Minnesota Legislature
SF 2570
as introduced - 91st Legislature (2019 - 2020) Posted on 06/02/2020 10:25am
2.34 2.35
2.36 2.37 2.38 2.39 2.40 2.41
2.42 2.43 2.44 3.1 3.2
3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29
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 5.32 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 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 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19
9.20
9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 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 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 12.34 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18
13.19
13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29
13.30 13.31 13.32 13.33 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30
14.31
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
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 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 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22
18.23
18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 19.1 19.2 19.3 19.4 19.5 19.6
19.7
19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21
19.22 19.23 19.24
19.25 19.26 19.27 19.28 19.29 19.30 19.31 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17
20.18
20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 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 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
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 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
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 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 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 30.32 30.33 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19
31.20
31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2
32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 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
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
35.1 35.2 35.3 35.4 35.5 35.6
35.7 35.8 35.9 35.10
35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25
35.26 35.27 35.28 35.29 35.30 35.31 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 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 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 39.32 39.33 40.1 40.2 40.3 40.4 40.5
40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19
40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 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 43.31 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15
44.16 44.17 44.18 44.19 44.20 44.21 44.22
44.23 44.24 44.25 44.26 44.27 44.28
44.29 44.30 44.31 44.32 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16
45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30
46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26
46.27 46.28 46.29 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 48.1 48.2
48.3 48.4 48.5 48.6 48.7
48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20
48.21 48.22 48.23 48.24 48.25 48.26
48.27 48.28 48.29 48.30 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 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 53.32 53.33 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 55.1 55.2 55.3 55.4 55.5 55.6
55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 56.1 56.2 56.3 56.4 56.5 56.6
56.7 56.8 56.9 56.10 56.11 56.12 56.13
56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22
56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17
57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 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 58.32 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19
60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15
61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26
62.27 62.28
62.29 62.30 62.31 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 63.34 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19
65.20
65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 67.1 67.2 67.3 67.4 67.5
67.6
67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 68.1 68.2
68.3
68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19
68.20
68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 69.1 69.2 69.3 69.4 69.5 69.6 69.7
69.8
69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18
69.19
69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31
69.32
70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8
70.9
70.10 70.11 70.12 70.13
70.14
70.15 70.16 70.17 70.18 70.19
70.20
70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12
71.13
71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26
71.27
71.28 71.29 71.30 71.31 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 73.1 73.2 73.3 73.4
73.5
73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17
73.18
73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17
74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 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
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 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 79.1 79.2 79.3 79.4 79.5 79.6 79.7
79.8
79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28
79.29 79.30 79.31 79.32 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 80.34 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 81.33 81.34 81.35 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33 82.34 83.1 83.2 83.3
83.4
83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 83.33 83.34 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 84.33 84.34 84.35 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 85.33 85.34 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11
86.12
86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 86.34 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27
87.28 87.29 87.30 87.31 87.32 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 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 90.33 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 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 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 94.32 94.33 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
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 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 100.1 100.2
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
100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14
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
102.1 102.2
102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 105.33 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8
107.9
107.10 107.11 107.12 107.13 107.14 107.15
107.16
107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10
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
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
109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15
110.16
110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 111.33 111.34
112.1
112.2 112.3 112.4
112.5
112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11
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
115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19
116.20
116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30
118.31
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
119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 120.1 120.2 120.3 120.4 120.5 120.6
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
122.1
122.2 122.3 122.4 122.5 122.6 122.7
122.8
122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 123.1 123.2 123.3 123.4
123.5
123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23
123.24
123.25 123.26 123.27 123.28 123.29 123.30 123.31 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9
124.10
124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2 126.3 126.4
126.5
126.6 126.7 126.8 126.9
126.10
126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 127.33 127.34 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15
128.16
128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27
128.28
128.29 128.30 128.31 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9
129.10
129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17
130.18
130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 131.1 131.2
131.3
131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15
131.16
131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24
131.25
131.26 131.27 131.28 131.29 131.30 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8
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
133.27 133.28 133.29 133.30 133.31 133.32 133.33 133.34
134.1
134.2 134.3 134.4 134.5 134.6 134.7
134.8
134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27
134.28
134.29 134.30 134.31 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 135.34 135.35 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 137.34 138.1 138.2
138.3
138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 143.1 143.2 143.3 143.4 143.5 143.6 143.7
143.8
143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24
144.25
144.26 144.27 144.28 144.29 144.30 144.31 144.32 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13
145.14
145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10
148.11
148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30
148.31
149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8
150.9
150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15
151.16
151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 153.1 153.2 153.3 153.4 153.5
153.6
153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10
155.11
155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27
156.28
156.29 156.30 156.31 156.32 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19
157.20
157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28
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
160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8
161.9
161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17
161.18
161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 162.1 162.2 162.3 162.4 162.5 162.6
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
162.23 162.24 162.25 162.26 162.27 162.28 162.29 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15
163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10
164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26
166.27
166.28 166.29 166.30 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 171.33 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14
174.15
174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17
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
176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18
177.19
177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 178.34 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14
179.15
179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 180.34 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 181.33 181.34 181.35 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 182.33 182.34 182.35 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 183.33 183.34 183.35 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 184.32 184.33 184.34 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 185.33 185.34 186.1 186.2 186.3 186.4 186.5 186.6 186.7
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
186.30 186.31 186.32 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 187.33 187.34 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8
188.9
188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 188.34 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31
189.32
190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 190.33 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11
192.12
192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 192.33 192.34 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16
193.17
193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 193.33 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13
194.14
194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32 194.33 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31
195.32
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
197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 198.1 198.2 198.3 198.4
198.5
198.6 198.7 198.8
198.9
198.10 198.11
198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30
199.1 199.2 199.3 199.4
199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31
199.32 199.33 200.1 200.2
200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11
200.12
200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21
200.22 200.23 200.24
200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26
201.27 201.28
201.29 201.30 201.31 201.32 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24
202.25 202.26 202.27 202.28 202.29 202.30 202.31 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20
203.21
203.22 203.23 203.24 203.25 203.26 203.27
203.28
204.1 204.2 204.3 204.4 204.5 204.6
204.7
204.8 204.9 204.10 204.11
204.12
204.13 204.14 204.15 204.16 204.17 204.18
204.19
204.20 204.21 204.22 204.23 204.24 204.25
204.26
204.27 204.28 204.29 205.1 205.2
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
205.26 205.27 205.28 205.29 205.30 205.31 206.1 206.2 206.3 206.4
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
206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33 207.34 207.35 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22
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
211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 212.1 212.2 212.3 212.4 212.5
212.6
212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25
212.26
212.27 212.28 212.29 212.30 212.31 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 214.32 214.33 215.1 215.2 215.3 215.4 215.5 215.6 215.7
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
216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 217.34 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33
219.1
219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 220.1 220.2 220.3 220.4 220.5 220.6
220.7
220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26
220.27
220.28 220.29 220.30 220.31 220.32 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24
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
222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 222.34 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 223.34 223.35 224.1 224.2 224.3
224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30
226.31
227.1 227.2 227.3 227.4 227.5 227.6 227.7
227.8 227.9 227.10 227.11 227.12 227.13
227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16
228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8
229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 230.33 230.34 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 231.34 231.35 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18
232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 232.34 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 233.34 233.35 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31
234.32 234.33 234.34 234.35 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 235.33
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
236.28 236.29 236.30 236.31 236.32 236.33 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14
237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 237.33 238.1 238.2
238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21
238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9
239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22
239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29
240.30 240.31 240.32 241.1 241.2 241.3 241.4 241.5 241.6 241.7
241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17
241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 242.1 242.2
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
243.29 243.30 243.31 243.32 243.33 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 244.33 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21
245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31
246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19
246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 246.33 247.1 247.2
247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15
247.16
247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 247.33 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16
248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 248.33
249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12
249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 249.33 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 250.33 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29
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
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
254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18
254.19
254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 254.33 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10
255.11
255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 256.1 256.2 256.3
256.4
256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23
256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 256.32 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8
257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 257.31 258.1 258.2 258.3 258.4
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
258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 259.1 259.2 259.3 259.4 259.5 259.6
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
260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21
260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31 260.32 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 261.32 261.33 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14
262.15 262.16
262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9
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
264.27 264.28 264.29 264.30 264.31 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 265.32 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 266.32 266.33 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33 267.34 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27
268.28 268.29 268.30 268.31
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
269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31 270.32 270.33 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11
273.12
273.13 273.14 273.15 273.16
273.17 273.18 273.19 273.20
273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 274.1 274.2 274.3
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
275.29 275.30 275.31 275.32 275.33 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10
278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18
278.19
278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 280.1 280.2 280.3 280.4 280.5 280.6
280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 280.33 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27
281.28 281.29 281.30 281.31
282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17
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
285.26 285.27 285.28 285.29 285.30 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15
286.16 286.17 286.18 286.19
286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 286.32 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9
287.10 287.11 287.12 287.13
287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 287.33 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14
288.15 288.16 288.17 288.18
288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 288.33 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 289.32 289.33 289.34 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 290.32 290.33 290.34 290.35 291.1 291.2
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
291.30 291.31 292.1 292.2
292.3 292.4 292.5 292.6
292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27
292.28 292.29 292.30 292.31
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
294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24
295.25 295.26 295.27 295.28
295.29 295.30 295.31 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28
296.29 296.30 296.31 296.32
297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14
297.15 297.16 297.17 297.18
297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 297.33
298.1 298.2 298.3 298.4 298.5
298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32
299.1 299.2 299.3 299.4
299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18
299.19 299.20 299.21 299.22
299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21
300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 300.32
301.1 301.2 301.3 301.4
301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17
301.18 301.19 301.20 301.21
301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19
302.20 302.21 302.22 302.23
302.24 302.25 302.26 302.27 302.28 302.29
302.30 302.31 302.32 302.33
303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 304.32 305.1 305.2 305.3
305.4 305.5 305.6 305.7 305.8
305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 305.32 305.33 305.34 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30 306.31 306.32 306.33 306.34 307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 307.32 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33 309.1 309.2 309.3 309.4 309.5
309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21
309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24 310.25 310.26 310.27 310.28 310.29 310.30 310.31 310.32 310.33 310.34 311.1 311.2 311.3
311.4 311.5 311.6 311.7
311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 311.33 312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8
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
313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20
314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 314.32 315.1 315.2
315.3 315.4 315.5 315.6
315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23
315.24 315.25 315.26 315.27
315.28 315.29 315.30 315.31 315.32 315.33 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 317.1 317.2 317.3 317.4 317.5
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
318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16
319.17 319.18 319.19 319.20
319.21 319.22 319.23 319.24 319.25 319.26 319.27 319.28 319.29 319.30 319.31 319.32 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 320.31 320.32
321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24
321.25 321.26 321.27 321.28 321.29 321.30 321.31 321.32 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 323.1 323.2 323.3 323.4
323.5 323.6 323.7 323.8
323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13
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
326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19 327.20 327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30
328.31
329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12
329.13 329.14 329.15 329.16
329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 329.32 329.33 329.34 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 330.32 330.33 330.34 330.35 331.1 331.2 331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 331.34 331.35 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 332.32 332.33 332.34 333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19
333.20 333.21 333.22 333.23
333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23
334.24 334.25 334.26 334.27
334.28 334.29 334.30 334.31 334.32 334.33 334.34 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16
335.17 335.18 335.19 335.20
335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26 336.27 336.28 336.29 336.30 336.31 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11 337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 338.32 338.33 338.34 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 339.33 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8
341.9 341.10 341.11 341.12
341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 342.1 342.2 342.3
342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29
344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30
346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29 347.30 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16
348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26
349.27 349.28 349.29 349.30 349.31 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25
350.26 350.27 350.28 350.29 350.30 350.31 350.32 350.33 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21
351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 352.1 352.2 352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28
353.29 353.30 353.31 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17
354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16
356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 357.1 357.2 357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24
358.25 358.26 358.27 358.28 358.29 358.30 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 359.31 360.1 360.2 360.3 360.4
360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 361.32 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9
362.10 362.11 362.12 362.13
362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 362.33 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14
363.15 363.16 363.17 363.18
363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 363.33 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 367.1 367.2 367.3 367.4 367.5 367.6 367.7
367.8 367.9 367.10 367.11
367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 368.1 368.2
368.3 368.4 368.5 368.6
368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25
368.26 368.27 368.28 368.29
369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19
369.20 369.21 369.22 369.23
369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32
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
370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 370.32 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10
371.11 371.12 371.13 371.14
371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 372.33 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 373.33 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 374.33 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 375.32 375.33 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29
377.30 377.31 377.32 377.33
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
379.26 379.27 379.28 379.29 379.30 379.31 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24
380.25 380.26 380.27 380.28
380.29 380.30 380.31 380.32 380.33 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29 381.30 381.31 381.32 381.33 381.34 381.35 382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16
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
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
384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31 384.32 385.1 385.2
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
A bill for an act
relating to human services; modifying policy provisions relating to housing, health
care, chemical and mental health, continuing care for older adults, operations,
direct care and treatment, child and families services, and disability services;
requiring a report; amending Minnesota Statutes 2018, sections 13.46, subdivisions
2, 3; 13.461, subdivision 28; 62U.03; 62U.04, subdivision 11; 119B.02, subdivision
6; 144.216, by adding subdivisions; 144.218, by adding a subdivision; 144.225,
subdivision 2b; 144.226, subdivision 1; 144A.471, subdivision 8; 144A.475,
subdivision 6; 145.902; 176.011, subdivision 9; 216C.435, subdivision 13; 245.095;
245A.02, subdivisions 3, 8, 9, 12, 14, by adding subdivisions; 245A.03,
subdivisions 1, 3, 7; 245A.04, subdivisions 1, 2, 4, 6, 7, 10, by adding a subdivision;
245A.05; 245A.07, subdivisions 1, 2, 2a, 3; 245C.03, subdivision 2; 245C.04,
subdivision 3; 245C.08, subdivision 1; 245C.10, subdivision 3; 245C.16,
subdivision 1; 245D.03, subdivision 1; 245D.071, subdivisions 1, 3; 245D.09,
subdivision 4a; 245D.091, subdivisions 2, 3, 4; 245E.01, subdivision 8; 245E.02,
subdivision 4, by adding subdivisions; 245G.01, subdivisions 8, 21, by adding
subdivisions; 245G.04; 245G.05; 245G.06, subdivisions 1, 2, 4; 245G.07; 245G.08,
subdivision 3; 245G.10, subdivision 4; 245G.11, subdivisions 7, 8; 245G.12;
245G.13, subdivision 1; 245G.15, subdivisions 1, 2; 245G.18, subdivisions 3, 5;
245G.22, subdivisions 1, 2, 3, 4, 6, 7, 15, 16, 17, 19; 252.32, subdivisions 1a, 3a;
253B.18, subdivision 13, by adding subdivisions; 253D.28, subdivision 3; 254B.04,
by adding a subdivision; 254B.05, subdivisions 1, 5; 256.01, subdivision 29;
256.021, subdivision 2; 256.045, subdivisions 3, 4, 5, 6, 10; 256.0451, subdivisions
1, 3, 5, 6, 7, 9, 10, 11, 12, 13, 19, 21, 22, 23, 24; 256.046, subdivision 1; 256.9685,
subdivision 1; 256B.02, subdivision 7; 256B.038; 256B.04, subdivision 21;
256B.043, subdivision 1; 256B.056, subdivisions 1a, 4, 7, 7a, 10; 256B.0561,
subdivision 2; 256B.057, subdivision 1; 256B.0575, subdivision 2; 256B.0621,
subdivision 2; 256B.0625, subdivisions 1, 3c, 3d, 3e, 27, 53, by adding a
subdivision; 256B.0638, subdivision 3; 256B.064, subdivisions 1a, 1b, 2, by adding
subdivisions; 256B.0651, subdivisions 1, 2, 12, 13, 17; 256B.0652, subdivisions
2, 5, 8, 10, 12; 256B.0653, subdivision 3; 256B.0659, subdivisions 3a, 12;
256B.0705, subdivisions 1, 2; 256B.0711, subdivisions 1, 2; 256B.0751;
256B.0753, subdivision 1, by adding a subdivision; 256B.0911, subdivisions 1a,
3a, 3f, 6; 256B.0913, subdivision 5a; 256B.0915, subdivisions 3a, 6; 256B.0916,
subdivision 9; 256B.0918, subdivision 2; 256B.092, subdivision 1b; 256B.093,
subdivision 4; 256B.0941, subdivisions 1, 3; 256B.097, subdivision 1; 256B.27,
subdivision 3; 256B.439, subdivision 1; 256B.49, subdivisions 13, 14, 17;
256B.4912, by adding subdivisions; 256B.4914, subdivisions 2, 3, 14; 256B.501,
subdivision 4a; 256B.69, subdivision 5a; 256B.75; 256B.765; 256B.85, subdivisions
1, 2, 4, 5, 6, 8, 9, 10, 11, 11b, 12, 12b, 13a, 18a, by adding a subdivision; 256D.44,
subdivision 5; 256E.21, subdivision 5; 256I.03, subdivisions 8, 15; 256I.04,
subdivisions 1, 2a, 2b, by adding subdivisions; 256I.05, subdivisions 1a, 1c;
256J.21, subdivision 2; 256J.45, subdivision 3; 256L.03, subdivision 1; 256L.15,
subdivision 1; 256M.41, subdivision 3, by adding a subdivision; 256N.02,
subdivisions 10, 16, 17, 18; 256N.22, subdivision 1; 256N.23, subdivisions 2, 6;
256N.24, subdivisions 1, 8, 11, 12, 14; 256N.28, subdivision 6; 256R.02,
subdivisions 4, 17, 18, 19, 29, 42a, 48a; 256R.07, subdivisions 1, 2; 256R.09,
subdivision 2; 256R.10, subdivision 1; 256R.13, subdivision 4; 256R.39; 259.241;
259.35, subdivision 1; 259.37, subdivision 2; 259.53, subdivision 4; 259.75; 259.83,
subdivisions 1, 1a, 3; 259A.75, subdivisions 1, 2, 3, 4, 5; 260.761, subdivision 2;
260C.101, by adding a subdivision; 260C.139, subdivision 3; 260C.171, subdivision
2; 260C.178, subdivision 1; 260C.212, subdivisions 1, 2, by adding a subdivision;
260C.219; 260C.451, subdivision 9; 260C.503, subdivision 2; 260C.515,
subdivisions 3, 4; 260C.605, subdivision 1; 260C.607, subdivision 6; 260C.609;
260C.611; 260C.613, subdivision 6; 260C.615, subdivision 1; 260C.623,
subdivisions 3, 4; 260C.625; 260C.629, subdivision 2; 394.307, subdivision 1;
402A.16, subdivision 3; 462.3593, subdivision 1; 518A.53, subdivision 11;
518A.685; 604A.33, subdivision 1; 609.2231, subdivision 3a; 609.232, subdivisions
3, 11; 626.556, subdivisions 2, 3, 3c, 3e, 4, 7, 10, 10a, 10b, 10d, 10e, 10f, 10m,
11, 11c; 626.5561, subdivision 1; 626.557, subdivisions 3, 3a, 4, 4a, 6, 9, 9b, 9c,
9d, 10, 10b, 12b, 14, 17; 626.5572, subdivisions 2, 3, 4, 6, 8, 9, 16, 17, 20, 21, by
adding a subdivision; 626.558, subdivision 2; Laws 2017, First Special Session
chapter 6, article 1, section 44; proposing coding for new law in Minnesota Statutes,
chapters 245A; 256B; 518A; 609; repealing Minnesota Statutes 2018, sections
62U.15, subdivision 2; 119B.125, subdivision 8; 256.476, subdivisions 1, 2, 3, 4,
5, 6, 8, 9, 10, 11; 256B.057, subdivision 8; 256B.0625, subdivisions 3a, 19a, 19c;
256B.0652, subdivision 6; 256B.0659, subdivisions 1, 2, 3, 3a, 4, 5, 6, 7, 7a, 8, 9,
10, 11, 11a, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29,
30, 31; 256B.0752; 256B.79, subdivision 7; 256I.05, subdivision 3; 256J.751,
subdivision 1; 256L.04, subdivision 13; 256R.08, subdivision 2; 256R.49.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
HOUSING
Section 1.
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, deleted text begin anddeleted text end arranging for medical and
social servicesnew text begin , and services identified in section 256I.03, subdivision 12new text end .
Sec. 2.
Minnesota Statutes 2018, section 256I.03, subdivision 15, is amended to read:
Subd. 15.
Supportive housing.
"Supportive housing" means housing deleted text begin with support
services according to the continuum of care coordinated assessment system established
under Code of Federal Regulations, title 24, section 578.3deleted text end new text begin that is not time-limited and
provides or coordinates services necessary for a resident to maintain housing stabilitynew text end .
Sec. 3.
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 receives licensed residential crisis stabilization services under section
256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive
concurrent housing support payments if receiving licensed residential crisis stabilization
services under section 256B.0624, subdivision 7.
new text begin
(d) An individual who receives ongoing rental subsidies is not eligible for housing
support payments under paragraph (a) or (b).
new text end
Sec. 4.
Minnesota Statutes 2018, section 256I.04, subdivision 2a, is amended to read:
Subd. 2a.
License required; staffing qualifications.
(a) Except as provided in paragraph
(b), an agency may not enter into an agreement with an establishment to provide housing
support unless:
(1) the establishment is licensed by the Department of Health as a hotel and restaurant;
a board and lodging establishment; a boarding care home before March 1, 1985; or a
supervised living facility, and the service provider for residents of the facility is licensed
under chapter 245A. However, an establishment licensed by the Department of Health to
provide lodging need not also be licensed to provide board if meals are being supplied to
residents under a contract with a food vendor who is licensed by the Department of Health;
(2) the residence is: (i) licensed by the commissioner of human services under Minnesota
Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior
to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265;
(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120,
with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02,
subdivision 4a, as a community residential setting by the commissioner of human services;
or
(3) the establishment is registered under chapter 144D and provides three meals a day.
(b) The requirements under paragraph (a) do not apply to establishments exempt from
state licensure because they are:
(1) located on Indian reservations and subject to tribal health and safety requirements;
or
(2) deleted text begin a supportive housing establishment that has an approved habitability inspection and
an individual lease agreement and that serves people who have experienced long-term
homelessness and were referred through a coordinated assessment in section 256I.03,
subdivision 15deleted text end new text begin supportive housing establishments where an individual has an approved
habitability inspection and an individual lease agreementnew text end .
(c) Supportive housing establishments new text begin that serve individuals who have experienced
long-term homelessness new text end and emergency shelters must participate in the homeless management
information systemnew text begin and a coordinated assessment system as defined by the commissionernew text end .
(d) Effective July 1, 2016, an agency shall not have an agreement with a provider of
housing support unless all staff members who have direct contact with recipients:
(1) have skills and knowledge acquired through one or more of the following:
(i) a course of study in a health- or human services-related field leading to a bachelor
of arts, bachelor of science, or associate's degree;
(ii) one year of experience with the target population served;
(iii) experience as a mental health certified peer specialist according to section 256B.0615;
or
(iv) meeting the requirements for unlicensed personnel under sections 144A.43 to
144A.483;
(2) hold a current driver's license appropriate to the vehicle driven if transporting
recipients;
(3) complete training on vulnerable adults mandated reporting and child maltreatment
mandated reporting, where applicable; and
(4) complete housing support orientation training offered by the commissioner.
Sec. 5.
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) that the provider complies with the prohibition on limiting or restricting the number
of hours an applicant or recipient is 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. 6.
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
A provider of supplementary services
shall ensure that a recipient has, at a minimum, assistance with services as identified in the
recipient's professional statement of need under section 256I.03, subdivision 12. A provider
of supplementary services shall maintain case notes with the date and description of services
provided to each recipient.
new text end
Sec. 7.
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. 8.
Minnesota Statutes 2018, section 256I.05, subdivision 1c, is amended to read:
Subd. 1c.
Rate increases.
An agency may not increase the rates negotiated for housing
support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).
(a) An agency may increase the rates for room and board to the MSA equivalent rate
for those settings whose current rate is below the MSA equivalent rate.
(b) An agency may increase the rates for residents in adult foster care whose difficulty
of care has increased. The total housing support rate for these residents must not exceed the
maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase
difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding
by home and community-based waiver programs under title XIX of the Social Security Act.
(c) The room and board rates will be increased each year when the MSA equivalent rate
is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less
the amount of the increase in the medical assistance personal needs allowance under section
256B.35.
(d) When housing support pays for an individual's room and board, or other costs
necessary to provide room and board, the rate payable to the residence must continue for
up to 18 calendar days per incident that the person is temporarily absent from the residence,
not to exceed 60 days in a calendar year, if the absence or absences deleted text begin have received the prior
approval ofdeleted text end new text begin are reported in advance tonew text end the county agency's social service staff. deleted text begin Prior approvaldeleted text end new text begin
Advance reportingnew text end is not required for emergency absences due to crisis, illness, or injury.
(e) For facilities meeting substantial change criteria within the prior year. Substantial
change criteria exists if the establishment experiences a 25 percent increase or decrease in
the total number of its beds, if the net cost of capital additions or improvements is in excess
of 15 percent of the current market value of the residence, or if the residence physically
moves, or changes its licensure, and incurs a resulting increase in operation and property
costs.
(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid
for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who
reside in residences that are licensed by the commissioner of health as a boarding care home,
but are not certified for the purposes of the medical assistance program. However, an increase
under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical
assistance reimbursement rate for nursing home resident class A, in the geographic grouping
in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to
9549.0058.
Sec. 9. 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 2
HEALTH CARE
Section 1.
Minnesota Statutes 2018, section 62U.03, is amended to read:
62U.03 PAYMENT RESTRUCTURING; CARE COORDINATION PAYMENTS.
(a) By January 1, 2010, health plan companies shall include health care homes in their
provider networks and by July 1, 2010, shall pay a care coordination fee for their members
who choose to enroll in health care homes certified by the deleted text begin commissioners of health and
human servicesdeleted text end new text begin commissionernew text end under section 256B.0751. Health plan companies shall develop
payment conditions and terms for the care coordination fee for health care homes participating
in their network in a manner that is consistent with the system developed under section
256B.0753. Nothing in this section shall restrict the ability of health plan companies to
selectively contract with health care providers, including health care homes. Health plan
companies may reduce or reallocate payments to other providers to ensure that
implementation of care coordination payments is cost neutral.
(b) By July 1, 2010, the commissioner of management and budget shall implement the
care coordination payments for participants in the state employee group insurance program.
The commissioner of management and budget may reallocate payments within the health
care system in order to ensure that the implementation of this section is cost neutral.
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 62U.04, subdivision 11, is amended to read:
Subd. 11.
Restricted uses of the all-payer claims data.
(a) Notwithstanding subdivision
4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's
designee shall only use the data submitted under subdivisions 4 and 5 for the following
purposes:
(1) to evaluate the performance of the health care home program as authorized under
deleted text begin sectionsdeleted text end new text begin sectionnew text end 256B.0751, subdivision 6deleted text begin , and 256B.0752, subdivision 2deleted text end ;
(2) to study, in collaboration with the reducing avoidable readmissions effectively
(RARE) campaign, hospital readmission trends and rates;
(3) to analyze variations in health care costs, quality, utilization, and illness burden based
on geographical areas or populations;
(4) to evaluate the state innovation model (SIM) testing grant received by the Departments
of Health and Human Services, including the analysis of health care cost, quality, and
utilization baseline and trend information for targeted populations and communities; and
(5) to compile one or more public use files of summary data or tables that must:
(i) be available to the public for no or minimal cost by March 1, 2016, and available by
web-based electronic data download by June 30, 2019;
(ii) not identify individual patients, payers, or providers;
(iii) be updated by the commissioner, at least annually, with the most current data
available;
(iv) contain clear and conspicuous explanations of the characteristics of the data, such
as the dates of the data contained in the files, the absence of costs of care for uninsured
patients or nonresidents, and other disclaimers that provide appropriate context; and
(v) not lead to the collection of additional data elements beyond what is authorized under
this section as of June 30, 2015.
(b) The commissioner may publish the results of the authorized uses identified in
paragraph (a) so long as the data released publicly do not contain information or descriptions
in which the identity of individual hospitals, clinics, or other providers may be discerned.
