burdensome to a provider;
(2) are minimally burdensome to the service recipient and the least disruptive to the
service recipient in receiving and maintaining allowed services;
(3) consider existing best practices and use of electronic deleted text begin service delivery documentationdeleted text end new text begin
visit verificationnew text end ;
(4) are conducted according to all state and federal laws;
(5) are effective methods for preventing fraud when balanced against the requirements
of clauses (1) and (2); and
(6) are consistent with the Department of Human Services' policies related to covered
services, flexibility of service use, and quality assurance.
(b) The commissioner shall make training available to providers on the electronic deleted text begin service
delivery documentationdeleted text end new text begin visit verificationnew text end system requirements.
(c) The commissioner shall establish baseline measurements related to preventing fraud
and establish measures to determine the effect of electronic deleted text begin service delivery documentationdeleted text end new text begin
visit verificationnew text end requirements on program integrity.
new text begin
(d) The commissioner shall make a state-selected electronic visit verification system
available to providers of services.
new text end
new text begin Subd. 3a. new text end
new text begin Provider requirements. new text end
new text begin
(a) Providers of services may select their own
electronic visit verification system that meets the requirements established by the
commissioner.
new text end
new text begin
(b) All electronic visit verification systems used by providers to comply with the
requirements established by the commissioner must provide data to the commissioner in a
format and at a frequency to be established by the commissioner.
new text end
new text begin
(c) Providers must implement the electronic visit verification systems required under
this section by January 1, 2020, for personal care services and by January 1, 2023, for home
health services in accordance with the 21st Century Cures Act, Public Law 114-255, and
the Centers for Medicare and Medicaid Services guidelines. For the purposes of this
paragraph, "personal care services" and "home health services" have the meanings given
in United States Code, title 42, section 1396b(l)(5). Reimbursement rates for providers must
not be reduced as a result of federal action to reduce the federal medical assistance percentage
under the 21st Century Cures Act, Public Law 114.255, Code of Federal Regulations, title
32, section 310.32.
new text end
deleted text begin Subd. 4. deleted text end
deleted text begin Legislative report. deleted text end
deleted 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:
deleted text end
deleted 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
deleted text end
deleted 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.
deleted text end
deleted 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.
deleted text end
Sec. 65. new text begin DIRECTIONS TO COMMISSIONER; NEMT DRIVER ENROLLMENT
IMPACT.
new text end
new text begin
By August 1, 2021, the commissioner of human services shall issue a report to the chairs
and ranking minority members of the house of representatives and senate committees with
jurisdiction over health and human services. The commissioner must include in the report
the commissioner's findings regarding the impact of driver enrollment under Minnesota
Statutes, section 256B.0625, subdivision 17, paragraph (c), on the program integrity of the
nonemergency medical transportation program. The commissioner must include a
recommendation, based on the findings in the report, regarding expanding the driver
enrollment requirement.
new text end
Sec. 66. new text begin UNIVERSAL IDENTIFICATION NUMBER FOR CHILDREN IN EARLY
CHILDHOOD PROGRAMS.
new text end
new text begin
By July 1, 2020, the commissioners of the Departments of Education, Health, and Human
Services shall identify a process to establish and implement a universal identification number
for children participating in early childhood programs to eliminate potential duplication in
programs. The commissioners shall report the identified process and any associated fiscal
cost to the chairs and ranking minority members of the legislative committees with
jurisdiction over health, human services, and education. A universal identification number
established and implemented under this section is private data on individuals, as defined in
Minnesota Statutes, section 13.02, subdivision 12, except that the commissioners of
education, health, and human services may share the universal identification number with
each other pursuant to their data sharing authority under Minnesota Statutes, section 13.46,
subdivision 2, clause (9), and Minnesota Statutes, section 145A.17, subdivision 3, paragraph
(e).
new text end
Sec. 67. new text begin DIRECTION TO COMMISSIONER; FEDERAL WAIVER FOR MEDICAL
ASSISTANCE SELF-ATTESTATION REMOVAL.
new text end
new text begin
The commissioner of human services shall seek all necessary federal waivers to
implement the removal of the self-attestation when establishing eligibility for medical
assistance.
new text end
Sec. 68. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
The revisor of statutes shall codify Laws 2017, First Special Session chapter 6, article
3, section 49, as amended in this act, in Minnesota Statutes, chapter 256B.
new text end
Sec. 69. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, section 256B.0705,
new text end
new text begin
is repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
ARTICLE 2
CHILDREN AND FAMILIES SERVICES
Section 1.
Minnesota Statutes 2018, 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 new text begin and the Department of Human Services new text end 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;
(31) to a health care provider governed by sections 144.291 to 144.298, to the extent
necessary to coordinate services;
(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
(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.
(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.
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 2018, section 13.46, subdivision 4, is amended to read:
Subd. 4.
Licensing data.
(a) As used in this subdivision:
(1) "licensing data" are all data collected, maintained, used, or disseminated by the
welfare system pertaining to persons licensed or registered or who apply for licensure or
registration or who formerly were licensed or registered under the authority of the
commissioner of human services;
(2) "client" means a person who is receiving services from a licensee or from an applicant
for licensure; and
(3) "personal and personal financial data" are Social Security numbers, identity of and
letters of reference, insurance information, reports from the Bureau of Criminal
Apprehension, health examination reports, and social/home studies.
(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, license
holders, and former licensees are public: name, address, telephone number of licensees,
date of receipt of a completed application, dates of licensure, licensed capacity, type of
client preferred, variances granted, record of training and education in child care and child
development, type of dwelling, name and relationship of other family members, previous
license history, class of license, the existence and status of complaints, and the number of
serious injuries to or deaths of individuals in the licensed program as reported to the
commissioner of human services, the local social services agency, or any other county
welfare agency. For purposes of this clause, a serious injury is one that is treated by a
physician.
(ii) new text begin Except as provided in item (v), new text end when a correction order, an order to forfeit a fine,
an order of license suspension, an order of temporary immediate suspension, an order of
license revocation, an order of license denial, or an order of conditional license has been
issued, or a complaint is resolved, the following data on current and former licensees and
applicants are public: the general nature of the complaint or allegations leading to the
temporary immediate suspension; the substance and investigative findings of the licensing
or maltreatment complaint, licensing violation, or substantiated maltreatment; the existence
of settlement negotiations; the record of informal resolution of a licensing violation; orders
of hearing; findings of fact; conclusions of law; specifications of the final correction order,
fine, suspension, temporary immediate suspension, revocation, denial, or conditional license
contained in the record of licensing action; whether a fine has been paid; and the status of
any appeal of these actions.
(iii) When a license denial under section 245A.05 or a sanction under section 245A.07
is based on a determination that a license holder, applicant, or controlling individual is
responsible for maltreatment under section 626.556 or 626.557, the identity of the applicant,
license holder, or controlling individual as the individual responsible for maltreatment is
public data at the time of the issuance of the license denial or sanction.
(iv) When a license denial under section 245A.05 or a sanction under section 245A.07
is based on a determination that a license holder, applicant, or controlling individual is
disqualified under chapter 245C, the identity of the license holder, applicant, or controlling
individual as the disqualified individual and the reason for the disqualification are public
data at the time of the issuance of the licensing sanction or denial. If the applicant, license
holder, or controlling individual requests reconsideration of the disqualification and the
disqualification is affirmed, the reason for the disqualification and the reason to not set aside
the disqualification are public data.
new text begin
(v) A correction order or fine issued to a child care provider for a licensing violation is
private data on individuals under section 13.02, subdivision 12, or nonpublic data under
section 13.02, subdivision 9, if the correction order or fine is seven years old or older.
new text end
(2) For applicants who withdraw their application prior to licensure or denial of a license,
the following data are public: the name of the applicant, the city and county in which the
applicant was seeking licensure, the dates of the commissioner's receipt of the initial
application and completed application, the type of license sought, and the date of withdrawal
of the application.
(3) For applicants who are denied a license, the following data are public: the name and
address of the applicant, the city and county in which the applicant was seeking licensure,
the dates of the commissioner's receipt of the initial application and completed application,
the type of license sought, the date of denial of the application, the nature of the basis for
the denial, the existence of settlement negotiations, the record of informal resolution of a
denial, orders of hearings, findings of fact, conclusions of law, specifications of the final
order of denial, and the status of any appeal of the denial.
(4) When maltreatment is substantiated under section 626.556 or 626.557 and the victim
and the substantiated perpetrator are affiliated with a program licensed under chapter 245A,
the commissioner of human services, local social services agency, or county welfare agency
may inform the license holder where the maltreatment occurred of the identity of the
substantiated perpetrator and the victim.
(5) Notwithstanding clause (1), for child foster care, only the name of the license holder
and the status of the license are public if the county attorney has requested that data otherwise
classified as public data under clause (1) be considered private data based on the best interests
of a child in placement in a licensed program.
(c) The following are private data on individuals under section 13.02, subdivision 12,
or nonpublic data under section 13.02, subdivision 9: personal and personal financial data
on family day care program and family foster care program applicants and licensees and
their family members who provide services under the license.
(d) The following are private data on individuals: the identity of persons who have made
reports concerning licensees or applicants that appear in inactive investigative data, and the
records of clients or employees of the licensee or applicant for licensure whose records are
received by the licensing agency for purposes of review or in anticipation of a contested
matter. The names of reporters of complaints or alleged violations of licensing standards
under chapters 245A, 245B, 245C, and 245D, and applicable rules and alleged maltreatment
under sections 626.556 and 626.557, are confidential data and may be disclosed only as
provided in section 626.556, subdivision 11, or 626.557, subdivision 12b.
(e) Data classified as private, confidential, nonpublic, or protected nonpublic under this
subdivision become public data if submitted to a court or administrative law judge as part
of a disciplinary proceeding in which there is a public hearing concerning a license which
has been suspended, immediately suspended, revoked, or denied.
(f) Data generated in the course of licensing investigations that relate to an alleged
violation of law are investigative data under subdivision 3.
(g) Data that are not public data collected, maintained, used, or disseminated under this
subdivision that relate to or are derived from a report as defined in section 626.556,
subdivision 2, or 626.5572, subdivision 18, are subject to the destruction provisions of
sections 626.556, subdivision 11c, and 626.557, subdivision 12b.
(h) Upon request, not public data collected, maintained, used, or disseminated under
this subdivision that relate to or are derived from a report of substantiated maltreatment as
defined in section 626.556 or 626.557 may be exchanged with the Department of Health
for purposes of completing background studies pursuant to section 144.057 and with the
Department of Corrections for purposes of completing background studies pursuant to
section 241.021.
(i) Data on individuals collected according to licensing activities under chapters 245A
and 245C, data on individuals collected by the commissioner of human services according
to investigations under chapters 245A, 245B, 245C, and 245D, and sections 626.556 and
626.557 may be shared with the Department of Human Rights, the Department of Health,
the Department of Corrections, the ombudsman for mental health and developmental
disabilities, and the individual's professional regulatory board when there is reason to believe
that laws or standards under the jurisdiction of those agencies may have been violated or
the information may otherwise be relevant to the board's regulatory jurisdiction. Background
study data on an individual who is the subject of a background study under chapter 245C
for a licensed service for which the commissioner of human services is the license holder
may be shared with the commissioner and the commissioner's delegate by the licensing
division. Unless otherwise specified in this chapter, the identity of a reporter of alleged
maltreatment or licensing violations may not be disclosed.
(j) In addition to the notice of determinations required under section 626.556, subdivision
10f, if the commissioner or the local social services agency has determined that an individual
is a substantiated perpetrator of maltreatment of a child based on sexual abuse, as defined
in section 626.556, subdivision 2, and the commissioner or local social services agency
knows that the individual is a person responsible for a child's care in another facility, the
commissioner or local social services agency shall notify the head of that facility of this
determination. The notification must include an explanation of the individual's available
appeal rights and the status of any appeal. If a notice is given under this paragraph, the
government entity making the notification shall provide a copy of the notice to the individual
who is the subject of the notice.
(k) All not public data collected, maintained, used, or disseminated under this subdivision
and subdivision 3 may be exchanged between the Department of Human Services, Licensing
Division, and the Department of Corrections for purposes of regulating services for which
the Department of Human Services and the Department of Corrections have regulatory
authority.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 3.
Minnesota Statutes 2018, section 13.461, subdivision 28, is amended to read:
Subd. 28.
Child care assistance program.
new text begin (a) new text end Data collected, maintained, used, or
disseminated by the welfare system pertaining to persons selected as legal nonlicensed child
care providers by families receiving child care assistance are classified under section 119B.02,
subdivision 6new text begin , paragraph (a). Child care assistance program payment data is classified under
section 119B.02, subdivision 6, paragraph (b)new text end .
new text begin
(b) Data relating to child care assistance program disqualification is governed by section
124D.165, subdivision 4a.
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. 4.
Minnesota Statutes 2018, section 119B.02, subdivision 6, is amended to read:
Subd. 6.
Data.
new text begin (a) new text end Data collected, maintained, used, or disseminated by the welfare
system pertaining to persons selected as legal nonlicensed child care providers by families
receiving child care assistance shall be treated as licensing data as provided in section 13.46,
subdivision 4.
new text begin
(b) For purposes of this paragraph, "child care assistance program payment data" means
data for a specified time period showing (1) that a child care assistance program payment
under this chapter was made, and (2) the amount of child care assistance payments made
to a child care center. Child care assistance program payment data may include the number
of families and children on whose behalf payments were made for the specified time period.
Any child care assistance program payment data that may identify a specific child care
assistance recipient or benefit paid on behalf of a specific child care assistance recipient,
as determined by the commissioner, is private data on individuals as defined in section
13.02, subdivision 12. Data related to a child care assistance payment is public if the data
relates to a child care assistance payment made to a licensed child care center or a child
care center exempt from licensure and:
new text end
new text begin
(1) the child care center receives payment of more than $100,000 from the child care
assistance program under this chapter in a period of one year or less; or
new text end
new text begin
(2) when the commissioner or county agency either:
new text end
new text begin
(i) disqualified the center from receipt of a payment from the child care assistance
program under this chapter for wrongfully obtaining child care assistance under section
256.98, subdivision 8, paragraph (c);
new text end
new text begin
(ii) refused a child care authorization, revoked a child care authorization, stopped
payment, or denied payment for a bill for the center under section 119B.13, subdivision 6,
paragraph (d); or
new text end
new text begin
(iii) made a finding of financial misconduct under section 245E.02.
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. 5.
Minnesota Statutes 2018, 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 misuse
substances or have a substance use disorder, 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) substance use disorder treatment activities of licensed professionals in private
practice as defined in section 245G.01, subdivision 17;
(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;
(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 payments;
(28) a county that is an eligible vendor under section 254B.05 to provide care coordination
and comprehensive assessment services; deleted text begin or
deleted text end
(29) a recovery community organization that is an eligible vendor under section 254B.05
to provide peer recovery support servicesdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(30) family child care that is provided by an unrelated individual to families that do not
receive child care assistance if the number of children served does not exceed six children,
of which there are no more than a combined total of two infants and toddlers that includes
no more than one infant.
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.
Sec. 6.
Minnesota Statutes 2018, 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;
(4) observation of the program in operation; and
(5) an inspection for the health, safety, and fire standards in licensing requirements for
a child care license holder.
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.
(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 new text begin allnew text end
violations of law or rule observed during the inspection and offer technical assistance on
how to comply with applicable laws and rules. new text begin The commissioner shall not issue a correction
order or negative action for violations of law or rule not discussed in an exit interview.new text end
Nothing in this paragraph limits the ability of the commissioner to issue a correction order
or negative action for violations of law or rule deleted text begin not discussed in an exit interview ordeleted text end in the
event that a license holder chooses not to participate in an exit interview.
(d) 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 begin Inspections of family child care providers shall be
conducted in accordance with section 245A.055. It shall not constitute a violation of rule
or statute for an individual who is related to a licensed family child care provider as defined
in section 245A.02, subdivision 13, to be present in the residence during business hours,
unless the individual provides sufficient hours or days of child care services for statutory
training requirements to apply, or the spouse is designated to be a caregiver, helper, or
substitute in the family child care program.
new text end
(e) deleted text begin No later than November 19, 2017,deleted text end The commissioner shall make publicly available
on the department's website 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 yearnew text begin . The results of inspection reports shall not
be displayed on the department's website for longer than the minimum required time under
federal lawnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment, with
the exception that the amendments to paragraph (e) are effective August 1, 2019, and the
requirement for inspections of family child care centers to be conducted in accordance with
section 245A.055 is effective July 1, 2020.
new text end
Sec. 7.
Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision to
read:
new text begin Subd. 18. new text end
new text begin Plain-language handbook. new text end
new text begin
By January 1, 2020, the commissioner of human
services shall, following consultation with family child care license holders, parents, and
county agencies, develop a plain-language handbook that describes the process and
requirements to become a licensed family child care provider. The handbook shall include
a list of the applicable statutory provisions and rules that apply to licensed family child care
providers. The commissioner shall electronically publish the handbook on the Department
of Human Services website, available at no charge to the public. Each county human services
office and the Department of Human Services shall maintain physical copies of the handbook
for public use.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 8.
new text begin
[245A.055] FAMILY CHILD CARE PROVIDER INSPECTIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Inspections. new text end
new text begin
The commissioner shall conduct inspections of each family
child care provider pursuant to section 245A.04, subdivision 4, paragraph (d).
new text end
new text begin Subd. 2. new text end
new text begin Types of child care licensing inspections. new text end
new text begin
(a) "Initial inspection" means an
inspection before issuing an initial license under section 245A.04, subdivision 4, paragraph
(a).
new text end
new text begin
(b) "Full inspection" means the inspection of a family child care provider to determine
ongoing compliance with all applicable legal requirements for family child care providers.
A full inspection shall be conducted for temporary provisional licensees and for providers
who do not meet the requirements needed for an abbreviated inspection.
new text end
new text begin
(c) "Abbreviated inspection" means the inspection of a family child care provider to
determine ongoing compliance with key indicators that statistically predict compliance with
all applicable legal requirements for family child care providers. Abbreviated inspections
are available for family child care providers who have been licensed for at least three years
with the latest inspection finding no Level 4 violations. Providers must also not have had
any substantiated licensing complaints that amount to a Level 4 violation, substantiated
complaints of maltreatment, or sanctions under section 245A.07 in the past three years. If
a county licensor finds that the provider has failed to comply with any key indicator during
an abbreviated inspection, the county licensor shall immediately conduct a full inspection.
new text end
new text begin
(d) "Follow-up inspection" means a full inspection conducted following an inspection
that found more than one Level 4 violation.
new text end
new text begin Subd. 3. new text end
new text begin Enforcement actions. new text end
new text begin
(a) Except where required by federal law, enforcement
actions under this subdivision may be taken based on the risk level of the violation as follows:
new text end
new text begin
(1) Level 1: a violation that presents no risk of harm or minimal risk of harm, warranting
verbal technical assistance under section 245A.066, subdivision 1;
new text end
new text begin
(2) Level 2: a violation that presents a low risk of harm, warranting issuance of a technical
assistance notice under section 245A.066, subdivision 2;
new text end
new text begin
(3) Level 3: a violation that presents a moderate risk of harm, warranting issuance of a
fix-it ticket under section 245A.065; and
new text end
new text begin
(4) Level 4: a violation that presents a substantial risk of harm, warranting issuance of
a correction order or conditional license under section 245A.06.
new text end
new text begin
(b) The commissioner shall, following consultation with family child care license holders,
parents, and county agencies, issue a report by January 1, 2020, that identifies the violations
of this chapter and Minnesota Rules, chapter 9502, that constitute Level 1, Level 2, Level
3, or Level 4 violations based on the schedule in paragraph (a). The commissioner shall
also identify the rules and statutes that may be violated at more than one risk level, such
that the county licensor may assign the violation a risk level according to the licensor's
discretion during an inspection. The report shall also identify all rules and statutory provisions
that must be enforced in accordance with federal law. 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
website. By July 1, 2020, the commissioner shall develop, distribute, and provide training
on guidelines on the use of the risk-based violation levels in paragraph (a) during family
child care provider inspections.
new text end
new text begin Subd. 4. new text end
new text begin Follow-up inspections. new text end
new text begin
If, upon inspection, the commissioner finds more than
one Level 4 violation, the commissioner shall conduct a follow-up inspection within six
months. The date of the follow-up inspection does not alter the provider's annual inspection
date.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020, with the exception that
subdivision 3, paragraph (b), is effective the day following final enactment.
new text end
Sec. 9.
Minnesota Statutes 2018, section 245A.06, subdivision 1, is amended to read:
Subdivision 1.
Contents of correction orders and conditional licenses.
(a) new text begin Except as
provided in paragraph (c), new text end if the commissioner finds that the applicant or license holder has
failed to comply with an applicable law or rule and this failure does not imminently endanger
the health, safety, or rights of the persons served by the program, the commissioner may
issue a correction order and an order of conditional license to the applicant or license holder.
When issuing a conditional license, the commissioner shall consider the nature, chronicity,
or severity of the violation of law or rule and the effect of the violation on the health, safety,
or rights of persons served by the program. The correction order or conditional license must
state the following in plain language:
(1) the conditions that constitute a violation of the law or rule;
(2) the specific law or rule violated;
(3) the time allowed to correct each violation; and
(4) if a license is made conditional, the length and terms of the conditional license, and
the reasons for making the license conditional.
(b) Nothing in this section prohibits the commissioner from proposing a sanction as
specified in section 245A.07, prior to issuing a correction order or conditional license.
new text begin
(c) For family child care license holders, the commissioner may issue a correction order
or conditional license as provided in this section if, upon inspection, the commissioner finds
a Level 4 violation as provided in section 245A.055, subdivision 3, or if a child care provider
fails to correct a Level 3 violation as required under section 245A.065, paragraph (e).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020.
new text end
Sec. 10.
Minnesota Statutes 2018, section 245A.06, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Licensing interpretation disputes. new text end
new text begin
When a county licensor and child care
provider dispute the interpretation of a licensing requirement, a county licensor must seek
clarification from the Department of Human Services in writing before issuing a correction
order related to the disputed interpretation. The license holder must be included in all
correspondence between the county and the Department of Human Services regarding the
dispute. The provider must be given the opportunity to contribute pertinent information that
may impact the decision by the Department of Human Services.
new text end
Sec. 11.
Minnesota Statutes 2018, section 245A.065, is amended to read:
245A.065 CHILD CARE FIX-IT TICKET.
new text begin Subdivision 1. new text end
new text begin Contents of fix-it tickets. new text end
(a) deleted text begin In lieu of a correction order under section
245A.06,deleted text end The commissioner deleted text begin shalldeleted text end new text begin maynew text end issue a fix-it ticket to a family child care or child
care center license holder ifnew text begin , upon inspection,new text end the commissioner finds that:
(1) the license holder has failed to comply with a requirement in this chapter or Minnesota
Rules, chapter 9502 or 9503deleted text begin , that the commissioner determines to be eligible for a fix-it
ticketdeleted text end ;
(2) the violation does not imminently endanger the health, safety, or rights of the persons
served by the program;
(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 begin and
new text end
(4) the violation deleted text begin candeleted text end new text begin cannotnew text end be corrected at the time of inspectiondeleted text begin or within 48 hours,
excluding Saturdays, Sundays, and holidays; and
deleted text end
deleted 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 holidaysdeleted text end .
(b) new text begin The commissioner shall not issue a fix-it ticket for violations that are corrected at
the time of the inspection.
new text end
new text begin (c) new text end The fix-it ticket must state:
(1) the conditions that constitute a violation of the law or rule;
(2) the specific law or rule violated; and
(3) that the violation deleted text begin was corrected at the time of inspection ordeleted text end must be corrected within
48 hours, excluding Saturdays, Sundays, and holidays.
deleted text begin (c)deleted text end new text begin (d)new text end The commissioner shall not publicly publish a fix-it ticket on the department's
websitenew text begin , unless required by federal lawnew text end .
deleted text begin (d)deleted text end new text begin (e)new text end 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.
deleted text begin (e)deleted text end new text begin (f)new text end If the violation is not corrected deleted text begin at the time of inspection ordeleted text end 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 deleted text begin mustdeleted text end new text begin maynew text end issue
a correction ordernew text begin , according to section 245A.06,new text end for the violation of Minnesota law or rule
identified in the fix-it ticketdeleted text begin according to section 245A.06deleted text end .
deleted 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 websitedeleted text end new text begin (g) Beginning
July 1, 2020, the commissioner may issue a fix-it ticket to a family child care license holder
if, upon inspection, the commissioner finds a Level 3 violation as provided in section
245A.055, subdivision 3new text end .
new text begin Subd. 2. new text end
new text begin Fix-it ticket laws and rules. new text end
new text begin
(a) For family child care license holders, violations
of the following laws and rules may qualify only for a fix-it ticket: 9502.0335, subpart 10;
9502.0375, subpart 2; 9502.0395; 9502.0405, subpart 3; 9502.0405, subpart 4, item A;
9502.0415, subpart 3; 9502.0425, subpart 2 (outdoor play spaces must be free from litter,
rubbish, unlocked vehicles, or human or animal waste); 9502.0425, subpart 3 (wading pools
must be kept clean); 9502.0425, subpart 5; 9502.0425, subpart 7, item F (screens on exterior
doors and windows when biting insects are prevalent); 9502.0425, subpart 8; 9502.0425,
subpart 10; 9502.0425, subpart 11 (decks free of splinters); 9502.0425, subpart 13 (toilets
flush thoroughly); 9502.0425, subpart 16; 9502.0435, subpart 1; 9502.0435, subpart 3;
9502.0435, subpart 7; 9502.0435, subpart 8, item B; 9502.0435, subpart 8, item E; 9502.0435,
subpart 12, items A through E; 9502.0435, subpart 13; 9502.0435, subpart 14; 9502.0435,
subpart 15; 9502.0435, subpart 15, items A and B; 9502.0445, subpart 1, item B; 9502.0445,
subpart 3, items B through D; 9502.0445, subpart 4, items A through C; 245A.04, subdivision
14, paragraph (c); 245A.06, subdivision 8; 245A.07, subdivision 5; 245A.146, subdivision
3, paragraph (c); 245A.148; 245A.152; 245A.50, subdivision 7; 245A.51, subdivision 3,
paragraph (d) (emergency preparedness plan available for review and posted in prominent
location).
new text end
new text begin
(b) For child care center license holders, violations of the following laws and rules may
qualify only for a fix-it ticket: 9503.0120, item B; 9503.0120, item E; 9503.0125, item E;
9503.0125, item F; 9503.0125, item I; 9503.0125, item M; 9503.0140, subpart 2; 9503.0140,
subpart 7, item D; 9503.0140, subpart 9; 9503.0140, subpart 10; 9503.0140, subpart 13;
9503.0140, subpart 14; 9503.0140, subpart 15; 9503.0140, subpart 16 (item missing from
first-aid kit); 9503.0140, subpart 18; 9503.0140, subpart 19; 9503.0140, subpart 20;
9503.0140, subpart 21 (emergency plan not posted in prominent place); 9503.0145, subpart
2; 9503.0145, subpart 3; 9503.0145, subpart 4, item D; 9503.0145, subpart 8 (drinking water
provided in single service cups or at an accessible drinking fountain); 9503.0155, subpart
7, item D; 9503.0155, subpart 13; 9503.0155, subpart 16; 9503.0155, subpart 17; 9503.0155,
subpart 18, item D; 9503.0170, subpart 3; 9503.0145, subpart 7, item D; 245A.04, subdivision
14, paragraph (c); 245A.06, subdivision 8; 245A.07, subdivision 5; 245A.14, subdivision
8, paragraph (b) (experienced aide identification posting); 245A.146, subdivision 3, paragraph
(c); 245A.152; 245A.41, subdivision 3, paragraph (d); 245A.41, subdivision 3, paragraph
(e); 245A.41, subdivision 3, paragraph (f).
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. 12.
new text begin
[245A.066] CHILD CARE TECHNICAL ASSISTANCE.
new text end
new text begin Subdivision 1. new text end
new text begin Verbal technical assistance. new text end
new text begin
The commissioner may provide verbal
technical assistance to a family child care license holder if, upon inspection, the commissioner
finds a Level 1 violation as provided in section 245A.055, subdivision 3.
new text end
new text begin Subd. 2. new text end
new text begin Technical assistance notice. new text end
new text begin
(a) The commissioner may issue a written technical
assistance notice to a family child care license holder if, upon inspection, the commissioner
finds a Level 2 violation as provided in section 245A.055, subdivision 3.
new text end
new text begin
(b) The technical assistance notice 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) examples of how to correct the violation.
new text end
new text begin
(c) The commissioner shall not publicly publish a written technical assistance notice on
the department's website, unless required by federal law.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020.
new text end
Sec. 13.
Minnesota Statutes 2018, section 245A.14, subdivision 4, is amended to read:
Subd. 4.
Special family day care homes.
Nonresidential child care programs serving
14 or fewer children that are conducted at a location other than the license holder's own
residence shall be licensed under this section and the rules governing family day care or
group family day care if:
(a) The license holder is the primary provider of care and the nonresidential child care
program is conducted in a dwelling that is located on a residential lot;
(b) The license holder is an employer who may or may not be the primary provider of
care, and the purpose for the child care program is to provide child care services to children
of the license holder's employees;
(c) The license holder is a church or religious organization;
(d) The license holder is a community collaborative child care provider. For purposes
of this subdivision, a community collaborative child care provider is a provider participating
in a cooperative agreement with a community action agency as defined in section 256E.31;
(e) The license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this paragraph to exceed the licensed capacity of 14 children by no more than five
children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:
(1) the program does not exceed a capacity of 14 children more than a cumulative total
of four hours per day;
(2) the program meets a one to seven staff-to-child ratio during the variance period;
(3) all employees receive at least an extra four hours of training per year than required
in the rules governing family child care each year;
(4) the facility has square footage required per child under Minnesota Rules, part
9502.0425;
(5) the program is in compliance with local zoning regulations;
(6) the program is in compliance with the applicable fire code as follows:
(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2003,
Section 202; or
(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2003,
Section 202; and
(7) any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the license; deleted text begin or
deleted text end
(f) The license holder is the primary provider of care and has located the licensed child
care program in a commercial space, if the license holder meets the following requirements:
(1) the program is in compliance with local zoning regulations;
(2) the program is in compliance with the applicable fire code as follows:
(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2003,
Section 202; or
(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire Code 2003,
Section 202;
(3) any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and
(4) the license holder prominently displays the license issued by the commissioner which
contains the statement "This special family child care provider is not licensed as a child
care centerdeleted text begin .deleted text end "new text begin ; or
new text end
new text begin
(g) The license holder is the primary provider of care and has located the licensed child
care program in a portion of a building that is used exclusively for the purpose of providing
child care services, if the license holder meets the requirements in paragraph (f), clauses
(1) to (4), and if any available shared kitchen, bathroom, or other space that the provider
uses is separate from the indoor activity area used by the children.
new text end
Sec. 14.
Minnesota Statutes 2018, section 245A.14, is amended by adding a subdivision
to read:
new text begin Subd. 16. new text end
new text begin Water bottles in child care centers. new text end
new text begin
Notwithstanding Minnesota Rules, part
9503.0145, subpart 8, a child care center may provide drinking water for children in
individual covered water bottles, labeled with the child's name. Water bottles provided by
the child care center must be washed, rinsed, and sanitized daily after use and stored clean
and dry in a manner that protects them from contamination.
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 2018, 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 that, before the implementation
of NETStudy 2.0, 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) Before the implementation of NETStudy 2.0, county 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 child care programs, the commissioner shall require a county agency to
conduct one unannounced licensing deleted text begin reviewdeleted text end new text begin inspectionnew text end at least annually.
(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.
(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:
(1) the results of each licensing deleted text begin reviewdeleted text end new text begin inspectionnew text end completed, including the date of the
deleted text begin reviewdeleted text end new text begin inspectionnew text end , and any deleted text begin licensingdeleted text end correction order issued; and
(2) any death, serious injury, or determination of substantiated maltreatment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 16.
Minnesota Statutes 2018, section 245A.50, subdivision 1, is amended to read:
Subdivision 1.
Initial training.
(a) License holders, caregivers, and substitutes must
comply with the training requirements in this section.
(b) Helpers who assist with care on a regular basis must complete six hours of training
within one year after the date of initial employment.
(c) Training requirements established under this section that must be completed prior
to initial licensure must be satisfied only by a newly licensed child care provider or by a
child care provider who has not held an active child care license in Minnesota in the previous
12 months. A child care provider deleted text begin who relocates within the state ordeleted text end who voluntarily cancels
a license or allows the license to lapse for a period of less than 12 months and who seeks
reinstatement of the lapsed or canceled license within 12 months of the lapse or cancellation
must satisfy the annual, ongoing training requirements, and is not required to satisfy the
training requirements that must be completed prior to initial licensure.new text begin A child care provider
who relocates within the state must (1) satisfy the annual, ongoing training requirements
according to the schedules established in this section and (2) not be required to satisfy the
training requirements under this section that the child care provider completed prior to initial
licensure. If a licensed provider moves to a new county, the new county is prohibited from
requiring the provider to complete any orientation class or training for new providers.
new text end
Sec. 17.
Minnesota Statutes 2018, section 245A.50, subdivision 2, is amended to read:
Subd. 2.
Child development and learning 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 learning and behavior
guidance training prior to initial licensure, and before caring for children. For purposes of
this subdivision, "child development and learning training" means training in understanding
how children develop physically, cognitively, emotionally, and socially and learn as part
of the children's family, culture, and community. "Behavior guidance training" means
training in the understanding of the functions of child behavior and strategies for managing
challenging situations. deleted text begin At least two hours of child development and learning or behavior
guidance training must be repeated annually.deleted text end new text begin The new text end training curriculum shall be developed
or approved by the commissioner of human services.
(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 January 1, 2020.
new text end
Sec. 18.
Minnesota Statutes 2018, section 245A.50, subdivision 3, is amended to read:
Subd. 3.
First aid.
(a) When children are present in a family child care home governed
by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person must be present
in the home who has been trained in first aid. The first aid training must have been provided
by an individual approved to provide first aid instruction. First aid training may be less than
eight hours and persons qualified to provide first aid training include individuals approved
as first aid instructors. First aid training must be repeated deleted text begin every two yearsdeleted text end new text begin before the license
holder's license expires in the second year after the prior first aid trainingnew text end .
(b) A family child care provider is exempt from the first aid training requirements under
this subdivision related to any substitute caregiver who provides less than 30 hours of care
during any 12-month period.
(c) Video training reviewed and approved by the county licensing agency satisfies the
training requirement of this subdivision.
Sec. 19.
Minnesota Statutes 2018, section 245A.50, subdivision 4, is amended to read:
Subd. 4.
Cardiopulmonary resuscitation.
(a) When children are present in a family
child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one
caregiver must be present in the home who has been trained in cardiopulmonary resuscitation
(CPR), including CPR techniques for infants and children, and in the treatment of obstructed
airways. The CPR training must have been provided by an individual approved to provide
CPR instruction, must be repeated at least once deleted text begin every two yearsdeleted text end new text begin before the license holder's
license expires in the second year after the prior CPR trainingnew text end , and must be documented in
the caregiver's records.
(b) A family child care provider is exempt from the CPR training requirement in this
subdivision related to any substitute caregiver who provides less than 30 hours of care during
any 12-month period.
(c) 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 training and
incorporates psychomotor skills to support the instruction.
Sec. 20.
Minnesota Statutes 2018, 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 deleted text begin every two yearsdeleted text end new text begin before the license holder's license expires
in the second year after the prior sudden unexpected infant death reduction training and
abusive head trauma trainingnew text end . 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.
(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.
Sec. 21.
Minnesota Statutes 2018, section 245A.50, subdivision 6, is amended to read:
Subd. 6.
Child passenger restraint systems; training requirement.
(a) A license
holder must comply with all seat belt and child passenger restraint system requirements
under section 169.685.
(b) Family and group family child care programs licensed by the Department of Human
Services that serve a child or children under deleted text begin ninedeleted text end new text begin eightnew text end years of age must document training
that fulfills the requirements in this subdivision.
(1) Before a license holder, staff person, caregiver, or helper transports a child or children
under age deleted text begin ninedeleted text end new text begin eightnew text end in a motor vehicle, the person placing the child or children in a passenger
restraint must satisfactorily complete training on the proper use and installation of child
restraint systems in motor vehicles. Training completed under this subdivision may be used
to meet initial training under subdivision 1 or ongoing training under subdivision 7.
(2) Training required under this subdivision must be at least one hour in length, completed
at initial training, and repeated at least once deleted text begin every five yearsdeleted text end new text begin before the license holder's
license expires in the fifth year after the prior child passenger restraint system trainingnew text end . At
a minimum, the training must address the proper use of child restraint systems based on the
child's size, weight, and age, and the proper installation of a car seat or booster seat in the
motor vehicle used by the license holder to transport the child or children.
(3) Training under this subdivision must be provided by individuals who are certified
and approved by the Department of Public Safety, Office of Traffic Safety. License holders
may obtain a list of certified and approved trainers through the Department of Public Safety
website or by contacting the agency.
(c) Child care providers that only transport school-age children as defined in section
245A.02, subdivision 19, paragraph (f), in child care buses as defined in section 169.448,
subdivision 1, paragraph (e), are exempt from this subdivision.
Sec. 22.
Minnesota Statutes 2018, 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 deleted text begin 16deleted text end new text begin tennew text end 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 8new text begin , and the annual refresher training course in subdivision 12,new text end shall count
toward the annual deleted text begin 16-hourdeleted text end new text begin ten-hournew text end training requirement. Additional ongoing training
subjects to meet the annual deleted text begin 16-hourdeleted text end new text begin ten-hournew text end training requirement must be selected from
the following areas:
(1) child development and learning training under subdivision 2, paragraph (a);
(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;
(3) relationships with families, including training in building a positive, respectful
relationship with the child's family;
(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;
(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;
(6) professionalism, including training in knowledge, skills, and abilities that promote
ongoing professional development; and
(7) health, safety, and nutrition, including training in establishing healthy practices;
ensuring safety; and providing healthy nutrition.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 23.
Minnesota Statutes 2018, section 245A.50, subdivision 9, is amended to read:
Subd. 9.
Supervising for safety; training requirement.
(a) Before initial licensure and
before caring for a child, 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 the completion of the six-hour Supervising for Safety
for Family Child Care course developed by the commissioner.
(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 documentdeleted text begin :deleted text end new text begin the completion of the two-hour courses Health and Safety I and
Health and Safety II at least once before the license holder's license expires in the fifth year
after the prior supervising for safety training.
new text end
deleted text begin
(1) the annual completion of a two-hour active supervision course developed by the
commissioner; and
deleted text end
deleted 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).
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 24.
Minnesota Statutes 2018, section 245A.50, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Annual refresher training course. new text end
new text begin
Beginning January 1, 2020, license holders,
staff persons, caregivers, substitutes, and helpers must complete an annual refresher training
course, as developed by the commissioner of human services. The annual refresher training
course must incorporate training on: (1) active supervision; (2) child development and
learning, and behavior guidance; and (3) any training required by the child care development
block grant. The annual refresher training course shall not exceed two hours. Providers may
complete the annual refresher training course online through self-study. Providers must
document completion of the annual refresher training course.
new text end
Sec. 25.
Minnesota Statutes 2018, section 245A.50, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Related individual training exemption. new text end
new text begin
An individual who is related to a
child in a child care program may care for or have contact with that child at the child care
site without completing the training requirements under this chapter, unless the individual
is designated to be a caregiver, helper, or substitute in the child care program.
new text end
Sec. 26.
Minnesota Statutes 2018, section 245A.50, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Emergency substitute caregiver training exemption. new text end
new text begin
During an emergency,
substitute caregivers are exempt from training requirements under this section.
new text end
Sec. 27.
Minnesota Statutes 2018, section 245A.51, subdivision 3, is amended to read:
Subd. 3.
Emergency preparedness plan.
(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:
(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
(2) a designated relocation site and evacuation route;
(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;
(4) accommodations for a child with a disability or a chronic medical condition;
(5) procedures for storing a child's medically necessary medicine that facilitate easy
removal during an evacuation or relocation;
(6) procedures for continuing operations in the period during and after a crisis; and
(7) procedures for communicating with local emergency management officials, law
enforcement officials, or other appropriate state or local authorities.
(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.
(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.
(d) The license holder must have the emergency preparedness plan available for review
and posted in a prominent location. deleted text begin The license holder must provide a physical or electronic
copy of the plan to the child's parent or legal guardian upon enrollment.
deleted text end
Sec. 28.
new text begin
[245A.60] OMBUDSPERSON FOR CHILD CARE PROVIDERS.
new text end
new text begin Subdivision 1. new text end
new text begin Appointment. new text end
new text begin
The governor shall appoint an ombudsperson in the
classified service to assist child care providers, including family child care providers and
legal nonlicensed child care providers, with licensing, compliance, and other issues facing
child care providers. The ombudsperson must be selected without regard to the person's
political affiliation. The ombudsperson shall serve a term of two years and may be removed
prior to the end of the term for just cause.
new text end
new text begin Subd. 2. new text end
new text begin Duties. new text end
new text begin
(a) The ombudsperson's duties shall include:
new text end
new text begin
(1) addressing all areas of concern to child care providers related to the provision of
child care services, including licensing, correction orders, penalty assessments, complaint
investigations, and other interactions with agency staff;
new text end
new text begin
(2) assisting providers with interactions with county licensors and with appealing
correction orders;
new text end
new text begin
(3) providing recommendations for child care improvement or child care provider
education;
new text end
new text begin
(4) operating a telephone line to answer questions and provide guidance to child care
providers; and
new text end
new text begin
(5) assisting child care license applicants.
new text end
new text begin
(b) The ombudsperson must report annually by December 31 to the commissioner and
the chairs and ranking minority members of the legislative committees with jurisdiction
over child care on the services provided by the ombudsperson to child care providers,
including the number, types, and locations of child care providers served, and the activities
of the ombudsperson to carry out the duties under this section. The commissioner shall
determine the form of the report and may specify additional reporting requirements.
new text end
new text begin Subd. 3. new text end
new text begin Staff. new text end
new text begin
The ombudsperson may appoint and compensate out of available funds
a deputy, confidential secretary, and other employees in the unclassified service as authorized
by law. The ombudsperson and the full-time staff are members of the Minnesota State
Retirement Association. The ombudsperson may delegate to members of the staff any
authority or duties of the office except the duty to formally make recommendations to a
child care provider or reports to the commissioner or the legislature.
new text end
new text begin Subd. 4. new text end
new text begin Access to records. new text end
new text begin
(a) The ombudsperson or designee, excluding volunteers,
has access to data of a state agency necessary for the discharge of the ombudsperson's duties,
including records classified as confidential data on individuals or private data on individuals
under chapter 13 or any other law. The ombudsperson's data request must relate to a specific
case and is subject to section 13.03, subdivision 4. If the data concerns an individual, the
ombudsperson or designee shall first obtain the individual's consent. If the individual cannot
consent and has no legal guardian, then access to the data is authorized by this section.
new text end
new text begin
(b) On a quarterly basis, each state agency responsible for licensing, regulating, and
enforcing state and federal laws and regulations concerning child care providers must provide
the ombudsperson copies of all correction orders, penalty assessments, and complaint
investigation reports for all child care providers.
new text end
new text begin Subd. 5. new text end
new text begin Independence of action. new text end
new text begin
In carrying out the duties under this section, the
ombudsperson shall operate independently of the department and may provide testimony
or make periodic reports to the legislature to address areas of concern and advocate for child
care providers.
new text end
new text begin Subd. 6. new text end
new text begin Civil actions. new text end
new text begin
The ombudsperson or designee is not civilly liable for any action
taken under this section if the action was taken in good faith, was within the scope of the
ombudsperson's authority, and did not constitute willful or reckless misconduct.
new text end
new text begin Subd. 7. new text end
new text begin Qualifications. new text end
new text begin
The ombudsperson must be a person who has at least five years
of experience providing child care. The ombudsperson must be experienced in dealing with
governmental entities, interpretation of laws and regulations, investigations, record keeping,
report writing, public speaking, and management. A person is not eligible to serve as the
ombudsperson while holding public office and must not have been previously employed
by the Department of Human Services or as a county licensor.
new text end
new text begin Subd. 8. new text end
new text begin Office support. new text end
new text begin
The commissioner shall provide the ombudsperson with the
necessary office space, supplies, equipment, and clerical support to effectively perform the
duties under this section.
new text end
new text begin Subd. 9. new text end
new text begin Posting. new text end
new text begin
(a) The commissioner shall post on the department's website the address
and telephone number for the office of the ombudsperson. The commissioner shall provide
all child care providers with the address and telephone number of the office. Counties must
provide child care providers with the name, address, and telephone number of the office.
new text end
new text begin
(b) The ombudsperson must approve all posting and notice required by the department
and counties under this subdivision.
new text end
Sec. 29.
Minnesota Statutes 2018, section 252.27, subdivision 2a, is amended to read:
Subd. 2a.
Contribution amount.
(a) The natural or adoptive parents of a minor child, new text begin
not new text end including a child determined eligible for medical assistance without consideration of
parental incomenew text begin under the TEFRA option or for the purposes of accessing home and
community-based waiver servicesnew text end , 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 1.94 percent of adjusted gross income at 275 percent of
federal poverty guidelines and increases to 5.29 percent of adjusted gross income for those
with adjusted gross income up to 545 percent of federal poverty guidelines;
(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines
and less than 675 percent of federal poverty guidelines, the parental contribution shall be
5.29 percent of adjusted gross income;
(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty
guidelines and less than 975 percent of federal poverty guidelines, the parental contribution
shall be determined using a sliding fee scale established by the commissioner of human
services which begins at 5.29 percent of adjusted gross income at 675 percent of federal
poverty guidelines and increases to 7.05 percent of adjusted gross income for those with
adjusted gross income up to 975 percent of federal poverty guidelines; and
(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty
guidelines, the parental contribution shall be 8.81 percent of adjusted gross income.
If the child lives with the parent, the annual adjusted gross income is reduced by $2,400
prior to calculating the parental contribution. If the child resides in an institution specified
in section 256B.35, the parent is responsible for the personal needs allowance specified
under that section in addition to the parental contribution determined under this section.
The parental contribution is reduced by any amount required to be paid directly to the child
pursuant to a court order, but only if actually paid.
(c) The household size to be used in determining the amount of contribution under
paragraph (b) includes natural and adoptive parents and their dependents, including the
child receiving services. Adjustments in the contribution amount due to annual changes in
the federal poverty guidelines shall be implemented on the first day of July following
publication of the changes.
(d) For purposes of paragraph (b), "income" means the adjusted gross income of the
natural or adoptive parents determined according to the previous year's federal tax form,
except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
have been used to purchase a home shall not be counted as income.
(e) The contribution shall be explained in writing to the parents at the time eligibility
for services is being determined. The contribution shall be made on a monthly basis effective
with the first month in which the child receives services. Annually upon redetermination
or at termination of eligibility, if the contribution exceeded the cost of services provided,
the local agency or the state shall reimburse that excess amount to the parents, either by
direct reimbursement if the parent is no longer required to pay a contribution, or by a
reduction in or waiver of parental fees until the excess amount is exhausted. All
reimbursements must include a notice that the amount reimbursed may be taxable income
if the parent paid for the parent's fees through an employer's health care flexible spending
account under the Internal Revenue Code, section 125, and that the parent is responsible
for paying the taxes owed on the amount reimbursed.
(f) The monthly contribution amount must be reviewed at least every 12 months; when
there is a change in household size; and when there is a loss of or gain in income from one
month to another in excess of ten percent. The local agency shall mail a written notice 30
days in advance of the effective date of a change in the contribution amount. A decrease in
the contribution amount is effective in the month that the parent verifies a reduction in
income or change in household size.
(g) Parents of a minor child who do not live with each other shall each pay the
contribution required under paragraph (a). An amount equal to the annual court-ordered
child support payment actually paid on behalf of the child receiving services shall be deducted
from the adjusted gross income of the parent making the payment prior to calculating the
parental contribution under paragraph (b).
(h) The contribution under paragraph (b) shall be increased by an additional five percent
if the local agency determines that insurance coverage is available but not obtained for the
child. For purposes of this section, "available" means the insurance is a benefit of employment
for a family member at an annual cost of no more than five percent of the family's annual
income. For purposes of this section, "insurance" means health and accident insurance
coverage, enrollment in a nonprofit health service plan, health maintenance organization,
self-insured plan, or preferred provider organization.
Parents who have more than one child receiving services shall not be required to pay
more than the amount for the child with the highest expenditures. There shall be no resource
contribution from the parents. The parent shall not be required to pay a contribution in
excess of the cost of the services provided to the child, not counting payments made to
school districts for education-related services. Notice of an increase in fee payment must
be given at least 30 days before the increased fee is due.
(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in
the 12 months prior to July 1:
(1) the parent applied for insurance for the child;
(2) the insurer denied insurance;
(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a
complaint or appeal, in writing, to the commissioner of health or the commissioner of
commerce, or litigated the complaint or appeal; and
(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
For purposes of this section, "insurance" has the meaning given in paragraph (h).
A parent who has requested a reduction in the contribution amount under this paragraph
shall submit proof in the form and manner prescribed by the commissioner or county agency,
including, but not limited to, the insurer's denial of insurance, the written letter or complaint
of the parents, court documents, and the written response of the insurer approving insurance.
The determinations of the commissioner or county agency under this paragraph are not rules
subject to chapter 14.
Sec. 30.
new text begin
[256.4751] PARENT-TO-PARENT PEER SUPPORT GRANTS.
new text end
new text begin
(a) The commissioner shall make available grants to organizations to support
parent-to-parent peer support programs that provide information and emotional support for
families of children and youth with special health care needs.
new text end
new text begin
(b) For the purposes of this section, "special health care needs" means disabilities, chronic
illnesses or conditions, health-related educational or behavioral problems, or the risk of
developing disabilities, conditions, illnesses, or problems.
new text end
new text begin
(c) Eligible organizations must have an established parent-to-parent program that:
new text end
new text begin
(1) conducts outreach and support to parents or guardians of a child or youth with special
health care needs;
new text end
new text begin
(2) provides to parents and guardians information, tools, and training to support their
child and to successfully navigate the health and human services systems;
new text end
new text begin
(3) facilitates ongoing peer support for parents and guardians from trained volunteer
support parents;
new text end
new text begin
(4) has staff and volunteers located statewide; and
new text end
new text begin
(5) is affiliated with and communicates regularly with other parent-to-parent programs
and national organizations to ensure best practices are implemented.
new text end
new text begin
(d) Grant recipients must use grant funds for the purposes in paragraph (c).
new text end
new text begin
(e) Grant recipients 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 from the previous year, including the number of families
served and the number of volunteer support parents trained.
new text end
Sec. 31.
Minnesota Statutes 2018, section 256B.14, subdivision 2, is amended to read:
Subd. 2.
Actions to obtain payment.
The state agency shall promulgate rules to
determine the ability of responsible relatives to contribute partial or complete payment or
repayment of medical assistance furnished to recipients for whom they are responsible. All
medical assistance exclusions shall be allowed, and a resource limit of $10,000 for
nonexcluded resources shall be implemented. Above these limits, a contribution of one-third
of the excess resources shall be required. These rules shall not require payment or repayment
when payment would cause undue hardship to the responsible relative or that relative's
immediate family. These rules shall deleted text begin be consistent with the requirements of section 252.27
fordeleted text end new text begin not apply tonew text end parents of children whose eligibility for medical assistance was determined
without deeming of the parents' resources and incomenew text begin under the TEFRA option or for the
purposes of accessing home and community-based waiver servicesnew text end . The county agency
shall give the responsible relative notice of the amount of the payment or repayment. If the
state agency or county agency finds that notice of the payment obligation was given to the
responsible relative, but that the relative failed or refused to pay, a cause of action exists
against the responsible relative for that portion of medical assistance granted after notice
was given to the responsible relative, which the relative was determined to be able to pay.
The action may be brought by the state agency or the county agency in the county where
assistance was granted, for the assistance, together with the costs of disbursements incurred
due to the action.
In addition to granting the county or state agency a money judgment, the court may,
upon a motion or order to show cause, order continuing contributions by a responsible
relative found able to repay the county or state agency. The order shall be effective only
for the period of time during which the recipient receives medical assistance from the county
or state agency.
Sec. 32.
Minnesota Statutes 2018, section 256M.41, subdivision 3, is amended to read:
Subd. 3.
Payments deleted text begin based on performancedeleted text end .
deleted text begin (a)deleted text end The commissioner shall make payments
under this section to each county deleted text begin board on a calendar year basis in an amount determined
under paragraph (b)deleted text end new text begin on or before July 10 of each yearnew text end .
deleted text begin
(b) Calendar year allocations under subdivision 1 shall be paid to counties in the following
manner:
deleted text end
deleted text begin
(1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties
on or before July 10 of each year;
deleted text end
deleted text begin
(2) ten percent of the allocation shall be withheld until the commissioner determines if
the county has met the performance outcome threshold of 90 percent based on face-to-face
contact with alleged child victims. In order to receive the performance allocation, the county
child protection workers must have a timely face-to-face contact with at least 90 percent of
all alleged child victims of screened-in maltreatment reports. The standard requires that
each initial face-to-face contact occur consistent with timelines defined in section 626.556,
subdivision 10, paragraph (i). The commissioner shall make threshold determinations in
January of each year and payments to counties meeting the performance outcome threshold
shall occur in February of each year. Any withheld funds from this appropriation for counties
that do not meet this requirement shall be reallocated by the commissioner to those counties
meeting the requirement; and
deleted text end
deleted text begin
(3) ten percent of the allocation shall be withheld until the commissioner determines
that the county has met the performance outcome threshold of 90 percent based on
face-to-face visits by the case manager. In order to receive the performance allocation, the
total number of visits made by caseworkers on a monthly basis to children in foster care
and children receiving child protection services while residing in their home must be at least
90 percent of the total number of such visits that would occur if every child were visited
once per month. The commissioner shall make such determinations in January of each year
and payments to counties meeting the performance outcome threshold shall occur in February
of each year. Any withheld funds from this appropriation for counties that do not meet this
requirement shall be reallocated by the commissioner to those counties meeting the
requirement. For 2015, the commissioner shall only apply the standard for monthly foster
care visits.
deleted text end
deleted text begin
(c) The commissioner shall work with stakeholders and the Human Services Performance
Council under section 402A.16 to develop recommendations for specific outcome measures
that counties should meet in order to receive funds withheld under paragraph (b), and include
in those recommendations a determination as to whether the performance measures under
paragraph (b) should be modified or phased out. The commissioner shall report the
recommendations to the legislative committees having jurisdiction over child protection
issues by January 1, 2018.
deleted text end
Sec. 33.
Minnesota Statutes 2018, section 256M.41, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin County performance on child protection measures. new text end
new text begin
The commissioner shall
set child protection measures and standards. The commissioner shall require an
underperforming county to demonstrate that the county designated sufficient funds and
implemented a reasonable strategy to improve child protection performance, including the
provision of a performance improvement plan and additional remedies identified by the
commissioner. The commissioner may redirect up to 20 percent of a county's funds under
this section toward the performance improvement plan. Sanctions under section 256M.20,
subdivision 3, related to noncompliance with federal performance standards also apply.
new text end
Sec. 34.
new text begin
[260C.216] FOSTER CARE RECRUITMENT GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment and authority. new text end
new text begin
The commissioner of human services
shall make grants to facilitate partnerships between counties and community groups or faith
communities to develop and utilize innovative, nontraditional shared recruitment methods
to increase and stabilize the number of available foster care families.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility. new text end
new text begin
An eligible applicant for a foster care recruitment grant under
subdivision 1 is an organization or entity that:
new text end
new text begin
(1) provides a written description identifying the county and community organizations
or faith communities that will partner to develop innovative shared methods to recruit
families through their community or faith organizations for foster care in the county;
new text end
new text begin
(2) agrees to incorporate efforts by the partnership or a third party to offer additional
support services including host families, family coaches, or resource referrals for families
in crisis such as homelessness, unemployment, hospitalization, substance abuse treatment,
incarceration, or domestic violence, as an alternative to foster care; and
new text end
new text begin
(3) describes how the proposed partnership model can be generalized to be used in other
areas of the state.
new text end
new text begin Subd. 3. new text end
new text begin Allowable grant activities. new text end
new text begin
Grant recipients may use grant funds to:
new text end
new text begin
(1) develop materials that promote the partnership's innovative methods of nontraditional
recruitment of foster care families through the partner community organizations or faith
communities;
new text end
new text begin
(2) develop an onboarding vehicle or training program for recruited foster care families
that is accessible, relatable, and easy to understand, to be used by the partner community
organizations or faith communities;
new text end
new text begin
(3) establish sustainable communication between the partnership and the recruited
families for ongoing support; or
new text end
new text begin
(4) provide support services including host families, family coaches, or resource referrals
for families in crisis such as homelessness, unemployment, hospitalization, substance abuse
treatment, incarceration, or domestic violence, as an alternative to the foster care system.
new text end
new text begin Subd. 4. new text end
new text begin Reporting new text end
new text begin
The commissioner shall report on the use of foster care recruitment
grants to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services by December 31, 2020. The report shall include the name
and location of grant recipients, the amount of each grant, the services provided, and the
effects on the foster care system. The commissioner shall determine the form required for
the report and may specify additional reporting requirements.
new text end
new text begin Subd. 5. new text end
new text begin Funding. new text end
new text begin
The commissioner of human services may use available parent support
outreach program funds for foster care recruitment grants under Minnesota Statutes, section
260C.216.
new text end
Sec. 35.
new text begin
[260C.218] PARENT SUPPORT FOR BETTER OUTCOMES GRANTS.
new text end
new text begin
The commissioner of human services may use available parent support outreach program
funds to provide mentoring, guidance, and support services to parents navigating the child
welfare system in Minnesota, in order to promote the development of safe, stable, and
healthy families, including parent mentoring, peer-to-peer support groups, housing support
services, training, staffing, and administrative costs.
new text end
Sec. 36.
Minnesota Statutes 2018, section 518A.32, subdivision 3, is amended to read:
Subd. 3.
Parent not considered voluntarily unemployed, underemployed, or employed
on a less than full-time basis.
A parent is not considered voluntarily unemployed,
underemployed, or employed on a less than full-time basis upon a showing by the parent
that:
(1) the unemployment, underemployment, or employment on a less than full-time basis
is temporary and will ultimately lead to an increase in income;
(2) the unemployment, underemployment, or employment on a less than full-time basis
represents a bona fide career change that outweighs the adverse effect of that parent's
diminished income on the child; or
(3) the unemployment, underemployment, or employment on a less than full-time basis
is because a parent is physically or mentally incapacitated or due to incarcerationdeleted text begin , except
where the reason for incarceration is the parent's nonpayment of supportdeleted 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. 37.
Minnesota Statutes 2018, section 518A.51, is amended to read:
518A.51 FEES FOR IV-D SERVICES.
(a) When a recipient of IV-D services is no longer receiving assistance under the state's
title IV-A, IV-E foster care, or medical assistance programs, the public authority responsible
for child support enforcement must notify the recipient, within five working days of the
notification of ineligibility, that IV-D services will be continued unless the public authority
is notified to the contrary by the recipient. The notice must include the implications of
continuing to receive IV-D services, including the available services and fees, cost recovery
fees, and distribution policies relating to fees.
(b) In the case of an individual who has never received assistance under a state program
funded under title IV-A of the Social Security Act and for whom the public authority has
collected at least deleted text begin $500deleted text end new text begin $550new text end of support, the public authority must impose an annual federal
collections fee of deleted text begin $25deleted text end new text begin $35new text end for each case in which services are furnished. This fee must be
retained by the public authority from support collected on behalf of the individual, but not
from the first deleted text begin $500deleted text end new text begin $550new text end collected.
(c) When the public authority provides full IV-D services to an obligee who has applied
for those services, upon written notice to the obligee, the public authority must charge a
cost recovery fee of two percent of the amount collected. This fee must be deducted from
the amount of the child support and maintenance collected and not assigned under section
256.741 before disbursement to the obligee. This fee does not apply to an obligee who:
(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, or
medical assistance programs; or
(2) has received assistance under the state's title IV-A or IV-E foster care programs,
until the person has not received this assistance for 24 consecutive months.
(d) When the public authority provides full IV-D services to an obligor who has applied
for such services, upon written notice to the obligor, the public authority must charge a cost
recovery fee of two percent of the monthly court-ordered child support and maintenance
obligation. The fee may be collected through income withholding, as well as by any other
enforcement remedy available to the public authority responsible for child support
enforcement.
(e) Fees assessed by state and federal tax agencies for collection of overdue support
owed to or on behalf of a person not receiving public assistance must be imposed on the
person for whom these services are provided. The public authority upon written notice to
the obligee shall assess a fee of $25 to the person not receiving public assistance for each
successful federal tax interception. The fee must be withheld prior to the release of the funds
received from each interception and deposited in the general fund.
(f) Federal collections fees collected under paragraph (b) and cost recovery fees collected
under paragraphs (c) and (d) retained by the commissioner of human services shall be
considered child support program income according to Code of Federal Regulations, title
45, section 304.50, and shall be deposited in the special revenue fund account established
under paragraph (h). The commissioner of human services must elect to recover costs based
on either actual or standardized costs.
(g) The limitations of this section on the assessment of fees shall not apply to the extent
inconsistent with the requirements of federal law for receiving funds for the programs under
title IV-A and title IV-D of the Social Security Act, United States Code, title 42, sections
601 to 613 and United States Code, title 42, sections 651 to 662.
(h) The commissioner of human services is authorized to establish a special revenue
fund account to receive the federal collections fees collected under paragraph (b) and cost
recovery fees collected under paragraphs (c) and (d).
(i) The nonfederal share of the cost recovery fee revenue must be retained by the
commissioner and distributed as follows:
(1) one-half of the revenue must be transferred to the child support system special revenue
account to support the state's administration of the child support enforcement program and
its federally mandated automated system;
(2) an additional portion of the revenue must be transferred to the child support system
special revenue account for expenditures necessary to administer the fees; and
(3) the remaining portion of the revenue must be distributed to the counties to aid the
counties in funding their child support enforcement programs.
(j) The nonfederal share of the federal collections fees must be distributed to the counties
to aid them in funding their child support enforcement programs.
(k) The commissioner of human services shall distribute quarterly any of the funds
dedicated to the counties under paragraphs (i) and (j) using the methodology specified in
section 256.979, subdivision 11. The funds received by the counties must be reinvested in
the child support enforcement program and the counties must not reduce the funding of
their child support programs by the amount of the funding distributed.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2019.
new text end
Sec. 38. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; TEFRA
OPTION IMPROVEMENT MEASURES.
new text end
new text begin
(a) The commissioner of human services shall, using existing appropriations, develop
content to be included on the MNsure website explaining the TEFRA option under medical
assistance for applicants who indicate during the application process that a child in the
family has a disability.
new text end
new text begin
(b) The commissioner shall develop a cover letter explaining the TEFRA option under
medical assistance, as well as the application and renewal process, to be disseminated with
the DHS-6696A form to applicants who may qualify for medical assistance under the TEFRA
option. The commissioner shall provide the content and the form to the executive director
of MNsure for inclusion on the MNsure website. The commissioner shall also develop and
implement education and training for lead agency staff statewide to improve understanding
of the medical assistance-TEFRA enrollment and renewal processes and procedures.
new text end
new text begin
(c) The commissioner shall convene a stakeholder group that shall consider improvements
to the TEFRA option enrollment and renewal processes, including but not limited to revisions
to, or the development of, application and renewal paperwork specific to the TEFRA option;
possible technology solutions; and county processes.
new text end
new text begin
(d) The stakeholder group must include representatives from the Department of Human
Services Health Care Division, MNsure, representatives from at least two counties in the
metropolitan area and from at least one county in greater Minnesota, the Arc Minnesota,
Gillette Children's Specialty Healthcare, the Autism Society of Minnesota, Proof Alliance,
the Minnesota Consortium for Citizens with Disabilities, and other interested stakeholders
as identified by the commissioner of human services.
new text end
new text begin
(e) The stakeholder group shall submit a report of the group's recommended
improvements and any associated costs to the commissioner by December 31, 2020. The
group shall also provide copies of the report to each stakeholder group member. The
commissioner shall provide a copy of the report to the legislative committees with jurisdiction
over medical assistance.
new text end
Sec. 39. new text begin MINNESOTA 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
(a) The commissioner of human services shall develop
a pilot project that tests an alternative benefit delivery system for the distribution of public
assistance benefits. The commissioner shall work with Dakota County and Olmsted County
to develop the pilot project in accordance with this section. The commissioner shall apply
for any federal waivers necessary to implement the pilot project.
new text end
new text begin
(b) Prior to authorizing the pilot project, Dakota and Olmsted Counties must provide
the following information to the commissioner:
new text end
new text begin
(1) identification of any federal waivers required to implement the pilot project and a
timeline for obtaining the waivers;
new text end
new text begin
(2) identification of data sharing requirements between the counties and the commissioner
to administer the pilot project and evaluate the outcome measures under subdivision 4,
including the technology systems that will be developed to administer the pilot project and
a description of the elements of the technology systems that will ensure the privacy of the
data of the participants and provide financial oversight and accountability for expended
funds;
new text end
new text begin
(3) documentation that demonstrates receipt of private donations or grants totaling at
least $2,800,000 per year for three years to support implementation of the pilot project;
new text end
new text begin
(4) a complete plan for implementing the pilot project, including an assurance that each
participant's unified benefit amount is proportionate to and in no event exceeds the total
amount that the participant would have received by participating in the underlying programs
for which they are eligible upon entering the pilot project, information about the
administration of the unified benefit amount to ensure that the benefit is used by participants
for the services provided through the underlying programs included in the unified benefit,
an explanation of which funds will be issued directly to providers and which funds will be
available on an EBT card, and information about consequences and remedies for improper
use of the unified benefit;
new text end
new text begin
(5) an evaluation plan developed in consultation with the commissioner of management
and budget to ensure that the pilot project includes an evaluation using an experimental or
quasi-experimental design and a formal evaluation of the results of the pilot project; and
new text end
new text begin
(6) documentation that demonstrates the receipt of a formal commitment of grants or
contracts with the federal government to complete a comprehensive evaluation of the pilot
project.
new text end
new text begin
(c) The commissioner may authorize the pilot project only after reviewing the information
submitted under paragraph (b) and issuing a formal written approval of the proposed project.
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 may receive public assistance;
new text end
new text begin
(2) eliminate, where possible, regulatory or program restrictions to allow a comprehensive
approach to meeting the needs of the families in the pilot project; and
new text end
new text begin
(3) focus on prevention-oriented supports and interventions.
new text end
new text begin Subd. 3. new text end
new text begin Pilot project participants. new text end
new text begin
The pilot project developed by the commissioner
must include requirements that participants:
new text end
new text begin
(1) be 30 years of age or younger with a minimum of one child and income below 200
percent of federal poverty guidelines;
new text end
new text begin
(2) voluntarily agree to participate in the pilot project;
new text end
new text begin
(3) be informed of the right to voluntarily discontinue participation in the pilot project;
new text end
new text begin
(4) be eligible for or receiving assistance under the Minnesota family investment program
under Minnesota Statutes, chapter 256J, and at least one of the following programs: (i) the
child care assistance program under Minnesota Statutes, chapter 119B; (ii) the diversionary
work program under Minnesota Statutes, section 256J.95; (iii) the supplemental nutrition
assistance program under Minnesota Statutes, chapter 256D; or (iv) state or federal housing
support;
new text end
new text begin
(5) provide informed, written consent that the participant waives eligibility for the
programs included in the unified benefit set for the duration of their participation in the
pilot project;
new text end
new text begin
(6) be enrolled in an education program that is focused on obtaining a career that will
result in a livable wage;
new text end
new text begin
(7) receive as the unified benefit only an amount that is proportionate to and does not
exceed the total value of the benefits the participant would be eligible to receive under the
underlying programs upon entering the pilot project; and
new text end
new text begin
(8) shall not have the unified benefit amount counted as income for child support or tax
purposes.
new text end
new text begin Subd. 4. new text end
new text begin Outcomes. new text end
new text begin
(a) The outcome measures for the pilot project must be developed
in consultation with the commissioner of management and budget, and 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 the areas of behavioral
health, incarceration, involvement with the child welfare system;
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, grade point average, 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; and progress in career preparation;
and
new text end
new text begin
(5) improvement in health care access and health outcomes for parents and children and
other outcomes determined in consultation with the commissioner of human services and
the commissioner of management and budget.
new text end
new text begin
(b) Dakota and Olmsted Counties shall report on the progress and outcomes of the pilot
project to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services by January 15 of each year that the pilot project operates,
beginning January 15, 2021.
new text end
Sec. 40. new text begin DIRECTION TO COMMISSIONER; CHILD CARE ASSISTANCE
PROGRAM REDESIGN.
new text end
new text begin
(a) By January 15, 2020, the commissioner of human services shall, following
consultation with families, providers, and county agencies, report to the chairs and ranking
minority members of the legislative committees having jurisdiction over child care with a
proposal, for implementation by July 1, 2020, that redesigns the child care assistance program
to meet all applicable federal requirements, achieve at least the following objectives, and
include at least the following features:
new text end
new text begin
(1) eliminates fraud;
new text end
new text begin
(2) eliminates program inefficiencies;
new text end
new text begin
(3) eliminates barriers to families entering the program;
new text end
new text begin
(4) improves accessibility to child care for families in greater Minnesota and in the
metropolitan area;
new text end
new text begin
(5) improves the quality of available child care;
new text end
new text begin
(6) eliminates assistance rate disparities between greater Minnesota and the metropolitan
area;
new text end
new text begin
(7) ensures future access to assistance and child care for families in greater Minnesota
and in the metropolitan area;
new text end
new text begin
(8) develops additional options for providers to complete required training including
through online or remote access;
new text end
new text begin
(9) improves ease of provider access to required training and quality improvement
resources;
new text end
new text begin
(10) reforms the Parent Aware program, including by removing barriers to participation
for family child care providers, by implementing a method for evaluating the quality and
effectiveness of four-star rated programs, and by incorporating licensing violations, sanctions,
or maltreatment determinations into the star-rating program standards;
new text end
new text begin
(11) proposes legislation that codifies Parent Aware program standards;
new text end
new text begin
(12) implements a licensing and inspection structure based on differential monitoring;
new text end
new text begin
(13) amends licensing requirements that have led to closure of child care programs,
especially family child care programs;
new text end
new text begin
(14) recommends business development and technical assistance resources to promote
provider recruitment and retention;
new text end
new text begin
(15) allows for family child care licensing alternatives, including permitting multiple
family child care providers to operate in a commercial or other building other than the
providers' residences; and
new text end
new text begin
(16) improves family child care licensing efficiencies, including by adding a variance
structure and updating child ratios.
new text end
new text begin
(b) The commissioner shall seek all necessary federal waivers to implement the proposed
redesign described in paragraph (a), including to authorize use of existing federal funding.
new text end
Sec. 41. new text begin DIRECTION TO COMMISSIONER; ABBREVIATED INSPECTION
MODEL.
new text end
new text begin
(a) By January 1, 2020, the commissioner of human services shall, following consultation
with family child care license holders, parents, and county agencies, develop the key
indicators for use in the abbreviated inspection process under Minnesota Statutes, section
245A.055, subdivision 2, paragraph (c), and report the results to the chairs and ranking
minority members of the legislative committees with jurisdiction over child care. In
developing the key indicators that predict full compliance with the statutes and rules
governing licensed child care providers, the commissioner shall utilize an empirically based
statistical methodology similar to the licensing key indicator systems as developed by the
National Association for Regulatory Administration and the Research Institute for Key
Indicators.
new text end
new text begin
(b) By July 1, 2020, the commissioner of human services shall develop, distribute, and
provide training to implement abbreviated inspections as described in Minnesota Statutes,
section 245A.055, subdivision 2, paragraph (c).
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. 42. new text begin DIRECTION TO COMMISSIONER; CHILD CARE TRAINING
REQUIREMENTS.
new text end
new text begin
(a) The commissioner of human services shall develop an annual refresher course as
described in Minnesota Statutes, section 245A.50, subdivision 12, for child care providers
who previously completed the training requirements under Minnesota Statutes, chapter
245A.
new text end
new text begin
(b) The commissioner must propose any necessary legislative changes to develop and
implement the annual refresher training course in paragraph (a) and to eliminate duplicative
training requirements for the 2020 legislative session.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 43. new text begin DIRECTION TO COMMISSIONER; CORRECTION ORDER
ENFORCEMENT REVIEW.
new text end
new text begin
By January 1, 2020, the commissioner of human services shall develop and implement
a process to review licensing inspection results provided under Minnesota Statutes, section
245A.16, subdivision 1, paragraph (h), clause (1), by county to identify trends in correction
order enforcement. The commissioner shall develop guidance and training as needed to
address any imbalance or inaccuracy in correction order enforcement. The commissioner
shall include the results in the annual report on child care under Minnesota Statutes, section
245A.153, provided that the results are limited to summary data as defined in Minnesota
Statutes, section 13.02, subdivision 19.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 44. new text begin DIRECTION TO COMMISSIONER; SUBSTITUTE CAREGIVER
PERMISSION.
new text end
new text begin
(a) The commissioner of human services shall amend Minnesota Rules, part 9502.0365,
subpart 5, to permit licensed providers to use substitute caregivers for a cumulative total of
720 hours in any 12-month period.
new text end
new text begin
(b) The commissioner of human services may use the good cause exemption under
Minnesota Statutes, section 14.388, subdivision 1, clause (3), to adopt rules under this
section, and Minnesota Statutes, section 14.386, does not apply except as provided under
Minnesota Statutes, section 14.388.
new text end
Sec. 45. new text begin FAMILY CHILD CARE TASK FORCE.
new text end
new text begin Subdivision 1. new text end
new text begin Membership. new text end
new text begin
(a) The Family Child Care Task Force shall consist of 14
members, appointed as follows:
new text end
new text begin
(1) two members representing family child care providers from greater Minnesota,
including one appointed by the speaker of the house of representatives and one appointed
by the senate majority leader;
new text end
new text begin
(2) two members representing family care providers from the metropolitan area as defined
in Minnesota Statutes, section 473.121, subdivision 2, including one appointed by the speaker
of the house of representatives and one appointed by the senate majority leader;
new text end
new text begin
(3) two members appointed by the Minnesota Association of Child Care Professionals;
new text end
new text begin
(4) two members appointed by the Minnesota Child Care Provider Information Network;
new text end
new text begin
(5) two members representing Department of Human Services-recognized family child
care associations from greater Minnesota, including one appointed by the senate majority
leader and one appointed by the senate minority leader;
new text end
new text begin
(6) two members appointed by the Association of Minnesota Child Care Licensors,
including one from greater Minnesota and one from the metropolitan area, as defined in
Minnesota Statutes, section 473.121, subdivision 2;
new text end
new text begin
(7) one member appointed by the Greater Minnesota Partnership; and
new text end
new text begin
(8) one member appointed by the Minnesota Chamber of Commerce.
new text end
new text begin
(b) Appointments to the task force must be made by June 15, 2019.
new text end
new text begin Subd. 2. new text end
new text begin Compensation. new text end
new text begin
Public members of the task force may be compensated as
provided by Minnesota Statutes, section 15.059, subdivision 3.
new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin
The task force must:
new text end
new text begin
(1) identify difficulties that providers face regarding licensing and inspection, including
licensing requirements that have led to the closure of family child care programs; propose
regulatory reforms to improve licensing efficiency, including a variance structure and
updated child ratios; and recommend business development and technical assistance resources
to promote provider recruitment and retention;
new text end
new text begin
(2) identify alternative family child care business models, including permitting multiple
family child care providers to operate in a building other than the providers' residences; and
new text end
new text begin
(3) review Parent Aware program participation and identify obstacles and suggested
improvements.
new text end
new text begin Subd. 4. new text end
new text begin Officers; meetings. new text end
new text begin
(a) The task force must elect a chair and vice-chair from
among its members and may elect other officers as necessary.
new text end
new text begin
(b) The task force must meet at least three times. The commissioner of human services
must convene the first meeting by August 1, 2019, at which the task force must at least
make introductions, identify concerns of the members and issues related to the duties under
subdivision 4, and assign tasks for each member to complete before the second meeting.
The chair must convene the second meeting by November 1, 2019, at which the task force
must at least review members' work on the tasks from the first meeting and develop a plan
for members to create proposals relating to the duties of the task force under subdivision 4.
The chair must convene the third meeting by February 1, 2020, at which the task force must
at least discuss which of the members' proposals to include in its final report.
new text end
new text begin
(c) In accordance with paragraph (b), the agenda for each meeting must be determined
by the chair and vice-chair.
new text end
new text begin
(d) Meetings of the task force are subject to the Minnesota Open Meeting Law under
Minnesota Statutes, chapter 13D.
new text end
new text begin Subd. 5. new text end
new text begin Administrative support. new text end
new text begin
The division of child care licensing in the Department
of Human Services must provide administrative support and meeting space to support the
task force as needed.
new text end
new text begin Subd. 6. new text end
new text begin Report required. new text end
new text begin
By March 1, 2020, the task force must submit a written report
to the chairs and ranking minority members of the committees in the house of representatives
and the senate with jurisdiction over child care. The report must include:
new text end
new text begin
(1) a description of the difficulties that providers face regarding licensing and inspection,
and recommendations for addressing those difficulties;
new text end
new text begin
(2) a description of alternative family child care business models, and recommendations
for facilitating the delivery of child care through those alternative models;
new text end
new text begin
(3) a description of obstacles to participation in the Parent Aware program and
recommendations for increasing participation; and
new text end
new text begin
(4) any draft legislation necessary to implement the recommendations.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
The task force expires upon submission of the report in subdivision
6 or March 1, 2020, whichever is later.
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 begin INSTRUCTION TO COMMISSIONER; REVIEW OF CHILD CARE
LICENSING AND BACKGROUND STUDY PROVISIONS.
new text end
new text begin
The commissioner of human services shall review existing statutes and rules relating to
child care licensing and background study requirements and propose legislation for the 2020
legislative session that eliminates unnecessary and duplicative record keeping or
documentation requirements for child care providers. The commissioner shall also establish
a process for child care providers to electronically submit requested information to the
commissioner.
new text end
Sec. 47. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes, in consultation with the Department of Human Services, House
Research Department, and Senate Counsel, Research and Fiscal Analysis shall change the
terms "food support" and "food stamps" to "Supplemental Nutrition Assistance Program"
or "SNAP" in Minnesota Statutes when appropriate. The revisor may make technical and
other necessary changes to sentence structure to preserve the meaning of the text.
new text end
Sec. 48. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall remove the terms "child care assistance program," "basic
sliding fee child care," and "MFIP child care," or similar terms wherever the terms appear
in Minnesota Statutes. The revisor shall also make technical and other necessary changes
to sentence structure to preserve the meaning of the text.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020.
new text end
Sec. 49. new text begin REVISOR INSTRUCTION; MINNESOTA RULES, CHAPTER 9502.
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 the Department of Human Services shall
prepare legislation for the 2020 legislative session to repeal and enact as statutes Minnesota
Rules, chapter 9502, and recodify Minnesota Statutes sections governing licensing of child
care facilities. The revisor of statutes shall provide a courtesy copy of the proposed legislation
to the chief authors in the house of representatives and senate of this act.
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 begin REVISOR INSTRUCTION; MINNESOTA RULES, CHAPTER 9503.
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 the Department of Human Services shall
prepare legislation for the 2020 legislative session to repeal and enact as statutes Minnesota
Rules, chapter 9503, and recodify Minnesota Statutes sections governing licensing of child
care facilities. The revisor of statutes shall provide a courtesy copy of the proposed legislation
to the chief authors in the house of representatives and senate of this act.
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. new text begin REVISOR INSTRUCTION; RECODIFY MINNESOTA STATUTES,
CHAPTER 245A; RECODIFY MINNESOTA RULES, CHAPTER 9502.
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 2020 legislative session to: (1) recodify Minnesota Statutes,
chapter 245A; and (2) repeal and enact as statutes the rules governing day care facility
licensing in Minnesota Rules, chapter 9502.
new text end
Sec. 52. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2018, sections 119B.011, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,
10a, 11, 12, 13, 13a, 14, 15, 16, 17, 18, 19, 19a, 19b, 20, 20a, 21, and 22; 119B.02; 119B.025,
subdivisions 1, 2, 3, and 4; 119B.03, subdivisions 1, 2, 3, 4, 5, 6, 6a, 6b, 8, 9, and 10;
119B.035; 119B.04; 119B.05, subdivisions 1, 4, and 5; 119B.06, subdivisions 1, 2, and 3;
119B.08, subdivisions 1, 2, and 3; 119B.09, subdivisions 1, 3, 4, 4a, 5, 6, 7, 8, 9, 9a, 10,
11, 12, and 13; 119B.095; 119B.097; 119B.10, subdivisions 1, 2, and 3; 119B.105; 119B.11,
subdivisions 1, 2a, 3, and 4; 119B.12, subdivisions 1 and 2; 119B.125; 119B.13, subdivisions
1, 1a, 3, 3a, 3b, 3c, 4, 5, 6, and 7; 119B.14; 119B.15; and 119B.16,
new text end
new text begin
are repealed effective
July 1, 2020.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, parts 3400.0010; 3400.0020, subparts 1, 4, 5, 8, 9a, 10a, 12, 17a,
18, 18a, 20, 24, 25, 26, 28, 29a, 31b, 32b, 33, 34a, 35, 37, 38, 38a, 38b, 39, 40, 40a, and
44; 3400.0030; 3400.0035; 3400.0040, subparts 1, 3, 4, 5, 5a, 6a, 6b, 6c, 7, 8, 9, 10, 11, 12,
13, 14, 15, 15a, 17, and 18; 3400.0060, subparts 2, 4, 5, 6, 6a, 7, 8, 9, and 10; 3400.0080,
subparts 1, 1a, 1b, and 8; 3400.0090, subparts 1, 2, 3, and 4; 3400.0100, subparts 2a, 2b,
2c, and 5; 3400.0110, subparts 1, 1a, 2, 2a, 3, 4a, 7, 8, 9, 10, and 11; 3400.0120, subparts
1, 1a, 2, 2a, 3, and 5; 3400.0130, subparts 1, 1a, 2, 3, 3a, 3b, 5, 5a, and 7; 3400.0140, subparts
1, 2, 4, 5, 6, 7, 8, 9, 9a, 10, and 14; 3400.0150; 3400.0170, subparts 1, 3, 4, 6a, 7, 8, 9, 10,
and 11; 3400.0180; 3400.0183, subparts 1, 2, and 5; 3400.0185; 3400.0187, subparts 1, 2,
3, 4, and 6; 3400.0200; 3400.0220; 3400.0230, subpart 3; and 3400.0235, subparts 1, 2, 3,
4, 5, and 6,
new text end
new text begin
are repealed are effective July 1, 2020.
new text end
new text begin
(c)
new text end
new text begin
Laws 2017, First Special Session chapter 6, article 7, section 34,
new text end
new text begin
is repealed effective
July 1, 2019.
new text end
ARTICLE 3
CHEMICAL AND MENTAL HEALTH
Section 1.
Minnesota Statutes 2018, section 13.851, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Mental health data sharing. new text end
new text begin
Section 641.15, subdivision 3a, governs the
sharing of data on prisoners who may have a mental illness or need services with county
social service agencies or welfare system personnel.
new text end
Sec. 2.
new text begin
[245.4663] OFFICER-INVOLVED COMMUNITY-BASED CARE
COORDINATION GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment and authority. new text end
new text begin
(a) The commissioner shall award grants
to programs that provide officer-involved community-based care coordination services
under section 256B.0625, subdivision 56a. The commissioner shall balance awarding grants
to counties outside the metropolitan area and counties inside the metropolitan area.
new text end
new text begin
(b) The commissioner shall provide outreach, technical assistance, and program
development support to increase capacity of new and existing officer-involved
community-based care coordination programs, particularly in areas where officer-involved
community-based care coordination programs have not been established, especially in
greater Minnesota.
new text end
new text begin
(c) Funds appropriated for this section must be expended on activities described under
subdivision 3, technical assistance, and capacity building, including the capacity to maximize
revenue by billing services to available third-party reimbursement sources, in order to meet
the greatest need on a statewide basis.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility. new text end
new text begin
An eligible applicant for an officer-involved community-based care
coordination grant under subdivision 1, paragraph (a), is a county or tribe that operates or
is prepared to implement an officer-involved community-based care coordination program.
new text end
new text begin Subd. 3. new text end
new text begin Allowable grant activities. new text end
new text begin
Grant recipients may use grant funds for the costs
of providing officer-involved community-based care coordination services that are not
otherwise covered under section 256B.0625, subdivision 56a, and for the cost of services
for individuals not eligible for medical assistance.
new text end
new text begin Subd. 4. new text end
new text begin Reporting. new text end
new text begin
(a) The commissioner shall report annually on the use of
officer-involved community-based care coordination grants to the legislative committees
with jurisdiction over human services by December 31, beginning in 2020. Each report shall
include the name and location of the grant recipients, the amount of each grant, the services
provided or planning activities conducted, and the number of individuals receiving services.
