SF 2483

1st Engrossment - 90th Legislature (2017 - 2018) Posted on 05/03/2018 08:42am

A bill for an act
relating to human services; modifying adult foster care and community residential
setting license capacity; modifying home and community-based services plan
review and evaluation and intervention services; modifying requirements and
timelines for completing community support plans and coordinated service and
support plans; modifying housing support; directing the commissioner of human
services to allow brain injury and community access for disability inclusion waivers
customized living services provider to transfer capacity to up to three other housing
with services settings located in Hennepin County; requiring a report; amending
Minnesota Statutes 2016, sections 245D.071, subdivision 5; 245D.091, subdivisions
2, 3, 4; 256B.0659, subdivision 3a; 256B.0915, subdivision 6; 256B.092,
subdivisions 1b, 1g; 256I.04, by adding subdivisions; Minnesota Statutes 2017
Supplement, sections 245A.03, subdivision 7; 245A.11, subdivision 2a; 245D.03,
subdivision 1; 256B.0911, subdivisions 1a, 3a, 3f, 5; 256B.49, subdivision 13;
256B.4914, subdivision 3; 256I.03, subdivision 8; 256I.04, subdivision 2b.

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

Section 1.

Minnesota Statutes 2017 Supplement, section 245A.03, subdivision 7, is
amended to read:

Subd. 7.

Licensing moratorium.

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

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

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

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

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

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

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

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

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

(7) new foster care licenses or community residential setting licenses for people receiving
services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until June 30, deleted text begin 2018 deleted text end new text begin 2019 new text end . This exception is available when:

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

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

new text begin (8) a vacancy in a setting granted an exception under clause (7), created between January
1, 2017, and the date of the exception request, by the departure of a person receiving services
under chapter 245D and residing in the unlicensed setting between January 1, 2017, and
May 1, 2017. This exception is available when the lead agency provides documentation to
the commissioner on the eligibility criteria being met. This exception is available until June
30, 2019.
new text end

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

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

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

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 29, 2018.
new text end

Sec. 2.

Minnesota Statutes 2017 Supplement, section 245A.11, subdivision 2a, is amended
to read:

Subd. 2a.

Adult foster care and community residential setting license capacity.

(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of five beds, including
roomers and boarders, according to paragraphs (b) to (g).

(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.

(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to five, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.

(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to five, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:

(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;

(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;

(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and

(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.

(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of five adults if the fifth bed does not increase the overall statewide
capacity of licensed adult foster care or community residential setting beds in homes that
are not the primary residence of the license holder, as identified in a plan submitted to the
commissioner by the county, when the capacity is recommended by the county licensing
agency of the county in which the facility is located and if the recommendation verifies
that:

(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and

(4) the facility was licensed for adult foster care before deleted text begin March 1, 2011 deleted text end new text begin June 30, 2016 new text end .

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

Sec. 3.

Minnesota Statutes 2017 Supplement, section 245D.03, subdivision 1, is amended
to read:

Subdivision 1.

Applicability.

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

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

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

(2) adult companion services as defined under the brain injury, community access for
disability inclusion, 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 disability waiver plan;

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

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

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

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

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

(1) intervention services, including:

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

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

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

(2) in-home support services, including:

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

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

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

(4) day services, including:

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

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

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

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

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

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

Sec. 4.

Minnesota Statutes 2016, section 245D.071, subdivision 5, is amended to read:

Subd. 5.

Service plan review and evaluation.

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

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

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

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

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

Sec. 5.

Minnesota Statutes 2016, section 245D.091, subdivision 2, is amended to read:

Subd. 2.

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

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

(1) ethical considerations;

(2) functional assessment;

(3) functional analysis;

(4) measurement of behavior and interpretation of data;

(5) selecting intervention outcomes and strategies;

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

(7) data collection;

(8) staff and caregiver training;

(9) support plan monitoring;

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

(11) demonstrated expertise with populations being served; and

(12) must be a:

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

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

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

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

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

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

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

Sec. 6.

Minnesota Statutes 2016, section 245D.091, subdivision 3, is amended to read:

Subd. 3.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 7.

Minnesota Statutes 2016, section 245D.091, subdivision 4, is amended to read:

Subd. 4.

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

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

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

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

(b) In addition, a behavior specialist must:

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

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

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

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

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

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

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

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

Sec. 8.

Minnesota Statutes 2016, section 256B.0659, subdivision 3a, is amended to read:

Subd. 3a.

Assessment; defined.

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

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

Sec. 9.

Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 1a, is
amended to read:

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

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

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

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

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

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

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

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

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

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

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

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

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

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

(ii) consumer support grants under section 256.476; or

(iii) section 256B.85;

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

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

(4) obtaining necessary diagnostic information to determine eligibility under clauses (2)
and (3) new text begin ; and
new text end

new text begin (5) notwithstanding Minnesota Rules, parts 9525.0004 to 9525.0024, initial eligibility
determination for case management services available under Minnesota Rules, part
9525.0016 new text end .

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

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

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

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

Sec. 10.

Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 3a, is
amended to read:

Subd. 3a.

Assessment and support planning.