(c) Nothing in this subdivision shall be construed to prohibit the commissioner from
using the data collected under subdivision 4 to complete the state-based risk adjustment
system assessment due to the legislature on October 1, 2015.
(d) The commissioner or the commissioner's designee may use the data submitted under
subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1,
2023.
(e) The commissioner shall consult with the all-payer claims database work group
established under subdivision 12 regarding the technical considerations necessary to create
the public use files of summary data described in paragraph (a), clause (5).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 3.
Minnesota Statutes 2018, section 256.01, subdivision 29, is amended to read:
Subd. 29.
State medical review team.
(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, deleted text begin subdivisiondeleted text end new text begin subdivisions new text end 7, paragraph (b), new text begin and 12; and new text end 256B.057, subdivision 9,
deleted text begin and 256B.055, subdivision 12,deleted text end the commissioner shall review all medical evidence deleted text begin submitted
by county agencies with a referraldeleted text end and seek deleted text begin additionaldeleted text end information from providers, applicants,
and enrollees to support the determination of disability where necessary. Disability shall
be determined according to the rules of title XVI and title XIX of the Social Security Act
and pertinent rules and policies of the Social Security Administration.
(b) Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.
(c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:
(1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;
(2) the average length of time from receipt of the application to a decision;
(3) the number of appeals, appeal results, and the length of time taken from the date the
person involved requested an appeal for a written decision to be made on each appeal;
(4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and
(5) specific information on the medical certification, licensure, or other credentials of
the person or persons performing the medical review determinations and length of time in
that position.
(d) Any appeal made under section 256.045, subdivision 3, of a disability determination
made by the state medical review team must be decided according to the timelines under
section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within
the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be
immediately reviewed by the chief human services judge.
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 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 rehabilitation 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.
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.043, subdivision 1, is amended to read:
Subdivision 1.
Alternative and complementary health care.
The commissioner of
human services, through the medical director and in consultation with the Health Services
deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end established under section 256B.0625, subdivision 3c,
as part of the commissioner's ongoing duties, shall consider the potential for improving
quality and obtaining cost savings through greater use of alternative and complementary
treatment methods and clinical practice; shall incorporate these methods into the medical
assistance and MinnesotaCare programs; and shall make related legislative recommendations
as appropriate. The commissioner shall post the recommendations required under this
subdivision on agency websites.
Sec. 6.
Minnesota Statutes 2018, section 256B.056, subdivision 1a, is amended to read:
Subd. 1a.
Income and assets generally.
(a)(1) Unless specifically required by state law
or rule or federal law or regulation, the methodologies used in counting income and assets
to determine eligibility for medical assistance for persons whose eligibility category is based
on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental
Security Income program shall be used, except as provided under subdivision 3, paragraph
(a), clause (6).
(2) Increases in benefits under title II of the Social Security Act shall not be counted as
income for purposes of this subdivision until July 1 of each year. Effective upon federal
approval, for children eligible under section 256B.055, subdivision 12, or for home and
community-based waiver services whose eligibility for medical assistance is determined
without regard to parental income, child support payments, including any payments made
by an obligor in satisfaction of or in addition to a temporary or permanent order for child
support, and Social Security payments are not counted as income.
(b)(1) The modified adjusted gross income methodology as defined in deleted text begin the Affordable
Care Actdeleted text end new text begin United States Code, title 42, section 1396a(e)(14),new text end shall be used for eligibility
categories based on:
(i) children under age 19 and their parents and relative caretakers as defined in section
256B.055, subdivision 3a;
(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;
(iii) pregnant women as defined in section 256B.055, subdivision 6;
(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision
deleted text begin 8deleted text end new text begin 1new text end ; and
(v) adults without children as defined in section 256B.055, subdivision 15.
For these purposes, a "methodology" does not include an asset or income standard, or
accounting method, or method of determining effective dates.
(2) For individuals whose income eligibility is determined using the modified adjusted
gross income methodology in clause (1)deleted text begin ,deleted text end new text begin :
new text end
new text begin (i) new text end the commissioner shall subtract from the individual's modified adjusted gross income
an amount equivalent to five percent of the federal poverty guidelinesdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(ii) the individual's current monthly income and household size is used to determine
eligibility for the 12-month eligibility period. If an individual's income is expected to vary
month to month, eligibility is determined based on the income predicted for the 12-month
eligibility period.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 7.
Minnesota Statutes 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) deleted text begin Effective January 1, 2014,deleted text end To be eligible for medical assistancedeleted text begin ,deleted text end 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 deleted text begin 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 7adeleted text end .
(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 shall 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 recipient.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 8.
Minnesota Statutes 2018, section 256B.056, subdivision 7, is amended to read:
Subd. 7.
Period of eligibility.
new text begin (a) new text end Eligibility is available for the month of application
and for three months prior to application if the person was eligible in those prior months.
A redetermination of eligibility must occur every 12 months.
new text begin
(b) For a person eligible for an insurance affordability program who reports a change
that makes the person eligible for medical assistance, eligibility is available for the month
the change was reported and for three months prior to the month the change was reported,
if the person was eligible in those prior months.
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. 9.
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.
(d) Notwithstanding paragraph (a), deleted text begin individualsdeleted text end new text begin a person who isnew text end eligible under subdivision
5 shall be deleted text begin required to renew eligibilitydeleted text end new text begin subject to a review of the person's incomenew text end every six
months.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 10.
Minnesota Statutes 2018, section 256B.056, subdivision 10, is amended to read:
Subd. 10.
Eligibility verification.
(a) The commissioner shall require women who are
applying for the continuation of medical assistance coverage following the end of the 60-day
postpartum period to update their income and asset information and to submit any required
income or asset verification.
(b) The commissioner shall determine the eligibility of private-sector health care coverage
for infants less than one year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph deleted text begin (b)deleted text end new text begin (c)new text end , and shall pay for private-sector coverage if this
is determined to be cost-effective.
(c) The commissioner shall verify assets and income for all applicants, and for all
recipients upon renewal.
(d) The commissioner shall utilize information obtained through the electronic service
established by the secretary of the United States Department of Health and Human Services
and other available electronic data sources in Code of Federal Regulations, title 42, sections
435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish
standards to define when information obtained electronically is reasonably compatible with
information provided by applicants and enrollees, including use of self-attestation, to
accomplish real-time eligibility determinations and maintain program integrity.
new text begin
(e) Each person applying for or receiving medical assistance under section 256B.055,
subdivision 7, and any other person whose resources are required by law to be disclosed to
determine the applicant's or recipient's eligibility must authorize the commissioner to obtain
information from financial institutions to identify unreported accounts as required in section
256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner
may determine that the applicant or recipient is ineligible for medical assistance. For purposes
of this paragraph, an authorization to identify unreported accounts meets the requirements
of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not
be furnished to the financial institution.
new text end
new text begin
(f) County and tribal agencies shall comply with the standards established by the
commissioner for appropriate use of the asset verification system specified in section 256.01,
subdivision 18f.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon implementation of Minnesota
Statutes, section 256.01, subdivision 18f. The commissioner of human services shall notify
the revisor of statutes when this section is effective.
new text end
Sec. 11.
Minnesota Statutes 2018, section 256B.0561, subdivision 2, is amended to read:
Subd. 2.
Periodic data matching.
(a) deleted text begin Beginning April 1, 2018,deleted text end The commissioner shall
conduct periodic data matching to identify recipients who, based on available electronic
data, may not meet eligibility criteria for the public health care program in which the recipient
is enrolled. The commissioner shall conduct data matching for medical assistance or
MinnesotaCare recipients at least once during a recipient's 12-month period of eligibility.
(b) If data matching indicates a recipient may no longer qualify for medical assistance
or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no
more than 30 days to confirm the information obtained through the periodic data matching
or provide a reasonable explanation for the discrepancy to the state or county agency directly
responsible for the recipient's case. If a recipient does not respond within the advance notice
period or does not respond with information that demonstrates eligibility or provides a
reasonable explanation for the discrepancy within the 30-day time period, the commissioner
shall terminate the recipient's eligibility in the manner provided for by the laws and
regulations governing the health care program for which the recipient has been identified
as being ineligible.
(c) The commissioner shall not terminate eligibility for a recipient who is cooperating
with the requirements of paragraph (b) and needs additional time to provide information in
response to the notification.
new text begin
(d) A recipient whose eligibility was terminated according to paragraph (b) may be
eligible for medical assistance no earlier than the first day of the month in which the recipient
provides information that demonstrates the recipient's eligibility.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end Any termination of eligibility for benefits under this section may be appealed as
provided for in sections 256.045 to 256.0451, and the laws governing the health care
programs for which eligibility is terminated.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 12.
Minnesota Statutes 2018, section 256B.057, subdivision 1, is amended to read:
Subdivision 1.
Infants and pregnant women.
(a) An infant less than two years of age
deleted text begin or a pregnant womandeleted text end is eligible for medical assistance if the deleted text begin individual'sdeleted text end new text begin infant'snew text end countable
household income is equal to or less than deleted text begin 275deleted text end new text begin 283new text end percent of the federal poverty guideline
for the same household size deleted text begin or an equivalent standard when converted using modified
adjusted gross income methodology as required under the Affordable Care Actdeleted text end .new text begin Medical
assistance for an uninsured infant younger than two years of age may be paid with federal
funds available under title XXI of the Social Security Act and the state children's health
insurance program, for an infant with countable income above 275 percent and equal to or
less than 283 percent of the federal poverty guideline for the household size.
new text end
new text begin
(b) A pregnant woman is eligible for medical assistance if the woman's countable income
is equal to or less than 278 percent of the federal poverty guideline for the applicable
household size.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end An infant born to a woman who was eligible for and receiving medical assistance
on the date of the child's birth shall continue to be eligible for medical assistance without
redetermination until the child's first birthday.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 13.
Minnesota Statutes 2018, section 256B.0575, subdivision 2, is amended to read:
Subd. 2.
Reasonable expenses.
For the purposes of subdivision 1, paragraph (a), clause
(9), reasonable expenses are limited to expenses that have not been previously used as a
deduction from income and were not:
(1) for long-term care expenses incurred during a period of ineligibility as defined in
section 256B.0595, subdivision 2;
(2) incurred more than three months before the month of application associated with the
current period of eligibility;
(3) for expenses incurred by a recipient that are duplicative of services that are covered
under chapter 256B; deleted text begin or
deleted text end
(4) nursing facility expenses incurred without a timely assessment as required under
section 256B.0911deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(5) for private room fees incurred by an assisted living client as defined in section
144G.01, subdivision 3.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 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. 14.
Minnesota Statutes 2018, section 256B.0625, subdivision 1, is amended to read:
Subdivision 1.
Inpatient hospital services.
(a) Medical assistance covers inpatient
hospital servicesnew text begin performed by hospitals holding Medicare certifications for the services
performednew text end . deleted text begin A second medical opinion is required prior to reimbursement for elective surgeries
requiring a second opinion. The commissioner shall publish in the State Register a list of
elective surgeries that require a second medical opinion prior to reimbursement, and the
criteria and standards for deciding whether an elective surgery should require a second
medical opinion. The list and the criteria and standards are not subject to the requirements
of sections 14.001 to 14.69. The commissioner's decision whether a second medical opinion
is required, made in accordance with rules governing that decision, is not subject to
administrative appeal.
deleted text end
(b) When determining medical necessity for inpatient hospital services, the medical
review agent shall follow industry standard medical necessity criteria in determining the
following:
(1) whether a recipient's admission is medically necessary;
(2) whether the inpatient hospital services provided to the recipient were medically
necessary;
(3) whether the recipient's continued stay was or will be medically necessary; and
(4) whether all medically necessary inpatient hospital services were provided to the
recipient.
The medical review agent will determine medical necessity of inpatient hospital services,
including inpatient psychiatric treatment, based on a review of the patient's medical condition
and records, in conjunction with industry standard evidence-based criteria to ensure consistent
and optimal application of medical appropriateness criteria.
new text 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 256B.0625, subdivision 3c, is amended to read:
Subd. 3c.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end .
(a) The commissioner,
after receiving recommendations from professional physician associations, professional
associations representing licensed nonphysician health care professionals, and consumer
groups, shall establish a deleted text begin 13-memberdeleted text end new text begin 14-membernew text end Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory
Councilnew text end , which consists of deleted text begin 12deleted text end new text begin 13new text end voting members and one nonvoting member. The Health
Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall advise the commissioner regardingnew text begin : (1)new text end
health services pertaining to the administration of health care benefits covered under deleted text begin the
medical assistance and MinnesotaCare programs.deleted text end new text begin Minnesota health care programs (MHCP);
and (2) evidence-based decision making and health care benefit and coverage policies for
Minnesota health care programs. The council shall consider available evidence of quality,
safety, and cost-effectiveness when making recommendations.new text end The Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end shall meet at least quarterly. The Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end shall annually deleted text begin electdeleted text end new text begin selectnew text end a deleted text begin physiciandeleted text end chair from among its
members, who shall work directly with the commissioner's medical directordeleted text begin ,deleted text end to establish
the agenda for each meeting. The Health Services deleted text begin Policy Committee shall alsodeleted text end new text begin Advisory
Council maynew text end recommend criteria for verifying centers of excellence for specific aspects of
medical care where a specific set of combined services, a volume of patients necessary to
maintain a high level of competency, or a specific level of technical capacity is associated
with improved health outcomes.new text begin The Health Services Advisory Council may also recommend
criteria and standards for determining services that require prior authorization or whether
certain providers must obtain prior authorization for their services under section 256B.0625,
subdivision 25.
new text end
(b) The commissioner shall establish a dental deleted text begin subcommitteedeleted text end new text begin subcouncilnew text end to operate under
the Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end . The dental deleted text begin subcommitteedeleted text end new text begin
subcouncilnew text end consists of general dentists, dental specialists, safety net providers, dental
hygienists, health plan company and county and public health representatives, health
researchers, consumers, and a designee of the commissioner of health. The dental
deleted text begin subcommitteedeleted text end new text begin subcouncilnew text end shall advise the commissioner regarding:
(1) the critical access dental program under section 256B.76, subdivision 4, including
but not limited to criteria for designating and terminating critical access dental providers;
(2) any changes to the critical access dental provider program necessary to comply with
program expenditure limits;
(3) dental coverage policy based on evidence, quality, continuity of care, and best
practices;
(4) the development of dental delivery models; and
(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
deleted text begin
(c) The Health Services Policy Committee shall study approaches to making provider
reimbursement under the medical assistance and MinnesotaCare programs contingent on
patient participation in a patient-centered decision-making process, and shall evaluate the
impact of these approaches on health care quality, patient satisfaction, and health care costs.
The committee shall present findings and recommendations to the commissioner and the
legislative committees with jurisdiction over health care by January 15, 2010.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end The Health Services deleted text begin Policy Committee shalldeleted text end new text begin Advisory Council maynew text end monitor and
track the practice patterns of deleted text begin physicians providing services to medical assistance and
MinnesotaCare enrolleesdeleted text end new text begin health care providers who serve MHCP recipientsnew text end under
fee-for-service, managed care, and county-based purchasing. The deleted text begin committeedeleted text end new text begin council's
monitoring and trackingnew text end shall focus on services or specialties for which there is a high
variation in utilization new text begin or quality new text end across deleted text begin physiciansdeleted text end new text begin providersnew text end , or which are associated with
high medical costs. The commissioner, based upon the findings of the deleted text begin committeedeleted text end new text begin councilnew text end ,
deleted text begin shall regularlydeleted text end new text begin maynew text end notify deleted text begin physiciansdeleted text end new text begin providersnew text end whose practice patterns indicate new text begin below
average quality or new text end higher than average utilization or costs. Managed care and county-based
purchasing plans shall provide the commissioner with utilization and cost data necessary
to implement this paragraph, and the commissioner shall make deleted text begin thisdeleted text end new text begin thenew text end data available to the
deleted text begin committeedeleted text end new text begin Health Services Advisory Councilnew text end .
deleted text begin
(e) The Health Services Policy Committee shall review caesarean section rates for the
fee-for-service medical assistance population. The committee may develop best practices
policies related to the minimization of caesarean sections, including but not limited to
standards and guidelines for health care providers and health care facilities.
deleted text end
Sec. 16.
Minnesota Statutes 2018, section 256B.0625, subdivision 3d, is amended to read:
Subd. 3d.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end members.
new text begin (a) new text end The
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end consists of:
(1) deleted text begin sevendeleted text end new text begin sixnew text end voting members who are licensed physicians actively engaged in the practice
of medicine in Minnesota, deleted text begin one of whom must be actively engaged in the treatment of persons
with mental illness, anddeleted text end three of whom must represent health plans currently under contract
to serve deleted text begin medical assistancedeleted text end new text begin MHCPnew text end recipients;
(2) two voting members who are new text begin licensed new text end physician specialists actively practicing their
specialty in Minnesota;
(3) two voting members who are nonphysician health care professionals licensed or
registered in their profession and actively engaged in their practice of their profession in
Minnesota;
new text begin
(4) one voting member who is a health care or mental health professional licensed or
registered in their profession, actively engaged in the practice of their profession in
Minnesota, and actively engaged in the treatment of persons with mental illness;
new text end
deleted text begin (4) one consumerdeleted text end new text begin (5) two consumersnew text end who shall serve as deleted text begin adeleted text end voting deleted text begin memberdeleted text end new text begin membersnew text end ; and
deleted text begin (5)deleted text end new text begin (6)new text end the commissioner's medical directornew text begin ,new text end who shall serve as a nonvoting member.
new text begin (b) new text end Members of the Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall not be
employed by the deleted text begin Department of Human Servicesdeleted text end new text begin state of Minnesotanew text end , except for the medical
director.new text begin A quorum shall comprise a simple majority of the voting members and vacant
seats must not count toward a quorum.
new text end
Sec. 17.
Minnesota Statutes 2018, section 256B.0625, subdivision 3e, is amended to read:
Subd. 3e.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end terms and
compensation.
deleted text begin Committeedeleted text end Members shall serve staggered three-year terms, with one-third
of the voting members' terms expiring annually. Members may be reappointed by the
commissioner. The commissioner may require more frequent Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end meetings as needed. An honorarium of $200 per meeting and
reimbursement for mileage and parking shall be paid to each deleted text begin committeedeleted text end new text begin councilnew text end member
in attendance except the medical director. The Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory
Councilnew text end does not expire as provided in section 15.059, subdivision 6.
Sec. 18.
Minnesota Statutes 2018, section 256B.0625, subdivision 27, is amended to read:
Subd. 27.
Organ and tissue transplants.
deleted text begin All organ transplants must be performed at
transplant centers meeting united network for organ sharing criteria or at Medicare-approved
organ transplant centers.deleted text end new text begin Organ and tissue transplants are a covered service. new text end Stem cell or
bone marrow transplant centers must meet the standards established by the Foundation for
the Accreditation of Hematopoietic Cell Therapy.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 19.
Minnesota Statutes 2018, section 256B.0625, subdivision 53, is amended to read:
Subd. 53.
Centers of excellence.
For complex medical procedures with a high degree
of variation in outcomes, for which the Medicare program requires facilities providing the
services to meet certain criteria as a condition of coverage, the commissioner may develop
centers of excellence facility criteria in consultation with the Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end under subdivision 3c. The criteria must reflect facility traits
that have been linked to superior patient safety and outcomes for the procedures in question,
and must be based on the best available empirical evidence. For medical assistance recipients
enrolled on a fee-for-service basis, the commissioner may make coverage for these procedures
conditional upon the facility providing the services meeting the specified criteria. Only
facilities meeting the criteria may be reimbursed for the procedures in question.
Sec. 20.
Minnesota Statutes 2018, section 256B.0638, subdivision 3, is amended to read:
Subd. 3.
Opioid prescribing work group.
(a) The commissioner of human services, in
consultation with the commissioner of health, shall appoint the following voting members
to an opioid prescribing work group:
(1) two consumer members who have been impacted by an opioid abuse disorder or
opioid dependence disorder, either personally or with family members;
(2) one member who is a licensed physician actively practicing in Minnesota and
registered as a practitioner with the DEA;
(3) one member who is a licensed pharmacist actively practicing in Minnesota and
registered as a practitioner with the DEA;
(4) one member who is a licensed nurse practitioner actively practicing in Minnesota
and registered as a practitioner with the DEA;
(5) one member who is a licensed dentist actively practicing in Minnesota and registered
as a practitioner with the DEA;
(6) two members who are nonphysician licensed health care professionals actively
engaged in the practice of their profession in Minnesota, and their practice includes treating
pain;
(7) one member who is a mental health professional who is licensed or registered in a
mental health profession, who is actively engaged in the practice of that profession in
Minnesota, and whose practice includes treating patients with chemical dependency or
substance abuse;
(8) one member who is a medical examiner for a Minnesota county;
(9) one member of the Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end established
under section 256B.0625, subdivisions 3c to 3e;
(10) one member who is a medical director of a health plan company doing business in
Minnesota;
(11) one member who is a pharmacy director of a health plan company doing business
in Minnesota; and
(12) one member representing Minnesota law enforcement.
(b) In addition, the work group shall include the following nonvoting members:
(1) the medical director for the medical assistance program;
(2) a member representing the Department of Human Services pharmacy unit; and
(3) the medical director for the Department of Labor and Industry.
(c) An honorarium of $200 per meeting and reimbursement for mileage and parking
shall be paid to each voting member in attendance.
Sec. 21.
Minnesota Statutes 2018, section 256B.0751, is amended to read:
256B.0751 HEALTH CARE HOMES.
Subdivision 1.
Definitions.
(a) For purposes of deleted text begin sectionsdeleted text end new text begin sectionnew text end 256B.0751 deleted text begin to 256B.0753deleted text end ,
the following definitions apply.
(b) "Commissioner" means the commissioner of deleted text begin human servicesdeleted text end new text begin healthnew text end .
deleted text begin
(c) "Commissioners" means the commissioner of human services and the commissioner
of health, acting jointly.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end "Health plan company" has the meaning provided in section 62Q.01, subdivision
4.
deleted text begin (e)deleted text end new text begin (d)new text end "Personal clinician" means a physician licensed under chapter 147, a physician
assistant licensed and practicing under chapter 147A, or an advanced practice nurse licensed
and registered to practice under chapter 148.
deleted text begin
(f) "State health care program" means the medical assistance and MinnesotaCare
programs.
deleted text end
Subd. 2.
Development and implementation of standards.
(a) deleted text begin By July 1, 2009,deleted text end The
deleted text begin commissionersdeleted text end new text begin commissionernew text end of health deleted text begin and human servicesdeleted text end shall develop and implement
standards of certification for health care homes deleted text begin for state health care programsdeleted text end . In developing
these standards, the deleted text begin commissionersdeleted text end new text begin commissionernew text end shall consider existing standards developed
by national independent accrediting and medical home organizations. The standards
developed by the deleted text begin commissionersdeleted text end new text begin commissionernew text end must meet the following criteria:
(1) emphasize, enhance, and encourage the use of primary care, and include the use of
primary care physicians, advanced practice nurses, and physician assistants as personal
clinicians;
(2) focus on delivering high-quality, efficient, and effective health care services;
(3) encourage patient-centered care, including active participation by the patient and
family or a legal guardian, or a health care agent as defined in chapter 145C, as appropriate
in decision making and care plan development, and providing care that is appropriate to the
patient's race, ethnicity, and language;
(4) provide patients with a consistent, ongoing contact with a personal clinician or team
of clinical professionals to ensure continuous and appropriate care for the patient's condition;
(5) ensure that health care homes develop and maintain appropriate comprehensive care
plans for their patients with complex or chronic conditions, including an assessment of
health risks and chronic conditions;
(6) enable and encourage utilization of a range of qualified health care professionals,
including dedicated care coordinators, in a manner that enables providers to practice to the
fullest extent of their license;
(7) focus initially on patients who have or are at risk of developing chronic health
conditions;
(8) incorporate measures of quality, resource use, cost of care, and patient experience;
(9) ensure the use of health information technology and systematic follow-up, including
the use of patient registries; and
(10) encourage the use of scientifically based health care, patient decision-making aids
that provide patients with information about treatment options and their associated benefits,
risks, costs, and comparative outcomes, and other clinical decision support tools.
(b) In developing these standards, the deleted text begin commissionersdeleted text end new text begin commissionernew text end shall consult with
national and local organizations working on health care home models, physicians, relevant
state agencies, health plan companies, hospitals, other providers, patients, and patient
advocates. deleted text begin The commissioners may satisfy this requirement by continuing the provider
directed care coordination advisory committee.
deleted text end
(c) For the purposes of developing and implementing these standards, the deleted text begin commissionersdeleted text end new text begin
commissionernew text end may use the expedited rulemaking process under section 14.389.
Subd. 3.
Requirements for clinicians certified as health care homes.
(a) A personal
clinician or a primary care clinic may be certified as a health care home. If a primary care
clinic is certified, all of the primary care clinic's clinicians must meet the criteria of a health
care home. In order to be certified as a health care home, a clinician or clinic must meet the
standards set by the deleted text begin commissionersdeleted text end new text begin commissionernew text end in accordance with this section.
Certification as a health care home is voluntary. In order to maintain their status as health
care homes, clinicians or clinics must renew their certification every three years.
(b) Clinicians or clinics certified as health care homes must offer their health care home
services to all their patients with complex or chronic health conditions who are interested
in participation.
(c) Health care homes must participate in the health care home collaborative established
under subdivision 5.
Subd. 4.
Alternative models and waivers of requirements.
(a) Nothing in this section
shall preclude the continued development of existing medical or health care home projects
currently operating or under development by the commissioner of human services or preclude
the commissioner new text begin of human services new text end from establishing alternative models and payment
mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs
under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term
care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and
medical assistance, are in the waiting period for Medicare, or who have other primary
coverage.
(b) The commissioner deleted text begin of healthdeleted text end shall waive health care home certification requirements
if an applicant demonstrates that compliance with a certification requirement will create a
major financial hardship or is not feasible, and the applicant establishes an alternative way
to accomplish the objectives of the certification requirement.
Subd. 5.
Health care home collaborative.
deleted text begin By July 1, 2009,deleted text end The deleted text begin commissionersdeleted text end new text begin
commissionernew text end shall establish a health care home collaborative to provide an opportunity for
health care homes and state agencies to exchange information related to quality improvement
and best practices.
Subd. 6.
Evaluation and continued development.
(a) For continued certification under
this section, health care homes must meet process, outcome, and quality standards as
developed and specified by the deleted text begin commissionersdeleted text end new text begin commissionernew text end . The deleted text begin commissionersdeleted text end new text begin
commissionernew text end shall collect data from health care homes necessary for monitoring compliance
with certification standards and for evaluating the impact of health care homes on health
care quality, cost, and outcomes.
(b) The deleted text begin commissionersdeleted text end new text begin commissionernew text end may contract with a private entity to perform an
evaluation of the effectiveness of health care homes. Data collected under this subdivision
is classified as nonpublic data under chapter 13.
Subd. 7.
Outreach.
deleted text begin Beginning July 1, 2009,deleted text end The commissioner new text begin of human services new text end shall
encourage state health care program enrollees who have a complex or chronic condition to
select a primary care clinic with clinicians who have been certified as health care homes.
Subd. 8.
Coordination with local services.
The health care home and the county shall
coordinate care and services provided to patients enrolled with a health care home who have
complex medical needs or a disability, and who need and are eligible for additional local
services administered by counties, including but not limited to waivered services, mental
health services, social services, public health services, transportation, and housing. The
coordination of care and services must be as provided in the plan established by the patient
and new text begin the new text end health care home.
Subd. 9.
Pediatric care coordination.
The commissioner new text begin of human services new text end shall
implement a pediatric care coordination service for children with high-cost medical or
high-cost psychiatric conditions who are at risk of recurrent hospitalization or emergency
room use for acute, chronic, or psychiatric illness, who receive medical assistance services.
Care coordination services must be targeted to children not already receiving care
coordination through another service and may include but are not limited to the provision
of health care home services to children admitted to hospitals that do not currently provide
care coordination. Care coordination services must be provided by care coordinators who
are directly linked to provider teams in the care delivery setting, but who may be part of a
community care team shared by multiple primary care providers or practices. For purposes
of this subdivision, the commissioner new text begin of human services new text end shall, to the extent possible, use
the existing health care home certification and payment structure established under this
section and section 256B.0753.