The commissioner shall determine the form required for the reports and may specify
additional reporting requirements.
new text end
new text begin
(b) The reporting requirements under this subdivision are in addition to the reporting
requirements under section 256B.0625, subdivision 56a, paragraph (e).
new text end
Sec. 3.
Minnesota Statutes 2018, 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 placementnew text begin , whether or not the child is receiving case management servicesnew text end ;
(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 services, including transportation for children receiving
school-linked mental health services when school is not in session;
(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
website 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;
(16) psychiatric consultation for primary care practitioners;deleted text begin and
deleted text end
(17) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grantsdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(18) promoting and developing a provider's capacity to deliver multigenerational mental
health treatment and services.
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 this paragraph must be
designed to foster independent living in the community.
Sec. 4.
Minnesota Statutes 2018, section 254A.03, subdivision 3, is amended to read:
Subd. 3.
Rules for substance use disorder care.
(a) The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level of
chemical dependency care for each recipient of public assistance seeking treatment for
substance misuse or substance use disorder. Upon federal approval of a comprehensive
assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding
the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of
comprehensive assessments under section 254B.05 may determine and approve the
appropriate level of substance use disorder treatment for a recipient of public assistance.
The process for determining an individual's financial eligibility for the consolidated chemical
dependency treatment fund or determining an individual's enrollment in or eligibility for a
publicly subsidized health plan is not affected by the individual's choice to access a
comprehensive assessment for placement.
(b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.
new text begin
(c) If a screen result is positive for alcohol or substance misuse, a brief screening for
alcohol or substance use disorder that is provided to a recipient of public assistance within
a primary care clinic, hospital, or other medical setting or school setting establishes medical
necessity and approval for an initial set of substance use disorder services identified in
section 254B.05, subdivision 5. The initial set of services approved for a recipient whose
screen result is positive may include four hours of individual or group substance use disorder
treatment, two hours of substance use disorder treatment coordination, or two hours of
substance use disorder peer support services provided by a qualified individual according
to chapter 245G. A recipient must obtain an assessment pursuant to paragraph (a) to be
approved for additional treatment services.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Contingent upon federal approval, this section is effective July
1, 2019. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained or denied.
new text end
Sec. 5.
Minnesota Statutes 2018, section 254A.19, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Assessment via telemedicine. new text end
new text begin
Notwithstanding Minnesota Rules, part
9530.6615, subpart 3, item A, a chemical use assessment may be conducted via telemedicine.
new text end
Sec. 6.
Minnesota Statutes 2018, section 254B.02, subdivision 1, is amended to read:
Subdivision 1.
Chemical dependency treatment allocation.
The chemical dependency
treatment appropriation shall be placed in a special revenue account. deleted text begin The commissioner
shall annually transfer funds from the chemical dependency fund to pay for operation of
the drug and alcohol abuse normative evaluation system and to pay for all costs incurred
by adding two positions for licensing of chemical dependency treatment and rehabilitation
programs located in hospitals for which funds are not otherwise appropriated.deleted text end The deleted text begin remainder
of thedeleted text end money in the special revenue account must be used according to the requirements in
this chapter.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 7.
Minnesota Statutes 2018, section 254B.03, subdivision 2, is amended to read:
Subd. 2.
Chemical dependency fund payment.
(a) Payment from the chemical
dependency fund is limited to payments for services other than detoxification licensed under
Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally
recognized tribal lands, would be required to be licensed by the commissioner as a chemical
dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and
services other than detoxification provided in another state that would be required to be
licensed as a chemical dependency program if the program were in the state. Out of state
vendors must also provide the commissioner with assurances that the program complies
substantially with state licensing requirements and possesses all licenses and certifications
required by the host state to provide chemical dependency treatment. Vendors receiving
payments from the chemical dependency fund must not require co-payment from a recipient
of benefits for services provided under this subdivision. The vendor is prohibited from using
the client's public benefits to offset the cost of services paid under this section. The vendor
shall not require the client to use public benefits for room or board costs. This includes but
is not limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP
benefits. Retention of SNAP benefits is a right of a client receiving services through the
consolidated chemical dependency treatment fund or through state contracted managed care
entities. Payment from the chemical dependency fund shall be made for necessary room
and board costs provided by vendors deleted text begin certified according todeleted text end new text begin meeting the criteria under new text end section
254B.05new text begin , subdivision 1anew text end , or in a community hospital licensed by the commissioner of health
according to sections 144.50 to 144.56 to a client who is:
(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and
(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.
(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.
(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. deleted text begin The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment servicesdeleted text end new text begin The commissioner
may deny vendor certification to a provider if the commissioner determines that the services
currently available in the local area are sufficient to meet local need and that the addition
of new services would be detrimental to individuals seeking these servicesnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 8.
Minnesota Statutes 2018, section 254B.03, subdivision 4, is amended to read:
Subd. 4.
Division of costs.
(a) Except for services provided by a county under section
254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out
of local money, pay the state for 22.95 percent of the cost of chemical dependency services,
deleted text begin including thosedeleted text end new text begin except that the county shall pay the state for ten percent of the nonfederal
share of the cost of chemical dependencynew text end services provided to persons deleted text begin eligible fordeleted text end new text begin enrolled
innew text end medical assistance under chapter 256Bnew text begin , and ten percent of the cost of room and board
services under section 254B.05, subdivision 5, paragraph (b), clause (12)new text end . Counties may
use the indigent hospitalization levy for treatment and hospital payments made under this
section.
(b) 22.95 percent of any state collections from private or third-party pay, less 15 percent
for the cost of payment and collections, must be distributed to the county that paid for a
portion of the treatment under this section.
deleted text begin
(c) For fiscal year 2017 only, the 22.95 percentages under paragraphs (a) and (b) are
equal to 20.2 percent.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 9.
Minnesota Statutes 2018, section 254B.04, subdivision 1, is amended to read:
Subdivision 1.
Eligibility.
new text begin (a)new text end Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, deleted text begin and persons eligible for medical assistance benefits under
sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, ordeleted text end who meet the
income standards of section 256B.056, subdivision 4,new text begin and are not enrolled in medical
assistance,new text end are entitled to chemical dependency fund services. State money appropriated
for this paragraph must be placed in a separate account established for this purpose.
new text begin (b) new text end 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.
new text begin
(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible
for room and board services under section 254B.05, subdivision 5, paragraph (b), clause
(12).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 10.
Minnesota Statutes 2018, 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 section
245G.11, subdivision 1, paragraph (b);
(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
(10) meets the requirements of section 245G.08, subdivision 5, 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 section 245G.15,
subdivision 2; 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
(c) Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
of room and board and are exempt from paragraph (a), clauses (6) to (15).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 11.
Minnesota Statutes 2018, section 254B.06, subdivision 1, is amended to read:
Subdivision 1.
State collections.
The commissioner is responsible for all collections
from persons determined to be partially responsible for the cost of care of an eligible person
receiving services under Laws 1986, chapter 394, sections 8 to 20. The commissioner may
initiate, or request the attorney general to initiate, necessary civil action to recover the unpaid
cost of care. The commissioner may collect all third-party payments for chemical dependency
services provided under Laws 1986, chapter 394, sections 8 to 20, including private insurance
and federal Medicaid and Medicare financial participation. deleted text begin The commissioner shall deposit
in a dedicated account a percentage of collections to pay for the cost of operating the chemical
dependency consolidated treatment fund invoice processing and vendor payment system,
billing, and collections.deleted text end The remaining receipts must be deposited in the chemical dependency
fund.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 12.
Minnesota Statutes 2018, section 254B.06, subdivision 2, is amended to read:
Subd. 2.
Allocation of collections.
deleted text begin (a) The commissioner shall allocate all federal
financial participation collections to a special revenue account.deleted text end The commissioner shall
allocate 77.05 percent of patient payments and third-party payments to the special revenue
account and 22.95 percent to the county financially responsible for the patient.
deleted text begin
(b) For fiscal year 2017 only, the commissioner's allocation to the special revenue account
shall be increased from 77.05 percent to 79.8 percent and the county financial responsibility
shall be reduced from 22.95 percent to 20.2 percent.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 13.
Minnesota Statutes 2018, section 256B.0625, subdivision 24, is amended to read:
Subd. 24.
Other medical or remedial care.
Medical assistance covers any other medical
or remedial care licensed and recognized under state law unless otherwise prohibited by
lawdeleted text begin , except licensed chemical dependency treatment programs or primary treatment or
extended care treatment units in hospitals that are covered under chapter 254B. The
commissioner shall include chemical dependency services in the state medical assistance
plan for federal reporting purposes, but payment must be made under chapter 254Bdeleted text end . The
commissioner shall publish in the State Register a list of elective surgeries that require a
second medical opinion before medical assistance reimbursement, and the criteria and
standards for deciding whether an elective surgery should require a second medical opinion.
The list and criteria and standards are not subject to the requirements of sections 14.01 to
14.69.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 14.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 24a. new text end
new text begin Substance use disorder services. new text end
new text begin
Medical assistance covers substance use
disorder treatment services according to section 254B.05, subdivision 5, except for room
and board.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 15.
Minnesota Statutes 2018, section 256B.0625, subdivision 56a, is amended to
read:
Subd. 56a.
deleted text begin Post-arrestdeleted text end new text begin Officer-involved new text end community-based deleted text begin servicedeleted text end new text begin care
new text end coordination.
(a) Medical assistance covers deleted text begin post-arrestdeleted text end new text begin officer-involved new text end community-based
deleted text begin servicedeleted text end new text begin care new text end coordination for an individual who:
(1) has deleted text begin been identified as havingdeleted text end new text begin screened positive for benefiting from treatment for new text end a
mental illness or substance use disorder using a deleted text begin screeningdeleted text end tool approved by the commissioner;
(2) does not require the security of a public detention facility and is not considered an
inmate of a public institution as defined in Code of Federal Regulations, title 42, section
435.1010;
(3) meets the eligibility requirements in section 256B.056; and
(4) has agreed to participate in deleted text begin post-arrestdeleted text end new text begin officer-involved new text end community-based deleted text begin servicedeleted text end
new text begin care new text end coordination deleted text begin through a diversion contract in lieu of incarcerationdeleted text end .
(b) deleted text begin Post-arrestdeleted text end new text begin Officer-involvednew text end community-based deleted text begin servicedeleted text end new text begin care new text end coordination means
navigating services to address a client's mental health, chemical health, social, economic,
and housing needs, or any other activity targeted at reducing the incidence of jail utilization
and connecting individuals with existing covered services available to them, including, but
not limited to, targeted case management, waiver case management, or care coordination.
(c) deleted text begin Post-arrestdeleted text end new text begin Officer-involved new text end community-based deleted text begin servicedeleted text end new text begin care new text end coordination must be
provided by an individual who is an employee of deleted text begin a countydeleted text end or is under contract with a countynew text begin ,
or is an employee of or under contract with an Indian health service facility or facility owned
and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638
facilitynew text end to provide deleted text begin post-arrestdeleted text end new text begin officer-involved new text end community-based new text begin care new text end coordination and is
qualified under one of the following criteria:
(1) a licensed mental health professional as defined in section 245.462, subdivision 18,
clauses (1) to (6);
(2) a mental health practitioner as defined in section 245.462, subdivision 17, working
under the clinical supervision of a mental health professional; deleted text begin or
deleted text end
(3) a certified peer specialist under section 256B.0615, working under the clinical
supervision of a mental health professionaldeleted text begin .deleted text end new text begin ;
new text end
new text begin
(4) an individual qualified as an alcohol and drug counselor under section 245G.11,
subdivision 5; or
new text end
new text begin
(5) a recovery peer qualified under section 245G.11, subdivision 8, working under the
supervision of an individual qualified as an alcohol and drug counselor under section
245G.11, subdivision 5.
new text end
(d) Reimbursement is allowed for up to 60 days following the initial determination of
eligibility.
(e) Providers of deleted text begin post-arrestdeleted text end new text begin officer-involved new text end community-based deleted text begin servicedeleted text end new text begin care new text end 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 deleted text begin post-arrestdeleted text end new text begin officer-involved
new text end community-based deleted text begin servicedeleted text end new text begin care new text end coordination do not duplicate services or payments provided
under section 256B.0625, subdivision 20, 256B.0753, 256B.0755, or 256B.0757.
deleted 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.
deleted text end
Sec. 16.
Minnesota Statutes 2018, section 256B.0757, subdivision 1, is amended to read:
Subdivision 1.
Provision of coverage.
(a) The commissioner shall provide medical
assistance coverage of health home services for eligible individuals with chronic conditions
who select a designated provider as the individual's health home.
(b) The commissioner shall implement this section in compliance with the requirements
of the state option to provide health homes for enrollees with chronic conditions, as provided
under the Patient Protection and Affordable Care Act, Public Law 111-148, sections 2703
and 3502. Terms used in this section have the meaning provided in that act.
(c) The commissioner shall establish health homes to serve populations with serious
mental illness who meet the eligibility requirements described under subdivision 2deleted text begin , clause
(4)deleted text end . The health home services provided by health homes shall focus on both the behavioral
and the physical health of these populations.
Sec. 17.
Minnesota Statutes 2018, section 256B.0757, subdivision 2, is amended to read:
Subd. 2.
Eligible individual.
new text begin
(a) The commissioner may elect to develop health home
models in accordance with United States Code, title 42, section 1396w-4.
new text end
new text begin (b) new text end An individual is eligible for health home services under this section if the individual
is eligible for medical assistance under this chapter and has deleted text begin at least:
deleted text end
deleted text begin
(1) two chronic conditions;
deleted text end
deleted text begin
(2) one chronic condition and is at risk of having a second chronic condition;
deleted text end
deleted text begin
(3) one serious and persistent mental health condition; or
deleted text end
deleted text begin (4)deleted text end a condition that meets the definition new text begin of mental illness as described new text end in section 245.462,
subdivision 20, paragraph (a), or new text begin emotional disturbance as defined in section new text end 245.4871,
subdivision 15, clause (2)deleted text begin ; and has a current diagnostic assessment as defined in Minnesota
Rules, part 9505.0372, subpart 1, item B or C, as performed or reviewed by a mental health
professional employed by or under contract with the behavioral health homedeleted text end . The
commissioner shall establish criteria for determining continued eligibility.
Sec. 18.
Minnesota Statutes 2018, section 256B.0757, subdivision 4, is amended to read:
Subd. 4.
Designated provider.
deleted text begin (a)deleted text end Health home services are voluntary and an eligible
individual may choose any designated provider. The commissioner shall establish designated
providers to serve as health homes and provide the services described in subdivision 3 to
individuals eligible under subdivision 2. The commissioner shall apply for grants as provided
under section 3502 of the Patient Protection and Affordable Care Act to establish health
homes and provide capitated payments to designated providers. For purposes of this section,
"designated provider" means a provider, clinical practice or clinical group practice, rural
clinic, community health center, community mental health center, or any other entity that
is determined by the commissioner to be qualified to be a health home for eligible individuals.
This determination must be based on documentation evidencing that the designated provider
has the systems and infrastructure in place to provide health home services and satisfies the
qualification standards established by the commissioner in consultation with stakeholders
and approved by the Centers for Medicare and Medicaid Services.
deleted text begin
(b) The commissioner shall develop and implement certification standards for designated
providers under this subdivision.
deleted text end
Sec. 19.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 9. new text end
new text begin Discharge criteria. new text end
new text begin
(a) An individual may be discharged from behavioral health
home services if:
new text end
new text begin
(1) the behavioral health home services provider is unable to locate, contact, and engage
the individual for a period of greater than three months after persistent efforts by the
behavioral health home services provider; or
new text end
new text begin
(2) the individual is unwilling to participate in behavioral health home services as
demonstrated by the individual's refusal to meet with the behavioral health home services
provider, or refusal to identify the individual's goals or the activities or support necessary
to achieve the individual's health and wellness goals.
new text end
new text begin
(b) Before discharge from behavioral health home services, the behavioral health home
services provider must offer a face-to-face meeting with the individual, the individual's
identified supports, and the behavioral health home services provider to discuss options
available to the individual, including maintaining behavioral health home services.
new text end
Sec. 20.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Behavioral health home services provider requirements. new text end
new text begin
A behavioral
health home services provider must:
new text end
new text begin
(1) be an enrolled Minnesota Health Care Programs provider;
new text end
new text begin
(2) provide a medical assistance covered primary care or behavioral health service;
new text end
new text begin
(3) utilize an electronic health record;
new text end
new text begin
(4) utilize an electronic patient registry that contains data elements required by the
commissioner;
new text end
new text begin
(5) demonstrate the organization's capacity to administer screenings approved by the
commissioner for substance use disorder or alcohol and tobacco use;
new text end
new text begin
(6) demonstrate the organization's capacity to refer an individual to resources appropriate
to the individual's screening results;
new text end
new text begin
(7) have policies and procedures to track referrals to ensure that the referral met the
individual's needs;
new text end
new text begin
(8) conduct a brief needs assessment when an individual begins receiving behavioral
health home services. The brief needs assessment must be completed with input from the
individual and the individual's identified supports. The brief needs assessment must address
the individual's immediate safety and transportation needs and potential barriers to
participating in behavioral health home services;
new text end
new text begin
(9) conduct a health wellness assessment within 60 days after intake that contains all
required elements identified by the commissioner;
new text end
new text begin
(10) conduct a health action plan that contains all required elements identified by the
commissioner within 90 days after intake and updated at least once every six months or
more frequently if significant changes to an individual's needs or goals occur;
new text end
new text begin
(11) agree to cooperate and participate with the state's monitoring and evaluation of
behavioral health home services; and
new text end
new text begin
(12) utilize the form approved by the commissioner to obtain the individual's written
consent to begin receiving behavioral health home services.
new text end
Sec. 21.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Provider training and practice transformation requirements. new text end
new text begin
(a) The
behavioral health home services provider must ensure that all staff delivering behavioral
health home services receive adequate preservice and ongoing training including:
new text end
new text begin
(1) training approved by the commissioner that describes the goals and principles of
behavioral health home services; and
new text end
new text begin
(2) training on evidence-based practices to promote an individual's ability to successfully
engage with medical, behavioral health, and social services to reach the individual's health
and wellness goals.
new text end
new text begin
(b) The behavioral health home services provider must ensure that staff are capable of
implementing culturally responsive services as determined by the individual's culture,
beliefs, values, and language as identified in the individual's health wellness assessment.
new text end
new text begin
(c) The behavioral health home services provider must participate in the department's
practice transformation activities to support continued skill and competency development
in the provision of integrated medical, behavioral health, and social services.
new text end
Sec. 22.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Staff qualifications. new text end
new text begin
(a) A behavioral health home services provider must
maintain staff with required professional qualifications appropriate to the setting.
new text end
new text begin
(b) If behavioral health home services are offered in a mental health setting, the
integration specialist must be a registered nurse licensed under the Minnesota Nurse Practice
Act, sections 148.171 to 148.285.
new text end
new text begin
(c) If behavioral health home services are offered in a primary care setting, the integration
specialist must be a mental health professional as defined in section 245.462, subdivision
18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6).
new text end
new text begin
(d) If behavioral health home services are offered in either a primary care setting or
mental health setting, the systems navigator must be a mental health practitioner as defined
in section 245.462, subdivision 17, or a community health worker as defined in section
256B.0625, subdivision 49.
new text end
new text begin
(e) If behavioral health home services are offered in either a primary care setting or
mental health setting, the qualified health home specialist must be one of the following:
new text end
new text begin
(1) a peer support specialist as defined in section 256B.0615;
new text end
new text begin
(2) a family peer support specialist as defined in section 256B.0616;
new text end
new text begin
(3) a case management associate as defined in section 245.462, subdivision 4, paragraph
(g), or 245.4871, subdivision 4, paragraph (j);
new text end
new text begin
(4) a mental health rehabilitation worker as defined in section 256B.0623, subdivision
5, clause (4);
new text end
new text begin
(5) a community paramedic as defined in section 144E.28, subdivision 9;
new text end
new text begin
(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5);
or
new text end
new text begin
(7) a community health worker as defined in section 256B.0625, subdivision 49.
new text end
Sec. 23.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Service delivery standards. new text end
new text begin
(a) A behavioral health home services provider
must meet the following service delivery standards:
new text end
new text begin
(1) establish and maintain processes to support the coordination of an individual's primary
care, behavioral health, and dental care;
new text end
new text begin
(2) maintain a team-based model of care, including regular coordination and
communication between behavioral health home services team members;
new text end
new text begin
(3) use evidence-based practices that recognize and are tailored to the medical, social,
economic, behavioral health, functional impairment, cultural, and environmental factors
affecting the individual's health and health care choices;
new text end
new text begin
(4) use person-centered planning practices to ensure the individual's health action plan
accurately reflects the individual's preferences, goals, resources, and optimal outcomes for
the individual and the individual's identified supports;
new text end
new text begin
(5) use the patient registry to identify individuals and population subgroups requiring
specific levels or types of care and provide or refer the individual to needed treatment,
intervention, or service;
new text end
new text begin
(6) utilize Department of Human Services Partner Portal to identify past and current
treatment or services and to identify potential gaps in care;
new text end
new text begin
(7) deliver services consistent with standards for frequency and face-to-face contact as
required by the commissioner;
new text end
new text begin
(8) ensure that all individuals receiving behavioral health home services have a diagnostic
assessment completed within six months of when the individual begins receiving behavioral
health home services;
new text end
new text begin
(9) deliver services in locations and settings that meet the needs of the individual;
new text end
new text begin
(10) provide a central point of contact to ensure that individuals and the individual's
identified supports can successfully navigate the array of services that impact the individual's
health and well-being;
new text end
new text begin
(11) have capacity to assess an individual's readiness for change and the individual's
capacity to integrate new health care or community supports into the individual's life;
new text end
new text begin
(12) offer or facilitate the provision of wellness and prevention education on
evidenced-based curriculums specific to the prevention and management of common chronic
conditions;
new text end
new text begin
(13) help an individual set up and prepare for appointments, including accompanying
the individual to appointments as appropriate, and follow up with the individual after medical,
behavioral health, social service, or community support appointments;
new text end
new text begin
(14) offer or facilitate the provision of health coaching related to chronic disease
management and how to navigate complex systems of care to the individual, the individual's
family, and identified supports;
new text end
new text begin
(15) connect an individual, the individual's family, and identified supports to appropriate
support services that help the individual overcome access or service barriers, increase
self-sufficiency skills, and improve overall health;
new text end
new text begin
(16) provide effective referrals and timely access to services; and
new text end
new text begin
(17) establish a continuous quality improvement process for providing behavioral health
home services.
new text end
new text begin
(b) The behavioral health home services provider must also create a plan, in partnership
with the individual and the individual's identified supports, to support the individual after
discharge from a hospital, residential treatment program, or other setting. The plan must
include protocols for:
new text end
new text begin
(1) maintaining contact between the behavioral health home services team member and
the individual and the individual's identified supports during and after discharge;
new text end
new text begin
(2) linking the individual to new resources as needed;
new text end
new text begin
(3) reestablishing the individual's existing services and community and social supports;
and
new text end
new text begin
(4) following up with appropriate entities to transfer or obtain the individual's service
records as necessary for continued care.
new text end
new text begin
(c) If the individual is enrolled in a managed care plan, a behavioral health home services
provider must:
new text end
new text begin
(1) notify the behavioral health home services contact designated by the managed care
plan within 30 days of when the individual begins behavioral health home services; and
new text end
new text begin
(2) adhere to the managed care plan communication and coordination requirements
described in the behavioral health home services manual.
new text end
new text begin
(d) Before terminating behavioral health home services, the behavioral health home
services provider must:
new text end
new text begin
(1) provide a 60-day notice of termination of behavioral health home services to all
individuals receiving behavioral health home services, the department, and managed care
plans, if applicable; and
new text end
new text begin
(2) refer individuals receiving behavioral health home services to a new behavioral
health home services provider.
new text end
Sec. 24.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Provider variances. new text end
new text begin
(a) The commissioner may grant a variance to specific
requirements under subdivision 10, 11, 12, or 13 for a behavioral health home services
provider according to this subdivision.
new text end
new text begin
(b) The commissioner may grant a variance if the commissioner finds that (1) failure to
grant the variance would result in hardship or injustice to the applicant, (2) the variance
would be consistent with the public interest, and (3) the variance would not reduce the level
of services provided to individuals served by the organization.
new text end
new text begin
(c) The commissioner may grant a variance from one or more requirements to permit
an applicant to offer behavioral health home services of a type or in a manner that is
innovative if the commissioner finds that the variance does not impede the achievement of
the criteria in subdivision 10, 11, 12, or 13 and may improve the behavioral health home
services provided by the applicant.
new text end
new text begin
(d) The commissioner's decision to grant or deny a variance request is final and not
subject to appeal.
new text end
Sec. 25.
new text begin
[256B.0759] SUBSTANCE USE DISORDER 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 shall develop and implement a medical
assistance demonstration project to test reforms of Minnesota's substance use disorder
treatment system to ensure individuals with substance use disorders have access to a full
continuum of high quality care.
new text end
new text begin Subd. 2. new text end
new text begin Provider participation. new text end
new text begin
Substance use disorder treatment providers may elect
to participate in the demonstration project and fulfill the requirements under subdivision 3.
To participate, a provider must notify the commissioner of the provider's intent to participate
in a format required by the commissioner and enroll as a demonstration project provider.
new text end
new text begin Subd. 3. new text end
new text begin Provider standards. new text end
new text begin
(a) The commissioner shall establish requirements for
participating providers that are consistent with the federal requirements of the demonstration
project.
new text end
new text begin
(b) Participating residential providers must obtain applicable licensure under chapters
245F, 245G, or other applicable standards for the services provided and must:
new text end
new text begin
(1) deliver services in accordance with American Society of Addiction Medicine (ASAM)
standards;
new text end
new text begin
(2) maintain formal patient referral arrangements with providers delivering step-up or
step-down levels of care in accordance with ASAM standards; and
new text end
new text begin
(3) provide or arrange for medication-assisted treatment services if requested by a client
for whom an effective medication exists.
new text end
new text begin
(c) Participating outpatient providers must be licensed and must:
new text end
new text begin
(1) deliver services in accordance with ASAM standards; and
new text end
new text begin
(2) maintain formal patient referral arrangements with providers delivering step-up or
step-down levels of care in accordance with ASAM standards.
new text end
new text begin
(d) If the provider standards under chapter 245G or other applicable standards conflict
or are duplicative, the commissioner may grant variances to the standards if the variances
do not conflict with federal requirements. The commissioner shall publish service
components, service standards, and staffing requirements for participating providers that
are consistent with ASAM standards and federal requirements.
new text end
new text begin Subd. 4. new text end
new text begin Provider payment rates. new text end
new text begin
(a) Payment rates for participating providers must
be increased for services provided to medical assistance enrollees.
new text end
new text begin
(b) For substance use disorder services under section 254B.05, subdivision 5, paragraph
(b), clause (8), payment rates must be increased by 15 percent over the rates in effect on
January 1, 2020.
new text end
new text begin
(c) For substance use disorder services under section 254B.05, subdivision 5, paragraph
(b), clauses (1), (6), (7), and (10), payment rates must be increased by ten percent over the
rates in effect on January 1, 2021.
new text end
new text begin Subd. 5. new text end
new text begin Federal approval. new text end
new text begin
The commissioner shall seek federal approval to implement
the demonstration project under this section and to receive federal financial participation.
new text end
Sec. 26.
Minnesota Statutes 2018, section 256I.04, subdivision 1, is amended to read:
Subdivision 1.
Individual eligibility requirements.
An individual is eligible for and
entitled to a housing support payment to be made on the individual's behalf if the agency
has approved the setting where the individual will receive housing support and the individual
meets the requirements in paragraph (a), (b), or (c).
(a) The individual is aged, blind, or is over 18 years of age with a disability 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 housing support in which the individual resides.
(b) The individual meets a category of eligibility under section 256D.05, subdivision 1,
paragraph (a), clauses (1), (3), (4) to (8), and (13), 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 housing support in which the
individual resides.
(c) The individual deleted text begin 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.deleted text end new text begin lacks a fixed, adequate, nighttime residence
upon discharge from a residential behavioral health treatment program, as determined by
treatment staff from the residential behavioral health treatment program. An individual is
eligible under this paragraph for up to three months, including a full or partial month from
the individual's move-in date at a setting approved for housing support following discharge
from treatment, plus two full months.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 27.
Minnesota Statutes 2018, section 256I.04, subdivision 2f, is amended to read:
Subd. 2f.
Required services.
new text begin (a) new text end In licensed and registered settings under subdivision
2a, providers shall ensure that participants have at a minimum:
(1) food preparation and service for three nutritional meals a day on site;
(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
(3) housekeeping, including cleaning and lavatory supplies or service; and
(4) maintenance and operation of the building and grounds, including heat, water, garbage
removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair
and maintain equipment and facilities.
new text begin
(b) Providers serving participants described in subdivision 1, paragraph (c), shall assist
participants in applying for continuing housing support payments before the end of the
eligibility period.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 28.
Minnesota Statutes 2018, section 256I.06, subdivision 8, is amended to read:
Subd. 8.
Amount of housing support payment.
(a) The amount of a room and board
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 room and board rate for that same month. The housing support payment is
determined by multiplying the housing support 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.
(c) For an individual who receives deleted text begin licensed residential crisis stabilization services under
section 256B.0624, subdivision 7,deleted text end new text begin housing support payments under section 256I.04,
subdivision 1, paragraph (c),new text end the deleted text begin amount ofdeleted text end housing support payment new text begin amount new text end is determined
by multiplying the housing support rate times the period of time the individual was a resident.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 29.
Minnesota Statutes 2018, section 256K.45, subdivision 2, is amended to read:
Subd. 2.
Homeless youth report.
The commissioner shall prepare a biennial report,
beginning in February 2015, which provides meaningful information to the legislative
committees having jurisdiction over the issue of homeless youth, that includes, but is not
limited to: (1) a list of the areas of the state with the greatest need for services and housing
for homeless youth, and the level and nature of the needs identified; (2) details about grants
madenew text begin , including shelter-linked youth mental health grants under section 256K.46new text end ; (3) the
distribution of funds throughout the state based on population need; (4) follow-up
information, if available, on the status of homeless youth and whether they have stable
housing two years after services are provided; and (5) any other outcomes for populations
served to determine the effectiveness of the programs and use of funding.
Sec. 30.
new text begin
[256K.46] SHELTER-LINKED YOUTH MENTAL HEALTH GRANT
PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment and authority. new text end
new text begin
(a) The commissioner shall award grants
to provide mental health services to homeless or sexually exploited youth. To be eligible,
housing providers must partner with community-based mental health practitioners to provide
a continuum of mental health services, including short-term crisis response, support for
youth in longer-term housing settings, and ongoing relationships to support youth in other
housing arrangements in the community for homeless or sexually exploited youth.
new text end
new text begin
(b) The commissioner shall consult with the commissioner of management and budget
to identify evidence-based mental health services for youth and give priority in awarding
grants to proposals that include evidence-based mental health services for youth.
new text end
new text begin
(c) The commissioner may make two-year grants under this section.
new text end
new text begin
(d) Money appropriated for this section must be expended on activities described under
subdivision 4, technical assistance, and capacity building to meet the greatest need on a
statewide basis. The commissioner shall provide outreach, technical assistance, and program
development support to increase capacity of new and existing service providers to better
meet needs statewide, particularly in areas where shelter-linked youth mental health services
have not been established, especially in greater Minnesota.
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) "Commissioner" means the commissioner of human services, unless otherwise
indicated.
new text end
new text begin
(c) "Housing provider" means a shelter, housing program, or other entity providing
services under the Homeless Youth Act in section 256K.45 and the Safe Harbor for Sexually
Exploited Youth Act in section 145.4716.
new text end
new text begin
(d) "Mental health practitioner" has the meaning given in section 245.462, subdivision
17.
new text end
new text begin
(e) "Youth" has the meanings given for "homeless youth," "youth at risk for
homelessness," and "runaway" in section 256K.45, subdivision 1a, "sexually exploited
youth" in section 260C.007, subdivision 31, and "youth eligible for services" in section
145.4716, subdivision 3.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility. new text end
new text begin
An eligible applicant for shelter-linked youth mental health grants
under subdivision 1 is a housing provider that:
new text end
new text begin
(1) demonstrates that the provider received targeted trauma training focused on sexual
exploitation and adolescent experiences of homelessness; and
new text end
new text begin
(2) partners with a community-based mental health practitioner who has demonstrated
experience or access to training regarding adolescent development and trauma-informed
responses.
new text end
new text begin Subd. 4. new text end
new text begin Allowable grant activities. new text end
new text begin
(a) Grant recipients may conduct the following
activities with community-based mental health practitioners:
new text end
new text begin
(1) develop programming to prepare youth to receive mental health services;
new text end
new text begin
(2) provide on-site mental health services, including group skills and therapy sessions.
Grant recipients are encouraged to use evidence-based mental health services;
new text end
new text begin
(3) provide mental health case management, as defined in section 256B.0625, subdivision
20; and
new text end
new text begin
(4) consult, train, and educate housing provider staff regarding mental health. Grant
recipients are encouraged to provide staff with access to a mental health crisis line 24 hours
a day, seven days a week.
new text end
new text begin
(b) Only after promoting and assisting participants with obtaining health insurance
coverage for which the participant is eligible, and only after mental health practitioners bill
covered services to medical assistance or health plan companies, grant recipients may use
grant funds to fill gaps in insurance coverage for mental health services.
new text end
new text begin
(c) Grant funds may be used for purchasing equipment, connection charges, on-site
coordination, set-up fees, and site fees to deliver shelter-linked youth mental health services
defined in this subdivision via telemedicine consistent with section 256B.0625, subdivision
3b.
new text end
new text begin Subd. 5. new text end
new text begin Reporting. new text end
new text begin
Grant recipients shall report annually on the use of shelter-linked
youth mental health grants to the commissioner by December 31, beginning in 2020. Each
report shall include the name and location of the grant recipient, the amount of each grant,
the youth mental health services provided, and the number of youth receiving services. The
commissioner shall determine the form required for the reports and may specify additional
reporting requirements. The commissioner shall include the shelter-linked youth mental
health services program in the biennial report required under section 256K.45, subdivision
2.
new text end
Sec. 31.
Minnesota Statutes 2018, section 641.15, subdivision 3a, is amended to read:
Subd. 3a.
Intake procedure; approved mental health screeningnew text begin ; data sharingnew text end .
As
part of its intake procedure for new prisoners, the sheriff or local corrections shall use a
mental health screening tool approved by the commissioner of correctionsnew text begin ,new text end in consultation
with the commissioner of human services and local corrections staffnew text begin ,new text end to identify persons
who may have new text begin a new text end mental illness.new text begin Notwithstanding section 13.85, the sheriff or local corrections
may share the names of persons who have screened positive for or may have a mental illness
with the local county social services agency. The sheriff or local corrections may refer a
person to county personnel of the welfare system, as defined in section 13.46, subdivision
1, paragraph (c), in order to arrange for services upon discharge and may share private data
on the individual as necessary to:
new text end
new text begin
(1) provide assistance in filling out an application for medical assistance or
MinnesotaCare;
new text end
new text begin
(2) make a referral for case management as provided under section 245.467, subdivision
4;
new text end
new text begin
(3) provide assistance in obtaining a state photo identification;
new text end
new text begin
(4) secure a timely appointment with a psychiatrist or other appropriate community
mental health provider;
new text end
new text begin
(5) provide prescriptions for a 30-day supply of all necessary medications; or
new text end
new text begin
(6) provide for behavioral health service coordination.
new text end
Sec. 32.
Laws 2017, First Special Session chapter 6, article 8, section 71, the effective
date, is amended to read:
EFFECTIVE DATE.
This section is effective for services provided on July 1, 2017,
through deleted text begin April 30, 2019, and expires May 1, 2019deleted text end new text begin June 30, 2019, and expires July 1, 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. 33.
Laws 2017, First Special Session chapter 6, article 8, section 72, the effective
date, is amended to read:
EFFECTIVE DATE.
This section is effective for services provided on July 1, 2017,
through deleted text begin April 30, 2019, and expires May 1, 2019deleted text end new text begin June 30, 2019, and expires July 1, 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. 34. new text begin DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER
TREATMENT PROGRAM SYSTEMS IMPROVEMENT.
new text end
new text begin
The commissioner of human services, in consultation with counties, tribes, managed
care organizations, substance use disorder treatment associations, and other relevant
stakeholders, shall develop a plan, proposed timeline, and summary of necessary resources
to make systems improvements to minimize the regulatory paperwork for substance use
disorder programs licensed under Minnesota Statutes, chapter 245A, and regulated under
Minnesota Statutes, chapters 245F and 245G, and Minnesota Rules, parts 2960.0580 to
2960.0700. The plan shall include procedures to ensure that continued input from all
stakeholders is considered and that the planned systems improvements maximize client
benefits and utility for providers, regulatory agencies, and payers.
new text end
Sec. 35. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
PERSON-CENTERED TELEPRESENCE PLATFORM EXPANSION.
new text end
new text begin
(a) By January 15, 2020, the commissioner of human services shall develop and provide
to the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services a proposal, including a timeline, a summary of necessary
resources, and any necessary legislative changes, to adapt and expand statewide, a common,
interoperable, person-centered telepresence platform for delivering behavioral health and
other health care services.
new text end
new text begin
(b) In developing the proposal, the commissioner shall consult with the commissioners
of management and budget, MN.IT services, corrections, health, and education, and other
relevant stakeholders including but not limited to county services agencies in the areas of
human services, health, and corrections or law enforcement from counties outside the
metropolitan area; public health representatives; behavioral health and primary care service
providers, including providers from outside the metropolitan area; representatives of the
Minnesota School Boards Association; representatives of the Minnesota Hospital Association,
including rural hospital emergency departments; community mental health centers; adolescent
treatment centers; child advocacy centers; and the domestic abuse perpetrator program.
new text end
new text begin
(c) In developing the proposal, the commissioner shall:
new text end
new text begin
(1) explore opportunities for improving behavioral health and other health care service
delivery through the use of a common interoperable person-centered telepresence platform
that provides connectivity and technical support to potential users;
new text end
new text begin
(2) review and coordinate state and local innovation initiatives and investments designed
to leverage telepresence connectivity and collaboration;
new text end
new text begin
(3) identify necessary standards and capabilities for a common interoperable telepresence
platform;
new text end
new text begin
(4) identify barriers to providing telepresence technology, including limited availability
of bandwidth, limitations in providing certain services via telepresence, and broadband
infrastructure needs;
new text end
new text begin
(5) make recommendations for governance to ensure the person-centered responsiveness
of a common telepresence platform;
new text end
new text begin
(6) develop incentives for ongoing innovation by service providers in Minnesota's health
and human services systems;
new text end
new text begin
(7) evaluate the use of vendors to provide a common telepresence platform that meets
identified standards and capabilities;
new text end
new text begin
(8) identify sustainable financial support for a common telepresence platform, including
infrastructure costs and start-up costs for potential users; and
new text end
new text begin
(9) identify the benefits to the state, political subdivisions, tribal governments, and
constituents from using a common person-centered telepresence platform for delivering
behavioral health services.
new text end
Sec. 36. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
IMPROVING SCHOOL-LINKED MENTAL HEALTH GRANT PROGRAM.
new text end
new text begin
(a) The commissioner of human services, in collaboration with the commissioner of
education, representatives from the education community, mental health providers, and
advocates, shall assess the school-linked mental health grant program under Minnesota
Statutes, section 245.4901, and develop recommendations for improvements. The assessment
must include but is not limited to the following:
new text end
new text begin
(1) promoting stability among current grantees and school partners;
new text end
new text begin
(2) assessing the minimum number of full-time equivalents needed per school site to
effectively carry out the program;
new text end
new text begin
(3) developing a funding formula that promotes sustainability and consistency across
grant cycles;
new text end
new text begin
(4) reviewing current data collection and evaluation; and
new text end
new text begin
(5) analyzing the impact on outcomes when a school has a school-linked mental health
program, a multi-tier system of supports, and sufficient school support personnel to meet
the needs of students.
new text end
new text begin
(b) The commissioner shall provide a report of the findings of the assessment and
recommendations, including any necessary statutory changes, to the legislative committees
with jurisdiction over mental health and education by January 15, 2020.
new text end
Sec. 37. new text begin OFFICER-INVOLVED COMMUNITY-BASED CARE COORDINATION;
PLANNING GRANTS.
new text end
new text begin
In fiscal year 2020, the commissioner shall award up to ten planning grants of up to
$10,000 available to counties and tribes to establish new officer-involved community-based
care coordination programs. An eligible applicant for a planning grant under this section is
a county or tribe that does not have a fully functioning officer-involved community-based
care coordination program and has not yet taken steps to implement an officer-involved
community-based care coordination program. Planning grant recipients may use grant funds
for the start-up costs of a new officer-involved community-based care coordination program,
including data platform design, data collection, and quarterly reporting.
new text end
Sec. 38. new text begin COMMUNITY COMPETENCY RESTORATION TASK FORCE.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; purpose. new text end
new text begin
The Community Competency Restoration Task
Force is established to evaluate and study community competency restoration programs and
develop recommendations to address the needs of individuals deemed incompetent to stand
trial.
new text end
new text begin Subd. 2. new text end
new text begin Membership. new text end
new text begin
(a) The Community Competency Restoration Task Force consists
of the following members, appointed as follows:
new text end
new text begin
(1) a representative appointed by the governor's office;
new text end
new text begin
(2) the commissioner of human services or designee;
new text end
new text begin
(3) the commissioner of corrections or designee;
new text end
new text begin
(4) a representative from direct care and treatment services with experience in competency
evaluations, appointed by the commissioner of human services;
new text end
new text begin
(5) a representative appointed by the designated State Protection and Advocacy system;
new text end
new text begin
(6) the ombudsman for mental health and developmental disabilities;
new text end
new text begin
(7) a representative appointed by the Minnesota Hospital Association;
new text end
new text begin
(8) a representative appointed by the Association of Minnesota Counties;
new text end
new text begin
(9) two representatives appointed by the Minnesota Association of County Social Service
Administrators: one from the seven-county metropolitan area, as defined under Minnesota
Statutes, section 473.121, subdivision 2, and one from outside the seven-county metropolitan
area;
new text end
new text begin
(10) a representative appointed by the Board of Public Defense;
new text end
new text begin
(11) a representative appointed by the Minnesota County Attorney Association;
new text end
new text begin
(12) a representative appointed by the Chiefs of Police;
new text end
new text begin
(13) a representative appointed by the Minnesota Psychiatric Society;
new text end
new text begin
(14) a representative appointed by the Minnesota Psychological Association;
new text end
new text begin
(15) a representative appointed by the State Court Administrator;
new text end
new text begin
(16) a representative appointed by the Minnesota Association of Community Mental
Health Programs;
new text end
new text begin
(17) a representative appointed by the Minnesota Sheriff's Association;
new text end
new text begin
(18) a representative appointed by the Sentencing Commission;
new text end
new text begin
(19) a jail administrator appointed by the commissioner of corrections;
new text end
new text begin
(20) a representative from an organization providing reentry services appointed by the
commissioner of corrections;
new text end
new text begin
(21) a representative from a mental health advocacy organization appointed by the
commissioner of human services;
new text end
new text begin
(22) a person with direct experience with competency restoration appointed by the
commissioner of human services;
new text end
new text begin
(23) representatives from organizations representing racial and ethnic groups
overrepresented in the justice system appointed by the commissioner of corrections; and
new text end
new text begin
(24) a crime victim appointed by the commissioner of corrections.
new text end
new text begin
(b) Appointments to the task force must be made no later than July 15, 2019, and members
of the task force may be compensated as provided under Minnesota Statutes, section 15.059,
subdivision 3.
new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin
The task force must:
new text end
new text begin
(1) identify current services and resources available for individuals in the criminal justice
system who have been found incompetent to stand trial;
new text end
new text begin
(2) analyze current trends of competency referrals by county and the impact of any
diversion projects or stepping-up initiatives;
new text end
new text begin
(3) analyze selected case reviews and other data to identify risk levels of those individuals,
service usage, housing status, and health insurance status prior to being jailed;
new text end
new text begin
(4) research how other states address this issue, including funding and structure of
community competency restoration programs, and jail-based programs; and
new text end
new text begin
(5) develop recommendations to address the growing number of individuals deemed
incompetent to stand trial including increasing prevention and diversion efforts, providing
a timely process for reducing the amount of time individuals remain in the criminal justice
system, determining how to provide and fund competency restoration services in the
community, and defining the role of the counties and state in providing competency
restoration.
new text end
new text begin Subd. 4. new text end
new text begin Officers; meetings. new text end
new text begin
(a) The commissioner of human services shall convene
the first meeting of the task force no later than August 1, 2019.
new text end
new text begin
(b) The task force must elect a chair and vice-chair from among its members and may
elect other officers as necessary.
new text end
new text begin
(c) The task force is subject to the Minnesota Open Meeting Law under Minnesota
Statutes, chapter 13D.
new text end
new text begin Subd. 5. new text end
new text begin Staff. new text end
new text begin
(a) The commissioner of human services must provide staff assistance
to support the task force's work.
new text end
new text begin
(b) The task force may utilize the expertise of the Council of State Governments Justice
Center.
new text end
new text begin Subd. 6. new text end
new text begin Report required. new text end
new text begin
(a) By February 1, 2020, the task force shall submit a report
on its progress and findings to the chairs and ranking minority members of the legislative
committees with jurisdiction over mental health and corrections.
new text end
new text begin
(b) By February 1, 2021, the task force must submit a written report including
recommendations to address the growing number of individuals deemed incompetent to
stand trial to the chairs and ranking minority members of the legislative committees with
jurisdiction over mental health and corrections.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
The task force expires upon submission of the report in subdivision
6, paragraph (b), or February 1, 2021, whichever is later.
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. 39. new text begin SPECIALIZED MENTAL HEALTH COMMUNITY SUPERVISION 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 Anoka County to develop and implement a pilot project from July 1, 2019, to June 30,
2021, to evaluate the impact of a coordinated, multidisciplinary service delivery approach
for offenders with mental illness who are on probation, parole, supervised release, or pretrial
status in Anoka County.
new text end
new text begin Subd. 2. new text end
new text begin Pilot project goals and design. new text end
new text begin
(a) The pilot project must provide enhanced
assessment, case management, treatment services, and community supervision for offenders
with mental illness who have symptoms or behavior resulting in heightened risk to harm
themselves or others, to recidivate, to commit violations of supervision, or to face
incarceration or reincarceration.
new text end
new text begin
(b) The goals of the pilot project are to:
new text end
new text begin
(1) improve mental health service delivery and supervision coordination through
establishment of a multidisciplinary caseload management team that must include at least
one probation officer and social services professional who share case management
responsibilities;
new text end
new text begin
(2) provide expedited assessment, diagnosis, and community-based treatment and
programming for acute symptom and behavior management;
new text end
new text begin
(3) enhance community supervision through a specialized caseload and team specifically
trained to work with individuals with mental illness;
new text end
new text begin
(4) offer community-based mental health treatment and programming alternatives to
incarceration if available and appropriate;
new text end
new text begin
(5) reduce incarceration related to unmanaged mental illness and technical violations;
new text end
new text begin
(6) eliminate or reduce duplication of services between county social services and
corrections; and
new text end
new text begin
(7) improve collaboration among, and reduce barriers between, criminal justice system
partners, county social services, and community service providers.
new text end
new text begin Subd. 3. new text end
new text begin Target population. new text end
new text begin
The target population of the pilot project is:
new text end
new text begin
(1) adult offenders on probation, parole, supervised release, or pretrial status in Anoka
County who have been assessed with significant or unmanaged mental illness or acute
symptoms that pose a risk to harm themselves or others, or increase their risk to recidivate
or commit technical violations of supervision;
new text end
new text begin
(2) adult offenders who receive county social service case management for mental illness
while under correctional supervision in Anoka County; and
new text end
new text begin
(3) adult offenders incarcerated in jail in Anoka County who have significant or
unmanaged mental illness and may be safely treated in a community setting under
correctional supervision.
new text end
new text begin Subd. 4. new text end
new text begin Evaluation and report. new text end
new text begin
By October 1, 2021, Anoka County must report to the
commissioner of human services on the impact and outcomes of the project.
new text end
Sec. 40. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2018, section 254B.03, subdivision 4a,
new text end
new text begin
is repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, parts 9530.6800; and 9530.6810,
new text end
new text begin
are repealed.
new text end
ARTICLE 4
CONTINUING CARE FOR OLDER ADULTS
Section 1.
Minnesota Statutes 2018, section 144A.073, is amended by adding a subdivision
to read:
new text begin Subd. 16. new text end
new text begin Moratorium exception funding. new text end
new text begin
In fiscal year 2020, the commissioner may
approve moratorium exception projects under this section for which the full annualized state
share of medical assistance costs does not exceed $2,000,000 plus any carryover of previous
appropriations for this purpose.
new text end
Sec. 2.
Minnesota Statutes 2018, section 256R.25, is amended to read:
256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to deleted text begin (n)deleted text end new text begin (o)new text end .
(b) For a facility licensed as a nursing home, the portion related to the provider surcharge
under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
nursing home and a boarding care home, the portion related to the provider surcharge under
section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
of nursing home beds divided by its total number of licensed beds.
(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
amount of the fee divided by the sum of the facility's resident days.
(d) The portion related to development and education of resident and family advisory
councils under section 144A.33 is $5 per resident day divided by 365.
(e) The portion related to scholarships is determined under section 256R.37.
(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
(g) The portion related to consolidation rate adjustments shall be as determined under
section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.
(h) The portion related to single-bed room incentives is as determined under section
256R.41.
(i) The portions related to real estate taxes, special assessments, and payments made in
lieu of real estate taxes directly identified or allocated to the nursing facility are the actual
amounts divided by the sum of the facility's resident days. Allowable costs under this
paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate
taxes shall not exceed the amount which the nursing facility would have paid to a city or
township and county for fire, police, sanitation services, and road maintenance costs had
real estate taxes been levied on that property for those purposes.
(j) The portion related to employer health insurance costs is the allowable costs divided
by the sum of the facility's resident days.
(k) The portion related to the Public Employees Retirement Association is actual costs
divided by the sum of the facility's resident days.
(l) The portion related to quality improvement incentive payment rate adjustments is
the amount determined under section 256R.39.
(m) The portion related to performance-based incentive payments is the amount
determined under section 256R.38.
(n) The portion related to special dietary needs is the amount determined under section
256R.51.
new text begin
(o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.
new text end
Sec. 3.
new text begin
[256R.481] RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
new text end
new text begin
(a)The commissioner shall allow each nonprofit nursing facility located within the
boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once
annually for a rate add-on to the facility's external fixed costs payment rate.
new text end
new text begin
(b) A facility seeking an add-on to its external fixed costs payment rate under this section
must apply annually to the commissioner to receive the add-on. A facility must submit the
application within 60 calendar days of the effective date of any add-on under this section.
The commissioner may waive the deadlines required by this paragraph under extraordinary
circumstances.
new text end
new text begin
(c) The commissioner shall provide the add-on to each eligible facility that applies by
the application deadline.
new text end
new text begin
(d) The add-on to the external fixed costs payment rate is the difference on January 1
of the median total payment rate for case mix classification PA1 of the nonprofit facilities
located in an adjacent city in another state and in cities contiguous to the adjacent city minus
the eligible nursing facility's total payment rate for case mix classification PA1 as determined
under section 256R.22, subdivision 4.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
The add-on to the external fixed costs payment rate described in
Minnesota Statutes, section 256R.481, is available for the rate years beginning on and after
January 1, 2021.
new text end
Sec. 4. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, section 256R.53, subdivision 2,
new text end
new text begin
is repealed effective January
1, 2021.
new text end
ARTICLE 5
DISABILITY SERVICES
Section 1.
Minnesota Statutes 2018, section 245A.03, subdivision 7, is amended to read:
Subd. 7.
Licensing moratorium.
(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a license is issued during this moratorium, and the license
holder changes the license holder's primary residence away from the physical location of
the foster care license, the commissioner shall revoke the license according to section
245A.07. The commissioner shall not issue an initial license for a community residential
setting licensed under chapter 245D. When approving an exception under this paragraph,
the commissioner shall consider the resource need determination process in paragraph (h),
the availability of foster care licensed beds in the geographic area in which the licensee
seeks to operate, the results of a person's choices during their annual assessment and service
plan review, and the recommendation of the local county board. The determination by the
commissioner is final and not subject to appeal. Exceptions to the moratorium include:
(1) foster care settings that are required to be registered under chapter 144D;
(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);
(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;
(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital level care;
(5) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner for the transition of people from personal care assistance to
the home and community-based services;
(6) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner for the transition of people from the residential care waiver
services to foster care services. This exception applies only when:
(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service to help the person make an informed choice;
and
(ii) the person's foster care services are less than or equal to the cost of the person's
services delivered in the residential care waiver service setting as determined by the lead
agency; or
(7) new foster care licenses or community residential setting licenses for people receiving
services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until June 30, deleted text begin 2018deleted text end new text begin 2019new text end . This exception is available when:
(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and
(ii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the unlicensed
setting as determined by the lead agencynew text begin ; or
new text end
new text begin (8) a vacancy in a setting granted an exception under clause (7), created between January
1, 2017, and the date of the exception request, by the departure of a person receiving services
under chapter 245D and residing in the unlicensed setting between January 1, 2017, and
May 1, 2017. This exception is available when the lead agency provides documentation to
the commissioner on the eligibility criteria being met. This exception is available until June
30, 2019new 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 deleted text begin served by the program moves out of adeleted text end new text begin for any reason
permanently vacates a bed in an adult new text end foster new text begin care new text end home that is not the primary residence of
the license holderdeleted text begin according to section 256B.49, subdivision 15, paragraph (f)deleted text end , or deleted text begin thedeleted text end new text begin a bed
in annew text end adult community residential setting, the county shall immediately inform the
deleted text begin Department of Human Services Licensing Divisiondeleted text end new text begin commissionernew text end . new text begin Within six months of
the second bed being permanently vacated, new text end the deleted text begin department maydeleted text end new text begin commissioner shall new text end decrease
the statewide licensed capacity for adult foster care settingsnew text begin by one bed for every two beds
vacatednew 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 determined under section 256B.493 will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet the
informed decisions of those people who want to move out of corporate foster care or
community residential settings, long-term service needs within budgetary limits, including
seeking proposals from service providers or lead agencies to change service type, capacity,
or location to improve services, increase the independence of residents, and better meet
needs identified by the long-term services and supports reports and statewide data and
information.
(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.
(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services
licensing division that the license holder provides or intends to provide these waiver-funded
services.
(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493. Annually, by August 1, the commissioner shall provide
information and data on capacity of licensed long-term services and supports, actions taken
under the subdivision to manage statewide long-term services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over the
health and human services budget.
(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019, except the amendment to
paragraph (a) adding clause (8) is effective retroactively from July 1, 2018, and applies to
exception requests made on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2018, section 245A.11, subdivision 2a, is amended to read:
Subd. 2a.
Adult foster care and community residential setting license capacity.
(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of deleted text begin fivedeleted text end new text begin up to sixnew text end beds,
including roomers and boarders, according to paragraphs (b) to (g).
(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.
(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.
(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to five, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.
(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to five, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:
(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;
(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;
(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and
(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.
(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of deleted text begin fivedeleted text end new text begin sixnew text end adults if the fifth deleted text begin bed doesdeleted text end new text begin and sixth beds donew text end not increase
the overall statewide capacity of licensed adult foster care or community residential setting
beds in homes that are not the primary residence of the license holder, as identified in a plan
submitted to the commissioner by the county, when the capacity is recommended by the
county licensing agency of the county in which the facility is located and if the
recommendation verifies that:
(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;
(2) the five-bed new text begin or six-bed new text end living arrangement is specified for each resident in the
resident's:
(i) individualized plan of care;
(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;
(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and
(4) the facility was licensed for adult foster care before deleted text begin March 1, 2011deleted text end new text begin June 30, 2016new text end .
(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after June 30, deleted text begin 2019deleted text end new text begin 2021new text end . The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before June 30, deleted text begin 2019deleted text end new text begin 2021new text end , to continue with a capacity
of five new text begin or six new text end adults if the license holder continues to comply with the requirements in
paragraph (f).
Sec. 3.
Minnesota Statutes 2018, section 245D.03, subdivision 1, is amended to read:
Subdivision 1.
Applicability.
(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.
(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:
(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end , and elderly waiver plans,
excluding out-of-home respite care provided to children in a family child foster care home
licensed under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care
license holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7,
and 8, or successor provisions; and section 245D.061 or successor provisions, which must
be stipulated in the statement of intended use required under Minnesota Rules, part
2960.3000, subpart 4;
(2) adult companion services as defined under the brain injury, community access for
disability inclusion,new text begin community alternative care,new text end and elderly waiver plans, excluding adult
companion services provided under the Corporation for National and Community Services
Senior Companion Program established under the Domestic Volunteer Service Act of 1973,
Public Law 98-288;
(3) personal support as defined under the developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end waiver
plan;
(4) 24-hour emergency assistance, personal emergency response as defined under the
community access for disability inclusion and developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end waiver
plans;
(5) night supervision services as defined under the brain injurynew text begin , community access for
disability inclusion, community alternative care, and developmental disabilitiesnew text end waiver deleted text begin plandeleted text end new text begin
plansnew text end ;
(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end , and elderly
waiver plans, excluding providers licensed by the Department of Health under chapter 144A
and those providers providing cleaning services only; and
(7) individual community living support under section 256B.0915, subdivision 3j.
(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:
(1) intervention services, including:
(i) deleted text begin behavioraldeleted text end new text begin positivenew text end support services as defined under the brain injury and community
access for disability inclusionnew text begin , community alternative care, and developmental disabilitiesnew text end
waiver plans;
(ii) in-home or out-of-home crisis respite services as defined under thenew text begin brain injury,
community access for disability inclusion, community alternative care, andnew text end developmental
deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end waiver deleted text begin plandeleted text end new text begin plansnew text end ; and
(iii) specialist services as defined under the currentnew text begin brain injury, community access for
disability inclusion, community alternative care, andnew text end developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end
waiver deleted text begin plandeleted text end new text begin plansnew text end ;
(2) in-home support services, including:
(i) in-home family support and supported living services as defined under the
developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end waiver plan;
(ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans;
(iii) semi-independent living services; and
(iv) individualized home supports services as defined under the brain injury, community
alternative care, and community access for disability inclusion waiver plans;
(3) residential supports and services, including:
(i) supported living services as defined under the developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end
waiver plan provided in a family or corporate child foster care residence, a family adult
foster care residence, a community residential setting, or a supervised living facility;
(ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting; and
(iii) residential services provided to more than four persons with developmental
disabilities in a supervised living facility, including ICFs/DD;
(4) day services, including:
(i) structured day services as defined under the brain injury waiver plan;
(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end waiver plan; and
(iii) prevocational services as defined under the brain injury and community access for
disability inclusion waiver plans; and
(5) employment exploration services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental deleted text begin disabilitydeleted text end new text begin
disabilitiesnew text end waiver plans;
(6) employment development services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental deleted text begin disabilitydeleted text end new text begin
disabilitiesnew text end waiver plans; and
(7) employment support services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental deleted text begin disabilitydeleted text end new text begin disabilitiesnew text end
waiver plans.
Sec. 4.
Minnesota Statutes 2018, section 245D.071, subdivision 5, is amended to read:
Subd. 5.
Service plan review and evaluation.
(a) The license holder must give the
person or the person's legal representative and case manager an opportunity to participate
in the ongoing review and development of the service plan and the methods used to support
the person and accomplish outcomes identified in subdivisions 3 and 4. new text begin At least once per
year, or within 30 days of a written request by the person, the person's legal representative,
or the case manager, new text end the license holder, in coordination with the person's support team or
expanded support team, must meet with the person, the person's legal representative, and
the case manager, and participate in service plan review meetings following stated timelines
established in the person's coordinated service and support plan or coordinated service and
support plan addendum deleted text begin or within 30 days of a written request by the person, the person's
legal representative, or the case manager, at a minimum of once per yeardeleted text end . The purpose of
the service plan review is to determine whether changes are needed to the service plan based
on the assessment information, the license holder's evaluation of progress towards
accomplishing outcomes, or other information provided by the support team or expanded
support team.
new text begin
(b) At least once per year, the license holder, in coordination with the person's support
team or expanded support team, must meet with the person, the person's legal representative,
and the case manager to discuss how technology might be used to meet the person's desired
outcomes. The coordinated service and support plan addendum must include a summary of
this discussion. The summary must include a statement regarding any decision made related
to the use of technology and a description of any further research that must be completed
before a decision regarding the use of technology can be made. Nothing in this paragraph
requires the coordinated service and support plan addendum to include the use of technology
for the provision of services.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end The license holder must summarize the person's status and progress toward
achieving the identified outcomes and make recommendations and identify the rationale
for changing, continuing, or discontinuing implementation of supports and methods identified
in subdivision 4 in a report available at the time of the progress review meeting. The report
must be sent at least five working days prior to the progress review meeting if requested by
the team in the coordinated service and support plan or coordinated service and support
plan addendum.
deleted text begin (c)deleted text end new text begin (d)new text end The license holder must send the coordinated service and support plan addendum
to the person, the person's legal representative, and the case manager by mail within ten
working days of the progress review meeting. Within ten working days of the mailing of
the coordinated service and support plan addendum, the license holder must obtain dated
signatures from the person or the person's legal representative and the case manager to
document approval of any changes to the coordinated service and support plan addendum.
deleted text begin (d)deleted text end new text begin (e)new text end If, within ten working days of submitting changes to the coordinated service and
support plan and coordinated service and support plan addendum, the person or the person's
legal representative or case manager has not signed and returned to the license holder the
coordinated service and support plan or coordinated service and support plan addendum or
has not proposed written modifications to the license holder's submission, the submission
is deemed approved and the coordinated service and support plan addendum becomes
effective and remains in effect until the legal representative or case manager submits a
written request to revise the coordinated service and support plan addendum.
Sec. 5.
Minnesota Statutes 2018, section 245D.09, subdivision 5, is amended to read:
Subd. 5.
Annual training.
A license holder must provide annual training to direct support
staff on the topics identified in subdivision 4, clauses (3) to (10). If the direct support staff
has a first aid certification, annual training under subdivision 4, clause (9), is not required
as long as the certification remains current. deleted text begin A license holder must provide a minimum of
24 hours of annual training to direct service staff providing intensive services and having
fewer than five years of documented experience and 12 hours of annual training to direct
service staff providing intensive services and having five or more years of documented
experience in topics described in subdivisions 4 and 4a, paragraphs (a) to (f). Training on
relevant topics received from sources other than the license holder may count toward training
requirements. A license holder must provide a minimum of 12 hours of annual training to
direct service staff providing basic services and having fewer than five years of documented
experience and six hours of annual training to direct service staff providing basic services
and having five or more years of documented experience.
deleted text end
Sec. 6.
Minnesota Statutes 2018, section 245D.09, subdivision 5a, is amended to read:
Subd. 5a.
Alternative sources of training.
deleted text begin
The commissioner may approve online
training and competency-based assessments in place of a specific number of hours of training
in the topics covered in subdivision 4. The commissioner must provide a list of preapproved
trainings that do not need approval for each individual license holder.
deleted text end
Orientation or training received by the staff person from sources other than the license
holder in the same subjects as identified in subdivision 4 may count toward the orientation
and annual training requirements if received in the 12-month period before the staff person's
date of hire. The license holder must maintain documentation of the training received from
other sources and of each staff person's competency in the required area according to the
requirements in subdivision 3.
Sec. 7.
Minnesota Statutes 2018, section 245D.091, subdivision 2, is amended to read:
Subd. 2.
deleted text begin Behaviordeleted text end new text begin Positive supportnew text end professional qualifications.
A deleted text begin behaviordeleted text end new text begin positive
supportnew text end professional providing deleted text begin behavioraldeleted text end new text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text begin anddeleted text end new text begin ,new text end community access for disability
inclusionnew text begin , community alternative care, and developmental disabilitiesnew text end waiver plans or
successor plans:
(1) ethical considerations;
(2) functional assessment;
(3) functional analysis;
(4) measurement of behavior and interpretation of data;
(5) selecting intervention outcomes and strategies;
(6) behavior reduction and elimination strategies that promote least restrictive approved
alternatives;
(7) data collection;
(8) staff and caregiver training;
(9) support plan monitoring;
(10) co-occurring mental disorders or neurocognitive disorder;
(11) demonstrated expertise with populations being served; and
(12) must be a:
(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board
of Psychology competencies in the above identified areas;
(ii) clinical social worker licensed as an independent clinical social worker under chapter
148D, or a person with a master's degree in social work from an accredited college or
university, with at least 4,000 hours of post-master's supervised experience in the delivery
of clinical services in the areas identified in clauses (1) to (11);
(iii) physician licensed under chapter 147 and certified by the American Board of
Psychiatry and Neurology or eligible for board certification in psychiatry with competencies
in the areas identified in clauses (1) to (11);
(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical
services who has demonstrated competencies in the areas identified in clauses (1) to (11);
(v) person with a master's degree from an accredited college or university in one of the
behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services with demonstrated competencies in the areas
identified in clauses (1) to (11); deleted text begin or
deleted text end
(vi)new text begin person with a master's degree or PhD in one of the behavioral sciences or related
fields with demonstrated expertise in positive support services; or
new text end
new text begin (vii)new text end registered nurse who is licensed under sections 148.171 to 148.285, and who is
certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
mental health nursing by a national nurse certification organization, or who has a master's
degree in nursing or one of the behavioral sciences or related fields from an accredited
college or university or its equivalent, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services.
Sec. 8.
Minnesota Statutes 2018, section 245D.091, subdivision 3, is amended to read:
Subd. 3.
deleted text begin Behaviordeleted text end new text begin Positive supportnew text end analyst qualifications.
(a) A deleted text begin behaviordeleted text end new text begin positive
supportnew text end analyst providing deleted text begin behavioraldeleted text end new text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text begin anddeleted text end new text begin ,new text end community access for disability
inclusionnew text begin , community alternative care, and developmental disabilitiesnew text end waiver plans or
successor plans:
(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
discipline; deleted text begin or
deleted text end
(2) meet the qualifications of a mental health practitioner as defined in section 245.462,
subdivision 17new text begin ; or
new text end
new text begin (3) be a board-certified behavior analyst or board-certified assistant behavior analyst by
the Behavior Analyst Certification Board, Incorporatednew text end .
(b) In addition, a deleted text begin behaviordeleted text end new text begin positive supportnew text end analyst must:
(1) have four years of supervised experience deleted text begin working with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorderdeleted text end new text begin
conducting functional behavior assessments and designing, implementing, and evaluating
effectiveness of positive practices behavior support strategies for people who exhibit
challenging behaviors as well as co-occurring mental disorders and neurocognitive disordernew text end ;
(2) have received deleted text begin ten hours of instruction in functional assessment and functional analysis;deleted text end new text begin
training prior to hire or within 90 calendar days of hire that includes:
new text end
new text begin
(i) ten hours of instruction in functional assessment and functional analysis;
new text end
new text begin
(ii) 20 hours of instruction in the understanding of the function of behavior;
new text end
new text begin
(iii) ten hours of instruction on design of positive practices behavior support strategies;
new text end
new text begin
(iv) 20 hours of instruction preparing written intervention strategies, designing data
collection protocols, training other staff to implement positive practice strategies,
summarizing and reporting program evaluation data, analyzing program evaluation data to
identify design flaws in behavioral interventions or failures in implementation fidelity, and
recommending enhancements based on evaluation data; and
new text end
new text begin
(v) eight hours of instruction on principles of person-centered thinking;
new text end
deleted text begin
(3) have received 20 hours of instruction in the understanding of the function of behavior;
deleted text end
deleted text begin
(4) have received ten hours of instruction on design of positive practices behavior support
strategies;
deleted text end
deleted text begin
(5) have received 20 hours of instruction on the use of behavior reduction approved
strategies used only in combination with behavior positive practices strategies;
deleted text end
deleted text begin (6)deleted text end new text begin (3)new text end be determined by a deleted text begin behaviordeleted text end new text begin positive supportnew text end professional to have the training
and prerequisite skills required to provide positive practice strategies as well as behavior
reduction approved and permitted intervention to the person who receives deleted text begin behavioraldeleted text end new text begin positivenew text end
support; and
deleted text begin (7)deleted text end new text begin (4)new text end be under the direct supervision of a deleted text begin behaviordeleted text end new text begin positive supportnew text end professional.
new text begin
(c) Meeting the qualifications for a positive support professional under subdivision 2
shall substitute for meeting the qualifications listed in paragraph (b).
new text end
Sec. 9.
Minnesota Statutes 2018, section 245D.091, subdivision 4, is amended to read:
Subd. 4.
deleted text begin Behaviordeleted text end new text begin Positive supportnew text end specialist qualifications.
(a) A deleted text begin behaviordeleted text end new text begin positive
supportnew text end specialist providing deleted text begin behavioraldeleted text end new text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text begin anddeleted text end new text begin ,new text end community access for disability
inclusionnew text begin , community alternative care, and developmental disabilitiesnew text end waiver plans or
successor plans:
(1) have an associate's degree in a social services discipline; or
(2) have two years of supervised experience working with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
(b) In addition, a behavior specialist must:
(1) have receivednew text begin training prior to hire or within 90 calendar days of hire that includes:
new text end
new text begin (i)new text end a minimum of four hours of training in functional assessment;
deleted text begin (2) have receiveddeleted text end new text begin (ii)new text end 20 hours of instruction in the understanding of the function of
behavior;
deleted text begin (3) have receiveddeleted text end new text begin (iii)new text end ten hours of instruction on design of positive practices behavioral
support strategies;new text begin and
new text end
new text begin
(iv) eight hours of instruction on principles of person-centered thinking;
new text end
deleted text begin (4)deleted text end new text begin (2)new text end be determined by a deleted text begin behaviordeleted text end new text begin positive supportnew text end professional to have the training
and prerequisite skills required to provide positive practices strategies as well as behavior
reduction approved intervention to the person who receives deleted text begin behavioraldeleted text end new text begin positivenew text end support;
and
deleted text begin (5)deleted text end new text begin (3)new text end be under the direct supervision of a deleted text begin behaviordeleted text end new text begin positive supportnew text end professional.
new text begin
(c) Meeting the qualifications for a positive support professional under subdivision 2
shall substitute for meeting the qualifications listed in paragraphs (a) and (b).
new text end
Sec. 10.
Minnesota Statutes 2018, section 252.275, subdivision 3, is amended to read:
Subd. 3.
Reimbursement.
Counties shall be reimbursed for all expenditures made
pursuant to subdivision 1 at a rate of deleted text begin 70deleted text end new text begin 85new text end percent, up to the allocation determined pursuant
to subdivisions 4 and 4b. However, the commissioner shall not reimburse costs of services
for any person if the costs exceed the state share of the average medical assistance costs for
services provided by intermediate care facilities for a person with a developmental disability
for the same fiscal year, and shall not reimburse costs of a onetime living allowance for any
person if the costs exceed $1,500 in a state fiscal year. The commissioner may make
payments to each county in quarterly installments. The commissioner may certify an advance
of up to 25 percent of the allocation. Subsequent payments shall be made on a reimbursement
basis for reported expenditures and may be adjusted for anticipated spending patterns.
Sec. 11.
new text begin
[256.488] ADAPTIVE FITNESS ACCESS GRANT.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) "Adaptive fitness" means the practice of physical fitness
by an individual with primary physical disabilities, either as a consequence of the natural
aging process or due to a developmental disability, mental health issue, congenital condition,
trauma, injury, or disease.
new text end
new text begin
(b) "Adaptive fitness center" means a center with modified equipment, equipment
arrangement and space for access, and trainers with skills in modifying exercise programs
specific to the physical and cognitive needs of individuals with disabilities.
new text end
new text begin
(c) "Commissioner" means the commissioner of human services.
new text end
new text begin
(d) "Disability" has the meaning given in the Americans with Disabilities Act.
new text end
new text begin Subd. 2. new text end
new text begin Establishment. new text end
new text begin
A statewide adaptive fitness access grant program is established
under the Department of Human Services to award grants to promote access to adaptive
fitness for individuals with disabilities.
new text end
new text begin Subd. 3. new text end
new text begin Application and review. new text end
new text begin
(a) The commissioner must develop a grant application
that must contain, at a minimum:
new text end
new text begin
(1) a description of the purpose or project for which the grant will be used;
new text end
new text begin
(2) a description of the specific problem the grant intends to address;
new text end
new text begin
(3) a description of achievable objectives, a work plan, and a timeline for implementation
and completion of processes or projects enabled by the grant;
new text end
new text begin
(4) a description of the existing frameworks and experience providing adaptive fitness;
and
new text end
new text begin
(5) a proposed process for documenting and evaluating results of the grant.
new text end
new text begin
(b) An applicant must apply using the grant application developed by the commissioner.
new text end
new text begin
(c) The commissioner shall review each application. The commissioner shall establish
criteria to evaluate applications, including but not limited to:
new text end
new text begin
(1) the application is complete;
new text end
new text begin
(2) the eligibility of the applicant;
new text end
new text begin
(3) the thoroughness and clarity in identifying the specific problem the grant intends to
address;
new text end
new text begin
(4) a description of the population demographics and service area of the proposed project;
new text end
new text begin
(5) documentation the grant applicant has received cash or in-kind contributions of value
equal to the requested grant amount; and
new text end
new text begin
(6) the proposed project's longevity and demonstrated financial sustainability after the
initial grant period.
new text end
new text begin
(d) In evaluating applications, the commissioner may request additional information
regarding a proposed project, including information on project cost. An applicant's failure
to timely provide the information requested disqualifies an applicant.
new text end
new text begin Subd. 4. new text end
new text begin Awards. new text end
new text begin
(a) The commissioner shall award grants to eligible applicants to
provide adaptive fitness for individuals with disabilities.
new text end
new text begin
(b) The commissioner shall award grants to qualifying nonprofit organizations that
provide adaptive fitness in adaptive fitness centers. Grants must be used to assist one or
more qualified nonprofit organizations to provide adaptive fitness, including: (1) stay fit;
(2) activity-based locomotor exercise; (3) equipment necessary for adaptive fitness programs;
(4) operating expenses related to staffing of adaptive fitness programs; and (5) other adaptive
fitness programs as deemed appropriate by the commissioner.
new text end
new text begin
(c) An applicant may apply for and the commissioner may award grants for two-year
periods, and the commissioner shall determine the number of grants awarded. The
commissioner may reallocate underspending among grantees within the same grant period.
new text end
new text begin Subd. 5. new text end
new text begin Report. new text end
new text begin
Beginning December 1, 2020, and every two years thereafter, the
commissioner of human services shall submit a report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services.
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. 12.
Minnesota Statutes 2018, section 256B.0625, subdivision 19a, is amended to
read:
Subd. 19a.
Personal care assistance services.
Medical assistance covers personal care
assistance services in a recipient's home. Effective January 1, deleted text begin 2010deleted text end new text begin 2020new text end , to qualify for
personal care assistance services, a recipient must require assistance and be determined
dependent in one new text begin critical new text end activity of daily living as defined in section 256B.0659, subdivision
1, paragraph deleted text begin (b)deleted text end new text begin (e)new text end , or in a Level I behavior as defined in section 256B.0659, subdivision
1, paragraph (c)new text begin , or have a behavior that shows increased vulnerability due to cognitive
deficits or socially inappropriate behavior that requires assistance at least four times per
weeknew text end . Recipients or responsible parties must be able to identify the recipient's needs, direct
and evaluate task accomplishment, and provide for health and safety. Approved hours may
be used outside the home when normal life activities take them outside the home. To use
personal care assistance 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. Total hours for services, whether actually performed inside
or outside the recipient's home, cannot exceed that which is otherwise allowed for personal
care assistance services in an in-home setting according to sections 256B.0651 to 256B.0654.
Medical assistance does not cover personal care assistance services for residents of a hospital,
nursing facility, intermediate care facility, health care facility licensed by the commissioner
of health, or unless a resident who is otherwise eligible is on leave from the facility and the
facility either pays for the personal care assistance services or forgoes the facility per diem
for the leave days that personal care assistance services are used. All personal care assistance
services must be provided according to sections 256B.0651 to 256B.0654. Personal care
assistance services may not be reimbursed if the personal care assistant is the spouse or paid
guardian of the recipient or the parent of a recipient under age 18, or the responsible party
or the family foster care provider of a recipient who cannot direct the recipient's own care
unless, in the case of a foster care provider, a county or state case manager visits the recipient
as needed, but not less than every six months, to monitor the health and safety of the recipient
and to ensure the goals of the care plan are met. Notwithstanding the provisions of section
256B.0659, the unpaid guardian or conservator of an adult, who is not the responsible party
and not the personal care provider organization, may be reimbursed to provide personal
care assistance services to the recipient if the guardian or conservator meets all criteria for
a personal care assistant according to section 256B.0659, and shall not be considered to
have a service provider interest for purposes of participation on the screening team under
section 256B.092, subdivision 7.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, or upon federal approval,
whichever is later. The commissioner shall implement the modified eligibility criteria as
annual assessments occur. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end
Sec. 13.
Minnesota Statutes 2018, section 256B.0652, subdivision 6, is amended to read:
Subd. 6.
Authorization; personal care assistance and qualified professional.
(a) All
personal care assistance services, supervision by a qualified professional, and additional
services beyond the limits established in subdivision 11, must be authorized by the
commissioner or the commissioner's designee before services begin except for the
assessments established in subdivision 11 and section 256B.0911. The authorization for
personal care assistance and qualified professional services under section 256B.0659 must
be completed within 30 days after receiving a complete request.
(b) The amount of personal care assistance services authorized must be based on the
recipient's home care rating. The home care rating shall be determined by the commissioner
or the commissioner's designee based on information submitted to the commissioner
identifying the following for recipients with dependencies in two or more activities of daily
living:
(1) total number of dependencies of activities of daily living as defined in section
256B.0659;
(2) presence of complex health-related needs as defined in section 256B.0659; and
(3) presence of Level I behavior as defined in section 256B.0659.
(c) For purposes meeting the criteria in paragraph (b), the methodology to determine
total time for personal care assistance services for each home care rating is based on the
median paid units per day for each home care rating from fiscal year 2007 data for the
personal care assistance program. Each home care rating has a base level of hours assigned.
Additional time is added through the assessment and identification of the following:
(1) 30 additional minutes per day for a dependency in each critical activity of daily living
as defined in section 256B.0659;
(2) 30 additional minutes per day for each complex health-related function as defined
in section 256B.0659; and
(3) 30 additional minutes per day for each behavior issue as defined in section 256B.0659,
subdivision 4, paragraph (d).
(d) Effective July 1, 2011, the home care rating for recipients who have a dependency
in one activity of daily living or Level I behavior shall equal no more than two units per
day. new text begin Effective January 1, 2020, the home care rating for recipients who have a dependency
in one critical activity of daily living or one Level I behavior or that require assistance with
a behavior that shows increased vulnerability due to cognitive deficits or socially
inappropriate behavior at least four times per week shall equal no more than two units per
day. new text end Recipients with this home care rating are not subject to the methodology in paragraph
(c) and are not eligible for more than two units per day.
(e) A limit of 96 units of qualified professional supervision may be authorized for each
recipient receiving personal care assistance services. A request to the commissioner to
exceed this total in a calendar year must be requested by the personal care provider agency
on a form approved by the commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, or upon federal approval,
whichever is later. The commissioner shall implement the modified eligibility criteria as
annual assessments occur. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end
Sec. 14.
Minnesota Statutes 2018, section 256B.0658, is amended to read:
256B.0658 HOUSING ACCESS GRANTS.
The commissioner of human services shall award through a competitive process contracts
for grants to public and private agencies to support and assist individuals deleted text begin eligible for publicly
funded home and community-based services, including state plan home caredeleted text end new text begin with a disability
as defined in section 256B.051, subdivision 2, paragraph (e)new text end , to access housing. Grants may
be awarded to agencies that may include, but are not limited to, the following supports:
assessment to ensure suitability of housing, accompanying an individual to look at housing,
filling out applications and rental agreements, meeting with landlords, helping with Section
8 or other program applications, helping to develop a budget, obtaining furniture and
household goods, if necessary, and assisting with any problems that may arise with housing.
Sec. 15.
Minnesota Statutes 2018, section 256B.0659, subdivision 3a, is amended to read:
Subd. 3a.
Assessment; defined.
(a) "Assessment" means a review and evaluation of a
recipient's need for personal care assistance services conducted in person. Assessments for
personal care assistance services shall be conducted by the county public health nurse or a
certified public health nurse under contract with the county except when a long-term care
consultation assessment is being conducted for the purposes of determining a person's
eligibility for home and community-based waiver services including personal care assistance
services according to section 256B.0911. new text begin During the transition to MnCHOICES, a certified
assessor may complete the assessment defined in this subdivision. new text end An in-person assessment
must include: documentation of health status, determination of need, evaluation of service
effectiveness, identification of appropriate services, service plan development or modification,
coordination of services, referrals and follow-up to appropriate payers and community
resources, completion of required reports, recommendation of service authorization, and
consumer education. Once the need for personal care assistance services is determined under
this section, the county public health nurse or certified public health nurse under contract
with the county is responsible for communicating this recommendation to the commissioner
and the recipient. An in-person assessment must occur at least annually or when there is a
significant change in the recipient's condition or when there is a change in the need for
personal care assistance services. A service update may substitute for the annual face-to-face
assessment when there is not a significant change in recipient condition or a change in the
need for personal care assistance service. A service update may be completed by telephone,
used when there is no need for an increase in personal care assistance services, and used
for two consecutive assessments if followed by a face-to-face assessment. A service update
must be completed on a form approved by the commissioner. A service update or review
for temporary increase includes a review of initial baseline data, evaluation of service
effectiveness, redetermination of service need, modification of service plan and appropriate
referrals, update of initial forms, obtaining service authorization, and on going consumer
education. Assessments or reassessments must be completed on forms provided by the
commissioner within 30 days of a request for home care services by a recipient or responsible
party.
(b) This subdivision expires when notification is given by the commissioner as described
in section 256B.0911, subdivision 3a.
Sec. 16.
Minnesota Statutes 2018, section 256B.0659, subdivision 11, is amended to read:
Subd. 11.
Personal care assistant; requirements.
(a) A personal care assistant must
meet the following requirements:
(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of
age with these additional requirements:
(i) supervision by a qualified professional every 60 days; and
(ii) employment by only one personal care assistance provider agency responsible for
compliance with current labor laws;
(2) be employed by a personal care assistance provider agency;
(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:
(i) not disqualified under section 245C.14; or
(ii) is disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;
(4) be able to effectively communicate with the recipient and personal care assistance
provider agency;
(5) be able to provide covered personal care assistance services according to the recipient's
personal care assistance care plan, respond appropriately to recipient needs, and report
changes in the recipient's condition to the supervising qualified professional or physician;
(6) not be a consumer of personal care assistance services;
(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;
(8) effective January 1, 2010, complete standardized training as determined by the
commissioner before completing enrollment. The training must be available in languages
other than English and to those who need accommodations due to disabilities. Personal care
assistant training must include successful completion of the following training components:
basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic
roles and responsibilities of personal care assistants including information about assistance
with lifting and transfers for recipients, emergency preparedness, orientation to positive
behavioral practices, fraud issues, and completion of time sheets. Upon completion of the
training components, the personal care assistant must demonstrate the competency to provide
assistance to recipients;
(9) complete training and orientation on the needs of the recipient; and
(10) be limited to providing and being paid for up to 275 hours per month of personal
care assistance services regardless of the number of recipients being served or the number
of personal care assistance provider agencies enrolled with. The number of hours worked
per day shall not be disallowed by the department unless in violation of the law.