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

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

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

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

(e) The person or the person's legal representative must be provided with a written
community support plan within deleted text begin 40 calendar days of the assessment visit deleted text end new text begin the timelines
established by the commissioner new text end , regardless of whether the individual is eligible for
Minnesota health care programs. new text begin The timeline for completing the community support plan
and any required coordinated service and support plan must not exceed 56 calendar days
from the assessment visit.
new text end

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

(g) The written community support plan must include:

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

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

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

(4) referral information; and

(5) informal caregiver supports, if applicable.

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

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

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

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

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

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

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

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

(5) information about Minnesota health care programs;

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

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

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

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

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

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

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

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

Sec. 11.

Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 3f, is
amended to read:

Subd. 3f.

Long-term care reassessments and community support plan updates.

new text begin (a)
Prior to a face-to-face reassessment, the certified assessor must review the person's most
recent assessment. new text end Reassessments must be tailored using the professional judgment of the
assessor to the person's known needs, strengths, preferences, and circumstances.
Reassessments provide information to support the person's informed choice and opportunities
to express choice regarding activities that contribute to quality of life, as well as information
and opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments deleted text begin allow for deleted text end new text begin require new text end a review of new text begin the most recent
assessment, review of new text end the current new text begin coordinated service and new text end support plan's effectiveness,
monitoring of services, and the development of an updated person-centered community
support plan. Reassessments verify continued eligibility or offer alternatives as warranted
and provide an opportunity for quality assurance of service delivery. Face-to-face deleted text begin assessments deleted text end new text begin
reassessments new text end must be conducted annually or as required by federal and state laws and rules. new text begin
For reassessments, the certified assessor and the individual responsible for developing the
coordinated service and support plan must ensure the continuity of care for the person
receiving services and complete the updated community support plan and the updated
coordinated service and support plan within the timelines established by the commissioner.
new text end

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

Sec. 12.

Minnesota Statutes 2017 Supplement, 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. 13.

Minnesota Statutes 2016, section 256B.0915, subdivision 6, is amended to read:

Subd. 6.

Implementation of coordinated service and support plan.

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

(1) is developed new text begin with new text end and signed by the recipient within deleted text begin ten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessor deleted text end new text begin the timelines
established by the commissioner. The timeline for completing the community support plan
under section 256B.0911, subdivision 3a, and the coordinated service and support plan must
not exceed 56 calendar days from the assessment visit new text end ;

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

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

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

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

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

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

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

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

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

Sec. 14.

Minnesota Statutes 2016, section 256B.092, subdivision 1b, is amended to read:

Subd. 1b.

Coordinated service and support plan.

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

(1) is developed new text begin with new text end and signed by the recipient within deleted text begin ten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessor deleted text end new text begin the timelines
established by the commissioner. The timeline for completing the community support plan
under section 256B.0911, subdivision 3a, and the coordinated service and support plan must
not exceed 56 calendar days from the assessment visit new text end ;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 15.

Minnesota Statutes 2016, section 256B.092, subdivision 1g, is amended to read:

Subd. 1g.

Conditions not requiring development of coordinated service and support
plan.

new text begin (a) new text end Unless otherwise required by federal law, the county agency is not required to
complete a coordinated service and support plan as defined in subdivision 1b for:

(1) persons whose families are requesting respite care for their family member who
resides with them, or whose families are requesting a family support grant and are not
requesting purchase or arrangement of habilitative services; and

(2) persons with developmental disabilities, living independently without authorized
services or receiving funding for services at a rehabilitation facility as defined in section
268A.01, subdivision 6, and not in need of or requesting additional services.

new text begin (b) 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 their needs and to minimize the impact of the
disability on the person's life must develop a person-centered service plan based on the
person's assessed needs and preferences. The person-centered service plan must be reviewed
annually. This paragraph applies to persons with developmental disabilities who are receiving
case management services under Minnesota Rules, part 9525.0036, and who make an
informed choice to decline an assessment under section 256B.0911.
new text end

Sec. 16.

Minnesota Statutes 2017 Supplement, section 256B.49, subdivision 13, is amended
to read:

Subd. 13.

Case management.

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

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

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

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

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

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

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

(1) finalizing the coordinated service and support plan;

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

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

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

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

(1) phasing out the use of prohibited procedures;

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

(3) accomplishment of identified outcomes.

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

Sec. 17.

Minnesota Statutes 2017 Supplement, 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;

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; deleted text end and

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

Sec. 18.

Minnesota Statutes 2017 Supplement, section 256I.03, subdivision 8, is amended
to read:

Subd. 8.

Supplementary services.

"Supplementary services" means housing support
services provided to individuals in addition to room and board including, but not limited
to, oversight and up to 24-hour supervision, medication reminders, assistance with
transportation, arranging for meetings and appointments, and arranging for medical and
social services. new text begin Providers must comply with section 256I.04, subdivision 2h.
new text end

Sec. 19.

Minnesota Statutes 2017 Supplement, section 256I.04, subdivision 2b, is amended
to read:

Subd. 2b.

Housing support agreements.

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

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

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

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

(3) the provision of housing support;

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

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

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

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

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

Sec. 20.

Minnesota Statutes 2016, 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. 21.

Minnesota Statutes 2016, 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. 22. new text begin DIRECTION TO COMMISSIONER; BI AND CADI WAIVER
CUSTOMIZED LIVING SERVICES PROVIDER LOCATED IN HENNEPIN
COUNTY.
new text end

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

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

Sec. 23. new text begin DIRECTION TO THE COMMISSIONER.
new text end

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

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