Subd. 10.
Health care homes advisory committee.
(a) The deleted text begin commissioners of health
and human servicesdeleted text end new text begin commissionernew text end shall establish a health care homes advisory committee
to advise the deleted text begin commissionersdeleted text end new text begin commissionernew text end on the ongoing statewide implementation of the
health care homes program authorized in this section.
(b) The deleted text begin commissionersdeleted text end new text begin commissionernew text end shall establish an advisory committee that includes
representatives of the health care professions such as primary care providers; mental health
providers; nursing and care coordinators; certified health care home clinics with statewide
representation; health plan companies; state agencies; employers; academic researchers;
consumers; and organizations that work to improve health care quality in Minnesota. At
least 25 percent of the committee members must be consumers or patients in health care
homes. The deleted text begin commissionersdeleted text end new text begin commissionernew text end , in making appointments to the committee, shall
ensure geographic representation of all regions of the state.
(c) The advisory committee shall advise the deleted text begin commissionersdeleted text end new text begin commissionernew text end on ongoing
implementation of the health care homes program, including, but not limited to, the following
activities:
(1) implementation of certified health care homes across the state on performance
management and implementation of benchmarking;
(2) implementation of modifications to the health care homes program based on results
of the legislatively mandated health care homes evaluation;
(3) statewide solutions for engagement of employers and commercial payers;
(4) potential modifications of the health care homes rules or statutes;
(5) consumer engagement, including patient and family-centered care, patient activation
in health care, and shared decision making;
(6) oversight for health care homes subject matter task forces or workgroups; and
(7) other related issues as requested by the deleted text begin commissionersdeleted text end new text begin commissionernew text end .
(d) The advisory committee shall have the ability to establish subcommittees on specific
topics. The advisory committee is governed by section 15.059. Notwithstanding section
15.059, the advisory committee does not expire.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 22.
Minnesota Statutes 2018, section 256B.0753, subdivision 1, is amended to read:
Subdivision 1.
Development.
The commissioner of human services, in coordination
with the commissioner of health, shall develop a payment system that provides per-person
care coordination payments to health care homes certified under section 256B.0751 for
providing care coordination services and directly managing on-site or employing care
coordinators. The care coordination payments under this section are in addition to the quality
incentive payments in section 256B.0754, subdivision 1. The care coordination payment
system must vary the fees paid by thresholds of care complexity, with the highest fees being
paid for care provided to individuals requiring the most intensive care coordination. In
developing the criteria for care coordination payments, the commissioner shall consider the
feasibility of including the additional time and resources needed by patients with limited
English-language skills, cultural differences, or other barriers to health care. The
commissioner may determine a schedule for phasing in care coordination fees such that the
fees will be applied first to individuals who have, or are at risk of developing, complex or
chronic health conditions. deleted text begin Development of the payment system must be completed by
January 1, 2010.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 23.
Minnesota Statutes 2018, section 256B.0753, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Definitions. new text end
new text begin
For the purposes of this section, the definitions in section
256B.0751, subdivision 1, apply.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 24.
Minnesota Statutes 2018, section 256B.75, is amended to read:
256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
(a) For outpatient hospital facility fee payments for services rendered on or after October
1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
which there is a federal maximum allowable payment. Effective for services rendered on
or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
emergency room facility fees shall be increased by eight percent over the rates in effect on
December 31, 1999, except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall be paid
at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
upper limit. If it is determined that a provision of this section conflicts with existing or
future requirements of the United States government with respect to federal financial
participation in medical assistance, the federal requirements prevail. The commissioner
may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper limitations.
(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in deleted text begin 2016deleted text end new text begin 2017new text end , the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.
(c) Effective for services provided on or after July 1, 2003, rates that are based on the
Medicare outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this provision.
(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory rate.
(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
this paragraph.
(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three percent
from the current statutory rates. Mental health services and facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 25.
Minnesota Statutes 2018, section 256L.03, subdivision 1, is amended to read:
Subdivision 1.
Covered health services.
(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation
services, personal care assistance and case management services, new text begin behavioral health home
services, new text end and nursing home or intermediate care facilities services.
(b) No public funds shall be used for coverage of abortion under MinnesotaCare except
where the life of the female would be endangered or substantial and irreversible impairment
of a major bodily function would result if the fetus were carried to term; or where the
pregnancy is the result of rape or incest.
(c) Covered health services shall be expanded as provided in this section.
(d) For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.
Sec. 26.
Minnesota Statutes 2018, section 256L.15, subdivision 1, is amended to read:
Subdivision 1.
Premium determination for MinnesotaCare.
(a) Families with children
and individuals shall pay a premium determined according to subdivision 2.
(b) Members of the military and their families who meet the eligibility criteria for
MinnesotaCare upon eligibility approval made within 24 months following the end of the
member's tour of active duty shall have their premiums paid by the commissioner. The
effective date of coverage for an individual or family who meets the criteria of this paragraph
shall be the first day of the month following the month in which eligibility is approved. This
exemption applies for 12 months.
(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their
families shall have their premiums waived by the commissioner in accordance with section
5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An
individual must indicate status as an American Indian, as defined under Code of Federal
Regulations, title 42, section 447.50, to qualify for the waiver of premiums. The
commissioner shall accept attestation of an individual's status as an American Indian as
verification until the United States Department of Health and Human Services approves an
electronic data source for this purpose.
deleted text begin
(d) For premiums effective August 1, 2015, and after, the commissioner, after consulting
with the chairs and ranking minority members of the legislative committees with jurisdiction
over human services, shall increase premiums under subdivision 2 for recipients based on
June 2015 program enrollment. Premium increases shall be sufficient to increase projected
revenue to the fund described in section 16A.724 by at least $27,800,000 for the biennium
ending June 30, 2017. The commissioner shall publish the revised premium scale on the
Department of Human Services website and in the State Register no later than June 15,
2015. The revised premium scale applies to all premiums on or after August 1, 2015, in
place of the scale under subdivision 2.
deleted text end
deleted text begin
(e) By July 1, 2015, the commissioner shall provide the chairs and ranking minority
members of the legislative committees with jurisdiction over human services the revised
premium scale effective August 1, 2015, and statutory language to codify the revised
premium schedule.
deleted text end
deleted text begin
(f) Premium changes authorized under paragraph (d) must only apply to enrollees not
otherwise excluded from paying premiums under state or federal law. Premium changes
authorized under paragraph (d) must satisfy the requirements for premiums for the Basic
Health Program under title 42 of Code of Federal Regulations, section 600.505.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 27. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) The revisor of statutes shall renumber the provisions of Minnesota Statutes listed in
column A to the references listed in column B.
new text end
|
new text begin
Column A new text end |
new text begin
Column B new text end |
|
|
new text begin
256B.0751, subd. 1 new text end |
new text begin
62U.03, subd. 2 new text end |
|
|
new text begin
256B.0751, subd. 2 new text end |
new text begin
62U.03, subd. 3 new text end |
|
|
new text begin
256B.0751, subd. 3 new text end |
new text begin
62U.03, subd. 4 new text end |
|
|
new text begin
256B.0751, subd. 4 new text end |
new text begin
62U.03, subd. 5 new text end |
|
|
new text begin
256B.0751, subd. 5 new text end |
new text begin
62U.03, subd. 6 new text end |
|
|
new text begin
256B.0751, subd. 6 new text end |
new text begin
62U.03, subd. 7 new text end |
|
|
new text begin
256B.0751, subd. 7 new text end |
new text begin
62U.03, subd. 8 new text end |
|
|
new text begin
256B.0751, subd. 8 new text end |
new text begin
62U.03, subd. 9 new text end |
|
|
new text begin
256B.0751, subd. 9 new text end |
new text begin
62U.03, subd. 10 new text end |
|
|
new text begin
256B.0751, subd. 10 new text end |
new text begin
62U.03, subd. 11 new text end |
new text begin
(b) The revisor of statutes shall change the applicable references to Minnesota Statutes,
section 256B.0751, to section 62U.03. The revisor shall make necessary cross-reference
changes in Minnesota Statutes consistent with the renumbering. 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 the day following final enactment.
new text end
Sec. 28. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, sections 62U.15, subdivision 2; 256B.057, subdivision 8;
256B.0625, subdivision 3a; 256B.0752; 256B.79, subdivision 7; and 256L.04, subdivision
13,
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 3
CHEMICAL AND MENTAL HEALTH
Section 1.
Minnesota Statutes 2018, section 245G.01, subdivision 8, is amended to read:
Subd. 8.
Client.
"Client" means an individual accepted by a license holder for assessment
or treatment of a substance use disorder. An individual remains a client until the license
holder no longer provides or intends to provide the individual with treatment service.new text begin Client
also includes the meaning of patient under section 144.651, subdivision 2.
new text end
Sec. 2.
Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 10a. new text end
new text begin Day of service initiation. new text end
new text begin
"Day of service initiation" means the day the
license holder begins the provision of a treatment service identified in section 245G.07.
new text end
Sec. 3.
Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 20a. new text end
new text begin Person-centered. new text end
new text begin
"Person-centered" means a client actively participates in
the client's treatment planning of services. This includes a client making meaningful and
informed choices about the client's own goals, objectives, and the services the client receives
in collaboration with the client's identified natural supports.
new text end
Sec. 4.
Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 20b. new text end
new text begin Staff or staff member. new text end
new text begin
"Staff" or "staff member" means an individual who
works under the direction of the license holder regardless of the individual's employment
status including but not limited to an intern, consultant, individual who works part time, or
individual who does not provide direct care services.
new text end
Sec. 5.
Minnesota Statutes 2018, section 245G.01, subdivision 21, is amended to read:
Subd. 21.
Student intern.
"Student intern" means an individual who is new text begin enrolled in a
program specializing in alcohol and drug counseling or mental health counseling at an
accredited educational institution and is new text end authorized by a licensing board to provide services
under supervision of a licensed professional.
Sec. 6.
Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 28. new text end
new text begin Treatment week. new text end
new text begin
"Treatment week" means the seven-day period that the
program identified in the program's policy and procedure manual as the day of the week
that the treatment program week starts and ends for the purpose of identifying the nature
and number of treatment services an individual receives weekly.
new text end
Sec. 7.
Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 29. new text end
new text begin Volunteer. new text end
new text begin
"Volunteer" means an individual who, under the direction of the
license holder, provides services or an activity to a client without compensation.
new text end
Sec. 8.
Minnesota Statutes 2018, section 245G.04, is amended to read:
245G.04 deleted text begin INITIAL SERVICES PLANdeleted text end new text begin SERVICE INITIATIONnew text end .
new text begin Subdivision 1. new text end
new text begin Initial services plan. new text end
deleted text begin (a)deleted text end The license holder must complete an initial
services plan deleted text begin ondeleted text end new text begin within 24 hours ofnew text end the day of service initiation. The plan must new text begin be
person-centered and client-specific, new text end address the client's immediate health and safety concerns,
new text begin and new text end identify the new text begin treatment new text end needsnew text begin of the clientnew text end to be addressed deleted text begin in the first treatment session,
and make treatment suggestions for the clientdeleted text end during the time between deleted text begin intakedeleted text end new text begin the day of
service initiationnew text end and deleted text begin completiondeleted text end new text begin developmentnew text end of the individual treatment plan.
new text begin Subd. 2. new text end
new text begin Vulnerable adult status. new text end
deleted text begin (b) The initial services plan must include a
determination ofdeleted text end new text begin (a) Within 24 hours of the day of service initiation, a nonresidential program
must determine new text end whether a client is a vulnerable adult as defined in section 626.5572,
subdivision 21. An adult client of a residential program is a vulnerable adult.
new text begin (b)new text end An individual abuse prevention plan, according to sections 245A.65, subdivision 2,
paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for a client who meets
the definition of vulnerable adult.
Sec. 9.
Minnesota Statutes 2018, section 245G.05, is amended to read:
245G.05 COMPREHENSIVE ASSESSMENT AND ASSESSMENT SUMMARY.
Subdivision 1.
Comprehensive assessment.
(a) A comprehensive assessment of the
client's substance use disorder must be administered face-to-face by an alcohol and drug
counselor within three calendar days deleted text begin afterdeleted text end new text begin from the day ofnew text end service initiation for a residential
program or deleted text begin during the initial session for all other programsdeleted text end new text begin within three sessions of the day
of service initiation for a client in a nonresidential programnew text end . If the comprehensive assessment
is not completed deleted text begin during the initial session,deleted text end new text begin within the required time frame, new text end the deleted text begin client-centereddeleted text end new text begin
person-centerednew text end reason for the delaynew text begin and the planned completion datenew text end must be documented
in the client's file deleted text begin and the planned completion datedeleted text end . new text begin The comprehensive assessment is
complete upon a qualified staff member's dated signature. new text end If the client received a
comprehensive assessment that authorized the treatment service, an alcohol and drug
counselor new text begin may use the comprehensive assessment for requirements of this subdivision but
new text end must new text begin document a new text end review deleted text begin thedeleted text end new text begin of the comprehensive new text end assessmentnew text begin and update the comprehensive
assessment as necessarynew text end to deleted text begin determinedeleted text end new text begin ensurenew text end compliance with this subdivisiondeleted text begin , includingdeleted text end new text begin
withinnew text end applicable timelines. deleted text begin If available, the alcohol and drug counselor may use current
information provided by a referring agency or other source as a supplement. Information
gathered more than 45 days before the date of admission is not considered current.deleted text end The
comprehensive assessment must include sufficient information to complete the assessment
summary according to subdivision 2 and the individual treatment plan according to section
245G.06. The comprehensive assessment must include information about the client's needs
that relate to substance use and personal strengths that support recovery, including:
(1) age, sex, cultural background, sexual orientation, living situation, economic status,
and level of education;
(2) new text begin a description of the new text end circumstances new text begin on the day new text end of service initiation;
(3) new text begin a list of new text end previous attempts at treatment for substance misuse or substance use disorder,
compulsive gambling, or mental illness;
(4) new text begin a list of new text end substance use history including amounts and types of substances used,
frequency and duration of use, periods of abstinence, and circumstances of relapse, if any.
For each substance used within the previous 30 days, the information must include the date
of the most recent use and new text begin address the absence or presence of new text end previous withdrawal symptoms;
(5) specific problem behaviors exhibited by the client when under the influence of
substances;
(6) deleted text begin family statusdeleted text end new text begin the client's desire for family involvement in the treatment programnew text end ,
family historynew text begin of substance use and misusenew text end , deleted text begin includingdeleted text end history or presence of physical or
sexual abuse, new text begin and new text end level of family supportdeleted text begin , and substance misuse or substance use disorder
of a family member or significant otherdeleted text end ;
(7) physical new text begin and medical new text end concerns or diagnoses, deleted text begin the severity of the concerns, anddeleted text end new text begin current
medical treatment needed or being received related to the diagnoses, andnew text end whether the
concerns deleted text begin are being addressed by adeleted text end new text begin need to be referred to an appropriatenew text end health care
professional;
(8) mental health history deleted text begin and psychiatric statusdeleted text end , including symptomsdeleted text begin , disability,deleted text end new text begin and the
effect on the client's ability to function;new text end current new text begin mental health new text end treatment deleted text begin supports,deleted text end new text begin ;new text end and
psychotropic medication needed to maintain stabilitydeleted text begin ;deleted text end new text begin .new text end The assessment must utilize screening
tools approved by the commissioner pursuant to section 245.4863 to identify whether the
client screens positive for co-occurring disorders;
(9) arrests and legal interventions related to substance use;
(10) new text begin a description of how the client's use affected the client's new text end ability to function
appropriately in work and educational settings;
(11) ability to understand written treatment materials, including rules and the client's
rights;
(12) new text begin a description of any new text end risk-taking behavior, including behavior that puts the client at
risk of exposure to blood-borne or sexually transmitted diseases;
(13) social network in relation to expected support for recovery deleted text begin anddeleted text end new text begin ;
new text end
new text begin (14)new text end leisure time activities that are associated with substance use;
deleted text begin (14)deleted text end new text begin (15)new text end whether the client is pregnant and, if so, the health of the unborn child and the
client's current involvement in prenatal care;
deleted text begin (15)deleted text end new text begin (16)new text end whether the client recognizes deleted text begin problemsdeleted text end new text begin needsnew text end related to substance use and is
willing to follow treatment recommendations; and
deleted text begin (16) collateraldeleted text end new text begin (17)new text end informationnew text begin from a collateral contact may be included, but is not
requirednew text end . deleted text begin If the assessor gathered sufficient information from the referral source or the client
to apply the criteria in Minnesota Rules, parts 9530.6620 and 9530.6622, a collateral contact
is not required.
deleted text end
(b) If the client is identified as having opioid use disorder or seeking treatment for opioid
use disorder, the program must provide educational information to the client concerning:
(1) risks for opioid use disorder and dependence;
(2) treatment options, including the use of a medication for opioid use disorder;
(3) the risk of and recognizing opioid overdose; and
(4) the use, availability, and administration of naloxone to respond to opioid overdose.
(c) The commissioner shall develop educational materials that are supported by research
and updated periodically. The license holder must use the educational materials that are
approved by the commissioner to comply with this requirement.
(d) If the comprehensive assessment is completed to authorize treatment service for the
client, at the earliest opportunity during the assessment interview the assessor shall determine
if:
(1) the client is in severe withdrawal and likely to be a danger to self or others;
(2) the client has severe medical problems that require immediate attention; or
(3) the client has severe emotional or behavioral symptoms that place the client or others
at risk of harm.
If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the
assessment interview and follow the procedures in the program's medical services plan
under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The
assessment interview may resume when the condition is resolved.
Subd. 2.
Assessment summary.
(a) An alcohol and drug counselor must complete an
assessment summary within three calendar days deleted text begin afterdeleted text end new text begin from the day ofnew text end service initiation for
a residential program and within three sessions deleted text begin for all other programsdeleted text end new text begin from the day of service
initiation for a client in a nonresidential programnew text end .new text begin The comprehensive assessment summary
is complete upon a qualified staff member's dated signature.new text end If the comprehensive assessment
is used to authorize the treatment service, the alcohol and drug counselor must prepare an
assessment summary on the same date the comprehensive assessment is completed. If the
comprehensive assessment and assessment summary are to authorize treatment services,
the assessor must determine appropriate services for the client using the dimensions in
Minnesota Rules, part 9530.6622, and document the recommendations.
(b) An assessment summary must include:
(1) a risk description according to section 245G.05 for each dimension listed in paragraph
(c);
(2) a narrative summary supporting the risk descriptions; and
(3) a determination of whether the client has a substance use disorder.
(c) An assessment summary must contain information relevant to treatment service
planning and recorded in the dimensions in clauses (1) to (6). The license holder must
consider:
(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with
withdrawal symptoms and current state of intoxication;
(2) Dimension 2, biomedical conditions and complications; the degree to which any
physical disorder of the client would interfere with treatment for substance use, and the
client's ability to tolerate any related discomfort. The license holder must determine the
impact of continued deleted text begin chemicaldeleted text end new text begin substancenew text end use on the unborn child, if the client is pregnant;
(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications;
the degree to which any condition or complication is likely to interfere with treatment for
substance use or with functioning in significant life areas and the likelihood of harm to self
or others;
(4) Dimension 4, readiness for change; the support necessary to keep the client involved
in treatment service;
(5) Dimension 5, relapse, continued use, and continued problem potential; the degree
to which the client recognizes relapse issues and has the skills to prevent relapse of either
substance use or mental health problems; and
(6) Dimension 6, recovery environment; whether the areas of the client's life are
supportive of or antagonistic to treatment participation and recovery.
Sec. 10.
Minnesota Statutes 2018, section 245G.06, subdivision 1, is amended to read:
Subdivision 1.
General.
Each client must have deleted text begin andeleted text end new text begin a person-centerednew text end individual treatment
plan developed by an alcohol and drug counselor within deleted text begin sevendeleted text end new text begin tennew text end days new text begin from the day new text end of
service initiation for a residential program and within deleted text begin threedeleted text end new text begin fivenew text end sessions for deleted text begin all other
programsdeleted text end new text begin from the day of service initiation for a client in a nonresidential program. Opioid
treatment programs must complete the individual treatment plan within 21 days from the
day of service initiationnew text end . deleted text begin The client must have active, direct involvement in selecting the
anticipated outcomes of the treatment process and developing the treatment plan.deleted text end The
individual treatment plan must be signed by the client and the alcohol and drug counselor
and document the client's involvement in the development of the plan. deleted text begin The plan may be a
continuation of the initial services plan required in section 245G.04.deleted text end new text begin The individual treatment
plan is developed upon the qualified staff member's dated signature.new text end Treatment planning
must include ongoing assessment of client needs. An individual treatment plan must be
updated based on new information gathered about the client's conditionnew text begin , the client's level
of participation,new text end and on whether methods identified have the intended effect. A change to
the plan must be signed by the client and the alcohol and drug counselor. deleted text begin The plan must
provide for the involvement of the client's family and people selected by the client as
important to the success of treatment at the earliest opportunity, consistent with the client's
treatment needs and written consent.deleted text end new text begin If the client chooses to have family or others involved
in treatment, the client's individual treatment plan must include goals and methods identifying
how the family or others will be involved in the client's treatment.
new text end
Sec. 11.
Minnesota Statutes 2018, section 245G.06, subdivision 2, is amended to read:
Subd. 2.
Plan contents.
An individual treatment plan must be recorded in the six
dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue
identified in the assessment summary, prioritized according to the client's needs and focus,
and must include:
(1) specific new text begin goals and new text end methods to address each identified neednew text begin in the comprehensive
assessment summarynew text end , including amount, frequency, and anticipated duration of treatment
service. The methods must be appropriate to the client's language, reading skills, cultural
background, and strengths;
(2) resources to refer the client to when the client's needs are to be addressed concurrently
by another providernew text begin and identification of whether the client has an assessed need of peer
support services and, if available, how peer support services are made available to the client
with an assessed neednew text end ; and
(3) goals the client must reach to complete treatment and terminate services.
Sec. 12.
Minnesota Statutes 2018, section 245G.06, subdivision 4, is amended to read:
Subd. 4.
Service discharge summary.
(a) An alcohol and drug counselor must write a
new text begin service new text end discharge summary for each client. The new text begin service discharge new text end summary must be
completed within five days of the client's service termination deleted text begin or within five days from the
client's or program's decision to terminate services, whichever is earlier.deleted text end new text begin The client's file
must include verification that the client was provided a copy of the client's service discharge
summary. If the program is unable to provide a copy of the client's service discharge summary
directly to the client, the program must document the reason.
new text end
(b) The service discharge summary must be recorded in the six dimensions listed in
section 245G.05, subdivision 2, paragraph (c), and include the following information:
(1) the client's issues, strengths, and needs while participating in treatment, including
services provided;
(2) the client's progress toward achieving each goal identified in the individual treatment
plan;
(3) a risk description according to section 245G.05; deleted text begin and
deleted text end
(4) the reasons for and circumstances of service termination. If a program discharges a
client at staff request, the reason for discharge and the procedure followed for the decision
to discharge must be documented and comply with the deleted text begin program's policies on staff-initiated
client discharge. If a client is discharged at staff request, the program must give the client
crisis and other referrals appropriate for the client's needs and offer assistance to the client
to access the services.deleted text end new text begin requirements in section 245G.14, subdivision 3, clause (3);
new text end
deleted text begin
(c) For a client who successfully completes treatment, the summary must also include:
deleted text end
deleted text begin (1)deleted text end new text begin (5) new text end the client's living arrangements at service termination;
deleted text begin (2)deleted text end new text begin (6) new text end continuing care recommendations, including transitions between more or less
intense services, or more frequent to less frequent services, and referrals made with specific
attention to continuity of care for mental health, as needed;new text begin and
new text end
deleted text begin (3)deleted text end new text begin (7) new text end service termination diagnosisdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(4) the client's prognosis.
deleted text end
Sec. 13.
Minnesota Statutes 2018, section 245G.07, is amended to read:
245G.07 TREATMENT SERVICE.
Subdivision 1.
Treatment service.
(a) A deleted text begin license holderdeleted text end new text begin licensed residential treatment
program new text end must deleted text begin offerdeleted text end new text begin provide new text end the deleted text begin followingdeleted text end treatment servicesnew text begin in clauses (1) to (5) to each
clientnew text end , unless clinically inappropriate and the justifying clinical rationale is documenteddeleted text begin :deleted text end new text begin .
A nonresidential treatment program must offer all treatment services in clauses (1) to (5)
and document in the individual treatment plan the specific services for which a client has
an assessed need and the plan to provide the services:
new text end
(1) individual and group counseling to help the client identify and address needs related
to substance use and develop strategies to avoid harmful substance use after discharge and
to help the client obtain the services necessary to establish a lifestyle free of the harmful
effects of substance use disorderdeleted text begin ;deleted text end new text begin . Notwithstanding subdivision 3, individual and group
counseling services must be provided by an individual who meets the staff qualifications
of an alcohol and drug counselor in section 245G.11, subdivision 5;
new text end
(2) client education strategies to avoid inappropriate substance use and health problems
related to substance use and the necessary lifestyle changes to regain and maintain health.
Client education must include information on tuberculosis education on a form approved
by the commissioner, the human immunodeficiency virus according to section 245A.19,
other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis.
A licensed alcohol and drug counselor must be present during an educational group;
(3) a service to help the client integrate gains made during treatment into daily living
and to reduce the client's reliance on a staff member for support;
(4) a service to address issues related to co-occurring disorders, including client education
on symptoms of mental illness, the possibility of comorbidity, and the need for continued
medication compliance while recovering from substance use disorder. A group must address
co-occurring disorders, as needed. When treatment for mental health problems is indicated,
the treatment must be integrated into the client's individual treatment plan;new text begin and
new text end
deleted text begin
(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support
services provided one-to-one by an individual in recovery. Peer support services include
education, advocacy, mentoring through self-disclosure of personal recovery experiences,
attending recovery and other support groups with a client, accompanying the client to
appointments that support recovery, assistance accessing resources to obtain housing,
employment, education, and advocacy services, and nonclinical recovery support to assist
the transition from treatment into the recovery community; and
deleted text end
deleted text begin (6) on July 1, 2018, or upon federal approval, whichever is later, caredeleted text end new text begin (5) treatmentnew text end
coordination provided new text begin one-to-one new text end by an individual who meets the staff qualifications in
section 245G.11, subdivision 7new text begin , or an alcohol and drug counselor under section 245G.11,
subdivision 5new text end . deleted text begin Caredeleted text end new text begin Treatmentnew text end coordination services include:
(i) assistance in coordination with significant others to help in the treatment planning
process whenever possible;
(ii) assistance in coordination with and follow up for medical services as identified in
the treatment plan;
(iii) facilitation of referrals to substance use disorder services as indicated by a client's
medical provider, comprehensive assessment, or treatment plan;
(iv) facilitation of referrals to mental health services as identified by a client's
comprehensive assessment or treatment plan;
(v) assistance with referrals to economic assistance, social services, housing resources,
and prenatal care according to the client's needs;
(vi) life skills advocacy and support accessing treatment follow-up, disease management,
and education services, including referral and linkages to long-term services and supports
as needed; and
(vii) documentation of the provision of deleted text begin caredeleted text end new text begin treatmentnew text end coordination services in the client's
file.
(b) A treatment service provided to a client must be provided according to the individual
treatment plan and must consider cultural differences and special needs of a client.
Subd. 2.
Additional treatment service.
A license holder may provide or arrange the
following additional treatment service as a part of the client's individual treatment plan:
(1) relationship counseling provided by a qualified professional to help the client identify
the impact of the client's substance use disorder on others and to help the client and persons
in the client's support structure identify and change behaviors that contribute to the client's
substance use disorder;
(2) therapeutic recreation to allow the client to participate in recreational activities
without the use of mood-altering chemicals and to plan and select leisure activities that do
not involve the inappropriate use of chemicals;
(3) stress management and physical well-being to help the client reach and maintain an
appropriate level of health, physical fitness, and well-being;
(4) living skills development to help the client learn basic skills necessary for independent
living;
(5) employment or educational services to help the client become financially independent;
(6) socialization skills development to help the client live and interact with others in a
positive and productive manner; deleted text begin and
deleted text end
(7) room, board, and supervision at the treatment site to provide the client with a safe
and appropriate environment to gain and practice new skillsdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(8) peer recovery support services provided one-to-one by an individual in recovery.