(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).
(c) Persons who do not qualify as a personal care assistant include parents, stepparents,
and legal guardians of minors; spouses; paid legal guardians of adults; family foster care
providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of
a residential setting.
new text begin
(d) Personal care assistance services qualify for the enhanced rate described in subdivision
17a if the personal care assistant providing the services:
new text end
new text begin
(1) provides services, according to the care plan in subdivision 7, to a recipient who
qualifies for ten or more hours per day of personal care assistance services; and
new text end
new text begin
(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in Code of
Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved training
or competency requirements.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 17.
Minnesota Statutes 2018, section 256B.0659, is amended by adding a subdivision
to read:
new text begin Subd. 17a. new text end
new text begin Enhanced rate. new text end
new text begin
An enhanced rate of 110 percent of the rate paid for personal
care assistance services shall be paid for services provided to persons who qualify for ten
or more hours of personal care assistance service per day when provided by a personal care
assistant who meets the requirements of subdivision 11, paragraph (d). The enhanced rate
for personal care assistance services includes, and is not in addition to, any rate adjustments
implemented by the commissioner to comply with the terms of a collective bargaining
agreement between the state of Minnesota and an exclusive representative of individual
providers under section 179A.54 for increased financial incentives for providing services
to people with complex needs.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 18.
Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
Subd. 21.
Requirements for provider enrollment of personal care assistance provider
agencies.
(a) All personal care assistance provider agencies must provide, at the time of
enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
a format determined by the commissioner, information and documentation that includes,
but is not limited to, the following:
(1) the personal care assistance provider agency's current contact information including
address, telephone number, and e-mail address;
(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid
revenue in the previous calendar year is up to and including $300,000, the provider agency
must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is
over $300,000, the provider agency must purchase a surety bond of $100,000. The surety
bond must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
(3) proof of fidelity bond coverage in the amount of $20,000;
(4) proof of workers' compensation insurance coverage;
(5) proof of liability insurance;
(6) a description of the personal care assistance provider agency's organization identifying
the names of all owners, managing employees, staff, board of directors, and the affiliations
of the directors, owners, or staff to other service providers;
(7) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety including process for notification and resolution of consumer
grievances, identification and prevention of communicable diseases, and employee
misconduct;
(8) copies of all other forms the personal care assistance provider agency uses in the
course of daily business including, but not limited to:
(i) a copy of the personal care assistance provider agency's time sheet if the time sheet
varies from the standard time sheet for personal care assistance services approved by the
commissioner, and a letter requesting approval of the personal care assistance provider
agency's nonstandard time sheet;
(ii) the personal care assistance provider agency's template for the personal care assistance
care plan; and
(iii) the personal care assistance provider agency's template for the written agreement
in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
(9) a list of all training and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;
(10) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this sectionnew text begin , including the requirements
under subdivision 11, paragraph (d), if enhanced personal care assistance services are
provided and submitted for an enhanced rate under subdivision 17anew text end ;
(11) documentation of the agency's marketing practices;
(12) disclosure of ownership, leasing, or management of all residential properties that
is used or could be used for providing home care services;
(13) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services for
employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
care assistance choice option and 72.5 percent of revenue from other personal care assistance
providers. The revenue generated by the qualified professional and the reasonable costs
associated with the qualified professional shall not be used in making this calculation; and
(14) effective May 15, 2010, documentation that the agency does not burden recipients'
free exercise of their right to choose service providers by requiring personal care assistants
to sign an agreement not to work with any particular personal care assistance recipient or
for another personal care assistance provider agency after leaving the agency and that the
agency is not taking action on any such agreements or requirements regardless of the date
signed.
(b) Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider agency
enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
the information specified in paragraph (a) from all personal care assistance providers
beginning July 1, 2009.
(c) All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before enrollment of the agency as a provider. Employees
in management and supervisory positions and owners who are active in the day-to-day
operations of an agency who have completed the required training as an employee with a
personal care assistance provider agency do not need to repeat the required training if they
are hired by another agency, if they have completed the training within the past three years.
By September 1, 2010, the required training must be available with meaningful access
according to title VI of the Civil Rights Act and federal regulations adopted under that law
or any guidance from the United States Health and Human Services Department. The
required training must be available online or by electronic remote connection. The required
training must provide for competency testing. Personal care assistance provider agency
billing staff shall complete training about personal care assistance program financial
management. This training is effective July 1, 2009. Any personal care assistance provider
agency enrolled before that date shall, if it has not already, complete the provider training
within 18 months of July 1, 2009. Any new owners or employees in management and
supervisory positions involved in the day-to-day operations are required to complete
mandatory training as a requisite of working for the agency. Personal care assistance provider
agencies certified for participation in Medicare as home health agencies are exempt from
the training required in this subdivision. When available, Medicare-certified home health
agency owners, supervisors, or managers must successfully complete the competency test.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 19.
Minnesota Statutes 2018, section 256B.0659, subdivision 24, is amended to read:
Subd. 24.
Personal care assistance provider agency; general duties.
A personal care
assistance provider agency shall:
(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;
(2) comply with general medical assistance coverage requirements;
(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;
(4) comply with background study requirements;
(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;
(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;
(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;
(8) withhold and pay all applicable federal and state taxes;
(9) deleted text begin effective January 1, 2010,deleted text end document that the agency uses a minimum of 72.5 percent
of the revenue generated by the medical assistance rate for personal care assistance services
for employee personal care assistant wages and benefits. The revenue generated by the
qualified professional and the reasonable costs associated with the qualified professional
shall not be used in making this calculation;
(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;
(11) enter into a written agreement under subdivision 20 before services are provided;
(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;
(13) provide the recipient with a copy of the home care bill of rights at start of service;
deleted text begin and
deleted text end
(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissionerdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(15) document that the agency uses the additional revenue due to the enhanced rate under
subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements
under subdivision 11, paragraph (d).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 20.
Minnesota Statutes 2018, section 256B.0659, subdivision 28, is amended to read:
Subd. 28.
Personal care assistance provider agency; required documentation.
(a)
Required documentation must be completed and kept in the personal care assistance provider
agency file or the recipient's home residence. The required documentation consists of:
(1) employee files, including:
(i) applications for employment;
(ii) background study requests and results;
(iii) orientation records about the agency policies;
(iv) trainings completed with demonstration of competencenew text begin , including verification of
the completion of training required under subdivision 11, paragraph (d), for any services
billed at the enhanced rate under subdivision 17anew text end ;
(v) supervisory visits;
(vi) evaluations of employment; and
(vii) signature on fraud statement;
(2) recipient files, including:
(i) demographics;
(ii) emergency contact information and emergency backup plan;
(iii) personal care assistance service plan;
(iv) personal care assistance care plan;
(v) month-to-month service use plan;
(vi) all communication records;
(vii) start of service information, including the written agreement with recipient; and
(viii) date the home care bill of rights was given to the recipient;
(3) agency policy manual, including:
(i) policies for employment and termination;
(ii) grievance policies with resolution of consumer grievances;
(iii) staff and consumer safety;
(iv) staff misconduct; and
(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
resolution of consumer grievances;
(4) time sheets for each personal care assistant along with completed activity sheets for
each recipient served; and
(5) agency marketing and advertising materials and documentation of marketing activities
and costs.
(b) The commissioner may assess a fine of up to $500 on provider agencies that do not
consistently comply with the requirements of this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 21.
Minnesota Statutes 2018, section 256B.0911, subdivision 1a, is amended to read:
Subd. 1a.
Definitions.
For purposes of this section, the following definitions apply:
(a) Until additional requirements apply under paragraph (b), "long-term care consultation
services" means:
(1) intake for and access to assistance in identifying services needed to maintain an
individual in the most inclusive environment;
(2) providing recommendations for and referrals to cost-effective community services
that are available to the individual;
(3) development of an individual's person-centered community support plan;
(4) providing information regarding eligibility for Minnesota health care programs;
(5) face-to-face long-term care consultation assessments, which may be completed in a
hospital, nursing facility, intermediate care facility for persons with developmental disabilities
(ICF/DDs), regional treatment centers, or the person's current or planned residence;
(6) determination of home and community-based waiver and other service eligibility as
required under sections 256B.0913, 256B.0915, new text begin 256B.092,new text end and 256B.49, including level
of care determination for individuals who need an institutional level of care as determined
under subdivision 4e, based on assessment and community support plan development,
appropriate referrals to obtain necessary diagnostic information, and including an eligibility
determination for consumer-directed community supports;
(7) providing recommendations for institutional placement when there are no
cost-effective community services available;
(8) providing access to assistance to transition people back to community settings after
institutional admission; and
(9) providing information about competitive employment, with or without supports, for
school-age youth and working-age adults and referrals to the Disability Linkage Line and
Disability Benefits 101 to ensure that an informed choice about competitive employment
can be made. For the purposes of this subdivision, "competitive employment" means work
in the competitive labor market that is performed on a full-time or part-time basis in an
integrated setting, and for which an individual is compensated at or above the minimum
wage, but not less than the customary wage and level of benefits paid by the employer for
the same or similar work performed by individuals without disabilities.
(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c,
and 3a, "long-term care consultation services" also means:
(1) service eligibility determination for state plan deleted text begin home caredeleted text end services identified in:
(i) section 256B.0625, subdivisions deleted text begin 7deleted text end deleted text begin ,deleted text end 19adeleted text begin ,deleted text end and 19c;
(ii) consumer support grants under section 256.476; or
(iii) section 256B.85;
(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
deleted text begin determination of eligibility fordeleted text end new text begin gaining access tonew text end case management services available under
sections 256B.0621, subdivision 2, deleted text begin paragraphdeleted text end new text begin clausenew text end (4), deleted text begin anddeleted text end 256B.0924new text begin ,new text end and Minnesota
Rules, part 9525.0016;
(3) determination deleted text begin of institutional level of care, home and community-based service
waiver, and other servicedeleted text end new text begin ofnew text end eligibility deleted text begin as required under section deleted text end deleted text begin , determination
of eligibility for family support grants under section 252.32,deleted text end new text begin fornew text end semi-independent living
services under section 252.275deleted text begin , and day training and habilitation services under section
deleted text end ; and
(4) obtaining necessary diagnostic information to determine eligibility under clauses (2)
and (3).
(c) "Long-term care options counseling" means the services provided by the linkage
lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also
includes telephone assistance and follow up once a long-term care consultation assessment
has been completed.
(d) "Minnesota health care programs" means the medical assistance program under this
chapter and the alternative care program under section 256B.0913.
(e) "Lead agencies" means counties administering or tribes and health plans under
contract with the commissioner to administer long-term care consultation assessment and
support planning services.
(f) "Person-centered planning" is a process that includes the active participation of a
person in the planning of the person's services, including in making meaningful and informed
choices about the person's own goals, talents, and objectives, as well as making meaningful
and informed choices about the services the person receives. For the purposes of this section,
"informed choice" means a voluntary choice of services by a person from all available
service options based on accurate and complete information concerning all available service
options and concerning the person's own preferences, abilities, goals, and objectives. In
order for a person to make an informed choice, all available options must be developed and
presented to the person to empower the person to make decisions.
Sec. 22.
Minnesota Statutes 2018, section 256B.0911, subdivision 3a, is amended to read:
Subd. 3a.
Assessment and support planning.
(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment in order to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on which an assessment was requested or recommended. Upon statewide implementation
of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
requesting personal care assistance services deleted text begin and home care nursing. The commissioner shall
provide at least a 90-day notice to lead agencies prior to the effective date of this requirementdeleted text end .
Face-to-face assessments must be conducted according to paragraphs (b) to (i).
(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.
(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, new text begin conversation-based,new text end person-centered assessment.
The assessment must include the health, psychological, functional, environmental, and
social needs of the individual necessary to develop a community support plan that meets
the individual's needs and preferences.
(d) The assessment must be conducted in a face-to-face new text begin conversationalnew text end interview with
the person being assessed deleted text begin anddeleted text end new text begin .new text end The person's legal representativenew text begin must provide input during
the assessment process and may do so remotely if requestednew text end . At the request of the person,
other individuals may participate in the assessment to provide information on the needs,
strengths, and preferences of the person necessary to develop a community support plan
that ensures the person's health and safety. Except for legal representatives or family members
invited by the person, persons participating in the assessment may not be a provider of
service or have any financial interest in the provision of services. For persons who are to
be assessed for elderly waiver customized living or adult day services under section
256B.0915, with the permission of the person being assessed or the person's designated or
legal representative, the client's current or proposed provider of services may submit a copy
of the provider's nursing assessment or written report outlining its recommendations regarding
the client's care needs. The person conducting the assessment must notify the provider of
the date by which this information is to be submitted. This information shall be provided
to the person conducting the assessment prior to the assessment. For a person who is to be
assessed for waiver services under section 256B.092 or 256B.49, with the permission of
the person being assessed or the person's designated legal representative, the person's current
provider of services may submit a written report outlining recommendations regarding the
person's care needs deleted text begin 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 reassessmentdeleted text end new text begin the person
completed in consultation with someone who is known to the person and has interaction
with the person on a regular basis. The provider must submit the report at least 60 days
before the end of the person's current service agreement. The certified assessor must consider
the content of the submitted report prior to finalizing the person's assessment or reassessmentnew text end .
(e) new text begin The certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit.new text end The
person or the person's legal representative must be provided with a written community
support plan within deleted text begin 40 calendar days of the assessment visitdeleted text end new text begin the timelines established by
the commissionernew text end , regardless of whether the deleted text begin individualdeleted text end new text begin personnew text end is eligible for Minnesota
health care programs.
(f) For a person being assessed for elderly waiver services under section 256B.0915, a
provider who submitted information under paragraph (d) shall receive the final written
community support plan when available and the Residential Services Workbook.
(g) The written community support plan must include:
(1) a summary of assessed needs as defined in paragraphs (c) and (d);
(2) the individual's options and choices to meet identified needs, including all available
options for case management services and providers, including service provided in a
non-disability-specific setting;
(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;
(4) referral information; and
(5) informal caregiver supports, if applicable.
For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.
(h) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person must be transferred or referred to long-term care options counseling
services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
telephone assistance and follow up.
(i) The person has the right to make the final decision between institutional placement
and community placement after the recommendations have been provided, except as provided
in section 256.975, subdivision 7a, paragraph (d).
(j) The lead agency must give the person receiving assessment or support planning, or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:
(1) written recommendations for community-based services and consumer-directed
options;
(2) documentation that the most cost-effective alternatives available were offered to the
individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;
(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the individual selects nursing facility placement, the lead
agency shall forward information needed to complete the level of care determinations and
screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;
(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, and state plan home care, case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);
(5) information about Minnesota health care programs;
(6) the person's freedom to accept or reject the recommendations of the team;
(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;
(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b); and
(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3. new text begin The certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated.
new text end
(k) Face-to-face assessment completed as part of eligibility determination for the
alternative care, elderly waiver, new text begin developmental disabilities, new text end community access for disability
inclusion, community alternative care, and brain injury waiver programs under sections
256B.0913, 256B.0915, new text begin 256B.092, new text end and 256B.49 is valid to establish service eligibility for
no more than 60 calendar days after the date of assessment.
(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.
(m) If an eligibility update is completed within 90 days of the previous face-to-face
assessment and documented in the department's Medicaid Management Information System
(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
of the previous face-to-face assessment when all other eligibility requirements are met.
(n) At the time of reassessment, the certified assessor shall assess each person receiving
waiver services currently residing in a community residential setting, or licensed adult foster
care home that is not the primary residence of the license holder, or in which the license
holder is not the primary caregiver, to determine if that person would prefer to be served in
a community-living setting as defined in section 256B.49, subdivision 23. The certified
assessor shall offer the person, through a person-centered planning process, the option to
receive alternative housing and service options.
Sec. 23.
Minnesota Statutes 2018, section 256B.0911, subdivision 3f, is amended to read:
Subd. 3f.
Long-term care reassessments and community support plan updates.
new text begin (a)
Prior to a face-to-face reassessment, the certified assessor must review the person's most
recent assessment.new text end Reassessments must be tailored using the professional judgment of the
assessor to the person's known needs, strengths, preferences, and circumstances.
Reassessments provide information to support the person's informed choice and opportunities
to express choice regarding activities that contribute to quality of life, as well as information
and opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments deleted text begin allow fordeleted text end new text begin requirenew text end a review of new text begin the most recent
assessment, review ofnew text end the current new text begin coordinated service and new text end support plan's effectiveness,
monitoring of services, and the development of an updated person-centered community
support plan. Reassessments verify continued eligibility or offer alternatives as warranted
and provide an opportunity for quality assurance of service delivery. Face-to-face deleted text begin assessmentsdeleted text end new text begin
reassessmentsnew text end must be conducted annually or as required by federal and state laws and rules.new text begin
For reassessments, the certified assessor and the individual responsible for developing the
coordinated service and support plan must ensure the continuity of care for the person
receiving services and complete the updated community support plan and the updated
coordinated service and support plan no more than 60 days from the reassessment visit.
new text end
new text begin
(b) The commissioner shall develop mechanisms for providers and case managers to
share information with the assessor to facilitate a reassessment and support planning process
tailored to the person's current needs and preferences.
new text end
Sec. 24.
Minnesota Statutes 2018, section 256B.0911, is amended by adding a subdivision
to read:
new text begin Subd. 3g. new text end
new text begin Assessments for Rule 185 case management. new text end
new text begin
Unless otherwise required by
federal law, the county agency is not required to conduct or arrange for an annual needs
reassessment by a certified assessor. The case manager who works on behalf of the person
to identify the person's needs and to minimize the impact of the disability on the person's
life must instead develop a person-centered service plan based on the person's assessed
needs and preferences. The person-centered service plan must be reviewed annually for
persons with developmental disabilities who are receiving only case management services
under Minnesota Rules, part 9525.0036, and who make an informed choice to decline an
assessment under this section.
new text end
Sec. 25.
Minnesota Statutes 2018, section 256B.0911, subdivision 5, is amended to read:
Subd. 5.
Administrative activity.
(a) The commissioner shall streamline the processes,
including timelines for when assessments need to be completed, required to provide the
services in this section and shall implement integrated solutions to automate the business
processes to the extent necessary for community support plan approval, reimbursement,
program planning, evaluation, and policy development.
(b) The commissioner of human services shall work with lead agencies responsible for
conducting long-term consultation services to modify the MnCHOICES application and
assessment policies to create efficiencies while ensuring federal compliance with medical
assistance and long-term services and supports eligibility criteria.
new text begin
(c) The commissioner shall work with lead agencies responsible for conducting long-term
consultation services to develop a set of measurable benchmarks sufficient to demonstrate
quarterly improvement in the average time per assessment and other mutually agreed upon
measures of increasing efficiency. The commissioner shall collect data on these benchmarks
and provide to the lead agencies and the chairs and ranking minority members of the
legislative committees with jurisdiction over human services an annual trend analysis of
the data in order to demonstrate the commissioner's compliance with the requirements of
this subdivision.
new text end
Sec. 26.
Minnesota Statutes 2018, section 256B.0915, subdivision 6, is amended to read:
Subd. 6.
Implementation of coordinated service and support plan.
(a) Each elderly
waiver client shall be provided a copy of a written coordinated service and support plan
deleted text begin whichdeleted text end new text begin thatnew text end :
(1) is developed new text begin with new text end and signed by the recipient within deleted text begin ten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessordeleted text end new text begin the timelines
established by the commissioner. The timeline for completing the community support plan
under section 256B.0911, subdivision 3a, and the coordinated service and support plan must
not exceed 60 calendar days from the assessment visitnew text end ;
(2) includes the person's need for service and identification of service needs that will be
or that are met by the person's relatives, friends, and others, as well as community services
used by the general public;
(3) reasonably ensures the health and welfare of the recipient;
(4) identifies the person's preferences for services as stated by the person or the person's
legal guardian or conservator;
(5) reflects the person's informed choice between institutional and community-based
services, as well as choice of services, supports, and providers, including available case
manager providers;
(6) identifies long-range and short-range goals for the person;
(7) identifies specific services and the amount, frequency, duration, and cost of the
services to be provided to the person based on assessed needs, preferences, and available
resources;
(8) includes information about the right to appeal decisions under section 256.045; and
(9) includes the authorized annual and estimated monthly amounts for the services.
(b) In developing the coordinated service and support plan, the case manager should
also include the use of volunteers, religious organizations, social clubs, and civic and service
organizations to support the individual in the community. The lead agency must be held
harmless for damages or injuries sustained through the use of volunteers and agencies under
this paragraph, including workers' compensation liability.
Sec. 27.
Minnesota Statutes 2018, section 256B.0915, subdivision 10, is amended to read:
Subd. 10.
Waiver payment rates; managed care organizations.
The commissioner
shall adjust the elderly waiver capitation payment rates for managed care organizations paid
under section 256B.69, subdivisions 6b and 23, to reflect the maximum service rate limits
for customized living services and 24-hour customized living services under subdivisions
3e and 3hnew text begin , and the rate adjustment under subdivision 18new text end . Medical assistance rates paid to
customized living providers by managed care organizations under this section shall not
exceed the maximum service rate limits and component rates as determined by the
commissioner under subdivisions 3e and 3hnew text begin , plus any rate adjustment under subdivision
18new text end .
Sec. 28.
Minnesota Statutes 2018, section 256B.0915, is amended by adding a subdivision
to read:
new text begin Subd. 18. new text end
new text begin
Disproportionate share establishment customized living rate
adjustment.
new text end
new text begin
(a) For purposes of this section, "designated disproportionate share
establishment" means a housing with services establishment registered under chapter 144D
that meets the requirements of paragraph (d).
new text end
new text begin
(b) A housing with services establishment registered under chapter 144D may apply
annually between June 1 and June 15 to the commissioner to be designated as a
disproportionate share establishment. The applying housing with services establishment
must apply to the commissioner in the manner determined by the commissioner. The applying
housing with services establishment must document as a percentage the census of elderly
waiver participants residing in the establishment on May 31 of the year of application.
new text end
new text begin
(c) Only a housing with services establishment registered under chapter 144D with a
census of at least 50 percent elderly waiver participants on May 31 of the application year
is eligible under this section for designation as a disproportionate share establishment.
new text end
new text begin
(d) By June 30, the commissioner shall designate as a disproportionate share establishment
any housing with services establishment that complies with the requirements of paragraph
(b) and meets the eligibility criteria described in paragraph (c).
new text end
new text begin
(e) A designated disproportionate share establishment's customized living rate adjustment
is the sum of 0.83 plus the product of 0.36 multiplied by the percentage of elderly waiver
participants residing in the establishment as reported on the establishment's most recent
application for designation as a disproportionate share establishment. No establishment may
receive a customized living rate adjustment greater than 1.10.
new text end
new text begin
(f) The commissioner shall multiply the customized living rate and 24-hour customized
living rate for a designated disproportionate share establishment by the amount determined
under paragraph (e).
new text end
new text begin
(g) The value of the rate adjustment under paragraph (e) shall not be included in an
individual elderly waiver client's monthly case mix budget cap.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, or upon federal approval,
whichever is later, and applies to rates paid on or after January 1, 2021. The commissioner
of human services shall inform the revisor of statutes when federal approval is obtained.
new text end
Sec. 29.
Minnesota Statutes 2018, section 256B.092, subdivision 1b, is amended to read:
Subd. 1b.
Coordinated service and support plan.
(a) Each recipient of home and
community-based waivered services shall be provided a copy of the written coordinated
service and support plan deleted text begin whichdeleted text end new text begin thatnew text end :
(1) is developed new text begin with new text end and signed by the recipient within deleted text begin ten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessordeleted text end new text begin the timelines
established by the commissioner. The timeline for completing the community support plan
under section 256B.0911, subdivision 3a, and the coordinated service and support plan must
not exceed 60 calendar days from the assessment visitnew text end ;
(2) includes the person's need for service, including identification of service needs that
will be or that are met by the person's relatives, friends, and others, as well as community
services used by the general public;
(3) reasonably ensures the health and welfare of the recipient;
(4) identifies the person's preferences for services as stated by the person, the person's
legal guardian or conservator, or the parent if the person is a minor, including the person's
choices made on self-directed options and on services and supports to achieve employment
goals;
(5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (o), of service and support providers, and identifies all available options for case
management services and providers;
(6) identifies long-range and short-range goals for the person;
(7) identifies specific services and the amount and frequency of the services to be provided
to the person based on assessed needs, preferences, and available resources. The coordinated
service and support plan shall also specify other services the person needs that are not
available;
(8) identifies the need for an individual program plan to be developed by the provider
according to the respective state and federal licensing and certification standards, and
additional assessments to be completed or arranged by the provider after service initiation;
(9) identifies provider responsibilities to implement and make recommendations for
modification to the coordinated service and support plan;
(10) includes notice of the right to request a conciliation conference or a hearing under
section 256.045;
(11) is agreed upon and signed by the person, the person's legal guardian or conservator,
or the parent if the person is a minor, and the authorized county representative;
(12) is reviewed by a health professional if the person has overriding medical needs that
impact the delivery of services; and
(13) includes the authorized annual and monthly amounts for the services.
(b) In developing the coordinated service and support plan, the case manager is
encouraged to include the use of volunteers, religious organizations, social clubs, and civic
and service organizations to support the individual in the community. The lead agency must
be held harmless for damages or injuries sustained through the use of volunteers and agencies
under this paragraph, including workers' compensation liability.
(c) Approved, written, and signed changes to a consumer's services that meet the criteria
in this subdivision shall be an addendum to that consumer's individual service plan.
Sec. 30.
Minnesota Statutes 2018, section 256B.092, is amended by adding a subdivision
to read:
new text begin Subd. 12a. new text end
new text begin Developmental disabilities waiver growth limit. new text end
new text begin
The commissioner shall
limit the total number of people receiving developmental disabilities waiver services to the
number of people receiving developmental disabilities waiver services on June 30, 2019.
The commissioner shall only add new recipients when an existing recipient permanently
leaves the program. The commissioner shall reserve capacity, within enrollment limits, to
re-enroll persons who temporarily discontinue and then resume waiver services within 90
days of the date that services were discontinued. When adding a new recipient, the
commissioner shall target persons who meet the priorities for accessing waiver services
identified in subdivision 12. The allocation limits include conversions from intermediate
care facilities for persons with developmental disabilities unless capacity at the facility is
permanently converted to home and community-based services through the developmental
disabilities waiver.
new text end
Sec. 31.
Minnesota Statutes 2018, section 256B.0921, is amended to read:
256B.0921 HOME AND COMMUNITY-BASED SERVICES deleted text begin INCENTIVEdeleted text end new text begin
INNOVATIONnew text end POOL.
The commissioner of human services shall develop an initiative to provide incentives
for innovation in: (1) achieving integrated competitive employment; (2) achieving integrated
competitive employment for youth under age 25 upon their graduation from school; (3)
living in the most integrated setting; and (4) other outcomes determined by the commissioner.
The commissioner shall seek requests for proposals and shall contract with one or more
entities to provide incentive payments for meeting identified outcomes.
Sec. 32.
Minnesota Statutes 2018, section 256B.49, is amended by adding a subdivision
to read:
new text begin Subd. 11b. new text end
new text begin Community access for disability inclusion waiver growth limit. new text end
new text begin
The
commissioner shall limit the total number of people receiving community access for disability
inclusion waiver services to the number of people receiving community access for disability
inclusion waiver services on June 30, 2019. The commissioner shall only add new recipients
when an existing recipient permanently leaves the program. The commissioner shall reserve
capacity, within enrollment limits, to re-enroll persons who temporarily discontinue and
then resume waiver services within 90 days of the date that services were discontinued.
When adding a new recipient, the commissioner shall target individuals who meet the
priorities for accessing waiver services identified in subdivision 11a. The allocation limits
includes conversions and diversions from nursing facilities.
new text end
Sec. 33.
Minnesota Statutes 2018, section 256B.49, subdivision 13, is amended to read:
Subd. 13.
Case management.
(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:
(1) finalizing the written coordinated service and support plan within deleted text begin ten working days
after the case manager receives the plan from the certified assessordeleted text end new text begin the timelines established
by the commissioner. The timeline for completing the community support plan under section
256B.0911, subdivision 3a, and the coordinated service and support plan must not exceed
60 calendar days from the assessment visitnew text end ;
(2) informing the recipient or the recipient's legal guardian or conservator of service
options;
(3) assisting the recipient in the identification of potential service providers and available
options for case management service and providers, including services provided in a
non-disability-specific setting;
(4) assisting the recipient to access services and assisting with appeals under section
256.045; and
(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.
(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:
(1) finalizing the coordinated service and support plan;
(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved coordinated service and support plan; and
(3) adjustments to the coordinated service and support plan.
(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision 1a, paragraph (e).
(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:
(1) phasing out the use of prohibited procedures;
(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and
(3) accomplishment of identified outcomes.
If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.
Sec. 34.
Minnesota Statutes 2018, section 256B.49, subdivision 14, is amended to read:
Subd. 14.
Assessment and reassessment.
(a) Assessments and reassessments shall be
conducted by certified assessors according to section 256B.0911, subdivision 2b. The
certified assessor, with the permission of the recipient or the recipient's designated legal
representative, may invite other individuals to attend the assessment. With the permission
of the recipient or the recipient's designated legal representative, the recipient's current
provider of services may submit a written report outlining their recommendations regarding
the recipient's care needs prepared by a direct service employee deleted text begin with at least 20 hours of
service to that client. The certified assessor must notify the provider of the date by which
this information is to be submitted. This information shall be provided to the certified
assessor and the person or the person's legal representative and must be considered prior to
the finalization of the assessment or reassessmentdeleted text end new text begin who is familiar with the person. The
provider must submit the report at least 60 days before the end of the person's current service
agreement. The certified assessor must consider the content of the submitted report prior
to finalizing the person's assessment or reassessmentnew text end .
(b) There must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and
subsequent assessments to initiate and maintain participation in the waiver program.
(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only face-to-face assessments conducted according
to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
determination or a nursing facility level of care determination must be accepted for purposes
of initial and ongoing access to waiver services payment.
(d) Recipients who are found eligible for home and community-based services under
this section before their 65th birthday may remain eligible for these services after their 65th
birthday if they continue to meet all other eligibility factors.
Sec. 35.
Minnesota Statutes 2018, 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.
new text begin
(e) "Direct care staff" means employees providing direct services to an individual
receiving services under this section. Direct care staff excludes executive, managerial, or
administrative staff.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end "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.
deleted text begin (f)deleted text end new text begin (g)new text end "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.
deleted text begin (g)deleted text end new text begin (h)new text end "Lead agency" means a county, partnership of counties, or tribal agency charged
with administering waivered services under sections 256B.092 and 256B.49.
deleted text begin (h)deleted text end new text begin (i)new text end "Median" means the amount that divides distribution into two equal groups,
one-half above the median and one-half below the median.
deleted text begin (i)deleted text end new text begin (j)new text end "Payment or rate" means reimbursement to an eligible provider for services
provided to a qualified individual based on an approved service authorization.
deleted text begin (j)deleted text end new text begin (k)new text end "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.
deleted text begin (k)deleted text end new text begin (l)new text end "Recipient" means a person receiving home and community-based services funded
under any of the disability waivers.
deleted text begin (l)deleted text end new text begin (m)new text end "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.
deleted text begin (m)deleted text end new text begin (n)new text end "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.
deleted text begin (n)deleted text end new text begin (o)new text end "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 deleted text begin an hourdeleted text end new text begin 15 minutesnew text end . A day
unit of service is six or more hours of time spent providing direct service;
(3) for unit-based services with programming under subdivision 8:
(i) for supported living services, a unit of service is a day or 15 minutes. When a day
rate is authorized, any portion of a calendar day where an individual receives services is
billable as a day; and
(ii) for all other services, a unit of service is 15 minutes; and
(4) for unit-based services without programming under subdivision 9, a unit of service
is 15 minutes.
Sec. 36.
Minnesota Statutes 2018, section 256B.4914, subdivision 3, is amended to read:
Subd. 3.
Applicable services.
Applicable services are those authorized under the state's
home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:
(1) 24-hour customized living;
(2) adult day care;
(3) adult day care bath;
deleted text begin
(4) behavioral programming;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end companion services;
deleted text begin (6)deleted text end new text begin (5)new text end customized living;
deleted text begin (7)deleted text end new text begin (6)new text end day training and habilitation;
new text begin
(7) employment development services;
new text end
new text begin
(8) employment exploration services;
new text end
new text begin
(9) employment support services;
new text end
deleted text begin (8)deleted text end new text begin (10)new text end housing access coordination;
deleted text begin (9)deleted text end new text begin (11)new text end independent living skills;
new text begin
(12) independent living skills specialist services;
new text end
new text begin
(13) individualized home supports;
new text end
deleted text begin (10)deleted text end new text begin (14)new text end in-home family support;
deleted text begin (11)deleted text end new text begin (15)new text end night supervision;
deleted text begin (12)deleted text end new text begin (16)new text end personal support;
new text begin
(17) positive support service;
new text end
deleted text begin (13)deleted text end new text begin (18)new text end prevocational services;
deleted text begin (14)deleted text end new text begin (19)new text end residential care services;
deleted text begin (15)deleted text end new text begin (20)new text end residential support services;
deleted text begin (16)deleted text end new text begin (21)new text end respite services;
deleted text begin (17)deleted text end new text begin (22)new text end structured day services;
deleted text begin (18)deleted text end new text begin (23)new text end supported employment services;
deleted text begin (19)deleted text end new text begin (24)new text end supported living services;
deleted text begin (20)deleted text end new text begin (25)new text end transportation services;new text begin and
new text end
deleted text begin
(21) individualized home supports;
deleted text end
deleted text begin
(22) independent living skills specialist services;
deleted text end
deleted text begin
(23) employment exploration services;
deleted text end
deleted text begin
(24) employment development services;
deleted text end
deleted text begin
(25) employment support services; and
deleted text end
(26) other services as approved by the federal government in the state home and
community-based services plan.
Sec. 37.
Minnesota Statutes 2018, 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 assistant (SOC
code 31-1014); 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 assistant (SOC code
31-1014); 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 assistant (SOC code
31-1014); 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 is the minimum wage in Minnesota
for large employers, except in a family foster care setting, the wage is 36 percent of the
minimum wage in Minnesota for large employers;
(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 assistant
(SOC code 31-1014); 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, 100 percent of the median wage for community
and social services specialist (SOC code 21-1099);
(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) for 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);
(11) for 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);
(12) for independent living skills specialist staff, 100 percent of mental health and
substance abuse social worker (SOC code 21-1023);
(13) for supported employment staff, 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 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);
(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);
(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);
(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);
(17) 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 assistant
(SOC code 31-1014);
(18) 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 assistant (SOC code
31-1014); 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);
(19) 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 assistant (SOC code
31-1014);
(20) 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 assistant
(SOC code 31-1014);
(21) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of behavior
professional, behavior analyst, and behavior specialists, which is 100 percent of the median
wage for clinical counseling and school psychologist (SOC code 19-3031);
(22) for registered nurse staff, 100 percent of the median wage for registered nurses
(SOC code 29-1141); and
(23) for licensed practical nurse staff, 100 percent of the median wage for licensed
practical nurses (SOC code 29-2061).
new text begin
(b) The commissioner shall adjust the base wage index in paragraph (j) with a competitive
workforce factor of 4.7 percent to provide increased compensation to direct care staff. A
provider shall use the additional revenue from the competitive workforce factor to increase
wages for or to improve benefits provided to direct care staff.
new text end
new text begin
(c) Beginning February 1, 2021, and every two years thereafter, the commissioner shall
report to the chairs and ranking minority members of the legislative committees and divisions
with jurisdiction over health and human services policy and finance an analysis of the
competitive workforce factor. The report shall include recommendations to adjust the
competitive workforce factor using (1) the most recently available wage data by SOC code
of the weighted average wage for direct care staff for residential services and direct care
staff for day services; (2) the most recently available wage data by SOC code of the weighted
average wage of comparable occupations; and (3) labor market data as required under
subdivision 10a, paragraph (g). The commissioner shall not recommend in any biennial
report an increase or decrease of the competitive workforce factor by more than two
percentage points from the current value. If, after a biennial analysis for the next report, the
competitive workforce factor is less than or equal to zero, the commissioner shall recommend
a competitive workforce factor of zero.
new text end
deleted text begin (b)deleted text end new text begin (d)new text end 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.
deleted text begin (c)deleted text end new text begin (e)new text end 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.
deleted text begin (d)deleted text end new text begin (f)new text end 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: 9.4 percent.
deleted text begin (e)deleted text end new text begin (g)new text end 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: 15.5 percent;
(5) client programming and supports ratio: 4.7 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.
deleted text begin (f)deleted text end new text begin (h)new text end 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: 7.0 percent;
(5) client programming and support ratio: 2.3 percent;
(6) general administrative support ratio: 13.25 percent;
(7) program-related expense ratio: 2.9 percent; and
(8) absence and utilization factor ratio: 3.9 percent.
deleted text begin (g)deleted text end new text begin (i)new text end 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: 2.9 percent; and
(6) absence and utilization factor ratio: 3.9 percent.
deleted text begin (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 end new text begin (j)new text end On July 1, 2022, and every deleted text begin fivedeleted text end new text begin
twonew text end years thereafter, the commissioner shall update the base wage index in paragraph (a)
based on deleted text begin the most recently availabledeleted text end wage data by SOC from the Bureau of Labor Statisticsnew text begin
available 30 months and one day prior to the scheduled updatenew text end . The commissioner shall
publish these updated values and load them into the rate management system.
deleted text begin (i) On July 1, 2017, 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 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 end new text begin (k)new text end On July 1, 2022, and
every deleted text begin fivedeleted text end new text begin twonew text end years thereafter, the commissioner shall update the framework components
in paragraph deleted text begin (d)deleted text end new text begin (f)new text end , clause (5); paragraph deleted text begin (e)deleted text end new text begin (g)new text end , clause (5); deleted text begin anddeleted text end paragraph deleted text begin (f)deleted text end new text begin (h)new text end , 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
deleted text begin date of thedeleted text end data deleted text begin most recentlydeleted text end available new text begin 30 months and one day new text end prior to the scheduled update.
The commissioner shall publish these updated values and load them into the rate management
system.
new text begin
(l) Upon the implementation of automatic inflation adjustments under paragraphs (j)
and (k), rate adjustments authorized under section 256B.439, subdivision 7; Laws 2013,
chapter 108, article 7, section 60; and Laws 2014, chapter 312, article 27, section 75, shall
be removed from service rates calculated under this section.
new text end
new text begin
(m) Any rate adjustments applied to the service rates calculated under this section outside
of the cost components and rate methodology specified in this section shall be removed
from rate calculations upon implementation of automatic inflation adjustments under
paragraphs (j) and (k).
new text end
deleted text begin (j)deleted text end new text begin (n)new text end 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 begin
(o) The commissioner shall update the general administrative support ratio in paragraph
(d), clause (4); paragraph (e), clause (4); paragraph (f), clause (6); paragraph (g), clause (6);
paragraph (h), clause (6); and paragraph (i), clause (4), for any changes to the annual licensing
fee under section 245A.10, subdivision 4, paragraph (b). The commissioner shall adjust
these ratios higher or lower by an amount equal in value to the percent change in general
administrative support costs attributable to the change in the licensing fee. The commissioner
shall publish these updated ratios and load them into the rate management system.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2021, or upon federal approval,
whichever is later, except the new paragraphs (b) and (o) are effective January 1, 2020, or
upon federal approval, whichever is later. The commissioner of human services shall notify
the revisor of statutes when federal approval is obtained.
new text end
Sec. 38.
Minnesota Statutes 2018, 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 deleted text begin (b)deleted text end new text begin (d)new text end , clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);
(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 deleted text begin (b)deleted text end new text begin
(d)new text end , 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 deleted text begin (b)deleted text end new text begin (d)new text end , 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. 39.
Minnesota Statutes 2018, 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 deleted text begin (d)deleted text end new text begin (f)new text end , clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);
(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 deleted text begin (d)deleted text end new text begin (f)new text end ,
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 deleted text begin (d)deleted text end new text begin (f)new text end , 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 deleted text begin (d)deleted text end new text begin (f)new text end , 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 deleted text begin (d)deleted text end new text begin (f)new text end , 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. 40.
Minnesota Statutes 2018, 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, independent living skills specialist
services, individualized home supports, hourly supported living services, employment
exploration services, employment development services, supported employment, and
employment support services provided to an individual outside of any day or residential
service plan must be calculated as follows, unless the services are authorized separately
under subdivision 6 or 7:
(1) determine the number of units of service to meet a recipient's needs;
(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
5;
(3) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (2). This is defined as the customized direct-care rate;
(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision
5, paragraph (a), or the customized direct-care rate;
(5) multiply the number of direct staff hours by the product of the supervision span of
control ratio in subdivision 5, paragraph deleted text begin (e)deleted text end new text begin (g)new text end , clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);
(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 deleted text begin (e)deleted text end new text begin (g)new text end ,
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 deleted text begin (e)deleted text end new text begin (g)new text end , 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 deleted text begin (e)deleted text end new text begin (g)new text end , 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 deleted text begin (e)deleted text end new text begin (g)new text end , clause (5);
(10) this is the subtotal rate;
(11) sum the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization factor ratio;
(12) divide the result of clause (10) by one minus the result of clause (11). This is the
total payment amount;
(13) for supported employment provided in a shared manner, divide the total payment
amount in clause (12) by the number of service recipients, not to exceed three. For
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. For independent living
skills training and individualized home supports provided in a shared manner, divide the
total payment amount in clause (12) by the number of service recipients, not to exceed two;
and
(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
Sec. 41.
Minnesota Statutes 2018, 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 deleted text begin (f)deleted text end new text begin (h)new text end , clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);
(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 deleted text begin (f)deleted text end new text begin (h)new text end ,
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 deleted text begin (f)deleted text end new text begin (h)new text end , 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 deleted text begin (f)deleted text end new text begin (h)new text end , 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 deleted text begin (f)deleted text end new text begin (h)new text end , 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 deleted text begin (g)deleted text end new text begin (i)new text end , clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);
(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 deleted text begin (g)deleted text end new text begin
(i)new text end , 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 deleted text begin (g)deleted text end new text begin (i)new text end , 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. 42.
Minnesota Statutes 2018, section 256B.4914, subdivision 10, is amended to read:
Subd. 10.
Updating payment values and additional information.
deleted text begin
(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.
deleted text end
deleted text begin (b)deleted text end new text begin (a)new text end 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.
deleted text begin
(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid
set of rates management system data, the commissioner, in consultation with stakeholders,
shall analyze for each service the average difference in the rate on December 31, 2013, and
the framework rate at the individual, provider, lead agency, and state levels. The
commissioner shall issue semiannual reports to the stakeholders on the difference in rates
by service and by county during the banding period under section 256B.4913, subdivision
4a. The commissioner shall issue the first report by October 1, 2014, and the final report
shall be issued by December 31, 2018.
deleted text end
deleted text begin (d)deleted text end new text begin (b)new text end 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 deleted text begin 6deleted text end new text begin 5new text end to
9, or issues that impact all services, including, but not limited to:
(1) values for transportation rates;
(2) values for services where monitoring technology replaces staff time;
(3) values for indirect services;
(4) values for nursing;
(5) values for the facility use rate in day services, and the weightings used in the day
service ratios and adjustments to those weightings;
(6) values for workers' compensation as part of employee-related expenses;
(7) values for unemployment insurance as part of employee-related expenses;
(8)new text begin direct care workforce labor market measures;
new text end
new text begin (9)new text end any changes in state or federal law with a direct impact on the underlying cost of
providing home and community-based services; deleted text begin and
deleted text end
deleted text begin (9)deleted text end new text begin (10)new text end outcome measures, determined by the commissioner, for home and
community-based services rates determined under this sectiondeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(11) different competitive workforce factors by service.
new text end
deleted text begin (e)deleted text end new text begin (c)new text end 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 deleted text begin (b) to (d)deleted text end new text begin (a)
and (b)new text end on deleted text begin the following dates:
deleted text end
deleted text begin
(1) January 15, 2015, with preliminary results and data;
deleted text end
deleted text begin
(2) January 15, 2016, with a status implementation update, and additional data and
summary information;
deleted text end
deleted text begin
(3) January 15, 2017, with the full report; and
deleted text end
deleted text begin (4)deleted text end January 15, deleted text begin 2020deleted text end new text begin 2021new text end , with another full report, and a full report once every four
years thereafter.
deleted text begin (f) The commissioner shall implement a regional adjustment factor to all rate calculations
in subdivisions 6 to 9, effective no later than January 1, 2015.deleted text end new text begin (d)new text end Beginning deleted text begin July 1, 2017deleted text end new text begin
January 1, 2022new text end , the commissioner shall renew analysis and implement changes to the
regional adjustment factors deleted text begin when adjustments required under subdivision 5, paragraph (h),
occurdeleted text end new text begin once every six yearsnew text end . Prior to implementation, the commissioner shall consult with
stakeholders on the methodology to calculate the adjustment.
deleted text begin (g)deleted text end new text begin (e)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 (h)deleted text end new text begin (f)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.
deleted 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.
deleted text end
deleted text begin (j)deleted text end new text begin (g)new text end Beginning July 1, 2017, the commissioner shall collect transportation and trip
information for all day services through the rates management system.
new text begin
(h) The commissioner, in consultation with stakeholders, shall study value-based models
and outcome-based payment strategies for fee-for-service home and community-based
services and report to the legislative committees with jurisdiction over the disability waiver
rate system by October 1, 2020, with recommended strategies to improve the quality,
efficiency, and effectiveness of 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. 43.
Minnesota Statutes 2018, section 256B.4914, subdivision 10a, is amended to
read:
Subd. 10a.
Reporting and analysis of cost data.
(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:
(1) worker wage costs;
(2) benefits paid;
(3) supervisor wage costs;
(4) executive wage costs;
(5) vacation, sick, and training time paid;
(6) taxes, workers' compensation, and unemployment insurance costs paid;
(7) administrative costs paid;
(8) program costs paid;
(9) transportation costs paid;
(10) vacancy rates; and
(11) other data relating to costs required to provide services requested by the
commissioner.
(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.
(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.
(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, deleted text begin 2020deleted text end new text begin 2021new text end . The commissioner shall make
recommendations in conjunction with reports submitted to the legislature according to
subdivision 10, paragraph deleted text begin (e)deleted text end new text begin (c)new text end . 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.
(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 begin
(f) By December 31, 2020, providers paid with rates calculated under subdivision 5,
paragraph (b), shall identify additional revenues from the competitive workforce factor and
prepare a written distribution plan for the revenues. A provider shall make the provider's
distribution plan available and accessible to all direct care staff for a minimum of one
calendar year. Upon request, a provider shall submit the written distribution plan to the
commissioner.
new text end
new text begin
(g) Providers enrolled to provide services with rates determined under section 256B.4914,
subdivision 3, shall submit labor market data to the commissioner annually on or before
November 1, including but not limited to:
new text end
new text begin
(1) number of direct care staff;
new text end
new text begin
(2) wages of direct care staff;
new text end
new text begin
(3) overtime wages of direct care staff;
new text end
new text begin
(4) hours worked by direct care staff;
new text end
new text begin
(5) overtime hours worked by direct care staff;
new text end
new text begin
(6) benefits provided to direct care staff;
new text end
new text begin
(7) direct care staff job vacancies; and
new text end
new text begin
(8) direct care staff retention rates.
new text end
new text begin
(h) The commissioner shall publish annual reports on provider and state-level labor
market data, including but not limited to the data obtained under paragraph (g).
new text end
new text begin
(i) The commissioner shall temporarily suspend payments to the provider if data requested
under paragraph (g) 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 EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment except
paragraph (g) is effective November 1, 2019, and paragraph (h) is effective February 1,
2020.
new text end
Sec. 44.
Minnesota Statutes 2018, section 256B.493, subdivision 1, is amended to read:
Subdivision 1.
Commissioner's duties; report.
The commissioner of human services
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 setting 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 deleted text begin necessary budgetary savingsdeleted text end new text begin
the reduction of statewide licensed capacitynew text end required in section 245A.03, subdivision 7,
paragraphs (c) and (d).new text begin Closure determinations by the commissioner are final and not subject
to appeal.
new text end
Sec. 45.
Minnesota Statutes 2018, section 256B.5013, subdivision 1, is amended to read:
Subdivision 1.
Variable rate adjustments.
(a) deleted text begin For rate years beginning on or after
October 1, 2000,deleted text end When there is a documented increase in the needs of a current ICF/DD
recipient, the county of financial responsibility may recommend a variable rate to enable
the facility to meet the individual's increased needs. Variable rate adjustments made under
this subdivision replace payments for persons with special needs for crisis intervention
services under section 256B.501, subdivision 8a. deleted text begin Effective July 1, 2003, facilities with a
base rate above the 50th percentile of the statewide average reimbursement rate for a Class
A facility or Class B facility, whichever matches the facility licensure, are not eligible for
a variable rate adjustment. Variable rate adjustments may not exceed a 12-month period,
except when approved for purposes established in paragraph (b), clause (1).deleted text end new text begin Once approved,
variable rate adjustments must continue to remain in place unless there is an identified
change in need. A review of needed resources must be done at the time of the individual's
annual support plan meeting. A request to adjust the resources of the individual must be
submitted if any change in need is identified.new text end Variable rate adjustments approved solely on
the basis of changes on a developmental disabilities screening document will end June 30,
2002.
new text begin
(b) The county of financial responsibility must act on a variable rate request within 30
days and notify the initiator of the request of the county's recommendation in writing.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end A variable rate may be recommended by the county of financial responsibility
for increased needs in the following situations:
(1) a need for resources due to an individual's full or partial retirement from participation
in a day training and habilitation service when the individual: (i) has reached the age of 65
or has a change in health condition that makes it difficult for the person to participate in
day training and habilitation services over an extended period of time because it is medically
contraindicated; and (ii) has expressed a desire for change through the developmental
disability screening process under section 256B.092;
(2) a need for additional resources for intensive short-term programming which is
necessary prior to an individual's discharge to a less restrictive, more integrated setting;
(3) a demonstrated medical need that significantly impacts the type or amount of services
needed by the individual; deleted text begin or
deleted text end
(4) a demonstrated behavioralnew text begin or cognitivenew text end need that significantly impacts the type or
amount of services needed by the individualdeleted text begin .deleted text end new text begin ; or
new text end
deleted text begin
(c) The county of financial responsibility must justify the purpose, the projected length
of time, and the additional funding needed for the facility to meet the needs of the individual.
deleted text end
deleted text begin
(d) The facility shall provide an annual report to the county case manager on the use of
the variable rate funds and the status of the individual on whose behalf the funds were
approved. The county case manager will forward the facility's report with a recommendation
to the commissioner to approve or disapprove a continuation of the variable rate.
deleted text end
deleted text begin
(e) Funds made available through the variable rate process that are not used by the facility
to meet the needs of the individual for whom they were approved shall be returned to the
state.
deleted text end
new text begin
(5) a demonstrated increased need for staff assistance, changes in the type of staff
credentials needed, or a need for expert consultation based on assessments conducted prior
to the annual support plan meeting.
new text end
new text begin
(d) Variable rate requests must include the following information:
new text end
new text begin
(1) the service needs change;
new text end
new text begin
(2) the variable rate requested and the difference from the current rate;
new text end
new text begin
(3) a basis for the underlying costs used for the variable rate and any accompanying
documentation; and
new text end
new text begin
(4) documentation of the expected outcomes to be achieved and the frequency of progress
monitoring associated with the rate increase.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end
Sec. 46.
Minnesota Statutes 2018, section 256B.5013, subdivision 6, is amended to read:
Subd. 6.
Commissioner's responsibilities.
The commissioner shall:
(1) make a determination to approve, deny, or modify a request for a variable rate
adjustment within 30 days of the receipt of the completed application;
(2) notify the ICF/DD facility and county case manager of the deleted text begin duration and conditions
of variable rate adjustment approvalsdeleted text end new text begin determinationnew text end ; and
(3) modify MMIS II service agreements to reimburse ICF/DD facilities for approved
variable rates.
Sec. 47.
Minnesota Statutes 2018, section 256B.5015, subdivision 2, is amended to read:
Subd. 2.
Services during the day.
new text begin (a) new text end Services during the day, as defined in section
256B.501, but excluding day training and habilitation services, shall be paid as a pass-through
payment deleted text begin no later than January 1, 2004deleted text end . The commissioner shall establish rates for these
services, other than day training and habilitation services, at deleted text begin levels that do not exceed 75deleted text end new text begin
100new text end percent of a recipient's day training and habilitation service costs prior to the service
change.
new text begin
(b) An individual qualifies for services during the day under paragraph (a) if:
new text end
new text begin
(1) through consultation with the individual and their support team or interdisciplinary
team, it has been determined that the individual's needs can best be met through partial or
full retirement from:
new text end
new text begin
(i) participation in a day training and habilitation service; or
new text end
new text begin
(ii) the use of services during the day in the individual's home environment; and
new text end
new text begin
(2) in consultation with the individual and their support team or interdisciplinary team,
an individualized plan has been developed with designated outcomes that:
new text end
new text begin
(i) addresses the support needs and desires contained in the person-centered plan or
individual support plan; and
new text end
new text begin
(ii) includes goals that focus on community integration as appropriate for the individual.
new text end
new text begin (c) new text end When establishing a rate for these services, the commissioner shall also consider an
individual recipient's needs as identified in the deleted text begin individualized servicedeleted text end new text begin individual supportnew text end
plan and the person's need for active treatment as defined under federal regulations. The
pass-through payments for services during the day shall be paid separately by the
commissioner and shall not be included in the computation of the ICF/DD facility total
payment rate.
Sec. 48.
Minnesota Statutes 2018, section 256B.85, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
(a) CFSS is available to a person who meets one of the following:
(1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056,
or 256B.057, subdivisions 5 and 9;
(2) is a participant in the alternative care program under section 256B.0913;
(3) is a waiver participant as defined under section 256B.0915, 256B.092, 256B.093, or
256B.49; or
(4) has medical services identified in a person's individualized education program and
is eligible for services as determined in section 256B.0625, subdivision 26.
(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
meet all of the following:
(1) new text begin based on an assessment under section 256B.0911, new text end require assistance and be determined
dependent in one new text begin critical new text end activity of daily living ornew text begin onenew text end Level I behavior deleted text begin based on assessment
under section 256B.0911deleted text end new text begin or have a behavior that shows increased vulnerability due to
cognitive deficits or socially inappropriate behavior that requires assistance at least four
times per weeknew text end ; and
(2) is not a participant under a family support grant under section 252.32.
new text begin
(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision
6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible
for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as
determined under section 256B.0911.
new text end
Sec. 49.
Minnesota Statutes 2018, section 256B.85, subdivision 8, is amended to read:
Subd. 8.
Determination of CFSS service authorization amount.
(a) All community
first services and supports must be authorized by the commissioner or the commissioner's
designee before services begin. The authorization for CFSS must be completed as soon as
possible following an assessment but no later than 40 calendar days from the date of the
assessment.
(b) The amount of CFSS authorized must be based on the participant's home care rating
described in paragraphs (d) and (e) and any additional service units for which the participant
qualifies as described in paragraph (f).
(c) The home care rating shall be determined by the commissioner or the commissioner's
designee based on information submitted to the commissioner identifying the following for
a participant:
(1) the total number of dependencies of activities of daily living;
(2) the presence of complex health-related needs; and
(3) the presence of Level I behavior.
(d) The methodology to determine the total service units for CFSS for each home care
rating is based on the median paid units per day for each home care rating from fiscal year
2007 data for the PCA program.
(e) Each home care rating is designated by the letters deleted text begin Pdeleted text end new text begin LTnew text end through Z and EN and has
the following base number of service units assigned:
(1) deleted text begin Pdeleted text end new text begin LT new text end home care rating requiresdeleted text begin Level I behavior or one to three dependencies in
ADLs and qualifies the person for five service unitsdeleted text end new text begin the presence of increased vulnerability
due to cognitive deficits and socially inappropriate behavior that requires assistance at least
four times per week, the presence of a Level I behavior, or a dependency in one critical
activity of daily living, and qualifies the person for two service unitsnew text end ;
(2) new text begin P home care rating requires two to three dependencies in ADLs, one of which must
be a critical ADL, and qualifies the person for five services units;
new text end
new text begin (3) new text end Q home care rating requires Level I behavior and deleted text begin onedeleted text end new text begin twonew text end to three dependencies in
ADLsnew text begin , one of which must be a critical ADL,new text end and qualifies the person for six service units;
deleted text begin (3)deleted text end new text begin (4)new text end R home care rating requires a complex health-related need and deleted text begin onedeleted text end new text begin twonew text end to three
dependencies in ADLsnew text begin , one of which must be a critical ADL,new text end and qualifies the person for
seven service units;
deleted text begin (4)deleted text end new text begin (5)new text end S home care rating requires four to six dependencies in ADLsnew text begin , one of which must
be a critical ADL,new text end and qualifies the person for ten service units;
deleted text begin (5)deleted text end new text begin (6)new text end T home care rating requires new text begin Level I behavior and new text end four to six dependencies in
ADLs deleted text begin and Level I behaviordeleted text end new text begin , one of which must be a critical ADL, new text end and qualifies the person
for 11 service units;
deleted text begin (6)deleted text end new text begin (7)new text end U home care rating requires four to six dependencies in ADLsnew text begin , one of which
must be a critical ADL,new text end and a complex health-related need and qualifies the person for 14
service units;
deleted text begin (7)deleted text end new text begin (8)new text end V home care rating requires seven to eight dependencies in ADLs and qualifies
the person for 17 service units;
deleted text begin (8)deleted text end new text begin (9)new text end W home care rating requires seven to eight dependencies in ADLs and Level I
behavior and qualifies the person for 20 service units;
deleted text begin (9)deleted text end new text begin (10)new text end Z home care rating requires seven to eight dependencies in ADLs and a complex
health-related need and qualifies the person for 30 service units; and
deleted text begin (10)deleted text end new text begin (11)new text end EN home care rating includes ventilator dependency as defined in section
256B.0651, subdivision 1, paragraph (g). A person who meets the definition of
ventilator-dependent and the EN home care rating and utilize a combination of CFSS and
home care nursing services is limited to a total of 96 service units per day for those services
in combination. Additional units may be authorized when a person's assessment indicates
a need for two staff to perform activities. Additional time is limited to 16 service units per
day.
(f) Additional service units are provided through the assessment and identification of
the following:
(1) 30 additional minutes per day for a dependency in each critical activity of daily
living;
(2) 30 additional minutes per day for each complex health-related need; and
(3) 30 additional minutes per day when the behavior requires assistance at least four
times per week for one or more of the following behaviors:
(i) level I behavior;
(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
or
(iii) increased need for assistance for participants who are verbally aggressive or resistive
to care so that the time needed to perform activities of daily living is increased.
(g) The service budget for budget model participants shall be based on:
(1) assessed units as determined by the home care rating; and
(2) an adjustment needed for administrative expenses.
Sec. 50.
Minnesota Statutes 2018, section 256C.23, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Family and community intervener. new text end
new text begin
"Family and community intervener"
means a paraprofessional, specifically trained in deafblindness, who works one-on-one with
a child who is deafblind to provide critical connections to people and the environment.
new text end
Sec. 51.
Minnesota Statutes 2018, section 256C.261, is amended to read:
256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND.
(a) The commissioner of human services shall 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.
The commissioner shall award grants for the purposes of:
(1) providing services and supports to persons 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 persons
who are deafblind 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.
(c) Consumer-directed services shall be provided in whole by grant-funded providers.
The Deaf and Hard-of-Hearing Services Division's regional service centers shall not provide
any aspect of a grant-funded consumer-directed services program.
(d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant under
paragraph (a).
(e) 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.new text begin Intervener
services include services provided by a family and community intervener as described in
paragraph (f).
new text end
new text begin
(f) The family and community intervener, as defined in section 256C.23, subdivision 7,
provides services to open channels of communication between the child and others; facilitate
the development or use of receptive and expressive communication skills by the child; and
develop and maintain a trusting, interactive relationship that promotes social and emotional
well-being. The family and community intervener also provides access to information and
the environment, and facilitates opportunities for learning and development. A family and
community intervener must have specific training in deafblindness, building language and
communication skills, and intervention strategies.
new text end
Sec. 52.
Minnesota Statutes 2018, section 256I.03, subdivision 8, is amended to read:
Subd. 8.
Supplementary services.
"Supplementary services" means housing support
services provided to individuals in addition to room and board including, but not limited
to, oversight and up to 24-hour supervision, medication reminders, assistance with
transportation, arranging for meetings and appointments, and arranging for medical and
social servicesnew text begin , and services identified in section 256I.03, subdivision 12new text end .
Sec. 53.
Minnesota Statutes 2018, section 256I.04, subdivision 2b, is amended to read:
Subd. 2b.
Housing support agreements.
(a) Agreements between agencies and providers
of housing support must be in writing on a form developed and approved by the commissioner
and must specify the name and address under which the establishment subject to the
agreement does business and under which the establishment, or service provider, if different
from the group residential housing establishment, is licensed by the Department of Health
or the Department of Human Services; the specific license or registration from the
Department of Health or the Department of Human Services held by the provider and the
number of beds subject to that license; the address of the location or locations at which
group residential housing is provided under this agreement; the per diem and monthly rates
that are to be paid from housing support funds for each eligible resident at each location;
the number of beds at each location which are subject to the agreement; whether the license
holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code;
and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
and subject to any changes to those sections.
(b) Providers are required to verify the following minimum requirements in the
agreement:
(1) current license or registration, including authorization if managing or monitoring
medications;
(2) all staff who have direct contact with recipients meet the staff qualifications;
(3) the provision of housing support;
(4) the provision of supplementary services, if applicable;
(5) reports of adverse events, including recipient death or serious injury; deleted text begin and
deleted text end
(6) submission of residency requirements that could result in recipient evictiondeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) confirmation that the provider will not limit or restrict the number of hours an
applicant or recipient chooses to be employed, as specified in subdivision 5.
new text end
(c) Agreements may be terminated with or without cause by the commissioner, the
agency, or the provider with two calendar months prior notice. The commissioner may
immediately terminate an agreement under subdivision 2d.
Sec. 54.
Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision
to read:
new text begin Subd. 2h. new text end
new text begin Required supplementary services. new text end
new text begin
Providers of supplementary services shall
ensure that recipients have, at a minimum, assistance with services as identified in the
recipient's professional statement of need under section 256I.03, subdivision 12. Providers
of supplementary services shall maintain case notes with the date and description of services
provided to individual recipients.
new text end
Sec. 55.
Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Employment. new text end
new text begin
A provider is prohibited from limiting or restricting the number
of hours an applicant or recipient is employed.
new text end
Sec. 56.
Minnesota Statutes 2018, section 256I.05, subdivision 1r, is amended to read:
Subd. 1r.
Supplemental rate; Anoka County.
new text begin (a) new text end 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 begin
(b) Notwithstanding the provisions in this section, a county agency shall negotiate a
supplemental rate for six 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 located in Anoka County that
operates a 12-bed facility and provides room and board and supplementary services to
individuals 18 to 24 years of age.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 57.
new text begin
[268A.061] HOME AND COMMUNITY-BASED PROVIDERS.
new text end
new text begin Subdivision 1. new text end
new text begin
Home and community-based provider eligibility for
payments.
new text end
new text begin
Notwithstanding Minnesota Rules, part 3300.5060, subparts 14 to 16, the
commissioner shall make payments for job-related services, vocational adjustment training,
and vocational evaluation services to any home and community-based services provider
licensed as an intensive support services provider under chapter 245D with whom the
commissioner has signed a limited-use vendor operating agreement.
new text end
new text begin Subd. 2. new text end
new text begin Limited-use agreements with home and community-based providers. new text end
new text begin
A
limited-use vendor operating agreement under this section may not limit the dollar amount
the provider may receive annually. The limited-use vendor operating agreement available
under this section must specify at a minimum that payments under the agreement are limited
to vocational rehabilitation services provided to individuals to whom the provider has
previously provided day services as described under section 245D.03, subdivision 1,
paragraph (c), clause (4), or any of the employment services described under section 245D.03,
subdivision 1, paragraph (c), clauses (5) to (7).
new text end
new text begin Subd. 3. new text end
new text begin Required limited-use agreements. new text end
new text begin
The commissioner must enter into a
limited-use vendor operating agreement that meets at least the minimal requirements of
subdivision 2 with a provider eligible under subdivision 1 if:
new text end
new text begin
(1) the home and community-based provider is not a current vocational rehabilitation
services provider;
new text end
new text begin
(2) each individual to be served under the limited-use vendor operating agreement was
receiving day or employment services from the provider immediately prior to the provider
serving the individual under the terms of the agreement; and
new text end
new text begin
(3) each individual to be served under the limited-use vendor operating agreement has
made an informed choice to remain with the provider.
new text end
Sec. 58.
Laws 2017, First Special Session chapter 6, article 1, section 44, is amended to
read:
Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS
BUDGET METHODOLOGY EXCEPTION.
(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:
(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:
(i) to increase the amount of time a person works or otherwise improves employment
opportunities;
(ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes,
section 256D.44, subdivision 5, deleted text begin paragraph (f), clause (1), item (ii), ordeleted text end paragraph (g)new text begin , clause
(1), item (iii)new text end ; or
(iii) to develop and implement a positive behavior support plan; or
(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).
(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.
(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.
Sec. 59.
Laws 2017, First Special Session chapter 6, article 1, section 45, is amended to
read:
Sec. 45.
CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
METHODOLOGY deleted text begin EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND
CRISIS RESIDENTIAL SETTINGSdeleted text end .
new text begin Subdivision 1. new text end
new text begin
Exception for persons leaving institutions and crisis residential
settings.
new text end
(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:
(1) is not offered available and appropriate services within 60 days since approval for
discharge from the individual's current institutional setting; and
(2) requires services that are more expensive than appropriate services provided in a
noninstitutional setting using the consumer-directed community supports option.
(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 begin Subd. 2. new text end
new text begin Shared services. new text end
new text begin
(a) Medical assistance payments for shared services under
consumer-directed community supports are limited to this subdivision.
new text end
new text begin
(b) For purposes of this subdivision, "shared services" means services provided at the
same time by the same direct care worker for individuals who have entered into an agreement
to share consumer-directed community support services.
new text end
new text begin
(c) Shared services may include services in the personal assistance category as outlined
in the consumer-directed community supports community support plan and shared services
agreement, except:
new text end
new text begin
(1) services for more than three individuals provided by one worker at one time;
new text end
new text begin
(2) use of more than one worker for the shared services; and
new text end
new text begin
(3) a child care program licensed under chapter 245A or operated by a local school
district or private school.
new text end
new text begin
(d) The individuals or, as needed, their representatives shall develop the plan for shared
services when developing or amending the consumer-directed community supports plan,
and must follow the consumer-directed community supports process for approval of the
plan by the lead agency. The plan for shared services in an individual's consumer-directed
community supports plan shall include the intention to utilize shared services based on
individuals' needs and preferences.
new text end
new text begin
(e) Individuals sharing services must use the same financial management services
provider.
new text end
new text begin
(f) Individuals whose consumer-directed community supports community support plans
include the intention to utilize shared services must also jointly develop, with the support
of their representatives as needed, a shared services agreement. This agreement must include:
new text end
new text begin
(1) the names of the individuals receiving shared services;
new text end
new text begin
(2) the individuals' representative, if identified in their consumer-directed community
supports plans, and their duties;
new text end
new text begin
(3) the names of the case managers;
new text end
new text begin
(4) the financial management services provider;
new text end
new text begin
(5) the shared services that must be provided;
new text end
new text begin
(6) the schedule for shared services;
new text end
new text begin
(7) the location where shared services must be provided;
new text end
new text begin
(8) the training specific to each individual served;
new text end
new text begin
(9) the training specific to providing shared services to the individuals identified in the
agreement;
new text end
new text begin
(10) instructions to follow all required documentation for time and services provided;
new text end
new text begin
(11) a contingency plan for each of the individuals that accounts for service provision
and billing in the absence of one of the individuals in a shared services setting due to illness
or other circumstances;
new text end
new text begin
(12) signatures of all parties involved in the shared services; and
new text end
new text begin
(13) agreement by each of the individuals who are sharing services on the number of
shared hours for services provided.
new text end
new text begin
(g) Any individual or any individual's representative may withdraw from participating
in a shared services agreement at any time.
new text end
new text begin
(h) The lead agency for each individual must authorize the use of the shared services
option based on the criteria that the shared service is appropriate to meet the needs, health,
and safety of each individual for whom they provide case management or care coordination.
new text end
new text begin
(i) Nothing in this subdivision must be construed to reduce the total authorized
consumer-directed community supports budget for an individual.
new text end
new text begin
(j) No later than September 30, 2019, the commissioner of human services shall:
new text end
new text begin
(1) 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 allow for a shared services option under consumer-directed
community supports; and
new text end
new text begin
(2) with stakeholder input, develop guidance for shared services in consumer-directed
community-supports within the Community Based Services Manual. Guidance must include:
new text end
new text begin
(i) recommendations for negotiating payment for one-to-two and one-to-three services;
and
new text end
new text begin
(ii) a template of the shared services agreement.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2019, or upon federal approval,
whichever is later, except for subdivision 2, paragraph (j), which is effective the day
following final enactment. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end
Sec. 60. new text begin DAY TRAINING AND HABILITATION DISABILITY WAIVER RATE
SYSTEM TRANSITION GRANTS.
new text end
new text begin
(a) The commissioner of human services shall establish annual grants to day training
and habilitation providers that are projected to experience a funding gap upon the full
implementation of Minnesota Statutes, section 256B.4914.
new text end
new text begin
(b) In order to be eligible for a grant under this section, a day training and habilitation
disability waiver provider must:
new text end
new text begin
(1) serve at least 100 waiver service participants;
new text end
new text begin
(2) be projected to receive a reduction in annual revenue from medical assistance for
day services during the first year of full implementation of disability waiver rate system
framework rates under Minnesota Statutes, section 256B.4914, of at least 15 percent and
at least $300,000 compared to the annual medical assistance revenue for day services the
provider received during the last full year during which banded rates under Minnesota
Statutes, section 256B.4913, subdivision 4a, were effective; and
new text end
new text begin
(3) agree to develop, submit, and implement a sustainability plan as provided in paragraph
new text end
new text begin
(c) A recipient of a grant under this section must develop a sustainability plan in
partnership with the commissioner of human services. The sustainability plan must include:
new text end
new text begin
(1) a review of all the provider's costs and an assessment of whether the provider is
implementing available cost-control options appropriately;
new text end
new text begin
(2) a review of all the provider's revenue and an assessment of whether the provider is
leveraging available resources appropriately; and
new text end
new text begin
(3) a practical strategy for closing the funding gap described in paragraph (b), clause
(2).
new text end
new text begin
(d) The commissioner of human services shall provide technical assistance and financial
management advice to grant recipients as they develop and implement their sustainability
plans.
new text end
new text begin
(e) In order to be eligible for an annual grant renewal, a grant recipient must demonstrate
to the commissioner of human services that it made a good faith effort to close the revenue
gap described in paragraph (b), clause (2).
new text end
Sec. 61. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
MNCHOICES 2.0.
new text end
new text begin
(a) The commissioner of human services must ensure that the MnCHOICES 2.0
assessment and support planning tool incorporates a qualitative approach with open-ended
questions and a conversational, culturally sensitive approach to interviewing that captures
the assessor's professional judgment based on the person's responses.
new text end
new text begin
(b) If the commissioner of human services convenes a working group or consults with
stakeholders for the purposes of modifying the assessment and support planning process or
tool, the commissioner must include members of the disability community, including
representatives of organizations and individuals involved in assessment and support planning.
new text end
new text begin
(c) Until MnCHOICES 2.0 is fully implemented, the commissioner shall permit counties
to use the most recent legacy documents related to long-term service and supports
assessments and shall reimburse counties in the same amount as the commissioner would
were the county using the MnCHOICES assessment tool.
new text end
Sec. 62. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
PAYMENTS FOR COUNTY HUMAN SERVICES ACTIVITIES.
new text end
new text begin
By December 1, 2019, the commissioner of human services shall provide a report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
human services finance and policy proposing a rate per assessment to be paid to counties
and tribes for all medical assistance and county human services activities currently reimbursed
via a random moment time study. The commissioner, in developing the proposal, shall use
past estimates of time spent on each relevant activity. The commissioner's report shall
include an explanation of how the commissioner determines the portion of capitated rates
paid to health plans attributable to each type of activity also performed by a county or tribe.
The commissioner's proposal must include a single rate per activity for each activity for all
populations, but may also include an alternative proposal for different rates per activity for
each activity for different populations.
new text end
Sec. 63. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
BARRIERS TO INDEPENDENT LIVING.
new text end
new text begin
By December 1, 2019, the commissioner of human services shall submit to the chairs
and ranking minority members of the legislative committees with jurisdiction over human
services finance and policy a report describing state and federal regulatory barriers, including
provisions of the Fair Housing Act, that create barriers to independent living for persons
with disabilities. In developing the report, the commissioner shall consult with stakeholders,
including individuals with disabilities, advocacy organizations, and service providers.
new text end
Sec. 64. new text begin ADULT FOSTER CARE MORATORIUM EXEMPTION.
new text end
new text begin
An adult foster care setting located in Elk River, Sherburne County, and licensed in
2003 to serve four people is exempt from the moratorium under Minnesota Statutes, section
245A.03, subdivision 7, until July 1, 2020.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 65. new text begin DIRECTION TO COMMISSIONER; BI AND CADI WAIVER
CUSTOMIZED LIVING SERVICES PROVIDER LOCATED IN HENNEPIN
COUNTY.
new text end
new text begin
(a) The commissioner of human services shall allow a housing with services establishment
located in Minneapolis that provides customized living and 24-hour customized living
services for clients enrolled in the brain injury (BI) or community access for disability
inclusion (CADI) waiver and had a capacity to serve 66 clients as of July 1, 2017, to transfer
service capacity of up to 66 clients to no more than three new housing with services
establishments located in Hennepin County.
new text end
new text begin
(b) Notwithstanding Minnesota Statutes, section 256B.492, the commissioner shall
determine that the new housing with services establishments described under paragraph (a)
meet the BI and CADI waiver customized living and 24-hour customized living size
limitation exception for clients receiving those services at the new housing with services
establishments described under paragraph (a).
new text end
Sec. 66. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
PERSONAL CARE ASSISTANCE SERVICES COMPARABILITY WAIVER.
new text end
new text begin
The commissioner of human services shall submit by July 1, 2019, a waiver request to
the Centers for Medicare and Medicaid Services to allow people receiving personal care
assistance services as of December 31, 2019, to continue their eligibility for personal care
assistance services under the personal care assistance service eligibility criteria in effect on
December 31, 2019.
new text end
Sec. 67. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
TRANSITION PERIOD FOR MODIFIED ELIGIBILITY OF PERSONAL CARE
ASSISTANCE.
new text end
new text begin
(a) Beginning at the latest date permissible under federal law, the modified eligibility
criteria under Minnesota Statutes, section 256B.0625, subdivision 19a, and Minnesota
Statutes, section 256B.0652, subdivision 6, paragraphs (b) and (d), shall apply on a rolling
basis, at the time of annual assessments, to people receiving personal care assistance as of
December 31, 2019.
new text end
new text begin
(b) The commissioner shall establish a transition period for people receiving personal
care assistance services as of December 31, 2019, who, at the time of the annual assessment
described in paragraph (a), are determined to be ineligible for personal care assistance
services. Service authorizations for this transition period shall not exceed one year.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained and when personal care assistance services provided under paragraph
(b) have expired.
new text end
Sec. 68. new text begin DIRECTION TO THE COMMISSIONER; REPORT ON ELIGIBILITY
FOR PERSONAL CARE ASSISTANCE AND ACCESS TO DEVELOPMENTAL
DISABILITIES AND COMMUNITY ACCESS FOR DISABILITY INCLUSION
WAIVERS.
new text end
new text begin
By December 15, 2020, the commissioner shall submit a report to chairs and ranking
minority members of the legislative committees with jurisdiction over human services on
modifications to the eligibility criteria for the personal care assistance program and limits
on the growth of the developmental disabilities and community access for disability inclusion
waivers enacted following the 2019 legislative session. The report shall include the impact
on people receiving or requesting services and any recommendations. By February 15, 2021,
the commissioner shall supplement the December 15, 2020, report with updated data and
information.
new text end
Sec. 69. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
INTERMEDIATE CARE FACILITY FOR PERSONS WITH DEVELOPMENTAL
DISABILITIES LEVEL OF CARE CRITERIA.
new text end
new text begin
By February 1, 2020, the commissioner of human services shall submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services finance and policy recommended language to codify in Minnesota Statutes
the commissioner's existing criteria for the determination of need for intermediate care
facility for persons with developmental disabilities level of care. The recommended language
shall include language clarifying "at risk of placement," "reasonable indication," and "might
require" as those expressions are used in Minnesota Statutes, section 256B.092, subdivision
7, paragraph (b). The recommended statutory language shall also include the commissioner's
current guidance with respect to the interpretation and application of the federal standard
under Code of Federal Regulations, title 42, section 483.440, that a person receiving the
services of an intermediate care facility for persons with developmental disabilities require
a continuous active treatment plan, including which characteristics are necessary or sufficient
for a determination of a need for active treatment. The commissioner shall submit the
recommended statutory language with a letter listing, with statutory references, all the
programs and services for which an intermediate care facility for persons with developmental
disabilities level of care is required.
new text end
Sec. 70. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
DIRECT CARE WORKFORCE RATE METHODOLOGY STUDY.
new text end
new text begin
The commissioner of human services, in consultation with stakeholders, shall evaluate
the feasibility of developing a rate methodology for the personal care assistance program
under Minnesota Statutes, section 256B.0659, and community first services and supports
under Minnesota Statutes, section 256B.85, similar to the disability waiver rate system
under Minnesota Statutes, section 256B.4914, including determining the component values
and factors to include in such a rate methodology; consider aligning any rate methodology
with the collective bargaining agreement and negotiation cycle under Minnesota Statutes,
section 179A.54; recommend strategies for ensuring adequate, competitive wages for direct
care workers; develop methods and determine the necessary resources for the commissioner
to more consistently collect and audit data from the direct care industry; and report
recommendations, including proposed draft legislation, to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services policy and
finance by February 1, 2020.
new text end
Sec. 71. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; HOME
CARE SERVICES PAYMENT REFORM PROPOSAL.
new text end
new text begin
The commissioner of human services shall submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services finance and
policy a proposal to adopt a budget-neutral prospective payment system for nursing services
and home health services under Minnesota Statutes, sections 256B.0625, subdivision 6a,
and 256B.0653, and home care nursing services under Minnesota Statutes, sections
256B.0625, subdivision 7, and 256B.0624, modeled on the Medicare fee-for-service home
health prospective payment system. The commissioner shall include in the proposal a case
mix adjusted episodic rate, including services, therapies and supplies, minimum visits
required for an episodic rate, consolidated billing requirements, outlier payments,
low-utilization payments, and other criteria at the commissioner's discretion. In addition to
the budget-neutral payment reform proposal, the commissioner shall also submit a proposed
mechanism for updating the payment rates to reflect inflation in health care costs.
new text end
Sec. 72. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) The revisor of statutes shall change the term "developmental disability waiver" or
similar terms to "developmental disabilities waiver" or similar terms wherever they appear
in Minnesota Statutes. The revisor shall also make technical and other necessary changes
to sentence structure to preserve the meaning of the text.
new text end
new text begin
(b) 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 2020 legislative session to codify existing session laws governing
consumer-directed community supports in Minnesota Statutes, chapter 256B.
new text end
Sec. 73. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, section 256I.05, subdivision 3,
new text end
new text begin
is repealed.
new text end
ARTICLE 6
DIRECT CARE AND TREATMENT
Section 1.
Minnesota Statutes 2018, section 246.54, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Administrative review of county liability for cost of care. new text end
new text begin
(a) The county of
financial responsibility may submit a written request for administrative review by the
commissioner of the county's payment of the cost of care when a delay in discharge of a
client from a regional treatment center, state-operated community-based behavioral health
hospital, or other state-operated facility results from the following actions by the facility:
new text end
new text begin
(1) the facility did not provide notice to the county that the facility has determined that
it is clinically appropriate for a client to be discharged;
new text end
new text begin
(2) the notice to the county that the facility has determined that it is clinically appropriate
for a client to be discharged was communicated on a holiday or weekend;
new text end
new text begin
(3) the required documentation or procedures for discharge were not completed in order
for the discharge to occur in a timely manner; or
new text end
new text begin
(4) the facility disagrees with the county's discharge plan.
new text end
new text begin
(b) The county of financial responsibility may not appeal the determination that it is
clinically appropriate for a client to be discharged from a regional treatment center,
state-operated community-based behavioral health hospital, or other state-operated facility.
new text end
new text begin
(c) The commissioner must evaluate the request for administrative review and determine
if the facility's actions listed in paragraph (a) caused undue delay in discharging the client.
If the commissioner determines that the facility's actions listed in paragraph (a) caused
undue delay in discharging the client, the county's liability will be reduced to the level of
the cost of care for a client whose stay in a facility is determined to be clinically appropriate,
effective on the date of the facility's action or failure to act that caused the delay. The
commissioner's determination under this subdivision is final.
new text end
new text begin
(d) If a county's liability is reduced pursuant to paragraph (c), a county's liability will
return to the level of the cost of care for a client whose stay in a facility is determined to no
longer be appropriate effective on the date the facility rectifies the action or failure to act
that caused the delay under paragraph (a).
new text end
new text begin
(e) Any difference in the county cost of care liability resulting from administrative review
under this subdivision shall not be billed to the client or applied to future reimbursement
from the client's estate or relatives.
new text end
Sec. 2. new text begin DIRECTION TO COMMISSIONER; REPORT REQUIRED; DISCHARGE
DELAY REDUCTION.
new text end
new text begin
No later than January 1, 2023, the commissioner of human services must submit a report
to the chairs and ranking minority members of the legislative committees with jurisdiction
over human services that provides an update on county and state efforts to reduce the number
of days clients spend in state-operated facilities after discharge from the facility has been
determined to be clinically appropriate. The report must also include information on the
fiscal impact of clinically inappropriate stays in these facilities.
new text end
Sec. 3. new text begin DIRECTION TO COMMISSIONER; MSOCS COON RAPIDS ILEX
CLOSURE.
new text end
new text begin
The commissioner of human services shall close the Minnesota state-operated community
services program known as MSOCS Coon Rapids Ilex. The commissioner must not reopen
or redesign the program. For the purposes of this section:
new text end
new text begin
(1) a program is considered closed if the commissioner discontinues providing services
at a given location;
new text end
new text begin
(2) a program is considered reopened if the commissioner opens a new program or begins
providing a new service at a location that was previously closed; and
new text end
new text begin
(3) a program is considered redesigned if the commissioner does not change the nature
of the services provided, but does change the focus of the population served by the program.
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. 4. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, section 246.18, subdivisions 8 and 9,
new text end
new text begin
are repealed.
new text end
ARTICLE 7
OPERATIONS
Section 1.
Minnesota Statutes 2018, section 16A.055, subdivision 1a, is amended to read:
Subd. 1a.
Additional duties.
The commissioner may assist state agencies by providing
analytical, statisticalnew text begin , program evaluation using experimental or quasi-experimental designnew text end ,
and organizational development services to state agencies in order to assist the agency to
achieve the agency's mission and to operate efficiently and effectively. new text begin For purposes of this
section, "experimental design" means a method of evaluating the impact of a service that
uses random assignment to assign participants into groups that respectively receive the
studied service and those that receive service as usual, so that any difference in outcomes
found at the end of the evaluation can be attributed to the studied service; and
"quasi-experimental design" means a method of evaluating the impact of a service that uses
strategies other than random assignment to establish statistically similar groups that
respectively receive the service and those that receive service as usual, so that any difference
in outcomes found at the end of the evaluation can be attributed to the studied service.
new text end
Sec. 2.
Minnesota Statutes 2018, section 245A.04, subdivision 7, is amended to read:
Subd. 7.
Grant of license; license extension.
(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
license new text begin consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043new text end . At minimum, the license shall state:
(1) the name of the license holder;
(2) the address of the program;
(3) the effective date and expiration date of the license;
(4) the type of license;
(5) the maximum number and ages of persons that may receive services from the program;
and
(6) any special conditions of licensure.