Peer support services include education; advocacy; mentoring through self-disclosure of
personal recovery experiences; attending recovery and other support groups with a client;
accompanying the client to appointments that support recovery; assistance accessing resources
to obtain housing, employment, education, and advocacy services; and nonclinical recovery
support to assist the transition from treatment into the recovery community.
new text end
Subd. 3.
Counselors.
A treatment service, including therapeutic recreation, must be
provided by an alcohol and drug counselor according to section 245G.11, unless the
individual providing the service is specifically qualified according to the accepted credential
required to provide the service. deleted text begin Therapeutic recreation does not include planned leisure
activities.deleted text end new text begin The commissioner shall maintain a current list of professionals qualified to provide
treatment services, notwithstanding the staff qualification requirements in section 245G.11,
subdivision 4.
new text end
Subd. 4.
Location of service provision.
The license holder may provide services at any
of the license holder's licensed locations or at another suitable location including a school,
government building, medical or behavioral health facility, or social service organization,
upon notification and approval of the commissioner. If services are provided off site from
the licensed site, the reason for the provision of services remotely must be documented.new text begin
The license holder may provide additional services under subdivision 2, clauses (2) to (5),
off-site if the license holder includes a policy and procedure detailing the off-site location
as a part of the treatment service description and the program abuse prevention plan.
new text end
Sec. 14.
Minnesota Statutes 2018, section 245G.08, subdivision 3, is amended to read:
Subd. 3.
Standing order protocol.
A license holder that maintains a supply of naloxone
available for emergency treatment of opioid overdose must have a written standing order
protocol by a physician who is licensed under chapter 147, that permits the license holder
to maintain a supply of naloxone on sitedeleted text begin , anddeleted text end new text begin . A license holdernew text end must require staff to undergo
deleted text begin specificdeleted text end training in deleted text begin administration of naloxonedeleted text end new text begin the specific mode of administration used at
the program, which may include intranasal administration, intramuscular injection, or bothnew text end .
Sec. 15.
Minnesota Statutes 2018, section 245G.10, subdivision 4, is amended to read:
Subd. 4.
Staff requirement.
It is the responsibility of the license holder to determine
an acceptable group size based on each client's needs except that treatment services provided
in a group shall not exceed 16 clients. deleted text begin A counselor in an opioid treatment program must not
supervise more than 50 clients.deleted text end The license holder must maintain a record that documents
compliance with this subdivision.
Sec. 16.
Minnesota Statutes 2018, section 245G.11, subdivision 7, is amended to read:
Subd. 7.
deleted text begin Caredeleted text end new text begin Treatmentnew text end coordination provider qualifications.
(a) deleted text begin Caredeleted text end new text begin Treatmentnew text end
coordination must be provided by qualified staff. An individual is qualified to provide deleted text begin caredeleted text end new text begin
treatmentnew text end coordination if the individualdeleted text begin :deleted text end new text begin meets the qualifications of an alcohol and drug
counselor under subdivision 5. An individual who does not meet the qualifications of an
alcohol and drug counselor under subdivision 5 is qualified to provide treatment coordination
if the individual:
new text end
(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 deleted text begin caredeleted text end new text begin treatmentnew text end
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 deleted text begin caredeleted text end new text begin treatmentnew text end coordinator must receive at least one hour of supervision regarding
individual service delivery from an alcohol and drug counselor weekly.
Sec. 17.
Minnesota Statutes 2018, section 245G.11, subdivision 8, is amended to read:
Subd. 8.
Recovery peer qualifications.
A recovery peer must:
(1) have a high school diploma or its equivalent;
(2) have a minimum of one year in recovery from substance use disorder;
(3) hold a current credential from deleted text begin a certification body approved by the commissioner
that demonstratesdeleted text end new text begin the Minnesota Certification Board, the Upper Midwest Indian Council
on Addictive Disorders, or the National Association for Alcoholism and Drug Abuse
Counselors. An individual may also receive a credential from a tribal nation when providing
peer recovery support services in a tribally licensed program. The credential must demonstratenew text end
skills and training in the domains of ethics and boundaries, advocacy, mentoring and
education, and recovery and wellness support; and
(4) receive ongoing supervision in areas specific to the domains of the recovery peer's
role by an alcohol and drug counselor deleted text begin or an individual with a certification approved by the
commissionerdeleted text end .
Sec. 18.
Minnesota Statutes 2018, section 245G.12, is amended to read:
245G.12 PROVIDER POLICIES AND PROCEDURES.
A license holder must develop a written policies and procedures manual, indexed
according to section 245A.04, subdivision 14, paragraph (c), that provides staff members
immediate access to all policies and procedures and provides a client and other authorized
parties access to all policies and procedures. The manual must contain the following
materials:
(1) assessment and treatment planning policies, including screening for mental health
concerns and treatment objectives related to the client's identified mental health concerns
in the client's treatment plan;
(2) policies and procedures regarding HIV according to section 245A.19;
(3) the license holder's methods and resources to provide information on tuberculosis
and tuberculosis screening to each client and to report a known tuberculosis infection
according to section 144.4804;
(4) personnel policies according to section 245G.13;
(5) policies and procedures that protect a client's rights according to section 245G.15;
(6) a medical services plan according to section 245G.08;
(7) emergency procedures according to section 245G.16;
(8) policies and procedures for maintaining client records according to section 245G.09;
(9) procedures for reporting the maltreatment of minors according to section 626.556,
and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
(10) a description of treatment services, including the amount and type of services
providednew text begin and the program's treatment weeknew text end ;
(11) the methods used to achieve desired client outcomes;
(12) the hours of operation; and
(13) the target population served.
Sec. 19.
Minnesota Statutes 2018, section 245G.13, subdivision 1, is amended to read:
Subdivision 1.
Personnel policy requirements.
A license holder must have written
personnel policies that are available to each staff member. The personnel policies must:
(1) ensure that staff member retention, promotion, job assignment, or pay are not affected
by a good faith communication between a staff member and the department, the Department
of Health, the ombudsman for mental health and developmental disabilities, law enforcement,
or a local agency for the investigation of a complaint regarding a client's rights, health, or
safety;
(2) contain a job description for each staff member position specifying responsibilities,
degree of authority to execute job responsibilities, and qualification requirements;
(3) provide for a job performance evaluation based on standards of job performance
conducted on a regular and continuing basis, including a written annual review;
(4) describe behavior that constitutes grounds for disciplinary action, suspension, or
dismissal, including policies that address staff member problematic substance use and the
requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement
with a client in violation of chapter 604, and policies prohibiting client abuse described in
sections 245A.65, 626.556, 626.557, and 626.5572;
(5) identify how the program will identify whether behaviors or incidents are problematic
substance use, including a description of how the facility must address:
(i) receiving treatment for substance use within the period specified for the position in
the staff qualification requirements, including medication-assisted treatment;
(ii) substance use that negatively impacts the staff member's job performance;
(iii) deleted text begin chemicaldeleted text end new text begin substancenew text end use that affects the credibility of treatment services with a client,
referral source, or other member of the community;
(iv) symptoms of intoxication or withdrawal on the job; and
(v) the circumstances under which an individual who participates in monitoring by the
health professional services program for a substance use or mental health disorder is able
to provide services to the program's clients;
(6) include a chart or description of the organizational structure indicating lines of
authority and responsibilities;
(7) include orientation within 24 working hours of starting for each new staff member
based on a written plan that, at a minimum, must provide training related to the staff member's
specific job responsibilities, policies and procedures, client confidentiality, HIV minimum
standards, and client needs; and
(8) include policies outlining the license holder's response to a staff member with a
behavior problem that interferes with the provision of treatment service.
Sec. 20.
Minnesota Statutes 2018, section 245G.15, subdivision 1, is amended to read:
Subdivision 1.
Explanation.
A client has the rights identified in sections 144.651,
148F.165, and 253B.03, as applicable. The license holder must give each client deleted text begin atdeleted text end new text begin on the
day ofnew text end service initiation a written statement of the client's rights and responsibilities. A staff
member must review the statement with a client at that time.
Sec. 21.
Minnesota Statutes 2018, section 245G.15, subdivision 2, is amended to read:
Subd. 2.
Grievance procedure.
deleted text begin Atdeleted text end new text begin On the day ofnew text end service initiation, the license holder
must explain the grievance procedure to the client or the client's representative. The grievance
procedure must be posted in a place visible to clients, and made available upon a client's or
former client's request. The grievance procedure must require that:
(1) a staff member helps the client develop and process a grievance;
(2) current telephone numbers and addresses of the Department of Human Services,
Licensing Division; the Office of Ombudsman for Mental Health and Developmental
Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board
of Behavioral Health and Therapy, when applicable, be made available to a client; and
(3) a license holder responds to the client's grievance within three days of a staff member's
receipt of the grievance, and the client may bring the grievance to the highest level of
authority in the program if not resolved by another staff member.
Sec. 22.
Minnesota Statutes 2018, section 245G.18, subdivision 3, is amended to read:
Subd. 3.
Staff ratios.
deleted text begin At least 25 percent of a counselor's scheduled work hours must
be allocated to indirect services, including documentation of client services, coordination
of services with others, treatment team meetings, and other duties.deleted text end A counseling group
consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of
the license holder to determine an acceptable group size based on the needs of the clients.
Sec. 23.
Minnesota Statutes 2018, section 245G.18, subdivision 5, is amended to read:
Subd. 5.
Program requirements.
In addition to the requirements specified in the client's
treatment plan under section 245G.06, programs serving an adolescent must include:
(1) coordination with the school system to address the client's academic needs;
(2) when appropriate, a plan that addresses the client's leisure activities without deleted text begin chemicaldeleted text end new text begin
substancenew text end use; and
(3) a plan that addresses family involvement in the adolescent's treatment.
Sec. 24.
Minnesota Statutes 2018, section 245G.22, subdivision 1, is amended to read:
Subdivision 1.
Additional requirements.
(a) An opioid treatment program licensed
under this chapter must alsonew text begin : (1)new text end comply with the requirements of this section and Code of
Federal Regulations, title 42, part 8deleted text begin . When federal guidance or interpretations are issued on
federal standards or requirements also required under this section, the federal guidance or
interpretations shall apply.deleted text end new text begin ; (2) be registered as a narcotic treatment program with the Drug
Enforcement Administration; (3) be accredited through an accreditation body approved by
the Division of Pharmacologic Therapy of the Center for Substance Abuse Treatment; (4)
be certified through the Division of Pharmacologic Therapy of the Center for Substance
Abuse Treatment; and (5) hold a license from the Minnesota Board of Pharmacy or equivalent
agency.
new text end
(b) Where a standard in this section differs from a standard in an otherwise applicable
administrative rule or statute, the standard of this section applies.
Sec. 25.
Minnesota Statutes 2018, section 245G.22, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For purposes of this section, the terms defined in this subdivision
have the meanings given them.
(b) "Diversion" means the use of a medication for the treatment of opioid addiction being
diverted from intended use of the medication.
(c) "Guest dose" means administration of a medication used for the treatment of opioid
addiction to a person who is not a client of the program that is administering or dispensing
the medication.
(d) "Medical director" means a deleted text begin physiciandeleted text end new text begin practitionernew text end licensed to practice medicine in
the jurisdiction that the opioid treatment program is located who assumes responsibility for
administering all medical services performed by the program, either by performing the
services directly or by delegating specific responsibility to deleted text begin (1) authorized program physicians;
(2) advanced practice registered nurses, when approved by variance by the State Opioid
Treatment Authority under section 254A.03 and the federal Substance Abuse and Mental
Health Services Administration; or (3) health care professionals functioning under the
medical director's direct supervisiondeleted text end new text begin a practitioner of the opioid treatment programnew text end .
(e) "Medication used for the treatment of opioid use disorder" means a medication
approved by the Food and Drug Administration for the treatment of opioid use disorder.
(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,
title 42, section 8.12, and includes programs licensed under this chapter.
(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605,
subpart 21a.
new text begin
(i) "Practitioner" means a staff member holding a current, unrestricted license to practice
medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing
and is currently registered with the Drug Enforcement Administration to order or dispense
controlled substances in Schedules II to V under the Controlled Substances Act, United
States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered
nurse and physician assistant if the staff member receives a variance by the state opioid
treatment authority under section 254A.03 and the federal Substance Abuse and Mental
Health Services Administration.
new text end
deleted text begin (i)deleted text end new text begin (j)new text end "Unsupervised use" means the use of a medication for the treatment of opioid use
disorder dispensed for use by a client outside of the program setting.
Sec. 26.
Minnesota Statutes 2018, section 245G.22, subdivision 3, is amended to read:
Subd. 3.
Medication orders.
Before the program may administer or dispense a medication
used for the treatment of opioid use disorder:
(1) a client-specific order must be received from an appropriately credentialed deleted text begin physiciandeleted text end new text begin
practitionernew text end who is enrolled as a Minnesota health care programs provider and meets all
applicable provider standards;
(2) the signed order must be documented in the client's record; and
(3) if the deleted text begin physiciandeleted text end new text begin practitionernew text end that issued the order is not able to sign the order when
issued, the unsigned order must be entered in the client record at the time it was received,
and the deleted text begin physiciandeleted text end new text begin practitionernew text end must review the documentation and sign the order in the
client's record within 72 hours of the medication being ordered. The license holder must
report to the commissioner any medication error that endangers a client's health, as
determined by the medical director.
Sec. 27.
Minnesota Statutes 2018, section 245G.22, subdivision 4, is amended to read:
Subd. 4.
High dose requirements.
A client being administered or dispensed a dose
beyond that set forth in subdivision 6, paragraph (a), deleted text begin clause (1),deleted text end that exceeds 150 milligrams
of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase,
must meet face-to-face with a prescribing deleted text begin physiciandeleted text end new text begin practitionernew text end . The meeting must occur
before the administration or dispensing of the increased medication dose.
Sec. 28.
Minnesota Statutes 2018, section 245G.22, subdivision 6, is amended to read:
Subd. 6.
Criteria for unsupervised use.
(a) To limit the potential for diversion of
medication used for the treatment of opioid use disorder to the illicit market, medication
dispensed to a client for unsupervised use shall be subject to the deleted text begin followingdeleted text end requirementsdeleted text begin :deleted text end new text begin
of this subdivision.
new text end
deleted text begin (1)deleted text end Any client in an opioid treatment program may receive a single unsupervised use
dose for a day that the clinic is closed for business, including Sundays and state and federal
holidaysdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(2) other treatment program decisions on dispensing medications used for the treatment
of opioid use disorder to a client for unsupervised use shall be determined by the medical
director.
deleted text end
(b) deleted text begin In determining whether a client may be permitted unsupervised use of medications,
a physiciandeleted text end new text begin A practitionernew text end with authority to prescribe must deleted text begin considerdeleted text end new text begin review and documentnew text end
the criteria in deleted text begin thisdeleted text end paragraphdeleted text begin . The criteria in this paragraph must also be considereddeleted text end new text begin (c)new text end when
determining whether dispensing medication for a client's unsupervised use is appropriate
to new text begin implement, new text end increasenew text begin ,new text end or deleted text begin todeleted text end extend the amount of time between visits to the program. The
criteria are:
(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics,
and alcohol;
(2) regularity of program attendance;
(3) absence of serious behavioral problems at the program;
(4) absence of known recent criminal activity such as drug dealing;
(5) stability of the client's home environment and social relationships;
(6) length of time in comprehensive maintenance treatment;
(7) reasonable assurance that unsupervised use medication will be safely stored within
the client's home; and
(8) whether the rehabilitative benefit the client derived from decreasing the frequency
of program attendance outweighs the potential risks of diversion or unsupervised use.
(c) The determination, including the basis of the determination must be documented in
the client's medical record.
Sec. 29.
Minnesota Statutes 2018, section 245G.22, subdivision 7, is amended to read:
Subd. 7.
Restrictions for unsupervised use of methadone hydrochloride.
(a) If a
deleted text begin physician with authority to prescribedeleted text end new text begin medical director or prescribing practitioner assesses
andnew text end determines that a client meets the criteria in subdivision 6 and may be dispensed a
medication used for the treatment of opioid addiction, the restrictions in this subdivision
must be followed when the medication to be dispensed is methadone hydrochloride.new text begin The
results of the assessment must be contained in the client file.
new text end
(b) During the first 90 days of treatment, the unsupervised use medication supply must
be limited to a maximum of a single dose each week and the client shall ingest all other
doses under direct supervision.
(c) In the second 90 days of treatment, the unsupervised use medication supply must be
limited to two doses per week.
(d) In the third 90 days of treatment, the unsupervised use medication supply must not
exceed three doses per week.
(e) In the remaining months of the first year, a client may be given a maximum six-day
unsupervised use medication supply.
(f) After one year of continuous treatment, a client may be given a maximum two-week
unsupervised use medication supply.
(g) After two years of continuous treatment, a client may be given a maximum one-month
unsupervised use medication supply, but must make monthly visits to the program.
Sec. 30.
Minnesota Statutes 2018, section 245G.22, subdivision 15, is amended to read:
Subd. 15.
Nonmedication treatment services; documentation.
(a) The program must
offer at least 50 consecutive minutes of individual or group therapy treatment services as
defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first
ten weeks following admission, and at least 50 consecutive minutes per month thereafter.
As clinically appropriate, the program may offer these services cumulatively and not
consecutively in increments of no less than 15 minutes over the required time period, and
for a total of 60 minutes of treatment services over the time period, and must document the
reason for providing services cumulatively in the client's record. The program may offer
additional levels of service when deemed clinically necessary.
(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
the assessment must be completed within 21 days new text begin from the day new text end of service initiation.
(c) Notwithstanding the requirements of individual treatment plans set forth in section
245G.06:
(1) treatment plan contents for a maintenance client are not required to include goals
the client must reach to complete treatment and have services terminated;
(2) treatment plans for a client in a taper or detox status must include goals the client
must reach to complete treatment and have services terminated;
(3) for the initial ten weeks after admission for all new admissions, readmissions, and
transfers, deleted text begin progress notesdeleted text end new text begin a weekly treatment plan reviewnew text end must be deleted text begin entered in a client's file at
least weekly and be recorded in each of the six dimensions upon the development of the
treatment plan and thereafterdeleted text end new text begin documented upon the completion of the treatment plan. Prior
to the completion of the treatment plan, all services must be documented according to section
245G.06, subdivision 3new text end . Subsequently, the counselor must document deleted text begin progressdeleted text end new text begin treatment
plan reviewsnew text end in the six dimensions at least once monthlynew text begin after the initial ten weeksnew text end or, when
clinical need warrants, more frequentlydeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(4) upon the development of the treatment plan and thereafter, treatment plan reviews
must occur weekly, or after each treatment service, whichever is less frequent, for the first
ten weeks after the treatment plan is developed. Following the first ten weeks of treatment
plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent
revisions or documentation.
deleted text end
Sec. 31.
Minnesota Statutes 2018, section 245G.22, subdivision 16, is amended to read:
Subd. 16.
Prescription monitoring program.
(a) The program must develop and
maintain a policy and procedure that requires the ongoing monitoring of the data from the
prescription monitoring program (PMP) for each client. The policy and procedure must
include how the program meets the requirements in paragraph (b).
(b) deleted text begin Ifdeleted text end new text begin Whennew text end a medication used for the treatment of substance use disorder is administered
or dispensed to a client, the license holder deleted text begin shall bedeleted text end new text begin isnew text end subject to the following requirements:
(1) upon admission to deleted text begin a methadone clinic outpatientdeleted text end new text begin an opioidnew text end treatment program, a
client must be notified in writing that the commissioner of human services and the medical
director must monitor the PMP to review the prescribed controlled drugs a client received;
(2) the medical director or the medical director's delegate must review the data from the
PMP described in section 152.126 before the client is ordered any controlled substance, as
defined under section 152.126, subdivision 1, paragraph (c), including medications used
for the treatment of opioid addiction, and the medical director's or the medical director's
delegate's subsequent reviews of the PMP data must occur at least every 90 days;
(3) a copy of the PMP data reviewed must be maintained in the client's filenew text begin along with
the licensed practitioner's decision for frequency of ongoing PMP checksnew text end ;
(4) when the PMP data contains a recent history of multiple prescribers or multiple
prescriptions for controlled substances, the physician's review of the data and subsequent
actions must be documented in the client's file within 72 hours and must contain the medical
director's determination of whether or not the prescriptions place the client at risk of harm
and the actions to be taken in response to the PMP findings. The provider must conduct
subsequent reviews of the PMP on a monthly basis; and
(5) if at any time the deleted text begin medical directordeleted text end new text begin licensed practitionernew text end believes the use of the
controlled substances places the client at risk of harm, the program must seek the client's
consent to discuss the client's opioid treatment with other prescribers and must seek the
client's consent for the other prescriber to disclose to the opioid treatment program's medical
director the client's condition that formed the basis of the other prescriptions. If the
information is not obtained within seven days, the medical director must document whether
or not changes to the client's medication dose or number of unsupervised use doses are
necessary until the information is obtained.
(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop
and implement an electronic system for the commissioner to routinely access the PMP data
to determine whether any client enrolled in an opioid addiction treatment program licensed
according to this section was prescribed or dispensed a controlled substance in addition to
that administered or dispensed by the opioid addiction treatment program. When the
commissioner determines there have been multiple prescribers or multiple prescriptions of
controlled substances for a client, the commissioner shall:
(1) inform the medical director of the opioid treatment program only that the
commissioner determined the existence of multiple prescribers or multiple prescriptions of
controlled substances; and
(2) direct the medical director of the opioid treatment program to access the data directly,
review the effect of the multiple prescribers or multiple prescriptions, and document the
review.
(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception
to, any applicable provision of Code of Federal Regulations, title 42, section 2.34 (c), before
implementing this subdivision.
Sec. 32.
Minnesota Statutes 2018, section 245G.22, subdivision 17, is amended to read:
Subd. 17.
Policies and procedures.
(a) A license holder must develop and maintain the
policies and procedures required in this subdivision.
(b) For a program that is not open every day of the year, the license holder must maintain
a policy and procedure that deleted text begin permits a client to receive a singledeleted text end new text begin covers requirements under
section 245G.22, subdivisions 6 and 7.new text end Unsupervised use of medication used for the treatment
of opioid use disorder for days that the program is closed for business, includingdeleted text begin ,deleted text end but not
limited todeleted text begin ,deleted text end Sundays and state and federal holidays deleted text begin as required under subdivision 6, paragraph
(a), clause (1)deleted text end new text begin , must meet the requirements under section 245G.22, subdivisions 6 and 7new text end .
(c) The license holder must maintain a policy and procedure that includes specific
measures to reduce the possibility of diversion. The policy and procedure must:
(1) specifically identify and define the responsibilities of the medical and administrative
staff for performing diversion control measures; and
(2) include a process for contacting no less than five percent of clients who have
unsupervised use of medication, excluding clients approved solely under subdivision 6,
paragraph (a), deleted text begin clause (1),deleted text end to require clients to physically return to the program each month.
The system must require clients to return to the program within a stipulated time frame and
turn in all unused medication containers related to opioid use disorder treatment. The license
holder must document all related contacts on a central log and the outcome of the contact
for each client in the client's record.new text begin The medical director must be informed of each outcome
that results in a situation in which a possible diversion issue was identified.
new text end
(d) Medication used for the treatment of opioid use disorder must be ordered,
administered, and dispensed according to applicable state and federal regulations and the
standards set by applicable accreditation entities. If a medication order requires assessment
by the person administering or dispensing the medication to determine the amount to be
administered or dispensed, the assessment must be completed by an individual whose
professional scope of practice permits an assessment. For the purposes of enforcement of
this paragraph, the commissioner has the authority to monitor the person administering or
dispensing the medication for compliance with state and federal regulations and the relevant
standards of the license holder's accreditation agency and may issue licensing actions
according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's
determination of noncompliance.
new text begin
(e) A counselor in an opioid treatment program must not supervise more than 50 clients.
new text end
Sec. 33.
Minnesota Statutes 2018, section 245G.22, subdivision 19, is amended to read:
Subd. 19.
Placing authorities.
A program must provide certain notification and
client-specific updates to placing authorities for a client who is enrolled in Minnesota health
care programs. At the request of the placing authority, the program must provide
client-specific updates, including but not limited to informing the placing authority of
positive drug deleted text begin screeningsdeleted text end new text begin testingsnew text end and changes in medications used for the treatment of opioid
use disorder ordered for the client.
Sec. 34.
Minnesota Statutes 2018, section 254B.04, is amended by adding a subdivision
to read:
new text begin Subd. 2c. new text end
new text begin
Eligibility to receive peer recovery support and treatment service
coordination.
new text end
new text begin
Notwithstanding Minnesota Rules, part 9530.6620, subpart 6, a placing
authority may authorize peer recovery support and treatment service coordination for a
person who scores a severity of one or more in dimension 4, 5, or 6, under Minnesota Rules,
part 9530.6622. Authorization for peer recovery support and treatment service coordination
under this subdivision does not need to be provided in conjunction with treatment services
under Minnesota Rules, part 9530.6622, subpart 4, 5, or 6.
new text end
Sec. 35.
Minnesota Statutes 2018, section 254B.05, subdivision 1, is amended to read:
Subdivision 1.
Licensure required.
(a) Programs licensed by the commissioner are
eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
notwithstanding the provisions of section 245A.03. American Indian programs that provide
substance use disorder treatment, extended care, transitional residence, or outpatient treatment
services, and are licensed by tribal government are eligible vendors.
(b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional
in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4,
is an eligible vendor of a comprehensive assessment and assessment summary provided
according to section 245G.05, and treatment services provided according to sections 245G.06
and 245G.07, subdivision 1, paragraphs (a), clauses (1) to deleted text begin (5)deleted text end new text begin (4)new text end , and (b); and subdivision
2.
(c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible
vendor for a comprehensive assessment and assessment summary when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and
completed according to the requirements of section 245G.05. A county is an eligible vendor
of care coordination services when provided by an individual who meets the staffing
credentials of section 245G.11, subdivisions 1 and 7, and provided according to the
requirements of section 245G.07, subdivision 1, new text begin paragraph (a), new text end clause deleted text begin (7)deleted text end new text begin (5)new text end .
(d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community
organization that meets certification requirements identified by the commissioner is an
eligible vendor of peer support services.
(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, are not eligible vendors. Programs that are not licensed as a residential or
nonresidential substance use disorder treatment or withdrawal management program by the
commissioner or by tribal government or do not meet the requirements of subdivisions 1a
and 1b are not eligible vendors.
Sec. 36.
Minnesota Statutes 2018, section 254B.05, subdivision 5, is amended to read:
Subd. 5.
Rate requirements.
(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.
(b) Eligible substance use disorder treatment services include:
(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;
(2) deleted text begin on July 1, 2018, or upon federal approval, whichever is later,deleted text end comprehensive
assessments provided according to sections 245.4863, paragraph (a), and 245G.05deleted text begin , and
Minnesota Rules, part 9530.6422deleted text end ;
(3) deleted text begin on July 1, 2018, or upon federal approval, whichever is later,deleted text end care coordination
services provided according to section 245G.07, subdivision 1, paragraph (a), clause deleted text begin (6)deleted text end new text begin
(5)new text end ;
(4) deleted text begin on July 1, 2018, or upon federal approval, whichever is later,deleted text end peer recovery support
services provided according to section 245G.07, subdivision deleted text begin 1, paragraph (a)deleted text end new text begin 2new text end , clause deleted text begin (5)deleted text end new text begin
(8)new text end ;
(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;
(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;
(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;
(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;
(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;
(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;
(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and
(12) room and board facilities that meet the requirements of subdivision 1a.
(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:
(1) programs that serve parents with their children if the program:
(i) provides on-site child care during the hours of treatment activity that:
(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or
(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:
(A) a child care center under Minnesota Rules, chapter 9503; or
(B) a family child care home under Minnesota Rules, chapter 9502;
(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or
programs or subprograms serving special populations, if the program or subprogram meets
the following requirements:
(i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;
(ii) is governed with significant input from individuals of that specific background; and
(iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;
(3) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; and
(4) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:
(i) the program meets the co-occurring requirements in section 245G.20;
(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;
(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;
(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;
(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and
(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.
(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.
(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).
(f) Subject to federal approval, chemical dependency services that are otherwise covered
as direct face-to-face services may be provided via two-way interactive video. The use of
two-way interactive video must be medically appropriate to the condition and needs of the
person being served. Reimbursement shall be at the same rates and under the same conditions
that would otherwise apply to direct face-to-face services. The interactive video equipment
and connection must comply with Medicare standards in effect at the time the service is
provided.
Sec. 37.
Minnesota Statutes 2018, section 256B.0941, subdivision 1, is amended to read:
Subdivision 1.
Eligibility.
(a) An individual who is eligible for mental health treatment
services in a psychiatric residential treatment facility must meet all of the following criteria:
(1) before admission, services are determined to be medically necessary deleted text begin by the state's
medical review agentdeleted text end according to Code of Federal Regulations, title 42, section 441.152;
(2) is younger than 21 years of age at the time of admission. Services may continue until
the individual meets criteria for discharge or reaches 22 years of age, whichever occurs
first;
(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic
and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression,
or a finding that the individual is a risk to self or others;
(4) has functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; an inability to adequately care for
one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill
the individual's needs;
(5) requires psychiatric residential treatment under the direction of a physician to improve
the individual's condition or prevent further regression so that services will no longer be
needed;
(6) utilized and exhausted other community-based mental health services, or clinical
evidence indicates that such services cannot provide the level of care needed; and
(7) was referred for treatment in a psychiatric residential treatment facility by a qualified
mental health professional licensed as defined in section 245.4871, subdivision 27, clauses
(1) to (6).
(b) A mental health professional making a referral shall submit documentation to the
state's medical review agent containing all information necessary to determine medical
necessity, including a standard diagnostic assessment completed within 180 days of the
individual's admission. Documentation shall include evidence of family participation in the
individual's treatment planning and signed consent for services.
Sec. 38.
Minnesota Statutes 2018, section 256B.0941, subdivision 3, is amended to read:
Subd. 3.
Per diem rate.
(a) The commissioner shall establish a statewide per diem rate
for psychiatric residential treatment facility services for individuals 21 years of age or
younger. The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers. Payment must not be made to more than one entity for each
individual for services provided under this section on a given day. The commissioner shall
set rates prospectively for the annual rate period. The commissioner shall require providers
to submit annual cost reports on a uniform cost reporting form and shall use submitted cost
reports to inform the rate-setting process. The cost reporting shall be done according to
federal requirements for Medicare cost reports.
(b) The following are included in the rate:
(1) costs necessary for licensure and accreditation, meeting all staffing standards for
participation, meeting all service standards for participation, meeting all requirements for
active treatment, maintaining medical records, conducting utilization review, meeting
inspection of care, and discharge planning. The direct services costs must be determined
using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
and service-related transportation; and
(2) payment for room and board provided by facilities meeting all accreditation and
licensing requirements for participation.
(c) A facility may submit a claim for payment outside of the per diem for professional
services arranged by and provided at the facility by an appropriately licensed professional
who is enrolled as a provider with Minnesota health care programs. Arranged services deleted text begin must
be billed by the facility on a separate claim, and the facility shall be responsible for payment
to the providerdeleted text end new text begin may be billed by either the facility or the licensed professionalnew text end . These services
must be included in the individual plan of care and are subject to prior authorization deleted text begin by the
state's medical review agentdeleted text end .
(d) Medicaid shall reimburse for concurrent services as approved by the commissioner
to support continuity of care and successful discharge from the facility. "Concurrent services"
means services provided by another entity or provider while the individual is admitted to a
psychiatric residential treatment facility. Payment for concurrent services may be limited
and these services are subject to prior authorization by the state's medical review agent.
Concurrent services may include targeted case management, assertive community treatment,
clinical care consultation, team consultation, and treatment planning.
(e) Payment rates under this subdivision shall not include the costs of providing the
following services:
(1) educational services;
(2) acute medical care or specialty services for other medical conditions;
(3) dental services; and
(4) pharmacy drug costs.
(f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
reasonable, and consistent with federal reimbursement requirements in Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
Management and Budget Circular Number A-122, relating to nonprofit entities.
ARTICLE 4
CONTINUING CARE FOR OLDER ADULTS
Section 1.
Minnesota Statutes 2018, section 245A.07, subdivision 3, is amended to read:
Subd. 3.
License suspension, revocation, or fine.
(a) The commissioner may suspend
or revoke a license, or impose a fine if:
(1) a license holder fails to comply fully with applicable laws or rules;
(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
a disqualification which has not been set aside under section 245C.22;
(3) a license holder knowingly withholds relevant information from or gives false or
misleading information to the commissioner in connection with an application for a license,
in connection with the background study status of an individual, during an investigation,
or regarding compliance with applicable laws or rules; or
(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to
submit the information required of an applicant under section 245A.04, subdivision 1,
paragraph (f) or (g).
A license holder who has had a license suspended, revoked, or has been ordered to pay
a fine must be given notice of the action by certified mail or personal service. If mailed, the
notice must be mailed to the address shown on the application or the last known address of
the license holder. The notice must state in plain language the reasons the license was
suspended or revoked, or a fine was ordered.
(b) If the license was suspended or revoked, the notice must inform the license holder
of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
a license. The appeal of an order suspending or revoking a license must be made in writing
by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
the commissioner within ten calendar days after the license holder receives notice that the
license has been suspended or revoked. If a request is made by personal service, it must be
received by the commissioner within ten calendar days after the license holder received the
order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a
timely appeal of an order suspending or revoking a license, the license holder may continue
to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and
(h), until the commissioner issues a final order on the suspension or revocation.
(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
holder of the responsibility for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
order to pay a fine must be made in writing by certified mail or personal service. If mailed,
the appeal must be postmarked and sent to the commissioner within ten calendar days after
the license holder receives notice that the fine has been ordered. If a request is made by
personal service, it must be received by the commissioner within ten calendar days after
the license holder received the order.
(2) The license holder shall pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies. If the license holder
receives state funds, the state, county, or municipal agencies or departments responsible for
administering the funds shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.
(3) A license holder shall promptly notify the commissioner of human services, in writing,
when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected as indicated by the order
to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
the license holder by certified mail or personal service that a second fine has been assessed.
The license holder may appeal the second fine as provided under this subdivision.
(4) Fines shall be assessed as follows:
(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph deleted text begin (c)deleted text end new text begin (f)new text end ;
(ii) if the commissioner determines that a determination of maltreatment for which the
license holder is responsible is the result of maltreatment that meets the definition of serious
maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
$5,000;
(iii) for a program that operates out of the license holder's home and a program licensed
under Minnesota Rules, parts 9502.0300 to deleted text begin 9502.0495deleted text end new text begin 9502.0445new text end , the fine assessed against
the license holder shall not exceed $1,000 for each determination of maltreatment;
(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule
governing matters of health, safety, or supervision, including but not limited to the provision
of adequate staff-to-child or adult ratios, and failure to comply with background study
requirements under chapter 245C; and
(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule
other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iv).
For purposes of this section, "occurrence" means each violation identified in the
commissioner's fine order. Fines assessed against a license holder that holds a license to
provide home and community-based services, as identified in section 245D.03, subdivision
1, and a community residential setting or day services facility license under chapter 245D
where the services are provided, may be assessed against both licenses for the same
occurrence, but the combined amount of the fines shall not exceed the amount specified in
this clause for that occurrence.
(5) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the case of a corporation, each
controlling individual is personally and jointly liable for payment.
(d) Except for background study violations involving the failure to comply with an order
to immediately remove an individual or an order to provide continuous, direct supervision,
the commissioner shall not issue a fine under paragraph (c) relating to a background study
violation to a license holder who self-corrects a background study violation before the
commissioner discovers the violation. A license holder who has previously exercised the
provisions of this paragraph to avoid a fine for a background study violation may not avoid
a fine for a subsequent background study violation unless at least 365 days have passed
since the license holder self-corrected the earlier background study violation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 2.
Minnesota Statutes 2018, section 245C.08, subdivision 1, is amended to read:
Subdivision 1.
Background studies conducted by Department of Human Services.
(a)
For a background study conducted by the Department of Human Services, the commissioner
shall review:
(1) information related to names of substantiated perpetrators of maltreatment of
vulnerable adults that has been received by the commissioner as required under section
626.557, subdivision 9c, paragraph deleted text begin (j)deleted text end new text begin (n)new text end ;
(2) the commissioner's records relating to the maltreatment of minors in licensed
programs, and from findings of maltreatment of minors as indicated through the social
service information system;
(3) information from juvenile courts as required in subdivision 4 for individuals listed
in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
(4) information from the Bureau of Criminal Apprehension, including information
regarding a background study subject's registration in Minnesota as a predatory offender
under section 243.166;
(5) except as provided in clause (6), information received as a result of submission of
fingerprints for a national criminal history record check, as defined in section 245C.02,
subdivision 13c, when the commissioner has reasonable cause for a national criminal history
record check as defined under section 245C.02, subdivision 15a, or as required under section
144.057, subdivision 1, clause (2);
(6) for a background study related to a child foster care application for licensure, a
transfer of permanent legal and physical custody of a child under sections 260C.503 to
260C.515, or adoptions, and for a background study required for family child care, certified
license-exempt child care, child care centers, and legal nonlicensed child care authorized
under chapter 119B, the commissioner shall also review:
(i) information from the child abuse and neglect registry for any state in which the
background study subject has resided for the past five years; and
(ii) when the background study subject is 18 years of age or older, or a minor under
section 245C.05, subdivision 5a, paragraph (c), information received following submission
of fingerprints for a national criminal history record check; and
(7) for a background study required for family child care, certified license-exempt child
care centers, licensed child care centers, and legal nonlicensed child care authorized under
chapter 119B, the background study shall also include, to the extent practicable, a name
and date-of-birth search of the National Sex Offender Public website.
(b) Notwithstanding expungement by a court, the commissioner may consider information
obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice
of the petition for expungement and the court order for expungement is directed specifically
to the commissioner.
(c) The commissioner shall also review criminal case information received according
to section 245C.04, subdivision 4a, from the Minnesota court information system that relates
to individuals who have already been studied under this chapter and who remain affiliated
with the agency that initiated the background study.
(d) When the commissioner has reasonable cause to believe that the identity of a
background study subject is uncertain, the commissioner may require the subject to provide
a set of classifiable fingerprints for purposes of completing a fingerprint-based record check
with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph
shall not be saved by the commissioner after they have been used to verify the identity of
the background study subject against the particular criminal record in question.
(e) The commissioner may inform the entity that initiated a background study under
NETStudy 2.0 of the status of processing of the subject's fingerprints.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 3.
Minnesota Statutes 2018, section 256.021, subdivision 2, is amended to read:
Subd. 2.
Review procedure.
(a) If a vulnerable adult or an interested person acting on
behalf of the vulnerable adult requests a review under this section, the panel shall review
the request at its next quarterly meeting. If the next quarterly meeting is within deleted text begin tendeleted text end new text begin 30
calendarnew text end days of the panel's receipt of the request for review, the review may be delayed
until the next subsequent meeting. The panel shall review the request and the investigation
memorandum and may review any other data on the investigation maintained by the lead
investigative agency that are pertinent and necessary to its review of the final disposition.
If more than one person requests a review under this section with respect to the same final
disposition, the review panel shall combine the requests into one review. The panel shall
submit its written request for the case file and other documentation relevant to the review
to the supervisor of the investigator conducting the investigation under review.
(b) Within 30 days of the review under this section, the panel shall notify the director
or manager of the lead investigative agency and the vulnerable adult or interested person
who requested the review as to whether the panel concurs with the final disposition or
whether the lead investigative agency must reconsider the final disposition. If the panel
determines that the lead investigative agency must reconsider the final disposition, the panel
must make specific recommendations to the director or manager of the lead investigative
agency. The recommendation must include an explanation of the factors that form the basis
of the recommendation to reconsider the final disposition and must specifically identify the
disputed facts, the disputed application of maltreatment definitions, the disputed application
of responsibility for maltreatment, and the disputed weighing of evidence, whichever apply.
Within 30 days the lead investigative agency shall conduct a review and report back to the
panel with its determination and the specific rationale for its final disposition. At a minimum,
the specific rationale must include a detailed response to each of the factors identified by
the panel that formed the basis for the recommendations of the panel.
(c) Upon receiving the report of reconsideration from the lead investigative agency, the
panel shall communicate the decision in writing to the vulnerable adult or interested person
acting on behalf of the vulnerable adult who requested the review. The panel shall include
the specific rationale provided by the lead investigative agency as part of the communication.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 4.
Minnesota Statutes 2018, section 256R.02, subdivision 4, is amended to read:
Subd. 4.
Administrative costs.
"Administrative costs" means the identifiable costs for
administering the overall activities of the nursing home. These costs include salaries and
wages of the administrator, assistant administrator, business office employees, security
guards,new text begin purchasing and inventory employees,new text end and associated fringe benefits and payroll
taxes, fees, contracts, or purchases related to business office functions, licenses, permits
except as provided in the external fixed costs category, employee recognition, travel including
meals and lodging, all training except as specified in subdivision 17, voice and data
communication or transmission, office supplies, property and liability insurance and other
forms of insurance except insurance that is a fringe benefit under subdivision 22, personnel
recruitment, legal services, accounting services, management or business consultants, data
processing, information technology, website, central or home office costs, business meetings
and seminars, postage, fees for professional organizations, subscriptions, security services,new text begin
nonpromotionalnew text end advertising, board of directors fees, working capital interest expense, bad
debts, bad debt collection fees, and costs incurred for travel and housing for persons employed
by a supplemental nursing services agency as defined in section 144A.70, subdivision 6.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 5.
Minnesota Statutes 2018, section 256R.02, subdivision 17, is amended to read:
Subd. 17.
Direct care costs.
"Direct care costs" means costs for the wages of nursing
administration, direct care registered nurses, licensed practical nurses, certified nursing
assistants, trained medication aides, employees conducting training in resident care topics
and associated fringe benefits and payroll taxes; services from anew text begin Minnesota registerednew text end
supplemental nursing services agencynew text begin up to the maximum allowable charges under section
144A.74, excluding associated lodging and travel costsnew text end ; supplies that are stocked at nursing
stations or on the floor and distributed or used individually, including, but not limited to:
alcohol, applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages,
water pitchers, tongue depressors, disposable gloves, enemas, enema equipment,new text begin personal
hygienenew text end soap, medication cups, diapers, deleted text begin plastic waste bags,deleted text end sanitary products, new text begin disposable
new text end thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic
agents, drugs deleted text begin that are not paiddeleted text end new text begin payablenew text end on a separate fee schedule by the medical assistance
program or any other payer, and deleted text begin technology relateddeleted text end new text begin clinical software costs specificnew text end to the
provision of nursing care to residents, such as electronic charting systems; costs of materials
used for resident care training, and training courses outside of the facility attended by direct
care staff on resident care topics; and costs for nurse consultants, pharmacy consultants,
and medical directors. Salaries and payroll taxes for nurse consultants who work out of a
central office must be allocated proportionately by total resident days or by direct
identification to the nursing facilities served by those consultants.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 6.
Minnesota Statutes 2018, section 256R.02, subdivision 18, is amended to read:
Subd. 18.
Employer health insurance costs.
"Employer health insurance costs" means
premium expenses for group coveragedeleted text begin ;deleted text end new text begin andnew text end actual expenses incurred for self-insured plans,
including deleted text begin reinsurance;deleted text end new text begin actual claims paid, stop loss premiums, plan fees,new text end and employer
contributions to employee health reimbursement and health savings accounts. new text begin Actual costs
of self-insurance plans must not include any allowance for future funding unless the plan
meets the Medicare requirements for reporting on a premium basis when the Medicare
regulations define the actual costs. new text end Premium and expense costs and contributions are
allowable for (1) all employees and (2) the spouse and dependents of those employees who
are employed on average at least 30 hours per week.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 7.
Minnesota Statutes 2018, section 256R.02, subdivision 19, is amended to read:
Subd. 19.
External fixed costs.
"External fixed costs" means costs related to the nursing
home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122;
family advisory council fee under section 144A.33; scholarships under section 256R.37;
planned closure rate adjustments under section 256R.40; consolidation rate adjustments
under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d;
single-bed room incentives under section 256R.41; property taxes, new text begin special new text end assessments, and
payments in lieu of taxes; employer health insurance costs; quality improvement incentive
payment rate adjustments under section 256R.39; performance-based incentive payments
under section 256R.38; special dietary needs under section 256R.51; deleted text begin rate adjustments for
compensation-related costs for minimum wage changes under section 256R.49 provided
on or after January 1, 2018;deleted text end and Public Employees Retirement Association employer costs.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 8.
Minnesota Statutes 2018, section 256R.02, subdivision 29, is amended to read:
Subd. 29.
Maintenance and plant operations costs.
"Maintenance and plant operations
costs" means the costs for the salaries and wages of the maintenance supervisor, engineers,
heating-plant employees, and other maintenance employees and associated fringe benefits
and payroll taxes. It also includes identifiable costs for maintenance and operation of the
building and grounds, including, but not limited to, fuel, electricity,new text begin plastic waste bags,new text end
medical waste and garbage removal, water, sewer, supplies, tools, deleted text begin anddeleted text end repairsnew text begin , and equipment
that is not required to be included in the property allowancenew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 9.
Minnesota Statutes 2018, section 256R.02, subdivision 42a, is amended to read:
Subd. 42a.
Real estate taxes.
"Real estate taxes" means the real estate tax liability shown
on the annual property tax deleted text begin statementdeleted text end new text begin statementsnew text end of the nursing facility for the reporting
period. The term does not include personnel costs or fees for late payment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 10.
Minnesota Statutes 2018, section 256R.02, subdivision 48a, is amended to read:
Subd. 48a.
Special assessments.
"Special assessments" means the actual special
assessments and related interest paid during the reporting periodnew text begin that are involuntary costsnew text end .
The term does not include personnel costs deleted text begin ordeleted text end new text begin ,new text end fees for late paymentnew text begin , or special assessments
for projects that are reimbursed in the property allowancenew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 11.
Minnesota Statutes 2018, section 256R.07, subdivision 1, is amended to read:
Subdivision 1.
Criteria.
A nursing facility shall keep adequate documentation. In order
to be adequate, documentation must:
(1) be maintained in orderly, well-organized files;
(2) not include documentation of more than one nursing facility in one set of files unless
transactions may be traced by the commissioner to the nursing facility's annual cost report;
(3) include a paid invoice or copy of a paid invoice with date of purchase, vendor name
and address, purchaser name and delivery destination address, listing of items or services
purchased, cost of items purchased, account number to which the cost is posted, and a
breakdown of any allocation of costs between accounts or nursing facilities. If any of the
information is not available, the nursing facility shall document its good faith attempt to
obtain the information;
(4) include contracts, agreements, amortization schedules, mortgages, other debt
instruments, and all other documents necessary to explain the nursing facility's costs or
revenues; and
(5) be retained by the nursing facility to support the five most recent annual cost reports.
The commissioner may extend the period of retention if the field audit was postponed
because of inadequate record keeping or accounting practices as in section 256R.13,
subdivisions 2 and 4, the records are necessary to resolve a pending appeal, or the records
are required for the enforcement of sections 256R.04; 256R.05, subdivision 2; 256R.06,
subdivisions 2, 6, and 7; 256R.08, subdivisions 1 deleted text begin todeleted text end new text begin andnew text end 3; and 256R.09, subdivisions 3 and
4.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 12.
Minnesota Statutes 2018, section 256R.07, subdivision 2, is amended to read:
Subd. 2.
Documentation of compensation.
Compensation for personal services,
regardless of whether treated as identifiable costs or costs that are not identifiable, must be
documented on payroll records. Payrolls must be supported by time and attendance or
equivalent records for individual employees. Salaries and wages of employees which are
allocated to more than one cost category must be supported by time distribution records.
deleted text begin The method used must produce a proportional distribution of actual time spent, or an accurate
estimate of time spent performing assigned duties. The nursing facility that chooses to
estimate time spent must use a statistically valid method. The compensation must reflect
an amount proportionate to a full-time basis if the services are rendered on less than a
full-time basis.deleted text end new text begin Salary allocations are allowable using the Medicare approved allocation
basis and methodology only if the salary costs cannot be directly determined including when
employees provide shared services to noncovered operations.
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. 13.
Minnesota Statutes 2018, section 256R.09, subdivision 2, is amended to read:
Subd. 2.
Reporting of statistical and cost information.
All nursing facilities shall
provide information annually to the commissioner on a form and in a manner determined
by the commissioner. The commissioner may separately require facilities to submit in a
manner specified by the commissioner documentation of statistical and cost information
included in the report to ensure accuracy in establishing payment rates and to perform audit
and appeal review functions under this chapter. The commissioner may also require nursing
facilities to provide statistical and cost information for a subset of the items in the annual
report on a semiannual basis. Nursing facilities shall report only costs directly related to the
operation of the nursing facility. The facility shall not include costs which are separately
deleted text begin reimburseddeleted text end new text begin reimbursablenew text end by residents, medical assistance, or other payors. Allocations of
costs from central, affiliated, or corporate office and related organization transactions shall
be reported according to sections 256R.07, subdivision 3, and 256R.12, subdivisions 1 to
7. The commissioner shall not grant facilities extensions to the filing deadline.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 14.
Minnesota Statutes 2018, section 256R.10, subdivision 1, is amended to read:
Subdivision 1.
General cost principles.
Only costs determined to be allowable shall be
used to compute the total payment rate for nursing facilities participating in the medical
assistance program. To be considered an allowable cost for rate-setting purposes, a cost
must satisfy the following criteria:
(1) the cost is ordinary, necessary, and related to resident care;
(2) the cost is what a prudent and cost-conscious business person would pay for the
specific good or service in the open market in an arm's-length transaction;
(3) the cost is for goods or services actually provided in the nursing facility;
(4)new text begin incurred costs that are not salary or wage costs must be paid within 180 days of the
end of the reporting period to be allowable costs of the reporting period;
new text end
new text begin (5)new text end the cost effects of transactions that have the effect of circumventing this chapter are
not allowable under the principle that the substance of the transaction shall prevail over
form; and
deleted text begin (5)deleted text end new text begin (6)new text end costs that are incurred due to management inefficiency, unnecessary care or
facilities, agreements not to compete, or activities not commonly accepted in the nursing
facility care field are not allowable.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 15.
Minnesota Statutes 2018, section 256R.13, subdivision 4, is amended to read:
Subd. 4.
Extended record retention requirements.
The commissioner shall extend the
period for retention of records under section 256R.09, subdivision 3, for purposes of
performing field audits as necessary to enforce sections 256R.04; 256R.05, subdivision 2;
256R.06, subdivisions 2, 6, and 7; 256R.08, subdivisions 1 deleted text begin todeleted text end new text begin andnew text end 3; and 256R.09,
subdivisions 3 and 4, with written notice to the facility postmarked no later than 90 days
prior to the expiration of the record retention requirement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 16.
Minnesota Statutes 2018, section 256R.39, is amended to read:
256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM.
The commissioner shall develop a quality improvement incentive program in consultation
with stakeholders. The annual funding pool available for quality improvement incentive
payments shall be equal to 0.8 percent of all operating payments, not including any rate
components resulting from equitable cost-sharing for publicly owned nursing facility program
participation under section 256R.48, critical access nursing facility program participation
under section 256R.47, or performance-based incentive payment program participation
under section 256R.38. deleted text begin For the period from October 1, 2015, to December 31, 2016, rate
adjustments provided under this section shall be effective for 15 months. Beginning January
1, 2017,deleted text end Annual rate adjustments provided under this section shall be effective for one rate
year.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 17.
Minnesota Statutes 2018, section 626.557, subdivision 3, is amended to read:
Subd. 3.
Timing of report.
(a) A mandated reporter who has reason to believe that a
vulnerable adult is being or has been maltreated, or who has knowledge that a vulnerable
adult has sustained a physical injury which is not reasonably explained shall immediately
report the information to the common entry point. If an individual is a vulnerable adult
solely because the individual deleted text begin is admitted to a facilitydeleted text end new text begin receives licensed servicesnew text end , a mandated
reporter is not required to report suspected maltreatment of the individual that occurred
prior to deleted text begin admissiondeleted text end new text begin receiving licensed servicesnew text end , unless:
(1) the individual deleted text begin was admitted to the facilitydeleted text end new text begin received licensed services new text end from another
deleted text begin facilitydeleted text end new text begin licensed provider new text end and the reporter has reason to believe the vulnerable adult was
maltreated deleted text begin in the previous facilitydeleted text end new text begin during the time period in which the vulnerable adult
received licensed servicesnew text end ; or
(2) the reporter knows or has reason to believe that the individual is a vulnerable adult
as defined in section 626.5572, subdivision 21, paragraph (a), clause (4).
(b) A person not required to report under the provisions of this section may voluntarily
report as described above.
(c) Nothing in this section requires a report of known or suspected maltreatment, if the
reporter knows or has reason to know that a report has been made to the common entry
point.
(d) Nothing in this section shall preclude a reporter from also reporting to a law
enforcement agency.
(e) A mandated reporter who knows or has reason to believe that an error under section
626.5572, subdivision 17, paragraph (c), clause (5), occurred must make a report under this
subdivision. If the reporter or deleted text begin a facilitydeleted text end new text begin licensed providernew text end , at any time believes that an
investigation by a lead investigative agency will determine or should determine that the
reported error was not neglect according to the criteria under section 626.5572, subdivision
17, paragraph (c), clause (5), the reporter or deleted text begin facilitydeleted text end new text begin licensed providernew text end may provide to the
common entry point or directly to the lead investigative agency information explaining how
the event meets the criteria under section 626.5572, subdivision 17, paragraph (c), clause
(5). The lead investigative agency shall consider this information when making an initial
disposition of the report under subdivision 9c.
Sec. 18.
Minnesota Statutes 2018, section 626.557, subdivision 3a, is amended to read:
Subd. 3a.
Report not required.
The following events are not required to be reported
under this section:
(1) A circumstance where federal law specifically prohibits a person from disclosing
patient identifying information in connection with a report of suspected maltreatment, unless
the vulnerable adult, or the vulnerable adult's guardian, conservator, or legal representative,
has consented to disclosure in a manner which conforms to federal requirements. deleted text begin Facilitiesdeleted text end new text begin
Licensed providersnew text end whose patients or residents are covered by such a federal law shall seek
consent to the disclosure of suspected maltreatment from each patient or resident, or a
guardian, conservator, or legal representative, upon the patient's or resident's deleted text begin admission to
the facilitydeleted text end new text begin receipt of licensed servicesnew text end . Persons who are prohibited by federal law from
reporting an incident of suspected maltreatment shall immediately seek consent to make a
report.
(2) Verbal or physical aggression occurring between patients, residents, or clients of a
deleted text begin facilitydeleted text end new text begin licensed providernew text end , or self-abusive behavior by these persons does not constitute
abuse unless the behavior causes serious harm. The deleted text begin operator of the facility or a designeedeleted text end new text begin
licensed providernew text end shall record incidents of aggression and self-abusive behavior to facilitate
review by licensing agencies and county and local welfare agencies.
(3) Accidents as defined in section 626.5572, subdivision 3.
(4) Events deleted text begin occurring in a facilitydeleted text end that result from deleted text begin an individual'sdeleted text end new text begin a licensed provider's
new text end error in the provision of therapeutic conduct to a vulnerable adult, as provided in section
626.5572, subdivision 17, paragraph (c), clause (4).
(5) Nothing in this section shall be construed to require a report of financial exploitation,
as defined in section 626.5572, subdivision 9, solely on the basis of the transfer of money
or property by gift or as compensation for services rendered.
Sec. 19.
Minnesota Statutes 2018, section 626.557, subdivision 4, is amended to read:
Subd. 4.
Reporting.