(b) The commissioner may issue deleted text begin an initialdeleted text end new text begin anew text end license for a period not to exceed two years
if:
(1) the commissioner is unable to conduct the evaluation or observation required by
subdivision 4, paragraph (a), clauses (3) and (4), because the program is not yet operational;
(2) certain records and documents are not available because persons are not yet receiving
services from the program; and
(3) the applicant complies with applicable laws and rules in all other respects.
(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program. deleted text begin A license shall not be
transferable to another individual, corporation, partnership, voluntary association, other
organization, or controlling individual or to another location.
deleted text end
deleted text begin
(d) A license holder must notify the commissioner and obtain the commissioner's approval
before making any changes that would alter the license information listed under paragraph
(a).
deleted text end
deleted text begin (e)deleted text end new text begin (d)new text end Except as provided in paragraphs deleted text begin (g)deleted text end new text begin (f)new text end and deleted text begin (h)deleted text end new text begin (g)new text end , the commissioner shall not
issue or reissue a license if the applicant, license holder, or controlling individual has:
(1) been disqualified and the disqualification was not set aside and no variance has been
granted;
(2) been denied a license within the past two years;
(3) had a license new text begin issued under this chapter new text end revoked within the past five years;
(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement
for which payment is delinquent; or
(5) failed to submit the information required of an applicant under subdivision 1,
paragraph (f) or (g), after being requested by the commissioner.
When a license new text begin issued under this chapter new text end is revoked under clause (1) or (3), the license
holder and controlling individual may not hold any license under chapter 245A or 245D for
five years following the revocation, and other licenses held by the applicant, license holder,
or controlling individual shall also be revoked.
deleted text begin (f)deleted text end new text begin (e)new text end The commissioner shall not issue or reissue a license new text begin under this chapternew text end if an
individual living in the household where the deleted text begin licenseddeleted text end services will be provided as specified
under section 245C.03, subdivision 1, has been disqualified and the disqualification has not
been set aside and no variance has been granted.
deleted text begin (g)deleted text end new text begin (f)new text end Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license new text begin issued
under this chapternew text end has been suspended or revoked and the suspension or revocation is under
appeal, the program may continue to operate pending a final order from the commissioner.
If the license under suspension or revocation will expire before a final order is issued, a
temporary provisional license may be issued provided any applicable license fee is paid
before the temporary provisional license is issued.
deleted text begin (h)deleted text end new text begin (g)new text end Notwithstanding paragraph deleted text begin (g)deleted text end new text begin (f)new text end , when a revocation is based on the
disqualification of a controlling individual or license holder, and the controlling individual
or license holder is ordered under section 245C.17 to be immediately removed from direct
contact with persons receiving services or is ordered to be under continuous, direct
supervision when providing direct contact services, the program may continue to operate
only if the program complies with the order and submits documentation demonstrating
compliance with the order. If the disqualified individual fails to submit a timely request for
reconsideration, or if the disqualification is not set aside and no variance is granted, the
order to immediately remove the individual from direct contact or to be under continuous,
direct supervision remains in effect pending the outcome of a hearing and final order from
the commissioner.
deleted text begin (i)deleted text end new text begin (h)new text end For purposes of reimbursement for meals only, under the Child and Adult Care
Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A,
part 226, relocation within the same county by a licensed family day care provider, shall
be considered an extension of the license for a period of no more than 30 calendar days or
until the new license is issued, whichever occurs first, provided the county agency has
determined the family day care provider meets licensure requirements at the new location.
deleted text begin (j)deleted text end new text begin (i)new text end Unless otherwise specified by statute, all licenses new text begin issued under this chapternew text end expire
at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
apply for and be granted a new license to operate the program or the program must not be
operated after the expiration date.
deleted text begin (k)deleted text end new text begin (j)new text end The commissioner shall not issue or reissue a license new text begin under this chapternew text end if it has
been determined that a tribal licensing authority has established jurisdiction to license the
program or service.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 3.
Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision to
read:
new text begin Subd. 7a. new text end
new text begin Notification required. new text end
new text begin
(a) A license holder must notify the commissioner and
obtain the commissioner's approval before making any change that would alter the license
information listed under subdivision 7, paragraph (a).
new text end
new text begin
(b) At least 30 days before the effective date of a change, the license holder must notify
the commissioner in writing of any change:
new text end
new text begin
(1) to the license holder's controlling individual as defined in section 245A.02, subdivision
5a;
new text end
new text begin
(2) to license holder information on file with the secretary of state;
new text end
new text begin
(3) in the location of the program or service licensed under this chapter; and
new text end
new text begin
(4) in the federal or state tax identification number associated with the license holder.
new text end
new text begin
(c) When a license holder notifies the commissioner of a change to the business structure
governing the licensed program or services but is not selling the business, the license holder
must provide amended articles of incorporation and other documentation of the change and
any other information requested by the commissioner.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 4.
new text begin
[245A.043] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP.
new text end
new text begin Subdivision 1. new text end
new text begin Transfer prohibited. new text end
new text begin
A license issued under this chapter is only valid
for a premises and individual, organization, or government entity identified by the
commissioner on the license. A license is not transferable or assignable.
new text end
new text begin Subd. 2. new text end
new text begin Change of ownership. new text end
new text begin
If the commissioner determines that there will be a
change of ownership, the commissioner shall require submission of a new license application.
A change of ownership occurs when:
new text end
new text begin
(1) the license holder sells or transfers 100 percent of the property, stock, or assets;
new text end
new text begin
(2) the license holder merges with another organization;
new text end
new text begin
(3) the license holder consolidates with two or more organizations, resulting in the
creation of a new organization;
new text end
new text begin
(4) there is a change in the federal tax identification number associated with the license
holder; or
new text end
new text begin
(5) there is a turnover of each controlling individual associated with the license within
a 12-month period. A change to the license holder's controlling individuals, including a
change due to a transfer of stock, is not a change of ownership if at least one controlling
individual who was listed on the license for at least 12 consecutive months continues to be
a controlling individual after the reported change.
new text end
new text begin Subd. 3. new text end
new text begin Change of ownership requirements. new text end
new text begin
(a) A license holder who intends to
change the ownership of the program or service under subdivision 2 to a party that intends
to assume operation without an interruption in service longer than 60 days after acquiring
the program or service must provide the commissioner with written notice of the proposed
sale or change, on a form provided by the commissioner, at least 60 days before the
anticipated date of the change in ownership. For purposes of this subdivision and subdivision
4, "party" means the party that intends to operate the service or program.
new text end
new text begin
(b) The party must submit a license application under this chapter on the form and in
the manner prescribed by the commissioner at least 30 days before the change of ownership
is complete and must include documentation to support the upcoming change. The form
and manner of the application prescribed by the commissioner shall require only information
which is specifically required by statute or rule. The party must comply with background
study requirements under chapter 245C and shall pay the application fee required in section
245A.10. A party that intends to assume operation without an interruption in service longer
than 60 days after acquiring the program or service is exempt from the requirements of
Minnesota Rules, part 9530.6800.
new text end
new text begin
(c) The commissioner may develop streamlined application procedures when the party
is an existing license holder under this chapter and is acquiring a program licensed under
this chapter or service in the same service class as one or more licensed programs or services
the party operates and those licenses are in substantial compliance according to the licensing
standards in this chapter and applicable rules. For purposes of this subdivision, "substantial
compliance" means within the past 12 months the commissioner did not: (i) issue a sanction
under section 245A.07 against a license held by the party or (ii) make a license held by the
party conditional according to section 245A.06.
new text end
new text begin
(d) Except when a temporary change of ownership license is issued pursuant to
subdivision 4, the existing license holder is solely responsible for operating the program
according to applicable rules and statutes until a license under this chapter is issued to the
party.
new text end
new text begin
(e) If a licensing inspection of the program or service was conducted within the previous
12 months and the existing license holder's license record demonstrates substantial
compliance with the applicable licensing requirements, the commissioner may waive the
party's inspection required by section 245A.04, subdivision 4. The party must submit to the
commissioner proof that the premises was inspected by a fire marshal or that the fire marshal
deemed that an inspection was not warranted and proof that the premises was inspected for
compliance with the building code or that no inspection was deemed warranted.
new text end
new text begin
(f) If the party is seeking a license for a program or service that has an outstanding
correction order, the party must submit a letter with the license application identifying how
and within what length of time the party shall resolve the outstanding correction order and
come into full compliance with the licensing requirements.
new text end
new text begin
(g) Any action taken under section 245A.06 or 245A.07 against the existing license
holder's license at the time the party is applying for a license, including when the existing
license holder is operating under a conditional license or is subject to a revocation, shall
remain in effect until the commissioner determines that the grounds for the action are
corrected or no longer exist.
new text end
new text begin
(h) The commissioner shall evaluate the application of the party according to section
245A.04, subdivision 6. Pursuant to section 245A.04, subdivision 7, if the commissioner
determines that the party complies with applicable laws and rules, the commissioner may
issue a license or a temporary change of ownership license.
new text end
new text begin
(i) The commissioner may deny an application as provided in section 245A.05. An
applicant whose application was denied by the commissioner may appeal the denial according
to section 245A.05.
new text end
new text begin
(j) This subdivision does not apply to a licensed program or service located in a home
where the license holder resides.
new text end
new text begin Subd. 4. new text end
new text begin Temporary change of ownership license. new text end
new text begin
(a) After receiving the party's
application and upon the written request of the existing license holder and the party, the
commissioner may issue a temporary change of ownership license to the party while the
commissioner evaluates the party's application. Until a decision is made to grant or deny a
license under this chapter, the existing license holder and the party shall both be responsible
for operating the program or service according to applicable laws and rules, and the sale or
transfer of the license holder's ownership interest in the licensed program or service does
not terminate the existing license.
new text end
new text begin
(b) The commissioner may establish criteria to issue a temporary change of ownership
license, if a license holder's death, divorce, or other event affects the ownership of the
program, when an applicant seeks to assume operation of the program or service to ensure
continuity of the program or service while a license application is evaluated. This subdivision
applies to any program or service licensed under this chapter.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 5.
Minnesota Statutes 2018, section 245A.065, is amended to read:
245A.065 CHILD CARE FIX-IT TICKET.
new text begin Subdivision 1. new text end
new text begin Contents of fix-it tickets. new text end
(a) In lieu of a correction order under section
245A.06, the commissioner deleted text begin shalldeleted text end new text begin maynew text end issue a fix-it ticket to a family child care or child care
center license holder if the commissioner finds that:
(1) the license holder has failed to comply with a requirement in this chapter or Minnesota
Rules, chapter 9502 or 9503deleted text begin , that the commissioner determines to be eligible for a fix-it
ticketdeleted text end ;
(2) the violation does not imminently endanger the health, safety, or rights of the persons
served by the program;
(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 begin and
new text end
(4) the violation deleted text begin candeleted text end new text begin cannotnew text end be corrected at the time of inspectiondeleted text begin or within 48 hours,
excluding Saturdays, Sundays, and holidays; and
deleted text end
deleted 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 holidaysdeleted text end .
(b) new text begin The commissioner shall not issue a fix-it ticket for violations that are corrected at
the time of the inspection.
new text end
new text begin (c) new text end The fix-it ticket must state:
(1) the conditions that constitute a violation of the law or rule;
(2) the specific law or rule violated; and
(3) that the violation deleted text begin was corrected at the time of inspection ordeleted text end must be corrected within
48 hours, excluding Saturdays, Sundays, and holidays.
deleted text begin (c)deleted text end new text begin (d)new text end The commissioner shall not publicly publish a fix-it ticket on the department's
website.
deleted text begin (d)deleted text end new text begin (e)new text end 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.
deleted text begin (e)deleted text end new text begin (f)new text end If the violation is not corrected deleted text begin at the time of inspection ordeleted text end 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 ordernew text begin , according to section 245A.06,new text end for the violation of Minnesota law or rule
identified in the fix-it ticketdeleted text begin according to section 245A.06deleted text end .
deleted 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 website.
deleted text end
new text begin Subd. 2. new text end
new text begin Fix-it ticket laws and rules. new text end
new text begin
(a) For family child care license holders, violations
of the following laws and rules may qualify only for a fix-it ticket: 9502.0335, subpart 10;
9502.0375, subpart 2; 9502.0395; 9502.0405, subpart 3; 9502.0405, subpart 4, item A;
9502.0415, subpart 3; 9502.0425, subpart 2 (outdoor play spaces must be free from litter,
rubbish, unlocked vehicles, or human or animal waste); 9502.0425, subpart 3 (wading pools
must be kept clean); 9502.0425, subpart 5; 9502.0425, subpart 7, item F (screens on exterior
doors and windows when biting insects are prevalent); 9502.0425, subpart 8; 9502.0425,
subpart 10; 9502.0425, subpart 11 (decks free of splinters); 9502.0425, subpart 13 (toilets
flush thoroughly); 9502.0425, subpart 16; 9502.0435, subpart 1; 9502.0435, subpart 3;
9502.0435, subpart 7; 9502.0435, subpart 8, item B; 9502.0435, subpart 8, item E; 9502.0435,
subpart 12, items A through E; 9502.0435, subpart 13; 9502.0435, subpart 14; 9502.0435,
subpart 15; 9502.0435, subpart 15, items A and B; 9502.0445, subpart 1, item B; 9502.0445,
subpart 3, items B through D; 9502.0445, subpart 4, items A through C; 245A.04, subdivision
14, paragraph (c); 245A.06, subdivision 8; 245A.07, subdivision 5; 245A.146, subdivision
3, paragraph (c); 245A.148; 245A.152; 245A.50, subdivision 7; 245A.51, subdivision 3,
paragraph (d) (emergency preparedness plan available for review and posted in prominent
location).
new text end
new text begin
(b) For child care center license holders, violations of the following laws and rules may
qualify only for a fix-it ticket: 9503.0120, item B; 9503.0120, item E; 9503.0125, item E;
9503.0125, item F; 9503.0125, item I; 9503.0125, item M; 9503.0140, subpart 2; 9503.0140,
subpart 7, item D; 9503.0140, subpart 9; 9503.0140, subpart 10; 9503.0140, subpart 13;
9503.0140, subpart 14; 9503.0140, subpart 15; 9503.0140, subpart 16 (item missing from
first-aid kit); 9503.0140, subpart 18; 9503.0140, subpart 19; 9503.0140, subpart 20;
9503.0140, subpart 21 (emergency plan not posted in prominent place); 9503.0145, subpart
2; 9503.0145, subpart 3; 9503.0145, subpart 4, item D; 9503.0145, subpart 8 (drinking water
provided in single service cups or at an accessible drinking fountain); 9503.0155, subpart
7, item D; 9503.0155, subpart 13; 9503.0155, subpart 16; 9503.0155, subpart 17; 9503.0155,
subpart 18, item D; 9503.0170, subpart 3; 9503.0145, subpart 7, item D; 245A.04, subdivision
14, paragraph (c); 245A.06, subdivision 8; 245A.07, subdivision 5; 245A.14, subdivision
8, paragraph (b) (experienced aide identification posting); 245A.146, subdivision 3, paragraph
(c); 245A.152; 245A.41, subdivision 3, paragraph (d); 245A.41, subdivision 3, paragraph
(e); 245A.41, subdivision 3, paragraph (f).
new text end
Sec. 6.
Minnesota Statutes 2018, section 245C.02, is amended by adding a subdivision to
read:
new text begin Subd. 20. new text end
new text begin Substance use disorder treatment field. new text end
new text begin
"Substance use disorder treatment
field" means a program exclusively serving individuals 18 years of age and older and that
is required to be:
new text end
new text begin
(1) licensed under chapter 245G; or
new text end
new text begin
(2) registered under section 157.17 as a board and lodge establishment that predominantly
serves individuals being treated for or recovering from a substance use disorder.
new text end
Sec. 7.
Minnesota Statutes 2018, section 245C.22, subdivision 4, is amended to read:
Subd. 4.
Risk of harm; set aside.
(a) The commissioner may set aside the disqualification
if the commissioner finds that the individual has submitted sufficient information to
demonstrate that the individual does not pose a risk of harm to any person served by the
applicant, license holder, or other entities as provided in this chapter.
(b) In determining whether the individual has met the burden of proof by demonstrating
the individual does not pose a risk of harm, the commissioner shall consider:
(1) the nature, severity, and consequences of the event or events that led to the
disqualification;
(2) whether there is more than one disqualifying event;
(3) the age and vulnerability of the victim at the time of the event;
(4) the harm suffered by the victim;
(5) vulnerability of persons served by the program;
(6) the similarity between the victim and persons served by the program;
(7) the time elapsed without a repeat of the same or similar event;
(8) documentation of successful completion by the individual studied of training or
rehabilitation pertinent to the event; and
(9) any other information relevant to reconsideration.
(c) If the individual requested reconsideration on the basis that the information relied
upon to disqualify the individual was incorrect or inaccurate and the commissioner determines
that the information relied upon to disqualify the individual is correct, the commissioner
must also determine if the individual poses a risk of harm to persons receiving services in
accordance with paragraph (b).
new text begin
(d) For an individual seeking employment in the substance use disorder treatment field,
the commissioner shall set aside the disqualification if the following criteria are met:
new text end
new text begin
(1) the individual is not disqualified for a crime of violence as listed under section
624.712, subdivision 5, except that the following crimes are prohibitory offenses: crimes
listed under section 152.021, subdivision 2 or 2a; 152.022, subdivision 2; 152.023,
subdivision 2; 152.024; or 152.025;
new text end
new text begin
(2) the individual is not disqualified under section 245C.15, subdivision 1;
new text end
new text begin
(3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph
(b);
new text end
new text begin
(4) the individual provided documentation of successful completion of treatment, at least
one year prior to the date of the request for reconsideration, at a program licensed under
chapter 245G, and has had no disqualifying crimes or conduct under section 245C.15 after
the successful completion of treatment;
new text end
new text begin
(5) the individual provided documentation demonstrating abstinence from controlled
substances, as defined in section 152.01, subdivision 4, for the period of one year prior to
the date of the request for reconsideration; and
new text end
new text begin
(6) the individual is seeking employment in the substance use disorder treatment field.
new text end
Sec. 8.
Minnesota Statutes 2018, section 245C.22, subdivision 5, is amended to read:
Subd. 5.
Scope of set-aside.
(a) If the commissioner sets aside a disqualification under
this section, the disqualified individual remains disqualified, but may hold a license and
have direct contact with or access to persons receiving services. Except as provided in
paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the
licensed program, applicant, or agency specified in the set aside notice under section 245C.23.
For personal care provider organizations, the commissioner's set-aside may further be limited
to a specific individual who is receiving services. For new background studies required
under section 245C.04, subdivision 1, paragraph (h), if an individual's disqualification was
previously set aside for the license holder's program and the new background study results
in no new information that indicates the individual may pose a risk of harm to persons
receiving services from the license holder, the previous set-aside shall remain in effect.
(b) If the commissioner has previously set aside an individual's disqualification for one
or more programs or agencies, and the individual is the subject of a subsequent background
study for a different program or agency, the commissioner shall determine whether the
disqualification is set aside for the program or agency that initiated the subsequent
background study. A notice of a set-aside under paragraph (c) shall be issued within 15
working days if all of the following criteria are met:
(1) the subsequent background study was initiated in connection with a program licensed
or regulated under the same provisions of law and rule for at least one program for which
the individual's disqualification was previously set aside by the commissioner;
(2) the individual is not disqualified for an offense specified in section 245C.15,
subdivision 1 or 2;
(3) the commissioner has received no new information to indicate that the individual
may pose a risk of harm to any person served by the program; and
(4) the previous set-aside was not limited to a specific person receiving services.
new text begin
(c) Notwithstanding paragraph (b), clause (2), for an individual who is employed in the
substance use disorder field, if the commissioner has previously set aside an individual's
disqualification for one or more programs or agencies in the substance use disorder treatment
field, and the individual is the subject of a subsequent background study for a different
program or agency in the substance use disorder treatment field, the commissioner shall set
aside the disqualification for the program or agency in the substance use disorder treatment
field that initiated the subsequent background study when the criteria under paragraph (b),
clauses (1), (3), and (4), are met and the individual is not disqualified for an offense specified
in section 254C.15, subdivision 1. A notice of a set-aside under paragraph (d) shall be issued
within 15 working days.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end When a disqualification is set aside under paragraph (b), the notice of background
study results issued under section 245C.17, in addition to the requirements under section
245C.17, shall state that the disqualification is set aside for the program or agency that
initiated the subsequent background study. The notice must inform the individual that the
individual may request reconsideration of the disqualification under section 245C.21 on the
basis that the information used to disqualify the individual is incorrect.
Sec. 9.
new text begin
[245I.01] OFFICE OF INSPECTOR GENERAL.
new text end
new text begin Subdivision 1. new text end
new text begin Creation. new text end
new text begin
A state Office of Inspector General is created.
new text end
new text begin Subd. 2. new text end
new text begin Director. new text end
new text begin
(a) The office shall be under the direction of an inspector general
who shall be appointed by the governor, with the advice and consent of the senate, for a
term ending on June 30 of the sixth calendar year after appointment. Senate confirmation
of the inspector general shall be as provided by section 15.066. The inspector general shall
appoint deputies to serve in the office as necessary to fulfill the duties of the office. The
inspector general may delegate to a subordinate employee the exercise of a specified statutory
power or duty, subject to the control of the inspector general. Every delegation must be by
written order filed with the secretary of state.
new text end
new text begin
(b) The inspector general shall be in the unclassified service, but may be removed only
for cause.
new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin
The inspector general shall, in coordination with counties where
applicable:
new text end
new text begin
(1) develop and maintain the licensing and regulatory functions related to hospitals,
boarding care homes, outpatient surgical centers, birthing centers, nursing homes, home
care agencies, supplemental nursing services agencies, hospice providers, housing with
services establishments, assisted living facilities, prescribed pediatric extended care centers,
and board and lodging establishments with special services consistent with chapters 144A,
144D, 144G, and 144H, and sections 144.50 to 144.58, 144.615, and 157.17;
new text end
new text begin
(2) notwithstanding the requirement under section 144A.52, subdivision 1, that the
director of the Office of Health Facility Complaints be appointed by the commissioner of
health, assume the role of director of the Office of Health Facility Complaints;
new text end
new text begin
(3) develop and maintain the licensing and regulatory functions related to adult day care,
child care and early education, children's residential facilities, foster care, home and
community-based services, independent living assistance for youth, outpatient mental health
clinics or centers, residential mental health treatment for adults, and substance use disorder
treatment consistent with chapters 245, 245A, 245D, 245F, 245G, 245H, 252, and 256;
new text end
new text begin
(4) conduct background studies according to sections 144.057, 144A.476, 144A.62,
144A.754, and 157.17 and chapter 245C. For the purpose of completing background studies,
the inspector general shall have authority to access maltreatment data maintained by local
welfare agencies or agencies responsible for assessing or investigating reports under section
626.556, and names of substantiated perpetrators related to maltreatment of vulnerable
adults maintained by the commissioner of human services under section 626.557;
new text end
new text begin
(5) develop and maintain the background study requirements consistent with chapter
245C;
new text end
new text begin
(6) be responsible for ensuring the detection, prevention, investigation, and resolution
of fraudulent activities or behavior by applicants, recipients, providers, and other participants
in the human services programs administered by the Department of Human Services;
new text end
new text begin
(7) require county agencies to identify overpayments, establish claims, and utilize all
available and cost-beneficial methodologies to collect and recover these overpayments in
the human services programs administered by the Department of Human Services; and
new text end
new text begin
(8) develop, maintain, and administer the common entry point established on July 1,
2015, under section 626.557, subdivision 9.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020.
new text end
Sec. 10.
new text begin
[245I.02] TRANSFER OF DUTIES.
new text end
new text begin Subdivision 1. new text end
new text begin Transfer and reorganization orders. new text end
new text begin
(a) Section 15.039 applies to the
transfer of duties required by this chapter.
new text end
new text begin
(b) For an employee affected by the transfer of duties required by this chapter, the
seniority accrued by the employee at the employee's former agency transfers to the employee's
new agency.
new text end
new text begin Subd. 2. new text end
new text begin Transfer of duties from the commissioner of human services. new text end
new text begin
The
commissioner of administration, with approval of the governor, may issue reorganization
orders under section 16B.37 as necessary to carry out the transfer of duties of the
commissioner of human services required by this chapter. The provision of section 16B.37,
subdivision 1, stating that transfers under that section may be made only to an agency that
has been in existence for at least one year does not apply to transfers to an agency created
by this chapter.
new text end
new text begin Subd. 3. new text end
new text begin Transfer of duties from the commissioner of health. new text end
new text begin
The commissioner of
administration, with approval of the governor, may issue reorganization orders under section
16B.37 as necessary to carry out the transfer of duties of the commissioner of health required
by this chapter. The provision of section 16B.37, subdivision 1, stating that transfers under
that section may be made only to an agency that has been in existence for at least one year
does not apply to transfers to an agency created by this chapter.
new text end
new text begin Subd. 4. new text end
new text begin Aggregate cost limit. new text end
new text begin
The commissioner of management and budget must
ensure that the aggregate cost for the inspector general of the Office of Inspector General
is not more than the aggregate cost of the primary executives in the Office of Inspector
General at the Department of Human Services and the Health Regulation Division at the
Department of Health immediately before the effective date of subdivision 2.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Subdivisions 1, 2, and 4, are effective July 1, 2020. Subdivision
3 is effective July 1, 2022.
new text end
Sec. 11.
new text begin
[256.0113] COUNTY HUMAN SERVICES STATE FUNDING
REALLOCATION.
new text end
new text begin
(a) Beginning October 1, 2019, counties and tribes or tribal agencies receiving human
services grants funded exclusively with state general fund dollars may allocate any
unexpended grant amounts to any county or tribal human services activity for the fourth
quarter of the county or tribe's fiscal year.
new text end
new text begin
(b) Any proposed reallocation of unspent funds must be approved by majority vote of
the county board or the tribe or tribal agency's governing body.
new text end
new text begin
(c) Each county, tribe, or tribal agency shall report any approved reallocation of unspent
grant funds to the commissioner of human services by March 31 of each year following a
reallocation under this section. The report shall describe the use of the reallocated human
services grant funds, compare how the funds were allocated prior to the reallocation, and
explain the advantages or disadvantages of the reallocation.
new text end
Sec. 12.
Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
Subd. 21.
Provider enrollment.
(a) If the commissioner or the Centers for Medicare
and Medicaid Services determines that a provider is designated "high-risk," the commissioner
may withhold payment from providers within that category upon initial enrollment for a
90-day period. The withholding for each provider must begin on the date of the first
submission of a claim.
(b) An enrolled provider that is also licensed by the commissioner under chapter 245A,
or is licensed as a home care provider by the Department of Health under chapter 144A and
has a home and community-based services designation on the home care license under
section 144A.484, must designate an individual as the entity's compliance officer. The
compliance officer must:
(1) develop policies and procedures to assure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;
(2) train the employees of the provider entity, and any agents or subcontractors of the
provider entity including billers, on the policies and procedures under clause (1);
(3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services, and implement action to remediate any resulting problems;
(4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;
(5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and
(6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.
The commissioner may require, as a condition of enrollment in medical assistance, that a
provider within a particular industry sector or category establish a compliance program that
contains the core elements established by the Centers for Medicare and Medicaid Services.
(c) The commissioner may revoke the enrollment of an ordering or rendering provider
for a period of not more than one year, if the provider fails to maintain and, upon request
from the commissioner, provide access to documentation relating to written orders or requests
for payment for durable medical equipment, certifications for home health services, or
referrals for other items or services written or ordered by such provider, when the
commissioner has identified a pattern of a lack of documentation. A pattern means a failure
to maintain documentation or provide access to documentation on more than one occasion.
Nothing in this paragraph limits the authority of the commissioner to sanction a provider
under the provisions of section 256B.064.
(d) The commissioner shall terminate or deny the enrollment of any individual or entity
if the individual or entity has been terminated from participation in Medicare or under the
Medicaid program or Children's Health Insurance Program of any other state.new text begin The
commissioner may exempt a rehabilitation agency from termination or denial that would
otherwise be required under this paragraph, if the agency:
new text end
new text begin
(1) is unable to retain Medicare certification and enrollment solely due to a lack of billing
to the Medicare program;
new text end
new text begin
(2) meets all other applicable Medicare certification requirements based on an on-site
review completed by the commissioner of health; and
new text end
new text begin
(3) serves primarily a pediatric population.
new text end
(e) As a condition of enrollment in medical assistance, the commissioner shall require
that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
Services, its agents, or its designated contractors and the state agency, its agents, or its
designated contractors to conduct unannounced on-site inspections of any provider location.
The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
and standards used to designate Medicare providers in Code of Federal Regulations, title
42, section 424.518. The list and criteria are not subject to the requirements of chapter 14.
The commissioner's designations are not subject to administrative appeal.
(f) As a condition of enrollment in medical assistance, the commissioner shall require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
high-risk for fraud, waste, or abuse.
(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable
medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
meeting the durable medical equipment provider and supplier definition in clause (3),
operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
annually renewed and designates the Minnesota Department of Human Services as the
obligee, and must be submitted in a form approved by the commissioner. For purposes of
this clause, the following medical suppliers are not required to obtain a surety bond: a
federally qualified health center, a home health agency, the Indian Health Service, a
pharmacy, and a rural health clinic.
(2) At the time of initial enrollment or reenrollment, durable medical equipment providers
and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and
fees in pursuing a claim on the bond.
(3) "Durable medical equipment provider or supplier" means a medical supplier that can
purchase medical equipment or supplies for sale or rental to the general public and is able
to perform or arrange for necessary repairs to and maintenance of equipment offered for
sale or rental.
(h) The Department of Human Services may require a provider to purchase a surety
bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
if: (1) the provider fails to demonstrate financial viability, (2) the department determines
there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
provider or category of providers is designated high-risk pursuant to paragraph (a) and as
per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an
amount of $100,000 or ten percent of the provider's payments from Medicaid during the
immediately preceding 12 months, whichever is greater. The surety bond must name the
Department of Human Services as an obligee and must allow for recovery of costs and fees
in pursuing a claim on the bond. This paragraph does not apply if the provider currently
maintains a surety bond under the requirements in section 256B.0659 or 256B.85.
Sec. 13. new text begin INFORMATION TECHNOLOGY PROJECTS; PERFORMANCE
REQUIREMENT.
new text end
new text begin
The commissioner of human services shall incorporate measurable indicators of progress
toward completion into every information technology project contract. The indicators of
progress toward completion must be periodic and at least measure progress for every 25
percent increment toward completion of the project. Every contract must withhold at least
ten percent of the total contract amount until the project is complete. The contract must
specify that in every instance where an indicator of progress toward completion is not met,
a specified proportion of the contract shall be withheld. The minimum amount withheld
shall be ten percent of the cumulative amount of the contract up to the date of the failure to
meet the indicator of progress toward completion. If an information technology project is
not completed on time according to the original contract, the commissioner shall reduce the
amount of the contract by ten percent.
new text end
Sec. 14. new text begin EVALUATION OF GRANT PROGRAMS; PROVEN-EFFECTIVE
PRACTICES.
new text end
new text begin
(a) The commissioner of management and budget shall consult with the commissioner
of human services to establish a plan to review the services delivered under grant programs
administered by the commissioner of human services to determine whether the grant programs
prioritize proven-effective or promising practices.
new text end
new text begin
(b) In accordance with the plan established in paragraph (a), the commissioner of
management and budget, in consultation with the commissioner of human services, shall
identify services to evaluate using an experimental or quasi-experimental design to provide
information needed to modify or develop grant programs to promote proven-effective
practices to improve the intended outcomes of the grant program.
new text end
new text begin
(c) The commissioner of management and budget, in consultation with the commissioner
of human services, shall develop reports for the legislature and other stakeholders to provide
information on incorporating proven-effective practices in program and budget decisions.
The commissioner of management and budget, under Minnesota Statutes, section 15.08,
may obtain additional relevant data to support the evaluation activities under this section.
new text end
new text begin
(d) For purposes of this section, the following terms have the meanings given:
new text end
new text begin
(1) "proven-effective practice" means a service or practice that offers a high level of
research on effectiveness for at least one outcome of interest, as determined through multiple
evaluations outside of Minnesota or one or more local evaluation in Minnesota. The research
on effectiveness used to determine whether a service is proven-effective must use rigorously
implemented experimental or quasi-experimental designs; and
new text end
new text begin
(2) "promising practices" means a service or practice that is supported by research
demonstrating effectiveness for at least one outcome of interest, and includes a single
evaluation that is not contradicted by other studies, but does not meet the full criteria for
the proven-effective designation. The research on effectiveness used to determine whether
a service is a promising practice must use rigorously implemented experimental or
quasi-experimental designs.
new text end
Sec. 15. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes, in consultation with staff from the House Research Department;
House Fiscal Analysis; the Office of Senate Counsel, Research and Fiscal Analysis; and
the respective departments shall prepare legislation for introduction in the 2020 legislative
session proposing the statutory changes needed to implement the transfers of duties required
by Minnesota Statutes, sections 245I.01 and 245I.02.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 16. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, sections 16A.724, subdivision 2; and 245G.11, subdivisions
1, 4, and 7,
new text end
new text begin
are repealed.
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 8
DEPARTMENT OF HUMAN SERVICES; HEALTH CARE
Section 1.
Minnesota Statutes 2018, section 13.69, subdivision 1, is amended to read:
Subdivision 1.
Classifications.
(a) The following government data of the Department
of Public Safety are private data:
(1) medical data on driving instructors, licensed drivers, and applicants for parking
certificates and special license plates issued to physically disabled persons;
(2) other data on holders of a disability certificate under section 169.345, except that (i)
data that are not medical data may be released to law enforcement agencies, and (ii) data
necessary for enforcement of sections 169.345 and 169.346 may be released to parking
enforcement employees or parking enforcement agents of statutory or home rule charter
cities and towns;
(3) Social Security numbers in driver's license and motor vehicle registration records,
except that Social Security numbers must be provided to the Department of Revenue for
purposes of tax administration, the Department of Labor and Industry for purposes of
workers' compensation administration and enforcement, the judicial branch for purposes of
debt collection, and the Department of Natural Resources for purposes of license application
administrationnew text begin , and except that the last four digits of the Social Security number must be
provided to the Department of Human Services for purposes of recovery of Minnesota health
care program benefits paidnew text end ; and
(4) data on persons listed as standby or temporary custodians under section 171.07,
subdivision 11, except that the data must be released to:
(i) law enforcement agencies for the purpose of verifying that an individual is a designated
caregiver; or
(ii) law enforcement agencies who state that the license holder is unable to communicate
at that time and that the information is necessary for notifying the designated caregiver of
the need to care for a child of the license holder.
The department may release the Social Security number only as provided in clause (3)
and must not sell or otherwise provide individual Social Security numbers or lists of Social
Security numbers for any other purpose.
(b) The following government data of the Department of Public Safety are confidential
data: data concerning an individual's driving ability when that data is received from a member
of the individual's family.
Sec. 2.
new text begin
[254A.21] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION
GRANTS.
new text end
new text begin
(a) The commissioner of human services shall award a grant to a statewide organization
that focuses solely on prevention of and intervention with fetal alcohol spectrum disorders.
The grant recipient must make subgrants to eligible regional collaboratives in rural and
urban areas of the state for the purposes specified in paragraph (c).
new text end
new text begin
(b) "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 a multicounty organization, a tribal government, a county-based purchasing entity, or a
community health board.
new text end
new text begin
(c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of
fetal alcohol spectrum 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. Eligible regional collaboratives must provide intensive services
to chemically dependent women to increase positive birth outcomes.
new text end
new text begin
(d) An eligible regional collaborative that receives a subgrant under this section must
report to the grant recipient by January 15 of each year on the services and programs funded
by the subgrant. 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.
The grant recipient must compile the information in the subgrant reports and submit a
summary report to the commissioner of human services by February 15 of each year.
new text end
Sec. 3.
Minnesota Statutes 2018, section 256.9365, is amended to read:
256.9365 PURCHASE OF deleted text begin CONTINUATIONdeleted text end new text begin HEALTH CAREnew text end COVERAGE FOR
deleted text begin AIDS PATIENTSdeleted text end new text begin PEOPLE LIVING WITH HIVnew text end .
Subdivision 1.
Program established.
The commissioner of human services shall establish
a program to pay deleted text begin privatedeleted text end new text begin the cost ofnew text end health plan premiumsnew text begin and cost sharing for prescriptions,
including co-payments, deductibles, and coinsurancenew text end for persons who have contracted human
immunodeficiency virus (HIV) to enable them to continue coverage under new text begin or enroll in new text end a
group or individual health plan. If a person is determined to be eligible under subdivision
2, the commissioner shall pay the deleted text begin portion of the group plan premium for which the individual
is responsible, if the individual is responsible for at least 50 percent of the cost of the
premium, or pay the individual plan premiumdeleted text end new text begin health insurance premiums and prescription
cost sharing, including co-payments and deductibles required under section 256B.0631new text end .
The commissioner shall not pay for that portion of a premium that is attributable to other
family members or dependentsnew text begin or is paid by the individual's employernew text end .
Subd. 2.
Eligibility requirements.
To be eligible for the program, an applicant must
deleted text begin satisfy the following requirements:deleted text end new text begin meet all eligibility requirements for and enroll in Part
B of the Ryan White HIV/AIDS Treatment Extension Act of 2009, Public Law 111-87.
new text end
deleted text begin
(1) the applicant must provide a physician's, advanced practice registered nurse's, or
physician assistant's statement verifying that the applicant is infected with HIV and is, or
within three months is likely to become, too ill to work in the applicant's current employment
because of HIV-related disease;
deleted text end
deleted text begin
(2) the applicant's monthly gross family income must not exceed 300 percent of the
federal poverty guidelines, after deducting medical expenses and insurance premiums;
deleted text end
deleted text begin
(3) the applicant must not own assets with a combined value of more than $25,000; and
deleted text end
deleted text begin
(4) if applying for payment of group plan premiums, the applicant must be covered by
an employer's or former employer's group insurance plan.
deleted text end
Subd. 3.
Cost-effective coverage.
Requirements for the payment of individual plan
premiums under deleted text begin subdivision 2, clause (5),deleted text end new text begin this sectionnew text end must be designed to ensure that the
state cost of paying an individual plan premium does not exceed the estimated state cost
that would otherwise be incurred in the medical assistance program. The commissioner
shall purchase the most cost-effective coverage available for eligible individuals.
Sec. 4.
Minnesota Statutes 2018, section 256B.04, subdivision 14, is amended to read:
Subd. 14.
Competitive bidding.
(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:
(1) eyeglasses;
(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;
(3) hearing aids and supplies; and
(4) durable medical equipment, including but not limited to:
(i) hospital beds;
(ii) commodes;
(iii) glide-about chairs;
(iv) patient lift apparatus;
(v) wheelchairs and accessories;
(vi) oxygen administration equipment;
(vii) respiratory therapy equipment;
(viii) electronic diagnostic, therapeutic and life-support systems;
(5) nonemergency medical transportation level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements; and
(6) drugs.
(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not
affect contract payments under this subdivision unless specifically identified.
(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation deleted text begin for special transportation servicesdeleted text end under the provisions of chapter 16Cnew text begin for
special transportation services or incontinence products and related suppliesnew 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. 5.
Minnesota Statutes 2018, section 256B.056, subdivision 1, is amended to read:
Subdivision 1.
Residency.
new text begin (a) new text end To be eligible for medical assistance, a person must reside
in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota, in
accordance with Code of Federal Regulations, title 42, section 435.403.
new text begin
(b) The commissioner shall identify individuals who are enrolled in medical assistance
and who are absent from the state for more than 30 consecutive days, but who continue to
qualify for medical assistance in accordance with paragraph (a).
new text end
new text begin
(c) If the individual is absent from the state for more than 30 consecutive days but still
deemed a resident of Minnesota in accordance with paragraph (a), any covered service
provided to the individual must be paid through the fee-for-service system and not through
the managed care capitated rate payment system under section 256B.69 or 256L.12.
new text end
Sec. 6.
Minnesota Statutes 2018, section 256B.056, subdivision 3, is amended to read:
Subd. 3.
Asset limitations for certain individuals.
(a) To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or if a member
of a household with two family members, husband and wife, or parent and child, the
household must not own more than $6,000 in assets, plus $200 for each additional legal
dependent. 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 accumulation of the clothing and personal needs allowance
according to section 256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not considered in determining
eligibility for medical assistance is the value of those assets excluded under the Supplemental
Security Income program for aged, blind, and disabled persons, with the following
exceptions:
(1) household goods and personal effects are not considered;
(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;
(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security
Income program;
(4) assets designated as burial expenses are excluded to the same extent excluded by the
Supplemental Security Income program. Burial expenses funded by annuity contracts or
life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;
(5) for a person who no longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical assistance under section 256B.057,
subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility
as an employed person with a disability, to the extent that the person's total assets remain
within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
(6) deleted text begin when a person enrolled in medical assistance under section 256B.057, subdivision
9, is age 65 or older and has been enrolled during each of the 24 consecutive deleted text end deleted text begin months deleted text end deleted text begin before
the person's 65th birthday, the assets owned by the person and the person's spouse must be
disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when
determining eligibility for medical assistance under section 256B.055, subdivision 7.deleted text end new text begin a
designated employment incentives asset account is disregarded when determining eligibility
for medical assistance for a person age 65 years or older under section 256B.055, subdivision
7. An employment incentives asset account must only be designated by a person who has
been enrolled in medical assistance under section 256B.057, subdivision 9, for a
24-consecutive-month period. A designated employment incentives asset account contains
qualified assets owned by the person and the person's spouse in the last month of enrollment
in medical assistance under section 256B.057, subdivision 9. Qualified assets include
retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's
other nonexcluded assets. An employment incentives asset account is no longer designated
when a person loses medical assistance eligibility for a calendar month or more before
turning age 65. A person who loses medical assistance eligibility before age 65 can establish
a new designated employment incentives asset account by establishing a new
24-consecutive-month period of enrollment under section 256B.057, subdivision 9.new text end The
income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions
in section 256B.059; and
(7) 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.
(b) new text begin Upon initial enrollment, new text end no asset limit shall apply to persons eligible under section
256B.055, subdivision 15new text begin . Upon renewal, a person eligible under section 256B.055,
subdivision 15, must not own either individually or as a member of a household more than
$1,000,000 in assets to continue to be eligible for medical assistancenew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (a) is effective July 1, 2019. Paragraph (b) is effective
upon federal approval.
new text end
Sec. 7.
Minnesota Statutes 2018, section 256B.056, subdivision 5c, is amended to read:
Subd. 5c.
Excess income standard.
(a) The excess income standard for parents and
caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard
specified in subdivision 4, paragraph (b).
(b) The excess income standard for a person whose eligibility is based on blindness,
disability, or age of 65 or more years shall equal deleted text begin 81deleted text end new text begin 82new text end percent of the federal poverty
guidelines.new text begin Effective July 1, 2021, the excess income standard for a person whose eligibility
is based on blindness disability, or age of 65 or more years, is the standard specified in
subdivision 4, paragraph (a).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 8.
Minnesota Statutes 2018, section 256B.056, subdivision 7a, is amended to read:
Subd. 7a.
Periodic renewal of eligibility.
(a) The commissioner shall make an annual
redetermination of eligibility based on information contained in the enrollee's case file and
other information available to the agency, including but not limited to information accessed
through an electronic database, without requiring the enrollee to submit any information
when sufficient data is available for the agency to renew eligibility.
(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the
commissioner must provide the enrollee with a prepopulated renewal form containing
eligibility information available to the agency and permit the enrollee to submit the form
with any corrections or additional information to the agency and sign the renewal form via
any of the modes of submission specified in section 256B.04, subdivision 18.
(c) An enrollee who is terminated for failure to complete the renewal process may
subsequently submit the renewal form and required information within four months after
the date of termination and have coverage reinstated without a lapse, if otherwise eligible
under this chapter.new text begin The local agency may close the enrollee's case file if the required
information is not submitted within four months of termination.
new text end
(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
required to renew eligibility every six months.
Sec. 9.
Minnesota Statutes 2018, section 256B.0625, subdivision 9, is amended to read:
Subd. 9.
Dental services.
(a) Medical assistance covers dental servicesnew text begin in accordance
with this subdivisionnew text end .
(b) Medical assistance dental coverage for deleted text begin nonpregnant adultsdeleted text end new text begin adults who are eligible
under section 256B.055, subdivision 7,new text end is limited to the following services:
(1) comprehensive exams, limited to once every five years;
(2) periodic exams, limited to one per year;
(3) limited exams;
(4) bitewing x-rays, limited to one per year;
(5) periapical x-rays;
(6) panoramic x-rays, limited to one every five years except (1) when medically necessary
for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once
every two years for patients who cannot cooperate for intraoral film due to a developmental
disability or medical condition that does not allow for intraoral film placement;
(7) prophylaxis, limited to one per year;
(8) application of fluoride varnish, limited to one per year;
(9) posterior fillings, all at the amalgam rate;
(10) anterior fillings;
(11) endodontics, limited to root canals on the anterior and premolars only;
(12) removable prostheses, each dental arch limited to one every six years;
(13) oral surgery, limited to extractions, biopsies, and incision and drainage of abscesses;
(14) palliative treatment and sedative fillings for relief of pain; and
(15) full-mouth debridement, limited to one every five years.
(c) In addition to the services specified in paragraph (b), medical assistance covers the
following services for adults, if provided in an outpatient hospital setting or freestanding
ambulatory surgical center as part of outpatient dental surgery:
(1) periodontics, limited to periodontal scaling and root planing once every two years;
(2) general anesthesia; and
(3) full-mouth survey once every five years.
deleted text begin (d)deleted text end new text begin (a)new text end Medical assistance covers medically necessary dental services for children and
pregnant women. The following guidelines apply:
(1) posterior fillings are paid at the amalgam rate;
(2) application of sealants are covered once every five years per permanent molar for
children only;
(3) application of fluoride varnish is covered once every six months; and
(4) orthodontia is eligible for coverage for children only.
deleted text begin (e)deleted text end new text begin (b)new text end In addition to the services specified in paragraphs (b) and (c), medical assistance
covers the following services for adults:
(1) house calls or extended care facility calls for on-site delivery of covered services;
(2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used;
(3) oral or IV sedation, if the covered dental service cannot be performed safely without
it or would otherwise require the service to be performed under general anesthesia in a
hospital or surgical center; and
(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
no more than four times per year.
deleted text begin (f)deleted text end new text begin (c)new text end The commissioner shall not require prior authorization for the services included
in paragraph deleted text begin (e)deleted text end new text begin (b)new text end , clauses (1) to (3), and shall prohibit managed care and county-based
purchasing plans from requiring prior authorization for the services included in paragraph
deleted text begin (e)deleted text end new text begin (b)new text end , clauses (1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.
Sec. 10.
Minnesota Statutes 2018, section 256B.0625, subdivision 12, is amended to read:
Subd. 12.
Eyeglasses, dentures, and prosthetic devices.
new text begin (a) new text end Medical assistance covers
deleted text begin eyeglasses, dentures, anddeleted text end prosthetic devices if prescribed by a licensed practitioner.
new text begin
(b) Medical assistance covers vision services, eyeglasses, and dentures for children and
adults eligible under section 256B.055, subdivision 7, if prescribed by a licensed practitioner.
new text end
Sec. 11.
Minnesota Statutes 2018, section 256B.0625, subdivision 13, is amended to read:
Subd. 13.
Drugs.
(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, physician assistant, or a nurse practitioner employed
by or under contract with a community health board as defined in section 145A.02,
subdivision 5, for the purposes of communicable disease control.
(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissioner.
(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:
(1) is not a therapeutic option for the patient;
(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and
(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.
(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals. deleted text begin Over-the-counter medications
must be dispensed in a quantity that is the lowest of: (1) the number of dosage units contained
in the manufacturer's original package; (2) the number of dosage units required to complete
the patient's course of therapy; or (3) if applicable, the number of dosage units dispensed
from a system using retrospective billing, as provided under subdivision 13e, paragraph
(b).
deleted text end
(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.
(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective April 1, 2019, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 12.
Minnesota Statutes 2018, section 256B.0625, subdivision 13e, is amended to
read:
Subd. 13e.
Payment rates.
(a) The basis for determining the amount of payment shall
be the lower of the deleted text begin actual acquisitiondeleted text end new text begin ingredientnew text end costs of the drugs deleted text begin or the maximum allowable
cost by the commissionerdeleted text end plus the deleted text begin fixeddeleted text end new text begin professionalnew text end dispensing fee; or the usual and
customary price charged to the public. new text begin The usual and customary price means the lowest
price charged by the provider to a patient who pays for the prescription by cash, check, or
charge account and includes prices the pharmacy charges to a patient enrolled in a
prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain. new text end The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any new text begin third-party new text end provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be
greater than the patient liability for the service. The deleted text begin pharmacydeleted text end new text begin professionalnew text end dispensing fee
shall be deleted text begin $3.65deleted text end new text begin $10.48new text end for deleted text begin legend prescription drugs, except thatdeleted text end new text begin prescriptions filled with
legend drugs meeting the definition of "covered outpatient drugs" according to United States
Code, title 42, section 1396r-8(k)(2).new text end The dispensing fee for intravenous solutions deleted text begin whichdeleted text end new text begin
thatnew text end must be compounded by the pharmacist shall be deleted text begin $8deleted text end new text begin $10.48new text end per bagdeleted text begin , $14 per bag for
cancer chemotherapy products, and $30 per bag for total parenteral nutritional products
dispensed in one liter quantities, or $44 per bag for total parenteral nutritional products
dispensed in quantities greater than one literdeleted text end . new text begin The professional dispensing fee for
prescriptions filled with over-the-counter drugs meeting the definition of covered outpatient
drugs shall be $10.48 for dispensed quantities equal to or greater than the number of units
contained in the manufacturer's original package. The professional dispensing fee shall be
prorated based on the percentage of the package dispensed when the pharmacy dispenses
a quantity less than the number of units contained in the manufacturer's original package.
new text end The pharmacy dispensing fee for new text begin prescribed new text end over-the-counter drugs new text begin not meeting the definition
of covered outpatient drugs new text end shall be $3.65deleted text begin , except that the fee shall be $1.31 for
retrospectively billing pharmacies when billing for quantities less than the number of units
contained in the manufacturer's original package. Actual acquisition cost includes quantity
and other special discounts except time and cash discounts. The actual acquisition cost of
a drug shall be estimated by the commissioner at wholesale acquisition cost plus four percent
for independently owned pharmacies located in a designated rural area within Minnesota,
and at wholesale acquisition cost plus two percent for all other pharmacies. A pharmacy is
"independently owned" if it is one of four or fewer pharmacies under the same ownership
nationally. A "designated rural area" means an area defined as a small rural area or isolated
rural area according to the four-category classification of the Rural Urban Commuting Area
system developed for the United States Health Resources and Services Administration.
Effective January 1, 2014, the actual acquisitiondeleted text end new text begin for quantities equal to or greater than the
number of units contained in the manufacturer's original package and shall be prorated based
on the percentage of the package dispensed when the pharmacy dispenses a quantity less
than the number of units contained in the manufacturer's original package. The National
Average Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost
of a drug. For drugs for which a NADAC is not reported, the commissioner shall estimate
the ingredient cost at the wholesale acquisition cost minus two percent. The ingredientnew text end cost
of a drug deleted text begin acquired throughdeleted text end new text begin for a provider participating innew text end the federal 340B Drug Pricing
Program shall be deleted text begin estimated by the commissioner at wholesale acquisition cost minus 40
percentdeleted text end new text begin either the 340B Drug Pricing Program ceiling price established by the Health
Resources and Services Administration or NADAC, whichever is lowernew text end . Wholesale
acquisition cost is defined as the manufacturer's list price for a drug or biological to
wholesalers or direct purchasers in the United States, not including prompt pay or other
discounts, rebates, or reductions in price, for the most recent month for which information
is available, as reported in wholesale price guides or other publications of drug or biological
pricing data. The maximum allowable cost of a multisource drug may be set by the
commissioner and it shall be comparable todeleted text begin , butdeleted text end new text begin the actual acquisition cost of the drug
product andnew text end no higher thandeleted text begin , the maximum amount paid by other third-party payors in this
state who have maximum allowable cost programsdeleted text end new text begin the NADAC of the generic productnew text end .
Establishment of the amount of payment for drugs shall not be subject to the requirements
of the Administrative Procedure Act.
(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.
(c) deleted text begin An additional dispensing fee of $.30 may be added to the dispensing fee paid to
pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities
when a unit dose blister card system, approved by the department, is used. Under this type
of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National
Drug Code (NDC) from the drug container used to fill the blister card must be identified
on the claim to the department. The unit dose blister card containing the drug must meet
the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return
of unused drugs to the pharmacy for reuse.deleted text end A pharmacy provider using packaging that meets
the standards set forth in Minnesota Rules, part 6800.2700, is required to credit the
department for the actual acquisition cost of all unused drugs that are eligible for reuse,
unless the pharmacy is using retrospective billing. The commissioner may permit the drug
clozapine to be dispensed in a quantity that is less than a 30-day supply.
(d) deleted text begin Whenever a maximum allowable cost has been set fordeleted text end new text begin If a pharmacy dispensesnew text end a
multisource drug, deleted text begin payment shall be the lower of the usual and customary price charged to
the public ordeleted text end new text begin the ingredient cost shall be the NADAC of the generic product ornew text end the maximum
allowable cost established by the commissioner unless prior authorization for the brand
name product has been granted according to the criteria established by the Drug Formulary
Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated
"dispense as written" on the prescription in a manner consistent with section 151.21,
subdivision 2.
(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
deleted text begin Effective January 1, 2014,deleted text end The commissioner shall discount the payment rate for drugs
obtained through the federal 340B Drug Pricing Program by deleted text begin 20deleted text end new text begin 28.6new text end percent. The payment
for drugs administered in an outpatient setting shall be made to the administering facility
or practitioner. A retail or specialty pharmacy dispensing a drug for administration in an
outpatient setting is not eligible for direct reimbursement.
(f) The commissioner may deleted text begin negotiate lower reimbursementdeleted text end new text begin establish maximum allowable
costnew text end rates for specialty pharmacy products deleted text begin than the ratesdeleted text end new text begin that are lower than the ingredient
cost formulasnew text end specified in paragraph (a). The commissioner may require individuals enrolled
in the health care programs administered by the department to obtain specialty pharmacy
products from providers with whom the commissioner has negotiated lower reimbursement
rates. Specialty pharmacy products are defined as those used by a small number of recipients
or recipients with complex and chronic diseases that require expensive and challenging drug
regimens. Examples of these conditions include, but are not limited to: multiple sclerosis,
HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency, Crohn's Disease,
rheumatoid arthritis, and certain forms of cancer. Specialty pharmaceutical products include
injectable and infusion therapies, biotechnology drugs, antihemophilic factor products,
high-cost therapies, and therapies that require complex care. The commissioner shall consult
with the Formulary Committee to develop a list of specialty pharmacy products subject to
deleted text begin this paragraphdeleted text end new text begin maximum allowable cost reimbursementnew text end . In consulting with the Formulary
Committee in developing this list, the commissioner shall take into consideration the
population served by specialty pharmacy products, the current delivery system and standard
of care in the state, and access to care issues. The commissioner shall have the discretion
to adjust the deleted text begin reimbursement ratedeleted text end new text begin maximum allowable costnew text end to prevent access to care issues.
(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.
new text begin
(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for all responding pharmacies to measure the
mean, mean weighted by total prescription volume, mean weighted by medical assistance
prescription volume, median, median weighted by total prescription volume, and median
weighted by total medical assistance prescription volume. The commissioner shall post a
copy of the final cost of dispensing survey report on the department's website. The initial
survey must be completed no later than January 1, 2021, and repeated every three years.
The commissioner shall provide a summary of the results of each cost of dispensing survey
and provide recommendations for any changes to the dispensing fee to the chairs and ranking
members of the legislative committees with jurisdiction over medical assistance pharmacy
reimbursement.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective April 1, 2019, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained or denied.
new text end
Sec. 13.
Minnesota Statutes 2018, section 256B.0625, subdivision 13f, is amended to read:
Subd. 13f.
Prior authorization.
(a) The Formulary Committee shall review and
recommend drugs which require prior authorization. The Formulary Committee shall
establish general criteria to be used for the prior authorization of brand-name drugs for
which generically equivalent drugs are available, but the committee is not required to review
each brand-name drug for which a generically equivalent drug is available.
(b) Prior authorization may be required by the commissioner before certain formulary
drugs are eligible for payment. The Formulary Committee may recommend drugs for prior
authorization directly to the commissioner. The commissioner may also request that the
Formulary Committee review a drug for prior authorization. Before the commissioner may
require prior authorization for a drug:
(1) the commissioner must provide information to the Formulary Committee on the
impact that placing the drug on prior authorization may have on the quality of patient care
and on program costs, information regarding whether the drug is subject to clinical abuse
or misuse, and relevant data from the state Medicaid program if such data is available;
(2) the Formulary Committee must review the drug, taking into account medical and
clinical data and the information provided by the commissioner; and
(3) the Formulary Committee must hold a public forum and receive public comment for
an additional 15 days.
The commissioner must provide a 15-day notice period before implementing the prior
authorization.
(c) Except as provided in subdivision 13j, prior authorization shall not be required or
utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness
if:
(1) there is no generically equivalent drug available; and
(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or
(3) the drug is part of the recipient's current course of treatment.
This paragraph applies to any multistate preferred drug list or supplemental drug rebate
program established or administered by the commissioner. Prior authorization shall
automatically be granted for 60 days for brand name drugs prescribed for treatment of mental
illness within 60 days of when a generically equivalent drug becomes available, provided
that the brand name drug was part of the recipient's course of treatment at the time the
generically equivalent drug became available.
deleted text begin
(d) Prior authorization shall not be required or utilized for any antihemophilic factor
drug prescribed for the treatment of hemophilia and blood disorders where there is no
generically equivalent drug available if the prior authorization is used in conjunction with
any supplemental drug rebate program or multistate preferred drug list established or
administered by the commissioner.
deleted text end
deleted text begin (e)deleted text end new text begin (d)new text end The commissioner may require prior authorization for brand name drugs whenever
a generically equivalent product is available, even if the prescriber specifically indicates
"dispense as written-brand necessary" on the prescription as required by section 151.21,
subdivision 2.
deleted text begin (f)deleted text end new text begin (e)new text end Notwithstanding this subdivision, the commissioner may automatically require
prior authorization, for a period not to exceed 180 days, for any drug that is approved by
the United States Food and Drug Administration on or after July 1, 2005. The 180-day
period begins no later than the first day that a drug is available for shipment to pharmacies
within the state. The Formulary Committee shall recommend to the commissioner general
criteria to be used for the prior authorization of the drugs, but the committee is not required
to review each individual drug. In order to continue prior authorizations for a drug after the
180-day period has expired, the commissioner must follow the provisions of this subdivision.
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 2018, section 256B.0625, subdivision 18d, is amended to
read:
Subd. 18d.
Advisory committee members.
(a) The Nonemergency Medical
Transportation Advisory Committee consists of:
(1) four voting members who represent counties, utilizing the rural urban commuting
area classification system. As defined in subdivision 17, these members shall be designated
as follows:
(i) two counties within the 11-county metropolitan area;
(ii) one county representing the rural area of the state; and
(iii) one county representing the super rural area of the state.
The Association of Minnesota Counties shall appoint one county within the 11-county
metropolitan area and one county representing the super rural area of the state. The Minnesota
Inter-County Association shall appoint one county within the 11-county metropolitan area
and one county representing the rural area of the state;
(2) three voting members who represent medical assistance recipients, including persons
with physical and developmental disabilities, persons with mental illness, seniors, children,
and low-income individuals;
(3) deleted text begin fourdeleted text end new text begin fivenew text end voting members who represent providers that deliver nonemergency medical
transportation services to medical assistance enrolleesnew text begin , one of whom is a taxicab owner or
operatornew text end ;
(4) two voting members of the house of representatives, one from the majority party and
one from the minority party, appointed by the speaker of the house, and two voting members
from the senate, one from the majority party and one from the minority party, appointed by
the Subcommittee on Committees of the Committee on Rules and Administration;
(5) one voting member who represents demonstration providers as defined in section
256B.69, subdivision 2;
(6) one voting member who represents an organization that contracts with state or local
governments to coordinate transportation services for medical assistance enrollees;
(7) one voting member who represents the Minnesota State Council on Disability;
(8) the commissioner of transportation or the commissioner's designee, who shall serve
as a voting member;
(9) one voting member appointed by the Minnesota Ambulance Association; and
(10) one voting member appointed by the Minnesota Hospital Association.
(b) Members of the advisory committee shall not be employed by the Department of
Human Services. Members of the advisory committee shall receive no compensation.
Sec. 15.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 66. new text end
new text begin Prescribed pediatric extended care (PPEC) center basic services. new text end
new text begin
Medical
assistance covers PPEC center basic services as defined under section 144H.01, subdivision
2. PPEC basic services shall be reimbursed according to section 256B.86.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the commissioner
of health and the revisor of statutes when federal approval is obtained.
new text end
Sec. 16.
Minnesota Statutes 2018, section 256B.064, subdivision 1a, is amended to read:
Subd. 1a.
Grounds for sanctions against vendors.
new text begin (a) new text end The commissioner may impose
sanctions against a vendor of medical care for any of the following: (1) fraud, theft, or abuse
in connection with the provision of medical care to recipients of public assistance; (2) a
pattern of presentment of false or duplicate claims or claims for services not medically
necessary; (3) a pattern of making false statements of material facts for the purpose of
obtaining greater compensation than that to which the vendor is legally entitled; (4)
suspension or termination as a Medicare vendor; (5) refusal to grant the state agency access
during regular business hours to examine all records necessary to disclose the extent of
services provided to program recipients and appropriateness of claims for payment; (6)
failure to repay an overpayment or a fine finally established under this section; (7) failure
to correct errors in the maintenance of health service or financial records for which a fine
was imposed or after issuance of a warning by the commissioner; and (8) any reason for
which a vendor could be excluded from participation in the Medicare program under section
1128, 1128A, or 1866(b)(2) of the Social Security Act.
new text begin
(b) The commissioner may impose sanctions against a pharmacy provider for failure to
respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph
(h).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective April 1, 2019.
new text end
Sec. 17.
Minnesota Statutes 2018, section 256B.69, subdivision 4, is amended to read:
Subd. 4.
Limitation of choice.
(a) The commissioner shall develop criteria to determine
when limitation of choice may be implemented in the experimental counties. The criteria
shall ensure that all eligible individuals in the county have continuing access to the full
range of medical assistance services as specified in subdivision 6.
(b) The commissioner shall exempt the following persons from participation in the
project, in addition to those who do not meet the criteria for limitation of choice:
(1) persons eligible for medical assistance according to section 256B.055, subdivision
1;
(2) persons eligible for medical assistance due to blindness or disability as determined
by the Social Security Administration or the state medical review team, unless:
(i) they are 65 years of age or older; or
(ii) they reside in Itasca County or they reside in a county in which the commissioner
conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
Security Act;
(3) recipients who currently have private coverage through a health maintenance
organization;
(4) recipients who are eligible for medical assistance by spending down excess income
for medical expenses other than the nursing facility per diem expense;
(5) recipients who receive benefits under the Refugee Assistance Program, established
under United States Code, title 8, section 1522(e);
(6) children who are both determined to be severely emotionally disturbed and receiving
case management services according to section 256B.0625, subdivision 20, except children
who are eligible for and who decline enrollment in an approved preferred integrated network
under section 245.4682;
(7) adults who are both determined to be seriously and persistently mentally ill and
received case management services according to section 256B.0625, subdivision 20;
(8) persons eligible for medical assistance according to section 256B.057, subdivision
10; deleted text begin and
deleted text end
(9) persons with access to cost-effective employer-sponsored private health insurance
or persons enrolled in a non-Medicare individual health plan determined to be cost-effective
according to section 256B.0625, subdivision 15new text begin ; and
new text end
new text begin (10) persons who are absent from the state for more than 30 consecutive days but still
deemed a resident of Minnesota, identified in accordance with section 256B.056, subdivision
1, paragraph (b)new text end .
Children under age 21 who are in foster placement may enroll in the project on an elective
basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an elective
basis. The commissioner may enroll recipients in the prepaid medical assistance program
for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by spending
down excess income.
(c) The commissioner may allow persons with a one-month spenddown who are otherwise
eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay their monthly
spenddown to the state.
(d) The commissioner may require those individuals to enroll in the prepaid medical
assistance program who otherwise would have been excluded under paragraph (b), clauses
(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
(e) Before limitation of choice is implemented, eligible individuals shall be notified and
after notification, shall be allowed to choose only among demonstration providers. The
commissioner may assign an individual with private coverage through a health maintenance
organization, to the same health maintenance organization for medical assistance coverage,
if the health maintenance organization is under contract for medical assistance in the
individual's county of residence. After initially choosing a provider, the recipient is allowed
to change that choice only at specified times as allowed by the commissioner. If a
demonstration provider ends participation in the project for any reason, a recipient enrolled
with that provider must select a new provider but may change providers without cause once
more within the first 60 days after enrollment with the second provider.
(f) An infant born to a woman who is eligible for and receiving medical assistance and
who is enrolled in the prepaid medical assistance program shall be retroactively enrolled to
the month of birth in the same managed care plan as the mother once the child is enrolled
in medical assistance unless the child is determined to be excluded from enrollment in a
prepaid plan under this section.
Sec. 18.
Minnesota Statutes 2018, section 256B.69, subdivision 31, is amended to read:
Subd. 31.
Payment reduction.
(a) Beginning September 1, 2011, the commissioner
shall reduce payments and limit future rate increases paid to managed care plans and
county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved on a
statewide aggregate basis by program. The commissioner may use competitive bidding,
payment reductions, or other reductions to achieve the reductions and limits in this
subdivision.
(b) Beginning September 1, 2011, the commissioner shall reduce payments to managed
care plans and county-based purchasing plans as follows:
(1) 2.0 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
(2) 2.82 percent for medical assistance families and children;
(3) 10.1 percent for medical assistance adults without children; and
(4) 6.0 percent for MinnesotaCare families and children.
(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed care
plans and county-based purchasing plans for calendar year 2012 to a percentage of the rates
in effect on August 31, 2011, as follows:
(1) 98 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
(2) 97.18 percent for medical assistance families and children;
(3) 89.9 percent for medical assistance adults without children; and
(4) 94 percent for MinnesotaCare families and children.
(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit the
maximum annual trend increases to rates paid to managed care plans and county-based
purchasing plans as follows:
(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
(2) 5.0 percent for medical assistance special needs basic care;
(3) 2.0 percent for medical assistance families and children;
(4) 3.0 percent for medical assistance adults without children;
(5) 3.0 percent for MinnesotaCare families and children; and
(6) 3.0 percent for MinnesotaCare adults without children.
(e) The commissioner may limit trend increases to less than the maximum. Beginning
July 1, 2014, the commissioner shall limit the maximum annual trend increases to rates paid
to managed care plans and county-based purchasing plans as follows for calendar years
2014 and 2015:
(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
(2) 5.0 percent for medical assistance special needs basic care;
(3) 2.0 percent for medical assistance families and children;
(4) 3.0 percent for medical assistance adults without children;
(5) 3.0 percent for MinnesotaCare families and children; and
(6) 4.0 percent for MinnesotaCare adults without children.
new text begin (f) new text end The commissioner may limit trend increases to less than the maximum. For calendar
year 2014, the commissioner shall reduce the maximum aggregate trend increases by
$47,000,000 in state and federal funds to account for the reductions in administrative
expenses in subdivision 5i.
new text begin
(g) Beginning January 1, 2020, to December 31, 2024, the commissioner shall limit the
maximum annual trend increases to rates paid to managed care plans and county-based
purchasing plans as follows for calendar years 2020, 2021, 2023, and 2024:
new text end
new text begin
(1) 3.4 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
new text end
new text begin
(2) 3.4 percent for medical assistance special needs basic care;
new text end
new text begin
(3) 2.4 percent for medical assistance families and children; and
new text end
new text begin
(4) 2.4 percent for medical assistance adults without children.
new text end
Sec. 19.
new text begin
[256B.86] PRESCRIBED PEDIATRIC EXTENDED CARE (PPEC) CENTER
SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Reimbursement rates. new text end
new text begin
The daily per-child payment rates for PPEC basic
services covered by medical assistance and provided at PPEC centers licensed under chapter
144H are:
new text end
new text begin
(1) for intense complexity: $550 for four or more hours and $275 for less than four hours;
new text end
new text begin
(2) for high complexity: $450 for four or more hours and $225 for less than four hours;
and
new text end
new text begin
(3) for moderate complexity: $400 for four or more hours and $200 for less than four
hours.
new text end
new text begin Subd. 2. new text end
new text begin Determination of complexity level. new text end
new text begin
Complexity level shall be determined
based on the level of nursing intervention required for each child using an assessment tool
approved by the commissioner.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end
Sec. 20.
Minnesota Statutes 2018, section 256L.03, subdivision 5, is amended to read:
Subd. 5.
Cost-sharing.
(a) Co-payments, coinsurance, and deductibles do not apply to
children under the age of 21 and to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5.
(b) The commissioner shall adjust co-payments, coinsurance, and deductibles for covered
services in a manner sufficient to maintain the actuarial value of the benefit to 94 percentnew text begin
for families or individuals with incomes equal to or below 150 percent of the federal poverty
guidelines; and to 87 percent for families or individuals with incomes that are above 150
percent of the federal poverty guidelines and equal to or less than 200 percent of the federal
poverty guidelines for the applicable family sizenew text end . 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.
(c) The cost-sharing changes authorized under paragraph (b) 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.
Sec. 21.
Minnesota Statutes 2018, section 256L.03, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Minnesota EHB Benchmark Plan. new text end
new text begin
Notwithstanding subdivisions 1, 2, 3, 3a,
and 3b, and section 256L.12, or any other law to the contrary, the services covered for
parents, caretakers, foster parents, or legal guardians and single adults without children
eligible for MinnesotaCare under section 256L.04 shall be the services covered under the
Minnesota EHB Benchmark Plan for plan year 2016 or the actuarial equivalent.
new text end
Sec. 22. new text begin CORRECTIVE PLAN TO ELIMINATE DUPLICATE PERSONAL
IDENTIFICATION NUMBERS.
new text end
new text begin
(a) The commissioner of human services shall design and implement a corrective plan
to address the issue of medical assistance enrollees being assigned more than one personal
identification number. Any corrections or fixes that are necessary to address this issue are
required to be completed by June 30, 2021.
new text end
new text begin
(b) By February 15, 2020, the commissioner shall submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services policy and finance on the progress of the corrective plan required in paragraph
(a), including an update on meeting the June 30, 2021, deadline. The report must also include
information on:
new text end
new text begin
(1) the number of medical assistance enrollees who have been assigned two or more
personal identification numbers;
new text end
new text begin
(2) any possible financial effect of enrollees having duplicate personal identification
numbers on health care providers and managed care organizations, including the effect on
reimbursement rates, meeting withhold requirements, and capitated payments; and
new text end
new text begin
(3) any effect on federal payments received by the state.
new text end
Sec. 23. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
QUALITY MEASURES FOR PRESCRIBED PEDIATRIC EXTENDED CARE
(PPEC) CENTERS.
new text end
new text begin
(a) The commissioner of human services, in consultation with community stakeholders
as defined by the commissioner and PPEC centers licensed prior to June 30, 2024, shall
develop quality measures for PPEC centers, procedures for PPEC centers to report quality
measures to the commissioner, and methods for the commissioner to make the results of
the quality measures available to the public.
new text end
new text begin
(b) The commissioner of human services shall submit by February 1, 2024, a report on
the topics described in paragraph (a) to the chairs and ranking minority members of the
legislative 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 upon the effective date of section 13.
new text end
Sec. 24. new text begin PAIN MANAGEMENT.
new text end
new text begin
(a) The Health Services Policy Committee established under Minnesota Statutes, section
256B.0625, subdivision 3c, shall evaluate and make recommendations on the integration
of nonpharmacologic pain management that are clinically viable and sustainable; reduce or
eliminate chronic pain conditions; improve functional status; and prevent addiction and
reduce dependence on opiates or other pain medications. The recommendations must be
based on best practices for the effective treatment of musculoskeletal pain provided by
health practitioners identified in paragraph (b), and covered under medical assistance. Each
health practitioner represented under paragraph (b) shall present the minimum best integrated
practice recommendations, policies, and scientific evidence for nonpharmacologic treatment
options for eliminating pain and improving functional status within their full professional
scope. Recommendations for integration of services may include guidance regarding
screening for co-occurring behavioral health diagnoses; protocols for communication between
all providers treating a unique individual, including protocols for follow-up; and universal
mechanisms to assess improvements in functional status.
new text end
new text begin
(b) In evaluating and making recommendations, the Health Services Policy Committee
shall consult and collaborate with the following health practitioners: acupuncture practitioners
licensed under Minnesota Statutes, chapter 147B; chiropractors licensed under Minnesota
Statutes, sections 148.01 to 148.10; physical therapists licensed under Minnesota Statutes,
sections 148.68 to 148.78; medical and osteopathic physicians licensed under Minnesota
Statutes, chapter 147, and advanced practice registered nurses licensed under Minnesota
Statutes, sections 148.171 to 148.285, with experience in providing primary care
collaboratively within a multidisciplinary team of health care practitioners who employ
nonpharmacologic pain therapies; and psychologists licensed under Minnesota Statutes,
section 148.907.
new text end
new text begin
(c) The commissioner shall submit a progress report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by January 15, 2020, and shall report final recommendations by August
1, 2020. The final report may also contain recommendations for developing and implementing
a pilot program to assess the clinical viability, sustainability, and effectiveness of integrated
nonpharmacologic, multidisciplinary treatments for managing musculoskeletal pain and
improving functional status.
new text end
Sec. 25. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, sections 16A.724, subdivision 2; and 256B.0625, subdivision
31c,
new text end
new text begin
are repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
ARTICLE 9
DEPARTMENT OF HEALTH
Section 1.
new text begin
[8.40] LITIGATION DEFENSE FUND.
new text end
new text begin
(a) There is created in the special revenue fund an account entitled the Pain-Capable
Unborn Child Protection Act litigation account for the purpose of providing funds to pay
for any costs and expenses incurred by the state attorney general in relation to actions
surrounding defense of sections 145.4141 to 145.4147.
new text end
new text begin
(b) The account shall be maintained by the commissioner of management and budget.
new text end
new text begin
(c) The litigation account shall consist of:
new text end
new text begin
(1) appropriations made to the account by the legislature; and
new text end
new text begin
(2) any donations, gifts, or grants made to the account by private citizens or entities.
new text end
new text begin
(d) The litigation account shall retain the interest income derived from the money credited
to the account.
new text end
new text begin
(e) Any funds in the litigation account are appropriated to the attorney general for the
purposes described in paragraph (a).
new text end
Sec. 2.
Minnesota Statutes 2018, section 18K.03, is amended to read:
18K.03 AGRICULTURAL CROP; POSSESSION AUTHORIZED.
new text begin Subdivision 1. new text end
new text begin Industrial hemp. new text end
Industrial hemp is an agricultural crop in this state. A
person may possess, transport, process, sell, or buy industrial hemp that is grown pursuant
to this chapter.
new text begin Subd. 2. new text end
new text begin Sale to medical cannabis manufacturers. new text end
new text begin
A licensee under this chapter may
sell hemp products derived from industrial hemp grown in this state to medical cannabis
manufacturers as authorized under sections 152.22 to 152.37.
new text end
Sec. 3.
Minnesota Statutes 2018, section 62J.495, subdivision 1, is amended to read:
Subdivision 1.
Implementation.
deleted text begin By January 1, 2015, all hospitals and health care
providers, as defined in section 62J.03, subdivision 8, must have in place an interoperable
electronic health records system within their hospital system or clinical practice setting.deleted text end
The commissioner of health, in consultation with the e-Health Advisory Committee, shall
develop deleted text begin a statewide plan to meet this goal, includingdeleted text end uniform standards to be used for the
interoperable new text begin electronic health records new text end system for sharing and synchronizing patient data
across systems. The standards must be compatible with federal efforts. The uniform standards
must be developed by January 1, 2009, and updated on an ongoing basis. The commissioner
shall include an update on standards development as part of an annual report to the legislature.
Individual health care providers in private practice with no other providers and health care
providers that do not accept reimbursement from a group purchaser, as defined in section
62J.03, subdivision 6, are excluded from the requirements of this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 4.
Minnesota Statutes 2018, section 62J.495, subdivision 3, is amended to read:
Subd. 3.
Interoperable electronic health record requirements.
(a) deleted text begin To meet the
requirements of subdivision 1,deleted text end Hospitals and health care providers must meet the following
criteria when implementing an interoperable electronic health records system within their
hospital system or clinical practice setting.
(b) The electronic health record must be a qualified electronic health record.
(c) The electronic health record must be certified by the Office of the National
Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health
care providers if a certified electronic health record product for the provider's particular
practice setting is available. This criterion shall be considered met if a hospital or health
care provider is using an electronic health records system that has been certified within the
last three years, even if a more current version of the system has been certified within the
three-year period.
(d) The electronic health record must meet the standards established according to section
3004 of the HITECH Act as applicable.
(e) The electronic health record must have the ability to generate information on clinical
quality measures and other measures reported under sections 4101, 4102, and 4201 of the
HITECH Act.
(f) The electronic health record system must be connected to a state-certified health
information organization either directly or through a connection facilitated by a state-certified
health data intermediary as defined in section 62J.498.
(g) A health care provider who is a prescriber or dispenser of legend drugs must have
an electronic health record system that meets the requirements of section 62J.497.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 5.
new text begin
[62J.84] PRESCRIPTION DRUG PRICE TRANSPARENCY.
new text end
new text begin Subdivision 1. new text end
new text begin Short title. new text end
new text begin
This section may be cited as the "Prescription Drug Price
Transparency Act."
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.
new text end
new text begin
(b) "Commissioner" means the commissioner of health.
new text end
new text begin
(c) "Manufacturer" means a drug manufacturer licensed under section 151.252.
new text end
new text begin
(d) "New prescription drug" means a prescription drug approved for marketing by the
United States Food and Drug Administration for which no previous wholesale acquisition
cost has been established for comparison.
new text end
new text begin
(e) "Patient assistance program" means a program that a manufacturer offers to the public
in which a consumer may reduce the consumer's out-of-pocket costs for prescription drugs
by using coupons, discount cards, prepaid gift cards, manufacturer debit cards, or by other
means.
new text end
new text begin
(f) "Prescription drug" or "drug" has the meaning provided in section 151.44, paragraph
(d).
new text end
new text begin
(g) "Price" means the wholesale acquisition cost as defined in United States Code, title
42, section 1395w-3a(c)(6)(B).
new text end
new text begin Subd. 3. new text end
new text begin Prescription drug price increases reporting. new text end
new text begin
(a) Beginning July 1, 2020, a
drug manufacturer must submit to the commissioner the information described in paragraph
(b) for each prescription drug for which:
new text end
new text begin
(1) the price was $100 or greater for a 30-day supply or for a course of treatment lasting
less than 30 days; and
new text end
new text begin
(2) there was a net increase of ten percent or greater in the price over the previous
12-month period.
new text end
new text begin
(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
the commissioner no later than 60 days after the price increase goes into effect, in the form
and manner prescribed by the commissioner, the following information:
new text end
new text begin
(1) the name and price of the drug and the net increase, expressed as a percentage;
new text end
new text begin
(2) the factors that contributed to the price increase;
new text end
new text begin
(3) the name of any generic version of the prescription drug available on the market;
new text end
new text begin
(4) the introductory price of the prescription drug when it was approved for marketing
by the Food and Drug Administration and the net yearly increase, by calendar year, in the
price of the prescription drug during the previous five years;
new text end
new text begin
(5) the direct costs incurred by the manufacturer that are associated with the prescription
drug, listed separately:
new text end
new text begin
(i) to manufacture the prescription drug;
new text end
new text begin
(ii) to market the prescription drug, including advertising costs; and
new text end
new text begin
(iii) to distribute the prescription drug;
new text end
new text begin
(6) the total sales revenue for the prescription drug during the previous 12-month period;
new text end
new text begin
(7) the manufacturer's net profit attributable to the prescription drug during the previous
12-month period;
new text end
new text begin
(8) the total amount of financial assistance the manufacturer has provided through patient
prescription assistance programs, if applicable;
new text end
new text begin
(9) any agreement between a manufacturer and another entity contingent upon any delay
in offering to market a generic version of the prescription drug;
new text end
new text begin
(10) the patent expiration date of the prescription drug if it is under patent;
new text end
new text begin
(11) the name and location of the company that manufactured the drug; and
new text end
new text begin
(12) the ten highest prices paid for the prescription drug during the previous calendar
year in any country other than the United States.
new text end
new text begin
(c) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.
new text end
new text begin Subd. 4. new text end
new text begin New prescription drug price reporting. new text end
new text begin
(a) Beginning March 15, 2020, no
later than 60 days after a manufacturer introduces a new prescription drug for sale in the
United States that is a new brand name drug with a price that is greater than $500 for a
30-day supply or a new generic drug with a price that is greater than $200 for a 30-day
supply, the manufacturer must submit to the commissioner, in the form and manner prescribed
by the commissioner, the following information:
new text end
new text begin
(1) the price of the prescription drug;
new text end
new text begin
(2) whether the Food and Drug Administration granted the new prescription drug a
breakthrough therapy designation or a priority review;
new text end
new text begin
(3) the direct costs incurred by the manufacturer that are associated with the prescription
drug, listed separately:
new text end
new text begin
(i) to manufacture the prescription drug;
new text end
new text begin
(ii) to market the prescription drug, including advertising costs; and
new text end
new text begin
(iii) to distribute the prescription drug; and
new text end
new text begin
(4) the patent expiration date of the drug if it is under patent.
new text end
new text begin
(b) The manufacturer may submit documentation necessary to support the information
reported under this subdivision.
new text end
new text begin Subd. 5. new text end
new text begin Newly acquired prescription drug price reporting. new text end
new text begin
(a) Beginning July 1,
2020, for every newly acquired prescription drug for which the price increases by more
than $100 for a 30-day supply from the price before the acquisition and the price after the
acquisition, the acquiring manufacturer must submit to the commissioner at least 60 days
after the acquiring manufacturer begins to sell the newly acquired prescription drug, in the
form and manner prescribed by the commissioner, the following information:
new text end
new text begin
(1) the price of the prescription drug at the time of acquisition and in the calendar year
prior to acquisition;
new text end
new text begin
(2) the name of the company from which the prescription drug was acquired, the date
acquired, and the purchase price;
new text end
new text begin
(3) the year the prescription drug was introduced to market and the price of the
prescription drug at the time of introduction;
new text end
new text begin
(4) the price of the prescription drug for the previous five years;
new text end
new text begin
(5) any agreement between a manufacturer and another entity contingent upon any delay
in offering to market a generic version of the manufacturer's drug; and
new text end
new text begin
(6) the patent expiration date of the drug if it is under patent.
new text end
new text begin
(b) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.
new text end
new text begin Subd. 6. new text end
new text begin Public posting of prescription drug price information. new text end
new text begin
(a) The commissioner
shall post on the department's website, or may contract with a private entity or consortium
that satisfies the standards of section 62U.04, subdivision 6, to meet this requirement, the
following information:
new text end
new text begin
(1) a list of the prescription drugs reported under subdivisions 3, 4, and 5, and the
manufacturers of those prescription drugs; and
new text end
new text begin
(2) information reported to the commissioner under subdivisions 3, 4, and 5.
new text end
new text begin
(b) The information must be published in an easy to read format and in a manner that
identifies the information that is disclosed on a per-drug basis and must not be aggregated
in a manner that prevents the identification of the prescription drug.
new text end
new text begin
(c) The commissioner shall not post to the department's website or a private entity
contracting with the commissioner shall not post any information described in this section
if
new text end
new text begin
the information is not public data under section 13.02, subdivision 8a; or is trade secret
information under section 13.37, subdivision 1, paragraph (b); or is information that is not
already available in the public domain.
new text end
new text begin
(d) If the commissioner withholds any information from public disclosure pursuant to
this subdivision, the commissioner shall post to the department's website a report describing
the nature of the information and the commissioner's basis for withholding the information
from disclosure.
new text end
new text begin Subd. 7. new text end
new text begin Consultation. new text end
new text begin
(a) The commissioner may consult with a private entity or
consortium that satisfies the standards of section 62U.04, subdivision 6, the University of
Minnesota, or the commissioner of commerce, as appropriate; in issuing the form and format
of the information reported under this section; in posting information pursuant to subdivision
6; and in taking any other action for the purpose of implementing this section.
new text end
new text begin
(b) The commissioner may consult with representatives of manufacturers to establish a
standard format for reporting information under this section to minimize administrative
burdens to the state and manufacturers.
new text end
new text begin Subd. 8. new text end
new text begin Enforcement and penalties. new text end
new text begin
(a) A manufacturer may be subject to a civil
penalty, as provided in paragraph (b), for:
new text end
new text begin
(1) failing to submit timely reports or notices as required by this section;
new text end
new text begin
(2) failing to provide information required under this section; or
new text end
new text begin
(3) providing inaccurate or incomplete information under this section.
new text end
new text begin
(b) The commissioner shall adopt a schedule of civil penalties, not to exceed $10,000
per day of violation, based on the severity of each violation.
new text end
new text begin
(c) The commissioner shall impose civil penalties under this section as provided in
section 144.99, subdivision 4.
new text end
new text begin
(d) The commissioner may remit or mitigate civil penalties under this section upon terms
and conditions the commissioner considers proper and consistent with public health and
safety.
new text end
new text begin
(e) Civil penalties collected under this section shall be deposited in the health care access
fund.
new text end
new text begin Subd. 9. new text end
new text begin Legislative report. new text end
new text begin
(a) No later than January 15 of each year, beginning January
15, 2021, the commissioner shall report to the chairs and ranking minority members of the
legislative committees with jurisdiction over commerce and health and human services
policy and finance on the implementation of this section, including, but not limited to, the
effectiveness in addressing the following goals:
new text end
new text begin
(1) promoting transparency in pharmaceutical pricing for the state and other payers;
new text end
new text begin
(2) enhancing the understanding on pharmaceutical spending trends; and
new text end
new text begin
(3) assisting the state and other payers in the management of pharmaceutical costs.
new text end
new text begin
(b) The report must include a summary of the information submitted to the commissioner
under subdivisions 3, 4, and 5.
new text end
Sec. 6.
Minnesota Statutes 2018, section 144.057, subdivision 3, is amended to read:
Subd. 3.
Reconsiderations.
The commissioner of health shall review and decide
reconsideration requests, including the granting of variances, in accordance with the
procedures and criteria contained in chapter 245C. new text begin The commissioner must set aside a
disqualification for an individual who requests reconsideration and who meets the criteria
described in section 245C.22, subdivision 4, paragraph (d). new text end The commissioner's decision
shall be provided to the individual and to the Department of Human Services. The
commissioner's decision to grant or deny a reconsideration of disqualification is the final
administrative agency action, except for the provisions under sections 245C.25, 245C.27,
and 245C.28, subdivision 3.
Sec. 7.
Minnesota Statutes 2018, section 144.1506, subdivision 2, is amended to read:
Subd. 2.
Expansion grant program.
(a) The commissioner of health shall award primary
care residency expansion grants to eligible primary care residency programs to plan and
implement new residency slots. A planning grant shall not exceed $75,000, and a training
grant shall not exceed $150,000 per new residency slot for the first year, $100,000 for the
second year, and $50,000 for the third year of the new residency slot.new text begin For eligible residency
programs longer than three years, training grants may be awarded for the duration of the
residency, not exceeding an average of $100,000 per residency slot per year.
new text end
(b) Funds may be spent to cover the costs of:
(1) planning related to establishing an accredited primary care residency program;
(2) obtaining accreditation by the Accreditation Council for Graduate Medical Education
or another national body that accredits residency programs;
(3) establishing new residency programs or new resident training slots;
(4) recruitment, training, and retention of new residents and faculty;
(5) travel and lodging for new residents;
(6) faculty, new resident, and preceptor salaries related to new residency slots;
(7) training site improvements, fees, equipment, and supplies required for new primary
care resident training slots; and
(8) supporting clinical education in which trainees are part of a primary care team model.
Sec. 8.
Minnesota Statutes 2018, section 144.3831, subdivision 1, is amended to read:
Subdivision 1.
Fee setting.
The commissioner of health may assess an annual fee of
deleted text begin $6.36deleted text end new text begin $9.72new text end for every service connection to a public water supply that is owned or operated
by a home rule charter city, a statutory city, a city of the first class, or a town. The
commissioner of health may also assess an annual fee for every service connection served
by a water user district defined in section 110A.02.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 9.
new text begin
[144.397] STATEWIDE TOBACCO CESSATION SERVICES.
new text end
new text begin
(a) The commissioner of health shall administer, or contract for the administration of,
statewide tobacco cessation services to assist Minnesotans who are seeking advice or services
to help them quit using tobacco products. The commissioner shall establish statewide public
awareness activities to inform the public of the availability of the services and encourage
the public to utilize the services because of the dangers and harm of tobacco use and
dependence.
new text end
new text begin
(b) Services to be provided may include, but are not limited to:
new text end
new text begin
(1) telephone-based coaching and counseling;
new text end
new text begin
(2) referrals;
new text end
new text begin
(3) written materials mailed upon request;
new text end
new text begin
(4) web-based texting or e-mail services; and
new text end
new text begin
(5) free Food and Drug Administration-approved tobacco cessation medications.
new text end
new text begin
(c) Services provided must be consistent with evidence-based best practices in tobacco
cessation services. Services provided must be coordinated with health plan company tobacco
prevention and cessation services that may be available to individuals depending on their
health coverage.
new text end
Sec. 10.
Minnesota Statutes 2018, section 144.552, is amended to read:
144.552 PUBLIC INTEREST REVIEW.
(a) The following entities must submit a plan to the commissioner:
(1) a hospital seeking to increase its number of licensed beds; or
(2) an organization seeking to obtain a hospital license and notified by the commissioner
under section 144.553, subdivision 1, paragraph (c), that it is subject to this section.
The plan must include information that includes an explanation of how the expansion will
meet the public's interest. When submitting a plan to the commissioner, an applicant shall
pay the commissioner for the commissioner's cost of reviewing and monitoring the plan,
as determined by the commissioner and notwithstanding section 16A.1283. Money received
by the commissioner under this section is appropriated to the commissioner for the purpose
of administering this section. new text begin If the commissioner does not issue a finding within the time
limit specified in paragraph (c), the commissioner must return to the applicant the entire
amount the applicant paid to the commissioner. new text end For a hospital that is seeking an exception
to the moratorium under section 144.551, the plan must be submitted to the commissioner
no later than August 1 of the calendar year prior to the year when the exception will be
considered by the legislature.
(b) Plans submitted under this section shall include detailed information necessary for
the commissioner to review the plan and reach a finding. The commissioner may request
additional information from the hospital submitting a plan under this section and from others
affected by the plan that the commissioner deems necessary to review the plan and make a
finding. If the commissioner determines that additional information is required from the
hospital submitting a plan under this section, the commissioner shall notify the hospital of
the additional information required no more than 30 days after the initial submission of the
plan.new text begin A hospital submitting a plan from whom the commissioner has requested additional
information shall submit the requested additional information within 14 calendar days of
the commissioner's request.
new text end
(c) The commissioner shall review the plan and, within deleted text begin 90deleted text end new text begin 150 calendarnew text end daysdeleted text begin , but no
more than six months if extenuating circumstances applydeleted text end new text begin of the initial submission of the
plannew text end , issue a finding on whether the plan is in the public interest. In making the
recommendation, the commissioner shall consider issues including but not limited to:
(1) whether the new hospital or hospital beds are needed to provide timely access to care
or access to new or improved servicesnew text begin given the number of available beds. For the purposes
of this clause, "available beds" means the number of licensed acute care beds that are
immediately available for use or could be brought online within 48 hours without significant
facility modificationsnew text end ;
(2) the financial impact of the new hospital or hospital beds on existing acute-care
hospitals that have emergency departments in the region;
(3) how the new hospital or hospital beds will affect the ability of existing hospitals in
the region to maintain existing staff;
(4) the extent to which the new hospital or hospital beds will provide services to
nonpaying or low-income patients relative to the level of services provided to these groups
by existing hospitals in the region; and
(5) the views of affected parties.
(d) If the plan is being submitted by an existing hospital seeking authority to construct
a new hospital, the commissioner shall also consider:
(1) the ability of the applicant to maintain the applicant's current level of community
benefit as defined in section 144.699, subdivision 5, at the existing facility; and
(2) the impact on the workforce at the existing facility including the applicant's plan for:
(i) transitioning current workers to the new facility;
(ii) retraining and employment security for current workers; and
(iii) addressing the impact of layoffs at the existing facility on affected workers.
(e) Prior to making a recommendation, the commissioner shall conduct a public hearing
in the affected hospital service area to take testimony from interested persons.
(f) Upon making a recommendation under paragraph (c), the commissioner shall provide
a copy of the recommendation to the chairs of the house of representatives and senate
committees having jurisdiction over health and human services policy and finance.
(g) If an exception to the moratorium is approved under section 144.551 after a review
under this section, the commissioner shall monitor the implementation of the exception up
to completion of the construction project. Thirty days after completion of the construction
project, the hospital shall submit to the commissioner a report on how the construction has
met the provisions of the plan originally submitted under the public interest review process
or a plan submitted pursuant to section 144.551, subdivision 1, paragraph (b), clause (20).
Sec. 11.
Minnesota Statutes 2018, section 144.586, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Care coordination implementation. new text end
new text begin
(a) This subdivision applies to hospital
discharges involving a child with a high-cost medical or chronic condition who needs
post-hospital continuing aftercare, including but not limited to home health care services,
post-hospital extended care services, or outpatient services for follow-up or ancillary care,
or is at risk of recurrent hospitalization or emergency room services due to a medical or
chronic condition.
new text end
new text begin
(b) In addition to complying with the discharge planning requirements in subdivision
2, the hospital must ensure that the following conditions are met and arrangements made
before discharging any patient described in paragraph (a):
new text end
new text begin
(1) the patient's primary care provider and either the health carrier or, if the patient is
enrolled in medical assistance, the managed care organization are notified of the patient's
date of anticipated discharge and provided a description of the patient's aftercare needs and
a copy of the patient's discharge plan, including any necessary medical information release
forms;
new text end
new text begin
(2) the appropriate arrangements for home health care or post-hospital extended care
services are made and the initial services as indicated on the discharge plan are scheduled;
and
new text end
new text begin
(3) if the patient is eligible for care coordination services through a health plan or health
certified medical home, the appropriate care coordinator has connected with the patient's
family.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 12.
new text begin
[144.591] DISCLOSURE OF HOSPITAL CHARGES.
new text end
new text begin
(a) Each hospital, including hospitals designated as critical access hospitals, shall provide
to each discharged patient within 30 calendar days of discharge an itemized description of
billed charges for medical services and goods the patient received during the hospital stay.
The itemized description of billed charges may include technical terms to describe the
medical services and goods if the technical terms are defined on the itemized description
with limited medical nomenclature. The itemized description of billed charges must not
describe a billed charge using only a medical billing code, "miscellaneous charges," or
"supply charges."
new text end
new text begin
(b) A hospital may not bill or otherwise charge a patient for the itemized description of
billed charges.
new text end
new text begin
(c) A hospital must provide an itemized description by secure e-mail, via a secure online
portal, or, upon request, by mail.
new text end
new text begin
(d) This section does not apply to patients enrolled in Medicare, medical assistance, the
MinnesotaCare program, or who receive health care coverage through an employer
self-insured health plan.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2020.
new text end
Sec. 13.
new text begin
[144.6502] ELECTRONIC MONITORING IN CERTAIN HEALTH CARE
FACILITIES.
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 terms defined in this
subdivision have the meanings given.
new text end
new text begin
(b) "Electronic monitoring" means the placement and use of an electronic monitoring
device by a resident in the resident's room or private living unit in accordance with this
section.
new text end
new text begin
(c) "Commissioner" means the commissioner of health.
new text end
new text begin
(d) "Department" means the Department of Health.
new text end
new text begin
(e) "Electronic monitoring device" means a camera or other device that captures, records,
or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
and is used to monitor the resident or activities in the room or private living unit.
new text end
new text begin
(f) "Facility" means a nursing home licensed under chapter 144A, a boarding care home
licensed under sections 144.50 to 144.56, or a housing with services establishment registered
under chapter 144D that is either subject to chapter 144G or has a disclosed special unit
under section 325F.72.
new text end
new text begin
(g) "Resident" means a person 18 years of age or older residing in a facility.
new text end
new text begin
(h) "Resident representative" means one of the following in the order of priority listed,
to the extent the person may reasonably be identified and located:
new text end
new text begin
(1) a court-appointed guardian;
new text end
new text begin
(2) a health care agent under section 145C.01, subdivision 2; or
new text end
new text begin
(3) a person who is not an agent of a facility or of a home care provider designated in
writing by the resident and maintained in the resident's records on file with the facility or
with the resident's executed housing with services contract.
new text end
new text begin Subd. 2. new text end
new text begin Electronic monitoring. new text end
new text begin
(a) A resident or a resident representative may conduct
electronic monitoring of the resident's room or private living unit through the use of electronic
monitoring devices placed in the resident's room or private living unit as provided in this
section.
new text end
new text begin
(b) Nothing in this section precludes the use of electronic monitoring of health care
allowed under other law.
new text end
new text begin
(c) Electronic monitoring authorized under this section is not a covered service under
home and community-based waivers under sections 256B.0913, 256B.0915, 256B.092, and
256B.49.
new text end
new text begin
(d) This section does not apply to monitoring technology authorized as a home and
community-based service under section 256B.0913, 256B.0915, 256B.092, or 256B.49.
new text end
new text begin Subd. 3. new text end
new text begin Consent to electronic monitoring. new text end
new text begin
(a) Except as otherwise provided in this
subdivision, a resident must consent to electronic monitoring in the resident's room or private
living unit in writing on a notification and consent form. If the resident has not affirmatively
objected to electronic monitoring and the resident's medical professional determines that
the resident currently lacks the ability to understand and appreciate the nature and
consequences of electronic monitoring, the resident representative may consent on behalf
of the resident. For purposes of this subdivision, a resident affirmatively objects when the
resident orally, visually, or through the use of auxiliary aids or services declines electronic
monitoring. The resident's response must be documented on the notification and consent
form.
new text end
new text begin
(b) Prior to a resident representative consenting on behalf of a resident, the resident must
be asked if the resident wants electronic monitoring to be conducted. The resident
representative must explain to the resident:
new text end
new text begin
(1) the type of electronic monitoring device to be used;
new text end
new text begin
(2) the standard conditions that may be placed on the electronic monitoring device's use,
including those listed in subdivision 6;
new text end
new text begin
(3) with whom the recording may be shared under subdivision 10 or 11; and
new text end
new text begin
(4) the resident's ability to decline all recording.
new text end
new text begin
(c) A resident, or resident representative when consenting on behalf of the resident, may
consent to electronic monitoring with any conditions of the resident's or resident
representative's choosing, including the list of standard conditions provided in subdivision
6. A resident, or resident representative when consenting on behalf of the resident, may
request that the electronic monitoring device be turned off or the visual or audio recording
component of the electronic monitoring device be blocked at any time.
new text end
new text begin
(d) Prior to implementing electronic monitoring, a resident, or resident representative
when acting on behalf of the resident, must obtain the written consent on the notification
and consent form of any other resident residing in the shared room or shared private living
unit. A roommate's or roommate's resident representative's written consent must comply
with the requirements of paragraphs (a) to (c). Consent by a roommate or a roommate's
resident representative under this paragraph authorizes the resident's use of any recording
obtained under this section, as provided under subdivision 10 or 11.
new text end
new text begin
(e) Any resident conducting electronic monitoring must immediately remove or disable
an electronic monitoring device prior to a new roommate moving into a shared room or
shared private living unit, unless the resident obtains the roommate's or roommate's resident
representative's written consent as provided under paragraph (d) prior to the roommate
moving into the shared room or shared private living unit. Upon obtaining the new
roommate's signed notification and consent form and submitting the form to the facility as
required under subdivision 5, the resident may resume electronic monitoring.
new text end
new text begin
(f) The resident or roommate, or the resident representative or roommate's resident
representative if the representative is consenting on behalf of the resident or roommate, may
withdraw consent at any time and the withdrawal of consent must be documented on the
original consent form as provided under subdivision 5, paragraph (c).
new text end
new text begin Subd. 4. new text end
new text begin Refusal of roommate to consent. new text end
new text begin
If a resident of a facility who is residing in
a shared room or shared living unit, or the resident representative of such a resident when
acting on behalf of the resident, wants to conduct electronic monitoring and another resident
living in or moving into the same shared room or shared living unit refuses to consent to
the use of an electronic monitoring device, the facility shall make a reasonable attempt to
accommodate the resident who wants to conduct electronic monitoring. A facility has met
the requirement to make a reasonable attempt to accommodate a resident or resident
representative who wants to conduct electronic monitoring when, upon notification that a
roommate has not consented to the use of an electronic monitoring device in the resident's
room, the facility offers to move the resident to another shared room or shared living unit
that is available at the time of the request. If a resident chooses to reside in a private room
or private living unit in a facility in order to accommodate the use of an electronic monitoring
device, the resident must pay either the private room rate in a nursing home setting, or the
applicable rent in a housing with services establishment. If a facility is unable to
accommodate a resident due to lack of space, the facility must reevaluate the request every
two weeks until the request is fulfilled. A facility is not required to provide a private room,
a single-bed room, or a private living unit to a resident who is unable to pay.
new text end
new text begin Subd. 5. new text end
new text begin Notice to facility. new text end
new text begin
(a) Electronic monitoring may begin only after the resident
or resident representative who intends to place an electronic monitoring device and any
roommate or roommate's resident representative completes the notification and consent
form and submits the form to the facility.
new text end
new text begin
(b) Upon receipt of any completed notification and consent form, the facility must place
the original form in the resident's file or file the original form with the resident's housing
with services contract. The facility must provide a copy to the resident and the resident's
roommate, if applicable.
new text end
new text begin
(c) In the event that a resident or roommate, or the resident representative or roommate's
resident representative if the representative is consenting on behalf of the resident or
roommate, chooses to alter the conditions under which consent to electronic monitoring is
given or chooses to withdraw consent to electronic monitoring, the facility must make
available the original notification and consent form so that it may be updated. Upon receipt
of the updated form, the facility must place the updated form in the resident's file or file the
original form with the resident's signed housing with services contract. The facility must
provide a copy of the updated form to the resident and the resident's roommate, if applicable.
new text end
new text begin
(d) If a new roommate, or the new roommate's resident representative when consenting
on behalf of the new roommate, does not submit to the facility a completed notification and
consent form and the resident conducting the electronic monitoring does not remove or
disable the electronic monitoring device, the facility must remove the electronic monitoring
device.
new text end
new text begin
(e) If a roommate, or the roommate's resident representative when withdrawing consent
on behalf of the roommate, submits an updated notification and consent form withdrawing
consent and the resident conducting electronic monitoring does not remove or disable the
electronic monitoring device, the facility must remove the electronic monitoring device.
new text end
new text begin
(f) Notwithstanding paragraph (a), the resident or resident representative who intends
to place an electronic monitoring device may do so without submitting a notification and
consent form to the facility, provided that:
new text end
new text begin
(1) the resident or resident representative reasonably fears retaliation by the facility;
new text end
new text begin
(2) the resident does not have a roommate;
new text end
new text begin
(3) the resident or resident representative submits the completed notification and consent
form to the Office of the Ombudsman for Long-Term Care;
new text end
new text begin
(4) the resident or resident representative submits the notification and consent form to
the facility within seven calendar days of placing the electronic monitoring device; and
new text end
new text begin
(5) the resident or resident representative immediately submits a Minnesota Adult Abuse
Reporting Center report or police report upon evidence from the electronic monitoring
device that suspected maltreatment has occurred between the time the electronic monitoring
device is placed under this paragraph and the time the resident or resident representative
submits the completed notification and consent form to the facility.
new text end
new text begin Subd. 6. new text end
new text begin Form requirements. new text end
new text begin
(a) The notification and consent form completed by the
resident must include, at a minimum, the following information:
new text end
new text begin
(1) the resident's signed consent to electronic monitoring or the signature of the resident
representative, if applicable. If a person other than the resident signs the consent form, the
form must document the following:
new text end
new text begin
(i) the date the resident was asked if the resident wants electronic monitoring to be
conducted;
new text end
new text begin
(ii) who was present when the resident was asked;
new text end
new text begin
(iii) an acknowledgment that the resident did not affirmatively object; and
new text end
new text begin
(iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end
new text begin
(2) the resident's roommate's signed consent or the signature of the roommate's resident
representative, if applicable. If a roommate's resident representative signs the consent form,
the form must document the following:
new text end
new text begin
(i) the date the roommate was asked if the roommate wants electronic monitoring to be
conducted;
new text end
new text begin
(ii) who was present when the roommate was asked;
new text end
new text begin
(iii) an acknowledgment that the roommate did not affirmatively object; and
new text end
new text begin
(iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end
new text begin
(3) the type of electronic monitoring device to be used;
new text end
new text begin
(4) a list of standard conditions or restrictions that the resident or a roommate may elect
to place on the use of the electronic monitoring device, including but not limited to:
new text end
new text begin
(i) prohibiting audio recording;
new text end
new text begin
(ii) prohibiting video recording;
new text end
new text begin
(iii) prohibiting broadcasting of audio or video;
new text end
new text begin
(iv) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device for the duration of an exam or procedure by
a health care professional;
new text end
new text begin
(v) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device while dressing or bathing is performed; and
new text end
new text begin
(vi) turning off the electronic monitoring device for the duration of a visit with a spiritual
adviser, ombudsman, attorney, financial planner, intimate partner, or other visitor;
new text end
new text begin
(5) any other condition or restriction elected by the resident or roommate on the use of
an electronic monitoring device;
new text end
new text begin
(6) a statement of the circumstances under which a recording may be disseminated under
subdivision 10;
new text end
new text begin
(7) a signature box for documenting that the resident or roommate has withdrawn consent;
and
new text end
new text begin
(8) an acknowledgment that the resident, in accordance with subdivision 3, consents,
authorizes, and allows the Office of Ombudsman for Long-Term Care and representatives
of its office to disclose information about the form limited to:
new text end
new text begin
(i) the fact that the form was received from the resident or resident representative;
new text end
new text begin
(ii) if signed by a resident representative, the name of the resident representative and
the source of authority allowing the resident representative to sign the notification and
consent form on the resident's behalf; and
new text end
new text begin
(iii) the type of electronic monitoring device placed.
new text end
new text begin
(b) Facilities must make the notification and consent form available to the residents and
inform residents of their option to conduct electronic monitoring of their rooms or private
living unit.
new text end
new text begin
(c) Notification and consent forms received by the Office of Ombudsman for Long-Term
Care are data protected under section 256.9744.
new text end
new text begin Subd. 7. new text end
new text begin Cost and installation. new text end
new text begin
(a) A resident choosing to conduct electronic monitoring
must do so at the resident's own expense, including paying purchase, installation,
maintenance, and removal costs.
new text end
new text begin
(b) If a resident chooses to place an electronic monitoring device that uses Internet
technology for visual or audio monitoring, the resident may be responsible for contracting
with an Internet service provider.
new text end
new text begin
(c) The facility shall make a reasonable attempt to accommodate the resident's installation
needs, including allowing access to the facility's public-use Internet or Wi-Fi systems when
available for other public uses.
new text end
new text begin
(d) All electronic monitoring device installations and supporting services must be
UL-listed.
new text end
new text begin Subd. 8. new text end
new text begin Notice to visitors. new text end
new text begin
(a) A facility shall post a sign at each facility entrance
accessible to visitors that states "Security cameras and audio devices may be present to
record persons and activities."
new text end
new text begin
(b) The facility is responsible for installing and maintaining the signage required in this
subdivision.
new text end
new text begin Subd. 9. new text end
new text begin Obstruction of electronic monitoring devices. new text end
new text begin
(a) A person must not knowingly
hamper, obstruct, tamper with, or destroy an electronic monitoring device placed in a
resident's room or private living unit without the permission of the resident or resident
representative.
new text end
new text begin
(b) It is not a violation of paragraph (a) if a person turns off the electronic monitoring
device or blocks the visual recording component of the electronic monitoring device at the
direction of the resident or resident representative, or if consent has been withdrawn.
new text end
new text begin Subd. 10. new text end
new text begin Dissemination of recordings. new text end
new text begin
(a) No person may access any video or audio
recording created through authorized electronic monitoring without the written consent of
the resident or resident representative.
new text end
new text begin
(b) Except as required under other law, a recording or copy of a recording made as
provided in this section may only be disseminated for the purpose of addressing health,
safety, or welfare concerns of a resident or residents.
new text end
new text begin
(c) A person disseminating a recording or copy of a recording made as provided in this
section in violation of paragraph (b) may be civilly or criminally liable.
new text end
new text begin Subd. 11. new text end
new text begin Admissibility of evidence. new text end
new text begin
Subject to applicable rules of evidence and
procedure, any video or audio recording created through electronic monitoring under this
section may be admitted into evidence in a civil, criminal, or administrative proceeding.
new text end
new text begin Subd. 12. new text end
new text begin Liability. new text end
new text begin
(a) For the purposes of state law, the mere presence of an electronic
monitoring device in a resident's room or private living unit is not a violation of the resident's
right to privacy under section 144.651 or 144A.44.
new text end
new text begin
(b) For the purposes of state law, a facility or home care provider is not civilly or
criminally liable for the mere disclosure by a resident or a resident representative of a
recording.
new text end
new text begin Subd. 13. new text end
new text begin Immunity from liability. new text end
new text begin
The Office of Ombudsman for Long-Term Care
and representatives of the office are immune from liability as provided under section
256.9742, subdivision 2.
new text end
new text begin Subd. 14. new text end
new text begin Resident protections. new text end
new text begin
(a) A facility must not:
new text end
new text begin
(1) refuse to admit a potential resident or remove a resident because the facility disagrees
with the potential resident's or the resident's decisions regarding electronic monitoring,
including when the decision is made by a resident representative acting on behalf of the
resident;
new text end
new text begin
(2) retaliate or discriminate against any resident for consenting or refusing to consent
to electronic monitoring; or
new text end
new text begin
(3) prevent the placement or use of an electronic monitoring device by a resident who
has provided the facility or the Office of the Ombudsman for Long-Term Care with notice
and consent as required under this section.
new text end
new text begin
(b) Any contractual provision prohibiting, limiting, or otherwise modifying the rights
and obligations in this section is contrary to public policy and is void and unenforceable.
new text end
new text begin Subd. 15. new text end
new text begin Employee discipline. new text end
new text begin
An employee of the facility or of a contractor providing
services at the facility, including an arranged home care provider as defined in section
144D.01, subdivision 2a, who is the subject of proposed corrective or disciplinary action
based upon evidence obtained by electronic monitoring must be given access to that evidence
for purposes of defending against the proposed action. The recording or a copy of the
recording must be treated confidentially by the employee and must not be further
disseminated to any other person except as required under law. Any copy of the recording
must be returned to the facility or resident who provided the copy when it is no longer
needed for purposes of defending against a proposed action.
new text end
new text begin Subd. 16. new text end
new text begin Penalties. new text end
new text begin
(a) The commissioner may issue a correction order as provided
under section 144A.10, 144A.45, or 144A.474, upon a finding that the facility has failed to
comply with subdivision 5, paragraphs (b) to (e); 6, paragraph (b); 7, paragraph (c); 8; 9;
10; or 14. For each violation of this section, the commissioner may impose a fine up to $500
upon a finding of noncompliance with a correction order issued according to this subdivision.
new text end
new text begin
(b) The commissioner may exercise the commissioner's authority provided under section
144D.05 to compel a housing with services establishment to meet the requirements of this
section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, and applies to all
agreements in effect, entered into, or renewed on or after that date.
new text end
Sec. 14.
Minnesota Statutes 2018, section 144.966, subdivision 2, is amended to read:
Subd. 2.
Newborn Hearing Screening Advisory Committee.
(a) The commissioner
of health shall establish a Newborn Hearing Screening Advisory Committee to advise and
assist the Department of Health and the Department of Education in:
(1) developing protocols and timelines for screening, rescreening, and diagnostic
audiological assessment and early medical, audiological, and educational intervention
services for children who are deaf or hard-of-hearing;
(2) designing protocols for tracking children from birth through age three that may have
passed newborn screening but are at risk for delayed or late onset of permanent hearing
loss;
(3) designing a technical assistance program to support facilities implementing the
screening program and facilities conducting rescreening and diagnostic audiological
assessment;
(4) designing implementation and evaluation of a system of follow-up and tracking; and
(5) evaluating program outcomes to increase effectiveness and efficiency and ensure
culturally appropriate services for children with a confirmed hearing loss and their families.
(b) The commissioner of health shall appoint at least one member from each of the
following groups with no less than two of the members being deaf or hard-of-hearing:
(1) a representative from a consumer organization representing culturally deaf persons;
(2) a parent with a child with hearing loss representing a parent organization;
(3) a consumer from an organization representing oral communication options;
(4) a consumer from an organization representing cued speech communication options;
(5) an audiologist who has experience in evaluation and intervention of infants and
young children;
(6) a speech-language pathologist who has experience in evaluation and intervention of
infants and young children;
(7) two primary care providers who have experience in the care of infants and young
children, one of which shall be a pediatrician;
(8) a representative from the early hearing detection intervention teams;
(9) a representative from the Department of Education resource center for the deaf and
hard-of-hearing or the representative's designee;
(10) a representative of the Commission of the Deaf, DeafBlind and Hard of Hearing;
(11) a representative from the Department of Human Services Deaf and Hard-of-Hearing
Services Division;
(12) one or more of the Part C coordinators from the Department of Education, the
Department of Health, or the Department of Human Services or the department's designees;
(13) the Department of Health early hearing detection and intervention coordinators;
(14) two birth hospital representatives from one rural and one urban hospital;
(15) a pediatric geneticist;
(16) an otolaryngologist;
(17) a representative from the Newborn Screening Advisory Committee under this
subdivision; and
(18) a representative of the Department of Education regional low-incidence facilitators.
The commissioner must complete the appointments required under this subdivision by
September 1, 2007.
(c) The Department of Health member shall chair the first meeting of the committee. At
the first meeting, the committee shall elect a chair from its membership. The committee
shall meet at the call of the chair, at least four times a year. The committee shall adopt
written bylaws to govern its activities. The Department of Health shall provide technical
and administrative support services as required by the committee. These services shall
include technical support from individuals qualified to administer infant hearing screening,
rescreening, and diagnostic audiological assessments.
Members of the committee shall receive no compensation for their service, but shall be
reimbursed as provided in section 15.059 for expenses incurred as a result of their duties
as members of the committee.
(d) By February 15, 2015, and by February 15 of the odd-numbered years after that date,
the commissioner shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and data privacy on the activities of the committee
that have occurred during the past two years.
(e) This subdivision expires June 30, deleted text begin 2019deleted text end new text begin 2025new 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 2018, section 144H.01, subdivision 5, is amended to read:
Subd. 5.
Medically complex or technologically dependent child.
"Medically complex
or technologically dependent child" means a child under deleted text begin 21deleted text end new text begin sevennew text end years of age who, because
of a medical condition, requires continuous therapeutic interventions or skilled nursing
supervision deleted text begin whichdeleted text end new text begin thatnew text end must be prescribed by a licensed physician and administered by, or
under the direct supervision of, a licensed registered nurse.
Sec. 16.
Minnesota Statutes 2018, section 144H.04, subdivision 1, is amended to read:
Subdivision 1.
Licenses.
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. deleted text begin Effective January 1, 2018,deleted text end new text begin Beginning July 1,
2020, new text end 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 begin EFFECTIVE DATE. new text end
new text begin
This section is effective retroactively from January 1, 2018.
new text end
Sec. 17.
Minnesota Statutes 2018, section 144H.04, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Licensure phase-in. new text end
new text begin
(a) The commissioner shall phase in licensure of PPEC
centers by issuing prior to June 30, 2024, no more than two licenses to applicants the
commissioner determines meet the requirements of this chapter. A license issued under this
subdivision is valid until June 30, 2024.
new text end
new text begin
(b) This subdivision expires July 1, 2024.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon the effective date of section 12.
new text end
Sec. 18.
Minnesota Statutes 2018, section 144H.06, is amended to read:
144H.06 APPLICATION OF RULES FOR HOSPICE SERVICES AND
RESIDENTIAL HOSPICE FACILITIES.
Minnesota Rules, chapter 4664, shall apply to PPEC centers licensed under this chapter,
except that the following parts, subparts, new text begin and new text end itemsdeleted text begin , and subitemsdeleted text end do not apply:
(1) Minnesota Rules, part 4664.0003, subparts 2, 6, 7, 11, 12, 13, 14, and 38;
(2) Minnesota Rules, part 4664.0008;
(3) Minnesota Rules, part 4664.0010, subparts 3; 4, deleted text begin items A, subitem (6), anddeleted text end new text begin item new text end B;
and 8;
(4) Minnesota Rules, part 4664.0020, subpart 13;
(5) Minnesota Rules, part 4664.0370, subpart 1;
(6) Minnesota Rules, part 4664.0390, subpart 1, items A, C, and E;
(7) Minnesota Rules, part 4664.0420;
(8) Minnesota Rules, part 4664.0425, subparts 3, item A; 4; and 6;
(9) Minnesota Rules, part 4664.0430, subparts 3, 4, 5, 7, 8, 9, 10, 11, and 12;
(10) Minnesota Rules, part 4664.0490; and
(11) Minnesota Rules, part 4664.0520.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 19.
Minnesota Statutes 2018, section 144H.07, subdivision 1, is amended to read:
Subdivision 1.
Services.
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 deleted text begin 14deleted text end new text begin 12.5new text end hours a day and up to six days a weeknew text begin
with hours of operation during normal waking hoursnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 20.
Minnesota Statutes 2018, section 144H.07, subdivision 2, is amended to read:
Subd. 2.
Limitations.
A PPEC center must comply with the following standards related
to services:
(1) a child is prohibited from attending a PPEC center for more than deleted text begin 14deleted text end new text begin 12.5new text end hours within
a 24-hour period;
(2) a PPEC center is prohibited from providing services other than those provided to
medically complex or technologically dependent children; and
(3) the maximum capacity for medically complex or technologically dependent children
at a center shall not exceed 45 children.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 21.
Minnesota Statutes 2018, section 144H.08, subdivision 2, is amended to read:
Subd. 2.
deleted text begin Duties of administratordeleted text end new text begin Administratorsnew text end .
new text begin (a) new text end The center administrator is
responsible and accountable for overall management of the center. The administrator must:
(1) designate in writing a person to be responsible for the center when the administrator
is absent from the center for more than 24 hours;
(2) maintain the following written records, in a place and form and using a system that
allows for inspection of the records by the commissioner during normal business hours:
(i) a daily census record, which indicates the number of children currently receiving
services at the center;
(ii) a record of all accidents or unusual incidents involving any child or staff member
that caused, or had the potential to cause, injury or harm to a person at the center or to center
property;
(iii) copies of all current agreements with providers of supportive services or contracted
services;
(iv) copies of all current agreements with consultants employed by the center,
documentation of each consultant's visits, and written, dated reports; and
(v) a personnel record for each employee, which must include an application for
employment, references, employment history for the preceding five years, and copies of all
performance evaluations;
(3) develop and maintain a current job description for each employee;
(4) provide necessary qualified personnel and ancillary services to ensure the health,
safety, and proper care for each child; and
(5) develop and implement infection control policies that comply with rules adopted by
the commissioner regarding infection control.
new text begin
(b) In order to serve as an administrator of a PPEC center, an individual must have at
least two years of experience in the past five years caring for or managing the care of
medically complex or technologically dependent individuals.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 22.
Minnesota Statutes 2018, section 144H.11, subdivision 2, is amended to read:
Subd. 2.
Registered nurses.
A registered nurse employed by a PPEC center must be a
registered nurse licensed in Minnesota, new text begin and new text end hold a current certification in cardiopulmonary
resuscitationdeleted text begin , and have experience in the previous 24 months in being responsible for the
care of acutely ill or chronically ill childrendeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 23.
Minnesota Statutes 2018, section 144H.11, subdivision 3, is amended to read:
Subd. 3.
Licensed practical nurses.
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, deleted text begin have at least two years of experience in pediatrics,deleted text end and hold a current
certification in cardiopulmonary resuscitation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 24.
Minnesota Statutes 2018, section 144H.11, subdivision 4, is amended to read:
Subd. 4.
Other direct care personnel.
(a) Direct care personnel governed by this
subdivision new text begin may new text end include nursing assistants deleted text begin anddeleted text end new text begin ornew text end individuals with training and experience
in the field of education, social services, or child care.
(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 begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 25.
Minnesota Statutes 2018, 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;
(12) if the abortion was performed via telemedicine, the facility code for the patient and
the facility code for the physician; deleted text begin and
deleted text end
(13) 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 knowndeleted text begin .deleted text end new text begin ;
new text end
new text begin
(14) whether a determination of probable postfertilization age was made and the probable
postfertilization age determined, including:
new text end
new text begin
(i) the method used to make such a determination; or
new text end
new text begin
(ii) if a determination was not made prior to performing an abortion, the basis of the
determination that a medical emergency existed; and
new text end
new text begin
(15) for abortions performed after a determination of postfertilization age of 20 or more
weeks, the basis of the determination that the pregnant woman had a condition that so
complicated her medical condition as to necessitate the abortion of her pregnancy to avert
her death or to avert serious risk of substantial and irreversible physical impairment of a
major bodily function, not including psychological or emotional conditions.
new text end
Sec. 26.
new text begin
[145.4141] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
For purposes of sections 145.4141 to 145.4147, the following
terms have the meanings given them.
new text end
new text begin Subd. 2. new text end
new text begin Abortion. new text end
new text begin
"Abortion" means the use or prescription of any instrument, medicine,
drug, or any other substance or device to terminate the pregnancy of a woman known to be
pregnant, with an intention other than to increase the probability of a live birth; to preserve
the life or health of the child after live birth; or to remove a dead unborn child who died as
the result of natural causes in utero, accidental trauma, or a criminal assault on the pregnant
woman or her unborn child; and which causes the premature termination of the pregnancy.
new text end
new text begin Subd. 3. new text end
new text begin Attempt to perform or induce an abortion. new text end
new text begin
"Attempt to perform or induce
an abortion" means an act, or an omission of a statutorily required act, that, under the
circumstances as the actor believes them to be, constitutes a substantial step in a course of
conduct planned to culminate in the performance or induction of an abortion in this state in
violation of sections 145.4141 to 145.4147.
new text end
new text begin Subd. 4. new text end
new text begin Fertilization. new text end
new text begin
"Fertilization" means the fusion of a human spermatozoon with
a human ovum.
new text end
new text begin Subd. 5. new text end
new text begin Medical emergency. new text end
new text begin
"Medical emergency" means a condition that, in reasonable
medical judgment, so complicates the medical condition of the pregnant woman that it
necessitates the immediate abortion of her pregnancy without first determining
postfertilization age to avert her death or for which the delay necessary to determine
postfertilization age will create serious risk of substantial and irreversible physical impairment
of a major bodily function not including psychological or emotional conditions. No condition
shall be deemed a medical emergency if based on a claim or diagnosis that the woman will
engage in conduct which she intends to result in her death or in substantial and irreversible
physical impairment of a major bodily function.
new text end
new text begin Subd. 6. new text end
new text begin Physician. new text end
new text begin
"Physician" means any person licensed to practice medicine and
surgery or osteopathic medicine and surgery in this state.
new text end
new text begin Subd. 7. new text end
new text begin Postfertilization age. new text end
new text begin
"Postfertilization age" means the age of the unborn child
as calculated from the fusion of a human spermatozoon with a human ovum.
new text end
new text begin Subd. 8. new text end
new text begin Probable postfertilization age of the unborn child. new text end
new text begin
"Probable postfertilization
age of the unborn child" means what, in reasonable medical judgment, will with reasonable
probability be the postfertilization age of the unborn child at the time the abortion is planned
to be performed or induced.
new text end
new text begin Subd. 9. new text end
new text begin Reasonable medical judgment. new text end
new text begin
"Reasonable medical judgment" means a
medical judgment that would be made by a reasonably prudent physician knowledgeable
about the case and the treatment possibilities with respect to the medical conditions involved.
new text end
new text begin Subd. 10. new text end
new text begin Unborn child or fetus. new text end
new text begin
"Unborn child" or "fetus" means an individual organism
of the species homo sapiens from fertilization until live birth.
new text end
new text begin Subd. 11. new text end
new text begin Woman. new text end
new text begin
"Woman" means a female human being whether or not she has
reached the age of majority.
new text end
Sec. 27.
new text begin
[145.4142] LEGISLATIVE FINDINGS.
new text end
new text begin
(a) The legislature makes the following findings.
new text end
new text begin
(b) Pain receptors (nociceptors) are present throughout an unborn child's entire body
and nerves link these receptors to the brain's thalamus and subcortical plate by 20 weeks.
new text end
new text begin
(c) By eight weeks after fertilization, an unborn child reacts to touch. After 20 weeks
an unborn child reacts to stimuli that would be recognized as painful if applied to an adult
human, for example by recoiling.
new text end
new text begin
(d) In the unborn child, application of such painful stimuli is associated with significant
increases in stress hormones known as the stress response.
new text end
new text begin
(e) Subjection to such painful stimuli is associated with long-term harmful
neurodevelopmental effects, such as altered pain sensitivity and, possibly, emotional,
behavioral, and learning disabilities later in life.
new text end
new text begin
(f) For the purposes of surgery on an unborn child, fetal anesthesia is routinely
administered and is associated with a decrease in stress hormones compared to the level
when painful stimuli is applied without anesthesia.
new text end
new text begin
(g) The position, asserted by some medical experts, that an unborn child is incapable of
experiencing pain until a point later in pregnancy than 20 weeks after fertilization
predominately rests on the assumption that the ability to experience pain depends on the
cerebral cortex and requires nerve connections between the thalamus and the cortex.
However, recent medical research and analysis, especially since 2007, provides strong
evidence for the conclusion that a functioning cortex is not necessary to experience pain.
new text end
new text begin
(h) Substantial evidence indicates that children born missing the bulk of the cerebral
cortex, those with hydranencephaly, nevertheless experience pain.
new text end
new text begin
(i) In adults, stimulation or ablation of the cerebral cortex does not alter pain perception,
while stimulation or ablation of the thalamus does.
new text end
new text begin
(j) Substantial evidence indicates that structures used for pain processing in early
development differ from those of adults, using different neural elements available at specific
times during development, such as the subcortical plate, to fulfill the role of pain processing.
new text end
new text begin
(k) The position asserted by some medical experts, that the unborn child remains in a
coma-like sleep state that precludes the unborn child experiencing pain is inconsistent with
the documented reaction of unborn children to painful stimuli and with the experience of
fetal surgeons who have found it necessary to sedate the unborn child with anesthesia to
prevent the unborn child from thrashing about in reaction to invasive surgery.
new text end
new text begin
(l) Consequently, there is substantial medical evidence that an unborn child is capable
of experiencing pain by 20 weeks after fertilization.
new text end
new text begin
(m) It is the purpose of the state to assert a compelling state interest in protecting the
lives of unborn children from the stage at which substantial medical evidence indicates that
they are capable of feeling pain.
new text end
Sec. 28.
new text begin
[145.4143] DETERMINATION OF POSTFERTILIZATION AGE.
new text end
new text begin Subdivision 1. new text end
new text begin Determination of postfertilization age. new text end
new text begin
Except in the case of a medical
emergency, no abortion shall be performed or induced or be attempted to be performed or
induced unless the physician performing or inducing it has first made a determination of
the probable postfertilization age of the unborn child or relied upon such a determination
made by another physician. In making such a determination, the physician shall make those
inquiries of the woman and perform or cause to be performed those medical examinations
and tests that a reasonably prudent physician, knowledgeable about the case and the medical
conditions involved, would consider necessary to perform in making an accurate diagnosis
with respect to postfertilization age.
new text end
new text begin Subd. 2. new text end
new text begin Unprofessional conduct. new text end
new text begin
Failure by any physician to conform to any
requirement of this section constitutes unprofessional conduct under section 147.091,
subdivision 1, paragraph (k).
new text end
Sec. 29.
new text begin
[145.4144] ABORTION OF UNBORN CHILD OF 20 OR MORE WEEKS
POSTFERTILIZATION AGE PROHIBITED; CAPABLE OF FEELING PAIN.
new text end
new text begin Subdivision 1. new text end
new text begin Abortion prohibition; exemption. new text end
new text begin
No person shall perform or induce
or attempt to perform or induce an abortion upon a woman when it has been determined,
by the physician performing or inducing or attempting to perform or induce the abortion,
or by another physician upon whose determination that physician relies, that the probable
postfertilization age of the woman's unborn child is 20 or more weeks unless, in reasonable
medical judgment, she has a condition which so complicates her medical condition as to
necessitate the abortion of her pregnancy to avert her death or to avert serious risk of
substantial and irreversible physical impairment of a major bodily function, not including
psychological or emotional conditions. No such condition shall be deemed to exist if it is
based on a claim or diagnosis that the woman will engage in conduct which she intends to
result in her death or in substantial and irreversible physical impairment of a major bodily
function.
new text end
new text begin Subd. 2. new text end
new text begin When abortion not prohibited. new text end
new text begin
When an abortion upon a woman whose
unborn child has been determined to have a probable postfertilization age of 20 or more
weeks is not prohibited by this section, the physician shall terminate the pregnancy in the
manner which, in reasonable medical judgment, provides the best opportunity for the unborn
child to survive unless, in reasonable medical judgment, termination of the pregnancy in
that manner would pose a greater risk either of the death of the pregnant woman or of the
substantial and irreversible physical impairment of a major bodily function, not including
psychological or emotional conditions, of the woman than would other available methods.
No such greater risk shall be deemed to exist if it is based on a claim or diagnosis that the
woman will engage in conduct which she intends to result in her death or in substantial and
irreversible physical impairment of a major bodily function.
new text end
Sec. 30.
new text begin
[145.4145] ENFORCEMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Criminal penalties. new text end
new text begin
A person who intentionally or recklessly performs
or induces or attempts to perform or induce an abortion in violation of sections 145.4141
to 145.4147 shall be guilty of a felony. No penalty may be assessed against the woman upon
whom the abortion is performed or induced or attempted to be performed or induced.
new text end
new text begin Subd. 2. new text end
new text begin Civil remedies. new text end
new text begin
(a) A woman upon whom an abortion has been performed or
induced in violation of sections 145.4141 to 145.4147, or the father of the unborn child who
was the subject of such an abortion, may maintain an action against the person who performed
or induced the abortion in intentional or reckless violation of sections 145.4141 to 145.4147
for damages. A woman upon whom an abortion has been attempted in violation of sections
145.4141 to 145.4147 may maintain an action against the person who attempted to perform
or induce the abortion in an intentional or reckless violation of sections 145.4141 to 145.4147
for damages.
new text end
new text begin
(b) A cause of action for injunctive relief against a person who has intentionally violated
sections 145.4141 to 145.4147 may be maintained by the woman upon whom an abortion
was performed or induced or attempted to be performed or induced in violation of sections
145.4141 to 145.4147; by a person who is the father of the unborn child subject to an
abortion, parent, sibling, or guardian of, or a current or former licensed health care provider
of, the woman upon whom an abortion has been performed or induced or attempted to be
performed or induced in violation of sections 145.4141 to 145.4147; by a county attorney
with appropriate jurisdiction; or by the attorney general. The injunction shall prevent the
abortion provider from performing or inducing or attempting to perform or induce further
abortions in this state in violation of sections 145.4141 to 145.4147.
new text end
new text begin
(c) If judgment is rendered in favor of the plaintiff in an action described in this section,
the court shall also render judgment for reasonable attorney fees in favor of the plaintiff
against the defendant.
new text end
new text begin
(d) If judgment is rendered in favor of the defendant and the court finds that the plaintiff's
suit was frivolous and brought in bad faith, the court shall also render judgment for reasonable
attorney fees in favor of the defendant against the plaintiff.
new text end
new text begin
(e) No damages or attorney fees may be assessed against the woman upon whom an
abortion was performed or induced or attempted to be performed or induced except according
to paragraph (d).
new text end
Sec. 31.
new text begin
[145.4146] PROTECTION OF PRIVACY IN COURT PROCEEDINGS.
new text end
new text begin
In every civil or criminal proceeding or action brought under the Pain-Capable Unborn
Child Protection Act, the court shall rule on whether the anonymity of a woman upon whom
an abortion has been performed or induced or attempted to be performed or induced shall
be preserved from public disclosure if she does not give her consent to such disclosure. The
court, upon motion or sua sponte, shall make such a ruling and, upon determining that her
anonymity should be preserved, shall issue orders to the parties, witnesses, and counsel and
shall direct the sealing of the record and exclusion of individuals from courtrooms or hearing
rooms to the extent necessary to safeguard her identity from public disclosure. Each such
order shall be accompanied by specific written findings explaining why the anonymity of
the woman should be preserved from public disclosure, why the order is essential to that
end, how the order is narrowly tailored to serve that interest, and why no reasonable, less
restrictive alternative exists. In the absence of written consent of the woman upon whom
an abortion has been performed or induced or attempted to be performed or induced, anyone,
other than a public official, who brings an action under section 145.4145, subdivision 2,
shall do so under a pseudonym. This section may not be construed to conceal the identity
of the plaintiff or of witnesses from the defendant or from attorneys for the defendant.
new text end
Sec. 32.
new text begin
[145.4147] SEVERABILITY.
new text end
new text begin
If any one or more provisions, sections, subsections, sentences, clauses, phrases, or
words of sections 145.4141 to 145.4146, or the application thereof to any person or
circumstance is found to be unconstitutional, the same is hereby declared to be severable
and the balance of sections 145.4141 to 145.4146 shall remain effective notwithstanding
such unconstitutionality. The legislature hereby declares that it would have passed sections
145.4141 to 145.4146, and each provision, section, subsection, sentence, clause, phrase, or
word thereof, irrespective of the fact that any one or more provisions, sections, subsections,
sentences, clauses, phrases, or words of sections 145.4141 to 145.4146, or the application
of sections 145.4141 to 145.4146, would be declared unconstitutional.
new text end
Sec. 33.
Minnesota Statutes 2018, section 145.4235, subdivision 2, is amended to read:
Subd. 2.
Eligibility for grants.
(a) The commissioner shall award grants to eligible
applicants under paragraph (c) for the reasonable expenses of alternatives to abortion
programs to support, encourage, and assist women in carrying their pregnancies to term and
caring for their babies after birth by providing information on, referral to, and assistance
with securing necessary services that enable women to carry their pregnancies to term and
care for their babies after birth. Necessary services must include, but are not limited to:
(1) medical care;
(2) nutritional services;
(3) housing assistance;
(4) adoption services;
(5) education and employment assistance, including services that support the continuation
and completion of high school;
(6) child care assistance; and
(7) parenting education and support services.
An applicant may not provide or assist a woman to obtain adoption services from a provider
of adoption services that is not licensed.
(b) In addition to providing information and referral under paragraph (a), an eligible
program may provide one or more of the necessary services under paragraph (a) that assists
women in carrying their pregnancies to term. To avoid duplication of efforts, grantees may
refer to other public or private programs, rather than provide the care directly, if a woman
meets eligibility criteria for the other programs.
(c) To be eligible for a grant, an agency or organization must:
(1) be a private, nonprofit organization;
(2) demonstrate that the program is conducted under appropriate supervision;
(3) not charge women for services provided under the program;
(4) provide each pregnant woman counseled with accurate information on the
developmental characteristics of babies and of unborn children, including offering the printed
information described in section 145.4243;
(5) ensure that its alternatives-to-abortion program's purpose is to assist and encourage
women in carrying their pregnancies to term and to maximize their potentials thereafter;
(6) ensure that none of the money provided is used to encourage or affirmatively counsel
a woman to have an abortion not necessary to prevent her death, to provide her an abortion,
or to directly refer her to an abortion provider for an abortion. The agency or organization
may provide nondirective counseling; and
(7) have had the alternatives to abortion program in existence deleted text begin for at least one year as of
July 1, 2011; or incorporated an alternative to abortion program that has been in existence
for at least one year as of July 1, 2011deleted text end new text begin for at least two years prior to the date the agency or
organization submits an application to the commissioner for a grant under this sectionnew text end .
(d) The provisions, words, phrases, and clauses of paragraph (c) are inseverable from
this subdivision, and if any provision, word, phrase, or clause of paragraph (c) or its
application to any person or circumstance is held invalid, the invalidity applies to all of this
subdivision.
(e) An organization that provides abortions, promotes abortions, or directly refers to an
abortion provider for an abortion is ineligible to receive a grant under this program. An
affiliate of an organization that provides abortions, promotes abortions, or directly refers
to an abortion provider for an abortion is ineligible to receive a grant under this section
unless the organizations are separately incorporated and independent from each other. To
be independent, the organizations may not share any of the following:
(1) the same or a similar name;
(2) medical facilities or nonmedical facilities, including but not limited to, business
offices, treatment rooms, consultation rooms, examination rooms, and waiting rooms;
(3) expenses;
(4) employee wages or salaries; or
(5) equipment or supplies, including but not limited to, computers, telephone systems,
telecommunications equipment, and office supplies.
(f) An organization that receives a grant under this section and that is affiliated with an
organization that provides abortion services must maintain financial records that demonstrate
strict compliance with this subdivision and that demonstrate that its independent affiliate
that provides abortion services receives no direct or indirect economic or marketing benefit
from the grant under this section.
(g) The commissioner shall approve any information provided by a grantee on the health
risks associated with abortions to ensure that the information is medically accurate.
Sec. 34.
Minnesota Statutes 2018, section 145.4242, is amended to read:
145.4242 INFORMED CONSENT.
(a) No abortion shall be performed in this state except with the voluntary and informed
consent of the female upon whom the abortion is to be performed. Except in the case of a
medical emergency or if the fetus has an anomaly incompatible with life, and the female
has declined perinatal hospice care, consent to an abortion is voluntary and informed only
if:
(1) the female is told the following, by telephone or in person, by the physician who is
to perform the abortion or by a referring physician, at least 24 hours before the abortion:
(i) the particular medical risks associated with the particular abortion procedure to be
employed including, when medically accurate, the risks of infection, hemorrhage, breast
cancer, danger to subsequent pregnancies, and infertility;
(ii) the probable gestational age of the unborn child at the time the abortion is to be
performed;
(iii) the medical risks associated with carrying her child to term; and
(iv) for abortions after 20 weeks gestational, whether or not an anesthetic or analgesic
would eliminate or alleviate organic pain to the unborn child caused by the particular method
of abortion to be employed and the particular medical benefits and risks associated with the
particular anesthetic or analgesic.
The information required by this clause may be provided by telephone without conducting
a physical examination or tests of the patient, in which case the information required to be
provided may be based on facts supplied to the physician by the female and whatever other
relevant information is reasonably available to the physician. It may not be provided by a
tape recording, but must be provided during a consultation in which the physician is able
to ask questions of the female and the female is able to ask questions of the physician. If a
physical examination, tests, or the availability of other information to the physician
subsequently indicate, in the medical judgment of the physician, a revision of the information
previously supplied to the patient, that revised information may be communicated to the
patient at any time prior to the performance of the abortion. Nothing in this section may be
construed to preclude provision of required information in a language understood by the
patient through a translator;
(2) the female is informed, by telephone or in person, by the physician who is to perform
the abortion, by a referring physician, or by an agent of either physician at least 24 hours
before the abortion:
(i) that medical assistance benefits may be available for prenatal care, childbirth, and
neonatal care;
(ii) that the father is liable to assist in the support of her child, even in instances when
the father has offered to pay for the abortion; and
(iii) that she has the right to review the printed materials described in section 145.4243,
that these materials are available on a state-sponsored website, and what the website address
is. The physician or the physician's agent shall orally inform the female that the materials
have been provided by the state of Minnesota and that they describe the unborn child, list
agencies that offer alternatives to abortion, and contain information on fetal pain. If the
female chooses to view the materials other than on the website, they shall either be given
to her at least 24 hours before the abortion or mailed to her at least 72 hours before the
abortion by certified mail, restricted delivery to addressee, which means the postal employee
can only deliver the mail to the addressee.
The information required by this clause may be provided by a tape recording if provision
is made to record or otherwise register specifically whether the female does or does not
choose to have the printed materials given or mailed to her;
(3) the female certifies in writing, prior to the abortion, that the information described
in clauses (1) and (2) has been furnished to her and that she has been informed of her
opportunity to review the information referred to in clause (2), item (iii); and
(4) prior to the performance of the abortion, the physician who is to perform the abortion
or the physician's agent obtains a copy of the written certification prescribed by clause (3)
and retains it on file with the female's medical record for at least three years following the
date of receipt.
(b) Prior to administering the anesthetic or analgesic as described in paragraph (a), clause
(1), item (iv), the physician must disclose to the woman any additional cost of the procedure
for the administration of the anesthetic or analgesic. If the woman consents to the
administration of the anesthetic or analgesic, the physician shall administer the anesthetic
or analgesic or arrange to have the anesthetic or analgesic administered.
(c) A female seeking an abortion of her unborn child diagnosed with fetal anomaly
incompatible with life must be informed of available perinatal hospice services and offered
this care as an alternative to abortion. If perinatal hospice services are declined, voluntary
and informed consent by the female seeking an abortion is given if the female receives the
information required in paragraphs (a), clause (1), and (b). The female must comply with
the requirements in paragraph (a), clauses (3) and (4).
new text begin
(d) If, at any time prior to the performance of an abortion, a female undergoes an
ultrasound examination, or a physician determines that ultrasound imaging will be used
during the course of a patient's abortion, the physician or the physician's agent shall orally
inform the patient of the opportunity to view or decline to view an active ultrasound image
of the unborn child.
new text end
Sec. 35.
Minnesota Statutes 2018, section 145.4244, is amended to read:
145.4244 INTERNET WEBSITE.
new text begin (a) new text end The commissioner of health shall develop and maintain a stable Internet website to
provide the information described under section 145.4243. No information regarding who
uses the website shall be collected or maintained. The commissioner of health shall monitor
the website on a weekly basis to prevent and correct tampering.
new text begin
(b) A health care facility performing abortions must provide the information described
in section 145.4243 on the facility's website or provide a link to the Department of Health
website where this information may be viewed.
new text end
Sec. 36.
Minnesota Statutes 2018, section 145.908, subdivision 1, is amended to read:
Subdivision 1.
Grant program established.
Within the limits of deleted text begin federal fundsdeleted text end available
deleted text begin specificallydeleted text end new text begin appropriations new text end for this purpose, the commissioner of health shall establish a
grant program to provide culturally competent programs to screen and treat pregnant women
and women who have given birth in the preceding 12 months for pre- and postpartum mood
and anxiety disorders. Organizations may use grant funds to establish new screening or
treatment programs, or expand or maintain existing screening or treatment programs. In
establishing the grant program, the commissioner shall prioritize expanding or enhancing
screening for pre- and postpartum mood and anxiety disorders in primary care settings. The
commissioner shall determine the types of organizations eligible for grants.
Sec. 37.
Minnesota Statutes 2018, section 145.928, subdivision 1, is amended to read:
Subdivision 1.
Goal; establishment.
It is the goal of the statedeleted text begin , by 2010,deleted text end to decrease deleted text begin by
50 percentdeleted text end the disparities in infant mortality rates and adult and child immunization rates
for American Indians and populations of color, as compared with rates for whites. To do
so and to achieve other measurable outcomes, the commissioner of health shall establish a
program to close the gap in the health status of American Indians and populations of color
as compared with whites in the following priority areas: infant mortality, new text begin access to and
utilization of high-quality prenatal care, new text end breast and cervical cancer screening, HIV/AIDS
and sexually transmitted infections, adult and child immunizations, cardiovascular disease,
diabetes, and accidental injuries and violence.
Sec. 38.
Minnesota Statutes 2018, section 145.928, subdivision 7, is amended to read:
Subd. 7.
Community grant program; immunization ratesnew text begin , prenatal care access and
utilization,new text end and infant mortality rates.
(a) The commissioner shall award grants to eligible
applicants for local or regional projects and initiatives directed at reducing health disparities
in one or deleted text begin bothdeleted text end new text begin morenew text end of the following priority areas:
(1) decreasing racial and ethnic disparities in infant mortality rates; deleted text begin or
deleted text end
new text begin
(2) decreasing racial and ethnic disparities in access to and utilization of high-quality
prenatal care; or
new text end
deleted text begin (2)deleted text end new text begin (3)new text end increasing adult and child immunization rates in nonwhite racial and ethnic
populations.
(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
coordination activities, and development of community supported strategies.
(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, community health boards,
tribal governments, and community clinics. Applicants must submit proposals to the
commissioner. A proposal must specify the strategies to be implemented to address one or
deleted text begin bothdeleted text end new text begin morenew text end of the priority areas listed in paragraph (a) and must be targeted to achieve the
outcomes established according to subdivision 3.
(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:
(1) is supported by the community the applicant will serve;
(2) is research-based or based on promising strategies;
(3) is designed to complement other related community activities;
(4) utilizes strategies that positively impact deleted text begin bothdeleted text end new text begin two or morenew text end priority areas;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with community-based organizations that reflect the
race or ethnicity of the population to be reached.
Sec. 39.
Minnesota Statutes 2018, section 145.986, subdivision 1, is amended to read:
Subdivision 1.
Purpose.
The purpose of the statewide health improvement program is
to:
(1) address the deleted text begin top threedeleted text end leading preventable causes of illness and deathdeleted text begin : tobacco use
and exposure, poor diet, and lack of regular physical activitydeleted text end new text begin as determined by the
commissioner through the statewide health assessmentnew text end ;
(2) promote the development, availability, and use of evidence-based, community level,
comprehensive strategies to create healthy communities; and
(3) measure the impact of the evidence-based, community health improvement practices
which over time work to contain health care costs and reduce chronic diseases.
Sec. 40.
Minnesota Statutes 2018, section 145.986, subdivision 1a, is amended to read:
Subd. 1a.
Grants to local communities.
(a) deleted text begin Beginning July 1, 2009,deleted text end The commissioner
of health shall award competitive grants to community health boards and tribal governments
to convene, coordinate, and implement deleted text begin evidence-baseddeleted text end new text begin proven-effectivenew text end strategies deleted text begin targeted
at reducing the percentage of Minnesotans who are obese or overweight and to reduce the
use of tobaccodeleted text end new text begin , and promising practices or activities that can be evaluated using experimental
or quasi-experimental designnew text end . 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)deleted text begin 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.deleted text end new text begin For purposes
of this subdivision, "proven-effective strategy" means a strategy or practice that offers a
high level of research on effectiveness for at least one outcome of interest; and "promising
practice or activity" means a practice or activity that is supported by research demonstrating
effectiveness for at least one outcome of interest.
new text end
deleted 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.
deleted text end
Sec. 41.
Minnesota Statutes 2018, section 145.986, subdivision 4, is amended to read:
Subd. 4.
Evaluation.
(a) Using the outcome measures established in subdivision 3, the
commissioner shall conduct a biennial evaluation of the statewide health improvement
program new text begin grants new text end funded under this section. new text begin The evaluation must use the most appropriate
experimental or quasi-experimental design suitable for the grant activity or project. new text end Grant
recipients shall cooperate with the commissioner in the evaluation and provide the
commissioner with the information necessary to conduct the evaluation, including information
on any impact on the health indicators listed in section 62U.10, subdivision 6, within the
geographic area or among the population targeted.
(b) Grant recipients will collect, monitor, and submit to the Department of Health baseline
and annual data and provide information to improve the quality and impact of community
health improvement strategies.
(c) For the purposes of carrying out the grant program under this section, including for
administrative purposes, the commissioner shall award contracts to appropriate entities to
assist in designing and implementing evaluation systems.new text begin The commissioner shall consult
with the commissioner of management and budget to ensure that the evaluation process is
using experimental or quasi-experimental design.
new text end
(d) Contracts awarded under paragraph (c) may be used to:
(1) develop grantee monitoring and reporting systems to track grantee progress, including
aggregated and disaggregated data;
(2) manage, analyze, and report program evaluation data results; and
(3) utilize innovative support tools to analyze and predict the impact of prevention
strategies on health outcomes and state health care costs over time.
new text begin
(e) For purposes of this subdivision, "experimental design" means a method of evaluating
the impact of a strategy that uses random assignment to establish statistically similar groups,
so that any difference in outcomes found at the end of the evaluation can be attributed to
the strategy being evaluated; and "quasi-experimental design" means a method of evaluating
the impact of a strategy that uses an approach other than random assignment to establish
statistically similar groups, so that any difference in outcomes found at the end of the
evaluation can be attributed to the strategy being evaluated.
new text end
Sec. 42.
Minnesota Statutes 2018, section 145.986, subdivision 5, is amended to read:
Subd. 5.
Report.
The commissioner shall submit a biennial report to the legislature on
the statewide health improvement program funded under this section. The report must
include information on each grant recipient, including the activities that were conducted by
the grantee using grant funds, the grantee's progress toward achieving the measurable
outcomes established under subdivision 2, and the data provided to the commissioner by
the grantee to measure these outcomes for grant activities. The commissioner shall provide
information on grants in which a corrective action plan was required under subdivision 1a,
the types of plan action, and the progress that has been made toward meeting the measurable
outcomes. In addition, the commissioner shall provide recommendations on future areas of
focus for health improvement. These reports are due by January 15 of every other year,
beginning in 2010. deleted text begin In the report due on January 15, 2014,deleted text end new text begin In the reports due beginning
January 15, 2020, new text end the commissioner shall include a description of the contracts awarded
under subdivision 4, paragraph (c), and the monitoring and evaluation systems that were
designed and implemented under these contracts.
Sec. 43.
Minnesota Statutes 2018, section 145.986, subdivision 6, is amended to read:
Subd. 6.
Supplantation of existing funds.
Community health boards and tribal
governments must use funds received under this section to develop new programs, expand
current programs deleted text begin that work to reduce the percentage of Minnesotans who are obese or
overweight or who use tobaccodeleted text end , or replace discontinued state or federal funds deleted text begin previously
used to reduce the percentage of Minnesotans who are obese or overweight or who use
tobaccodeleted text end . Funds must not be used to supplant current state or local funding to community
health boards or tribal governments deleted text begin used to reduce the percentage of Minnesotans who are
obese or overweight or to reduce tobacco usedeleted text end .
Sec. 44.
Minnesota Statutes 2018, section 152.22, is amended by adding a subdivision to
read:
new text begin Subd. 5a. new text end
new text begin Hemp. new text end
new text begin
"Hemp" means industrial hemp as defined in section 18K.02,
subdivision 3.
new text end
Sec. 45.
Minnesota Statutes 2018, section 152.22, subdivision 6, is amended to read:
Subd. 6.
Medical cannabis.
(a) "Medical cannabis" means any species of the genus
cannabis plant, or any mixture or preparation of them, including whole plant extracts and
resins, and is delivered in the form of:
(1) liquid, including, but not limited to, oil;
(2) pill;
(3) vaporized delivery method with use of liquid or oil but which does not require the
use of dried leaves or plant form; or
(4) any other method, excluding smoking, approved by the commissioner.
(b) This definition includes any part of the genus cannabis plant prior to being processed
into a form allowed under paragraph (a), that is possessed by a person while that person is
engaged in employment duties necessary to carry out a requirement under sections 152.22
to 152.37 for a registered manufacturer or a laboratory under contract with a registered
manufacturer.new text begin This definition also includes any hemp acquired by a manufacturer by a hemp
grower licensed under chapter 18K as permitted under section 152.29, subdivision 1,
paragraph (b).
new text end
Sec. 46.
Minnesota Statutes 2018, section 152.25, subdivision 4, is amended to read:
Subd. 4.
Reports.
(a) The commissioner shall provide regular updates to the task force
on medical cannabis therapeutic research and to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services, public safety,
judiciary, and civil law regardingnew text begin : (1)new text end any changes in federal law or regulatory restrictions
regarding the use of medical cannabisnew text begin and hemp; and (2) the market demand and supply in
this state for hemp products that can be used for medicinal purposesnew text end .
(b) The commissioner may submit medical research based on the data collected under
sections 152.22 to 152.37 to any federal agency with regulatory or enforcement authority
over medical cannabis to demonstrate the effectiveness of medical cannabis for treating a
qualifying medical condition.
Sec. 47.
Minnesota Statutes 2018, section 152.28, subdivision 1, is amended to read:
Subdivision 1.
Health care practitioner duties.
(a) Prior to a patient's enrollment in
the registry program, a health care practitioner shall:
(1) determine, in the health care practitioner's medical judgment, whether a patient suffers
from a qualifying medical condition, and, if so determined, provide the patient with a
certification of that diagnosis;
(2) determine whether a patient is developmentally or physically disabled and, as a result
of that disability, the patient is unable to self-administer medication or acquire medical
cannabis from a distribution facility, and, if so determined, include that determination on
the patient's certification of diagnosis;
(3) advise patients, registered designated caregivers, and parents or legal guardians who
are acting as caregivers of the existence of any nonprofit patient support groups or
organizations;
(4) provide explanatory information from the commissioner to patients with qualifying
medical conditions, including disclosure to all patients about the experimental nature of
therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the
proposed treatment; the application and other materials from the commissioner; and provide
patients with the Tennessen warning as required by section 13.04, subdivision 2; and
(5) agree to continue treatment of the patient's qualifying medical condition and report
medical findings to the commissioner.
(b) Upon notification from the commissioner of the patient's enrollment in the registry
program, the health care practitioner shall:
(1) participate in the patient registry reporting system under the guidance and supervision
of the commissioner;
(2) report health records of the patient throughout the ongoing treatment of the patient
to the commissioner in a manner determined by the commissioner and in accordance with
subdivision 2;
(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying
medical condition and, if so, issue the patient a new certification of that diagnosis; and
(4) otherwise comply with all requirements developed by the commissioner.
new text begin
(c) A health care practitioner may conduct a patient assessment to issue a recertification
as required under paragraph (b), clause (3), via telemedicine as defined under section
62A.671, subdivision 9.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end Nothing in this section requires a health care practitioner to participate in the
registry program.
Sec. 48.
Minnesota Statutes 2018, section 152.29, subdivision 1, is amended to read:
Subdivision 1.
Manufacturer; requirements.
(a) A manufacturer shall operate deleted text begin fourdeleted text end new text begin
eightnew text end distribution facilities, which may include the manufacturer's single location for
cultivation, harvesting, manufacturing, packaging, and processing but is not required to
include that location. deleted text begin A manufacturer is required to begin distribution of medical cannabis
from at least one distribution facility by July 1, 2015. All distribution facilities must be
operational and begin distribution of medical cannabis by July 1, 2016. The distribution
facilities shall be locateddeleted text end new text begin The commissioner shall designate the geographical service areas
to be served by each manufacturer new text end based on geographical need throughout the state to
improve patient access. deleted text begin A manufacturer shall disclose the proposed locations for the
distribution facilities to the commissioner during the registration process.deleted text end new text begin A manufacturer
shall not have more than two distribution facilities in each geographical service area assigned
to the manufacturer by the commissioner. new text end A manufacturer shall operate only one location
where all cultivation, harvesting, manufacturing, packaging, and processingnew text begin of medical
cannabisnew text end shall be conducted. deleted text begin Anydeleted text end new text begin This location may be one of the manufacturer's distribution
facility sites. Thenew text end additional distribution facilities may dispense medical cannabis and
medical cannabis products but may not contain any medical cannabis in a form other than
those forms allowed under section 152.22, subdivision 6, and the manufacturer shall not
conduct any cultivation, harvesting, manufacturing, packaging, or processing at deleted text begin an additionaldeleted text end new text begin
the othernew text end distribution facility deleted text begin sitedeleted text end new text begin sitesnew text end . Any distribution facility operated by the manufacturer
is subject to all of the requirements applying to the manufacturer under sections 152.22 to
152.37, including, but not limited to, security and distribution requirements.
new text begin
(b) A manufacturer may obtain hemp from a hemp grower licensed with the commissioner
of agriculture under chapter 18K if the hemp was grown in this state. A manufacturer may
use hemp for the purpose of making it available in a form allowable under section 152.22,
subdivision 6. Any hemp acquired by a manufacturer under this paragraph is subject to the
same quality control program, security and testing requirements, and any other requirement
for medical cannabis under sections 152.22 to 152.37 and Minnesota Rules, chapter 4770.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end A medical cannabis manufacturer shall contract with a laboratory approved by
the commissioner, subject to any additional requirements set by the commissioner, for
purposes of testing medical cannabis manufactured new text begin or hemp acquired new text end by the medical cannabis
manufacturer as to content, contamination, and consistency to verify the medical cannabis
meets the requirements of section 152.22, subdivision 6. The cost of laboratory testing shall
be paid by the manufacturer.
deleted text begin (c)deleted text end new text begin (d)new text end The operating documents of a manufacturer must include:
(1) procedures for the oversight of the manufacturer and procedures to ensure accurate
record keeping; deleted text begin and
deleted text end
(2) procedures for the implementation of appropriate security measures to deter and
prevent the theft of medical cannabis and unauthorized entrance into areas containing medical
cannabisdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) procedures for the delivery and transportation of hemp between hemp growers
licensed under chapter 18K and manufacturers.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end A manufacturer shall implement security requirements, including requirements
for new text begin the delivery and transportation of hemp, new text end protection of each location by a fully operational
security alarm system, facility access controls, perimeter intrusion detection systems, and
a personnel identification system.
deleted text begin (e)deleted text end new text begin (f)new text end A manufacturer shall not share office space with, refer patients to a health care
practitioner, or have any financial relationship with a health care practitioner.
deleted text begin (f)deleted text end new text begin (g)new text end A manufacturer shall not permit any person to consume medical cannabis on the
property of the manufacturer.
deleted text begin (g)deleted text end new text begin (h)new text end A manufacturer is subject to reasonable inspection by the commissioner.
deleted text begin (h)deleted text end new text begin (i)new text end For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is
not subject to the Board of Pharmacy licensure or regulatory requirements under chapter
151.
deleted text begin (i)deleted text end new text begin (j)new text end A medical cannabis manufacturer may not employ any person who is under 21
years of age or who has been convicted of a disqualifying felony offense. An employee of
a medical cannabis manufacturer must submit a completed criminal history records check
consent form, a full set of classifiable fingerprints, and the required fees for submission to
the Bureau of Criminal Apprehension before an employee may begin working with the
manufacturer. The bureau must conduct a Minnesota criminal history records check and
the superintendent is authorized to exchange the fingerprints with the Federal Bureau of
Investigation to obtain the applicant's national criminal history record information. The
bureau shall return the results of the Minnesota and federal criminal history records checks
to the commissioner.
deleted text begin (j)deleted text end new text begin (k)new text end A manufacturer may not operate in any location, whether for distribution or
cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a
public or private school existing before the date of the manufacturer's registration with the
commissioner.
deleted text begin (k)deleted text end new text begin (l)new text end A manufacturer shall comply with reasonable restrictions set by the commissioner
relating to signage, marketing, display, and advertising of medical cannabis.
new text begin
(m) Before a manufacturer acquires hemp, the manufacturer must verify that the person
from whom the manufacturer is acquiring hemp has a valid license issued by the
commissioner of agriculture under chapter 18K.
new text end
Sec. 49.
Minnesota Statutes 2018, section 152.29, subdivision 2, is amended to read:
Subd. 2.
Manufacturer; production.
(a) A manufacturer of medical cannabis shall
provide a reliable and ongoing supply of all medical cannabis needed for the registry program.
(b) All cultivation, harvesting, manufacturing, packaging, and processing of medical
cannabis new text begin or manufacturing, packaging, or processing of hemp acquired by the manufacturer
new text end must take place in an enclosed, locked facility at a physical address provided to the
commissioner during the registration process.
(c) A manufacturer must process and prepare any medical cannabis plant material into
a form allowable under section 152.22, subdivision 6, prior to distribution of any medical
cannabis.
Sec. 50.
Minnesota Statutes 2018, section 152.29, subdivision 3, is amended to read:
Subd. 3.
Manufacturer; distribution.
(a) A manufacturer shall require that employees
licensed as pharmacists pursuant to chapter 151 be the only employees to give final approval
for the distribution of medical cannabis to a patient.
(b) A manufacturer may dispense medical cannabis products, whether or not the products
have been manufactured by the manufacturer, but is not required to dispense medical cannabis
products.
(c) Prior to distribution of any medical cannabis, the manufacturer shall:
(1) verify that the manufacturer has received the registry verification from the
commissioner for that individual patient;
(2) verify that the person requesting the distribution of medical cannabis is the patient,
the patient's registered designated caregiver, or the patient's parent or legal guardian listed
in the registry verification using the procedures described in section 152.11, subdivision
2d;
(3) assign a tracking number to any medical cannabis distributed from the manufacturer;
(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to
chapter 151 has consulted with the patient to determine the proper dosage for the individual
patient after reviewing the ranges of chemical compositions of the medical cannabis and
the ranges of proper dosages reported by the commissioner. For purposes of this clause, a
consultation may be conducted remotely using a videoconference, so long as the employee
providing the consultation is able to confirm the identity of the patient, the consultation
occurs while the patient is at a distribution facility, and the consultation adheres to patient
privacy requirements that apply to health care services delivered through telemedicine;
(5) properly package medical cannabis in compliance with the United States Poison
Prevention Packing Act regarding child-resistant packaging and exemptions for packaging
for elderly patients, and label distributed medical cannabis with a list of all active ingredients
and individually identifying information, including:
(i) the patient's name and date of birth;
(ii) the name and date of birth of the patient's registered designated caregiver or, if listed
on the registry verification, the name of the patient's parent or legal guardian, if applicable;
(iii) the patient's registry identification number;
(iv) the chemical composition of the medical cannabis; and
(v) the dosage; and
(6) ensure that the medical cannabis distributed contains a maximum of a deleted text begin 30-daydeleted text end new text begin 90-daynew text end
supply of the dosage determined for that patient.
(d) A manufacturer shall require any employee of the manufacturer who is transporting
medical cannabis or medical cannabis products to a distribution facility to carry identification
showing that the person is an employee of the manufacturer.
Sec. 51.
Minnesota Statutes 2018, section 152.29, subdivision 3a, is amended to read:
Subd. 3a.
Transportation of medical cannabis; staffing.
new text begin (a) new text end A medical cannabis
manufacturer may staff a transport motor vehicle with only one employee if the medical
cannabis manufacturer is transporting medical cannabis to either a certified laboratory for
the purpose of testing or a facility for the purpose of disposal. If the medical cannabis
manufacturer is transporting medical cannabis for any other purpose or destination, the
transport motor vehicle must be staffed with a minimum of two employees as required by
rules adopted by the commissioner.
new text begin
(b) Notwithstanding paragraph (a), a medical cannabis manufacturer that is only
transporting hemp for any purpose may staff the transport motor vehicle with only one
employee.
new text end
Sec. 52.
Minnesota Statutes 2018, section 152.31, is amended to read:
152.31 DATA PRACTICES.
(a) Government data in patient files maintained by the commissioner and the health care
practitioner, and data submitted to or by a medical cannabis manufacturer, are private data
on individuals, as defined in section 13.02, subdivision 12, or nonpublic data, as defined in
section 13.02, subdivision 9, but may be used for purposes of complying with chapter 13
and complying with a request from the legislative auditor or the state auditor in the
performance of official duties. The provisions of section 13.05, subdivision 11, apply to a
registration agreement entered between the commissioner and a medical cannabis
manufacturer under section 152.25.
(b) Not public data maintained by the commissioner may not be used for any purpose
not provided for in sections 152.22 to 152.37, and may not be combined or linked in any
manner with any other list, dataset, or database.
new text begin
(c) The commissioner may execute data sharing arrangements with the commissioner
of agriculture to verify licensing information, inspection, and compliance related to hemp
growers under chapter 18K.
new text end
Sec. 53.
Minnesota Statutes 2018, section 157.22, is amended to read:
157.22 EXEMPTIONS.
This chapter does not apply to:
(1) interstate carriers under the supervision of the United States Department of Health
and Human Services;
(2) weddings, fellowship meals, or funerals conducted by a faith-based organization
using any building constructed and primarily used for religious worship or education;
(3) any building owned, operated, and used by a college or university in accordance
with health regulations promulgated by the college or university under chapter 14;
(4) any person, firm, or corporation whose principal mode of business is licensed under
sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food or beverage
establishment; provided that the holding of any license pursuant to sections 28A.04 and
28A.05 shall not exempt any person, firm, or corporation from the applicable provisions of
this chapter or the rules of the state commissioner of health relating to food and beverage
service establishments;
(5) family day care homes and group family day care homes governed by sections
245A.01 to 245A.16;
(6) nonprofit senior citizen centers for the sale of home-baked goods;
(7) fraternal, sportsman, or patriotic organizations that are tax exempt under section
501(c)(3), 501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue
Code of 1986, or organizations related to, affiliated with, or supported by such fraternal,
sportsman, or patriotic organizations for events held in the building or on the grounds of
the organization and at which home-prepared food is donated by organization members for
sale at the events, provided:
(i) the event is not a circus, carnival, or fair;
(ii) the organization controls the admission of persons to the event, the event agenda, or
both; and
(iii) the organization's licensed kitchen is not used in any manner for the event;
(8) food not prepared at an establishment and brought in by individuals attending a
potluck event for consumption at the potluck event. An organization sponsoring a potluck
event under this clause may advertise the potluck event to the public through any means.
Individuals who are not members of an organization sponsoring a potluck event under this
clause may attend the potluck event and consume the food at the event. Licensed food
establishments other than schools cannot be sponsors of potluck events. A school may
sponsor and hold potluck events in areas of the school other than the school's kitchen,
provided that the school's kitchen is not used in any manner for the potluck event. For
purposes of this clause, "school" means a public school as defined in section 120A.05,
subdivisions 9, 11, 13, and 17, or a nonpublic school, church, or religious organization at
which a child is provided with instruction in compliance with sections 120A.22 and 120A.24.
Potluck event food shall not be brought into a licensed food establishment kitchen;
(9) a home school in which a child is provided instruction at home;
(10) school concession stands serving commercially prepared, nonpotentially hazardous
foods, as defined in Minnesota Rules, chapter 4626;
(11) group residential facilities of ten or fewer beds licensed by the commissioner of
human services under Minnesota Rules, chapter 2960, provided the facility employs or
contracts with a certified food manager under Minnesota Rules, part 4626.2015;
(12) food served at fund-raisers or community events conducted in the building or on
the grounds of a faith-based organization, provided that a certified food manager, or a
volunteer trained in a food safety course, trains the food preparation workers in safe food
handling practices. This exemption does not apply to faith-based organizations at the state
agricultural society or county fairs or to faith-based organizations that choose to apply for
a license;
(13) food service events conducted following a disaster for purposes of feeding disaster
relief staff and volunteers serving commercially prepared, nonpotentially hazardous foods,
as defined in Minnesota Rules, chapter 4626; deleted text begin and
deleted text end
(14) chili or soup served at a chili or soup cook-off fund-raiser conducted by a
community-based nonprofit organization, provided:
(i) the municipality where the event is located approves the event;
(ii) the sponsoring organization must develop food safety rules and ensure that participants
follow these rules; and
(iii) if the food is not prepared in a kitchen that is licensed or inspected, a visible sign
or placard must be posted that states: "These products are homemade and not subject to
state inspection."
Foods exempt under this clause must be labeled to accurately reflect the name and
address of the person preparing the foodsdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(15) a special event food stand or a seasonal temporary food stand provided:
new text end
new text begin
(i) the stand is operated solely by a person or persons under the age of 14;
new text end
new text begin
(ii) the stand is located on private property with the permission of the property owner;
new text end
new text begin
(iii) the stand has gross receipts or contributions of $1,000 or less in a calendar year;
and
new text end
new text begin
(iv) the operator of the stand posts a sign or placard at the site that states "The products
sold at this stand are not subject to state inspection or regulation.", if the stand offers for
sale potentially hazardous food as defined in Minnesota Rules, part 4626.0020, subdivision
62.
new text end
Sec. 54. new text begin DIRECTION TO THE COMMISSIONER OF HEALTH.
new text end
new text begin
The commissioner of health shall prescribe the notification and consent form described
in Minnesota Statutes, section 144.6502, subdivision 6, no later than January 1, 2020. The
commissioner shall make the form available on the department's website.