(a) Except as provided in paragraph (b), a mandated reporter shall
immediately make an oral report to the common entry point. deleted text begin The common entry point may
accept electronic reports submitted through a web-based reporting system established by
the commissioner. Use of a telecommunications device for the deaf or other similar device
shall be considered an oral report. The common entry point may not require written reports.deleted text end
To the extent possible, the report must be of sufficient content to identify the vulnerable
adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of
previous maltreatment, the name and address of the reporter, the time, date, and location of
the incident, and any other information that the reporter believes might be helpful in
investigating the suspected maltreatment. A mandated reporter may disclose not public data,
as defined in section 13.02, and medical records under sections 144.291 to 144.298, to the
extent necessary to comply with this subdivision.
(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified
under Title 19 of the Social Security Act, a nursing home that is licensed under section
144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital
that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code
of Federal Regulations, title 42, section 482.66, may submit a report electronically to the
common entry point instead of submitting an oral report. The report may be a duplicate of
the initial report the deleted text begin facilitydeleted text end new text begin licensed providernew text end submits electronically to the commissioner
of health to comply with the reporting requirements under Code of Federal Regulations,
title 42, section 483.13. The commissioner of health may modify these reporting requirements
to include items required under paragraph (a) that are not currently included in the electronic
reporting form.
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 626.557, subdivision 4a, is amended to read:
Subd. 4a.
Internal reporting of maltreatment.
(a) Each deleted text begin facilitydeleted text end new text begin licensed providernew text end shall
establish and enforce an ongoing written procedure in compliance with applicable licensing
rules to ensure that all cases of suspected maltreatment are reported. If a deleted text begin facilitydeleted text end new text begin licensed
providernew text end has an internal reporting procedure, a mandated reporter may meet the reporting
requirements of this section by reporting internally. However, the deleted text begin facilitydeleted text end new text begin licensed providernew text end
remains responsible for complying with the immediate reporting requirements of this section.
(b) A deleted text begin facilitydeleted text end new text begin licensed providernew text end with an internal reporting procedure that receives an
internal report by a mandated reporter shall give the mandated reporter a written notice
stating whether the deleted text begin facilitydeleted text end new text begin licensed providernew text end has reported the incident to the common entry
point. The written notice must be provided within two working days and in a manner that
protects the confidentiality of the reporter.
(c) The written response to the mandated reporter shall note that if the mandated reporter
is not satisfied with the action taken by the deleted text begin facilitydeleted text end new text begin licensed providernew text end on whether to report
the incident to the common entry point, then the mandated reporter may report externally.
(d) A deleted text begin facilitydeleted text end new text begin licensed providernew text end may not prohibit a mandated reporter from reporting
externally, and a deleted text begin facilitydeleted text end new text begin licensed providernew text end is prohibited from retaliating against a mandated
reporter who reports an incident to the common entry point in good faith. The written notice
by the deleted text begin facilitydeleted text end new text begin licensed providernew text end must inform the mandated reporter of this protection from
retaliatory measures by the deleted text begin facilitydeleted text end new text begin licensed providernew text end against the mandated reporter for
reporting externally.
Sec. 21.
Minnesota Statutes 2018, section 626.557, subdivision 6, is amended to read:
Subd. 6.
Falsified reports.
A person or deleted text begin facilitydeleted text end new text begin licensed providernew text end who intentionally
makes a false report under the provisions of this section shall be liable in a civil suit for any
actual damages suffered by the reported deleted text begin facilitydeleted text end new text begin licensed providernew text end , person or persons and
for punitive damages up to $10,000 and attorney fees.
Sec. 22.
Minnesota Statutes 2018, section 626.557, subdivision 9, is amended to read:
Subd. 9.
Common entry point designation.
(a) deleted text begin Each county board shall designate a
common entry point for reports of suspected maltreatment, for use until the commissioner
of human services establishes a common entry point. Two or more county boards may
jointly designate a single common entry point.deleted text end The commissioner of human services shall
establish a common entry point deleted text begin effective July 1, 2015deleted text end . The common entry point is the unit
responsible for receiving the report of suspected maltreatment under this section.
(b) The common entry point must be available 24 hours per day to take calls from
reporters of suspected maltreatment. The common entry point shall use a standard intake
form that includes:
(1) the time and date of the report;
(2) new text begin the name, relationship, and identifying and contact information for the alleged victim
and alleged perpetrator;
new text end
new text begin (3) new text end the name, deleted text begin address, and telephone number of the person reporting;deleted text end new text begin relationship, and
contact information for the:
new text end
new text begin
(i) reporter;
new text end
new text begin
(ii) initial reporter, witnesses, and persons who may have knowledge about the
maltreatment; and
new text end
new text begin
(iii) alleged victim's legal surrogate and persons who may provide support to the alleged
victim;
new text end
new text begin
(4) the basis of vulnerability for the alleged victim;
new text end
deleted text begin (3)deleted text end new text begin (5)new text end the time, date, and location of the incident;
deleted text begin
(4) the names of the persons involved, including but not limited to, perpetrators, alleged
victims, and witnesses;
deleted text end
deleted text begin (5) whether there was a risk of imminent dangerdeleted text end new text begin (6) the immediate safety risknew text end to the
alleged victim;
deleted text begin (6)deleted text end new text begin (7)new text end a description of the suspected maltreatment;
deleted text begin
(7) the disability, if any, of the alleged victim;
deleted text end
deleted text begin
(8) the relationship of the alleged perpetrator to the alleged victim;
deleted text end
new text begin
(8) the impact of the suspected maltreatment on the alleged victim;
new text end
(9) whether a deleted text begin facilitydeleted text end new text begin licensed providernew text end was involved and, if so, which agency licenses
the deleted text begin facilitydeleted text end new text begin licensed providernew text end ;
new text begin
(10) the actions taken to protect the alleged victim;
new text end
deleted text begin (10) any action takendeleted text end new text begin (11) the required notifications and referrals madenew text end by the common
entry point;new text begin and
new text end
deleted text begin
(11) whether law enforcement has been notified;
deleted text end
(12) whether the reporter wishes to receive notification of the deleted text begin initial and final reports;
anddeleted text end new text begin disposition.
new text end
deleted text begin
(13) if the report is from a facility with an internal reporting procedure, the name, mailing
address, and telephone number of the person who initiated the report internally.
deleted text end
(c) The common entry point is not required to complete each item on the form prior to
dispatching the report to the appropriate lead investigative agency.
(d) The common entry point shall immediately report to a law enforcement agency any
incident in which there is reason to believe a crime has been committed.
(e) If a report is initially made to a law enforcement agency or a lead investigative agency,
those agencies shall take the report on the appropriate common entry point intake forms
and immediately forward a copy to the common entry point.
(f) The common entry point staff must receive training on how to screen and dispatch
reports efficiently and in accordance with this section.
(g) The commissioner of human services shall maintain a centralized database for the
collection of common entry point data, lead investigative agency data including maltreatment
report disposition, and appeals data. The common entry point shall have access to the
centralized database and must log the reports into the database deleted text begin and immediately identify
and locate prior reports of abuse, neglect, or exploitationdeleted text end .
(h) When appropriate, the common entry point staff must refer calls that do not allege
the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might
resolve the reporter's concerns.
(i) A common entry point must be operated in a manner that enables the commissioner
of human services to:
(1) track critical steps in the reporting, evaluation, referral, response, disposition, and
investigative process to ensure compliance with all requirements for all reports;
(2) maintain data to facilitate the production of aggregate statistical reports for monitoring
patterns of abuse, neglect, or exploitation;
(3) serve as a resource for the evaluation, management, and planning of preventative
and remedial services for vulnerable adults who have been subject to abuse, neglect, or
exploitation;
(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
of the common entry point; and
(5) track and manage consumer complaints related to the common entry point.
(j) The commissioners of human services and health shall collaborate on the creation of
a system for referring reports to the lead investigative agencies. This system shall enable
the commissioner of human services to track critical steps in the reporting, evaluation,
referral, response, disposition, investigation, notification, determination, and appeal processes.
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 626.557, subdivision 9b, is amended to read:
Subd. 9b.
Response to reports.
Law enforcement is the primary agency to conduct
investigations of any incident in which there is reason to believe a crime has been committed.
Law enforcement shall initiate a response immediately. If the common entry point notified
a county agency for emergency adult protective services, law enforcement shall cooperate
with that county agency when both agencies are involved and shall exchange data to the
extent authorized in subdivision 12b, paragraph (g). County adult protection shall initiate
a response immediately. Each lead investigative agency shall complete the investigative
process for reports within its jurisdiction. A lead investigative agency, county, adult protective
agency, licensed deleted text begin facilitydeleted text end new text begin providernew text end , or law enforcement agency shall cooperate with other
agencies in the provision of protective services, coordinating its investigations, and assisting
another agency within the limits of its resources and expertise and shall exchange data to
the extent authorized in subdivision 12b, paragraph (g). The lead investigative agency shall
obtain the results of any investigation conducted by law enforcement officials. The lead
investigative agency has the right to enter deleted text begin facilitiesdeleted text end new text begin licensed provider premisesnew text end and inspect
and copy records as part of investigations. The lead investigative agency has access to not
public data, as defined in section 13.02, and medical records under sections 144.291 to
144.298, that are maintained by deleted text begin facilitiesdeleted text end new text begin licensed providersnew text end to the extent necessary to
conduct its investigation. Each lead investigative agency shall develop guidelines for
prioritizing reports for investigation.
Sec. 24.
Minnesota Statutes 2018, section 626.557, subdivision 9c, is amended to read:
Subd. 9c.
Lead investigative agency; notifications, dispositions, determinations.
(a)
Upon request of the reporter, the lead investigative agency shall notify the reporter that it
has received the report, and provide information on the initial disposition of the report within
five business days of receipt of the report, provided that the notification will not endanger
the vulnerable adult or hamper the investigation.
(b) new text begin In making the initial disposition, the lead investigative agency may consider previous
reports of suspected maltreatment and may request and consider public information, records
maintained by a lead investigative agency or licensed providers, and information from any
other person who may have knowledge regarding the alleged maltreatment.
new text end
new text begin
(c) Unless the lead investigative agency knows the information would endanger the
well-being of the vulnerable adult, during the investigation period the lead investigative
agency shall inform the vulnerable adult of the maltreatment allegation, investigation
guidelines, time frame, and evidence standards used for determinations. The lead investigative
agency must also provide the information to the vulnerable adult's guardian or health care
agent if the allegation is applicable to the guardian or health care agent.
new text end
new text begin
(d) During the investigation and in the provision of adult protective services, the lead
investigative agency may coordinate with entities identified under section 626.557,
subdivision 12b, paragraph (g), and the primary support person to safeguard the welfare
and prevent further maltreatment of the vulnerable adult. The lead investigative agency
must request and consider the vulnerable adult's choice of a primary support person.
new text end
new text begin (e) new text end Upon conclusion of every investigation it conducts, the lead investigative agency
shall make a final disposition as defined in section 626.5572, subdivision 8.
deleted text begin (c)deleted text end new text begin (f)new text end When determining whether the deleted text begin facilitydeleted text end new text begin licensed providernew text end or individual is the
responsible party for substantiated maltreatment or whether both the deleted text begin facilitydeleted text end new text begin licensed providernew text end
and deleted text begin thedeleted text end individual are responsible for substantiated maltreatment, the lead investigative
agency shall consider at least the following mitigating factors:
(1) whether the actions of the deleted text begin facilitydeleted text end new text begin licensed providernew text end or deleted text begin thedeleted text end individual deleted text begin caregiversdeleted text end new text begin
caregivernew text end were in accordance with, and followed the terms of, an erroneous physician order,
prescription, resident care plan, or directive. This is not a mitigating factor when the deleted text begin facilitydeleted text end new text begin
licensed providernew text end ornew text begin individualnew text end caregiver is responsible for the issuance of the erroneous
order, prescription, plan, or directive or knows or should have known of the errors and took
no reasonable measures to correct the defect before administering care;
(2) the comparative responsibility between the deleted text begin facility, other caregivers,deleted text end new text begin licensed provider
or individual caregivernew text end and requirements placed upon the employee, including but not limited
to, the deleted text begin facility'sdeleted text end new text begin licensed provider'snew text end compliance with related regulatory standards and factors
such as the adequacy of deleted text begin facilitydeleted text end new text begin licensed provider'snew text end policies and procedures, the adequacy
of deleted text begin facilitydeleted text end new text begin the licensed provider'snew text end training, the adequacy of an individual's participation in
the training, the adequacy of caregiver supervision, the adequacy of deleted text begin facilitydeleted text end new text begin the licensed
provider'snew text end staffing levels, and a consideration of the scope of the individual employee's
authority; and
(3) whether the deleted text begin facilitydeleted text end new text begin licensed provider, employee,new text end or individual followed professional
standards in exercising professional judgment.
deleted text begin (d)deleted text end new text begin (g)new text end When substantiated maltreatment is determined to have been committed by an
individual who is also the deleted text begin facilitydeleted text end license holder, both the individual and the deleted text begin facilitydeleted text end new text begin licensed
providernew text end must be determined responsible for the maltreatment, and both the background
study disqualification standards under section 245C.15, subdivision 4, and the licensing
actions under section 245A.06 or 245A.07 apply.
deleted text begin (e)deleted text end new text begin (h)new text end The lead investigative agency shall complete its final disposition within 60
calendar daysnew text begin from the date of the initial disposition for the reportnew text end . If the lead investigative
agency is unable to complete its final disposition within 60 calendar days, the lead
investigative agency shall notify the following persons provided that the notification will
not endanger the vulnerable adult or hamper the investigation: (1) the vulnerable adult or
the vulnerable adult's guardian or health care agent, when known, if the lead investigative
agency knows them to be aware of the investigation; and (2) the deleted text begin facilitydeleted text end new text begin licensed providernew text end ,
where applicable. The notice shall contain the reason for the delay and the projected
completion date. If the lead investigative agency is unable to complete its final disposition
by a subsequent projected completion date, the lead investigative agency shall again notify
the vulnerable adult or the vulnerable adult's guardian or health care agent, when known if
the lead investigative agency knows them to be aware of the investigation, and the deleted text begin facilitydeleted text end new text begin
licensed providernew text end , where applicable, of the reason for the delay and the revised projected
completion date provided that the notification will not endanger the vulnerable adult or
hamper the investigation. The lead investigative agency must notify the health care agent
of the vulnerable adult only if the health care agent's authority to make health care decisions
for the vulnerable adult is currently effective under section 145C.06 and not suspended
under section 524.5-310 and the investigation relates to a duty assigned to the health care
agent by the principal. A lead investigative agency's inability to complete the final disposition
within 60 calendar days or by any projected completion date does not invalidate the final
disposition.
deleted text begin (f)deleted text end new text begin (i) When the lead investigative agency is the Department of Human Services or the
Department of Health,new text end within ten calendar days of completing the final disposition, the lead
investigative agency shall provide a copy of the public investigation memorandum under
subdivision 12b, paragraph (b), clause (1), deleted text begin when required to be completed under this section,deleted text end
to the following persons: (1) the vulnerable adult, or the vulnerable adult's guardian or health
care agent, if known,new text begin when the allegation is applicable to the surrogate's authority,new text end unless
the lead investigative agency knows that the notification would endanger the well-being of
the vulnerable adult; (2) the reporter, if the reporter requested notification when making the
report, provided this notification would not endanger the well-being of the vulnerable adult;
(3) the alleged perpetrator, if known; (4) the deleted text begin facilitydeleted text end new text begin licensed providernew text end ; and (5) the
ombudsman for long-term care, or the ombudsman for mental health and developmental
disabilities, as appropriate.
new text begin
(j) When the lead investigative agency is a county agency, within ten calendar days of
completing the final disposition, the lead investigative agency shall provide notification of
the final disposition to the following persons: (1) the vulnerable adult, or the vulnerable
adult's guardian or health agent, if known, when the allegation is applicable to the surrogate's
authority, unless the agency knows the notification would endanger the well-being of the
vulnerable adult; (2) the alleged perpetrator, if known; and (3) the personal care provider
organization under section 256B.0659 when the alleged incident involves a personal care
assistant or provider agency.
new text end
deleted text begin (g)deleted text end new text begin (k)new text end If, as a result of a reconsideration, review, or hearing, the lead investigative
agency changes the final disposition, or if a final disposition is changed on appeal, the lead
investigative agency shall notify the parties specified in paragraph (f).
deleted text begin (h)deleted text end new text begin (l)new text end The lead investigative agency shall notify the vulnerable adult who is the subject
of the report or the vulnerable adult's guardian or health care agent, if known, and any person
or deleted text begin facilitydeleted text end new text begin licensed providernew text end determined to have maltreated a vulnerable adult, of their appeal
or review rights under this section or section 256.021.
deleted text begin (i)deleted text end new text begin (m)new text end The lead investigative agency shall routinely provide investigation memoranda
for substantiated reports to the appropriate licensing boards. These reports must include the
names of substantiated perpetrators. The lead investigative agency may not provide
investigative memoranda for inconclusive or false reports to the appropriate licensing boards
unless the lead investigative agency's investigation gives reason to believe that there may
have been a violation of the applicable professional practice laws. If the investigation
memorandum is provided to a licensing board, the subject of the investigation memorandum
shall be notified and receive a summary of the investigative findings.
deleted text begin (j)deleted text end new text begin (n)new text end In order to avoid duplication, licensing boards shall consider the findings of the
lead investigative agency in their investigations if they choose to investigate. This does not
preclude licensing boards from considering other information.
deleted text begin (k)deleted text end new text begin (o)new text end The lead investigative agency must provide to the commissioner of human services
its final dispositions, including the names of all substantiated perpetrators. The commissioner
of human services shall establish records to retain the names of substantiated perpetrators.
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 626.557, subdivision 9d, is amended to read:
Subd. 9d.
Administrative reconsideration; review panel.
(a) Except as provided under
paragraph (e), any individual or deleted text begin facilitydeleted text end new text begin licensed providernew text end which a lead investigative agency
determines has maltreated a vulnerable adult, or the vulnerable adult or an interested person
acting on behalf of the vulnerable adult, regardless of the lead investigative agency's
determination, who contests the lead investigative agency's final disposition of an allegation
of maltreatment, may request the lead investigative agency to reconsider its final disposition.
The request for reconsideration must be submitted in writing to the lead investigative agency
within 15 calendar days after receipt of notice of final disposition or, if the request is made
by an interested person who is not entitled to notice, within 15 days after receipt of the
notice by the vulnerable adult or the vulnerable adult's guardian or health care agent. If
mailed, the request for reconsideration must be postmarked and sent to the lead investigative
agency within 15 calendar days of the individual's or deleted text begin facility'sdeleted text end new text begin licensed provider'snew text end receipt
of the final disposition. If the request for reconsideration is made by personal service, it
must be received by the lead investigative agency within 15 calendar days of the individual's
or deleted text begin facility'sdeleted text end new text begin licensed provider'snew text end receipt of the final disposition. An individual who was
determined to have maltreated a vulnerable adult under this section and who was disqualified
on the basis of serious or recurring maltreatment under sections 245C.14 and 245C.15, may
request reconsideration of the maltreatment determination and the disqualification. The
request for reconsideration of the maltreatment determination and the disqualification must
be submitted in writing within 30 calendar days of the individual's receipt of the notice of
disqualification under sections 245C.16 and 245C.17. If mailed, the request for
reconsideration of the maltreatment determination and the disqualification must be
postmarked and sent to the lead investigative agency within 30 calendar days of the
individual's receipt of the notice of disqualification. If the request for reconsideration is
made by personal service, it must be received by the lead investigative agency within 30
calendar days after the individual's receipt of the notice of disqualification.
(b) Except as provided under paragraphs (e) and (f), if the lead investigative agency
denies the request or fails to act upon the request within 15 working days after receiving
the request for reconsideration, the person or deleted text begin facilitydeleted text end new text begin licensed providernew text end entitled to a fair
hearing under section 256.045, may submit to the commissioner of human services a written
request for a hearing under that statute. The vulnerable adult, or an interested person acting
on behalf of the vulnerable adult, may request a review by the Vulnerable Adult Maltreatment
Review Panel under section 256.021 if the lead investigative agency denies the request or
fails to act upon the request, or if the vulnerable adult or interested person contests a
reconsidered disposition. new text begin The Vulnerable Adult Maltreatment Review Panel shall not conduct
a review if the interested person making the request on behalf of the vulnerable adult is also
the alleged perpetrator. new text end The lead investigative agency shall notify persons who request
reconsideration of their rights under this paragraph. The request must be submitted in writing
to the review panel and a copy sent to the lead investigative agency within 30 calendar days
of receipt of notice of a denial of a request for reconsideration or of a reconsidered
disposition. The request must specifically identify the aspects of the lead investigative
agency determination with which the person is dissatisfied.
(c) If, as a result of a reconsideration or review, the lead investigative agency changes
the final disposition, it shall notify the parties specified in subdivision 9c, paragraph deleted text begin (f)deleted text end new text begin (i)new text end .
(d) For purposes of this subdivision, "interested person acting on behalf of the vulnerable
adult" means a person designated in writing by the vulnerable adult to act on behalf of the
vulnerable adult, or a legal guardian or conservator or other legal representative, a proxy
or health care agent appointed under chapter 145B or 145C, or an individual who is related
to the vulnerable adult, as defined in section 245A.02, subdivision 13.
(e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis
of a determination of maltreatment, which was serious or recurring, and the individual has
requested reconsideration of the maltreatment determination under paragraph (a) and
reconsideration of the disqualification under sections 245C.21 to 245C.27, reconsideration
of the maltreatment determination and requested reconsideration of the disqualification
shall be consolidated into a single reconsideration. If reconsideration of the maltreatment
determination is denied and the individual remains disqualified following a reconsideration
decision, the individual may request a fair hearing under section 256.045. If an individual
requests a fair hearing on the maltreatment determination and the disqualification, the scope
of the fair hearing shall include both the maltreatment determination and the disqualification.
(f) If a maltreatment determination or a disqualification based on serious or recurring
maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, the license holder has the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for
under section 245A.08, the scope of the contested case hearing must include the maltreatment
determination, disqualification, and licensing sanction or denial of a license. In such cases,
a fair hearing must not be conducted under section 256.045. Except for family child care
and child foster care, reconsideration of a maltreatment determination under this subdivision,
and reconsideration of a disqualification under section 245C.22, must not be conducted
when:
(1) a denial of a license under section 245A.05, or a licensing sanction under section
245A.07, is based on a determination that the license holder is responsible for maltreatment
or the disqualification of a license holder based on serious or recurring maltreatment;
(2) the denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and
(3) the license holder appeals the maltreatment determination or disqualification, and
denial of a license or licensing sanction.
Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
determination or disqualification, but does not appeal the denial of a license or a licensing
sanction, reconsideration of the maltreatment determination shall be conducted under sections
626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
disqualification shall be conducted under section 245C.22. In such cases, a fair hearing shall
also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
626.557, subdivision 9d.
If the disqualified subject is an individual other than the license holder and upon whom
a background study must be conducted under chapter 245C, the hearings of all parties may
be consolidated into a single contested case hearing upon consent of all parties and the
administrative law judge.
(g) Until August 1, 2002, an individual or deleted text begin facilitydeleted text end new text begin licensed providernew text end that was determined
by the commissioner of human services or the commissioner of health to be responsible for
neglect under section 626.5572, subdivision 17, after October 1, 1995, and before August
1, 2001, that believes that the finding of neglect does not meet an amended definition of
neglect may request a reconsideration of the determination of neglect. The commissioner
of human services or the commissioner of health shall mail a notice to the last known address
of individuals who are eligible to seek this reconsideration. The request for reconsideration
must state how the established findings no longer meet the elements of the definition of
neglect. The commissioner shall review the request for reconsideration and make a
determination within 15 calendar days. The commissioner's decision on this reconsideration
is the final agency action.
(1) For purposes of compliance with the data destruction schedule under subdivision
12b, paragraph (d), when a finding of substantiated maltreatment has been changed as a
result of a reconsideration under this paragraph, the date of the original finding of a
substantiated maltreatment must be used to calculate the destruction date.
(2) For purposes of any background studies under chapter 245C, when a determination
of substantiated maltreatment has been changed as a result of a reconsideration under this
paragraph, any prior disqualification of the individual under chapter 245C that was based
on this determination of maltreatment shall be rescinded, and for future background studies
under chapter 245C the commissioner must not use the previous determination of
substantiated maltreatment as a basis for disqualification or as a basis for referring the
individual's maltreatment history to a health-related licensing board under section 245C.31.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 26.
Minnesota Statutes 2018, section 626.557, subdivision 10, is amended to read:
Subd. 10.
Duties of county social service agency.
(a) When the common entry point
refers a report to the county social service agency as the lead investigative agency or makes
a referral to the county social service agency for emergency adult protective services, or
when another lead investigative agency requests assistance from the county social service
agency for adult protective services, the county social service agency shall immediately
assess and offer emergency and continuing protective social services for purposes of
preventing further maltreatment and for safeguarding the welfare of the maltreated vulnerable
adult. The county shall use a standardized tool made available by the commissioner. The
information entered by the county into the standardized tool must be accessible to the
Department of Human Services. In cases of suspected sexual abuse, the county social service
agency shall immediately arrange for and make available to the vulnerable adult appropriate
medical examination and treatment. When necessary in order to protect the vulnerable adult
from further harm, the county social service agency shall seek authority to remove the
vulnerable adult from the situation in which the maltreatment occurred. The county social
service agency may also investigate to determine whether the conditions which resulted in
the reported maltreatment place other vulnerable adults in jeopardy of being maltreated and
offer protective social services that are called for by its determination.
(b) County social service agencies may enter deleted text begin facilitiesdeleted text end new text begin licensed provider's premisesnew text end and
inspect and copy records as part of an investigation. The county social service agency has
access to not public data, as defined in section 13.02, and medical records under sections
144.291 to 144.298, that are maintained by deleted text begin facilitiesdeleted text end new text begin licensed providersnew text end to the extent necessary
to conduct its investigation. The inquiry is not limited to the written records of the deleted text begin facilitydeleted text end new text begin
licensed providernew text end , but may include every other available source of information.
(c) When necessary in order to protect a vulnerable adult from serious harm, the county
social service agency shall immediately intervene on behalf of that adult to help the family,
vulnerable adult, or other interested person by seeking any of the following:
(1) a restraining order or a court order for removal of the perpetrator from the residence
of the vulnerable adult pursuant to section 518B.01;
(2) the appointment of a guardian or conservator pursuant to sections 524.5-101 to
524.5-502, or guardianship or conservatorship pursuant to chapter 252A;
(3) replacement of a guardian or conservator suspected of maltreatment and appointment
of a suitable person as guardian or conservator, pursuant to sections 524.5-101 to 524.5-502;
or
(4) a referral to the prosecuting attorney for possible criminal prosecution of the
perpetrator under chapter 609.
The expenses of legal intervention must be paid by the county in the case of indigent
persons, under section 524.5-502 and chapter 563.
In proceedings under sections 524.5-101 to 524.5-502, if a suitable relative or other
person is not available to petition for guardianship or conservatorship, a county employee
shall present the petition with representation by the county attorney. The county shall contract
with or arrange for a suitable person or organization to provide ongoing guardianship
services. If the county presents evidence to the court exercising probate jurisdiction that it
has made a diligent effort and no other suitable person can be found, a county employee
may serve as guardian or conservator. The county shall not retaliate against the employee
for any action taken on behalf of the ward or protected person even if the action is adverse
to the county's interest. Any person retaliated against in violation of this subdivision shall
have a cause of action against the county and shall be entitled to reasonable attorney fees
and costs of the action if the action is upheld by the court.
Sec. 27.
Minnesota Statutes 2018, section 626.557, subdivision 10b, is amended to read:
Subd. 10b.