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. 55. new text begin PERINATAL HOSPICE GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms have
the meanings given.
new text end
new text begin
(b) "Eligible program entity" means a hospital, hospice, health care facility, or
community-based organization. An eligible program entity must have a perinatal hospice
program coordinator who is eligible to be certified in perinatal loss care.
new text end
new text begin
(c) "Eligible training entity" means an eligible program entity that has experience
providing perinatal hospice services, or a qualified individual who is eligible to be certified
in perinatal loss care and has experience providing perinatal hospice services.
new text end
new text begin
(d) "Eligible to be certified in perinatal loss care" means an individual who meets the
criteria to sit for the perinatal loss care exam, or is already certified in perinatal loss care,
by the Hospice and Palliative Credentialing Center.
new text end
new text begin
(e) "Life-limiting prenatal diagnosis" means a fetal condition diagnosed before birth that
will with reasonable certainty result in the death of the child within six months after birth.
new text end
new text begin
(f) "Perinatal hospice" means comprehensive support to the pregnant woman and her
family that includes family-centered multidisciplinary care to meet their medical, spiritual,
and emotional needs from the time of a life-limiting prenatal diagnosis through the birth,
life, and natural death of the child, and through the postpartum period. Supportive care may
be provided by medical staff, counselors, clergy, mental health providers, social workers,
geneticists, certified nurse midwives, hospice professionals, and others.
new text end
new text begin Subd. 2. new text end
new text begin Perinatal hospice development grants. new text end
new text begin
Perinatal hospice development grants
are available to eligible program entities and must be used for expenditures to:
new text end
new text begin
(1) establish a new perinatal hospice program;
new text end
new text begin
(2) expand an existing perinatal hospice program;
new text end
new text begin
(3) recruit a perinatal hospice program coordinator; or
new text end
new text begin
(4) fund perinatal hospice administrative and coordinator expenses for a period of not
more than six months.
new text end
new text begin Subd. 3. new text end
new text begin Perinatal hospice training grants. new text end
new text begin
Perinatal hospice training grants are available
to eligible training entities and may be used for expenses to enable existing perinatal hospice
programs to provide training for members of a multidisciplinary team providing perinatal
hospice services. Funds must be used for:
new text end
new text begin
(1) development and operation of a perinatal hospice training program. The curriculum
must include but is not limited to training to provide the following services to families
eligible for perinatal hospice:
new text end
new text begin
(i) counseling at the time of a life-limiting prenatal diagnosis;
new text end
new text begin
(ii) specialized birth planning;
new text end
new text begin
(iii) specialized advance care planning;
new text end
new text begin
(iv) services to address the emotional needs of the family through prenatal and postpartum
counseling that:
new text end
new text begin
(A) helps the family prepare for the death of their child;
new text end
new text begin
(B) helps the family work within the health care delivery system to create a safe and
professionally supported environment where parents can parent their child during their brief
life in a way that is meaningful for that family and baby; and
new text end
new text begin
(C) helps the family with the grief that begins at diagnosis and continues after the death
of the child; and
new text end
new text begin
(v) evidence-based perinatal bereavement care;
new text end
new text begin
(2) trainer support, including travel expenses and reasonable living expenses during the
period of training;
new text end
new text begin
(3) trainee support, including tuition, books, travel expenses, program fees, and reasonable
living expenses during the period of training; or
new text end
new text begin
(4) materials used in the provision of training.
new text end
new text begin Subd. 4. new text end
new text begin Perinatal hospice awareness grants. new text end
new text begin
Perinatal hospice awareness grants are
available to eligible program entities and may be used for the creation and distribution of
materials promoting awareness of perinatal hospice programs.
new text end
new text begin Subd. 5. new text end
new text begin Report. new text end
new text begin
The commissioner of health shall report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services finance by February 1, 2023, on how the grant funds have been used.
new text end
Sec. 56. new text begin PLAN FOR A WORKING GROUP ON LINKS BETWEEN HEALTH
DISPARITIES AND EDUCATIONAL ACHIEVEMENT FOR CHILDREN FROM
AMERICAN INDIAN COMMUNITIES AND COMMUNITIES OF COLOR.
new text end
new text begin
(a) The commissioner of health, in consultation with the commissioner of education,
shall develop a plan to convene one or more working groups to:
new text end
new text begin
(1) examine the links between health disparities and disparities in educational achievement
for children from American Indian communities and communities of color; and
new text end
new text begin
(2) develop recommendations for programs, services, or funding to address health
disparities and decrease disparities in educational achievement for children from American
Indian communities and communities of color.
new text end
new text begin
(b) The plan shall include the possible membership of the proposed working group and
the duties for the proposed working group.
new text end
new text begin
(c) The commissioner shall submit the plan for the working group, including proposed
legislation establishing the working group, to the chairs and ranking minority members of
the legislative committees with jurisdiction over health and education by February 15, 2020.
new text end
Sec. 57. new text begin SALE OF CERTAIN CANNABINOID PRODUCTS WORKGROUP.
new text end
new text begin
(a) The commissioner of health, in consultation with the commissioners of commerce,
agriculture, and public safety, and the executive director of the Board of Pharmacy, shall
convene a workgroup to advise the legislature on how to regulate products that contain
cannabinoids extracted from hemp. For purposes of this section, "hemp" has the meaning
given to "industrial hemp" in Minnesota Statutes, section 18K.02, subdivision 3.
new text end
new text begin
(b) The commissioner shall assess the public health and consumer safety impact on the
sale of cannabinoids derived from hemp and shall develop a regulatory framework of what
the legislature would need to consider including, but not limited to:
new text end
new text begin
(1) cultivation standards for industrial hemp if the hemp is used for any product intended
for human or animal consumption;
new text end
new text begin
(2) labeling requirements for products containing cannabidoil extracted from hemp,
including the amount and percentage of cannabidiol in the product, the name of the
manufacturer of the product, and the ingredients contained in the product;
new text end
new text begin
(3) possible restrictions of advertising and marketing of the cannabidiol product;
new text end
new text begin
(4) restrictions of false, misleading, or unsubstantiated health claims;
new text end
new text begin
(5) requirements for the independent testing of cannabidiol products, including quality
control and chemical identification;
new text end
new text begin
(6) safety standards for edible products containing cannabinoids extracted from hemp,
including container and packaging requirements; and
new text end
new text begin
(7) any other requirement or procedure the commissioner deems necessary.
new text end
new text begin
(c) By January 15, 2020, the commissioner of health shall submit the results of the
workgroup to the chairs and ranking minority members of the legislative committees with
jurisdiction over public health, consumer protection, public safety, and agriculture.
new text end
Sec. 58. new text begin SHORT TITLE.
new text end
new text begin
Minnesota Statutes, sections 145.4141 to 145.4147 may be cited as the "Pain-Capable
Unborn Child Protection Act."
new text end
Sec. 59. new text begin STUDY ON BREASTFEEDING DISPARITIES; STAKEHOLDER
ENGAGEMENT.
new text end
new text begin
(a) The commissioner of health shall work with community stakeholders in Minnesota
including but not limited to representatives from the Minnesota Breastfeeding Coalition;
Academy of Lactation Policy and Practice; International Board of Lactation Consultant
Examiners; DONA International; HealthConnect; Reaching Sisters Everywhere; the La
Leche League; the women, infants, and children program; hospitals and clinics; local public
health professionals and organizations; community-based organizations; and representatives
of populations with low breastfeeding rates to carry out a study to identify barriers,
challenges, and successes affecting the initiation, duration, and exclusivity of breastfeeding.
new text end
new text begin
(b) The study must address policy, systemic, and environmental factors that both support
and create barriers to breastfeeding. The study must also identify and make recommendations
regarding culturally appropriate practices that have been shown to increase breastfeeding
rates in populations that have the greatest breastfeeding disparity rates.
new text end
new text begin
(c) The commissioner shall submit a report on the study with any recommendations to
the chairs and ranking minority members of the legislative committees with jurisdiction
over health care policy and finance on or before September 15, 2020.
new text end
Sec. 60. new text begin TRANSITION TO AUTHORIZED ELECTRONIC MONITORING IN
CERTAIN HEALTH CARE FACILITIES.
new text end
new text begin
Any resident, resident representative, or other person conducting electronic monitoring
in a resident's room or private living unit prior to January 1, 2020, must comply with the
requirements of Minnesota Statutes, section 144.6502, by January 1, 2020.
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. 61. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, sections 144.1464; and 144.1911,
new text end
new text begin
are repealed.
new text end
ARTICLE 10
MNSURE
Section 1.
Minnesota Statutes 2018, section 62V.05, subdivision 2, is amended to read:
Subd. 2.
Operations funding.
deleted text begin
(a) Prior to January 1, 2015, MNsure shall retain or collect
up to 1.5 percent of total premiums for individual and small group market health plans and
dental plans sold through MNsure to fund the cash reserves of MNsure, but the amount
collected shall not exceed a dollar amount equal to 25 percent of the funds collected under
section 62E.11, subdivision 6, for calendar year 2012.
deleted text end
deleted text begin
(b) Beginning January 1, 2015, MNsure shall retain or collect up to 3.5 percent of total
premiums for individual and small group market health plans and dental plans sold through
MNsure to fund the operations of MNsure, but the amount collected shall not exceed a
dollar amount equal to 50 percent of the funds collected under section 62E.11, subdivision
6, for calendar year 2012.
deleted text end
deleted text begin (c)deleted text end new text begin (a)new text end Beginning January 1, 2016, new text begin through December 31, 2019, new text end MNsure shall retain or
collect up to 3.5 percent of total premiums for individual and small group market health
plans and dental plans sold through MNsure to fund the operations of MNsure, but the
amount collected may never exceed a dollar amount greater than 100 percent of the funds
collected under section 62E.11, subdivision 6, for calendar year 2012.
deleted text begin
(d) For fiscal years 2014 and 2015, the commissioner of management and budget is
authorized to provide cash flow assistance of up to $20,000,000 from the special revenue
fund or the statutory general fund under section 16A.671, subdivision 3, paragraph (a), to
MNsure. Any funds provided under this paragraph shall be repaid, with interest, by June
30, 2015.
deleted text end
new text begin
(b) Beginning January 1, 2020, MNsure shall retain or collect up to two percent of total
premiums for individual and small group health plans and dental plans sold through MNsure
to fund the operations of MNsure, but the amount collected may never exceed a dollar
amount greater than 25 percent of the funds collected under section 62E.11, subdivision 6,
for calendar year 2012.
new text end
deleted text begin (e)deleted text end new text begin (c)new text end Funding for the operations of MNsure shall cover any compensation provided to
navigators participating in the navigator program.
new text begin
(d) Interagency agreements between MNsure and the Department of Human Services,
and the Public Assistance Cost Allocation Plan for the Department of Human Services,
shall not be modified to reflect any changes to the percentage of premiums that MNsure is
allowed to retain or collect under this section, and no additional funding shall be transferred
from the Department of Human Services to MNsure as a result of any changes to the
percentage of premiums that MNsure is allowed to retain or collect under this section.
new text end
Sec. 2.
Minnesota Statutes 2018, section 62V.05, subdivision 5, is amended to read:
Subd. 5.
Health carrier and health plan requirements; participation.
(a) Beginning
January 1, 2015, the board may establish certification requirements for health carriers and
health plans to be offered through MNsure that satisfy federal requirements under deleted text begin section
1311(c)(1) of the Affordable Care Act, Public Law 111-148deleted text end new text begin United States Code, title 42,
section 18031(c)(1)new text end .
(b) Paragraph (a) does not apply if by June 1, 2013, the legislature enacts regulatory
requirements that:
(1) apply uniformly to all health carriers and health plans in the individual market;
(2) apply uniformly to all health carriers and health plans in the small group market; and
(3) satisfy minimum federal certification requirements under deleted text begin section 1311(c)(1) of the
Affordable Care Act, Public Law 111-148deleted text end new text begin United States Code, title 42, section 18031(c)(1)new text end .
(c) In accordance with deleted text begin section 1311(e) of the Affordable Care Act, Public Law 111-148deleted text end new text begin
United States Code, title 42, section 18031(e)new text end , the board shall establish policies and
procedures for certification and selection of health plans to be offered as qualified health
plans through MNsure. The board shall certify and select a health plan as a qualified health
plan to be offered through MNsure, if:
(1) the health plan meets the minimum certification requirements established in paragraph
(a) or the market regulatory requirements in paragraph (b);
(2) the board determines that making the health plan available through MNsure is in the
interest of qualified individuals and qualified employers;
(3) the health carrier applying to offer the health plan through MNsure also applies to
offer health plans at each actuarial value level and service area that the health carrier currently
offers in the individual and small group markets; and
(4) the health carrier does not apply to offer health plans in the individual and small
group markets through MNsure under a separate license of a parent organization or holding
company under section 60D.15, that is different from what the health carrier offers in the
individual and small group markets outside MNsure.
(d) In determining the interests of qualified individuals and employers under paragraph
(c), clause (2), the board may not exclude a health plan for any reason specified under deleted text begin section
1311(e)(1)(B) of the Affordable Care Act, Public Law 111-148deleted text end new text begin United States Code, title
42, section 18031(e)(1)(B)new text end . deleted text begin The board may consider:
deleted text end
deleted text begin
(1) affordability;
deleted text end
deleted text begin
(2) quality and value of health plans;
deleted text end
deleted text begin
(3) promotion of prevention and wellness;
deleted text end
deleted text begin
(4) promotion of initiatives to reduce health disparities;
deleted text end
deleted text begin
(5) market stability and adverse selection;
deleted text end
deleted text begin
(6) meaningful choices and access;
deleted text end
deleted text begin
(7) alignment and coordination with state agency and private sector purchasing strategies
and payment reform efforts; and
deleted text end
deleted text begin
(8) other criteria that the board determines appropriate.
deleted text end
new text begin
(e) A health plan that meets the minimum certification requirements under paragraph
(c) and United States Code, title 42, section 18031(c)(1), and any regulations and guidance
issued under that section, is deemed to be in the interest of qualified individuals and qualified
employers. The board shall not establish certification requirements for health carriers and
health plans for participation in MNsure that are in addition to the certification requirements
under paragraph (c) and United States Code, title 42, section 18031(c)(1), and any regulations
and guidance issued under that section. The board shall not determine the cost of, cost-sharing
elements of, or benefits provided in health plans sold through MNsure.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end For qualified health plans offered through MNsure on or after January 1, 2015,
the board shall establish policies and procedures under paragraphs (c) and (d) for selection
of health plans to be offered as qualified health plans through MNsure by February 1 of
each year, beginning February 1, 2014. The board shall consistently and uniformly apply
all policies and procedures and any requirements, standards, or criteria to all health carriers
and health plans. For any policies, procedures, requirements, standards, or criteria that are
defined as rules under section 14.02, subdivision 4, the board may use the process described
in subdivision 9.
deleted text begin
(f) For 2014, the board shall not have the power to select health carriers and health plans
for participation in MNsure. The board shall permit all health plans that meet the certification
requirements under section 1311(c)(1) of the Affordable Care Act, Public Law 111-148, to
be offered through MNsure.
deleted text end
(g) Under this subdivision, the board shall have the power to verify that health carriers
and health plans are properly certified to be eligible for participation in MNsure.
(h) The board has the authority to decertify health carriers and health plans that fail to
maintain compliance with deleted text begin section 1311(c)(1) of the Affordable Care Act, Public Law 111-148deleted text end new text begin
United States Code, title 42, section 18031(c)(1)new text end .
(i) For qualified health plans offered through MNsure beginning January 1, 2015, health
carriers must use the most current addendum for Indian health care providers approved by
the Centers for Medicare and Medicaid Services and the tribes as part of their contracts with
Indian health care providers. MNsure shall comply with all future changes in federal law
with regard to health coverage for the tribes.
Sec. 3.
Minnesota Statutes 2018, section 62V.05, subdivision 10, is amended to read:
Subd. 10.
Limitations; risk-bearing.
(a) The board shall not bear insurance risk or enter
into any agreement with health care providers to pay claims.
(b) Nothing in this subdivision shall prevent MNsure from providing insurance for its
employees.
new text begin
(c) The commissioner of human services shall not bear insurance risk or enter into any
agreement with providers to pay claims for any health coverage administered by the
commissioner that is made available for purchase through the MNsure website as a qualifying
health plan or as an alternative to purchasing a qualifying health plan through MNsure or
an individual health plan offered outside of MNsure.
new text end
new text begin
(d) Nothing in this subdivision shall prohibit:
new text end
new text begin
(1) the commissioner of human services from administering the medical assistance
program under chapter 256B and the MinnesotaCare program under chapter 256L, as long
as health coverage under these programs is not purchased by the individual through the
MNsure Web site; and
new text end
new text begin
(2) employees of the Department of Human Services from obtaining insurance from the
state employee group insurance program.
new text end
Sec. 4.
Minnesota Statutes 2018, section 62V.08, is amended to read:
62V.08 REPORTS.
(a) MNsure shall submit a report to the legislature by January 15, 2015, and each January
15 thereafter, on: (1) the performance of MNsure operations; (2) meeting MNsure
responsibilities; (3) an accounting of MNsure budget activities; (4) practices and procedures
that have been implemented to ensure compliance with data practices laws, and a description
of any violations of data practices laws or procedures; and (5) the effectiveness of the
outreach and implementation activities of MNsure in reducing the rate of uninsurance.
(b) MNsure must publish its administrative and operational costs on a website to educate
consumers on those costs. The information published must include: (1) the amount of
premiums and federal premium subsidies collected; (2) the amount and source of revenue
received under section 62V.05, subdivision 1, paragraph (b), clause (3); (3) the amount and
source of any other fees collected for purposes of supporting operations; and (4) any misuse
of funds as identified in accordance with section 3.975. The website must be updated at
least annually.
new text begin
(c) As part of the report required to be submitted to the legislature in paragraph (a), and
the information required to be published in paragraph (b), MNsure shall include the total
amount spent on business continuity planning, data privacy protection, and cyber security
provisions.
new text end
Sec. 5.
Laws 2015, chapter 71, article 12, section 8, is amended to read:
Sec. 8. EXPANDED ACCESS TO QUALIFIED HEALTH PLANS AND SUBSIDIES.
The commissioner of commerce, in consultation with the Board of Directors of MNsure
and the MNsure Legislative Oversight Committee, shall develop a proposal to allow
individuals to purchase qualified health plans outside of MNsure directly from health plan
companies and to allow eligible individuals to receive advanced premium tax credits and
cost-sharing reductions when purchasing these health plans. The commissioner shall seek
all federal waivers and approvals necessary to implement this proposalnew text begin and shall submit the
necessary federal waivers and approvals to the federal government no later than October 1,
2019new text end . The commissioner shall submit a draft proposal to the MNsure board and the MNsure
Legislative Oversight Committee deleted text begin at least 30 days before submitting a final proposal to the
federal governmentdeleted text end new text begin no later than September 1, 2019,new text end and shall notify the board and legislative
oversight committee of any federal decision or action related to the proposal.
Sec. 6. new text begin MNSURE PROGRAM DEVELOPMENT.
new text end
new text begin
No funds shall be appropriated to the Board of Directors of MNsure for new program
development until 834 EDI transmissions are being processed automatically and are
conveying accurate information without the intervention of manual reviews and processes.
new text end
Sec. 7. new text begin RATES FOR INDIVIDUAL MARKET HEALTH AND DENTAL PLANS
FOR 2020.
new text end
new text begin
(a) Health carriers must take into account the reduction in the premium withhold
percentage under Minnesota Statutes, section 62V.05, subdivision 2, applicable beginning
in calendar year 2020 for individual market health plans and dental plans sold through
MNsure when setting rates for individual market health plans and dental plans for calendar
year 2020.
new text end
new text begin
(b) For purposes of this section, "dental plan," "health carrier," "health plan," and
"individual market" have the meanings given in Minnesota Statutes, section 62V.02.
new text end
Sec. 8. new text begin REQUEST FOR INFORMATION ON A PRIVATIZED STATE-BASED
MARKETPLACE SYSTEM.
new text end
new text begin
(a) The commissioner of human services, in consultation with the commissioners of
commerce and health, and interested stakeholders, shall develop a request for information
to consider the feasibility for a private vendor to provide the technology functionality for
the individual market currently provided by MNsure. The request shall seek options for a
privately run automated web-based broker system that provides certain core functions
including eligibility and enrollment functions, consumer outreach and assistance, and the
ability for consumers to compare and choose different qualified health plans. The system
must have the ability to integrate with the federal data hub and have account transfer
functionality to accept application handoffs compatible with the Medicaid and MinnesotaCare
eligibility and enrollment system maintained by the Department of Human Services.
new text end
new text begin
(b) The commissioner shall report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health insurance by February 15, 2020, the
results of the request for information and an analysis of the option for a privatized
marketplace, including estimated costs.
new text end
ARTICLE 11
HEALTH LICENSING BOARDS
Section 1.
Minnesota Statutes 2018, section 148.59, is amended to read:
148.59 LICENSE RENEWAL; LICENSE AND REGISTRATION FEES.
A licensed optometrist shall pay to the state Board of Optometry a fee as set by the board
in order to renew a license as provided by board rule. No fees shall be refunded. Fees may
not exceed the following amounts but may be adjusted lower by board direction and are for
the exclusive use of the board:
(1) optometry licensure application, $160;
(2) optometry annual licensure renewal, deleted text begin $135deleted text end new text begin $170new text end ;
(3) optometry late penalty fee, $75;
(4) annual license renewal card, $10;
(5) continuing education provider application, $45;
(6) emeritus registration, $10;
(7) endorsement/reciprocity application, $160;
(8) replacement of initial license, $12; deleted text begin and
deleted text end
(9) license verification, $50deleted text begin .deleted text end new text begin ;
new text end
new text begin
(10) jurisprudence state examination, $75;
new text end
new text begin
(11) Optometric Education Continuing Education data bank registration, $20; and
new text end
new text begin
(12) data requests and labels, $50.
new text end
Sec. 2.
Minnesota Statutes 2018, section 148E.180, is amended to read:
148E.180 FEE AMOUNTS.
Subdivision 1.
Application fees.
new text begin Nonrefundable new text end application fees for licensure deleted text begin are as
followsdeleted text end new text begin may not exceed the following amountsnew text end :
(1) for a licensed social worker, deleted text begin $45deleted text end new text begin $54new text end ;
(2) for a licensed graduate social worker, deleted text begin $45deleted text end new text begin $54new text end ;
(3) for a licensed independent social worker, deleted text begin $45deleted text end new text begin $54new text end ;
(4) for a licensed independent clinical social worker, deleted text begin $45deleted text end new text begin $54new text end ;
(5) for a temporary license, $50; and
(6) for a licensure by endorsement, deleted text begin $85deleted text end new text begin $92new text end .
The fee for criminal background checks is the fee charged by the Bureau of Criminal
Apprehension. The criminal background check fee must be included with the application
fee as required according to section 148E.055.
Subd. 2.
License fees.
new text begin Nonrefundable new text end license fees deleted text begin are as followsdeleted text end new text begin may not exceed the
following amounts but may be adjusted lower by board actionnew text end :
(1) for a licensed social worker, deleted text begin $81deleted text end new text begin $97new text end ;
(2) for a licensed graduate social worker, deleted text begin $144deleted text end new text begin $172new text end ;
(3) for a licensed independent social worker, deleted text begin $216deleted text end new text begin $258new text end ;
(4) for a licensed independent clinical social worker, deleted text begin $238.50deleted text end new text begin $284new text end ;
(5) for an emeritus inactive license, deleted text begin $43.20deleted text end new text begin $51new text end ;
(6) for an emeritus active license, one-half of the renewal fee specified in subdivision
3; and
(7) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
If the licensee's initial license term is less or more than 24 months, the required license
fees must be prorated proportionately.
Subd. 3.
Renewal fees.
new text begin Nonrefundable new text end renewal fees for deleted text begin licensure are as followsdeleted text end new text begin the
two-year renewal term may not exceed the following amounts but may be adjusted lower
by board actionnew text end :
(1) for a licensed social worker, deleted text begin $81deleted text end new text begin $97new text end ;
(2) for a licensed graduate social worker, deleted text begin $144deleted text end new text begin $172new text end ;
(3) for a licensed independent social worker, deleted text begin $216deleted text end new text begin $258new text end ; and
(4) for a licensed independent clinical social worker, deleted text begin $238.50deleted text end new text begin $284new text end .
Subd. 4.
Continuing education provider fees.
Continuing education provider fees are
deleted text begin as followsdeleted text end new text begin the following nonrefundable amountsnew text end :
(1) for a provider who offers programs totaling one to eight clock hours in a one-year
period according to section 148E.145, deleted text begin $50deleted text end new text begin $60new text end ;
(2) for a provider who offers programs totaling nine to 16 clock hours in a one-year
period according to section 148E.145, deleted text begin $100deleted text end new text begin $120new text end ;
(3) for a provider who offers programs totaling 17 to 32 clock hours in a one-year period
according to section 148E.145, deleted text begin $200deleted text end new text begin $240new text end ;
(4) for a provider who offers programs totaling 33 to 48 clock hours in a one-year period
according to section 148E.145, deleted text begin $400deleted text end new text begin $480new text end ; and
(5) for a provider who offers programs totaling 49 or more clock hours in a one-year
period according to section 148E.145, deleted text begin $600deleted text end new text begin $720new text end .
Subd. 5.
Late fees.
Late fees are deleted text begin as followsdeleted text end new text begin the following nonrefundable amountsnew text end :
(1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3;
(2) supervision plan late fee, $40; and
(3) license late fee, $100 plus the prorated share of the license fee specified in subdivision
2 for the number of months during which the individual practiced social work without a
license.
Subd. 6.
License cards and wall certificates.
(a) The fee for a license card as specified
in section 148E.095 is $10.
(b) The fee for a license wall certificate as specified in section 148E.095 is $30.
Subd. 7.
Reactivation fees.
Reactivation fees are deleted text begin as followsdeleted text end new text begin the following nonrefundable
amountsnew text end :
(1) reactivation from a temporary leave or emeritus status, the prorated share of the
renewal fee specified in subdivision 3; and
(2) reactivation of an expired license, 1-1/2 times the renewal fees specified in subdivision
3.
Sec. 3.
Minnesota Statutes 2018, section 150A.06, subdivision 3, is amended to read:
Subd. 3.
Waiver of examination.
(a) All or any part of the examination for dentists,
dental therapists, dental hygienists, or dental assistants, except 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 board.
(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 deleted text begin Minnesota-baseddeleted text end 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. 4.
Minnesota Statutes 2018, section 150A.06, is amended by adding a subdivision to
read:
new text begin Subd. 10. new text end
new text begin Emeritus inactive license. new text end
new text begin
A person licensed to practice dentistry, dental
therapy, dental hygiene, or dental assisting pursuant to section 150A.05 or Minnesota Rules,
part 3100.8500, who retires from active practice in the state may apply to the board for
emeritus inactive licensure. An application for emeritus inactive licensure may be made on
the biennial licensing form or by petitioning the board, and the applicant must pay a onetime
application fee pursuant to section 150A.091, subdivision 19. In order to receive emeritus
inactive licensure, the applicant must be in compliance with board requirements and cannot
be the subject of current disciplinary action resulting in suspension, revocation,
disqualification, condition, or restriction of the licensee to practice dentistry, dental therapy,
dental hygiene, or dental assisting. An emeritus inactive license is not a license to practice,
but is a formal recognition of completion of a person's dental career in good standing.
new text end
Sec. 5.
Minnesota Statutes 2018, section 150A.06, is amended by adding a subdivision to
read:
new text begin Subd. 11. new text end
new text begin Emeritus active licensure. new text end
new text begin
(a) A person licensed to practice dentistry, dental
therapy, dental hygiene, or dental assisting may apply for an emeritus active license if the
person is retired from active practice, is in compliance with board requirements, and is not
the subject of current disciplinary action resulting in suspension, revocation, disqualification,
condition, or restriction of the license to practice dentistry, dental therapy, dental hygiene,
or dental assisting.
new text end
new text begin
(b) An emeritus active licensee may engage only in the following types of practice:
new text end
new text begin
(1) pro bono or volunteer dental practice;
new text end
new text begin
(2) paid practice not to exceed 500 hours per calendar year for the exclusive purpose of
providing licensing supervision to meet the board's requirements; or
new text end
new text begin
(3) paid consulting services not to exceed 500 hours per calendar year.
new text end
new text begin
(c) An emeritus active licensee shall not hold out as a full licensee and may only hold
out as authorized to practice as described in this subdivision. The board may take disciplinary
or corrective action against an emeritus active licensee based on violations of applicable
law or board requirements.
new text end
new text begin
(d) A person may apply for an emeritus active license by completing an application form
specified by the board and must pay the application fee pursuant to section 150A.091,
subdivision 20.
new text end
new text begin
(e) If an emeritus active license is not renewed every two years, the license expires. The
renewal date is the same as the licensee's renewal date when the licensee was in active
practice. In order to renew an emeritus active license, the licensee must:
new text end
new text begin
(1) complete an application form as specified by the board;
new text end
new text begin
(2) pay the required renewal fee pursuant to section 150A.091, subdivision 20; and
new text end
new text begin
(3) report at least 25 continuing education hours completed since the last renewal, which
must include:
new text end
new text begin
(i) at least one hour in two different required CORE areas;
new text end
new text begin
(ii) at least one hour of mandatory infection control;
new text end
new text begin
(iii) for dentists and dental therapists, at least 15 hours of fundamental credits for dentists
and dental therapists, and for dental hygienists and dental assistants, at least seven hours of
fundamental credits; and
new text end
new text begin
(iv) for dentists and dental therapists, no more than ten elective credits, and for dental
hygienists and dental assistants, no more than six elective credits.
new text end
Sec. 6.
Minnesota Statutes 2018, section 150A.091, is amended by adding a subdivision
to read:
new text begin Subd. 19. new text end
new text begin Emeritus inactive license. new text end
new text begin
An individual applying for emeritus inactive
licensure under section 150A.06, subdivision 10, must pay a onetime fee of $50. There is
no renewal fee for an emeritus inactive license.
new text end
Sec. 7.
Minnesota Statutes 2018, section 150A.091, is amended by adding a subdivision
to read:
new text begin Subd. 20. new text end
new text begin Emeritus active license. new text end
new text begin
An individual applying for emeritus active licensure
under section 150A.06, subdivision 11, must pay a fee upon application and upon renewal
every two years. The fees for emeritus active license application and renewal are as follows:
dentist, $212; dental therapist, $100; dental hygienist, $75; and dental assistant, $55.
new text end
Sec. 8.
Minnesota Statutes 2018, section 151.01, subdivision 23, is amended to read:
Subd. 23.
Practitioner.
"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, or licensed
advanced practice registered nurse. For purposes of sections 151.15, subdivision 4;new text begin 151.211,
subdivision 3;new text end 151.252, subdivision 3; 151.37, subdivision 2, paragraphs (b), (e), and (f);
and 151.461, "practitioner" also means a physician assistant authorized to prescribe, dispense,
and administer under chapter 147A. For purposes of sections 151.15, subdivision 4;new text begin 151.211,
subdivision 3;new text end 151.252, subdivision 3; 151.37, subdivision 2, paragraph (b); and 151.461,
"practitioner" also means a dental therapist authorized to dispense and administer under
chapter 150A.
Sec. 9.
Minnesota Statutes 2018, section 151.06, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Information provision; sources of lower cost prescription drugs. new text end
new text begin
(a) The
board shall publish a page on its website that provides regularly updated information
concerning:
new text end
new text begin
(1) patient assistance programs offered by drug manufacturers, including information
on how to access the programs;
new text end
new text begin
(2) the prescription drug assistance program established by the Minnesota Board of
Aging under section 256.975, subdivision 9;
new text end
new text begin
(3) the websites through which individuals can access information concerning eligibility
for and enrollment in Medicare, medical assistance, MinnesotaCare, and other
government-funded programs that help pay for the cost of health care;
new text end
new text begin
(4) availability of providers that are authorized to participate under section 340b of the
federal Public Health Services Act, United States Code, title 42, section 256b;
new text end
new text begin
(5) having a discussion with the pharmacist or the consumer's health care provider about
alternatives to a prescribed drug, including a lower cost or generic drug if the drug prescribed
is too costly for the consumer; and
new text end
new text begin
(6) any other resource that the board deems useful to individuals who are attempting to
purchase prescription drugs at lower costs.
new text end
new text begin
(b) The board must prepare educational materials, including brochures and posters, based
on the information it provides on its website under paragraph (a). The materials must be in
a form that can be downloaded from the board's website and used for patient education by
pharmacists and by health care practitioners who are licensed to prescribe. The board is not
required to provide printed copies of these materials.
new text end
new text begin
(c) The board shall require pharmacists and pharmacies to make available to patients
information on sources of lower cost prescription drugs, including information on the
availability of the website established under paragraph (a).
new text end
Sec. 10.
Minnesota Statutes 2018, section 151.211, subdivision 2, is amended to read:
Subd. 2.
Refill requirements.
new text begin Except as provided in subdivision 3, new text end a prescription drug
order may be refilled only with the written, electronic, or verbal consent of the prescriber
and in accordance with the requirements of this chapter, the rules of the board, and where
applicable, section 152.11. The date of such refill must be recorded and initialed upon the
original prescription drug order, or within the electronically maintained record of the original
prescription drug order, by the pharmacist, pharmacist intern, or practitioner who refills the
prescription.
Sec. 11.
Minnesota Statutes 2018, section 151.211, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Emergency prescription refills. new text end
new text begin
(a) A pharmacist may, using sound professional
judgment and in accordance with accepted standards of practice, dispense a legend drug
without a current prescription drug order from a licensed practitioner if all of the following
conditions are met:
new text end
new text begin
(1) the patient has been compliant with taking the medication and has consistently had
the drug filled or refilled as demonstrated by records maintained by the pharmacy;
new text end
new text begin
(2) the pharmacy from which the legend drug is dispensed has record of a prescription
drug order for the drug in the name of the patient who is requesting it, but the prescription
drug order does not provide for a refill, or the time during which the refills were valid has
elapsed;
new text end
new text begin
(3) the pharmacist has tried but is unable to contact the practitioner who issued the
prescription drug order, or another practitioner responsible for the patient's care, to obtain
authorization to refill the prescription;
new text end
new text begin
(4) the drug is essential to sustain the life of the patient or to continue therapy for a
chronic condition;
new text end
new text begin
(5) failure to dispense the drug to the patient would result in harm to the health of the
patient; and
new text end
new text begin
(6) the drug is not a controlled substance listed in section 152.02, subdivisions 3 to 6,
except for a controlled substance that has been specifically prescribed to treat a seizure
disorder, in which case the pharmacist may dispense up to a 72-hour supply.
new text end
new text begin
(b) If the conditions in paragraph (a) are met, the amount of the drug dispensed by the
pharmacist to the patient must not exceed a 30-day supply, or the quantity originally
prescribed, whichever is less, except as provided for controlled substances in paragraph (a),
clause (6). If the standard unit of dispensing for the drug exceeds a 30-day supply, the
amount of the drug dispensed or sold must not exceed the standard unit of dispensing.
new text end
new text begin
(c) A pharmacist shall not dispense or sell the same drug to the same patient, as provided
in this section, more than one time in any 12-month period.
new text end
new text begin
(d) A pharmacist must notify the practitioner who issued the prescription drug order not
later than 72 hours after the drug is sold or dispensed. The pharmacist must request and
receive authorization before any additional refills may be dispensed. If the practitioner
declines to provide authorization for additional refills, the pharmacist must inform the patient
of that fact.
new text end
new text begin
(e) The record of a drug sold or dispensed under this section shall be maintained in the
same manner required for prescription drug orders under this section.
new text end
Sec. 12.
Minnesota Statutes 2018, section 152.126, subdivision 6, is amended to read:
Subd. 6.
Access to reporting system data.
(a) Except as indicated in this subdivision,
the data submitted to the board under subdivision 4 is private data on individuals as defined
in section 13.02, subdivision 12, and not subject to public disclosure.
(b) Except as specified in subdivision 5, the following persons shall be considered
permissible users and may access the data submitted under subdivision 4 in the same or
similar manner, and for the same or similar purposes, as those persons who are authorized
to access similar private data on individuals under federal and state law:
(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has
delegated the task of accessing the data, to the extent the information relates specifically to
a current patient, to whom the prescriber is:
(i) prescribing or considering prescribing any controlled substance;
(ii) providing emergency medical treatment for which access to the data may be necessary;
(iii) providing care, and the prescriber has reason to believe, based on clinically valid
indications, that the patient is potentially abusing a controlled substance; or
(iv) providing other medical treatment for which access to the data may be necessary
for a clinically valid purpose and the patient has consented to access to the submitted data,
and with the provision that the prescriber remains responsible for the use or misuse of data
accessed by a delegated agent or employee;
(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has
delegated the task of accessing the data, to the extent the information relates specifically to
a current patient to whom that dispenser is dispensing or considering dispensing any
controlled substance and with the provision that the dispenser remains responsible for the
use or misuse of data accessed by a delegated agent or employee;
(3) a licensed pharmacist who is providing pharmaceutical care for which access to the
data may be necessary to the extent that the information relates specifically to a current
patient for whom the pharmacist is providing pharmaceutical care: (i) if the patient has
consented to access to the submitted data; or (ii) if the pharmacist is consulted by a prescriber
who is requesting data in accordance with clause (1);
(4) an individual who is the recipient of a controlled substance prescription for which
data was submitted under subdivision 4, or a guardian of the individual, parent or guardian
of a minor, or health care agent of the individual acting under a health care directive under
chapter 145C;
(5) personnel or designees of a health-related licensing board listed in section 214.01,
subdivision 2, or of the Emergency Medical Services Regulatory Board, assigned to conduct
a bona fide investigation of a complaint received by that board that alleges that a specific
licensee is impaired by use of a drug for which data is collected under subdivision 4, has
engaged in activity that would constitute a crime as defined in section 152.025, or has
engaged in the behavior specified in subdivision 5, paragraph (a);
(6) personnel of the board engaged in the collection, review, and analysis of controlled
substance prescription information as part of the assigned duties and responsibilities under
this section;
(7) authorized personnel of a vendor under contract with the state of Minnesota who are
engaged in the design, implementation, operation, and maintenance of the prescription
monitoring program as part of the assigned duties and responsibilities of their employment,
provided that access to data is limited to the minimum amount necessary to carry out such
duties and responsibilities, and subject to the requirement of de-identification and time limit
on retention of data specified in subdivision 5, paragraphs (d) and (e);
(8) federal, state, and local law enforcement authorities acting pursuant to a valid search
warrant;
(9) personnel of the Minnesota health care programs assigned to use the data collected
under this section to identify and manage recipients whose usage of controlled substances
may warrant restriction to a single primary care provider, a single outpatient pharmacy, and
a single hospital;
(10) personnel of the Department of Human Services assigned to access the data pursuant
to paragraph (i);
(11) personnel of the health professionals services program established under section
214.31, to the extent that the information relates specifically to an individual who is currently
enrolled in and being monitored by the program, and the individual consents to access to
that information. The health professionals services program personnel shall not provide this
data to a health-related licensing board or the Emergency Medical Services Regulatory
Board, except as permitted under section 214.33, subdivision 3.
For purposes of clause (4), access by an individual includes persons in the definition of
an individual under section 13.02; and
(12) personnel or designees of a health-related licensing board listed in section 214.01,
subdivision 2, assigned to conduct a bona fide investigation of a complaint received by that
board that alleges that a specific licensee is inappropriately prescribing controlled substances
as defined in this section.
(c) By July 1, 2017, every prescriber licensed by a health-related licensing board listed
in section 214.01, subdivision 2, practicing within this state who is authorized to prescribe
controlled substances for humans and who holds a current registration issued by the federal
Drug Enforcement Administration, and every pharmacist licensed by the board and practicing
within the state, shall register and maintain a user account with the prescription monitoring
program. Data submitted by a prescriber, pharmacist, or their delegate during the registration
application process, other than their name, license number, and license type, is classified
as private pursuant to section 13.02, subdivision 12.
(d) Only permissible users identified in paragraph (b), clauses (1), (2), (3), (6), (7), (9),
and (10), may directly access the data electronically. No other permissible users may directly
access the data electronically. If the data is directly accessed electronically, the permissible
user shall implement and maintain a comprehensive information security program that
contains administrative, technical, and physical safeguards that are appropriate to the user's
size and complexity, and the sensitivity of the personal information obtained. The permissible
user shall identify reasonably foreseeable internal and external risks to the security,
confidentiality, and integrity of personal information that could result in the unauthorized
disclosure, misuse, or other compromise of the information and assess the sufficiency of
any safeguards in place to control the risks.
(e) The board shall not release data submitted under subdivision 4 unless it is provided
with evidence, satisfactory to the board, that the person requesting the information is entitled
to receive the data.
(f) The board shall maintain a log of all persons who access the data for a period of at
least three years and shall ensure that any permissible user complies with paragraph deleted text begin (c)deleted text end new text begin (d)new text end
prior to attaining direct access to the data.
(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into pursuant
to subdivision 2. A vendor shall not use data collected under this section for any purpose
not specified in this section.
(h) The board may participate in an interstate prescription monitoring program data
exchange system provided that permissible users in other states have access to the data only
as allowed under this section, and that section 13.05, subdivision 6, applies to any contract
or memorandum of understanding that the board enters into under this paragraph.
(i) With available appropriations, the commissioner of human services shall establish
and implement a system through which the Department of Human Services shall routinely
access the data for the purpose of determining whether any client enrolled in an opioid
treatment program licensed according to chapter 245A has been prescribed or dispensed a
controlled substance in addition to that administered or dispensed by the opioid 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.
If determined necessary, the commissioner of human services shall seek a federal waiver
of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section
2.34, paragraph (c), prior to implementing this paragraph.
(j) The board shall review the data submitted under subdivision 4 on at least a quarterly
basis and shall establish criteria, in consultation with the advisory task force, for referring
information about a patient to prescribers and dispensers who prescribed or dispensed the
prescriptions in question if the criteria are met.
new text begin
(k) The board shall conduct random audits, on at least a quarterly basis, of electronic
access by permissible users, as identified in paragraph (b), clauses (1), (2), (3), (6), (7), (9),
and (10), to the data in subdivision 4, to ensure compliance with permissible use as defined
in this section. A permissible user whose account has been selected for a random audit shall
respond to an inquiry by the board, no later than 30 days after receipt of notice that an audit
is being conducted. Failure to respond may result in deactivation of access to the electronic
system and referral to the appropriate health licensing board, or the commissioner of human
services, for further action.
new text end
new text begin
(l) A permissible user who has delegated the task of accessing the data in subdivision 4
to an agent or employee shall audit the use of the electronic system by delegated agents or
employees on at least a quarterly basis to ensure compliance with permissible use as defined
in this section. When a delegated agent or employee has been identified as inappropriately
accessing data, the permissible user must immediately remove access for that individual
and notify the board within seven days. The board shall notify all permissible users associated
with the delegated agent or employee of the alleged violation.
new text end
Sec. 13.
new text begin
[214.122] INFORMATION PROVISION; PHARMACEUTICAL
ASSISTANCE PROGRAMS.
new text end
new text begin
(a) The Board of Medical Practice and the Board of Nursing shall at least annually inform
licensees who are authorized to prescribe prescription drugs of the availability of the Board
of Pharmacy's website that contains information on resources and programs to assist patients
with the cost of prescription drugs. The boards shall provide licensees with the website
address established by the Board of Pharmacy under section 151.06, subdivision 6, and the
materials described under section 151.06, subdivision 6, paragraph (b).
new text end
new text begin
(b) Licensees must make available to patients information on sources of lower cost
prescription drugs, including information on the availability of the website established by
the Board of Pharmacy under section 151.06, subdivision 6.
new text end
Sec. 14. new text begin GUIDELINES AUTHORIZING PATIENT-ASSISTED MEDICATION
ADMINISTRATION IN EMERGENCIES.
new text end
new text begin
(a) Within the limits of the board's available appropriation, the Emergency Medical
Services Regulatory Board shall propose guidelines authorizing EMTs, AEMTs, and
paramedics certified under Minnesota Statutes, section 144E.28, to assist a patient in
emergency situations with administering prescription medications that are:
new text end
new text begin
(1) carried by a patient;
new text end
new text begin
(2) intended to treat adrenal insufficiency or other rare conditions that require emergency
treatment with a previously prescribed medication;
new text end
new text begin
(3) intended to treat a specific life-threatening condition; and
new text end
new text begin
(4) administered via routes of delivery that are within the scope of training of the EMT,
AEMT, or paramedic.
new text end
new text begin
(b) The Emergency Medical Services Regulatory Board shall submit the proposed
guidelines and draft legislation as necessary to the chairs and ranking minority members of
the legislative committees with jurisdiction over health care by January 1, 2020.
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 12
MISCELLANEOUS
Section 1.
Minnesota Statutes 2018, section 62A.30, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Mammograms. new text end
new text begin
(a) For purposes of subdivision 2, coverage for a preventive
mammogram screening (1) includes digital breast tomosynthesis for enrollees at risk for
breast cancer, and (2) is covered as a preventive item or service, as described under section
62Q.46.
new text end
new text begin
(b) For purposes of this subdivision, "digital breast tomosynthesis" means a radiologic
procedure that involves the acquisition of projection images over the stationary breast to
produce cross-sectional digital three-dimensional images of the breast. "At risk for breast
cancer" means:
new text end
new text begin
(1) having a family history with one or more first- or second-degree relatives with breast
cancer;
new text end
new text begin
(2) testing positive for BRCA1 or BRCA2 mutations;
new text end
new text begin
(3) having heterogeneously dense breasts or extremely dense breasts based on the Breast
Imaging Reporting and Data System established by the American College of Radiology; or
new text end
new text begin
(4) having a previous diagnosis of breast cancer.
new text end
new text begin
(c) This subdivision does not apply to coverage provided through a public health care
program under chapter 256B or 256L.
new text end
new text begin
(d) Nothing in this subdivision limits the coverage of digital breast tomosynthesis in a
policy, plan, certificate, or contract referred to in subdivision 1 that is in effect prior to
January 1, 2020.
new text end
new text begin
(e) Nothing in this subdivision prohibits a policy, plan, certificate, or contract referred
to in subdivision 1 from covering digital breast tomosynthesis for an enrollee who is not at
risk for breast cancer.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, and applies to health
plans issued, sold, or renewed on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2018, section 62D.12, is amended by adding a subdivision to
read:
new text begin Subd. 20. new text end
new text begin Dividends, distributions, or transfers. new text end
new text begin
(a) A for-profit health maintenance
organization may pay dividends or make distributions or transfers, including to a legal entity
that is an affiliate of the health maintenance organization or that is a subsidiary corporation
of a local unit of government organized under chapter 383B, in accordance with section
60D.20, subdivision 2, except that the commissioner referenced in section 60D.20,
subdivision 2, shall be the commissioner of health.
new text end
new text begin
(b) If a nonprofit health maintenance organization plans on distributing or transferring
an amount, including to a legal entity that is an affiliate of the health maintenance
organization or that is a subsidiary corporation of a local unit of government organized
under chapter 383B, that together with other distributions or transfers made within the
preceding 12 months exceeds the greater of: (1) ten percent of the health maintenance
organization's net worth on December 31 of the preceding year; or (2) the health maintenance
organization's net income, not including realized capital gains, for the 12-month period
ending on December 31 of the preceding year, but does not include pro rata distributions
of any class of the health maintenance organization's own securities, the health maintenance
organization must meet the requirements of paragraph (c).
new text end
new text begin
(c) Prior to making a distribution or transfer identified in paragraph (b), a nonprofit
health maintenance organization must notify the commissioner of the planned distribution
or transfer. Upon receipt of notification, the commissioner shall review the distribution or
transfer to determine whether the distribution or transfer is reasonable in relation to the
health maintenance organization's outstanding liabilities and the quality of the health
maintenance organization's earnings and the extent to which the reported earnings include
items such as surplus relief reinsurance transactions and reserve restrengthening, and in
consideration of the factors described in section 60D.20, subdivision 4. No distribution or
transfer shall be made by the health maintenance organization until: (1) 30 days after the
commissioner has received notice and has not within this time period disapproved the
distribution or transfer; or (2) the commissioner has approved the distribution or transfer
within the 30-day period.
new text end
new text begin
(d) For purposes of this subdivision, "affiliate" means an entity that controls, is controlled
by, or is under common control with the health maintenance organization including a
nonprofit hospital that is within the same integrated health care system as the health
maintenance organization.
new text end
new text begin
(e) The commissioner of health shall enforce this subdivision.
new text end
Sec. 3.
Minnesota Statutes 2018, section 62K.07, is amended to read:
62K.07 INFORMATION DISCLOSURES.
new text begin Subdivision 1. new text end
new text begin In general. new text end
(a) A health carrier offering individual or small group health
plans must submit the following information in a format determined by the commissioner
of commerce:
(1) claims payment policies and practices;
(2) periodic financial disclosures;
(3) data on enrollment;
(4) data on disenrollment;
(5) data on the number of claims that are denied;
(6) data on rating practices;
(7) information on cost-sharing and payments with respect to out-of-network coverage;
and
(8) other information required by the secretary of the United States Department of Health
and Human Services under the Affordable Care Act.
(b) A health carrier offering an individual or small group health plan must comply with
all information disclosure requirements of all applicable state and federal law, including
the Affordable Care Act.
(c) Except for qualified health plans sold on MNsure, information reported under
paragraph (a), clauses (3) and (4), is nonpublic data as defined under section 13.02,
subdivision 9. Information reported under paragraph (a), clauses (1) through (8), must be
reported by MNsure for qualified health plans sold through MNsure.
new text begin Subd. 2. new text end
new text begin Prescription drug costs. new text end
new text begin
(a) Each health carrier that offers a prescription drug
benefit in its individual health plans or small group health plans shall include in the applicable
rate filing required under section 62A.02 the following information about covered prescription
drugs:
new text end
new text begin
(1) the 25 most frequently prescribed drugs in the previous plan year;
new text end
new text begin
(2) the 25 most costly prescription drugs as a portion of the individual health plan's or
small group health plan's total annual expenditures in the previous plan year;
new text end
new text begin
(3) the 25 prescription drugs that have caused the greatest increase in total individual
health plan or small group health plan spending in the previous plan year;
new text end
new text begin
(4) the projected impact of the cost of prescription drugs on premium rates;
new text end
new text begin
(5) if any health plan offered by the health carrier requires enrollees to pay cost-sharing
on any covered prescription drugs including deductibles, co-payments, or coinsurance in
an amount that is greater than the amount the enrollee's health plan would pay for the drug
absent the applicable enrollee cost-sharing and after accounting for any rebate amount; and
new text end
new text begin
(6) if the health carrier prohibits third-party payments including manufacturer drug
discounts or coupons that cover all or a portion of an enrollee's cost-sharing requirements
including deductibles, co-payments, or coinsurance from applying toward the enrollee's
cost-sharing obligations under the enrollee's health plan.
new text end
new text begin
(b) The commissioner of commerce, in consultation with the commissioner of health,
shall release a summary of the information reported in paragraph (a) at the same time as
the information required under section 62A.02, subdivision 2, paragraph (c).
new text end
new text begin Subd. 3. new text end
new text begin Enforcement. new text end
deleted text begin (d)deleted text end The commissioner of commerce shall enforce this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for individual health plans and small
group health plans offered, issued, sold, or renewed on or after January 1, 2021.
new text end
Sec. 4.
Minnesota Statutes 2018, section 62Q.01, is amended by adding a subdivision to
read:
new text begin Subd. 6b. new text end
new text begin Nonquantitative treatment limitations or NQTLs. new text end
new text begin
"Nonquantitative treatment
limitations" or "NQTLs" means processes, strategies, or evidentiary standards, or other
factors that are not expressed numerically, but otherwise limit the scope or duration of
benefits for treatment. NQTLs include but are not limited to:
new text end
new text begin
(1) medical management standards limiting or excluding benefits based on (i) medical
necessity or medical appropriateness, or (ii) whether the treatment is experimental or
investigative;
new text end
new text begin
(2) formulary design for prescription drugs;
new text end
new text begin
(3) health plans with multiple network tiers;
new text end
new text begin
(4) criteria and parameters for provider inclusion in provider networks, including
credentialing standards and reimbursement rates;
new text end
new text begin
(5) health plan methods for determining usual, customary, and reasonable charges;
new text end
new text begin
(6) fail-first or step therapy protocols;
new text end
new text begin
(7) exclusions based on failure to complete a course of treatment;
new text end
new text begin
(8) restrictions based on geographic location, facility type, provider specialty, and other
criteria that limit the scope or duration of benefits for services provided under the health
plan;
new text end
new text begin
(9) in- and out-of-network geographic limitations;
new text end
new text begin
(10) standards for providing access to out-of-network providers;
new text end
new text begin
(11) limitations on inpatient services for situations where the enrollee is a threat to self
or others;
new text end
new text begin
(12) exclusions for court-ordered and involuntary holds;
new text end
new text begin
(13) experimental treatment limitations;
new text end
new text begin
(14) service coding;
new text end
new text begin
(15) exclusions for services provided by clinical social workers; and
new text end
new text begin
(16) provider reimbursement rates, including rates of reimbursement for mental health
and substance use disorder services in primary care.
new text end
Sec. 5.
Minnesota Statutes 2018, section 62Q.47, is amended to read:
62Q.47 ALCOHOLISM, MENTAL HEALTH, AND CHEMICAL DEPENDENCY
SERVICES.
(a) All health plans, as defined in section 62Q.01, that provide coverage for alcoholism,
mental health, or chemical dependency services, must comply with the requirements of this
section.
(b) Cost-sharing requirements and benefit or service limitations for outpatient mental
health and outpatient chemical dependency and alcoholism services, except for persons
placed in chemical dependency services under Minnesota Rules, parts 9530.6600 to
9530.6655, must not place a greater financial burden on the insured or enrollee, or be more
restrictive than those requirements and limitations for outpatient medical services.
(c) Cost-sharing requirements and benefit or service limitations for inpatient hospital
mental health and inpatient hospital and residential chemical dependency and alcoholism
services, except for persons placed in chemical dependency services under Minnesota Rules,
parts 9530.6600 to 9530.6655, must not place a greater financial burden on the insured or
enrollee, or be more restrictive than those requirements and limitations for inpatient hospital
medical services.
new text begin
(d) A health plan company must not impose an NQTL with respect to mental health and
substance use disorders in any classification of benefits unless, under the terms of the health
plan as written and in operation, any processes, strategies, evidentiary standards, or other
factors used in applying the NQTL to mental health and substance use disorders in the
classification are comparable to, and are applied no more stringently than, the processes,
strategies, evidentiary standards, or other factors used in applying the NQTL with respect
to medical and surgical benefits in the same classification.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end All health plans must meet the requirements of the federal Mental Health Parity
Act of 1996, Public Law 104-204; Paul Wellstone and Pete Domenici Mental Health Parity
and Addiction Equity Act of 2008; the Affordable Care Act; and any amendments to, and
federal guidance or regulations issued under, those acts.
new text begin
(f) The commissioner may require information from health plan companies to confirm
that mental health parity is being implemented by the health plan company. Information
required may include comparisons between mental health and substance use disorder
treatment and other medical conditions, including a comparison of prior authorization
requirements, drug formulary design, claim denials, rehabilitation services, and other
information the commissioner deems appropriate.
new text end
new text begin
(g) Regardless of the health care provider's professional license, if the service provided
is consistent with the provider's scope of practice and the health plan company's credentialing
and contracting provisions, mental health therapy visits and medication maintenance visits
shall be considered primary care visits for the purpose of applying any enrollee cost-sharing
requirements imposed under the enrollee's health plan.
new text end
new text begin
(h) By June 1 of each year, beginning June 1, 2021, the commissioner of commerce, in
consultation with the commissioner of health, shall submit a report on compliance and
oversight to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and commerce. The report must:
new text end
new text begin
(1) describe the commissioner's process for reviewing health plan company compliance
with United States Code, title 42, section 18031(j), any federal regulations or guidance
relating to compliance and oversight, and compliance with this section and section 62Q.53;
new text end
new text begin
(2) identify any enforcement actions taken by either commissioner during the preceding
12-month period regarding compliance with parity for mental health and substance use
disorders benefits under state and federal law, summarizing the results of any market conduct
examinations. The summary must include: (i) the number of formal enforcement actions
taken; (ii) the benefit classifications examined in each enforcement action; and (iii) the
subject matter of each enforcement action, including quantitative and nonquantitative
treatment limitations;
new text end
new text begin
(3) detail any corrective action taken by either commissioner to ensure health plan
company compliance with this section and section 62Q.53, and United States Code, title
42, section 18031(j); and
new text end
new text begin
(4) describe the information provided by either commissioner to the public about
alcoholism, mental health, or chemical dependency parity protections under state and federal
law.
new text end
new text begin
The report must be written in nontechnical, readily understandable language and must be
made available to the public by, among other means as the commissioners find appropriate,
posting the report on department websites. Individually identifiable information must be
excluded from the report, consistent with state and federal privacy protections.
new text end
Sec. 6.
new text begin
[62Q.528] DRUG COVERAGE IN EMERGENCY SITUATIONS.
new text end
new text begin
A health plan that provides prescription drug coverage must provide coverage for a
prescription drug dispensed by a pharmacist under section 151.211, subdivision 3, under
the terms of coverage that would apply had the prescription drug been dispensed according
to a prescription.
new text end
Sec. 7.
Minnesota Statutes 2018, section 525A.11, is amended to read:
525A.11 PERSONS THAT MAY RECEIVE ANATOMICAL GIFT; PURPOSE
OF ANATOMICAL GIFT.
(a) An anatomical gift may be made to the following persons named in the document
of gift:
(1) a hospital; accredited medical school, dental school, college, or university; organ
procurement organization; or nonprofit organization in medical education or research, for
research or education;
(2) subject to paragraph (b), an individual designated by the person making the anatomical
gift if the individual is the recipient of the part; and
(3) an eye bank or tissue bank.
(b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be
transplanted into the individual, the part passes in accordance with paragraph (g) in the
absence of an express, contrary indication by the person making the anatomical gift.
(c) If an anatomical gift of one or more specific parts or of all parts is made in a document
of gift that does not name a person described in paragraph (a) but identifies the purpose for
which an anatomical gift may be used, the following rules apply:
(1) if the part is an eye and the gift is for the purpose of transplantation or therapy, the
gift passes to the appropriate eye bank;
(2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the
gift passes to the appropriate tissue bank;
(3) if the part is an organ and the gift is for the purpose of transplantation or therapy,
the gift passes to the appropriate organ procurement organization as custodian of the organ;
and
(4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research or
education, the gift passes to the appropriate procurement organization.
(d) For the purpose of paragraph (c), if there is more than one purpose of an anatomical
gift set forth in the document of gift but the purposes are not set forth in any priority, the
gift must be used for transplantation or therapy, if suitable. If the gift cannot be used for
transplantation or therapy, the gift may be used for research or education.
(e) If an anatomical gift of one or more specific parts is made in a document of gift that
does not name a person described in paragraph (a) and does not identify the purpose of the
gift, the gift may be used only for transplantation or therapy, and the gift passes in accordance
with paragraph (g).
(f) If a document of gift specifies only a general intent to make an anatomical gift by
words such as "donor," "organ donor," or "body donor," or by a symbol or statement of
similar import, the gift may be used only for transplantation or therapy, and the gift passes
in accordance with paragraph (g).
(g) For purposes of paragraphs (b), (e), and (f), the following rules apply:
(1) if the part is an eye, the gift passes to the appropriate eye bank;
(2) if the part is tissue, the gift passes to the appropriate tissue bank; and
(3) if the part is an organ, the gift passes to the appropriate organ procurement
organization as custodian of the organ.
(h) An anatomical gift of an organ for transplantation or therapy, other than an anatomical
gift under paragraph (a), clause (2), passes to the organ procurement organization as custodian
of the organ.
(i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the decedent's
body or part is not used for transplantation, therapy, research, or education, custody of the
body or part passes to the person under obligation to dispose of the body or part.
(j) A person may not accept an anatomical gift if the person knows that the gift was not
effectively made under section 525A.05 or 525A.10 or if the person knows that the decedent
made a refusal under section 525A.07 that was not revoked. For purposes of this paragraph,
if a person knows that an anatomical gift was made on a document of gift, the person is
deemed to know of any amendment or revocation of the gift or any refusal to make an
anatomical gift on the same document of gift.
(k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter
affects the allocation of organs for transplantation or therapy.
new text begin
(l) For purposes of paragraphs (c), clauses (1) and (4), and (g), no gift of an eye or a part
of an eye shall be directly or indirectly processed by or distributed to a for profit entity, and
no gift shall be sold or distributed for profit.
new text end
ARTICLE 13
FORECAST ADJUSTMENT
Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
|
new text begin
The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2017, First Special
Session chapter 6, article 18, from the general fund, or any other fund named, to the
commissioner of human services for the purposes specified in this article, to be available
for the fiscal year indicated for each purpose. The figure "2019" used in this article means
that the appropriations listed are available for the fiscal year ending June 30, 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
2019 new text end |
||||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
(318,423,000) new text end |
||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2019 new text end |
||
|
new text begin
General new text end |
new text begin
(317,538,000) new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
8,410,000 new text end |
|
|
new text begin
Federal TANF new text end |
new text begin
(9,295,000) new text end |
|
new text begin Subd. 2. new text end
new text begin
Forecasted Programs
|
|||||
|
new text begin
(a) Minnesota Family Investment Program (MFIP)/Diversionary Work Program (DWP) new text end |
|||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
(19,361,000) new text end |
|
|
new text begin
Federal TANF new text end |
new text begin
(8,893,000) new text end |
|
|
new text begin
(b) MFIP Child Care Assistance new text end |
new text begin
(16,789,000) new text end |
|||||
|
new text begin
(c) General Assistance new text end |
new text begin
(7,928,000) new text end |
|||||
|
new text begin
(d) Minnesota Supplemental Aid new text end |
new text begin
(549,000) new text end |
|||||
|
new text begin
(e) Housing Support new text end |
new text begin
(13,836,000) new text end |
|||||
|
new text begin
(f) Northstar Care for Children new text end |
new text begin
(19,027,000) new text end |
|||||
|
new text begin
(g) MinnesotaCare new text end |
new text begin
8,410,000 new text end |
|||||
new text begin
This appropriation is from the health care
access fund.
new text end
|
new text begin
(h) Medical Assistance new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
(222,176,000) new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
-0- new text end |
|
|
new text begin
(i) Alternative Care new text end |
new text begin
-0- new text end |
|||||
|
new text begin
(j) Consolidated Chemical Dependency Treatment Fund (CCDTF) Entitlement new text end |
new text begin
(17,872,000) new text end |
|||||
new text begin Subd. 3. new text end
new text begin
Technical Activities
|
new text begin
(402,000) new text end |
|||||
new text begin
This appropriation is from the federal TANF
fund.
new text end
Sec. 3. new text begin EFFECTIVE DATE.
new text end
new text begin
Sections 1 and 2 are effective the day following final enactment.
new text end
ARTICLE 14
APPROPRIATIONS
Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.
|
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 "2020" and "2021" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2020, or June 30, 2021, respectively.
"The first year" is fiscal year 2020. "The second year" is fiscal year 2021. "The biennium"
is fiscal years 2020 and 2021.
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
2020 new text end |
new text begin
2021 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
8,059,011,000 new text end |
new text begin
$ new text end |
new text begin
7,936,257,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2020 new text end |
new text begin
2021 new text end |
|
|
new text begin
General new text end |
new text begin
7,269,109,000 new text end |
new text begin
7,141,320,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,299,000 new text end |
new text begin
4,299,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
513,185,000 new text end |
new text begin
515,750,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
270,522,000 new text end |
new text begin
272,992,000 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 begin
(a) Nonfederal Expenditures. 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) Nonfederal Expenditures; Reporting.
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) Maintenance of Effort Expenditures
Required. 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) Limitation; Exceptions. The
commissioner must 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) Supplemental Expenditures. 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) Reduction of Appropriations; Exception.
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. Any unexpended balance in the
appropriations 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 2020 and 2021 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
Working Family Credit as TANF/MOE.
|
||||||
new text begin
The commissioner may claim as TANF/MOE
up to $6,707,000 per year of working family
credit expenditures in each fiscal year.
new text end
new text begin Subd. 4. new text end
new text begin
Central Office; Operations
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
120,177,000 new text end |
new text begin
118,098,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,174,000 new text end |
new text begin
4,174,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
20,709,000 new text end |
new text begin
20,709,000 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) the statewide data management system
authorized in Minnesota Statutes, section
125A.744, subdivision 3;
new text end
new text begin
(2) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 245.495,
paragraph (b);
new text end
new text begin
(3) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end
new text begin
(4) targeted case management under
Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end
new text begin
(5) residential services for children with severe
emotional disturbance under Minnesota
Statutes, section 256B.0945, subdivision 4,
paragraph (d); and
new text end
new text begin
(6) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end
new text begin
(b) Transfer; Systems Account. By June 30,
2021, the commissioner shall transfer
$17,718,000 from the state systems account
authorized in Minnesota Statutes, section
256.014, subdivision 2, to the general fund.
This is a onetime transfer.
new text end
new text begin
(c) Transfer; Medical Assistance Holding
Account. By June 30, 2021, the commissioner
shall transfer $2,600,000 from the medical
assistance holding account under Minnesota
Statutes, section 256.01, subdivision 2, to the
general fund. This is a onetime transfer.
new text end
new text begin
(d) Transfer; SSI Interim Assistance
Operations Account. By June 30, 2021, the
commissioner shall transfer $3,600,000 from
the SSI interim assistance operations account
under Minnesota Statutes, section 256D.06,
subdivision 5, paragraph (e), to the general
fund. This is a onetime transfer.
new text end
new text begin
(e) Transfer to Office of Legislative Auditor.
$300,000 in fiscal year 2020 and $300,000 in
fiscal year 2021 are from the general fund 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
(f) Transfer to Office of Legislative Auditor.
$400,000 in fiscal year 2020 and $400,000 in
fiscal year 2021 are from the general fund for
transfer to the Office of the Legislative
Auditor for audit activities under Minnesota
Statutes, section 3.972, subdivision 2a.
new text end
new text begin
(g) Fraud Prevention Investigations.
$425,000 in fiscal year 2020 and $425,000 in
fiscal year 2021 are from the general fund for
the fraud prevention investigation project
under Minnesota Statutes, section 256.983.
new text end
new text begin
(h) Family Child Care Task Force. $75,000
in fiscal year 2020 is from the general fund
for the Family Child Care Task Force under
article 2, section 45. This is a onetime
appropriation.
new text end
new text begin
(i) Ombudsperson for Child Care
Providers. $114,000 in fiscal year 2020 and
$120,000 in fiscal year 2021 are from the
general fund for the ombudsperson for child
care providers under Minnesota Statutes,
section 245A.60.
new text end
new text begin
(j) Development of New Child Care
Regulatory System. $409,000 in fiscal year
2020 is from the general fund for development
of a new child care regulatory system based
on the risk-based violation levels under
Minnesota Statutes, section 245A.055,
subdivision 3, including use of an abbreviated
inspection under Minnesota Statutes, section
245A.055, subdivision 2. Of this amount,
$300,000 is for researching and developing
the abbreviated inspection model based on key
indicators, and $109,000 is to update the
Electronic Licensing Inspection Checklist
Information (ELICI) system. This is a onetime
appropriation.
new text end
new text begin
(k) Reducing Appropriations for Unfilled
Positions. The general fund and nongeneral
fund appropriations to the Department of
Human Services for agency operations for the
biennium ending June 30, 2021, are reduced
for salary and benefit amounts attributable to
any positions that are not filled within 180
days of the posting of the position. This
paragraph applies only to positions that are
posted in fiscal years 2019, 2020, and 2021.
Reductions made under this section must be
reflected as reductions in agency base budgets
for fiscal years 2022 and 2023. The
commissioner of management and budget must
report to the chairs and ranking minority
members of the senate and the house of
representatives health and human services
finance committees regarding the amount of
reductions in appropriations under this section.
This paragraph expires December 31, 2021.
new text end
new text begin
(l) Base Level Adjustment. The general fund
base is $120,223,000 in fiscal year 2022 and
$122,712,000 in fiscal year 2023.
new text end
new text begin Subd. 5. new text end
new text begin
Central Office; Children and Families
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
10,818,000 new text end |
new text begin
10,787,000 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
(a) Financial Institution Data Match and
Payment of Fees. The commissioner is
authorized to allocate up to $310,000 each
year in fiscal year 2020 and fiscal year 2021
from the state systems account authorized in
Minnesota Statutes, section 256.014,
subdivision 2, 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
(b) Base Level Adjustment. The general fund
base is $10,733,000 in fiscal year 2022 and
$10,680,000 in fiscal year 2023.
new text end
new text begin Subd. 6. new text end
new text begin
Central Office; Health Care
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
23,099,000 new text end |
new text begin
23,702,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
24,313,000 new text end |
new text begin
24,313,000 new text end |
new text begin
new text begin Base Level Adjustment.new text end The general fund
base is $24,088,000 in fiscal year 2022 and
$24,074,000 in fiscal year 2023.
new text end
new text begin Subd. 7. new text end
new text begin
Central Office; Continuing Care for
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
16,259,000 new text end |
new text begin
16,434,000 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
Office of Ombudsman for Long-Term Care.
$1,312,000 in fiscal year 2020 and $1,501,000
in fiscal year 2021 are from the general fund
for nine additional regional ombudsmen and
one deputy director in the Office of
Ombudsman for Long-Term Care, to perform
the duties in Minnesota Statutes, section
256.9742.
new text end
new text begin Subd. 8. new text end
new text begin
Central Office; Community Supports
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
34,558,000 new text end |
new text begin
34,168,000 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) Social Functioning Measurement Tool.
$100,000 in fiscal year 2020 is from the
general fund for the commissioner to
determine whether the Center for Victims of
Torture's social functioning measurement tool
can be adapted for other populations that
receive targeted case management and other
medical assistance services. This is a onetime
appropriation and is available until June 30,
2023.
new text end
new text begin
(b) Person-Centered Telepresence Platform
Expansion. $100,000 in fiscal year 2020 is
from the general fund for development of a
proposal to expand and implement a statewide
person-centered telepresence platform. This
is a onetime appropriation.
new text end
new text begin
(c) new text begin Base Level Adjustment. new text end The general fund
base is $34,483,000 in fiscal year 2022 and
$34,085,000 in fiscal year 2023.
new text end
new text begin Subd. 9. new text end
new text begin
Forecasted Programs; MFIP/DWP
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
79,959,000 new text end |
new text begin
80,738,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
75,607,000 new text end |
new text begin
76,851,000 new text end |
new text begin Subd. 10. new text end
new text begin
Forecasted Programs; MFIP Child
|
new text begin
105,380,000 new text end |
new text begin
-0- new text end |
||||
new text begin Subd. 11. new text end
new text begin
Forecasted Programs; General
|
new text begin
49,791,000 new text end |
new text begin
50,308,000 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 2020 and $6,729,812
in fiscal year 2021. 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. 12. new text end
new text begin
Forecasted Programs; Minnesota
|
new text begin
42,271,000 new text end |
new text begin
45,860,000 new text end |
||||
new text begin Subd. 13. new text end
new text begin
Forecasted Programs; Housing
|
new text begin
167,680,000 new text end |
new text begin
170,253,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Forecasted Programs; Northstar Care
|
new text begin
86,497,000 new text end |
new text begin
94,095,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Forecasted Programs; MinnesotaCare
|
new text begin
25,100,000 new text end |
new text begin
27,665,000 new text end |
||||
new text begin
This appropriation is from the health care
access fund.
new text end
new text begin Subd. 16. new text end
new text begin
Forecasted Programs; Medical
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
5,610,367,000 new text end |
new text begin
5,616,974,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
439,598,000 new text end |
new text begin
439,598,000 new text end |
new text begin
(a) Behavioral Health Services. $1,000,000
in fiscal year 2020 and $1,000,000 in fiscal
year 2021 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) Base Level Adjustment. The health care
access fund base is $439,598,000 in fiscal year
2022 and $439,598,000 in fiscal year 2023.
new text end
new text begin Subd. 17. new text end
new text begin
Forecasted Programs; Alternative
|
new text begin
45,135,000 new text end |
new text begin
45,154,000 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. 18. new text end
new text begin
Forecasted Programs; Chemical
|
new text begin
127,503,000 new text end |
new text begin
131,750,000 new text end |
||||
new text begin
Transfer; Consolidated Chemical
Dependency Treatment Fund. Any balance
remaining in the consolidated chemical
dependency treatment fund at the end of fiscal
year 2020, estimated to be $23,855,000, shall
be transferred to the general fund.
new text end
new text begin Subd. 19. new text end
new text begin
Grant Programs; Support Services
|
||||||
|
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
96,312,000 new text end |
new text begin
96,311,000 new text end |
new text begin Subd. 20. new text end
new text begin
Grant Programs; Basic Sliding Fee
|
new text begin
44,655,000 new text end |
new text begin
-0- new text end |
||||
new text begin
new text begin Base Level Adjustment.new text end The general fund
base is $236,264,000 in fiscal year 2022 and
zero in fiscal year 2023.
new text end
new text begin Subd. 21. new text end
new text begin
Grant Programs; Child Care
|
new text begin
1,737,000 new text end |
new text begin
1,737,000 new text end |
||||
new text begin Subd. 22. new text end
new text begin
Grant Programs; Child Support
|
new text begin
50,000 new text end |
new text begin
50,000 new text end |
||||
new text begin Subd. 23. new text end
new text begin
Grant Programs; Children's Services
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
39,165,000 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
new text begin Title IV-E Adoption Assistance.new text end 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
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 Subd. 24. new text end
new text begin
Grant Programs; Children and
|
new text begin
58,201,000 new text end |
new text begin
58,201,000 new text end |
||||
new text begin Subd. 25. new text end
new text begin
Grant Programs; Children and
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
22,665,000 new text end |
new text begin
22,065,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
-0- new text end |
new text begin
1,000,000 new text end |
new text begin
(a) Minnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2020 do not
cancel but are available for this purpose in
fiscal year 2021.
new text end
new text begin
(b) Pathways to Prosperity. $1,000,000 in
fiscal year 2021 is from the federal TANF
fund for the unified benefit amount of the
Minnesota Pathways to Prosperity and
Well-Being pilot project. The commissioner
shall award the grant only upon issuance of
formal approval of the pilot project plan as
required under article 2, section 39,
subdivision 1, paragraph (c), and after
fulfillment of the condition in article 2, section
39, subdivision 1, paragraph (b), clause (3).
No amount of the appropriation may be used
for any other purpose of the pilot project. The
base for this appropriation is $1,000,000 in
fiscal year 2022 and $1,000,000 in fiscal year
2023. This is not an ongoing appropriation.
The commissioner of management and budget
shall not include a base amount for this
appropriation in fiscal year 2024. This section
expires June 30, 2023.
new text end
new text begin
(c) Homeless Youth Drop-In Program
Grant. Notwithstanding Minnesota Statutes,
section 16B.97, $100,000 in fiscal year 2020
is from the general fund for a grant to an
organization in Anoka County providing
services and programming through a drop-in
program to meet the basic needs, including
mental health needs, of homeless youth in the
north metropolitan suburbs, to develop a
model of its homeless youth drop-in program
that can be shared and replicated in other
communities throughout Minnesota. This is a
onetime appropriation.
new text end
new text begin
(d) Shelter-Linked Youth Mental Health
Grants. $500,000 in fiscal year 2020 is from
the general fund for shelter-linked youth
mental health grants under Minnesota Statutes,
section 256K.46. This is a onetime
appropriation and is available until June 30,
2023. This paragraph expires July 1, 2023.
new text end
new text begin Subd. 26. new text end
new text begin
Grant Programs; Health Care Grants
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
3,711,000 new text end |
new text begin
3,711,000 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 Subd. 27. new text end
new text begin
Grant Programs; Other Long-Term
|
new text begin
1,925,000 new text end |
new text begin
1,925,000 new text end |
||||
new text begin Subd. 28. new text end
new text begin
Grant Programs; Aging and Adult
|
new text begin
32,811,000 new text end |
new text begin
32,995,000 new text end |
||||
new text begin Subd. 29. new text end
new text begin
Grant Programs; Deaf and
|
new text begin
2,675,000 new text end |
new text begin
2,675,000 new text end |
||||
new text begin
Base Level Adjustment. The general fund
base is $2,886,000 in fiscal year 2022 and
$2,886,000 in fiscal year 2023.
new text end
new text begin Subd. 30. new text end
new text begin
Grant Programs; Disabilities Grants
|
new text begin
21,995,000 new text end |
new text begin
21,996,000 new text end |
||||
new text begin
(a) Semi-Independent Living Services
Grants. $1,000,000 in fiscal year 2020 and
$1,000,000 in fiscal year 2021 are from the
general fund for reimbursement to lead
agencies under Minnesota Statutes, section
252.275.
new text end
new text begin
(b) Parent-to-Parent Peer Support Grants.
$100,000 in fiscal year 2020 and $100,000 in
fiscal year 2021 are from the general fund for
grants under Minnesota Statutes, section
256.4751.
new text end
new text begin
(c) Adaptive Fitness Access Grants.
$125,000 in fiscal year 2020 and $125,000 in
fiscal year 2021 are from the general fund for
the grant program under Minnesota Statutes,
section 256.488.
new text end
new text begin
(d) Day Training and Habilitation Disability
Waiver Rate System Transition Grants.
$200,000 in fiscal year 2020 and $200,000 in
fiscal year 2021 are from the general fund for
day training and habilitation disability waiver
rate system transition grants under article 5,
section 94.
new text end
new text begin
(e) Family Support Grants. The general fund
base for family support grants under
Minnesota Statutes, section 252.32, is
$10,278,000 in fiscal year 2022 and
$8,278,000 in fiscal year 2023. The
commissioner may use up to $2,000,000 of
the 2022 fiscal year base funding to reimburse
counties that issue family support grants in an
amount that exceeds the county's allocation in
fiscal year 2021.
new text end
new text begin
(f) Base Level Adjustment. The general fund
base is $27,996,000 in fiscal year 2022 and
$25,996,000 in fiscal year 2023.
new text end
new text begin Subd. 31. new text end
new text begin
Grant Programs; Housing Support
|
new text begin
9,339,000 new text end |
new text begin
10,389,000 new text end |
||||
new text begin
(a) Community-Based Housing and
Behavioral Health Services for Opiate
Addiction. Notwithstanding Minnesota
Statutes, section 16B.97, $25,000 in fiscal year
2020 and $25,000 in fiscal year 2021 are from
the general fund for a grant to Oasis Central
Minnesota, Inc., serving Morrison County to
provide opioid programming, behavioral
health services, and residential housing with
employment services.
new text end
new text begin
(b) Transitional Housing Program.
Notwithstanding Minnesota Statutes, section
16B.97, $50,000 in fiscal year 2020 is from
the general fund for a transitional housing and
support program located in Rice County that
serves women and children in crisis to enhance
current services and supports and to determine
if the program's model can be expanded
statewide. The commissioner of human
services shall report by February 1, 2020, to
the chairs and ranking minority members of
the legislative committees with jurisdiction
over transitional housing programs on the
outcomes of the program and provide
recommendations on expanding the program's
model statewide. This is a onetime
appropriation.
new text end
new text begin Subd. 32. new text end
new text begin
Grant Programs; Adult Mental Health
|
new text begin
86,858,000 new text end |
new text begin
82,577,000 new text end |
||||
new text begin
(a) Taylor Hayden Violence Prevention
Grants. $100,000 in fiscal year 2020 is for
violence prevention grants to nonprofit
organizations with expertise in violence
prevention to conduct violence prevention
initiatives or public awareness and education
campaigns on violence prevention. This is a
onetime appropriation.
new text end
new text begin
(b) Project Legacy. $250,000 in fiscal year
2020 is for a grant to Project Legacy to
provide counseling and outreach to youth and
young adults from families with a history of
generational poverty. Money from this
appropriation must be spent for mental health
care, medical care, chemical dependency
intervention, housing, and mentoring and
counseling services for first generation college
students. This is a onetime appropriation and
is available until June 30, 2023. This
paragraph expires July 1, 2023.
new text end
new text begin
(c) Housing Options for Persons with
Serious Mental Illness. $2,000,000 in fiscal
year 2020 is for adult mental health grants
under Minnesota Statutes, section 245.4661,
subdivision 9, paragraph (a), clause (2), to
increase availability of housing options with
supports for persons with serious mental
illness. This is a onetime appropriation and is
available until June 30, 2023. This paragraph
expires July 1, 2023.
new text end
new text begin
(d) Officer-Involved Community-Based
Care Coordination Grants. $1,000,000 in
fiscal year 2020 is for officer-involved
community-based care coordination grants.
Of this amount:
new text end
new text begin
(1) $900,000 is for officer-involved
community-based care coordination grants
under Minnesota Statutes, section 245.4663.
Of this amount, $500,000 shall be awarded to
Blue Earth county. This is a onetime
appropriation and is available until June 30,
2023; and
new text end
new text begin
(2) $100,000 is for up to ten planning grants
under article 3, section 38. In awarding these
grants, the commissioner must place a priority
on funding nonmetro programs. This is a
onetime appropriation and is available until
June 30, 2023.
new text end
new text begin
This paragraph expires July 1, 2023.
new text end
new text begin
(e) Mobile Mental Health Crisis Response
Team Funding. $4,150,000 in fiscal year
2020 and $4,150,000 in fiscal year 2021 are
for adult mental health grants under Minnesota
Statutes, section 245.4661, subdivision 9,
paragraph (a), clause (1), to fund regional
mobile mental health crisis response teams
throughout the state. This is a onetime
appropriation and is available until June 30,
2023. This paragraph expires July 1, 2023.
new text end
new text begin
(f) Specialized Mental Health Community
Supervision Pilot Project. $200,000 in fiscal
year 2020 and $200,000 in fiscal year 2021
are for a grant to Anoka County for
establishment of a specialized mental health
community supervision caseload pilot project.
This is a onetime appropriation.
new text end
new text begin
(g) Base Level Adjustment. The general fund
base is $78,427,000 in fiscal year 2022 and
$78,427,000 in fiscal year 2023.
new text end
new text begin Subd. 33. new text end
new text begin
Grant Programs; Child Mental Health
|
new text begin
21,519,000 new text end |
new text begin
20,826,000 new text end |
||||
new text begin
(a) Community-Based Children's Mental
Health Grant. Notwithstanding Minnesota
Statutes, section 16B.97, $193,000 in fiscal
year 2020 is from the general fund for a grant
to the Family Enhancement Center for staffing
and administrative support to provide children
access to expert mental health services
regardless of a child's insurance status or
income. This is a onetime appropriation and
is available until June 30, 2021.
new text end
new text begin
(b) Telemedicine Equipment for
School-Linked Mental Health Services.
$500,000 in fiscal year 2020 is for grants to
purchase equipment to deliver school-linked
mental health services by telemedicine. The
grants may be awarded to new or existing
providers statewide. The commissioner shall
report to the legislative committees with
jurisdiction over mental health on the
effectiveness of the grants after funds
appropriated under this section are expended.
This is a onetime appropriation and available
until June 30, 2023. This paragraph expires
July 1, 2023.
new text end
new text begin Subd. 34. new text end
new text begin
Grant Programs; Chemical
|
||||||
|
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) Problem Gambling. $225,000 in fiscal
year 2020 and $225,000 in fiscal year 2021
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
(b) Fetal Alcohol Spectrum Disorders
Grants. $250,000 in fiscal year 2020 and
$250,000 in fiscal year 2021 are from the
general fund for a grant under Minnesota
Statutes, section 254A.21, to a statewide
organization that focuses solely on prevention
of and intervention with fetal alcohol spectrum
disorders.
new text end
new text begin Subd. 35. new text end
new text begin
Direct Care and Treatment -
|
||||||
new text begin
Transfer; State-Operated Services Account.
Any balance remaining in the state operated
services account at the end of fiscal year 2019,
estimated to be $13,000,000 shall be
transferred to the general fund.
new text end
new text begin Subd. 36. new text end
new text begin
Direct Care and Treatment - Mental
|
new text begin
129,209,000 new text end |
new text begin
129,201,000 new text end |
||||
new text begin
new text begin Base Level Adjustment. new text end The general fund
base is $129,197,000 in fiscal year 2022 and
$129,197,000 in fiscal year 2023.
new text end
new text begin Subd. 37. new text end
new text begin
Direct Care and Treatment -
|
new text begin
15,036,000 new text end |
new text begin
13,448,000 new text end |
||||
new text begin
Base Level Adjustment. The general fund
base is $13,447,000 in fiscal year 2022 and
$13,447,000 in fiscal year 2023.
new text end
new text begin Subd. 38. new text end
new text begin
Direct Care and Treatment - Forensic
|
new text begin
112,126,000 new text end |
new text begin
115,342,000 new text end |
||||
new text begin
Base Level Adjustment. The general fund
base is $115,944,000 in fiscal year 2022 and
$115,944,000 in fiscal year 2023.
new text end
new text begin Subd. 39. new text end
new text begin
Direct Care and Treatment - Sex
|
new text begin
87,338,000 new text end |
new text begin
87,887,000 new text end |
||||
new text begin
(a) new text begin Transfer Authority. new text end Money appropriated
for the Minnesota sex offender program may
be transferred between fiscal years of the
biennium with the approval of the
commissioner of management and budget.
new text end
new text begin
(b) new text begin Base Level Adjustment.new text end The general fund
base is $88,432,000 in fiscal year 2022 and
$88,432,000 in fiscal year 2023.
new text end
new text begin Subd. 40. new text end
new text begin
Direct Care and Treatment -
|
new text begin
47,499,000 new text end |
new text begin
47,708,000 new text end |
||||
new text begin
(a) Community Competency Restoration
Task Force. $200,000 in fiscal year 2020 is
for the Community Competency Restoration
Task Force under article 3, section 38. This is
a onetime appropriation and is available until
June 30, 2023.
new text end
new text begin
(b) Base Level Adjustment. The general fund
base is $47,632,000 in fiscal year 2022 and
$47,632,000 in fiscal year 2023.
new text end
new text begin Subd. 41. new text end
new text begin
Technical Activities
|
new text begin
95,781,000 new text end |
new text begin
96,008,000 new text end |
||||
new text begin
(a) Generally. This appropriation is from the
federal TANF fund.
new text end
new text begin
(b) Base Level Adjustment. The TANF fund
base is $96,360,000 in fiscal year 2022 and
$96,620,000 in fiscal year 2023.
new text end
Sec. 3. new text begin COMMISSIONER OF HEALTH
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
225,900,000 new text end |
new text begin
$ new text end |
new text begin
227,953,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2020 new text end |
new text begin
2021 new text end |
|
|
new text begin
General new text end |
new text begin
157,897,000 new text end |
new text begin
157,988,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
56,290,000 new text end |
new text begin
58,252,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Health Improvement
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
129,824,000 new text end |
new text begin
129,096,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
7,150,000 new text end |
new text begin
6,969,000 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 in
fiscal year 2020 and $3,579,000 in fiscal year
2021 are from the TANF fund for home
visiting and nutritional services 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 in fiscal year 2020 and
$2,000,000 in fiscal year 2021 are from the
TANF fund 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 in fiscal year 2020 and
$4,978,000 in fiscal year 2021 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in each
fiscal year must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1. $978,000 of
the funding in each fiscal year 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 in fiscal year 2020 and
$1,156,000 in fiscal year 2021 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
new text end
new text begin
(5) The commissioner may use up to 6.23
percent of the amounts appropriated from the
TANF fund 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) Perinatal Hospice Grants. $515,000 in
fiscal year 2020 is from the general fund for
perinatal hospice development, training, and
awareness grants under article 9, section 54.
Eligible entities may apply for multiple grants.
The commissioner may use up to $15,000 for
administration of these grants. This is a
onetime appropriation and is available until
June 30, 2023.
new text end
new text begin
(d) Statewide Tobacco Cessation. $1,598,000
in fiscal year 2020 and $2,748,000 in fiscal
year 2021 are from the general fund for
statewide tobacco cessation services under
Minnesota Statutes, section 144.397. The base
for this appropriation is $2,878,000 in fiscal
year 2022 and $2,878,000 in fiscal year 2023.
new text end
new text begin
(e) Safe Harbor for Sexually Exploited
Youth. $500,000 in fiscal year 2020 and
$500,000 in fiscal year 2021 are from the
general fund for the statewide program for
safe harbor for sexually exploited youth. Of
these amounts:
new text end
new text begin
(1) $470,000 in fiscal year 2020 and $470,000
in fiscal year 2021 are for grants for
comprehensive services, including
trauma-informed, culturally specific services
for sexually exploited youth under Minnesota
Statutes, section 145.4716;
new text end
new text begin
(2) $5,000 in fiscal year 2020 and $5,000 in
fiscal year 2021 are for evaluation activities
under Minnesota Statutes, section 145.4718.
The base appropriation includes $45,000 in
fiscal year 2020 and $45,000 in fiscal year
2021 for evaluation activities under Minnesota
Statutes, section 145.4718; and
new text end
new text begin
(3) $25,000 in fiscal year 2020 and $25,000
in fiscal year 2021 are for training and
protocol implementation.
new text end
new text begin
(f) Study on Breastfeeding Disparities.
$79,000 in fiscal year 2020 is from the general
fund for a study on breastfeeding disparities.
new text end
new text begin
(g) Palliative Care Advisory Council.
$44,000 in fiscal year 2020 and $44,000 in
fiscal year 2021 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
(h) Study on the Increase in Abortions after
20 Weeks. $42,000 in fiscal year 2020 is from
the general fund for an evaluation of the
increase in abortions occurring after the
gestational age of 20 weeks and the reasons
for the increase. The commissioner shall report
the findings to the chairs and ranking minority
members of the legislative committees with
jurisdiction over health care policy and finance
by February 15, 2020. This is a onetime
appropriation.
new text end
new text begin
(i) Positive Abortion Alternatives Grants.
$336,000 in fiscal year 2020 and $336,000 in
fiscal year 2021 are from the general fund for
the positive abortion alternatives grants under
Minnesota Statutes, section 145.4235.
new text end
new text begin
(j) Mental Health Services for Pre- and
Postpartum Women. $100,000 in fiscal year
2020 is from the general fund for mental
health services to women suffering from pre-
and postpartum mood and anxiety disorders
under Minnesota Statutes, section 145.908.
This is a onetime appropriation and is
available until June 30, 2023.
new text end
new text begin
(k) Comprehensive Suicide Prevention.
$1,321,000 in fiscal year 2020 and $1,321,000
in fiscal year 2021 are from the general fund
for a Minnesota-based suicide prevention
lifeline as part of the suicide prevention plan
described in Minnesota Statutes, section
145.56. This is a onetime appropriation and
is available until June 30, 2023.
new text end
new text begin
(l) Health Professionals Loan Forgiveness.
$354,000 in fiscal year 2020 is from the
general fund for transfer to the health
professional education loan forgiveness
program account for loan forgiveness for
mental health professionals agreeing to
practice in designated rural areas under
Minnesota Statutes, section 144.1501,
subdivision 2, paragraph (a), clause (1). This
is a onetime appropriation and is available
until June 30, 2023. If the commissioner does
not receive enough qualified applicants to use
the entire allocation of funds as required, the
remaining funds may be used for loan
forgiveness for mental health professionals
agreeing to practice in underserved urban
communities or may be allocated
proportionally among other eligible
professionals agreeing to practice in
designated rural areas.
new text end
new text begin
(m) Cannabinoid Products Workgroup.
$10,000 in fiscal year 2020 is from the general
fund for the cannabinoid products workgroup
under article 1, section 56. This is a onetime
appropriation.
new text end
new text begin
(n) Base Level Adjustment. The general fund
base is $128,431,000 in fiscal year 2022 and
$127,831,000 in fiscal year 2023.
new text end
new text begin Subd. 3. new text end
new text begin
Health Protection
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
18,637,000 new text end |
new text begin
19,456,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
49,140,000 new text end |
new text begin
51,283,000 new text end |
new text begin
(a) Public Health Laboratory Equipment.
$840,000 in fiscal year 2020 and $655,000 in
fiscal year 2021 are from the general fund for
equipment for the public health laboratory.
This is a onetime appropriation and is
available until June 30, 2023.
new text end
new text begin
(b) Base Level Adjustment. The general fund
base is $18,801,000 in fiscal year 2022 and
$18,801,000 in fiscal year 2023. The state
government special revenue fund base is
$51,283,000 in fiscal year 2022 and
$51,290,000 in fiscal year 2023.
new text end
new text begin Subd. 4. new text end
new text begin
Health Operations
|
new text begin
9,436,000 new text end |
new text begin
9,436,000 new text end |
||||
Sec. 4. new text begin HEALTH-RELATED BOARDS
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
23,996,000 new text end |
new text begin
$ new text end |
new text begin
24,016,000 new text end |
||
new text begin
This appropriation is from the state
government special revenue fund unless
specified otherwise. The amounts that may be
spent for each purpose are specified in the
following subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Board of Chiropractic Examiners
|
new text begin
605,000 new text end |
new text begin
605,000 new text end |
||||
new text begin Subd. 3. new text end
new text begin
Board of Dentistry
|
new text begin
1,468,000 new text end |
new text begin
1,465,000 new text end |
||||
new text begin
Emeritus Licensing Activities. $8,000 in
fiscal year 2020 and $5,000 in fiscal year 2021
are for emeritus licensing activities under
Minnesota Statutes, section 150A.06.
new text end
new text begin Subd. 4. new text end
new text begin
Board of Dietetics and Nutrition
|
new text begin
145,000 new text end |
new text begin
145,000 new text end |
||||
new text begin Subd. 5. new text end
new text begin
Board of Marriage and Family Therapy
|
new text begin
376,000 new text end |
new text begin
377,000 new text end |
||||
new text begin Subd. 6. new text end
new text begin
Board of Medical Practice
|
new text begin
5,405,000 new text end |
new text begin
5,405,000 new text end |
||||
new text begin
Health Professional Services Program. This
appropriation includes $1,023,000 in fiscal
year 2020 and $1,002,000 in fiscal year 2021
for the health professional services program.
new text end
new text begin Subd. 7. new text end
new text begin
Board of Nursing
|
new text begin
4,916,000 new text end |
new text begin
4,916,000 new text end |
||||
new text begin Subd. 8. new text end
new text begin
Board of Nursing Home Administrators
|
new text begin
2,898,000 new text end |
new text begin
2,898,000 new text end |
||||
new text begin
(a) Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2020
and $150,000 in fiscal year 2021 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end
new text begin
(b) Administrative Services Unit -
Retirement Costs. Of this appropriation,
$558,000 in fiscal year 2020 is for 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
(c) Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of this
appropriation, $200,000 in fiscal year 2020
and $200,000 in fiscal year 2021 are for costs
of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards. 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
appropriations currently available to that
board, the administrative services unit is
authorized to transfer money from this
appropriation to the board for payment of
those costs with the approval of the
commissioner of management and budget. The
commissioner of management and budget must
require any board that has an unexpended
balance for an amount transferred under this
paragraph to transfer the unexpended amount
to the administrative services unit to be
deposited in the state government special
revenue fund.
new text end
new text begin Subd. 9. new text end
new text begin
Board of Optometry
|
new text begin
176,000 new text end |
new text begin
176,000 new text end |
||||
new text begin Subd. 10. new text end
new text begin
Board of Pharmacy
|
new text begin
3,326,000 new text end |
new text begin
3,338,000 new text end |
||||
new text begin
$25,000 in fiscal year 2020 is for random
audits under Minnesota Statutes, section
152.126, subdivision 6, paragraph (k), of
permissible users of the prescription
monitoring program. This is a onetime
appropriation.
new text end
new text begin Subd. 11. new text end
new text begin
Board of Physical Therapy
|
new text begin
557,000 new text end |
new text begin
559,000 new text end |
||||
new text begin Subd. 12. new text end
new text begin
Board of Podiatric Medicine
|
new text begin
209,000 new text end |
new text begin
209,000 new text end |
||||
new text begin Subd. 13. new text end
new text begin
Board of Psychology
|
new text begin
1,285,000 new text end |
new text begin
1,285,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Board of Social Work
|
new text begin
1,289,000 new text end |
new text begin
1,291,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Board of Veterinary Medicine
|
new text begin
332,000 new text end |
new text begin
338,000 new text end |
||||
new text begin Subd. 16. new text end
new text begin
Board of Behavioral Health and
|
new text begin
669,000 new text end |
new text begin
669,000 new text end |
||||
new text begin Subd. 17. new text end
new text begin
Board of Occupational Therapy
|
new text begin
340,000 new text end |
new text begin
340,000 new text end |
||||
Sec. 5. new text begin EMERGENCY MEDICAL SERVICES
|
new text begin
$ new text end |
new text begin
3,747,000 new text end |
new text begin
$ new text end |
new text begin
3,809,000 new text end |
||
new text begin
(a) Cooper/Sams Volunteer Ambulance
Program. $950,000 in fiscal year 2020 and
$950,000 in fiscal year 2021 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
2020 and $861,000 in fiscal year 2021 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 2020
and $89,000 in fiscal year 2021 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. $1,851,000 in fiscal
year 2020 and $1,913,000 in fiscal year 2021
are for board operations. The base for this
program is $1,880,000 in fiscal year 2022 and
$1,880,000 in fiscal year 2023.
new text end
new text begin
(c) Regional Grants. $585,000 in fiscal year
2020 and $585,000 in fiscal year 2021 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. $585,000
in fiscal year 2020 and $585,000 in fiscal year
2021 are for training grants under Minnesota
Statutes, section 144E.35.
new text end
new text begin
(e) Base Level Adjustment. The base is
$3,776,000 in fiscal year 2022 and $3,776,000
in fiscal year 2023.
new text end
Sec. 6. new text begin COUNCIL ON DISABILITY
|
new text begin
$ new text end |
new text begin
1,014,000 new text end |
new text begin
$ new text end |
new text begin
1,006,000 new text end |
||
Sec. 7. new text begin OMBUDSMAN FOR MENTAL
|
new text begin
$ new text end |
new text begin
2,688,000 new text end |
new text begin
$ new text end |
new text begin
2,438,000 new text end |
||
new text begin
Department of Psychiatry Monitoring.
$100,000 in fiscal year 2020 and $100,000 in
fiscal year 2021 are for monitoring the
Department of Psychiatry at the University of
Minnesota.
new text end
Sec. 8. new text begin OMBUDSPERSONS FOR FAMILIES
|
new text begin
$ new text end |
new text begin
467,000 new text end |
new text begin
$ new text end |
new text begin
467,000 new text end |
||
Sec. 9. new text begin COMMISSIONER OF MANAGEMENT
|
new text begin
$ new text end |
new text begin
498,000 new text end |
new text begin
$ new text end |
new text begin
498,000 new text end |
||
new text begin
(a) Transfer. By June 30, 2019, the
commissioner shall transfer $399,000,000
from the general fund to the health care access
fund. This is a onetime transfer.
new text end
new text begin
(b) Transfer. By June 30, 2020, the
commissioner shall transfer $168,776,000
from the general fund to the health care access
fund. This is a onetime transfer.
new text end
new text begin
(c) Transfer. By June 30, 2022, the
commissioner shall transfer $116,049,000
from the general fund to the health care access
fund. This is a onetime transfer. This
paragraph expires July 1, 2022.
new text end
new text begin
(d) Proven-Effective Practices Evaluation
Activities. $498,000 in fiscal year 2020 and
$498,000 in fiscal year 2021 are from the
general fund for evaluation activities under
Minnesota Statutes, section 16A.055,
subdivision 1a.
new text end
Sec. 10. new text begin COMMISSIONER OF COMMERCE
|
new text begin
$ new text end |
new text begin
39,000 new text end |
new text begin
$ new text end |
new text begin
-0- new text end |
||
Sec. 11.
Laws 2017, First Special Session chapter 6, article 18, section 7, is amended to
read:
Sec. 7. OMBUDSMAN FOR MENTAL
|
$ |
2,407,000 |
$ |
deleted text begin
2,427,000
deleted text end
new text begin
2,177,000 new text end |
||
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.
Sec. 12. new text begin TRANSFERS.
new text end
new text begin Subdivision 1. new text end
new text begin Forecasted programs. 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, 2021, within fiscal years among
the MFIP, general assistance, medical assistance, MinnesotaCare, MFIP child care assistance
under Minnesota Statutes, section 119B.05, Minnesota supplemental aid program, housing
support, 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 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 only to set up
and manage operating budgets 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 Committee and the house of representatives
Health and Human Services Finance Committee quarterly about the transfers made under
this subdivision.
new text end
Sec. 13. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end
new text begin
The commissioners of health and human services shall not use indirect cost allocations
to pay for the operational costs of any program for which they are responsible.
new text end
Sec. 14. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2021, unless a
different expiration date is explicit.
new text end
Sec. 15. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2019, unless a different effective date is specified.
new text end
APPENDIX
Repealed Minnesota Statutes: S2452-2
16A.724 HEALTH CARE ACCESS FUND.
Subd. 2.
Transfers.
(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.
Subd. 2.
Transfers.
(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.
119B.011 DEFINITIONS.
Subdivision 1.
Scope.
For the purposes of this chapter, the following terms have the meanings given.
Subd. 2.
Applicant.
"Child care fund applicants" means all parents, stepparents, legal guardians, or eligible relative caregivers who are members of the family and reside in the household that applies for child care assistance under the child care fund.
Subd. 3.
Application.
"Application" means the submission to a county agency, by or on behalf of a family, of a completed, signed, and dated:
(1) child care assistance universal application form; or
(2) child care addendum form in combination with a combined application form for MFIP, DWP, or food support.
Subd. 4.
Child.
"Child" means a person 12 years old or younger, or a person age 13 or 14 who is disabled, as defined in section 125A.02.
Subd. 5.
Child care.
"Child care" means the care of a child by someone other than a parent, stepparent, legal guardian, eligible relative caregiver, or the spouses of any of the foregoing in or outside the child's own home for gain or otherwise, on a regular basis, for any part of a 24-hour day.
Subd. 6.
Child care fund.
"Child care fund" means a program under this chapter providing:
(1) financial assistance for child care to parents engaged in employment, job search, or education and training leading to employment, or an at-home infant child care subsidy; and
(2) grants to develop, expand, and improve the access and availability of child care services statewide.
Subd. 7.
Child care services.
"Child care services" means the provision of child care as defined in subdivision 5.
Subd. 8.
Commissioner.
"Commissioner" means the commissioner of human services.
Subd. 9.
County board.
"County board" means the board of county commissioners in each county.
Subd. 10.
Department.
"Department" means the Department of Human Services.
Subd. 10a.
Diversionary work program.
"Diversionary work program" means the program established under section 256J.95.
Subd. 11.
Education program.
"Education program" means remedial or basic education or English as a second language instruction, a program leading to a commissioner of education-selected high school equivalency certification or high school diploma, postsecondary programs excluding postbaccalaureate programs, and other education and training needs as documented in an employment plan, as defined in subdivision 12. The employment plan must outline education and training needs of a recipient, meet state requirements for employment plans, meet the requirements of this chapter, and Minnesota Rules, parts 3400.0010 to 3400.0230, and meet the requirements of programs that provide federal reimbursement for child care services.
Subd. 12.
Employment plan.
"Employment plan" means employment of recipients financially eligible for child care assistance, or other work activities defined under section 256J.49, approved in an employability development, job search support plan, or employment plan that is developed by the county agency, if it is acting as an employment and training service provider, or by an employment and training service provider certified by the commissioner of employment and economic development or an individual designated by the county to provide employment and training services. The plans and designation of a service provider must meet the requirements of this chapter and chapter 256J or 256K, Minnesota Rules, parts 3400.0010 to 3400.0230, and other programs that provide federal reimbursement for child care services.
Subd. 13.
Family.
"Family" means parents, stepparents, guardians and their spouses, or other eligible relative caregivers and their spouses, and their blood related dependent children and adoptive siblings under the age of 18 years living in the same home including children temporarily absent from the household in settings such as schools, foster care, and residential treatment facilities or parents, stepparents, guardians and their spouses, or other relative caregivers and their spouses temporarily absent from the household in settings such as schools, military service, or rehabilitation programs. An adult family member who is not in an authorized activity under this chapter may be temporarily absent for up to 60 days. When a minor parent or parents and his, her, or their child or children are living with other relatives, and the minor parent or parents apply for a child care subsidy, "family" means only the minor parent or parents and their child or children. An adult age 18 or older who meets this definition of family and is a full-time high school or postsecondary student may be considered a dependent member of the family unit if 50 percent or more of the adult's support is provided by the parents, stepparents, guardians, and their spouses or eligible relative caregivers and their spouses residing in the same household.
Subd. 13a.
Family stabilization services.
"Family stabilization services" means the services under section 256J.575.
Subd. 14.
Human services board.
"Human services board" means a board established under section 402.02, Laws 1974, chapter 293, or Laws 1976, chapter 340.
Subd. 15.
Income.
"Income" means earned income as defined under section 256P.01, subdivision 3, unearned income as defined under section 256P.01, subdivision 8, and public assistance cash benefits, including the Minnesota family investment program, diversionary work program, work benefit, Minnesota supplemental aid, general assistance, refugee cash assistance, at-home infant child care subsidy payments, and child support and maintenance distributed to the family under section 256.741, subdivision 2a. The following are deducted from income: funds used to pay for health insurance premiums for family members, and child or spousal support paid to or on behalf of a person or persons who live outside of the household. Income sources not included in this subdivision and section 256P.06, subdivision 3, are not counted.
Subd. 16.
Legal nonlicensed child care provider.
"Legal nonlicensed child care provider" means: (1) a child care provider who is excluded from licensing requirements under section 245A.03, subdivision 2; or (2) a child care provider authorized to provide care in a child's home under section 119B.09, subdivision 13, provided the provider only cares for related children, children from a single, unrelated family, or both related children and children from a single, unrelated family.
Subd. 17.
MFIP.
"MFIP" means the Minnesota family investment program, the state's TANF program under Public Law 104-193, Title I, and includes the MFIP program under chapter 256J and tribal contracts under section 119B.02, subdivision 2, or 256.01, subdivision 2.
Subd. 18.
Postsecondary educational systems.
"Postsecondary educational systems" means the University of Minnesota Board of Regents and the Board of Trustees of the Minnesota State Colleges and Universities.
Subd. 19.
Provider.
"Provider" means: (1) an individual or child care center or facility, either licensed or unlicensed, providing legal child care services as defined under section 245A.03; or (2) an individual or child care center or facility holding a valid child care license issued by another state or a tribe and providing child care services in the licensing state or in the area under the licensing tribe's jurisdiction. A legally unlicensed family child care provider must be at least 18 years of age, and not a member of the MFIP assistance unit or a member of the family receiving child care assistance to be authorized under this chapter.
Subd. 19a.
Registration.
"Registration" means the process used by a county to determine whether the provider selected by a family applying for or receiving child care assistance to care for that family's children meets the requirements necessary for payment of child care assistance for care provided by that provider.
Subd. 19b.
Student parent.
"Student parent" means a person who is:
(1) under 21 years of age and has a child;
(2) pursuing a high school diploma or commissioner of education-selected high school equivalency certification;
(3) residing within a county that has a basic sliding fee waiting list under section 119B.03, subdivision 4; and
(4) not an MFIP participant.
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. Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, subpart 2, transition year child care may be used to support employment, approved education or training programs, or job search that meets the requirements of section 119B.10. Transition year child care is not available to families who have been disqualified from MFIP or DWP due to fraud.
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. Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, subpart 2, transition year extension child care may be used to support employment, approved education or training programs, 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.
Subd. 21.
Recoupment of overpayments.
"Recoupment of overpayments" means the reduction of child care assistance payments to an eligible family or a child care provider in order to correct an overpayment of child care assistance.
Subd. 22.
Service period.
"Service period" means the biweekly period used by the child care assistance program for billing and payment purposes.
119B.02 DUTIES OF COMMISSIONER.
Subdivision 1.
Child care services.
The commissioner shall develop standards for county and human services boards to provide child care services to enable eligible families to participate in employment, training, or education programs. Within the limits of available appropriations, the commissioner shall distribute money to counties to reduce the costs of child care for eligible families. The commissioner shall adopt rules to govern the program in accordance with this section. The rules must establish a sliding schedule of fees for parents receiving child care services. The rules shall provide that funds received as a lump-sum payment of child support arrearages shall not be counted as income to a family in the month received but shall be prorated over the 12 months following receipt and added to the family income during those months. The commissioner shall maximize the use of federal money under title I and title IV of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and other programs that provide federal or state reimbursement for child care services for low-income families who are in education, training, job search, or other activities allowed under those programs. Money appropriated under this section must be coordinated with the programs that provide federal reimbursement for child care services to accomplish this purpose. Federal reimbursement obtained must be allocated to the county that spent money for child care that is federally reimbursable under programs that provide federal reimbursement for child care services. The counties shall use the federal money to expand child care services. The commissioner may adopt rules under chapter 14 to implement and coordinate federal program requirements.
Subd. 2.
Contractual agreements with tribes.
The commissioner may enter into contractual agreements with a federally recognized Indian tribe with a reservation in Minnesota to carry out the responsibilities of county human service agencies to the extent necessary for the tribe to operate child care assistance programs under sections 119B.03 and 119B.05. An agreement may allow the state to make payments for child care assistance services provided under section 119B.05. The commissioner shall consult with the affected county or counties in the contractual agreement negotiations, if the county or counties wish to be included, in order to avoid the duplication of county and tribal child care services. Funding to support services under section 119B.03 may be transferred to the federally recognized Indian tribe with a reservation in Minnesota from allocations available to counties in which reservation boundaries lie. When funding is transferred under section 119B.03, the amount shall be commensurate to estimates of the proportion of reservation residents with characteristics identified in section 119B.03, subdivision 6, to the total population of county residents with those same characteristics.
Subd. 3.
Supervision of counties.
The commissioner shall supervise child care programs administered by the counties through standard-setting, technical assistance to the counties, approval of county child care fund plans, and distribution of public money for services. The commissioner shall provide training and other support services to assist counties in planning for and implementing child care assistance programs. The commissioner shall adopt rules under chapter 14 that establish minimum administrative standards for the provision of child care services by county boards of commissioners.
Subd. 4.
Universal application form.
The commissioner must develop and make available to all counties a universal application form for child care assistance under this chapter. The commissioner may develop and make available to all counties a child care addendum form to be used to supplement the combined application form for MFIP, DWP, or Food Support or to supplement other statewide application forms for public assistance programs for families applying for one of these programs in addition to child care assistance. The application must provide notice of eligibility requirements for assistance and penalties for wrongfully obtaining assistance.
Subd. 5.
Program integrity.
For child care assistance programs under this chapter, the commissioner shall enforce the requirements for program integrity and fraud prevention investigations under sections 256.046, 256.98, and 256.983.
Subd. 6.
Data.
Data collected, maintained, used, or disseminated by the welfare system pertaining to persons selected as legal nonlicensed child care providers by families receiving child care assistance shall be treated as licensing data as provided in section 13.46, subdivision 4.
Subd. 7.
Child care market rate survey.
Biennially, the commissioner shall survey prices charged by child care providers in Minnesota to determine the 75th percentile for like-care arrangements in county price clusters.
119B.025 DUTIES OF COUNTIES.
Subdivision 1.
Applications.
(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) counted income;
(8) spousal support and child support payments made to persons outside the household;
(9) residence; and
(10) inconsistent information, if related to eligibility.
(b) 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.
Subd. 2.
Social Security numbers.
The county must request Social Security numbers from all applicants for child care assistance under this chapter. A county may not deny child care assistance solely on the basis of failure of an applicant to report a Social Security number.
Subd. 3.
Redeterminations.
(a) Notwithstanding Minnesota Rules, part 3400.0180, item A, the county shall conduct a redetermination according to paragraphs (b) and (c).
(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.
(c) An applicant's eligibility must be redetermined no more frequently than every 12 months. The following criteria apply:
(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;
(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;
(3) for a family where at least one parent is younger than 21 years of age, does not have a high school degree or commissioner of education-selected high school equivalency certification, 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
(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.
Subd. 4.
Changes in eligibility.
(a) The county shall process a change in eligibility factors according to paragraphs (b) to (g).
(b) A family is subject to the reporting requirements in section 256P.07.
(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.
(d) A change in income occurs on the day the participant received the first payment reflecting the change in income.
(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.
(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.
(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.
119B.03 BASIC SLIDING FEE PROGRAM.
Subdivision 1.
Notice of allocation.
By October 1 of each year, the commissioner shall notify all counties of their final child care fund program allocation.
Subd. 2.
Waiting list.
Each county that receives funds under this section must keep a written record and report to the commissioner the number of eligible families who have applied for a child care subsidy or have requested child care assistance. Counties shall perform a preliminary determination of eligibility when a family requests child care assistance. At a minimum, a county must make a preliminary determination of eligibility based on family size, income, and authorized activity. A family seeking child care assistance must provide the required information to the county. A family that appears to be eligible must be put on a waiting list if funds are not immediately available. The waiting list must identify students in need of child care. Counties must review and update their waiting list at least every six months.
Subd. 3.
Eligible participants.
Families that meet the eligibility requirements under sections 119B.09 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.
Subd. 4.
Funding priority.
(a) First priority for child care assistance under the basic sliding fee program must be given to eligible non-MFIP families who do not have a high school diploma or commissioner of education-selected high school equivalency certification or who need remedial and basic skill courses in order to pursue employment or to pursue education leading to employment and who need child care assistance to participate in the education program. This includes student parents as defined under section 119B.011, subdivision 19b. Within this priority, the following subpriorities must be used:
(1) child care needs of minor parents;
(2) child care needs of parents under 21 years of age; and
(3) child care needs of other parents within the priority group described in this paragraph.
(b) Second priority must be given to parents who have completed their MFIP or DWP transition year, or parents who are no longer receiving or eligible for diversionary work program supports.
(c) Third priority must be given to families who are eligible for portable basic sliding fee assistance through the portability pool under subdivision 9.
(d) Fourth priority must be given to families in which at least one parent is a veteran as defined under section 197.447.
(e) Families under paragraph (b) must be added to the basic sliding fee waiting list on the date they begin the transition year under section 119B.011, subdivision 20, and must be moved into the basic sliding fee program as soon as possible after they complete their transition year.
Subd. 5.
Review of use of funds; reallocation.
(a) After each quarter, the commissioner shall review the use of basic sliding fee program allocations by county. The commissioner may reallocate unexpended or unencumbered money among those counties who have expended their full allocation or may allow a county to expend up to ten percent of its allocation in the subsequent allocation period.
(b) Any unexpended state and federal appropriations from the first year of the biennium may be carried forward to the second year of the biennium.
Subd. 6.
Allocation formula.
The basic sliding fee state and federal funds shall be allocated on a calendar year basis. Funds shall be allocated first in amounts equal to each county's guaranteed floor according to subdivision 8, with any remaining available funds allocated according to the following formula:
(a) One-fourth of the funds shall be allocated in proportion to each county's total expenditures for the basic sliding fee child care program reported during the most recent fiscal year completed at the time of the notice of allocation.
(b) Up to one-fourth of the funds shall be allocated in proportion to the number of families participating in the transition year child care program as reported during and averaged over the most recent six months completed at the time of the notice of allocation. Funds in excess of the amount necessary to serve all families in this category shall be allocated according to paragraph (f).
(c) Up to one-fourth of the funds shall be allocated in proportion to the average of each county's most recent six months of reported first, second, and third priority waiting list as defined in subdivision 2 and the reinstatement list of those families whose assistance was terminated with the approval of the commissioner under Minnesota Rules, part 3400.0183, subpart 1. Funds in excess of the amount necessary to serve all families in this category shall be allocated according to paragraph (f).
(d) Up to one-fourth of the funds shall be allocated in proportion to the average of each county's most recent six months of reported waiting list as defined in subdivision 2 and the reinstatement list of those families whose assistance was terminated with the approval of the commissioner under Minnesota Rules, part 3400.0183, subpart 1. Funds in excess of the amount necessary to serve all families in this category shall be allocated according to paragraph (f).
(e) The amount necessary to serve all families in paragraphs (b), (c), and (d) shall be calculated based on the basic sliding fee average cost of care per family in the county with the highest cost in the most recently completed calendar year.
(f) Funds in excess of the amount necessary to serve all families in paragraphs (b), (c), and (d) shall be allocated in proportion to each county's total expenditures for the basic sliding fee child care program reported during the most recent fiscal year completed at the time of the notice of allocation.
Subd. 6a.
Allocation due to increased funding.
When funding increases are implemented within a calendar year, every county must receive an allocation at least equal to its original allocation for the same time period. The remainder of the allocation must be recalculated to reflect the funding increase, according to formulas identified in subdivision 6.
Subd. 6b.
Allocation due to decreased funding.
When funding decreases are implemented within a calendar year, county allocations must be reduced in an amount proportionate to the reduction in the total allocation for the same time period. This applies when a funding decrease necessitates the revision of an existing calendar year allocation.
Subd. 8.
Guaranteed floor.
(a) Beginning January 1, 1996, each county's guaranteed floor shall equal 90 percent of the allocation received in the preceding calendar year. For the period January 1, 1999, to December 31, 1999, each county's guaranteed floor must be equal to its original calendar year 1998 allocation or its actual earnings for calendar year 1998, whichever is less.
(b) When the amount of funds available for allocation is less than the amount available in the previous year, each county's previous year allocation shall be reduced in proportion to the reduction in the statewide funding, for the purpose of establishing the guaranteed floor.
Subd. 9.
Portability pool.
(a) The commissioner shall establish a pool of up to five percent of the annual appropriation for the basic sliding fee program to provide continuous child care assistance for eligible families who move between Minnesota counties. At the end of each allocation period, any unspent funds in the portability pool must be used for assistance under the basic sliding fee program. If expenditures from the portability pool exceed the amount of money available, the reallocation pool must be reduced to cover these shortages.
(b) To be eligible for portable basic sliding fee assistance, a family that has moved from a county in which it was receiving basic sliding fee assistance to a county with a waiting list for the basic sliding fee program must:
(1) meet the income and eligibility guidelines for the basic sliding fee program; and
(2) notify the new county of residence within 60 days of moving and submit information to the new county of residence to verify eligibility for the basic sliding fee program.
(c) The receiving county must:
(1) accept administrative responsibility for applicants for portable basic sliding fee assistance at the end of the two months of assistance under the Unitary Residency Act;
(2) continue basic sliding fee assistance for the lesser of six months or until the family is able to receive assistance under the county's regular basic sliding program; and
(3) notify the commissioner through the quarterly reporting process of any family that meets the criteria of the portable basic sliding fee assistance pool.
Subd. 10.
Application; entry points.
Two or more methods of applying for the basic sliding fee program must be available to applicants in each county. To meet the requirements of this subdivision, a county may provide alternative methods of applying for assistance, including, but not limited to, a mail application, or application sites that are located outside of government offices.
119B.035 AT-HOME INFANT CHILD CARE PROGRAM.
Subdivision 1.
Establishment.
A family in which a parent provides care for the family's infant child may receive a subsidy in lieu of assistance if the family is eligible for or is receiving assistance under the basic sliding fee program. An eligible family must meet the eligibility factors under section 119B.09, except as provided in subdivision 4, and the requirements of this section. Subject to federal match and maintenance of effort requirements for the child care and development fund, and up to available appropriations, the commissioner shall provide assistance under the at-home infant child care program and for administrative costs associated with the program. At the end of a fiscal year, the commissioner may carry forward any unspent funds under this section to the next fiscal year within the same biennium for assistance under the basic sliding fee program.
Subd. 2.
Eligible families.
A family with an infant under the age of one year is eligible for assistance if:
(1) the family is not receiving MFIP, other cash assistance, or other child care assistance;
(2) the family has not previously received a lifelong total of 12 months of assistance under this section; and
(3) the family is participating in the basic sliding fee program or provides verification of participating in an authorized activity at the time of application and meets the program requirements.
Subd. 3.
Eligible parent.
A family is eligible for assistance under this section if one parent cares for the family's infant child. The eligible parent must:
(1) be over the age of 18;
(2) care for the infant full time in the infant's home; and
(3) care for any other children in the family who are eligible for child care assistance under this chapter.
For purposes of this section, "parent" means birth parent, adoptive parent, or stepparent.
Subd. 4.
Assistance.
(a) A family is limited to a lifetime total of 12 months of assistance under subdivision 2. The maximum rate of assistance is equal to 68 percent of the rate established under section 119B.13 for care of infants in licensed family child care in the applicant's county of residence.
(b) A participating family must report income and other family changes as specified in sections 256P.06 and 256P.07, and the county's plan under section 119B.08, subdivision 3.
(c) Persons who are admitted to the at-home infant child care program retain their position in any basic sliding fee program. Persons leaving the at-home infant child care program reenter the basic sliding fee program at the position they would have occupied.
(d) Assistance under this section does not establish an employer-employee relationship between any member of the assisted family and the county or state.
Subd. 5.
Implementation.
The commissioner shall implement the at-home infant child care program under this section through counties that administer the basic sliding fee program under section 119B.03. The commissioner must develop and distribute consumer information on the at-home infant child care program to assist parents of infants or expectant parents in making informed child care decisions.
119B.04 FEDERAL CHILD CARE AND DEVELOPMENT FUND.
Subdivision 1.
Commissioner to administer program.
The commissioner is authorized and directed to receive, administer, and expend funds available under the child care and development fund under Public Law 104-193, Title VI.
Subd. 2.
Rulemaking authority.
The commissioner may adopt rules under chapter 14 to administer the child care and development fund.
119B.05 MFIP CHILD CARE ASSISTANCE PROGRAM.
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;
(9) student parents as defined under section 119B.011, subdivision 19b; and
(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.
Subd. 4.
Contracts; other uses allowed.
Counties may contract for administration of the program or may arrange for or contract for child care funds to be used by other appropriate programs, in accordance with this section and as permitted by federal law and regulations.
Subd. 5.
Federal reimbursement.
Counties shall maximize their federal reimbursement under federal reimbursement programs for money spent for persons eligible under this chapter. The commissioner shall allocate any federal earnings to the county to be used to expand child care services under this chapter.
119B.06 FEDERAL CHILD CARE AND DEVELOPMENT BLOCK GRANT.
Subdivision 1.
Commissioner to administer block grant.
The commissioner is authorized and directed to receive, administer, and expend child care funds available under the child care and development block grant authorized under the Child Care and Development Block Grant Act of 2014, Public Law 113-186.
Subd. 2.
Rulemaking authority.
The commissioner may adopt rules under chapter 14 to administer the child care development block grant program.
Subd. 3.
Child care development fund plan development; review.
In an effort to improve state legislative involvement in the development of the Minnesota child care and development fund plan, the commissioner must present a draft copy of the plan to the legislative finance committees that oversee child care assistance funding no less than 30 days prior to the required deadline for submission of the plan to the federal government. The legislature must submit any adjustments to the plan to the commissioner for consideration within ten business days of receiving the draft plan. The commissioner must present a copy of the final plan to the chairs of the legislative finance committees that oversee child care assistance funding no less than four days prior to the deadline for submission of the plan to the federal government.
119B.08 REPORTING AND PAYMENTS.
Subdivision 1.
Reports.
The commissioner shall specify requirements for reports under the authority provided in section 256.01, subdivision 2, paragraph (p).
Subd. 2.
Monthly payments.
The commissioner shall make monthly payments on a reimbursement basis for expenditures reported outside of the electronic system used to administer child care assistance. Payments may be withheld if monthly reports are incomplete or untimely.
Subd. 3.
Child care fund plan.
The county and designated administering agency shall submit a biennial child care fund plan to the commissioner. The commissioner shall establish the dates by which the county must submit the plans. The plan shall include:
(1) a description of strategies to coordinate and maximize public and private community resources, including school districts, health care facilities, government agencies, neighborhood organizations, and other resources knowledgeable in early childhood development, in particular to coordinate child care assistance with existing community-based programs and service providers including child care resource and referral programs, early childhood family education, school readiness, Head Start, local interagency early intervention committees, special education services, early childhood screening, and other early childhood care and education services and programs to the extent possible, to foster collaboration among agencies and other community-based programs that provide flexible, family-focused services to families with young children and to facilitate transition into kindergarten. The county must describe a method by which to share information, responsibility, and accountability among service and program providers;
(2) a description of procedures and methods to be used to make copies of the proposed state plan reasonably available to the public, including members of the public particularly interested in child care policies such as parents, child care providers, culturally specific service organizations, child care resource and referral programs, interagency early intervention committees, potential collaborative partners and agencies involved in the provision of care and education to young children, and allowing sufficient time for public review and comment; and
(3) information as requested by the department to ensure compliance with the child care fund statutes and rules promulgated by the commissioner.
The commissioner shall notify counties within 90 days of the date the plan is submitted whether the plan is approved or the corrections or information needed to approve the plan. The commissioner shall withhold a county's allocation until it has an approved plan. Plans not approved by the end of the second quarter after the plan is due may result in a 25 percent reduction in allocation. Plans not approved by the end of the third quarter after the plan is due may result in a 100 percent reduction in the allocation to the county. Counties are to maintain services despite any reduction in their allocation due to plans not being approved.
119B.09 FINANCIAL ELIGIBILITY.
Subdivision 1.
General eligibility requirements.
(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, at application and redetermination, and 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 application and less than or equal to 67 percent of the state median income, adjusted for family size, at redetermination.
(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 at application and redetermination as 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.
(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.
Subd. 3.
Priorities; allocations.
If a county projects that its child care allocation is insufficient to meet the needs of all eligible families, it may prioritize among the families that remain to be served after the county has complied with the priority requirements of section 119B.03. Counties that have established a priority for families who are not MFIP participants beyond those established under section 119B.03 must submit the policy in the annual child care fund plan.
Subd. 4.
Eligibility; annual income; calculation.
(a) Annual income of the applicant family is the current monthly income of the family multiplied by 12 or the income for the 12-month period immediately preceding the date of application, or income calculated by the method which provides the most accurate assessment of income available to the family.
(b) Self-employment income must be calculated based on gross receipts less operating expenses.
(c) Income changes are processed under section 119B.025, subdivision 4. 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.
Subd. 4a.
Temporary ineligibility of military personnel.
Counties must reserve a family's position under the child care assistance fund if a family has been receiving child care assistance but is temporarily ineligible for assistance due to increased income from active military service. Activated military personnel may be temporarily ineligible until deactivation. A county must reserve a military family's position on the basic sliding fee waiting list under the child care assistance fund if a family is approved to receive child care assistance and reaches the top of the waiting list but is temporarily ineligible for assistance.
Subd. 5.
Provider choice.
Parents may choose child care providers as defined under section 119B.011, subdivision 19, that best meet the needs of their family. Counties shall make resources available to parents in choosing quality child care services. Counties may require a parent to sign a release stating their knowledge and responsibilities in choosing a legal provider described under section 119B.011, subdivision 19. When a county knows that a particular provider is unsafe, or that the circumstances of the child care arrangement chosen by the parent are unsafe, the county may deny a child care subsidy. A county may not restrict access to a general category of provider allowed under section 119B.011, subdivision 19.
Subd. 6.
Maximum child care assistance.
The maximum amount of child care assistance a local agency may pay for in a two-week period is 120 hours per child.
Subd. 7.
Date of eligibility for assistance.
(a) The date of eligibility for child care assistance under this chapter is the later of the date the application was received by the county; the beginning date of employment, education, or training; the date the infant is born for applicants to the at-home infant care program; or the date a determination has been made that the applicant is a participant in employment and training services under Minnesota Rules, part 3400.0080, or chapter 256J.
(b) Payment ceases for a family under the at-home infant child care program when a family has used a total of 12 months of assistance as specified under section 119B.035. Payment of child care assistance for employed persons on MFIP is effective the date of employment or the date of MFIP eligibility, whichever is later. Payment of child care assistance for MFIP or DWP participants in employment and training services is effective the date of commencement of the services or the date of MFIP or DWP eligibility, whichever is later. Payment of child care assistance for transition year child care must be made retroactive to the date of eligibility for transition year child care.
(c) Notwithstanding paragraph (b), payment of child care assistance for participants eligible under section 119B.05 may only be made retroactive for a maximum of six months from the date of application for child care assistance.
Subd. 8.
No employee-employer relationships.
Receipt of federal, state, or local funds by a child care provider either directly or through a parent who is a child care assistance recipient does not establish an employee-employer relationship between the child care provider and the county or state.
Subd. 9.
Licensed and legal nonlicensed family child care providers; assistance.
This subdivision applies to any provider providing care in a setting other than a child care center. Licensed and legal nonlicensed family child care providers and their employees are not eligible to receive child care assistance subsidies under this chapter for their own children or children in their family during the hours they are providing child care or being paid to provide child care. Child care providers and their employees are eligible to receive child care assistance subsidies for their children when they are engaged in other activities that meet the requirements of this chapter and for which child care assistance can be paid. The hours for which the provider or their employee receives a child care subsidy for their own children must not overlap with the hours the provider provides child care services.
Subd. 9a.
Child care centers; assistance.
(a) 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.
(b) Funds paid to providers during the period of time when a center is authorized for more than 25 children who are dependents of center employees must not be treated as overpayments under section 119B.11, subdivision 2a, due to noncompliance with this subdivision.
(c) 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.
Subd. 10.
Payment of funds.
All federal, state, and local child care funds must be paid directly to the parent when a provider cares for children in the children's own home. In all other cases, all federal, state, and local child care funds must be paid directly to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible family. Funds distributed under this chapter must not be used for child care services that are provided for a child by a child care provider who resides in the same household or occupies the same residence as the child.
Subd. 11.
Payment of other child care expenses.
Payment by a source other than the family, of part or all of a family's child care expenses not payable under this chapter, does not affect the family's eligibility for child care assistance, and the amount paid is excluded from the family's income, if the funds are paid directly to the family's child care provider on behalf of the family. Child care providers who accept third-party payments must maintain family-specific documentation of payment source, amount, type of expenses, and time period covered by the payment.
Subd. 12.
Sliding fee.
Child care services to families must be made available on a sliding fee basis. The commissioner shall convert eligibility requirements in this section and parent fee schedules in section 119B.12 to state median income, based on a family size of three, adjusted for family size, by July 1, 2008. The commissioner shall report to the 2008 legislature with the necessary statutory changes to codify this conversion to state median income.
Subd. 13.
Child care in the child's home.
(a) Child care assistance must only be authorized in the child's home if:
(1) the child's parents have authorized activities outside of the home; or
(2) one parent in a two-parent family is in an authorized activity outside of the home and one parent is unable to care for the child and meets the requirements in Minnesota Rules, part 3400.0040, subpart 5.
(b) In order for child care assistance to be authorized under paragraph (a), clause (1) or (2), one or more of the following circumstances must be met:
(1) the authorized activity occurs during times when out-of-home care is not available or when out-of-home care would result in disruption of the child's nighttime sleep schedule. If child care is needed during any period when out-of-home care is not available, in-home care can be approved for the entire time care is needed;
(2) the family lives in an area where out-of-home care is not available; or
(3) a child has a verified illness or disability that would place the child or other children in an out-of-home facility at risk or creates a hardship for the child and the family to take the child out of the home to a child care home or center.
119B.095 CHILD CARE AUTHORIZATIONS.
Subdivision 1.
General authorization requirements.
(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.
(b) Care must be authorized and scheduled with a provider based on the applicant's or participant's verified activity schedule when:
(1) the family requests care from more than one provider per child;
(2) the family requests care from a legal nonlicensed provider; or
(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.
(c) If the family remains eligible at redetermination, a new authorization with fewer hours, the same hours, or increased hours may be determined.
Subd. 2.
Maintain steady child care authorizations.
(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:
(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
(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.
(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.
(c) The county may reduce the amount of child care authorized if a parent requests a reduction or because of a change in:
(1) the child's school schedule;
(2) the custody schedule; or
(3) the provider's availability.
(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).
119B.097 AUTHORIZATION WITH A SECONDARY PROVIDER.
(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:
(1) an individual or child care center licensed under chapter 245A;
(2) an individual or child care center or facility holding a valid child care license issued by another state or tribe; or
(3) a child care center exempt from licensing under section 245A.03.
(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.
119B.10 EMPLOYMENT, EDUCATION, OR TRAINING ELIGIBILITY.
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) At application and redetermination, employed 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 child care assistance for employment. For purposes of this section, work-study programs must be counted as employment. An employed person with an MFIP or DWP employment plan shall receive child care assistance as specified in the person's employment plan. Child 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 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.
Subd. 2.
Financial eligibility required.
Persons participating in employment programs, training programs, or education programs are eligible for continued assistance from the child care fund, if they are financially eligible under the sliding fee scale set by the commissioner in section 119B.12.
Subd. 3.
Assistance for persons attending an approved education or training program.
(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.
(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, commissioner of education-selected high school equivalency, and English as a second language programs. A program exempt from this time limit must not run concurrently with a postsecondary program.
(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.
(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.
(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.
(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.
119B.105 EXTENDED ELIGIBILITY AND AUTHORIZATION.
Subdivision 1.
Three-month extended eligibility period.
(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.
(b) The family's three-month extended eligibility period applies when:
(1) a participant's employment or education program ends permanently;
(2) the other parent moves in and does not participate in an authorized activity;
(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;
(4) a student parent under section 119B.011, subdivision 19b, stops attending school; or
(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.
Subd. 2.
Extended eligibility and redetermination.
(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.
(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.
119B.11 COUNTY CONTRIBUTION.
Subdivision 1.
County contributions required.
(a) In addition to payments from basic sliding fee child care program participants, each county shall contribute from county tax or other sources a fixed local match equal to its calendar year 1996 required county contribution reduced by the administrative funding loss that would have occurred in state fiscal year 1996 under section 119B.15. The commissioner shall recover funds from the county as necessary to bring county expenditures into compliance with this subdivision. The commissioner may accept county contributions, including contributions above the fixed local match, in order to make state payments.
(b) The commissioner may accept payments from counties to:
(1) fulfill the county contribution as required under subdivision 1;
(2) pay for services authorized under this chapter beyond those paid for with federal or state funds or with the required county contributions; or
(3) pay for child care services in addition to those authorized under this chapter, as authorized under other federal, state, or local statutes or regulations.
(c) The county payments must be deposited in an account in the special revenue fund. Money in this account is appropriated to the commissioner for child care assistance under this chapter and other applicable statutes and regulations and is in addition to other state and federal appropriations.
Subd. 2a.
Recovery of overpayments.
(a) An amount of child care assistance paid to a recipient in excess of the payment due is recoverable by the county agency under paragraphs (b) and (c), even when the overpayment was caused by agency error or circumstances outside the responsibility and control of the family or provider.
(b) An overpayment must be recouped or recovered from the family if the overpayment benefited the family by causing the family to pay less for child care expenses than the family otherwise would have been required to pay under child care assistance program requirements. If the family remains eligible for child care assistance, the overpayment must be recovered through recoupment as identified in Minnesota Rules, part 3400.0187, except that the overpayments must be calculated and collected on a service period basis. If the family no longer remains eligible for child care assistance, the county may choose to initiate efforts to recover overpayments from the family for overpayment less than $50. If the overpayment is greater than or equal to $50, the county shall seek voluntary repayment of the overpayment from the family. If the county is unable to recoup the overpayment through voluntary repayment, the county shall initiate civil court proceedings to recover the overpayment unless the county's costs to recover the overpayment will exceed the amount of the overpayment. A family with an outstanding debt under this subdivision is not eligible for child care assistance until: (1) the debt is paid in full; or (2) satisfactory arrangements are made with the county to retire the debt consistent with the requirements of this chapter and Minnesota Rules, chapter 3400, and the family is in compliance with the arrangements.
(c) The county must recover an overpayment from a provider if the overpayment did not benefit the family by causing it to receive more child care assistance or to pay less for child care expenses than the family otherwise would have been eligible to receive or required to pay under child care assistance program requirements, and benefited the provider by causing the provider to receive more child care assistance than otherwise would have been paid on the family's behalf under child care assistance program requirements. If the provider continues to care for children receiving child care assistance, the overpayment must be recovered through reductions in child care assistance payments for services as described in an agreement with the county. The provider may not charge families using that provider more to cover the cost of recouping the overpayment. If the provider no longer cares for children receiving child care assistance, the county may choose to initiate efforts to recover overpayments of less than $50 from the provider. If the overpayment is greater than or equal to $50, the county shall seek voluntary repayment of the overpayment from the provider. If the county is unable to recoup the overpayment through voluntary repayment, the county shall initiate civil court proceedings to recover the overpayment unless the county's costs to recover the overpayment will exceed the amount of the overpayment. A provider with an outstanding debt under this subdivision is not eligible to care for children receiving child care assistance until:
(1) the debt is paid in full; or
(2) satisfactory arrangements are made with the county to retire the debt consistent with the requirements of this chapter and Minnesota Rules, chapter 3400, and the provider is in compliance with the arrangements.
(d) When both the family and the provider acted together to intentionally cause the overpayment, both the family and the provider are jointly liable for the overpayment regardless of who benefited from the overpayment. The county must recover the overpayment as provided in paragraphs (b) and (c). When the family or the provider is in compliance with a repayment agreement, the party in compliance is eligible to receive child care assistance or to care for children receiving child care assistance despite the other party's noncompliance with repayment arrangements.
Subd. 3.
Federal money; state recovery.
The commissioner shall recover from counties any state or federal money that was spent for persons found to be ineligible, except if the recovery is made by a county agency using any method other than recoupment, the county may keep 25 percent of the recovery. If a federal audit exception is taken based on a percentage of federal earnings, all counties shall pay a share proportional to their respective federal earnings during the period in question.
Subd. 4.
Maintenance of funding effort.
To receive money through this program, each county shall certify, in its annual plan to the commissioner, that the county has not reduced allocations from other federal and state sources, which, in the absence of the child care fund, would have been available for child care assistance. However, the county must continue contributions, as necessary, to maintain on the basic sliding fee program, families who are receiving assistance on July 1, 1995, until the family loses eligibility for the program or until a family voluntarily withdraws from the program. This subdivision does not affect the local match required for this program under other sections of the law.
119B.12 SLIDING FEE SCALE.
Subdivision 1.
Fee schedule.
All changes to parent fees must be implemented on the first Monday of the service period following the effective date of the change.
PARENT FEE SCHEDULE. The parent fee schedule is as follows, except as noted in subdivision 2:
| Income Range (as a percent of the state median income, except at the start of the first tier) | Co-payment (as a percentage of adjusted gross income) |
| 0-74.99% of federal poverty guidelines | $0/biweekly |
| 75.00-99.99% of federal poverty guidelines | $2/biweekly |
| 100.00% of federal poverty guidelines-27.72% | 2.61% |
| 27.73-29.04% | 2.61% |
| 29.05-30.36% | 2.61% |
| 30.37-31.68% | 2.61% |
| 31.69-33.00% | 2.91% |
| 33.01-34.32% | 2.91% |
| 34.33-35.65% | 2.91% |
| 35.66-36.96% | 2.91% |
| 36.97-38.29% | 3.21% |
| 38.30-39.61% | 3.21% |
| 39.62-40.93% | 3.21% |
| 40.94-42.25% | 3.84% |
| 42.26-43.57% | 3.84% |
| 43.58-44.89% | 4.46% |
| 44.90-46.21% | 4.76% |
| 46.22-47.53% | 5.05% |
| 47.54-48.85% | 5.65% |
| 48.86-50.17% | 5.95% |
| 50.18-51.49% | 6.24% |
| 51.50-52.81% | 6.84% |
| 52.82-54.13% | 7.58% |
| 54.14-55.45% | 8.33% |
| 55.46-56.77% | 9.20% |
| 56.78-58.09% | 10.07% |
| 58.10-59.41% | 10.94% |
| 59.42-60.73% | 11.55% |
| 60.74-62.06% | 12.16% |
| 62.07-63.38% | 12.77% |
| 63.39-64.70% | 13.38% |
| 64.71-67.00% | 14.00% |
| Greater than 67.00% | ineligible |
A family's biweekly co-payment fee is the fixed percentage established for the income range multiplied by the highest possible income within that income range.
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 percentage 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. 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. Payment 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.
119B.125 PROVIDER REQUIREMENTS.
Subdivision 1.
Authorization.
Except as provided in subdivision 5, a county or the commissioner must authorize the provider chosen by an applicant or a participant before the county can authorize payment for care provided by that provider. The commissioner must establish the requirements necessary for authorization of providers. A provider must be reauthorized every two years. A legal, nonlicensed family child care provider also must be reauthorized when another person over the age of 13 joins the household, a current household member turns 13, or there is reason to believe that a household member has a factor that prevents authorization. The provider is required to report all family changes that would require reauthorization. When a provider has been authorized for payment for providing care for families in more than one county, the county responsible for reauthorization of that provider is the county of the family with a current authorization for that provider and who has used the provider for the longest length of time.
Subd. 1a.
Background study required.
This subdivision only applies to legal, nonlicensed family child care providers. Prior to authorization, and as part of each reauthorization required in subdivision 1, the county shall perform a background study on every member of the provider's household who is age 13 and older. The county shall also perform a background study on an individual who has reached age ten but is not yet age 13 and is living in the household where the nonlicensed child care will be provided when the county has reasonable cause as defined under section 245C.02, subdivision 15.
Subd. 1b.
Training required.
(a) Effective November 1, 2011, prior to initial authorization as required in subdivision 1, a legal nonlicensed family child care provider must complete first aid and CPR training and provide the verification of first aid and CPR training to the county. The training documentation must have valid effective dates as of the date the registration request is submitted to the county. The training must have been provided by an individual approved to provide first aid and CPR instruction and have included CPR techniques for infants and children.
(b) Legal nonlicensed family child care providers with an authorization effective before November 1, 2011, must be notified of the requirements before October 1, 2011, or at authorization, and must meet the requirements upon renewal of an authorization that occurs on or after January 1, 2012.
(c) Upon each reauthorization after the authorization period when the initial first aid and CPR training requirements are met, a legal nonlicensed family child care provider must provide verification of at least eight hours of additional training listed in the Minnesota Center for Professional Development Registry.
(d) This subdivision only applies to legal nonlicensed family child care providers.
Subd. 2.
Persons who cannot be authorized.
(a) The provider seeking authorization under this section shall collect the information required under section 245C.05, subdivision 1, and forward the information to the county agency. The background study must include a review of the information required under section 245C.08, subdivisions 2, 3, and 4, paragraph (b). A nonlicensed family child care provider is not authorized under this section if any household member who is the subject of a background study is determined to have a disqualifying characteristic under paragraphs (b) to (e) or under section 245C.14 or 245C.15. If a county has determined that a provider is able to be authorized in that county, and a family in another county later selects that provider, the provider is able to be authorized in the second county without undergoing a new background investigation unless one of the following conditions exists:
(1) two years have passed since the first authorization;
(2) another person age 13 or older has joined the provider's household since the last authorization;
(3) a current household member has turned 13 since the last authorization; or
(4) there is reason to believe that a household member has a factor that prevents authorization.
(b) The person has refused to give written consent for disclosure of criminal history records.
(c) The person has been denied a family child care license or has received a fine or a sanction as a licensed child care provider that has not been reversed on appeal.
(d) The person has a family child care licensing disqualification that has not been set aside.
(e) The person has admitted or a county has found that there is a preponderance of evidence that fraudulent information was given to the county for child care assistance application purposes or was used in submitting child care assistance bills for payment.
Subd. 3.
Authorization exception.
When a county denies a person authorization as a legal nonlicensed family child care provider under subdivision 2, the county later may authorize that person as a provider if the following conditions are met:
(1) after receiving notice of the denial of the authorization, the person applies for and obtains a valid child care license issued under chapter 245A, issued by a tribe, or issued by another state;
(2) the person maintains the valid child care license; and
(3) the person is providing child care in the state of licensure or in the area under the jurisdiction of the licensing tribe.
Subd. 4.
Unsafe care.
A county may deny authorization as a child care provider to any applicant or rescind authorization of any provider when the county knows or has reason to believe that the provider is unsafe or that the circumstances of the chosen child care arrangement are unsafe. The county must include the conditions under which a provider or care arrangement will be determined to be unsafe in the county's child care fund plan under section 119B.08, subdivision 3.
Subd. 5.
Provisional payment.
After a county receives a completed application from a provider, the county may issue provisional authorization and payment to the provider during the time needed to determine whether to give final authorization to the provider.
Subd. 6.
Record-keeping requirement.
All providers receiving child care assistance payments must keep daily attendance records at the site where services are delivered for children receiving child care assistance and must make those records available immediately to the county or the commissioner upon request. The attendance records must be completed daily and include the date, the first and last name of each child in attendance, and the times when each child is dropped off and picked up. To the extent possible, the times that the child was dropped off to and picked up from the child care provider must be entered by the person dropping off or picking up the child. The daily attendance records must be retained at the site where services are delivered for six years after the date of service. A county or the commissioner may deny authorization as a child care provider to any applicant, rescind authorization of any provider, or establish an overpayment claim in the system against a current or former provider, when the county or the commissioner knows or has reason to believe that the provider has not complied with the record-keeping requirement in this subdivision. A provider's failure to produce attendance records as requested on more than one occasion constitutes grounds for disqualification as a provider.
Subd. 7.
Failure to comply with attendance record requirements.
(a) In establishing an overpayment claim for failure to provide attendance records in compliance with subdivision 6, the county or commissioner is limited to the six years prior to the date the county or the commissioner requested the attendance records.
(b) The commissioner may periodically audit child care providers to determine compliance with subdivision 6.
(c) When the commissioner or county establishes an overpayment claim against a current or former provider, the commissioner or county must provide notice of the claim to the provider. A notice of overpayment claim must specify the reason for the overpayment, the authority for making the overpayment claim, the time period in which the overpayment occurred, the amount of the overpayment, and the provider's right to appeal.
(d) The commissioner or county shall seek to recoup or recover overpayments paid to a current or former provider.
(e) When a provider has been disqualified or convicted of fraud under section 256.98, theft under section 609.52, or a federal crime relating to theft of state funds or fraudulent billing for a program administered by the commissioner or a county, recoupment or recovery must be sought regardless of the amount of overpayment.
Subd. 8.
Overpayment claim for failure to comply with access to records requirement.
(a) In establishing an overpayment claim under subdivision 6 for failure to provide access to attendance records, the county or commissioner is limited to the six years prior to the date the county or the commissioner requested the attendance records.
(b) When the commissioner or county establishes an overpayment claim against a current or former provider, the commissioner or county must provide notice of the claim to the provider. A notice of overpayment claim must specify the reason for the overpayment, the authority for making the overpayment claim, the time period in which the overpayment occurred, the amount of the overpayment, and the provider's right to appeal.
(c) The commissioner or county may seek to recover overpayments paid to a current or former provider. When a provider has been convicted of fraud under section 256.98, theft under section 609.52, or a federal crime relating to theft of state funds or fraudulent billing for a program administered by the commissioner or a county, recovery may be sought regardless of the amount of overpayment.
Subd. 9.
Reporting required for child's part-time attendance.
A provider must report to the county and report on the billing form as required when a child's attendance in child care falls to less than half of the child's authorized hours or days for a four-week period. If requested by the county or the commissioner, the provider must provide additional information to the county or commissioner on the attendance of specific children.
119B.13 CHILD CARE RATES.
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. 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. 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.
(d) If a child uses one provider, the maximum payment for one day of care must not exceed the daily rate. The maximum payment for one week of care must not exceed the weekly rate.
(e) If a child uses two providers under section 119B.097, the maximum payment must not exceed:
(1) the daily rate for one day of care;
(2) the weekly rate for one week of care by the child's primary provider; and
(3) two daily rates during two weeks of care by a child's secondary provider.
(f) 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.
(g) If 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.
(h) All maximum provider rates changes shall be implemented on the Monday following the effective date of the maximum provider rate.
(i) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum registration fees in effect on January 1, 2013, shall remain in effect.
Subd. 1a.
Legal nonlicensed family child care provider rates.
(a) Legal nonlicensed family child care providers receiving reimbursement under this chapter must be paid on an hourly basis for care provided to families receiving assistance.
(b) The maximum rate paid to legal nonlicensed family child care providers must be 68 percent of the county maximum hourly rate for licensed family child care providers. In counties or county price clusters where the maximum hourly rate for licensed family child care providers is higher than the maximum weekly rate for those providers divided by 50, the maximum hourly rate that may be paid to legal nonlicensed family child care providers is the rate equal to the maximum weekly rate for licensed family child care providers divided by 50 and then multiplied by 0.68. The maximum payment to a provider for one day of care must not exceed the maximum hourly rate times ten. The maximum payment to a provider for one week of care must not exceed the maximum hourly rate times 50.
(c) A rate which includes a special needs rate paid under subdivision 3 may be in excess of the maximum rate allowed under this subdivision.
(d) Legal nonlicensed family child care providers receiving reimbursement under this chapter may not be paid registration fees for families receiving assistance.
Subd. 3.
Provider rate for care of children with disabilities or special needs.
Counties shall reimburse providers for the care of children with disabilities or special needs, at a special rate to be approved by the county for care of these children, subject to the approval of the commissioner.
Subd. 3a.
Provider rate differential for accreditation.
A family child care provider or child care center shall be paid a 15 percent differential above the maximum rate established in subdivision 1, up to the actual provider rate, if the provider or center holds a current early childhood development credential or is accredited. For a family child care provider, early childhood development credential and accreditation includes an individual who has earned a child development associate degree, a child development associate credential, a diploma in child development from a Minnesota state technical college, or a bachelor's or post baccalaureate degree in early childhood education from an accredited college or university, or who is accredited by the National Association for Family Child Care or the Competency Based Training and Assessment Program. For a child care center, accreditation includes accreditation that meets the following criteria: the accrediting organization must demonstrate the use of standards that promote the physical, social, emotional, and cognitive development of children. The accreditation standards shall include, but are not limited to, positive interactions between adults and children, age-appropriate learning activities, a system of tracking children's learning, use of assessment to meet children's needs, specific qualifications for staff, a learning environment that supports developmentally appropriate experiences for children, health and safety requirements, and family engagement strategies. Based on an application process developed by the commissioner in conjunction with the commissioners of education and health, the Department of Human Services must accept applications from accrediting organizations beginning on July 1, 2013, and on an annual basis thereafter. The provider rate differential shall be paid to centers holding an accreditation from an approved accrediting organization beginning on a billing cycle to be determined by the commissioner, no later than the last Monday in February of a calendar year. The commissioner shall annually publish a list of approved accrediting organizations. An approved accreditation must be reassessed by the commissioner every two years. If an approved accrediting organization is determined to no longer meet the approval criteria, the organization and centers being paid the differential under that accreditation must be given a 90-day notice by the commissioner and the differential payment must end after a 15-day notice to affected families and centers as directed in Minnesota Rules, part 3400.0185, subparts 3 and 4. The following accreditations shall be recognized for the provider rate differential until an approval process is implemented: the National Association for the Education of Young Children, the Council on Accreditation, the National Early Childhood Program Accreditation, the National School-Age Care Association, or the National Head Start Association Program of Excellence. For Montessori programs, accreditation includes the American Montessori Society, Association of Montessori International-USA, or the National Center for Montessori Education.
Subd. 3b.
Provider rate differential for Parent Aware.
A family child care provider or child care center shall be paid a 15 percent differential if they hold a three-star Parent Aware rating or a 20 percent differential if they hold a four-star Parent Aware rating. A 15 percent or 20 percent rate differential must be paid above the maximum rate established in subdivision 1, up to the actual provider rate.
Subd. 3c.
Weekly rate paid for children attending high-quality care.
A licensed child care provider or license-exempt center may be paid up to the applicable weekly maximum rate, not to exceed the provider's actual charge, when the following conditions are met:
(1) the child is age birth to five years, but not yet in kindergarten;
(2) the child attends a child care provider that qualifies for the rate differential identified in subdivision 3a or 3b; and
(3) the applicant's activities qualify for at least 30 hours of care per week under sections 119B.03, 119B.05, and 119B.10, and Minnesota Rules, chapter 3400.
Subd. 4.
Rates charged to publicly subsidized families.
Child care providers receiving reimbursement under this chapter may not charge a rate to clients receiving assistance under this chapter that is higher than the private, full-paying client rate.
Subd. 5.
Provider notice.
The county shall inform both the family receiving assistance under this chapter and the child care provider of the payment amount and how and when payment will be received. If the county sends a family a notice that child care assistance will be terminated, the county shall inform the provider that unless the family requests to continue to receive assistance pending an appeal, child care payments will no longer be made. The notice to the provider must not contain any private data on the family or information on why payment will no longer be made.
Subd. 6.
Provider payments.
(a) The provider shall bill for services provided within ten days of the end of the service period. Payments under the child care fund shall be made within 21 days of receiving a complete bill from the provider. Counties or the state may establish policies that make payments on a more frequent basis.
(b) If a provider has received an authorization of care and been issued a billing form for an eligible family, the bill must be submitted within 60 days of the last date of service on the bill. A bill submitted more than 60 days after the last date of service must be paid if the county determines that the provider has shown good cause why the bill was not submitted within 60 days. Good cause must be defined in the county's child care fund plan under section 119B.08, subdivision 3, and the definition of good cause must include county error. Any bill submitted more than a year after the last date of service on the bill must not be paid.
(c) If a provider provided care for a time period without receiving an authorization of care and a billing form for an eligible family, payment of child care assistance may only be made retroactively for a maximum of six months from the date the provider is issued an authorization of care and billing form.
(d) A county 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.
Subd. 7.
Absent days.
(a) Licensed child care providers and license-exempt centers must not be reimbursed for more than 25 full-day absent days per child, excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal nonlicensed family child care providers must not be reimbursed for absent days. If a child attends for part of the time authorized to be in care in a day, but is absent for part of the time authorized to be in care in that same day, the absent time must be reimbursed but the time must not count toward the absent days limit. Child care providers must only be reimbursed for absent days if the provider has a written policy for child absences and charges all other families in care for similar absences.
(b) Notwithstanding paragraph (a), children with documented medical conditions that cause more frequent absences may exceed the 25 absent days limit, or ten consecutive full-day absent days limit. Absences due to a documented medical condition of a parent or sibling who lives in the same residence as the child receiving child care assistance do not count against the absent days limit in a fiscal year. Documentation of medical conditions must be on the forms and submitted according to the timelines established by the commissioner. A public health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a provider sends a child home early due to a medical reason, including, but not limited to, fever or contagious illness, the child care center director or lead teacher may verify the illness in lieu of a medical practitioner.
(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or commissioner of education-selected high school equivalency certification; and (3) is a student in a school district or another similar program that provides or arranges for child care, parenting support, social services, career and employment supports, and academic support to achieve high school graduation, upon request of the program and approval of the county. If a child attends part of an authorized day, payment to the provider must be for the full amount of care authorized for that day.
(d) Child care providers must be reimbursed for up to ten federal or state holidays or designated holidays per year when the provider charges all families for these days and the holiday or designated holiday falls on a day when the child is authorized to be in attendance. Parents may substitute other cultural or religious holidays for the ten recognized state and federal holidays. Holidays do not count toward the absent days limit.
(e) A family or child care provider must not be assessed an overpayment for an absent day payment unless (1) there was an error in the amount of care authorized for the family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) the family or provider did not timely report a change as required under law.
(f) The provider and family shall receive notification of the number of absent days used upon initial provider authorization for a family and ongoing notification of the number of absent days used as of the date of the notification.
(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days per child, excluding holidays, in a fiscal year; and ten consecutive full-day absent days.
119B.14 EXTENSION OF EMPLOYMENT OPPORTUNITIES.
The county board shall ensure that child care services available to eligible residents are well advertised and that everyone who receives or applies for MFIP assistance is informed of training and employment opportunities and programs, including child care assistance and child care resource and referral services.
119B.15 ADMINISTRATIVE EXPENSES.
The commissioner shall use up to 1/21 of the state and federal funds available for the basic sliding fee program and 1/21 of the state and federal funds available for the MFIP child care program for payments to counties for administrative expenses. The commissioner shall make monthly payments to each county based on direct service expenditures. Payments may be withheld if monthly reports are incomplete or untimely.
119B.16 FAIR HEARING PROCESS.
Subdivision 1.
Fair hearing allowed.
An applicant or recipient adversely affected by a county agency action may request a fair hearing in accordance with section 256.045.
Subd. 1a.
Fair hearing allowed for providers.
(a) This subdivision applies to providers caring for children receiving child care assistance.
(b) A provider to whom a county agency has assigned responsibility for an overpayment may request a fair hearing in accordance with section 256.045 for the limited purpose of challenging the assignment of responsibility for the overpayment and the amount of the overpayment. The scope of the fair hearing does not include the issues of whether the provider wrongfully obtained public assistance in violation of section 256.98 or was properly disqualified under section 256.98, subdivision 8, paragraph (c), unless the fair hearing has been combined with an administrative disqualification hearing brought against the provider under section 256.046.
Subd. 1b.
Joint fair hearings.
When a provider requests a fair hearing under subdivision 1a, the family in whose case the overpayment was created must be made a party to the fair hearing. All other issues raised by the family must be resolved in the same proceeding. When a family requests a fair hearing and claims that the county should have assigned responsibility for an overpayment to a provider, the provider must be made a party to the fair hearing. The human services judge assigned to a fair hearing may join a family or a provider as a party to the fair hearing whenever joinder of that party is necessary to fully and fairly resolve overpayment issues raised in the appeal.
Subd. 2.
Informal conference.
The county agency shall offer an informal conference to applicants and recipients adversely affected by an agency action to attempt to resolve the dispute. The county agency shall offer an informal conference to providers to whom the county agency has assigned responsibility for an overpayment in an attempt to resolve the dispute. The county agency or the provider may ask the family in whose case the overpayment arose to participate in the informal conference, but the family may refuse to do so. The county agency shall advise adversely affected applicants, recipients, and providers that a request for a conference with the agency is optional and does not delay or replace the right to a fair hearing.
144.1464 SUMMER HEALTH CARE INTERNS.
Subdivision 1.
Summer internships.
The commissioner of health, through a contract with a nonprofit organization as required by subdivision 4, shall award grants, within available appropriations, to hospitals, clinics, nursing facilities, and home care providers to establish a secondary and postsecondary summer health care intern program. The purpose of the program is to expose interested secondary and postsecondary pupils to various careers within the health care profession.
Subd. 2.
Criteria.
(a) The commissioner, through the organization under contract, shall award grants to hospitals, clinics, nursing facilities, and home care providers that agree to:
(1) provide secondary and postsecondary summer health care interns with formal exposure to the health care profession;
(2) provide an orientation for the secondary and postsecondary summer health care interns;
(3) pay one-half the costs of employing the secondary and postsecondary summer health care intern;
(4) interview and hire secondary and postsecondary pupils for a minimum of six weeks and a maximum of 12 weeks; and
(5) employ at least one secondary student for each postsecondary student employed, to the extent that there are sufficient qualifying secondary student applicants.
(b) In order to be eligible to be hired as a secondary summer health intern by a hospital, clinic, nursing facility, or home care provider, a pupil must:
(1) intend to complete high school graduation requirements and be between the junior and senior year of high school; and
(2) be from a school district in proximity to the facility.
(c) In order to be eligible to be hired as a postsecondary summer health care intern by a hospital or clinic, a pupil must:
(1) intend to complete a health care training program or a two-year or four-year degree program and be planning on enrolling in or be enrolled in that training program or degree program; and
(2) be enrolled in a Minnesota educational institution or be a resident of the state of Minnesota; priority must be given to applicants from a school district or an educational institution in proximity to the facility.
(d) Hospitals, clinics, nursing facilities, and home care providers awarded grants may employ pupils as secondary and postsecondary summer health care interns beginning on or after June 15, 1993, if they agree to pay the intern, during the period before disbursement of state grant money, with money designated as the facility's 50 percent contribution towards internship costs.
Subd. 3.
Grants.
The commissioner, through the organization under contract, shall award separate grants to hospitals, clinics, nursing facilities, and home care providers meeting the requirements of subdivision 2. The grants must be used to pay one-half of the costs of employing secondary and postsecondary pupils in a hospital, clinic, nursing facility, or home care setting during the course of the program. No more than 50 percent of the participants may be postsecondary students, unless the program does not receive enough qualified secondary applicants per fiscal year. No more than five pupils may be selected from any secondary or postsecondary institution to participate in the program and no more than one-half of the number of pupils selected may be from the seven-county metropolitan area.
Subd. 4.
Contract.
The commissioner shall contract with a statewide, nonprofit organization representing facilities at which secondary and postsecondary summer health care interns will serve, to administer the grant program established by this section. Grant funds that are not used in one fiscal year may be carried over to the next fiscal year. The organization awarded the grant shall provide the commissioner with any information needed by the commissioner to evaluate the program, in the form and at the times specified by the commissioner.
144.1911 INTERNATIONAL MEDICAL GRADUATES ASSISTANCE PROGRAM.
Subdivision 1.
Establishment.
The international medical graduates assistance program is established to address barriers to practice and facilitate pathways to assist immigrant international medical graduates to integrate into the Minnesota health care delivery system, with the goal of increasing access to primary care in rural and underserved areas of the state.
Subd. 2.
Definitions.
(a) For the purposes of this section, the following terms have the meanings given.
(b) "Commissioner" means the commissioner of health.
(c) "Immigrant international medical graduate" means an international medical graduate who was born outside the United States, now resides permanently in the United States, and who did not enter the United States on a J1 or similar nonimmigrant visa following acceptance into a United States medical residency or fellowship program.
(d) "International medical graduate" means a physician who received a basic medical degree or qualification from a medical school located outside the United States and Canada.
(e) "Minnesota immigrant international medical graduate" means an immigrant international medical graduate who has lived in Minnesota for at least two years.
(f) "Rural community" means a statutory and home rule charter city or township that is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
(g) "Underserved community" means a Minnesota area or population included in the list of designated primary medical care health professional shortage areas, medically underserved areas, or medically underserved populations (MUPs) maintained and updated by the United States Department of Health and Human Services.
Subd. 3.
Program administration.
In administering the international medical graduates assistance program, the commissioner shall:
(1) provide overall coordination for the planning, development, and implementation of a comprehensive system for integrating qualified immigrant international medical graduates into the Minnesota health care delivery system, particularly those willing to serve in rural or underserved communities of the state;
(2) develop and maintain, in partnership with community organizations working with international medical graduates, a voluntary roster of immigrant international medical graduates interested in entering the Minnesota health workforce to assist in planning and program administration, including making available summary reports that show the aggregate number and distribution, by geography and specialty, of immigrant international medical graduates in Minnesota;
(3) work with graduate clinical medical training programs to address barriers faced by immigrant international medical graduates in securing residency positions in Minnesota, including the requirement that applicants for residency positions be recent graduates of medical school. The annual report required in subdivision 10 shall include any progress in addressing these barriers;
(4) develop a system to assess and certify the clinical readiness of eligible immigrant international medical graduates to serve in a residency program. The system shall include assessment methods, an operating plan, and a budget. Initially, the commissioner may develop assessments for clinical readiness for practice of one or more primary care specialties, and shall add additional assessments as resources are available. The commissioner may contract with an independent entity or another state agency to conduct the assessments. In order to be assessed for clinical readiness for residency, an eligible international medical graduate must have obtained a certification from the Educational Commission of Foreign Medical Graduates. The commissioner shall issue a Minnesota certificate of clinical readiness for residency to those who pass the assessment;
(5) explore and facilitate more streamlined pathways for immigrant international medical graduates to serve in nonphysician professions in the Minnesota workforce; and
(6) study, in consultation with the Board of Medical Practice and other stakeholders, changes necessary in health professional licensure and regulation to ensure full utilization of immigrant international medical graduates in the Minnesota health care delivery system. The commissioner shall include recommendations in the annual report required under subdivision 10, due January 15, 2017.
Subd. 4.
Career guidance and support services.
(a) The commissioner shall award grants to eligible nonprofit organizations to provide career guidance and support services to immigrant international medical graduates seeking to enter the Minnesota health workforce. Eligible grant activities include the following:
(1) educational and career navigation, including information on training and licensing requirements for physician and nonphysician health care professions, and guidance in determining which pathway is best suited for an individual international medical graduate based on the graduate's skills, experience, resources, and interests;
(2) support in becoming proficient in medical English;
(3) support in becoming proficient in the use of information technology, including computer skills and use of electronic health record technology;
(4) support for increasing knowledge of and familiarity with the United States health care system;
(5) support for other foundational skills identified by the commissioner;
(6) support for immigrant international medical graduates in becoming certified by the Educational Commission on Foreign Medical Graduates, including help with preparation for required licensing examinations and financial assistance for fees; and
(7) assistance to international medical graduates in registering with the program's Minnesota international medical graduate roster.
(b) The commissioner shall award the initial grants under this subdivision by December 31, 2015.
Subd. 5.
Clinical preparation.
(a) The commissioner shall award grants to support clinical preparation for Minnesota international medical graduates needing additional clinical preparation or experience to qualify for residency. The grant program shall include:
(1) proposed training curricula;
(2) associated policies and procedures for clinical training sites, which must be part of existing clinical medical education programs in Minnesota; and
(3) monthly stipends for international medical graduate participants. Priority shall be given to primary care sites in rural or underserved areas of the state, and international medical graduate participants must commit to serving at least five years in a rural or underserved community of the state.
(b) The policies and procedures for the clinical preparation grants must be developed by December 31, 2015, including an implementation schedule that begins awarding grants to clinical preparation programs beginning in June of 2016.
Subd. 6.
International medical graduate primary care residency grant program and revolving account.
(a) The commissioner shall award grants to support primary care residency positions designated for Minnesota immigrant physicians who are willing to serve in rural or underserved areas of the state. No grant shall exceed $150,000 per residency position per year. Eligible primary care residency grant recipients include accredited family medicine, internal medicine, obstetrics and gynecology, psychiatry, and pediatric residency programs. Eligible primary care residency programs shall apply to the commissioner. Applications must include the number of anticipated residents to be funded using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded to grantees in a grant agreement do not lapse until the grant agreement expires. Before any funds are distributed, a grant recipient shall provide the commissioner with the following:
(1) a copy of the signed contract between the primary care residency program and the participating international medical graduate;
(2) certification that the participating international medical graduate has lived in Minnesota for at least two years and is certified by the Educational Commission on Foreign Medical Graduates. Residency programs may also require that participating international medical graduates hold a Minnesota certificate of clinical readiness for residency, once the certificates become available; and
(3) verification that the participating international medical graduate has executed a participant agreement pursuant to paragraph (b).
(b) Upon acceptance by a participating residency program, international medical graduates shall enter into an agreement with the commissioner to provide primary care for at least five years in a rural or underserved area of Minnesota after graduating from the residency program and make payments to the revolving international medical graduate residency account for five years beginning in their second year of postresidency employment. Participants shall pay $15,000 or ten percent of their annual compensation each year, whichever is less.
(c) A revolving international medical graduate residency account is established as an account in the special revenue fund in the state treasury. The commissioner of management and budget shall credit to the account appropriations, payments, and transfers to the account. Earnings, such as interest, dividends, and any other earnings arising from fund assets, must be credited to the account. Funds in the account are appropriated annually to the commissioner to award grants and administer the grant program established in paragraph (a). Notwithstanding any law to the contrary, any funds deposited in the account do not expire. The commissioner may accept contributions to the account from private sector entities subject to the following provisions:
(1) the contributing entity may not specify the recipient or recipients of any grant issued under this subdivision;
(2) the commissioner shall make public the identity of any private contributor to the account, as well as the amount of the contribution provided; and
(3) a contributing entity may not specify that the recipient or recipients of any funds use specific products or services, nor may the contributing entity imply that a contribution is an endorsement of any specific product or service.
Subd. 7.
Voluntary hospital programs.
A hospital may establish residency programs for foreign-trained physicians to become candidates for licensure to practice medicine in the state of Minnesota. A hospital may partner with organizations, such as the New Americans Alliance for Development, to screen for and identify foreign-trained physicians eligible for a hospital's particular residency program.
Subd. 8.
Board of Medical Practice.
Nothing in this section alters the authority of the Board of Medical Practice to regulate the practice of medicine.
Subd. 9.
Consultation with stakeholders.
The commissioner shall administer the international medical graduates assistance program, including the grant programs described under subdivisions 4, 5, and 6, in consultation with representatives of the following sectors:
(1) state agencies:
(i) Board of Medical Practice;
(ii) Office of Higher Education; and
(iii) Department of Employment and Economic Development;
(2) health care industry:
(i) a health care employer in a rural or underserved area of Minnesota;
(ii) a health plan company;
(iii) the Minnesota Medical Association;
(iv) licensed physicians experienced in working with international medical graduates; and
(v) the Minnesota Academy of Physician Assistants;
(3) community-based organizations:
(i) organizations serving immigrant and refugee communities of Minnesota;
(ii) organizations serving the international medical graduate community, such as the New Americans Alliance for Development and Women's Initiative for Self Empowerment; and
(iii) the Minnesota Association of Community Health Centers;
(4) higher education:
(i) University of Minnesota;
(ii) Mayo Clinic School of Health Professions;
(iii) graduate medical education programs not located at the University of Minnesota or Mayo Clinic School of Health Professions; and
(iv) Minnesota physician assistant education programs; and
(5) two international medical graduates.