Investigations; guidelines.
new text begin (a) new text end Each lead investigative agency shall develop
guidelines for prioritizing reports for investigationnew text begin and shall publicly post the guidelinesnew text end .
new text begin (b) new text end When investigating a report, the lead investigative agency shall conduct the following
activities, as appropriatenew text begin without exception unless: (i) the vulnerable adult, reporter, or
witness is deceased, refuses an interview, or is unable to be contacted despite diligent
attempts; (ii) the interview was conducted by law enforcement and an additional interview
will not further the civil investigation; (iii) the alleged vulnerable adult declines an interview;
or (iv) the agency has reason to know the activity will endanger the vulnerable adult or
impede the investigationnew text end :
(1) interview of the alleged victim;
(2) interview of the reporter and others who may have relevant information;
(3) interview of the alleged perpetrator;new text begin and
new text end
deleted text begin
(4) examination of the environment surrounding the alleged incident;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end review ofnew text begin records andnew text end pertinent documentation deleted text begin of the alleged incident; anddeleted text end new text begin .
new text end
new text begin
(c) The lead investigative agency shall conduct the following activities if appropriate to
further the investigation or necessary to prevent further maltreatment or to safeguard the
vulnerable adult:
new text end
new text begin
(1) examine the environment surrounding the alleged incident;
new text end
deleted text begin (6) consultationdeleted text end new text begin (2) consult new text end with professionalsdeleted text begin .deleted text end new text begin ;
new text end
new text begin
(3) request the vulnerable adult's choice of the primary support person; and
new text end
new text begin
(4) communicate with tribes, service providers, and the primary support person for the
vulnerable adult.
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. 28.
Minnesota Statutes 2018, section 626.557, subdivision 12b, is amended to read:
Subd. 12b.
Data management.
(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this sectionnew text begin during the
provision of adult protective servicesnew text end are welfare data under section 13.46.new text begin Investigative
data collected under this section are confidential data on individuals or protected nonpublic
data as defined under section 13.02.new text end Notwithstanding section 13.46, subdivision 1, paragraph
(a), data under this paragraph that are inactive investigative data on an individual who is a
vendor of services are private data on individuals, as defined in section 13.02. The identity
of the reporter may only be disclosed as provided in paragraph (c).
Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.
(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02.
Upon completion of the investigation, the data are classified as provided in clauses (1) to
(3) and paragraph (c).
(1) The investigation memorandum must contain the following data, which are public:
(i) the name of the deleted text begin facilitydeleted text end new text begin licensed providernew text end investigated;
(ii) a statement of the nature of the alleged maltreatment;
(iii) pertinent information obtained from medical or other records reviewed;
(iv) the identity of the investigator;
(v) a summary of the investigation's findings;
(vi) statement of whether the report was found to be substantiated, inconclusive, false,
or that no determination will be made;
(vii) a statement of any action taken by the deleted text begin facilitydeleted text end new text begin licensed providernew text end ;
(viii) a statement of any action taken by the lead investigative agency; and
(ix) when a lead investigative agency's determination has substantiated maltreatment, a
statement of whether an individual, individuals, or a deleted text begin facilitydeleted text end new text begin licensed providernew text end were
responsible for the substantiated maltreatment, if known.
The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data listed in clause (2).
(2) Data on individuals collected and maintained in the investigation memorandum are
private data, including:
(i) the name of the vulnerable adult;
(ii) the identity of the individual alleged to be the perpetrator;
(iii) the identity of the individual substantiated as the perpetrator; and
(iv) the identity of all individuals interviewed as part of the investigation.
(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.new text begin When the law
enforcement investigation is active, the data received by a lead investigative agency or
county agency responsible for protection of the vulnerable adult is confidential data on
individuals as defined in section 13.02, subdivision 3. When the law enforcement
investigation is completed, the investigative data are private data on individuals as defined
in section 13.02, subdivision 12.
new text end
(c) deleted text begin After the assessment or investigation is completed,deleted text end The name of the reporter must
be confidential. The subject of the report may compel disclosure of the name of the reporter
only with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. This subdivision does not
alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
that where the identity of the reporter is relevant to a criminal prosecution, the district court
shall do an in-camera review prior to determining whether to order disclosure of the identity
of the reporter.
(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:
(1) data from reports determined to be false, maintained for three years after the finding
was made;
(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;
(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and
(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.
(e) The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed deleted text begin facilitiesdeleted text end new text begin
providersnew text end reported under this section, the number of those requiring investigation under this
section, and the resolution of those investigations. On a biennial basis, the commissioners
of health and human services shall jointly report the following information to the legislature
and the governor:
(1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;
(2) trends about types of substantiated maltreatment found in the reporting period;
(3) if there are upward trends for types of maltreatment substantiated, recommendations
for addressing and responding to them;
(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
(5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;
(6) recommended changes to statutes affecting the protection of vulnerable adults; and
(7) any other information that is relevant to the report trends and findings.
(f) Each lead investigative agency must have a record retention policy.
(g) Lead investigative agencies, new text begin county agencies responsible for adult protective services,
new text end prosecuting authorities, and law enforcement agencies may exchange not public data, as
defined in section 13.02,new text begin with a tribe, provider, vulnerable adult, primary support person
for the vulnerable adult, state licensing board, federal or state agency, the ombudsperson
for long-term care, or the ombudsman for mental health and developmental disabilities,new text end if
the agency or authority deleted text begin requestingdeleted text end new text begin providingnew text end the data determines that the data are pertinent
and necessary deleted text begin to the requesting agency in initiating, furthering, or completingdeleted text end new text begin to prevent
further maltreatment, to safeguard the affected vulnerable adults, or to initiate, further, or
completenew text end an investigation under this section. Data collected under this section must be made
available to prosecuting authorities and law enforcement officials, local county agencies,
and licensing agencies investigating the alleged maltreatment under this section. The lead
investigative agency shall exchange not public data with the vulnerable adult maltreatment
review panel established in section 256.021 if the data are pertinent and necessary for a
review requested under that section. Notwithstanding section 138.17, upon completion of
the review, not public data received by the review panel must be destroyed.
(h) Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.
(i) A lead investigative agency may notify other affected parties and their authorized
representative if the lead investigative agency has reason to believe maltreatment has occurred
and determines the information will safeguard the well-being of the affected parties or dispel
widespread rumor or unrest in the affected deleted text begin facilitydeleted text end new text begin licensed providernew text end .
(j) Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 29.
Minnesota Statutes 2018, section 626.557, subdivision 14, is amended to read:
Subd. 14.
Abuse prevention plans.
(a) Each deleted text begin facilitydeleted text end new text begin licensed providernew text end , except home
health agencies and personal care attendant services providers, shall establish and enforce
an ongoing written abuse prevention plan. The plan shall contain an assessment of the
physical plant, its environment, and its population identifying factors which may encourage
or permit abuse, and a statement of specific measures to be taken to minimize the risk of
abuse. The plan shall comply with any rules governing the plan promulgated by the licensing
agency.
(b) Each deleted text begin facilitydeleted text end new text begin licensed providernew text end , including a home health care agency and personal
care attendant services providers, shall develop an individual abuse prevention plan for each
vulnerable adult residing there or receiving services from them. The plan shall contain an
individualized assessment of: (1) the person's susceptibility to abuse by other individuals,
including other vulnerable adults; (2) the person's risk of abusing other vulnerable adults;
and (3) statements of the specific measures to be taken to minimize the risk of abuse to that
person and other vulnerable adults. For the purposes of this paragraph, the term "abuse"
includes self-abuse.
(c) If the deleted text begin facilitydeleted text end new text begin licensed providernew text end , except home health agencies and personal care
attendant services providers, knows that the vulnerable adult has committed a violent crime
or an act of physical aggression toward others, the individual abuse prevention plan must
detail the measures to be taken to minimize the risk that the vulnerable adult might reasonably
be expected to pose to visitors to the deleted text begin facilitydeleted text end new text begin licensed providernew text end and persons outside the
deleted text begin facilitydeleted text end new text begin licensed providernew text end , if unsupervised. Under this section, a deleted text begin facilitydeleted text end new text begin licensed providernew text end
knows of a vulnerable adult's history of criminal misconduct or physical aggression if it
receives such information from a law enforcement authority or through a medical record
prepared by another deleted text begin facilitydeleted text end new text begin licensed providernew text end , another health care provider, or the deleted text begin facility'sdeleted text end new text begin
licensed provider'snew text end ongoing assessments of the vulnerable adult.
Sec. 30.
Minnesota Statutes 2018, section 626.557, subdivision 17, is amended to read:
Subd. 17.
Retaliation prohibited.
(a) A deleted text begin facilitydeleted text end new text begin licensed providernew text end or person shall not
retaliate against any person who reports in good faith suspected maltreatment pursuant to
this section, or against a vulnerable adult with respect to whom a report is made, because
of the report.
(b) In addition to any remedies allowed under sections 181.931 to 181.935, any deleted text begin facilitydeleted text end new text begin
licensed providernew text end or person which retaliates against any person because of a report of
suspected maltreatment is liable to that person for actual damages, punitive damages up to
$10,000, and attorney fees.
(c) There shall be a rebuttable presumption that any adverse action, as defined below,
within 90 days of a report, is retaliatory. For purposes of this clause, the term "adverse
action" refers to action taken by a deleted text begin facilitydeleted text end new text begin licensed providernew text end or person involved in a report
against the person making the report or the person with respect to whom the report was
made because of the report, and includes, but is not limited to:
(1) discharge or transfer from the deleted text begin facilitydeleted text end new text begin licensed provider's servicesnew text end ;
(2) discharge from or termination of employment;
(3) demotion or reduction in remuneration for services;
(4) restriction or prohibition of access to the deleted text begin facilitydeleted text end new text begin licensed provider's premisesnew text end or its
residents; or
(5) any restriction of rights set forth in section 144.651.
Sec. 31.
Minnesota Statutes 2018, section 626.5572, subdivision 2, is amended to read:
Subd. 2.
Abuse.
"Abuse" means:
(a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate,
or aiding and abetting a violation of:
(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;
(2) the use of drugs to injure or facilitate crime as defined in section 609.235;
(3) the solicitation, inducement, and promotion of prostitution as defined in section
609.322; and
(4) criminal sexual conduct in the first through fifth degrees as defined in sections
609.342 to 609.3451.
A violation includes any action that meets the elements of the crime, regardless of
whether there is a criminal proceeding or conviction.
(b) Conduct which is not an accident or therapeutic conduct as defined in this section,
which produces or could reasonably be expected to produce physical pain or injury or
emotional distress including, but not limited to, the following:
(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable
adult;
(2) use of repeated or malicious oral, written, or gestured language toward a vulnerable
adult or the treatment of a vulnerable adult which would be considered by a reasonable
person to be disparaging, derogatory, humiliating, harassing, or threatening;new text begin or
new text end
(3) usenew text begin , not authorized under chapter 245A or 245D or inconsistent with state and federal
patient rights,new text end of any aversive or deprivation procedure, unreasonable confinement, or
involuntary seclusion, including the forced separation of the vulnerable adult from other
persons against the will of the vulnerable adult or the legal representative of the vulnerable
adultdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(4) use of any aversive or deprivation procedures for persons with developmental
disabilities or related conditions not authorized under section 245.825.
deleted text end
(c) Any sexual contact or penetration as defined in section 609.341, between a deleted text begin facilitydeleted text end new text begin
licensed provider'snew text end staff person or a person providing services deleted text begin indeleted text end new text begin fornew text end the deleted text begin facilitydeleted text end new text begin licensed
providernew text end and a resident, patient, or client of deleted text begin that facilitydeleted text end new text begin the licensed providernew text end .
(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the
vulnerable adult's will to perform services for the advantage of another.
(e) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section
253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that authority
and within the boundary of reasonable medical practice, to any therapeutic conduct, including
any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition
of the vulnerable adult or, where permitted under law, to provide nutrition and hydration
parenterally or through intubation. This paragraph does not enlarge or diminish rights
otherwise held under law by:
(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or
(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.
(f) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, a person with authority to make health care decisions for the vulnerable
adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for
treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care,
provided that this is consistent with the prior practice or belief of the vulnerable adult or
with the expressed intentions of the vulnerable adult.
(g) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional
dysfunction or undue influence, engages in consensual sexual contact with:
(1) a person, including a deleted text begin facilitydeleted text end new text begin licensed providernew text end staff person, when a consensual sexual
personal relationship existed prior to the caregiving relationship; or
(2) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 32.
Minnesota Statutes 2018, section 626.5572, subdivision 3, is amended to read:
Subd. 3.
Accident.
"Accident" means a sudden, unforeseen, and unexpected occurrence
or event which:
(1) is not likely to occur and which could not have been prevented by exercise of due
care; and
(2) if occurring while a vulnerable adult is receiving services from a deleted text begin facilitydeleted text end new text begin licensed
providernew text end , happens when the deleted text begin facilitydeleted text end new text begin licensed providernew text end and the employee or person providing
services deleted text begin in the facilitydeleted text end are in compliance with the laws and rules relevant to the occurrence
or event.
Sec. 33.
Minnesota Statutes 2018, section 626.5572, subdivision 4, is amended to read:
Subd. 4.
Caregiver.
"Caregiver" means new text begin a paid provider, new text end an individualnew text begin ,new text end or deleted text begin facility who
has responsibility for the care of a vulnerable adult as a result of a family relationship, ordeleted text end new text begin
licensed providernew text end who has assumed responsibility for all or a portion of the care of a
vulnerable adult voluntarily, by contract, or by agreement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 34.
Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:
Subd. 6.
deleted text begin Facilitydeleted text end new text begin Licensed providernew text end .
(a) "deleted text begin Facilitydeleted text end new text begin Licensed providernew text end " means a hospital
or other entity required to be licensed under sections 144.50 to 144.58; a nursing home
required to be licensed to serve adults under section 144A.02; a deleted text begin facilitydeleted text end new text begin licensed providernew text end
or service required to be licensed under chapter 245A; a home care provider licensed or
required to be licensed under sections 144A.43 to 144A.482; a hospice provider licensed
under sections 144A.75 to 144A.755; or a person or organization that offers, provides, or
arranges for personal care assistance services under the medical assistance program as
authorized under sections 256B.0625, subdivision 19a, 256B.0651 to 256B.0654, 256B.0659,
or 256B.85.
(b) For services identified in paragraph (a) that are provided in the vulnerable adult's
own home or in another unlicensed location, the term "deleted text begin facilitydeleted text end new text begin licensed providernew text end " refers to
the provider, person, or organization that offers, provides, or arranges for personal care
services, and does not refer to the vulnerable adult's home or other location at which services
are rendered.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 35.
Minnesota Statutes 2018, section 626.5572, subdivision 8, is amended to read:
Subd. 8.
Final disposition.
"Final disposition" is the determination of an investigation
by a lead investigative agency that a report of maltreatment under Laws 1995, chapter 229,
is substantiated, inconclusive, false, or that no determination will be made. When a lead
investigative agency determination has substantiated maltreatment, the final disposition
also identifies, if known, which individual or individuals were responsible for the
substantiated maltreatment, and whether a deleted text begin facilitydeleted text end new text begin licensed providernew text end was responsible for the
substantiated maltreatment.
Sec. 36.
Minnesota Statutes 2018, section 626.5572, subdivision 9, is amended to read:
Subd. 9.
Financial exploitation.
"Financial exploitation" means:
(a) In breach of a fiduciary obligation recognized elsewhere in law, including pertinent
regulations, contractual obligations, documented consent by a competent person, or the
obligations of a responsible party under section 144.6501, a person:
(1) deleted text begin engages in unauthorized expenditure of funds entrusted to the actor by the vulnerable
adult which results or is likely to result in detriment to the vulnerable adultdeleted text end new text begin takes, uses, or
transfers the vulnerable adult's personal property or financial resources other than what a
reasonable person would deem the use, ownership, or obligations of the vulnerable adultnew text end ;
or
(2) fails to use the financial resources of the vulnerable adult to provide food, clothing,
shelter, health care, therapeutic conduct or supervision for the vulnerable adult, and the
failure results or is likely to result in detriment to the vulnerable adult.
(b) In the absence of legal authority a person:
(1) willfully uses, withholds, or disposes of funds or property of a vulnerable adult;
(2) obtains for the actor or another the performance of services by a third person for the
wrongful profit or advantage of the actor or another to the detriment of the vulnerable adult;
(3) acquires possession or control of, or an interest in, funds or property of a vulnerable
adult through the use of undue influence, harassment, duress, deception, or fraud; or
(4) forces, compels, coerces, or entices a vulnerable adult against the vulnerable adult's
will to perform services for the profit or advantage of another.
(c) Nothing in this definition requires a deleted text begin facilitydeleted text end new text begin licensed providernew text end or caregiver to provide
financial management or supervise financial management for a vulnerable adult except as
otherwise required by law.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 37.
Minnesota Statutes 2018, section 626.5572, subdivision 16, is amended to read:
Subd. 16.
Mandated reporter.
"Mandated reporter" means a professional or
professional's delegate while engaged in: (1) social services; (2) law enforcement; (3)
education; (4) the care of vulnerable adults; (5) any of the occupations referred to in section
214.01, subdivision 2; (6) an employee of a rehabilitation facility certified by the
commissioner of jobs and training for vocational rehabilitation; (7) an employee or person
providingnew text begin licensednew text end services deleted text begin in a facilitydeleted text end as defined in subdivision 6; or (8) a person that
performs the duties of the medical examiner or coroner.
Sec. 38.
Minnesota Statutes 2018, section 626.5572, subdivision 17, is amended to read:
Subd. 17.
Neglect.
deleted text begin
"Neglect" means:
deleted text end
new text begin
Neglect includes caregiver neglect and self-neglect.
new text end
(a)new text begin "Caregiver neglect" meansnew text end the failure or omission by a caregiver to supply a vulnerable
adult with care or services, including but not limited to, food, clothing, shelter, health care,
or supervision which is:
(1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or
mental health or safety, considering the physical and mental capacity or dysfunction of the
vulnerable adult; and
(2) which is not the result of an accident or therapeutic conduct.
(b) deleted text begin The absence or likelihood of absence of care or services, including but not limited
to, food, clothing, shelter, health care, or supervision necessary to maintain the physical
deleted text end deleted text begin and mental health of the vulnerable adultdeleted text end new text begin "Self-neglect" means neglect by a vulnerable adult
of food, clothing, shelter, health care, or other services not under the responsibility of a
caregivernew text end which a reasonable person would deem essential to obtain or maintain the
vulnerable adult's health, safety, deleted text begin ordeleted text end comfort deleted text begin considering the physical or mental capacity or
dysfunctiondeleted text end new text begin , or physical and mental healthnew text end of the vulnerable adult.
(c) For purposes of this section, a vulnerable adult is not neglected for the sole reason
that:
(1) the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C, or 252A, or sections
253B.03 or 524.5-101 to 524.5-502, refuses consent or withdraws consent, consistent with
that authority and within the boundary of reasonable medical practice, to any therapeutic
conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical
or mental condition of the vulnerable adult, or, where permitted under law, to provide
nutrition and hydration parenterally or through intubation; this paragraph does not enlarge
or diminish rights otherwise held under law by:
(i) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or
(ii) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct; or
(2) the vulnerable adult, a person with authority to make health care decisions for the
vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means or
prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu of
medical care, provided that this is consistent with the prior practice or belief of the vulnerable
adult or with the expressed intentions of the vulnerable adult;
(3) the vulnerable adult, who is not impaired in judgment or capacity by mental or
emotional dysfunction or undue influence, engages in consensual sexual contact with:
(i) a person including a deleted text begin facilitydeleted text end new text begin licensed providernew text end staff person when a consensual sexual
personal relationship existed prior to the caregiving relationship; or
(ii) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship; or
(4) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult which does not result in injury or harm which reasonably requires medical or mental
health care; or
(5) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult that results in injury or harm, which reasonably requires the care of a physician, and:
(i) the necessary care is provided in a timely fashion as dictated by the condition of the
vulnerable adult;
(ii) if after receiving care, the health status of the vulnerable adult can be reasonably
expected, as determined by the attending physician, to be restored to the vulnerable adult's
preexisting condition;
(iii) the error is not part of a pattern of errors by the individual;
(iv) if deleted text begin in a facilitydeleted text end new text begin receiving services from a licensed providernew text end , the error is immediately
reported as required under section 626.557, and recorded internally deleted text begin indeleted text end new text begin bynew text end the deleted text begin facilitydeleted text end new text begin licensed
providernew text end ;
(v) if deleted text begin in a facilitydeleted text end new text begin receiving licensed servicesnew text end , the deleted text begin facilitydeleted text end new text begin licensed providernew text end identifies
and takes corrective action and implements measures designed to reduce the risk of further
occurrence of this error and similar errors; and
(vi) if deleted text begin in a facilitydeleted text end new text begin receiving licensed servicesnew text end ,new text begin the licensed provider takesnew text end the actions
required under items (iv) and (v) are sufficiently documented for review and evaluation by
the deleted text begin facilitydeleted text end new text begin licensed providernew text end and any applicable licensing, certification, and ombudsman
agency.
(d) Nothing in this definition requires a caregiver, if regulated, to provide services in
excess of those required by the caregiver's license, certification, registration, or other
regulation.
(e) If the findings of an investigation by a lead investigative agency result in a
determination of substantiated maltreatment for the sole reason that the actions required of
a deleted text begin facilitydeleted text end new text begin licensed providernew text end under paragraph (c), clause (5), item (iv), (v), or (vi), were not
taken, then the deleted text begin facilitydeleted text end new text begin licensed providernew text end is subject to a correction order. An individual will
not be found to have neglected or maltreated the vulnerable adult based solely on the deleted text begin facility'sdeleted text end new text begin
licensed provider'snew text end not having taken the actions required under paragraph (c), clause (5),
item (iv), (v), or (vi). This must not alter the lead investigative agency's determination of
mitigating factors under section 626.557, subdivision 9c, paragraph deleted text begin (c)deleted text end new text begin (f)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. 39.
Minnesota Statutes 2018, section 626.5572, is amended by adding a subdivision
to read:
new text begin Subd. 17a. new text end
new text begin Primary support person. new text end
new text begin
"Primary support person" means a person or
persons identified by the lead investigative agency or agency responsible for adult protective
services as best able to coordinate with the agency to support protection of the vulnerable
adult, safeguard the vulnerable adult's welfare, and prevent further maltreatment. The primary
support person may be the vulnerable adult's guardian, health care agent, or other legal
representative, person authorized by the vulnerable adult under a supported decision making
or other agreement, or another person determined by the agency. If known to the agency,
the agency must consider the vulnerable adult's choice for primary support person.
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. 40.
Minnesota Statutes 2018, section 626.5572, subdivision 20, is amended to read:
Subd. 20.
Therapeutic conduct.
"Therapeutic conduct" means the provision of program
services, health care, or other personal care services done in good faith in the interests of
the vulnerable adult by: (1) an individual, deleted text begin facilitydeleted text end new text begin licensed providernew text end , or employee or person
providing services deleted text begin indeleted text end new text begin for new text end a deleted text begin facilitydeleted text end new text begin licensed providernew text end under the rights, privileges and
responsibilities conferred by state license, certification, or registration; or (2) a caregiver.
Sec. 41.
Minnesota Statutes 2018, section 626.5572, subdivision 21, is amended to read:
Subd. 21.
Vulnerable adult.
(a) "Vulnerable adult" means any person 18 years of age
or older who:
(1) is a resident or inpatient of a deleted text begin facilitydeleted text end new text begin licensed providernew text end ;
(2) receives services required to be licensed under chapter 245A, except that a person
receiving outpatient services for treatment of chemical dependency or mental illness, or one
who is served in the Minnesota sex offender program on a court-hold order for commitment,
or is committed as a sexual psychopathic personality or as a sexually dangerous person
under chapter 253B, is not considered a vulnerable adult unless the person meets the
requirements of clause (4);
(3) receives services from a home care provider required to be licensed under sections
144A.43 to 144A.482; or from a person or organization that offers, provides, or arranges
for personal care assistance services under the medical assistance program as authorized
under section 256B.0625, subdivision 19a, 256B.0651, 256B.0653, 256B.0654, 256B.0659,
or 256B.85; or
(4) regardless of residence or whether any type of service is received, possesses a physical
or mental infirmity or other physical, mental, or emotional dysfunction:
(i) that impairs the individual's ability to provide adequately for the individual's own
care without assistance, including the provision of food, shelter, clothing, health care, or
supervision; and
(ii) because of the dysfunction or infirmity and the need for care or services, the individual
has an impaired ability to protect the individual's self from maltreatment.
(b) For purposes of this subdivision, "care or services" means care or services for the
health, safety, welfare, or maintenance of an individual.
Sec. 42. new text begin DIRECTION TO COMMISSIONER; PROVIDER STANDARD
EVALUATION.
new text end
new text begin
By January 1, 2020, the commissioner of human services shall evaluate provider standards
for companion, homemaker, and respite services covered by the home and community-based
waivers under Minnesota Statutes, sections 256B.0915, 256B.092, and 256B.49, and shall
make recommendations to the legislative committees with jurisdiction over elderly waiver
services for adjustments to these provider standards. The goal of this evaluation is to promote
access to services by developing standards that ensure the well-being of participants while
being minimally burdensome to providers.
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. 43. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, sections 256R.08, subdivision 2; and 256R.49,
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 August 1, 2019.
new text end
ARTICLE 5
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 13.461, subdivision 28, is amended to read:
Subd. 28.
Child care assistance program.
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).new text end new text begin Child care assistance program payment data is classified under
section 119B.02, subdivision 6, paragraph (b)new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 3.
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. 4.
Minnesota Statutes 2018, section 144.216, is amended by adding a subdivision to
read:
new text begin Subd. 3. new text end
new text begin Reporting safe place newborn births. new text end
new text begin
A hospital that receives a safe place
newborn under section 145.902 shall report the birth of the newborn to the Office of Vital
Records within five days after receiving the newborn. The state registrar must register
information about the safe place newborn according to part 4601.0600, subpart 4, item C.
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. 5.
Minnesota Statutes 2018, section 144.216, is amended by adding a subdivision to
read:
new text begin Subd. 4. new text end
new text begin Status of safe place birth registrations. new text end
new text begin
(a) Information about the safe place
newborn registered under subdivision 3 shall constitute the record of birth for the child. The
record is confidential data on individuals as defined in section 13.02, subdivision 3.
Information on the birth record or a birth certificate issued from the birth record shall be
disclosed only to the responsible social services agency as defined in section 260C.007,
subdivision 27a, or pursuant to court order.
new text end
new text begin
(b) Pursuant to section 144.218, subdivision 6, if the safe place newborn was born in a
hospital and it is known that a record of birth was registered, the Office of Vital Records
shall replace the original birth record registered under section 144.215.
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. 6.
Minnesota Statutes 2018, section 144.218, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Safe place newborns. new text end
new text begin
If a hospital receives a safe place newborn under section
145.902 and it is known that a record of birth was registered, the hospital shall report the
newborn to the Office of Vital Records and identify the birth record. The state registrar
shall issue a replacement birth record free of information that identifies a parent. The prior
vital record is confidential data on individuals as defined in section 13.02, subdivision 3,
and shall not be disclosed except pursuant to court order.
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. 7.
Minnesota Statutes 2018, section 144.225, subdivision 2b, is amended to read:
Subd. 2b.
Commissioner of health; duties.
Notwithstanding the designation of certain
of this data as confidential under subdivision 2 or private under subdivision 2a, the
commissioner shall give the commissioner of human services access to birth record data
and data contained in recognitions of parentage prepared according to section 257.75
necessary to enable the commissioner of human services to identify a child who is subject
to threatened injury, as defined in section 626.556, subdivision 2, paragraph deleted text begin (p)deleted text end new text begin (s)new text end , by a
person responsible for the child's care, as defined in section 626.556, subdivision 2, paragraph
(j), clause (1). The commissioner shall be given access to all data included on official birth
records.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 8.
Minnesota Statutes 2018, section 144.226, subdivision 1, is amended to read:
Subdivision 1.
Which services are for fee.
(a) The fees for the following services shall
be the following or an amount prescribed by rule of the commissioner:
(b) The fee for the administrative review and processing of a request for a certified vital
record or a certification that the vital record cannot be found is $9. The fee is payable at the
time of application and is nonrefundable.
(c) The fee for processing a request for the replacement of a birth record for all events,
except new text begin for safe place newborns pursuant to section 144.218, subdivision 6, and new text end when filing
a recognition of parentage pursuant to section 257.73, subdivision 1, is $40. The fee is
payable at the time of application and is nonrefundable.
(d) The fee for administrative review and processing of a request for the filing of a
delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of
application and is nonrefundable.
(e) The fee for administrative review and processing of a request for the amendment of
any vital record is $40. The fee is payable at the time of application and is nonrefundable.