Subd. 10.
Report.
The commissioner shall submit an annual report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care and higher education on the progress of the integration of international medical graduates into the Minnesota health care delivery system. The report shall include recommendations on actions needed for continued progress integrating international medical graduates. The report shall be submitted by January 15 each year, beginning January 15, 2016.
245G.11 STAFF QUALIFICATIONS.
Subdivision 1.
General qualifications.
(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).
(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.
(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.
Subd. 4.
Alcohol and drug counselor supervisors.
An alcohol and drug counselor supervisor must:
(1) meet the qualification requirements in subdivision 5;
(2) have three or more years of experience providing individual and group counseling to individuals with substance use disorder; and
(3) know and understand the implications of this chapter and sections 245A.65, 626.556, 626.557, and 626.5572.
Subd. 7.
Care coordination provider qualifications.
(a) Care coordination must be provided by qualified staff. An individual is qualified to provide care coordination if the individual:
(1) is skilled in the process of identifying and assessing a wide range of client needs;
(2) is knowledgeable about local community resources and how to use those resources for the benefit of the client;
(3) has successfully completed 30 hours of classroom instruction on care coordination for an individual with substance use disorder;
(4) has either:
(i) a bachelor's degree in one of the behavioral sciences or related fields; or
(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest Indian Council on Addictive Disorders; and
(5) has at least 2,000 hours of supervised experience working with individuals with substance use disorder.
(b) A care coordinator must receive at least one hour of supervision regarding individual service delivery from an alcohol and drug counselor weekly.
246.18 DISPOSAL OF FUNDS.
Subd. 8.
State-operated services account.
(a) The state-operated services account is established in the special revenue fund. Revenue generated by new state-operated services listed under this section established after July 1, 2010, that are not enterprise activities must be deposited into the state-operated services account, unless otherwise specified in law:
(1) intensive residential treatment services;
(2) foster care services; and
(3) psychiatric extensive recovery treatment services.
(b) Funds deposited in the state-operated services account are appropriated to the commissioner of human services for the purposes of:
(1) providing services needed to transition individuals from institutional settings within state-operated services to the community when those services have no other adequate funding source; and
(2) funding the operation of the intensive residential treatment service program in Willmar.
Subd. 9.
Transfers.
The commissioner may transfer state mental health grant funds to the account in subdivision 8 for noncovered allowable costs of a provider certified and licensed under section 256B.0622 and operating under section 246.014.
254B.03 RESPONSIBILITY TO PROVIDE CHEMICAL DEPENDENCY TREATMENT.
Subd. 4a.
Division of costs for medical assistance services.
Notwithstanding subdivision 4, for chemical dependency services provided on or after October 1, 2008, and reimbursed by medical assistance, the county share is 30 percent of the nonfederal share.
256B.0625 COVERED SERVICES.
Subd. 31c.
Preferred incontinence product program.
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.
256B.0705 PERSONAL CARE ASSISTANCE SERVICES; MANDATED SERVICE VERIFICATION.
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have the meanings given them.
(b) "Personal care assistance services" or "PCA services" means services provided according to section 256B.0659.
(c) "Personal care assistant" or "PCA" has the meaning given in section 256B.0659, subdivision 1.
(d) "Service verification" means a random, unscheduled telephone call made for the purpose of verifying that the individual personal care assistant is present at the location where personal care assistance services are being provided and is providing services as scheduled.
Subd. 2.
Verification schedule.
An agency that submits claims for reimbursement for PCA services under this chapter must develop and implement administrative policies and procedures by which the agency verifies the services provided by a PCA. For each service recipient, the agency must conduct at least one service verification every 90 days. If more than one PCA provides services to a single service recipient, the agency must conduct a service verification for each PCA providing services before conducting a service verification for a PCA whose services were previously verified by the agency. Service verification must occur on an ongoing basis while the agency provides PCA services to the recipient. During service verification, the agency must speak with both the PCA and the service recipient or recipient's authorized representative. Only qualified professional service verifications are eligible for reimbursement. An agency may substitute a visit by a qualified professional that is eligible for reimbursement under section 256B.0659, subdivision 14 or 19.
Subd. 3.
Documentation of verification.
An agency must fully document service verifications in a legible manner and must maintain the documentation on site for at least five years from the date of documentation. For each service verification, documentation must include:
(1) the names and signatures of the service recipient or recipient's authorized representative, the PCA and any other agency staff present with the PCA during the service verification, and the staff person conducting the service verification; and
(2) the start and end time, day, month, and year of the service verification, and the corresponding PCA time sheet.
Subd. 4.
Variance.
The Office of Inspector General at the Department of Human Services may grant a variance to the service verification requirements in this section if an agency uses an electronic monitoring system or other methods that verify a PCA is present at the location where services are provided and is providing services according to the prescribed schedule. A decision to grant or deny a variance request is final and not subject to appeal under chapter 14.
256I.05 MONTHLY RATES.
Subd. 3.
Limits on rates.
When a room and board rate is used to pay for an individual's room and board, the rate payable to the residence must not exceed the rate paid by an individual not receiving a room and board rate under this chapter.
256R.53 FACILITY SPECIFIC EXEMPTIONS.
Subd. 2.
Nursing facility in Breckenridge.
The operating payment rate of a nonprofit nursing facility that exists on January 1, 2015, is located within the boundaries of the city of Breckenridge, and is reimbursed under this chapter, is equal to the greater of:
(1) the operating payment rate determined under section 256R.21, subdivision 3; or
(2) the median case mix adjusted rates, including comparable rate components as determined by the median case mix adjusted rates, including comparable rate components as determined by the commissioner, for the equivalent case mix indices of the nonprofit nursing facility or facilities located in an adjacent city in another state and in cities contiguous to the adjacent city. The Minnesota facility's operating payment rate with a case mix index of 1.0 is computed by dividing the adjacent city's nursing facility or facilities' median operating payment rate with an index of 1.02 by 1.02.
Repealed Minnesota Session Laws: S2452-2
Laws 2017, First Special Session chapter 6, article 7, section 34
Sec. 34. new text begin MINNESOTA 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
Repealed Minnesota Rule: S2452-2
3400.0010 PURPOSE AND APPLICABILITY.
Subpart 1.
Purpose.
The purpose of this chapter is to govern the administration of the child care fund, to reduce, according to a sliding fee schedule, the costs of child care services for eligible families to enable them to seek or retain employment or to participate in education or training programs to obtain employment, and to provide eligible families with the financial resources to find and afford quality child care for their children. This chapter sets eligibility standards for recipients and administrative requirements for agencies administering child care funds.
3400.0020 DEFINITIONS.
Subpart 1.
Scope.
As used in parts 3400.0010 to 3400.0230, the terms defined in Minnesota Statutes, section 119B.011, have the meanings given them in that section, and the following terms have the meanings given them in this part.
Subp. 4.
Administering agency.
"Administering agency" means a county social services agency or a public or nonprofit agency designated by the county board to administer the child care fund.
Subp. 5.
Administrative expenses.
"Administrative expenses" means costs associated with the direct services administration of the child care fund. Administrative expenses include:
A.
salaries, wages, and related payroll expenses incurred in the administration of the child care fund including direct personnel costs, expenses for general administration and supervision, and expenses for secretarial, clerical, accounting, and other support services;
Subp. 8.
Allocation.
"Allocation" means the share of the total state appropriation of child care funds that a county may earn and be reimbursed for in an allocation period. A county's allocation may be raised or lowered during the allocation period when the commissioner redistributes unexpended or unencumbered allocations or when additional funds become available.
Subp. 9a.
At-risk.
"At-risk" means environmental or familial factors that create barriers to a child's optimal achievement. Factors include, but are not limited to, a federal or state disaster, limited English proficiency in a family, a history of abuse or neglect, a determination that the children are at risk of abuse or neglect, family violence, homelessness, age of the mother, level of maternal education, mental illness, developmental disability, or parental chemical dependency or history of other substance abuse.
Subp. 10a.
Authorized hours.
"Authorized hours" means the number of hours in a service period, not to exceed the maximum hour limit established in Minnesota Statutes, section 119B.09, subdivision 6, that may be paid for child care for a child.
Subp. 12.
Child care assistance.
"Child care assistance" means financial assistance for child care that is funded under Minnesota Statutes, sections 119B.011 to 119B.16.
Subp. 17a.
Disability.
"Disability" means a functional limitation or health condition that interferes with a child's ability to walk, talk, see, hear, breathe, or learn.
Subp. 18.
Documentation.
"Documentation" means a written statement or record, including an electronic record, that substantiates or validates an assertion made by a person or an action taken by an administering agency.
Subp. 18a.
DWP.
"DWP" means the diversionary work program established in Minnesota Statutes, section 256J.95.
Subp. 20.
Eligible relative caregiver.
"Eligible relative caregiver" means a person identified under Minnesota Statutes, section 256J.08, subdivision 11, (1) who is a caregiver of a child receiving a MFIP grant or (2) who is an MFIP participant and the caregiver of a child. After an eligible relative caregiver begins receiving child care assistance, status as an eligible relative caregiver continues through all child care assistance programs until there is a break in the eligible relative caregiver's eligibility for child care assistance.
Subp. 24.
Family copayment fee.
"Family copayment fee" means the parent fee the family must contribute as its share of child care costs as determined under Minnesota Statutes, section 119B.12.
Subp. 25.
Full calendar month.
"Full calendar month" from the first day of a month to the last day of that month.
Subp. 26.
Full-day basis.
"Full-day basis" means child care provided by a provider for more than five hours per day.
Subp. 28.
Household status.
"Household status" means the number of individuals residing in the household and the relationship of the individuals to one another.
Subp. 29a.
Immunization record.
"Immunization record" means the statement described in Minnesota Statutes, section 121A.15, subdivision 1, 3, paragraph (c) or (d), or 4.
Subp. 31b.
Legal guardian.
"Legal guardian" means a person who has been appointed or accepted as a guardian according to Minnesota Statutes, section 260C.325, 524.5-201, 524.5-202, or 524.5-204 under tribal law.
Subp. 32b.
Minimum wage.
"Minimum wage" means the minimum wage applicable under Minnesota Statutes, chapter 177, to the applicant or participant or the premises where the applicant or participant is employed.
Subp. 33.
Overpayment.
"Overpayment" means the portion of a child care payment that is greater than the amount for which a recipient is eligible or greater than the amount a provider should have received.
Subp. 34a.
Participant.
"Participant" means a family receiving child care assistance under the child care fund.
Subp. 37.
Redetermination.
"Redetermination" means the process by which information is collected periodically by the county and used to determine whether a recipient is eligible for continued assistance under the child care fund.
Subp. 38.
Registration.
"Registration" means the process used by the county to obtain from a legal nonlicensed provider the information required under part 3400.0120, subpart 2.
Subp. 38a.
Residence.
"Residence" means the primary place where the family lives as identified by the applicant or participant.
Subp. 38b.
Scheduled hours.
"Scheduled hours" means the specific days and hours during a service period that a child will attend child care as determined by the child care worker, the parent, and the provider based on the parents' verified eligible activities schedules, the child's school schedule, and any other factors relevant to the family's child care needs.
Subp. 39.
State median income.
"State median income" means the state's annual median income for a family of three, adjusted for family size, developed by the Bureau of Census and published annually by the United States Department of Health and Human Services in the Federal Register.
Subp. 40.
Student.
"Student" means an individual enrolled in an educational program as defined in Minnesota Statutes, section 119B.011, subdivision 11. A non-MFIP student is a full-time student if the student is defined by the student's educational institution as a full-time student. A non-MFIP student is a part-time student if the student is defined by the student's educational institution as a part-time student. A MFIP student is a student who is in compliance with the education or training requirements in the student's employment plan.
Subp. 40a.
Temporarily absent.
"Temporarily absent" means a family member is living away from the family's residence but intends to return to the residence.
Subp. 44.
Weekly basis.
"Weekly basis" means child care provided by a provider for more than 35 but not more than 50 hours per week.
3400.0030 NOTICE OF BASIC SLIDING FEE PROGRAM ALLOCATION.
By July 1 of each year, the commissioner shall notify all county and human services boards of their allocation under the basic sliding fee program, including the amount available for payment of administrative expenses.
3400.0035 APPLICATION PROCEDURE.
Subpart 1.
Response to informational requests.
When a family asks for information about child care assistance, the administering agency must give the family information supplied by the department regarding the availability of federal and state child and dependent care tax credits; federal earned income tax credits; Minnesota working family credits; early childhood family education, school readiness, and Head Start programs; early childhood screening; MinnesotaCare; child care resource and referral services; other programs with services for young children and families; and the postsecondary child care grant program established in Minnesota Statutes, section 136A.125. The administering agency also must inform the family of the following items:
C.
whether a waiting list exists and, if so, the number of families on the waiting list or the estimated time that the applicant will spend on the waiting list before reaching the top of the list;
I.
the family's responsibility for paying provider charges that exceed county maximum payments in addition to the family copayment fee; and
J.
the importance of prompt reporting of a move to another county to avoid overpayments and to increase the likelihood of continuing benefits, because child care assistance benefits may be affected by moving to another county.
Subp. 2.
Application procedure.
An administering agency must follow the application procedures in items A and B.
A.
If a family requests child care assistance and it appears that the family is eligible for child care assistance and funds are available, or if a family requests an application, the administering agency must mail or hand the family a universal child care assistance application.
B.
If a family requests child care assistance and funds are not available, the administering agency must inform the family of a waiting list, screen the family for potential eligibility, and place the family on the waiting list if they appear eligible. The administering agency must place the family on the waiting list in the highest priority for which the family is eligible. As child care funds become available, the administering agency must inform the family at the head of the waiting list and ask the family to complete an application.
C.
The administering agency must accept signed and dated applications that are submitted by mail or delivered to the agency within 15 calendar days after the date of signature. A county may accept an application from an applicant who does not reside in that county but immediately must forward the application to the county where the applicant resides. The administering agency must mail a notice of approval or denial of assistance to the applicant within 30 calendar days after receiving the application. With the consent of the applicant, the administering agency may extend the response time by 15 calendar days.
Subp. 3.
Informational release.
When it appears that an applicant may be eligible for child care assistance but is unable to document eligibility for the program, the administering agency must offer an applicant the opportunity to sign an informational release to permit the county to verify whether an applicant qualifies for child care assistance. The administering agency must also offer an applicant an opportunity to sign an informational release to permit the county to give the family's child care provider the information listed in subpart 6 and in part 3400.0185, subparts 2 and 4, that is not required by Minnesota Statutes, section 119B.13, subdivision 5. The administering agency must give the applicant the information required by Minnesota Statutes, section 13.04, subdivision 2.
Subp. 4.
Notice of denial.
If the administering agency denies the application, the administering agency must document the reason or reasons for denying the application. The administering agency must provide written notice to the applicant of: the reason for denial; the provision in statute, rule, or county child care fund plan that is the basis for the denial; and the applicant's right to a fair hearing under part 3400.0230 and Minnesota Statutes, section 119B.16.
Subp. 5.
Notice of approval.
If the administering agency approves the application, the administering agency must send the applicant a notice of approval of the application. The notice of approval must specify the information in items A to I:
B.
the hours of care authorized, the maximum rate that may be paid, and how payments will be made;
D.
any change in income, residence, family size, family status, or employment, education, or training status must be reported within ten calendar days from the date the change occurs;
E.
except in cases where the license of a provider licensed by the state of Minnesota has been temporarily immediately suspended or where there is an imminent risk of harm to the health, safety, or rights of a child in care with a legal nonlicensed provider, license exempt center, or a provider licensed by an entity other than the state of Minnesota, any change in provider must be reported to the county and the provider at least 15 calendar days before the change occurs;
F.
the overpayment implications for the family if the changes described in items D and E are not reported as required;
G.
when child care assistance is terminated, the participant will be informed of the reason for the termination and the participant's appeal rights and the provider will be informed that, unless the family asks to continue to receive assistance pending an appeal, child care payments will no longer be made;
H.
the importance of prompt reporting of a move to another county to avoid overpayments and increase the likelihood of continuing benefits, because child care assistance benefits may be affected by moving to another county; and
I.
the family's responsibility for paying provider charges that exceed county maximum payments in addition to the family copayment fee.
Subp. 6.
Notice to provider.
If the administering agency approves an application, the administering agency must send the family's authorized provider a notice containing only the following information: the family's name; the fact that the family's request for child care assistance has been approved; the hours of care authorized; the maximum rate that may be paid by the child care assistance program; the number of absent days that have been paid for the child for the year as of the date of the notice; and how payments will be made.
Subp. 7.
Selection of provider.
An applicant must select a provider before payments can be made from the child care fund.
Subp. 8.
Selection of legal nonlicensed provider.
An applicant who selects a legal nonlicensed provider must be informed about the following information and must sign an acknowledgment that contains:
C.
an acknowledgment that the parent and the legal nonlicensed provider have reviewed the health and safety information provided by the county; and
D.
if the parent has selected a legal nonlicensed family child care provider, an assurance that the parent will provide an immunization record for each child to the legal nonlicensed family child care provider within 90 days of the date that care for the child begins and will give the legal nonlicensed family child care provider the information necessary to update the immunization record.
Subp. 9.
Selection of in-home provider.
An applicant who selects a provider who will provide child care in the applicant's home must be informed that this choice of care may create an employer/employee relationship between the parent and the provider and must be referred to resources available for more information about these legal rights and responsibilities.
3400.0040 ELIGIBILITY REQUIREMENTS AND STANDARDS.
Subpart 1.
Applicant requirements and standards.
All applicants for child care assistance and all child care assistance program participants must meet the standards and requirements in this part in addition to the eligibility requirements in part 3400.0060, 3400.0080, or 3400.0090 for the child care program for which the person is applying or in which the person is participating.
Subp. 3.
Documentation of eligibility information.
A.
An applicant for child care assistance must document the:
(1)
citizenship status or participation in a program that makes a child exempt from this documentation requirement for all children for whom child care assistance is being sought;
B.
The county must ask for the applicant's Social Security number, but the applicant is not required to disclose this information. Before asking for the applicant's social security number, the county must tell the applicant that:
(2)
the number is being solicited under the Code of Federal Regulations, title 45, section 98.71(a)(13); and
(3)
the social security number will be used by county, state, and federal governments and their employees for the purposes of verification, reporting, research, and any other purpose authorized by law.
Subp. 4.
Participant reporting responsibilities.
A participant must meet the reporting requirements in items A and B. A participant may report a change in person, by telephone, by facsimile, or by mail, including electronic mail.
A.
When there is a change in the information reported by the participant at application or at the most recent redetermination of eligibility, the participant must report the new information to the county within ten calendar days after the change occurs. This reporting requirement applies to changes in income, residence, employment status, education or training status, family status, or family size. A change in income occurs on the day the participant receives the first payment reflecting the change in income.
B.
Except in cases where the license of a provider licensed by the state of Minnesota has been temporarily immediately suspended or where there is an imminent risk of harm to the health, safety, or rights of a child in care with a legal, nonlicensed provider, license exempt center, or provider licensed by an entity other than the state of Minnesota, a participant must notify the county and the provider of the intent to change providers at least 15 calendar days before changing providers.
Subp. 5.
Employment, education, and training requirements.
In a family with a single parent, or unmarried legal guardian or eligible relative caregiver, the applicant or participant must meet employment, education, or training requirements and other eligibility requirements in this part and in part 3400.0060, 3400.0080, or 3400.0090 for the child care assistance program for which the family is applying or in which the family is participating.
In a family with more than one parent or any combination of parents, stepparents, legal guardians and spouses, and eligible relative caregivers and spouses, at least one parent, legal guardian, eligible relative caregiver, or spouse must meet employment, education, or training requirements and other eligibility requirements in this part and in part 3400.0060, 3400.0080, or 3400.0090 for the child care assistance program for which the family is applying or participating in. The other parents, legal guardians, eligible relative caregivers, or spouses must:
A.
meet employment, education, or training requirements and other eligibility requirements in this part and part 3400.0060, 3400.0080, or 3400.0090 for the child care assistance program for which the family is applying or participating in; or
B.
be unable to care for the applicant's child or dependent as determined by a licensed physician, licensed psychologist, or the local social services agency.
Subp. 5a.
Child support cooperation.
All applicants and participants of the child care assistance program must cooperate with establishment of paternity and enforcement of child support obligations for all minor children in the family with an absent parent. For purposes of this part, a family has met the cooperation requirement when the family complies with Minnesota Statutes, section 256.741, or there is a finding under Minnesota Statutes, section 256.741, subdivision 10, of good cause for failing to cooperate. The child care portion of the child support order for children receiving child care assistance must be assigned to the public authority as provided in Minnesota Statutes, section 256.741.
Subp. 6a.
Ineligibility for failure to pay fees under the child care fund.
A family that fails to pay the required family copayment fee under the child care fund is ineligible for child care assistance until the fees are paid or until the family reaches an agreement for payment with the provider and the county and then continues to comply with the payment agreement. When the county pays the parent, a family that fails to pay the provider the amount of the child care assistance payment is ineligible for child care assistance until the payment is made or until the family reaches an agreement for payment with the provider and the county and then continues to comply with the payment agreement.
Subp. 6b.
Ineligibility for failure to pay overpayments.
A family with an outstanding overpayment is ineligible for child care assistance until the overpayment is paid in full or until the family arranges to repay the overpayment according to part 3400.0187 and then continues to comply with the repayment agreement.
Subp. 6c.
Date of eligibility for assistance.
The date of eligibility for child care assistance under parts 3400.0060 and 3400.0080 must be determined according to Minnesota Statutes, section 119B.09, subdivision 7. The date of eligibility for child care assistance under part 3400.0090 is the date the family's MFIP or DWP case was closed.
Subp. 7.
Maximum biweekly child care assistance.
A family may not receive more than 120 hours of child care assistance per child every two weeks.
Subp. 8.
Child care assistance during employment.
A.
In addition to meeting other eligibility requirements, employed persons eligible for child care assistance under part 3400.0060, 3400.0080, or 3400.0090 must work at least an average of 20 hours per week and receive at least the minimum wage for all hours worked. Employed persons eligible for child care assistance under part 3400.0080 are exempt from this requirement if they have an approved employment plan that allows fewer work hours or a lower wage.
B.
The county and the participant may determine a length of time, not to exceed six months, over which the number of hours worked weekly can be averaged and counted toward the participant's meeting the average of 20 hours per week requirement. If the number of hours worked during the designated time period actually averages less than 20 hours per week, any child care assistance funds paid by the county on the participant's behalf during the designated time period are subject to recoupment or recovery.
C.
When a participant does not work by the hour and is not paid an hourly wage, the participant's earned income over a given period must be divided by the minimum wage to determine whether the participant has met the requirement to average at least 20 hours of work per week at minimum wage.
D.
Child care assistance during employment shall be authorized for the number of hours scheduled to be worked, including break and meal time during the employment, and up to two hours per day for travel time.
Subp. 9.
Child care assistance in support of employment.
A county must authorize child care assistance in support of employment for nonwork hours when the following conditions exist:
B.
the child care assistance does not exceed the amount of assistance that would be granted under subpart 8, item D, during employment.
Subp. 10.
Child care assistance during education or training.
Counties shall provide child care assistance to students eligible under part 3400.0060 or 3400.0080 and enrolled in county-approved education or training programs or employment plans according to items A to C.
A.
Counties must authorize child care for full-time students for the days of class and on nonclass days, if needed for study, as determined by the county, not to exceed the maximum biweekly child care allowed.
B.
Counties must authorize child care for part-time students as needed for:
(4)
two hours per week per credit hour for postsecondary students for study and academic appointments.
When a part-time student has more than one hour between classes on any one day, the study and academic appointment time authorized under subitem (4) shall be reduced by the number of hours between classes.
C.
Child care assistance for remedial classes is subject to county approval under subpart 12. Upon county approval of the remedial class or classes, the county shall authorize child care assistance necessary to enable the student to attend class and to complete class assignments.
Subp. 11.
Child care assistance during employment and education or training.
Employed students, including students on work study programs, are eligible for child care assistance during employment and education or training. Counties shall use the standards in subparts 8 and 10 to determine the amount of child care assistance. When full-time students request child care for employment, the employment hours must average at least ten hours per week at minimum wage. For purposes of determining whether the ten hours at minimum wage requirement in this subpart applies to a student, a full-time student retains full-time status during school breaks, including summers, if the student is expected to return to school full time after the break. Students eligible for child care assistance under part 3400.0080 are exempt from the ten hours per week at minimum wage requirement if they have an approved employment plan that allows fewer work hours or a lower wage. For purposes of determining whether the ten hours at minimum wage requirement in this subpart has been met, work-study hours and income must be counted as employment.
Subp. 12.
Acceptable course of study.
An acceptable course of study for a student eligible under part 3400.0060 is an education or training program approved by the county that will reasonably lead to full-time employment opportunities as determined by the county. An acceptable course of study for a student eligible under part 3400.0080 is an approved education or training program described in the MFIP participant's employment plan.
Subp. 13.
Satisfactory progress in education or training program.
Subject to the limitation in subpart 14, a county shall provide child care assistance to students with an approved education or training program for the length of the education or training program if the student is making satisfactory progress in the education or training program. Satisfactory progress in the education or training program means a student remains in good academic standing in the education or training program as determined by the educational institution and meets the requirements of the student's education plan under part 3400.0060 or employment plan under part 3400.0080. If the county determines that a student is not making satisfactory progress towards completion of an education or training program, the county shall notify the student and discontinue child care assistance according to part 3400.0185.
Subp. 14.
Maximum education or training under child care fund.
The maximum length of time a student is eligible for child care assistance under the child care fund for education or training is described in items A to D.
A.
A student eligible under part 3400.0060 is eligible for child care assistance according to Minnesota Statutes, section 119B.07.
B.
A student eligible under part 3400.0080 is eligible for child care assistance for the length of time necessary to complete activities authorized in the student's employment plan according to the standards in Minnesota Statutes, chapter 256J.
C.
A student eligible under part 3400.0060 who has completed or who has participated in but failed to complete an education or training program under the child care fund may receive child care assistance for a second education or training program if:
D.
A student eligible under part 3400.0060 with a baccalaureate degree may only obtain child care assistance for education or training if the education or training is for continuing education units, certification, or coursework that is related to the baccalaureate degree or current employment and that is necessary to update credentials to obtain or retain employment.
Subp. 15.
Changes in education or training programs.
A proposed change in an education or training program is subject to county approval before the change may be made. A county may not deny a request for a change in an education or training program when the student requesting the change can show that changing a course or focus of study is necessary for reasons related to the health and safety of the student.
Subp. 15a.
Child care assistance during job search.
A.
A county shall provide up to 240 hours per calendar year of child care assistance for job search activities to participants:
C.
At the option of the individual in job search and with prior county approval, child care may be used at a rate that is less than full time provided the total child care assistance does not exceed 240 hours of child care per calendar year.
D.
Job search includes locating and contacting potential employers, preparing for interviews, interviewing, and up to two hours of travel time per day.
Subp. 17.
Temporary ineligibility.
Counties must reserve a family's position under the child care assistance fund if a family has been receiving child care assistance but is temporarily ineligible for assistance. A county may reserve a family's position under the child care assistance fund if a family is approved to receive child care assistance and reaches the top of the waiting list but is temporarily ineligible for assistance. In its child care fund plan, a county must specify whether it reserves positions under the child care assistance fund for temporarily ineligible families who reach the top of the waiting list and, if so, the criteria used to make the decision whether to reserve a position. Employed participants may be temporarily ineligible for a maximum of 90 days. Child care assistance participants who are students may be temporarily ineligible for a maximum of one academic quarter or semester as determined by the educational institution.
Subp. 18.
Suspension.
Counties must suspend, and may not terminate, a family's child care assistance for up to one continuous year if there are temporary breaks when child care assistance is not needed or the family does not have an authorized provider but the family remains eligible for child care assistance.
3400.0060 BASIC SLIDING FEE PROGRAM.
Subp. 2.
Basic sliding fee allocation.
The commissioner shall allocate child care funds for the basic sliding fee program as provided in Minnesota Statutes, section 119B.03, subdivisions 6 to 9.
Subp. 4.
Reallocation of unexpended or unencumbered funds.
The commissioner shall reallocate unexpended or unencumbered funds according to items A to D.
A.
The commissioner may reallocate unexpended or unencumbered funds following the first, second, and third quarters of the allocation period as provided in Minnesota Statutes, section 119B.03, subdivision 5. Following the fourth quarter of the allocation period, the commissioner shall review county expenditures under the basic sliding fee program and shall reallocate unearned allocations to counties that had direct service earnings in excess of their allocation.
B.
The amount reallocated to any county shall be based on direct service earnings in excess of its allocation. The amount reallocated shall not be greater than the direct service earnings in excess of allocation minus the county's fixed local match to be calculated as specified in Minnesota Statutes, section 119B.11, subdivision 1.
C.
If the amount of funds available for reallocation is less than total county direct service earnings in excess of allocations, the reallocated funds shall be prorated to each county based on the ratio of the county's direct service earnings in excess of its allocation to the total of all county direct service earnings in excess of their allocation.
D.
If the amount of funds available for reallocation is greater than total county direct service earnings in excess of allocations under the basic sliding fee program, the funds remaining after the basic sliding fee reallocation shall be carried forward and added to the funds available for allocation in the next allocation period.
Subp. 5.
Families eligible for assistance under the basic sliding fee program.
To the extent of available allocations, a family is eligible for child care assistance under the basic sliding fee program if:
Subp. 6.
Basic sliding fee program waiting lists.
Counties must keep a written record of families who have requested child care assistance. When a family requests information about child care assistance, the county shall perform a preliminary determination of eligibility. If it appears that a family is or will be eligible for child care assistance and funds are not immediately available, the family shall be placed on a child care waiting list. The county must determine the highest priority group for which a family qualifies and must notify the family of this determination.
Families who inquire or apply while they are temporarily ineligible shall be placed on the waiting list if it appears they will be eligible for child care assistance. When a family advances to the top of the county's waiting list and is temporarily ineligible for child care assistance, the county shall leave the family at the top of the list according to priority group and serve the applicant who is next on the waiting list unless a different procedure is provided in the county's child care fund plan.
Subp. 6a.
Transfer of families from waiting list to basic sliding fee program.
Families on the basic sliding fee waiting list shall be moved into the basic sliding fee program as funding permits according to the priorities listed in Minnesota Statutes, section 119B.03. After the county has complied with the priority requirement in section 119B.03, the county must comply with any priority requirements adopted under part 3400.0140, subpart 10, to move families on the waiting list into the basic sliding fee program.
Subp. 7.
Waiting list; transfer of transition year families to the basic sliding fee program.
A.
The county shall place transition year families on the county's basic sliding fee program waiting list effective on the date the family became eligible for transition year child care assistance.
B.
If a transition year family moves to a new county, the date the family was placed on the basic sliding fee waiting list in the original county shall transfer with the family.
C.
Families who are eligible for, but do not use, transition year child care assistance retain their priority status for the basic sliding fee program. Families lose their priority status at the conclusion of their transition year.
D.
The county shall manage its basic sliding fee allocation in a way that allows families to move from transition year to the basic sliding fee program without any interruption in services. The county shall not serve families who are a lower priority on the basic sliding fee waiting list than a transition year family unless the county can ensure basic sliding fee program funding for the transition year family at the end of the transition year.
E.
When the transition year ends, the county shall move the transition year family into the basic sliding fee program. A transition year family that does not come to the top of the county's basic sliding fee program waiting list before completion of the transition year shall be moved into the basic sliding fee program as funding becomes available according to the priority under Minnesota Statutes, section 119B.03, subdivision 4. Transition year extension child care may be used to support employment or a job search that meets the requirements of Minnesota Statutes, section 119B.10, for the time necessary for the family to be moved from the basic sliding fee waiting list into the basic sliding fee program.
Subp. 8.
Application for child care assistance.
A family must apply for child care assistance in the family's county of residence.
Subp. 9.
County child care responsibility when family moves.
A.
When a family receiving child care assistance from the basic sliding fee program moves to a new county within Minnesota, the original county must continue to provide child care assistance for two full calendar months after the move if the family needs child care and remains eligible for the basic sliding fee program. The family is responsible for notifying the new county of residence within 60 days of moving and applying for basic sliding fee assistance in the new county. The limitation in Minnesota Statutes, section 119B.09, subdivision 1, paragraph (a), clause (2), regarding the family's household income at program entry does not apply when a family receiving assistance moves to another county and timely applies under this item to continue receiving assistance in the new county.
B.
If there is a waiting list for the basic sliding fee program in the receiving county when it assumes responsibility for the family, the receiving county must fund child care assistance for the family through the portability pool. Portability pool funding must continue for the lesser of six months or until the family is able to receive assistance under the receiving county's basic sliding fee program. The family must also be added to the basic sliding fee program waiting list according to portability pool priority group in the receiving county effective the date of the move. If the family reaches the top of the waiting list and funds become available before the six months have ended, the receiving county must immediately add the family to its basic sliding fee program. If basic sliding fee funds are not available when the six months has ended, services to the family must be terminated. The family must stay on the waiting list effective the date of the move. If funds become available after the family's child care assistance has been terminated due to the end of the portability pool period, the family must be treated as a new applicant and must have a household income that meets the income requirements in Minnesota Statutes, section 119B.09, subdivision 1, for program entry.
C.
If there is no waiting list for the basic sliding fee program and funds are available, the receiving county must immediately move the family into its basic sliding fee program when it assumes responsibility for the family according to Minnesota Statutes, section 256G.07.
D.
If the participant had an approved educational plan in the original county, the plan transfers with the participant. The plan remains in effect during the two months that the original county continues to pay for the family's child care assistance and during any time the family's child care assistance is paid through the portability pool. When the receiving county pays the family's basic sliding fee assistance from its own allocation, the receiving county may reject, approve, or modify the family's educational plan based on the receiving county's criteria for approving educational plans.
Subp. 10.
Continued eligibility under basic sliding fee program.
A county may not refuse continued child care assistance to a family receiving assistance under the basic sliding fee program when there is a change in the family's financial or household status provided that the family continues to meet the eligibility requirements in this part and the general eligibility requirements in part 3400.0040. Except for the job search time limit under Minnesota Statutes, section 119B.10, subdivision 1, paragraph (a), the education time limit in Minnesota Statutes, section 119B.07; and the time limit for the at-home infant care program in Minnesota Statutes, section 119B.035, subdivision 4, counties may not set a time limit for eligibility under the basic sliding fee program.
3400.0080 MFIP CHILD CARE PROGRAM.
Subpart 1.
Eligibility for MFIP child care program.
Persons listed in Minnesota Statutes, section 119B.05, subdivision 1, are eligible for the MFIP child care assistance program.
Subp. 1a.
Eligibility of sanctioned MFIP participant.
A MFIP participant eligible for child care assistance who has been sanctioned under the MFIP program may receive child care assistance:
A.
for that portion of the participant's job search support or employment plan which the participant is complying with according to Minnesota Statutes, chapter 256J; or
Subp. 1b.
Child care assistance for approved job search.
A MFIP participant who has an approved job search support plan or whose employment plan includes job search as an authorized activity is not limited to 240 hours of job search child care assistance in a calendar year.
Subp. 8.
County responsibility when a family moves to another county.
When a MFIP or DWP participant moves to a new county and the new county accepts responsibility for the participant's approved job search support or employment plan under Minnesota Statutes, section 256J.55, subdivision 3, the new county is responsible for providing child care assistance to the MFIP or DWP participant effective on the date that the county accepted responsibility for the plan. In all other cases, child care assistance must be provided according to Minnesota Statutes, section 256G.07, when a MFIP or DWP participant moves to a new county.
3400.0090 TRANSITION YEAR CHILD CARE.
Subpart 1.
Notice to family of eligibility.
The administering agency must notify a family, in writing, at the time the family's MFIP or DWP case closes of the family's potential eligibility for transition year child care. The notification must include information on how to establish eligibility for transition year child care and on the family's rights and responsibilities under the transition year child care program.
Subp. 2.
Eligibility.
Transition year child care assistance may only be used to support employment and job search related expenses. A family is eligible for transition year child care if the conditions in items A to D are met.
B.
At least one caregiver in the family received MFIP or DWP in at least three of the six months immediately preceding the month in which the family's MFIP or DWP case was closed.
C.
The family meets the income eligibility requirements specified in Minnesota Statutes, section 119B.09, subdivision 1.
D.
Transition year child care may be paid for the care of a child who would have been eligible to receive a MFIP grant, or for children who would have been eligible for MFIP, except for the child's receipt of SSI or Title IV-E foster care benefits.
Eligibility for transition year child care begins the first month after the family's MFIP or DWP case has closed and continues for 12 consecutive months. A family's temporary ineligibility for, suspension of, or failure to use child care assistance during the transition year does not suspend the transition year period. A former MFIP or DWP participant may apply for transition year child care any time during the transition year and, notwithstanding the application date, shall receive retroactive transition year child care assistance according to Minnesota Statutes, section 119B.09, subdivision 7. If a family was receiving child care assistance when the family's MFIP or DWP case closed, determination of eligibility for transition year child care assistance must be treated as a redetermination rather than a new application.
Subp. 3.
Loss of transition year child care eligibility.
A family in which all caregivers have been disqualified from receiving MFIP or DWP due to fraud is not eligible for transition year child care assistance.
Subp. 4.
Reestablishment of MFIP or DWP eligibility during transition year period.
If a transition year family reopens its MFIP or DWP case during the transition year period and subsequently meets the conditions in subpart 2, the family qualifies for a new 12-month transition year period. If the family received MFIP or DWP for only one or two of the previous six months, but meets the requirements in subpart 2, items A, C, and D, the family is eligible for the remaining months of the transition year, treating the month or months on MFIP or DWP as a suspension of the child care benefit but not the transition year period. To receive child care assistance while receiving MFIP or DWP, the family must meet the MFIP child care requirements under part 3400.0080.
3400.0100 FAMILY COPAYMENT FEE SCHEDULE.
Subp. 2a.
Copayment fees to be prorated during start-up service period.
Counties must prorate all copayment fees during the service period when the family first receives service based on the number of calendar days remaining in the service period.
Subp. 2b.
Payment of provider charges that exceed the maximum provider rate.
If the provider's charge for child care is greater than the maximum provider rate allowed under part 3400.0130, the family shall pay, in addition to any family copayment fee, the difference between the maximum provider rate and the provider charge.
Subp. 2c.
Payment of registration and activity fees that exceed the maximum rates.
In addition to the family copayment fee, a family must pay any registration fees that exceed the standards established in part 3400.0130, subpart 7, any optional activity fees, and any activity fees that exceed the standards established in part 3400.0130, subpart 8.
Subp. 5.
Publication of fee schedule in State Register.
The department shall publish annually in the State Register the state median income for a family of three, adjusted for family size, and a fee schedule. This information must be published after the date the state median income is published in the Federal Register by the United States Department of Health and Human Services. The department shall also distribute a copy of the fee schedule and the updated estimate of state median income to each county. The updated fee schedule shall take effect on July 1 or on the first day of the first full quarter following publication of the state median income in the State Register if publication occurs after July 1.
3400.0110 CHILD CARE ASSISTANCE PAYMENTS.
Subpart 1.
Payment options.
Counties must monitor child care payments to ensure that the funds are used for child care.
Subp. 1a.
Date payments must begin.
After approval of an application for child care assistance, payment of child care assistance must be authorized to begin as of the family's date of eligibility as determined under part 3400.0040, subpart 6c.
Subp. 2.
Authorization before payment of legal nonlicensed providers.
After a legal nonlicensed provider is authorized by the county, the county must pay the provider or parent retroactive to the date in item A, B, or C that occurred most recently:
Subp. 2a.
Provisional payment for legal nonlicensed providers.
A.
When a legal nonlicensed provider who has been provisionally authorized under Minnesota Statutes, section 119B.125, subdivision 5, does not receive final authorization by the county, the provisional authorization and payment must be terminated following notice to the provider as required under part 3400.0185 and Minnesota Statutes, section 119B.13, subdivision 5. The county must notify the family using the ineligible provider that the family must choose a new provider to continue receiving child care assistance. A provider's failure to receive final authorization does not cause payments made during the provisional authorization period to be overpayments.
B.
If a family appeals the adverse determination of provider eligibility and, while the appeal is pending, continues to use the provider who failed to receive final authorization, payments made after the notice period are subject to recovery as overpayments.
Subp. 3.
County authorization of child care.
Within the limits set by this chapter and Minnesota Statutes, chapter 119B, the amount of child care authorized must reflect the child care needs of the family and minimize out-of-pocket child care costs to the family. The amount of child care authorized must be based on the parents' schedule of participation in authorized activities, the child's school schedule, the provider's availability, and any other factors that would affect the amount of care that the child needs. The county must pay the provider's full charge up to the applicable maximum rate for all hours of child care authorized and scheduled for the family. When more than 50 hours of child care assistance for one child are authorized with one provider in a week, the county may reimburse the provider in an amount that exceeds the applicable maximum weekly rate, if the provider charges the same amount for more than 50 hours of care for a family not receiving child care assistance. A county must not authorize or pay for more than 120 hours of child care assistance per child every two weeks. To convert child care paid on a full-day or weekly basis into hours to determine if payment exceeds 120 hours of child care assistance, counties must follow the standards in items A and B.
Subp. 4a.
Reimbursement from other sources for child care costs.
A county must reduce the amount of a family's child care assistance payment by the amount of reimbursement earmarked for the same child care expenses that the family receives from sources other than the child care assistance fund.
Subp. 7.
County payment policies and schedule.
A county may not require parents to pay providers in advance of receiving payments from the child care fund as a condition for receiving payments from the child care fund. The county shall make payments at least monthly. Providers must be sent the forms necessary to bill for payment on or before the beginning of the billing cycle if the county has received the information necessary for child care to be authorized before this date.
Subp. 8.
Sick child care.
Sick child care means child care services provided to children who as a result of illness cannot attend the family's regular provider. In addition to making payments for regular child care, the county may make payments for sick child care. If the county chooses to pay sick child care, payment for sick child care must be at a rate comparable to like care arrangements in the county. The county's sick child care policy and rate shall be included in the county's child care fund plan required under part 3400.0150.
Subp. 9.
Payment during child absences and holidays.
A.
If a provider does not charge all families for days on which a child is absent from care, the child care assistance program must not pay that provider for days on which a child is absent from care.
B.
If a provider charges all families for days on which a child is absent from care, the child care assistance program must pay that provider for child absent days according to Minnesota Statutes, section 119B.13, subdivision 7.
C.
Provider charges for absent days in excess of the amount established by Minnesota Statutes, section 119B.13, subdivision 7, are the responsibility of the family receiving child care assistance.
D.
A provider must be paid for holiday days according to Minnesota Statutes, section 119B.13, subdivision 7, paragraph (b). State or federal holidays are determined according to Minnesota Statutes, section 645.44, subdivision 5. A provider can be paid for a holiday day only if the provider meets the requirements in Minnesota Statutes, section 119B.13, subdivision 7, paragraph (b), the provider does not provide care on the holiday, and it is in the provider's policies to charge all families for the holiday. If care is available on the holiday, but the child is absent on that day, the day is an absent day. If a provider is closed on a cultural or religious holiday not identified in Minnesota Statutes, section 645.44, subdivision 5, a parent may substitute that holiday for one of the ten state and federal holidays identified in Minnesota Statutes, section 645.44, subdivision 5, if the parent gives notice of the substitution to the county before the holiday occurs or within ten days after the holiday.
E.
The absent day provisions in this subpart and in Minnesota Statutes, section 119B.13, subdivision 7, including the limits on paid absent days and holidays, apply to child care assistance payments for child care provided during notice periods.
Subp. 10.
Payment during medical leaves of absence.
Counties must grant child care assistance during a parent's medical leave of absence from education or employment if:
B.
the parent is expected to return to employment or an approved education or training program within 90 calendar days after leaving the job, education, or training program; and
C.
the necessity of the medical leave and the inability to provide child care are documented by a physician or licensed psychologist.
The amount of child care authorized during the medical leave of absence must not exceed the equivalent of one month of full-time child care.
Subp. 11.
Payment during notice periods.
Child care assistance payments for child care provided during notice periods are subject to all payment rules and limits identified under this part.
3400.0120 ELIGIBLE PROVIDERS AND PROVIDER REQUIREMENTS.
Subpart 1.
Eligible providers.
Providers who meet the definition of provider in Minnesota Statutes, section 119B.011, subdivision 19, are eligible for payment from the child care fund. Within the limitations specified in Minnesota Statutes, sections 119B.09, subdivision 5, and 119B.25, parents may choose child care providers that best meet the needs of their family. Parents may choose more than one provider. A county may not deny a parent eligible for child care assistance the use of a provider holding a valid child care license.
Subp. 1a.
Provider acknowledgment.
A provider must sign a provider acknowledgment and the county must have a signed provider acknowledgment before the provider or parent may receive payment under the child care fund. The provider acknowledgment must include the following information:
A.
the provider's rate, charges for child absences and holidays, any notice days required before a child discontinues care, and any required registration or activity fees;
B.
documentation of the provider's license status and, if the provider is seeking the provider accreditation rate bonus, any accreditation or credential held by the provider;
C.
a statement acknowledging that charging child care assistance participants more than families not receiving child care assistance for like services or wrongfully obtaining child care assistance may be a crime;
D.
a statement acknowledging that parents must be given unlimited access to their children and to the provider caring for the children during all hours that the children are in the provider's care;
E.
a statement acknowledging that the provider is responsible for notifying the county as provided in subpart 5 of child absence days and the end of care;
F.
a statement acknowledging that the provider is responsible for immediately notifying the county of any changes to the information supplied by the provider in the provider's acknowledgment;
G.
a statement acknowledging that the provider is a mandated reporter of maltreatment of minors under Minnesota Statutes, section 626.556; and
H.
a statement acknowledging that when the county knows that a particular provider or child care arrangement is unsafe, the county may deny child care assistance payments to that provider.
Subp. 2.
Authorization of legal nonlicensed providers.
A.
A legal nonlicensed provider must be authorized by the county before the provider or parent may receive a payment under the child care fund. To be authorized by the county, a provider must provide the county with the following information:
(3)
an assurance that the provider is eligible to provide unlicensed care under Minnesota Statutes, section 245A.03, subdivision 2, paragraph (a);
(4)
a release to permit information on substantiated parental complaints concerning the health and safety of children in the provider's care to be disclosed to the public according to Minnesota Statutes, chapter 13;
(5)
an assurance that the provider is in compliance with state and local health ordinances and building and fire codes applicable to the premises where child care is provided; and
(6)
an acknowledgment that the parent and the legal nonlicensed provider have reviewed the health and safety information provided by the county.
B.
Legal nonlicensed providers who will receive payment from the county must provide the county with the provider's Social Security or tax identification number. The county may ask legal nonlicensed providers who will not receive payment from the county for their Social Security numbers; but legal nonlicensed providers who will not receive payment from the county are not required to disclose this information. Before asking for a legal nonlicensed provider's Social Security number, the county must tell the legal nonlicensed provider whether that disclosure is mandatory or voluntary, by what statutory or other authority the number is solicited, and how the number will be used.
C.
Legal nonlicensed family child care providers also must provide the county with an assurance that the provider will obtain an immunization record for each child in the provider's care within 90 days of starting to care for the child.
Subp. 2a.
Release for in-home providers.
To be authorized, an in-home provider must sign a release allowing the parent employing that provider to see information on the remittance advice about the amount of any funds being withheld from the payment for the provider and the reason for those withholdings.
Subp. 3.
Parental access to children in care.
Providers must permit parents unlimited access to their children and to the provider caring for their children during all hours the children are in the care of the provider.
Subp. 5.
Notice to county required when care has terminated.
When a provider knows that a family has ended care with the provider, the provider must notify the county that care has been terminated. When a provider believes that a family will be ending care with the provider, the provider must immediately notify the county of the date on which the provider believes the family will end care. A provider must also notify the county if a child or children have been absent for more than seven consecutive scheduled days.
3400.0130 CHILD CARE PROVIDER RATES.
Subpart 1.
Rate determination.
The commissioner shall determine the applicable maximum rate as described in Minnesota Statutes, section 119B.13. Any rate survey conducted by the commissioner shall include a survey of registration fees when it is usual and customary for a category of provider to charge registration fees.
Subp. 1a.
Maximum county child care assistance rate.
Except as provided in this part, the maximum rate that a county may pay for child care assistance is the provider's rate or the applicable maximum rate determined by the commissioner under Minnesota Statutes, section 119B.13, whichever is less. Except as provided in this part, if the provider's rate is more than the applicable maximum rate, the county may not pay more than the difference between the applicable maximum rate and the family's copayment fee.
Subp. 2.
Rate determination for license-exempt centers.
Rates paid to license-exempt centers as defined in Minnesota Statutes, section 245A.03, subdivision 2, must be the applicable maximum rate for licensed child care centers or the provider rate, whichever is less.
Subp. 3.
Rate determination; children with special needs.
A county must submit a request to pay a special needs rate to the commissioner. The request must be submitted with or as an amendment to the county child care fund plan. Upon written approval by the commissioner, the approved special needs rate must be paid retroactive to the date of the provider or parent request for the special needs rate.
Subp. 3a.
Rate determination; children with special needs due to disability.
When a parent or a provider asks the county for a special needs rate for an individual child with disabilities that exceeds the applicable maximum rate, the county must use the following process to determine whether a special needs rate is necessary and, if so, to establish the requested special needs rate. The county must:
B.
obtain the following documentation from the child care provider:
(1)
a description of the specialized training, services, or environmental adaptations that the provider will furnish to meet the individual needs of the child;
(2)
the provider's assurance of compliance with applicable provisions of the Americans with Disabilities Act;
(3)
the provider's assurance that the rate being sought is the same as the rate that would be charged for similar services provided to a child with a disability in a family not receiving child care assistance; and
(4)
if applicable, a statement from the provider explaining that the rate the provider charges for all children in care should be adopted as the special needs rate for the child with disabilities because the provider has chosen to spread the cost of caring for children with special needs across all families in care; and
Subp. 3b.
Rate determination; children with special needs due to inclusion in at-risk population.
To determine a special needs rate for a child who is included in an at-risk population defined in the county's child care fund plan, the county must use the following procedures. The county must:
A.
obtain documentary evidence showing that the child is included in the at-risk population defined in the county's child care fund plan;
B.
obtain the following documentation from the child care provider:
(1)
a description of the specialized training, services, or environmental adaptations that the provider will furnish to meet the individual needs of the child or the at-risk population;
(2)
the provider's assurance that the rate being sought is the same as the rate that would be charged for similar services provided to a child in the at-risk population in a family not receiving child care assistance; and
(3)
if applicable, a statement from the provider explaining that the rate the provider charges for all children in care should be adopted as the special needs rate for the child in the at-risk population because the provider has chosen to spread the cost of caring for children with special needs across all families in care;
C.
determine how many providers in the county offer child care for children in the at-risk population;
D.
identify the 75th percentile rate if the county finds that four or more providers offer child care for children in the at-risk population and pay the 75th percentile rate, the rate negotiated with the provider by the county, or the provider's rate, whichever is less;
E.
pay the lesser of the rate negotiated with the provider by the county or the provider's rate if the county finds that fewer than four providers offer child care for children in the at-risk population; and
Subp. 5.
Child care rate.
Child care payments shall be based on the applicable maximum rates in the county where care is provided when the care is provided in Minnesota. When child care is provided outside the state of Minnesota, the maximum rate must be based on the applicable maximum rate in the participant's county of residence. If a child remains in an age-based child care setting beyond the age at which the licensing laws would allow that child to move to a different age-based child care setting and (1) the child's age is within the range allowed by the licensing laws for that age-based child care setting, or (2) the child is in that age-based child care setting due to a licensing variance, the maximum rate paid for that child's care must be the rate for the age-based child care setting in which the child is located. A child is considered to be in the school-age rate category on the September 1 following the child's fifth birthday unless the parent informs the county that the child will not be starting school. All changes to provider rates shall be implemented on the Monday following the effective date of the rate change.
Subp. 5a.
Rates for in-home care.
When care is provided in the child's home, the applicable maximum rate must be based on the allowable rate for legal nonlicensed family child care.
Subp. 7.
Payment of registration fees.
If a provider charges families a registration fee to enroll children in the program and the registration fee is not included in the provider rate, the county shall pay the provider registration fee or the 75th percentile of the registration fees surveyed in subpart 1, whichever is less. The county may not pay for more than two registrations per child in a 12-month period.
3400.0140 COUNTY RESPONSIBILITIES.
Subpart 1.
County child care assistance policies and procedures.
Counties shall adopt policies and procedures for providing child care assistance to enable eligible applicants to seek or retain employment or to participate in education or training programs. All county policies that apply to child care assistance must be in writing and must be included in the county's biennial child care fund plan required under part 3400.0150.
Subp. 2.
Child care assistance information.
The county shall provide information on child care assistance to child care service providers, social service agencies, and the local news media as it deems necessary to ensure the full use of its child care fund allocation.
Subp. 4.
Determination of providers eligible for payments.
The county's process for approving providers eligible for payments under the child care fund may not exceed 30 calendar days, or 45 calendar days with the approval of the applicant, from the date the child care application is approved, the date the child care provider is selected by the applicant, or, the date the county received the results of the background investigation required by Minnesota Statutes, section 119B.125, subdivision 2, whichever is later. Reimbursement for child care expenses must be made according to the date of eligibility established in part 3400.0040, subpart 6c. If the county determines that a provider chosen by an applicant is not eligible to receive child care payments under the child care fund, the applicant may appeal the county's determination under part 3400.0230.
Subp. 5.
Additional information for legal nonlicensed providers.
The county shall provide each authorized legal nonlicensed family child care provider health and safety material supplied by the department and shall refer the provider to the child care resources and referral agency. The county must tell the provider that the county is required to keep a record of substantiated parental complaints concerning the health and safety of children in the care of legal nonlicensed providers and that, upon request, information governing substantiated complaints shall be released to the public as authorized under Minnesota Statutes, chapter 13.
Subp. 6.
Duties upon receipt of complaints against legal nonlicensed providers.
Within 24 hours of receiving a complaint concerning the health or safety of children under the care of a legal nonlicensed provider, a county must relay the complaint to:
A.
the county's child protection agency if the complaint alleges child maltreatment as defined in Minnesota Statutes, section 626.556, subdivision 10e;
B.
the county's public health agency if the complaint alleges a danger to public health due to communicable disease, unsafe water supply, sewage or waste disposal, or building structures;
C.
local law enforcement if the complaint alleges criminal activity that may endanger the health or safety of children under care; or
D.
other agencies with jurisdiction to investigate complaints relating to the health and safety of a child.
If a complaint is substantiated under item A, the county must keep a record of the substantiated complaint as provided in Minnesota Statutes, section 626.556. If a complaint is substantiated under items B to D, the county must keep a record of the substantiated complaint for three years. Upon request, information governing substantiated complaints shall be released to the public as authorized under Minnesota Statutes, chapter 13. Upon receiving notice of a substantiated complaint under items A to D, the county shall not make subsequent payments to that provider from the child care fund for child care services provided by that provider unless the conditions underlying the substantiated complaint have been corrected.
Subp. 7.
County contracts and designation of administering agency.
Counties may contract for the administration of all or part of the child care fund. The county shall designate the agency authorized to administer the child care fund in the county's child care fund plan. The county must describe in its child care fund plan how it will oversee the contractor's performance.
Subp. 8.
Agreement with employment and training services providers.
Cooperative agreements with employment and training services providers must specify that MFIP families participating in employment services and meeting the requirements of part 3400.0080 are eligible for child care assistance from the county responsible for the MFIP participant's approved job search support or employment plan or according to Minnesota Statutes, section 256G.07.
Subp. 9.
Local match.
The county shall provide a local match according to Minnesota Statutes, section 119B.11, subdivision 1.
Subp. 9a.
Child care assistance funding.
In the manner prescribed by the commissioner, counties shall claim funding for child care expenditures for all eligible recipients who are in employment, education, training, or other preemployment activities allowed under the federal and state reimbursement programs. The commissioner shall allocate any federal or state earnings to the county that claimed the funding and the county shall use the earnings to expand funding for child care services.
Subp. 10.
Eligibility priorities for beginning assistance.
If a county's basic sliding fee program allocation for child care is insufficient to fund all applications for child care assistance, the county may prioritize eligibility among the groups that remain to be served after the county has complied with the priority requirements set forth in Minnesota Statutes, section 119B.03, subdivision 4. The county shall include its rationale for the prioritization of eligibility for beginning assistance in its biennial child care fund plan. To the extent of available allocations, no eligible family may be excluded from receiving child care assistance.
Subp. 14.
Child care fund reports.
Counties must submit financial and program activity reports according to instructions and schedules that the commissioner establishes after considering such factors as the department's need to receive county data in a manner and on a schedule that meets federal reporting deadlines and the counties' need for lead time when changes in reporting requirements occur.
3400.0150 CHILD CARE FUND PLAN.
Subpart 1.
Submittal of plan.
By the date established by the commissioner, the county shall submit to the commissioner a biennial child care fund plan. The commissioner may require updates of information in the plan as necessary to comply with this chapter, Minnesota Statutes, sections 119B.011 to 119B.16, and federal law.
Subp. 2.
Plan content.
The plan must contain a complete description of the county's child care assistance program for applicants and participants eligible for assistance under Minnesota Statutes, chapter 119B. The plan must include the information required by Minnesota Statutes, section 119B.08, subdivision 3; the information required by this chapter; and all written forms, policies, and procedures used to administer the child care funds. The plan must describe how it serves persons with limited English proficiency, as required by title VI of the Civil Rights Act of 1964, United States Code, title 42, sections 2000, et seq. The information in the plan must be in the form prescribed by the commissioner and must include a description of the process used to assure that the information, forms, and notices about child care assistance are accurate, clearly written, and understandable to the intended recipient.
Subp. 3.
Plan amendments.
A county may amend its child care fund plan at any time but the amendment must be approved by the commissioner before it becomes effective. If approved by the commissioner, the amendment is effective on the date requested by the county unless a different effective date is set by the commissioner. Plan amendments must be approved or disapproved by the commissioner within 60 days after receipt of the amendment request.
3400.0170 INCOME ELIGIBILITY FOR CHILD CARE ASSISTANCE.
Subpart 1.
Proof of income eligibility.
An applicant requesting child care assistance must provide proof of income eligibility. For the purpose of determining income eligibility, annual income is the income of the family for the current month multiplied by 12, the income for the 12-month period immediately preceding the date of application, or the income calculated by the method that provides the most accurate assessment of annual income available to the family. The administering agency must use the method that provides the most accurate assessment of annual income currently available to the family. Income must be verified with documentary evidence. If the applicant does not have sufficient evidence of income, the administering agency must offer the applicant the opportunity to sign an informational release to permit the administering agency to verify whether the applicant qualifies for child care assistance.
Subp. 3.
Evaluation of income.
The administering agency shall determine income received or available to a family according to subparts 4 to 11. All income, unless specifically excluded in subpart 6, must be counted as income.
Subp. 4.
Determination of annual income.
The income standard for determining eligibility for child care assistance is annual income. Annual income is the sum of earned income, self-employment income, unearned income, and lump sum payments, which must be treated according to subpart 13. Negative self-employment income must be included in the determination of annual income, resulting in a reduction in total annual income. Earned income, self-employment income, unearned income, and lump sum payments must be calculated separately.
Subp. 6a.
Deductions from income.
The following items must be deducted from annual income:
A.
child or spousal support paid to or on behalf of a person or persons who live outside of the household; and
Subp. 7.
Earned income from self-employment.
In determining annual income for purposes of eligibility under this part, the administering agency shall determine earned income from self-employment. Earned income from self-employment is the difference between gross receipts and authorized self-employment expenses which may not include expenses under subpart 8. Self-employment business records must be kept separate from the family's personal records. If the person's business is a partnership or a corporation and that person is drawing a salary, the salary shall be treated as earned income under subpart 5.
Subp. 8.
Self-employment deductions which are not allowed.
In determining eligibility under this part, self-employment expenses must be subtracted from gross receipts. For purposes of this subpart, the document in items I to K is incorporated by reference. It is available through the Minitex interlibrary loan system. It is subject to frequent change. If the document in items I to K is amended, and if the amendments are incorporated by reference or otherwise made a part of state or federal law applicable to self-employment deductions, then the amendments to the document are also incorporated by reference into this subpart. However, the expenses listed in items A to P shall not be subtracted from gross receipts:
F.
transportation costs that exceed the amount allowed for use of a personal car in the United States Internal Revenue Code;
H.
wages and salaries paid to and other employment deductions made for members of a family for whom an employer is legally responsible, provided family income is only counted once;
I.
monthly expenses for each roomer greater than the flat rate deduction listed in the current Combined Program Manual issued by the Department of Human Services;
J.
monthly expenses for each boarder greater than the flat rate deduction listed in the current Combined Program Manual issued by the Department of Human Services;
K.
monthly expenses for each roomer-boarder greater than the flat rate deduction listed in the current Combined Program Manual issued by the Department of Human Services;
L.
annual expenses greater than two percent of the estimated market value on a county tax assessment form as a deduction for upkeep and repair against rental income;
M.
expenses not allowed by the United States Internal Revenue Code for self-employment income, unless specifically authorized in this chapter;
Subp. 9.
Self-employment budget period.
Gross receipts from self-employment must be budgeted in the month in which they are received. Expenses must be budgeted against gross receipts in the month the expenses are paid except for items A to C.
A.
The purchase cost of inventory items, including materials that are processed or manufactured, must be deducted as an expense at the time payment is received for the sale of those inventory items, processed materials, or manufactured items, regardless of when those costs are incurred or paid.
B.
Expenses to cover employee FICA, employee tax withholding, sales tax withholding, employee worker's compensation, employee unemployment compensation, business insurance, property rental, property taxes, and other costs that are commonly paid at least annually, but less often than monthly, must be prorated forward as deductions from gross receipts over the period they are intended to cover, beginning with the month in which the payment for these items is made.
C.
Gross receipts from self-employment may be prorated forward to equal the period of time over which the expenses were incurred. However, gross receipts must not be prorated over a period that exceeds 12 months. This provision applies only when gross receipts are not received monthly but expenses are incurred on an ongoing monthly basis.
Subp. 10.
Determination of farm income.
Farm income must be determined for a one-year period. Farm income is gross receipts minus operating expenses, except for expenses listed in subpart 8. Gross receipts include sales, rents, subsidies, soil conservation payments, production derived from livestock, and income from the sale of home-produced foods.
Subp. 11.
Determination of rental income.
A.
Income from rental property is considered self-employment earnings when the owner spends an average of 20 or more hours per week on maintenance or management of the property. The administering agency shall deduct an amount for upkeep and repairs according to subpart 8, item L, for real estate taxes, insurance, utilities, and interest on principal payments.
B.
When a family lives on the rental property, the administering agency shall divide the expenses for upkeep, taxes, insurance, utilities, and interest by the number of units to determine the expense per unit. The administering agency shall deduct expenses from rental income only for the number of units rented, not for units occupied by family members.
C.
When an owner does not spend an average of 20 or more hours per week on maintenance or management of the property, income from rental property is considered unearned income.
3400.0180 REDETERMINATION OF ELIGIBILITY.
A.
The county must redetermine each participating family's eligibility at least every six months. The county must redetermine the eligibility of families in the start-up phase of self-employment without an approved employment plan more frequently than once every six months if existing documentation is insufficient to accurately predict self-employment income. 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.
B.
The county must not treat a redetermination of eligibility as a new application for child care assistance. The participant is responsible for providing documentary evidence of continued eligibility.
C.
If redetermination establishes that a family is ineligible for further child care assistance, the county shall terminate the child care assistance as provided in part 3400.0185. If redetermination establishes the need for a change in the family's copayment, revisions shall be calculated according to part 3400.0100. When a change in income affects the amount of a participant's copayment, the new copayment amount is effective on the first day of the service period following the 15-day notice period.
D.
If a family timely reports the information required by part 3400.0040, subpart 4, and redetermination establishes a need for a change in the amount of the family's child care assistance, the amount of child care assistance paid to the family between the date the change was reported and the first date that the new child care assistance payment would be effective if the county properly implemented the change does not constitute an overpayment.
3400.0183 TERMINATION OF CHILD CARE ASSISTANCE.
Subpart 1.
Conditions for termination of child care assistance.
A.
A county may terminate child care assistance for families already receiving assistance when the county receives: (1) a revised allocation from the child care fund that is smaller than the allocation stated in the notice sent to the county under part 3400.0030; and (2) such short notice of a change in its allocation that the county could not have absorbed the difference in the allocation. The county must consult with and obtain approval from the commissioner before terminating assistance under this subpart.
B.
If the conditions described in this subpart occur, the county may terminate assistance to families in the order of last on, first off. When funds become available, counties must reinstate families that remain eligible for child care assistance and whose child care assistance was terminated due to insufficient funds before the county accepts new applications. Those families whose child care assistance was most recently terminated due to insufficient funds shall be reinstated first.
Subp. 2.
Conditions under which termination of child care assistance is required.
A county must terminate a family's child care assistance under the following conditions:
B.
when the family is no longer eligible to receive child care assistance under this chapter and Minnesota Statutes, chapter 119B; or
Subp. 5.
Effective date of disqualification period.
The effective date of a disqualification period is the later of:
A.
the date the family member was found guilty of wrongfully obtaining or attempting to obtain child care assistance by federal court, state court, or an administrative hearing determination or waiver, through a disqualification consent agreement, as part of an approved diversion plan under Minnesota Statutes, section 401.065, or as part of a court-ordered stay with probationary or other conditions; or
3400.0185 TERMINATION AND ADVERSE ACTIONS; NOTICE REQUIRED.
Subpart 1.
Notice of termination of child care assistance to participants.
A.
The county must notify a participant in writing of the termination of child care assistance. The notice must include the following information:
(3)
the statute, rule, or county child care fund plan provision that supports termination of assistance;
(5)
when the participant appeals the proposed action before the effective date of termination, the participant may choose:
(a)
to receive benefits while the appeal is pending, subject to recovery if the termination is upheld; or
(b)
to not receive benefits while the appeal is pending and to receive reimbursement for documented eligible child care expenditures made or incurred pending appeal if the termination is reversed.
B.
If child care assistance under part 3400.0060 is being terminated because a participant has moved to another county, the notice also must state that to continue receiving child care assistance under part 3400.0060 from the new county, the participant must apply for child care assistance in the new county within 60 days of the move.
C.
The notice must be mailed to the participant's last known address at least 15 calendar days before terminating assistance.
D.
If the participant's child care assistance is terminated under part 3400.0183, subpart 2, item A, and, before the effective date of termination, the participant asks the county to continue child care assistance, the termination must not take effect. If the participant's child care assistance is terminated under part 3400.0183, subpart 2, item B, and, before the effective date of termination, the participant reestablishes eligibility for child care assistance, the termination must not take effect.
Subp. 2.
Notice of termination of child care assistance to providers.
A.
When a family's child care assistance is terminated, the county must send the family's child care provider a notice containing only the following information:
(4)
that child care payments will no longer be made effective on the date of termination, unless the family asks to continue receiving assistance pending an appeal. The notice to a provider must not contain information on why payments will no longer be made.
B.
When a family stops using a provider but continues to receive assistance, the county must send the provider a notice containing the following information:
C.
This item applies to participants using a provider licensed by the state of Minnesota. Except in cases where the provider's license has been temporarily immediately suspended under Minnesota Statutes, section 245A.07, the county must mail the notice to the participant at least 15 calendar days before terminating payment to the provider. When the provider's license has been temporarily immediately suspended under Minnesota Statutes, section 245A.07, the county must send a notice of termination to the provider that is effective on the date of the temporary immediate suspension.
D.
This item applies to participants using a legal nonlicensed provider, license exempt center, or provider licensed by an entity other than the state of Minnesota. Except in cases where there is an imminent risk of harm to the health, safety, or rights of a child in care, the county must mail the notice to the provider at least 15 calendar days before terminating payment to the provider. In cases where there is an imminent risk of harm to the health, safety, or rights of a child in care, the county must send a notice of termination that is effective on the date of the notice. Whether there is an imminent risk of harm is determined by the county that authorized the provider for the family.
Subp. 3.
Notice to participants of adverse actions.
A.
The county must give a participant written notice of any action adversely affecting the participant.
B.
The notice must include the following information:
(5)
that the participant has the right to appeal the adverse action and the procedure for doing so; and
(6)
that if the participant appeals the adverse action before the effective date of the action, the participant may choose:
(a)
to continue receiving the same level of benefits while the appeal is pending, subject to recoupment or recovery if the adverse action is upheld; or
(b)
to receive the level of benefits indicated by the adverse action while the appeal is pending and to receive reimbursement for documented eligible child care expenditures made or incurred pending appeal if the adverse action is reversed.
C.
The notice must be mailed to the participant's last known address at least 15 calendar days before the effective date of the adverse action.
D.
If the participant corrects the condition requiring an adverse action before the effective date of the adverse action, the adverse action must not take effect.
Subp. 4.
Notice to providers of actions adverse to families.
The county must give a provider written notice of the following actions adverse to families: a reduction in the hours of authorized care and an increase in the family's copayment. The notice must include only the following information:
B.
a description of the adverse action that does not contain any information about why the action was taken;
D.
a statement that unless the family appeals the adverse action before the effective date, the adverse action will occur on the effective date. The notice must be mailed to the provider at least 15 calendar days before the effective date of the adverse action.
Subp. 5.
Notice to providers of actions adverse to the provider.
The county must give a provider written notice of the following actions adverse to the provider: a denial of authorization, a termination of authorization, a reduction in the number of hours of care with that provider, and a determination that the provider has an overpayment. The notice must include the following information:
C.
a statement that unless a family appeals the adverse action before the effective date or the provider appeals the overpayment determination, the adverse action will occur on the effective date. The notice must be mailed to the provider at least 15 calendar days before the effective date of the adverse action.
3400.0187 RECOUPMENT AND RECOVERY OF OVERPAYMENTS.
Subpart 1.
State recovery of overpayments.
The commissioner must recover from counties any state or federal money that was spent for persons found to be ineligible for child care assistance, except as provided in Minnesota Statutes, section 119B.11, subdivision 3.
Subp. 2.
Notice of overpayment.
The county must notify the person or persons assigned responsibility for the overpayment of the overpayment in writing. A notice of overpayment must specify the reason for the overpayment, the time period in which the overpayment occurred, the amount of the overpayment, and the right to appeal the county's overpayment determination.
Subp. 3.
Redetermination of eligibility.
When a county discovers that a family has received an overpayment, the county must immediately redetermine the family's eligibility for child care assistance.
Subp. 4.
Recoupment of overpayments from participants.
If the redetermination of eligibility indicates the family remains eligible for child care assistance, the county must recoup the overpayment by reducing the amount of assistance paid to or on behalf of the family for every service period at the rates in item A, B, C, or D until the overpayment debt is retired.
A.
When a family has an overpayment due to agency or provider error, the recoupment amount is one-fourth the family's copayment or $10, whichever is greater.
B.
When the family has an overpayment due to the family's first failure to report changes as required by part 3400.0040, subpart 4, the recoupment amount is one-half the family's copayment or $10, whichever is greater.
C.
When a family has an overpayment due to the family's failure to provide accurate information at the time of application or redetermination or the family's second or subsequent failure to report changes as required by part 3400.0040, subpart 4, the recoupment amount is one-half the family's copayment or $50, whichever is greater.
D.
When a family has an overpayment due to a violation of Minnesota Statutes, section 256.98, subdivision 1, as established by a court conviction, a court-ordered stay of conviction with probationary or other terms, a disqualification agreement, a pretrial diversion, or an administrative disqualification hearing or waiver, the recoupment amount equals the greater of:
E.
This item applies to families who have been disqualified or found to be ineligible for the child care assistance program and who have outstanding overpayments. If a disqualified or previously ineligible family returns to the child care assistance program, the county must begin recouping the family's outstanding overpayment using the recoupment schedule in items A to D unless another repayment schedule has been specified in a court order.
F.
If a family has more than one overpayment, the overpayments must not be consolidated into one overpayment. Instead, each overpayment must be recouped according to the schedule specified in this subpart from the child care benefit paid for the service period. If the amount to be recouped in a service period exceeds the child care benefit paid for that service period, the amount recouped must be applied to overpayments in the following order:
(1)
payment must first be applied to the oldest overpayment being recouped under item D and then to any other overpayments to be recouped under this item according to the age of the claim;
(2)
payment then must be applied to the oldest overpayment being recouped under item C and then to any other overpayments to be recouped under this item according to the age of the claim;
(3)
payment then must be applied to the oldest overpayment being recouped under item B and then to any other overpayments to be recouped under this item according to the age of the claim; and
(4)
payment then must be applied to the oldest overpayment being recouped under item A and then to any other overpayments to be recouped under this item according to the age of the claim.
Subp. 6.
Recoupment of overpayments from providers.
If the provider continues to receive child care assistance payments, the county must recoup the overpayment by reducing the amount of assistance paid to the provider for every payment at the rates in item A, B, or C until the overpayment debt is retired.
A.
When a provider has an overpayment due to agency or family error, the recoupment amount is one-tenth the provider's payment or $20, whichever is greater.
B.
When a provider has an overpayment due to the provider's failure to provide accurate information, the recoupment amount is one-fourth the provider's payment or $50, whichever is greater.
C.
When a provider has an overpayment due to a violation of Minnesota Statutes, section 256.98, subdivision 1, as established by a court conviction, a court-ordered stay of conviction with probationary or other terms, a disqualification agreement, a pretrial diversion, or an administrative disqualification hearing or waiver, the recoupment amount equals the greater of:
D.
This item applies to providers who have been disqualified from or are no longer able to be authorized by the child care assistance program and who have outstanding overpayments. If a provider returns to the child care assistance program as a provider or a participant, the county must begin recouping the provider's outstanding overpayment using the recoupment schedule in items A to D unless another repayment schedule has been specified in a court order.
E.
If a provider has more than one overpayment, the overpayments must not be consolidated into one overpayment. Instead, each overpayment must be recouped according to the schedule specified in this subpart from the payment made to the provider for the service period. If the amount to be recouped in a service period exceeds the payment to the provider for that service period, the amount recouped must be applied to overpayments in the following order:
(1)
payment must first be applied to the oldest overpayment being recouped under item C and then to any other overpayments to be recouped under this item according to the age of the claim;
(2)
payment then must be applied to the oldest overpayment being recouped under item B and then to any other overpayments to be recouped under this item according to the age of the claim; and
(3)
payment then must be applied to the oldest overpayment being recouped under item A and then to any other overpayments to be recouped under this item according to the age of the claim.
3400.0200 PAYMENTS TO COUNTIES OF ADMINISTRATIVE FUNDS.
The commissioner shall make administrative funds payments to the counties on a monthly basis. The commissioner may certify an advance to the counties for the first quarter of the fiscal year or the first quarter of the allocation period. Subsequent payments made to the counties for administrative expenses shall be based on actual expenditures as reported by the counties in the financial and program activity report required under part 3400.0140, subpart 14.
3400.0220 AUDIT EXCEPTIONS.
The commissioner shall recover from counties state or federal money spent for child care that is ineligible under this chapter. If a federal audit exception is taken based on a percentage of federal earnings, all counties shall pay a share proportional to their respective federal earnings during the period in question.
3400.0230 RIGHT TO FAIR HEARING.
Subp. 3.
Child care payments when fair hearing is requested.
A.
If the applicant or participant requests a fair hearing before the effective date of termination or adverse action or within ten days after the date of mailing the notice, whichever is later, the termination or adverse action shall not be taken until the conclusion of the fair hearing. Child care assistance paid pending a fair hearing is subject to recovery under part 3400.0187 to the extent the commissioner finds on appeal that the participant was not eligible for the amount of child care assistance paid.
B.
If the commissioner finds on appeal that child care assistance should have been terminated or the amount of benefits reduced, the county must send a notice of termination or reduction in benefits effective the date of the notice to the family and the child care provider.
C.
A participant may appeal the termination of child care assistance and choose not to receive child care assistance pending the appeal. If the commissioner finds on appeal that child care assistance should not have been terminated, the county must reimburse the participant for documented eligible child care expenditures made or incurred pending the appeal.
3400.0235 AT-HOME INFANT CHILD CARE PROGRAM.
Subpart 1.
Purpose and applicability.
This part governs the administration of the at-home infant child care program. All provisions in parts 3400.0010 to 3400.0230 apply to the at-home infant child care program unless otherwise specified in this part or in Minnesota Statutes, section 119B.035.
Subp. 2.
Administration of at-home infant child care program.
Within the limits of available funding the commissioner shall make payments for expenditures under the at-home infant child care program. Participation in the statewide pool shall be determined based on the order in which requests are received from counties. Following the birth or arrival of an infant, counties shall submit family requests for participation in the at-home infant child care program on forms provided by the commissioner. The commissioner shall respond within seven days to county inquiries about the availability of funds. The commissioner shall monitor the use of the pool and if the available funding is obligated, the commissioner shall create a waiting list of at-home infant child care referrals from the counties. As funds become available to the pool, the commissioner shall notify counties in which eligible families on the waiting list reside.
Subp. 3.
General eligibility requirements.
Items A to E govern eligibility for the at-home infant child care program.
A.
A family is eligible to receive assistance under the at-home infant child care program if one parent provides full-time care for the infant. The eligible parent must meet the requirements of Minnesota Statutes, section 119B.035, subdivision 3. The requirements of caring for the infant full-time may be met by one or both parents. For purposes of this part, eligible parents include birth parents, adoptive parents, and stepparents. Nonfamily members may provide regular care for the child but are limited to a maximum of ten hours of care per week.
B.
A family may apply for the at-home infant child care program before the child is born or anytime during the infant's first year. The family must apply before the end of the infant's first year to receive an at-home infant child care subsidy. Following the birth of a child, a family is eligible to receive a subsidy under the at-home infant child care program according to the date of eligibility in Minnesota Statutes, section 119B.09, subdivision 7, and when funding is available. A family shall only receive subsidy payments through the infant's twelfth month. "Infant" means a child from birth through 12 months of age and includes adopted infants.
C.
A family is limited to a lifetime total of 12 months of at-home infant child care assistance. At the time of application to the program, the parent or parents must declare whether they have previously participated in the at-home infant child care program. If the parent or parents declare that they have participated in the at-home infant child care program, the commissioner shall, at the request of the county, inform the county of the remaining months of eligibility for the at-home infant child care program.
D.
At the time of application to the at-home infant child care program, the family must meet the eligibility requirements in Minnesota Statutes, section 119B.035, subdivision 2, and be income-eligible based on these activities. At the time of application to the at-home infant child care program, a family who is not currently participating in the basic sliding fee program must provide verification of participation in an authorized activity within the nine months before the birth or expected arrival of the child.
E.
During the period a family receives a subsidy under the at-home infant child care program, the family is not eligible to receive basic sliding fee child care assistance for the infant or any other child in the family.
Subp. 4.
Continued eligibility under basic sliding fee program.
If families exiting the at-home infant child care program request continued child care assistance and meet all eligibility factors for the basic sliding fee program, the provisions in Minnesota Statutes, section 119B.035, subdivision 4, paragraph (c), apply.
Subp. 5.
Assistance payments.
Items A to C govern assistance payments under the at-home infant child care program.
A.
The number of months of at-home infant child care participation used shall be credited to the eligible parents. If an eligible parent later forms a new family, the number of months of at-home infant child care subsidy received shall be subtracted from the maximum assistance available under this part.
B.
There is no additional subsidy for infants with special needs or for multiple births. The county must subtract the family's copayment required by Minnesota Statutes, section 119B.12, to determine the final at-home infant child care subsidy for the family.
C.
Family income shall be determined or redetermined at the time a family applies for the at-home infant child care program. Family income shall be annualized from the beginning of the month in which the family would first participate in the at-home infant child care program. Family income includes:
(4)
other income the family may receive as determined under part 3400.0170 and Minnesota Statutes, section 119B.011, subdivision 15.
Excluded income is defined in part 3400.0170, subpart 6, and Minnesota Statutes, section 119B.011, subdivision 15. The calculation of the family copayment fee is described in part 3400.0100.
D.
For purposes of counting the number of months that a family has participated in the at-home infant child care program, any portion of a month in which a family receives a subsidy under the at-home infant child care program is considered a full month of participation in the at-home infant child care program.
For purposes of calculating the at-home infant child care program copayment and subsidy in the first service period, the county shall use the method described in part 3400.0100. In addition, the county shall prorate the subsidy received in the first and last service period of participation according to subitems (1) to (4).
(1)
If the family participates in the at-home infant child care program during the service period in which the infant is born or arrives in the home, the subsidy must be prorated to cover the number of calendar days from the date of birth or arrival until the end of the service period.
(2)
If the family participates in the at-home infant child care program during the service period of the infant's first birthday, the subsidy must be prorated to cover the number of calendar days from the beginning of the service period to the date of the infant's first birthday.
(3)
If the eligible parent leaves employment or another authorized activity in order to participate in the at-home infant child care program, the subsidy must be prorated to cover the number of calendar days from the date the eligible parent leaves the authorized activity to the end of the service period.
(4)
If the eligible parent returns to an authorized activity and will no longer be participating in the at-home infant child care program, the subsidy must be prorated to cover the number of calendar days from the beginning of the service period to the date the parent returns to the authorized activity. If all other eligibility conditions are met, the family shall be eligible to receive basic sliding fee child care assistance beginning on the day the eligible parent returns to the authorized activity.
Subp. 6.
County responsibilities.
Items A to C govern county responsibilities for the program.
A.
In addition to duties required under part 3400.0140, counties shall perform the following functions to administer the at-home infant child care program:
(3)
determine availability of and encumber ongoing basic sliding fee funding if the family was participating in the basic sliding fee program before participating in the at-home infant child care program or has reached the top of the county's waiting list for the basic sliding fee program;
(6)
notify the commissioner when a family's participation in the at-home infant child care program ends.
B.
During program participation, the county shall apply billing procedures established under Minnesota Statutes, chapter 119B, to issue the at-home infant child care subsidy to families.
C.
When a family's participation in the at-home infant child care program ends, the county shall send the family and the commissioner a notice indicating the number of months the family participated in the at-home infant child care program in that county.
9530.6800 ASSESSMENT OF NEED FOR TREATMENT PROGRAMS.
Subpart 1.
Assessment of need required for licensure.
Before a license or a provisional license may be issued, the need for the chemical dependency treatment or rehabilitation program must be determined by the commissioner. Need for an additional or expanded chemical dependency treatment program must be determined, in part, based on the recommendation of the county board of commissioners of the county in which the program will be located and the documentation submitted by the applicant at the time of application.
If the county board fails to submit a statement to the commissioner within 60 days of the county board's receipt of the written request from an applicant, as required under part 9530.6810, the commissioner shall determine the need for the applicant's proposed chemical dependency treatment program based on the documentation submitted by the applicant at the time of application.
Subp. 2.
Documentation of need requirements.
An applicant for licensure under parts 9530.2500 to 9530.4000 and Minnesota Statutes, chapter 245G, must submit the documentation in items A and B to the commissioner with the application for licensure:
A.
The applicant must submit documentation that it has requested the county board of commissioners of the county in which the chemical dependency treatment program will be located to submit to the commissioner both a written statement that supports or does not support the need for the program and documentation of the rationale used by the county board to make its determination.
B.
The applicant must submit a plan for attracting an adequate number of clients to maintain its proposed program capacity, including:
(3)
documentation that the capacity or program designs of existing programs are not sufficient to meet the service needs of the chemically abusing or chemically dependent target population if that information is available to the applicant;
(4)
a list of referral sources, with an estimation as to the number of clients the referral source will refer to the applicant's program in the first year of operation; and
(5)
any other information available to the applicant that supports the need for new or expanded chemical dependency treatment capacity.
9530.6810 COUNTY BOARD RESPONSIBILITY TO REVIEW PROGRAM NEED.
When an applicant for licensure under parts 9530.2500 to 9530.4000 or Minnesota Statutes, chapter 245G, requests a written statement of support for a proposed chemical dependency treatment program from the county board of commissioners of the county in which the proposed program is to be located, the county board, or the county board's designated representative, shall submit a statement to the commissioner that either supports or does not support the need for the applicant's program. The county board's statement must be submitted in accordance with items A and B:
A.
the statement must be submitted within 60 days of the county board's receipt of a written request from the applicant for licensure; and