(f) The fee for administrative review and processing of a request for the verification of
information from vital records is $9 when the applicant furnishes the specific information
to locate the vital record. When the applicant does not furnish specific information, the fee
is $20 per hour for staff time expended. Specific information includes the correct date of
the event and the correct name of the subject of the record. Fees charged shall approximate
the costs incurred in searching and copying the vital records. The fee is payable at the time
of application and is nonrefundable.
(g) The fee for administrative review and processing of a request for the issuance of a
copy of any document on file pertaining to a vital record or statement that a related document
cannot be found is $9. The fee is payable at the time of application and is nonrefundable.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 9.
Minnesota Statutes 2018, section 145.902, is amended to read:
145.902 GIVE LIFE A CHANCE; SAFE PLACE FOR NEWBORNS DUTIES;
IMMUNITY.
Subdivision 1.
General.
(a) For purposes of this section, a "safe place" means a hospital
licensed under sections 144.50 to 144.56,new text begin including the hospital where the newborn was
born,new text end a health care provider who provides urgent care medical services, or an ambulance
service licensed under chapter 144E dispatched in response to a 911 call from a mother or
a person with the mother's permission to relinquish a newborn infant.
(b) A safe place shall receive a newborn left with an employee on the premises of the
safe place during its hours of operation, provided that:
(1) the newborn was born within seven days of being left at the safe place, as determined
within a reasonable degree of medical certainty; and
(2) the newborn is left in an unharmed condition.
(c) The safe place must not inquire as to the identity of the mother or the person leaving
the newborn or call the police, provided the newborn is unharmed when presented to the
hospital. The safe place may ask the mother or the person leaving the newborn about the
medical history of the mother or newborn new text begin and if the newborn may have lineage to an Indian
tribe and, if known, the name of the tribe new text end but the mother or the person leaving the newborn
is not required to provide any information. The safe place may provide the mother or the
person leaving the newborn with information about how to contact relevant social service
agencies.
(d) A safe place that is a health care provider who provides urgent care medical services
shall dial 911, advise the dispatcher that the call is being made from a safe place for
newborns, and ask the dispatcher to send an ambulance or take other appropriate action to
transport the newborn to a hospital. An ambulance with whom a newborn is left shall
transport the newborn to a hospital for care. Hospitals must receive a newborn left with a
safe place and make the report as required in subdivision 2.
Subd. 2.
Reporting.
new text begin (a) new text end Within 24 hours of receiving a newborn under this section, the
hospital must inform the responsible social service agency that a newborn has been left at
the hospital, but must not do so in the presence of the mother or the person leaving the
newborn. The hospital must provide necessary care to the newborn pending assumption of
legal responsibility by the responsible social service agency pursuant to section 260C.139,
subdivision 5.
new text begin
(b) Within five days of receiving a newborn under this section, a hospital shall report
the newborn pursuant to section 144.216, subdivision 3. If a hospital receives a safe place
newborn under section 145.902 and it is known that a record of birth was registered because
the newborn was born at that hospital, the hospital shall report the newborn to the Office
of Vital Records and identify the birth record. The state registrar shall issue a replacement
birth record pursuant to section 144.218, subdivision 6.
new text end
Subd. 3.
Immunity.
(a) A safe place with responsibility for performing duties under
this section, and any new text begin hospital, new text end employee, doctor, ambulance personnel, or other medical
professional working at the safe place, are immune from any criminal liability that otherwise
might result from their actions, if they are acting in good faith in receiving a newborn, and
are immune from any civil liability new text begin or administrative penalty new text end that otherwise might result
from merely receiving a newborn.
(b) A safe place performing duties under this section, or an employee, doctor, ambulance
personnel, or other medical professional working at the safe place who is a mandated reporter
under section 626.556, is immune from any criminal or civil liability that otherwise might
result from the failure to make a report under that section if the person is acting in good
faith in complying with this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 10.
Minnesota Statutes 2018, section 256E.21, subdivision 5, is amended to read:
Subd. 5.
Child abuse.
"Child abuse" means sexual abuse, neglect, or physical abuse as
defined in section 626.556, subdivision 2, paragraphs (g), (k), and deleted text begin (n)deleted text end new text begin (p)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. 11.
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
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 12.
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 reallocate up to 20 percent of a county's funds under
this section toward the program improvement plan. Sanctions under section 256M.20,
subdivision 3, related to noncompliance with federal performance standards also apply.
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. 13.
Minnesota Statutes 2018, section 256N.02, subdivision 10, is amended to read:
Subd. 10.
Financially responsible agency.
"Financially responsible agency" means the
agency that is financially responsible for a child. These agencies include both local social
service agencies under section 393.07 and tribal social service agencies authorized in section
256.01, subdivision 14b, as part of the American Indian Child Welfare Initiative, and
Minnesota tribes who assume financial responsibility of children from other states. Under
Northstar Care for Children, the agency that is financially responsible at the time of placement
for foster care continues to be responsible under section 256N.27 for the local share of any
maintenance payments, even after finalization of the adoption deleted text begin ofdeleted text end new text begin ornew text end transfer of permanent
legal and physical custody of a child.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 14.
Minnesota Statutes 2018, section 256N.02, subdivision 16, is amended to read:
Subd. 16.
Permanent legal and physical custody.
"Permanent legal and physical
custody" meansnew text begin (1)new text end a new text begin full new text end transfer of permanent legal and physical custody new text begin ordered by a
Minnesota juvenile court under section 256C.515, subdivision 4, new text end to a relative deleted text begin ordered by a
Minnesota juvenile court under section 260C.515, subdivision 4,deleted text end new text begin who is not a parent as
defined in section 260C.007, subdivision 25,new text end or new text begin (2) new text end for a child under jurisdiction of a tribal
court, a judicial determination under a similar provision in tribal code which means that a
relative will assume the duty and authority to provide care, control, and protection of a child
who is residing in foster care, and to make decisions regarding the child's education, health
care, and general welfare until adulthood.new text begin For purposes of establishing eligibility for Northstar
kinship assistance, permanent legal and physical custody must not include joint legal custody,
joint physical custody, or joint legal and joint physical custody between a child's parent and
relative custodian.
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. 15.
Minnesota Statutes 2018, section 256N.02, subdivision 17, is amended to read:
Subd. 17.
Reassessment.
"Reassessment" means an update of a previous assessment
through the process under section 256N.24 for a child who has been continuously eligible
for Northstar Care for Children, or when a child identified as an at-risk child (Level A)
under deleted text begin guardianship ordeleted text end adoption assistance has manifested the disability upon which eligibility
for the agreement was based according to section 256N.25, subdivision 3, paragraph (b).
A reassessment may be used to update an initial assessment, a special assessment, or a
previous reassessment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 16.
Minnesota Statutes 2018, section 256N.02, subdivision 18, is amended to read:
Subd. 18.
Relative.
"Relative," as described in section 260C.007, subdivision 27, means
a person related to the child by blood, marriage, or adoptiondeleted text begin ,deleted text end new text begin ; the legal parent, guardian, or
custodian of the child's siblings;new text end or an individual who is an important friend with whom the
child has resided or had significant contact. For an Indian child, relative, as described in
section 260C.007, subdivision 26b, means a person who is a member of the Indian child's
family as defined in the Indian Child Welfare Act of 1978, United States Code, title 25,
section 1903, paragraphs (2), (6), and (9).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 17.
Minnesota Statutes 2018, section 256N.22, subdivision 1, is amended to read:
Subdivision 1.
General eligibility requirements.
(a) To be eligible for Northstar kinship
assistance under this section, there must be a judicial determination under section 260C.515,
subdivision 4, that a transfer of permanent legal and physical custody to a relative new text begin who is
not a parent of the child new text end is in the child's best interest. For a child under jurisdiction of a
tribal court, a judicial determination under a similar provision in tribal code indicating that
a relative will assume the duty and authority to provide care, control, and protection of a
child who is residing in foster care, and to make decisions regarding the child's education,
health care, and general welfare until adulthood, and that this is in the child's best interest
is considered equivalent. new text begin A child whose parent shares legal, physical, or legal and physical
custody with a relative custodian is not eligible for Northstar kinship assistance. new text end Additionally,
a child must:
(1) have been removed from the child's home pursuant to a voluntary placement
agreement or court order;
(2)(i) have resided with the prospective relative custodian who has been a licensed child
foster parent for at least six consecutive months; or
(ii) have received from the commissioner an exemption from the requirement in item
(i) that the prospective relative custodian has been a licensed child foster parent for at least
six consecutive months, based on a determination that:
(A) an expedited move to permanency is in the child's best interest;
(B) expedited permanency cannot be completed without provision of Northstar kinship
assistance;
(C) the prospective relative custodian is uniquely qualified to meet the child's needs, as
defined in section 260C.212, subdivision 2, on a permanent basis;
(D) the child and prospective relative custodian meet the eligibility requirements of this
section; and
(E) efforts were made by the legally responsible agency to place the child with the
prospective relative custodian as a licensed child foster parent for six consecutive months
before permanency, or an explanation why these efforts were not in the child's best interests;
(3) meet the agency determinations regarding permanency requirements in subdivision
2;
(4) meet the applicable citizenship and immigration requirements in subdivision 3;
(5) have been consulted regarding the proposed transfer of permanent legal and physical
custody to a relative, if the child is at least 14 years of age or is expected to attain 14 years
of age prior to the transfer of permanent legal and physical custody; and
(6) have a written, binding agreement under section 256N.25 among the caregiver or
caregivers, the financially responsible agency, and the commissioner established prior to
transfer of permanent legal and physical custody.
(b) In addition to the requirements in paragraph (a), the child's prospective relative
custodian or custodians must meet the applicable background study requirements in
subdivision 4.
(c) To be eligible for title IV-E Northstar kinship assistance, a child must also meet any
additional criteria in section 473(d) of the Social Security Act. The sibling of a child who
meets the criteria for title IV-E Northstar kinship assistance in section 473(d) of the Social
Security Act is eligible for title IV-E Northstar kinship assistance if the child and sibling
are placed with the same prospective relative custodian or custodians, and the legally
responsible agency, relatives, and commissioner agree on the appropriateness of the
arrangement for the sibling. A child who meets all eligibility criteria except those specific
to title IV-E Northstar kinship assistance is entitled to Northstar kinship assistance paid
through funds other than title IV-E.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 18.
Minnesota Statutes 2018, section 256N.23, subdivision 2, is amended to read:
Subd. 2.
Special needs determination.
(a) A child is considered a child with special
needs under this section if the requirements in paragraphs (b) to (g) are met.
(b) There must be a determination that the child must not or should not be returned to
the home of the child's parents as evidenced by:
(1) a court-ordered termination of parental rights;
(2) a petition to terminate parental rights;
(3) consent of parent to adoption accepted by the court under chapter 260C;
(4) in circumstances when tribal law permits the child to be adopted without a termination
of parental rights, a judicial determination by a tribal court indicating the valid reason why
the child cannot or should not return home;
(5) a voluntary relinquishment under section 259.25 deleted text begin or 259.47deleted text end or, if relinquishment
occurred in another state, the applicable laws in that state; or
(6) the death of the legal parent or parents if the child has two legal parents.
(c) There exists a specific factor or condition of which it is reasonable to conclude that
the child cannot be placed with adoptive parents without providing adoption assistance as
evidenced by:
(1) a determination by the Social Security Administration that the child meets all medical
or disability requirements of title XVI of the Social Security Act with respect to eligibility
for Supplemental Security Income benefits;
(2) a documented physical, mental, emotional, or behavioral disability not covered under
clause (1);
(3) a member of a sibling group being adopted at the same time by the same parent;
(4) an adoptive placement in the home of a parent who previously adopted a sibling for
whom they receive adoption assistance; or
(5) documentation that the child is an at-risk child.
(d) A reasonable but unsuccessful effort must have been made to place the child with
adoptive parents without providing adoption assistance as evidenced by:
(1) a documented search for an appropriate adoptive placement; or
(2) a determination by the commissioner that a search under clause (1) is not in the best
interests of the child.
(e) The requirement for a documented search for an appropriate adoptive placement
under paragraph (d), including the registration of the child with the state adoption exchange
and other recruitment methods under paragraph (f), must be waived if:
(1) the child is being adopted by a relative and it is determined by the child-placing
agency that adoption by the relative is in the best interests of the child;
(2) the child is being adopted by a foster parent with whom the child has developed
significant emotional ties while in the foster parent's care as a foster child and it is determined
by the child-placing agency that adoption by the foster parent is in the best interests of the
child; or
(3) the child is being adopted by a parent that previously adopted a sibling of the child,
and it is determined by the child-placing agency that adoption by this parent is in the best
interests of the child.
For an Indian child covered by the Indian Child Welfare Act, a waiver must not be
granted unless the child-placing agency has complied with the placement preferences required
by the Indian Child Welfare Act, United States Code, title 25, section 1915(a).
(f) To meet the requirement of a documented search for an appropriate adoptive placement
under paragraph (d), clause (1), the child-placing agency minimally must:
(1) conduct a relative search as required by section 260C.221 and give consideration to
placement with a relative, as required by section 260C.212, subdivision 2;
(2) comply with the placement preferences required by the Indian Child Welfare Act
when the Indian Child Welfare Act, United States Code, title 25, section 1915(a), applies;
(3) locate prospective adoptive families by registering the child on the state adoption
exchange, as required under section 259.75; and
(4) if registration with the state adoption exchange does not result in the identification
of an appropriate adoptive placement, the agency must employ additional recruitment
methods prescribed by the commissioner.
(g) Once the legally responsible agency has determined that placement with an identified
parent is in the child's best interests and made full written disclosure about the child's social
and medical history, the agency must ask the prospective adoptive parent if the prospective
adoptive parent is willing to adopt the child without receiving adoption assistance under
this section. If the identified parent is either unwilling or unable to adopt the child without
adoption assistance, the legally responsible agency must provide documentation as prescribed
by the commissioner to fulfill the requirement to make a reasonable effort to place the child
without adoption assistance. If the identified parent is willing to adopt the child without
adoption assistance, the parent must provide a written statement to this effect to the legally
responsible agency and the statement must be maintained in the permanent adoption record
of the legally responsible agency. For children under guardianship of the commissioner,
the legally responsible agency shall submit a copy of this statement to the commissioner to
be maintained in the permanent adoption record.
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 256N.23, subdivision 6, is amended to read:
Subd. 6.
Exclusions.
The commissioner must not enter into an adoption assistance
agreement with the following individuals:
(1) a child's biological parent or stepparent;
(2) a child's relative under section 260C.007, subdivision 26b or 27, with whom the
child resided immediately prior to child welfare involvement unless:
(i) the child was in the custody of a Minnesota county or tribal agency pursuant to an
order under chapter 260C or equivalent provisions of tribal code and the agency had
placement and care responsibility for permanency planning for the child; and
(ii) the child is under guardianship of the commissioner of human services according to
the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota tribal
court after termination of parental rights, suspension of parental rights, or a finding by the
tribal court that the child cannot safely return to the care of the parent;
(3) an individual adopting a child who is the subject of a direct adoptive placement under
section 259.47 or the equivalent in tribal code;
(4) a child's legal custodian or guardian who is now adopting the childnew text begin , except for a
relative custodian as defined in section 256N.02, subdivision 19, who is currently receiving
Northstar kinship assistance benefitsnew text end ; or
(5) an individual who is adopting a child who is not a citizen or resident of the United
States and was either adopted in another country or brought to the United States for the
purposes of adoption.
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 256N.24, subdivision 1, is amended to read:
Subdivision 1.
Assessment.
(a) Each child eligible under sections 256N.21, 256N.22,
and 256N.23, must be assessed to determine the benefits the child may receive under section
256N.26, in accordance with the assessment tool, process, and requirements specified in
subdivision 2.
(b) If an agency applies the emergency foster care rate for initial placement under section
256N.26, the agency may wait up to 30 days to complete the initial assessment.
(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic
level, level B, or one of ten supplemental difficulty of care levels, levels C to L.
(d) An assessment must not be completed for:
(1) a child eligible for Northstar deleted text begin kinship assistance under section 256N.22 ordeleted text end adoption
assistance under section 256N.23 who is determined to be an at-risk child. A child under
this clause must be assigned level A under section 256N.26, subdivision 1; and
(2) a child transitioning into Northstar Care for Children under section 256N.28,
subdivision 7, unless the commissioner determines an assessment is appropriate.
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 256N.24, subdivision 8, is amended to read:
Subd. 8.
Completing the special assessment.
(a) The special assessment must be
completed in consultation with the child's caregiver. Face-to-face contact with the caregiver
is not required to complete the special assessment.
(b) If a new special assessment is required prior to the effective date of the Northstar
kinship assistance agreement, it must be completed by the financially responsible agency,
in consultation with the legally responsible agency if different. If the prospective relative
custodian is unable or unwilling to cooperate with the special assessment process, the child
shall be assigned the basic level, level B under section 256N.26, subdivision 3deleted text begin , unless the
child is known to be an at-risk child, in which case, the child shall be assigned level A under
section 256N.26, subdivision 1deleted text end .
(c) If a special assessment is required prior to the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency, in consultation with
the legally responsible agency if different. If there is no financially responsible agency, the
special assessment must be completed by the agency designated by the commissioner. If
the prospective adoptive parent is unable or unwilling to cooperate with the special
assessment process, the child must be assigned the basic level, level B under section 256N.26,
subdivision 3, unless the child is known to be an at-risk child, in which case, the child shall
be assigned level A under section 256N.26, subdivision 1.
(d) Notice to the prospective relative custodians or prospective adoptive parents must
be provided as specified in subdivision 13.
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 256N.24, subdivision 11, is amended to read:
Subd. 11.
Completion of reassessment.
(a) The reassessment must be completed in
consultation with the child's caregiver. Face-to-face contact with the caregiver is not required
to complete the reassessment.
(b) For foster children eligible under section 256N.21, reassessments must be completed
by the financially responsible agency, in consultation with the legally responsible agency
if different.
(c) If reassessment is required after the effective date of the Northstar kinship assistance
agreement, the reassessment must be completed by the financially responsible agency.
(d) If a reassessment is required after the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency or, if there is no
financially responsible agency, the agency designated by the commissioner.
(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment, the
child must be assessed at level B under section 256N.26, subdivision 3, unless the child has
deleted text begin andeleted text end new text begin a Northstarnew text end adoption assistance deleted text begin or Northstar kinship assistancedeleted text end agreement in place and
is known to be an at-risk child, in which case the child must be assessed at level A under
section 256N.26, subdivision 1.
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 256N.24, subdivision 12, is amended to read:
Subd. 12.
Approval of initial assessments, special assessments, and reassessments.
(a)
Any agency completing initial assessments, special assessments, or reassessments must
designate one or more supervisors or other staff to examine and approve assessments
completed by others in the agency under subdivision 2. The person approving an assessment
must not be the case manager or staff member completing that assessment.
(b) In cases where a special assessment or reassessment for deleted text begin guardiandeleted text end new text begin Northstar kinshipnew text end
assistance and adoption assistance is required under subdivision 8 or 11, the commissioner
shall review and approve the assessment as part of the eligibility determination process
outlined in section 256N.22, subdivision 7, for Northstar kinship assistance, or section
256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum
for the negotiated agreement amount under section 256N.25.
(c) The new rate is effective the calendar month that the assessment is approved, or the
effective date of the agreement, whichever is later.
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 256N.24, subdivision 14, is amended to read:
Subd. 14.
Assessment tool determines rate of benefits.
The assessment tool established
by the commissioner in subdivision 2 determines the monthly benefit level for children in
foster care. The monthly payment for deleted text begin guardiandeleted text end new text begin Northstar kinshipnew text end assistance or adoption
assistance may be negotiated up to the monthly benefit level under foster care for those
children eligible for a payment under section 256N.26, subdivision 1.
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 256N.28, subdivision 6, is amended to read:
Subd. 6.
Appeals and fair hearings.
(a) A caregiver has the right to appeal to the
commissioner under section 256.045 when eligibility for Northstar Care for Children is
denied, and when payment or the agreement for an eligible child is modified or terminated.
(b) deleted text begin A relative custodian or adoptive parent has additional rights to appeal to the
commissioner pursuant to section 256.045. These rights include when the commissioner
terminates or modifies the Northstar kinship assistance or adoption assistance agreement
or when the commissioner denies an application for Northstar kinship assistance or adoption
assistance. A prospective relative custodian or adoptive parent who disagrees with a decision
by the commissioner before transfer of permanent legal and physical custody or finalization
of the adoption may request review of the decision by the commissioner or may appeal the
decision under section 256.045.deleted text end A Northstar kinship assistance or adoption assistance
agreement must be signed and in effect before the court order that transfers permanent legal
and physical custody or the adoption finalization; however, in some cases, there may be
extenuating circumstances as to why an agreement was not entered into before finalization
of permanency for the child. Caregivers who believe that extenuating circumstances exist
new text begin as to why an agreement was not entered into before finalization of permanency new text end in the case
of their child may request a fair hearing. Caregivers have the responsibility of proving that
extenuating circumstances exist. Caregivers must be required to provide written
documentation of each eligibility criterion at the fair hearing. deleted text begin Examples of extenuating
circumstances include: relevant facts regarding the child were known by the placing agency
and not presented to the caregivers before transfer of permanent legal and physical custody
or finalization of the adoption, or failure by the commissioner or a designee to advise
potential caregivers about the availability of Northstar kinship assistance or adoption
assistance for children in the state foster care system.deleted text end If a human services judge finds through
the fair hearing process that extenuating circumstances existed and that the child met allnew text begin
othernew text end eligibility criteria at the time the transfer of permanent legal and physical custody was
ordered or the adoption was finalized, the effective date and any associated federal financial
participation shall be retroactive from the date of the request for a fair hearing.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 26.
Minnesota Statutes 2018, section 259.241, is amended to read:
259.241 ADULT ADOPTION.
(a) Any adult person may be adopted, regardless of the adult person's residence. A
resident of Minnesota may petition the court of record having jurisdiction of adoption
proceedings to adopt an individual who has reached the age of 18 years or older.
(b) The consent of the person to be adopted shall be the only consent necessary, according
to section 259.24. The consent of an adult in the adult person's own adoption is invalid if
the adult is considered to be a vulnerable adult under section 626.5572, subdivision 21, or
if the person consenting to the adoption is determined not competent to give consent.
new text begin
(c) Notwithstanding paragraph (b), a person in extended foster care under section
260C.451 may consent to the person's own adoption if the court of jurisdiction finds the
person competent to give consent.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end The decree of adoption establishes a parent-child relationship between the adopting
parent or parents and the person adopted, including the right to inherit, and also terminates
the parental rights deleted text begin and sibling relationshipdeleted text end between the adopted person and the adopted
person's birth parents deleted text begin and siblingsdeleted text end according to section 259.59.
deleted text begin (d)deleted text end new text begin (e)new text end If the adopted person requests a change of name, the adoption decree shall order
the name change.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 27.
Minnesota Statutes 2018, section 259.35, subdivision 1, is amended to read:
Subdivision 1.
Parental responsibilities.
Prior to commencing an investigation of the
suitability of proposed adoptive parents, a child-placing agency shall give the individuals
the following written notice in all capital letters at least one-eighth inch high:
"Minnesota Statutes, section 259.59, provides that upon legally adopting a child, adoptive
parents assume all the rights and responsibilities of birth parents. The responsibilities include
providing for the child's financial support and caring for health, emotional, and behavioral
problems. Except for subsidized adoptions under Minnesota Statutes, chapter deleted text begin 259Adeleted text end new text begin 256Nnew text end ,
or any other provisions of law that expressly apply to adoptive parents and children, adoptive
parents are not eligible for state or federal financial subsidies besides those that a birth
parent would be eligible to receive for a child. Adoptive parents may not terminate their
parental rights to a legally adopted child for a reason that would not apply to a birth parent
seeking to terminate rights to a child. An individual who takes guardianship of a child for
the purpose of adopting the child shall, upon taking guardianship from the child's country
of origin, assume all the rights and responsibilities of birth and adoptive parents as stated
in this paragraph."
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 28.
Minnesota Statutes 2018, section 259.37, subdivision 2, is amended to read:
Subd. 2.
Disclosure to birth parents and adoptive parents.
new text begin (a) new text end An agency shall provide
a disclosure statement written in clear, plain language to be signed by the prospective
adoptive parents and birth parents, except that in intercountry adoptions, the signatures of
birth parents are not required. The disclosure statement must contain the following
information:
(1) fees charged to the adoptive parent, including any policy on sliding scale fees or fee
waivers and an itemization of the amount that will be charged for the adoption study,
counseling, postplacement services, family of origin searches, birth parent expenses
authorized under section 259.55, or any other services;
(2) timeline for the adoptive parent to make fee payments;
(3) likelihood, given the circumstances of the prospective adoptive parent and any specific
program to which the prospective adoptive parent is applying, that an adoptive placement
may be made and the estimated length of time for making an adoptive placement. These
estimates must be based on adoptive placements made with prospective parents in similar
circumstances applying to a similar program with the agency during the immediately
preceding three to five years. If an agency has not been in operation for at least three years,
it must provide summary data based on whatever adoptive placements it has made and may
include a statement about the kind of efforts it will make to achieve an adoptive placement,
including a timetable it will follow in seeking a child. The estimates must include a statement
that the agency cannot guarantee placement of a child or a time by which a child will be
placed;
(4) a statement of the services the agency will provide the birth and adoptive parents;
(5) a statement prepared by the commissioner under section 259.39 that explains the
child placement and adoption process and the respective legal rights and responsibilities of
the birth parent and prospective adoptive parent during the process including a statement
that the prospective adoptive parent is responsible for filing an adoption petition not later
than 12 months after the child is placed in the prospective adoptive home;
(6) a statement regarding any information the agency may have about attorney referral
services, or about obtaining assistance with completing legal requirements for an adoption;
and
(7) an acknowledgment to be signed by the birth parent and prospective adoptive parent
that they have received, read, and had the opportunity to ask questions of the agency about
the contents of the disclosure statement.
new text begin
(b) An agency responsible for a placement or an agency supervising the placement shall
obtain from the birth parents named on the original birth record an affidavit attesting to the
following:
new text end
new text begin
(1) the birth parent has been informed of the right of the adopted person at the age
specified in section 259.89 to request from the agency the name, last known address,
birthdate, and birthplace of the birth parents named on the adopted person's original birth
record;
new text end
new text begin
(2) each birth parent may file in the agency record an affidavit of nondisclosure objecting
to the release of any or all of the information listed in clause (1) about that birth parent only,
to the adopted person;
new text end
new text begin
(3) if the birth parent does not file an affidavit of nondisclosure objecting to the release
of information before the adopted person reaches the age specified in section 259.89, the
agency may provide the adopted person with the information upon request;
new text end
new text begin
(4) notwithstanding a birth parent's filed affidavit of nondisclosure, the adopted person
may petition the court according to section 259.61 for release of identifying information
about a birth parent. The birth parent must then have the opportunity to present evidence
to the court that nondisclosure of identifying information is of greater benefit to the birth
parent than disclosure to the adopted person;
new text end
new text begin
(5) any objection filed by the birth parent becomes invalid when withdrawn by the birth
parent; and
new text end
new text begin
(6) if the birth parent filed an affidavit of nondisclosure or the birth parent's file does
not contain an affidavit of disclosure, the agency shall release the identifying information
to the adopted person upon receipt of the birth parent's death record and a court order
authorizing disclosure under section 259.89, subdivision 5. A court order to release
information is not required when a birth parent's affidavit of disclosure is filed, and no
affidavit of nondisclosure was filed by either birth parent.
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. 29.
Minnesota Statutes 2018, section 259.53, subdivision 4, is amended to read:
Subd. 4.
Preadoption residence.
No petition shall be granted new text begin under this chapter new text end until
the child shall have lived three months in the proposed home, subject to a right of visitation
by the commissioner or an agency or their authorized representatives.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 30.
Minnesota Statutes 2018, section 259.75, is amended to read:
259.75 STATE ADOPTION EXCHANGE.
Subdivision 1.
Establishment; contents; availability.
The commissioner of human
services shall establish deleted text begin andeleted text end new text begin a statenew text end adoption exchange deleted text begin that contains a photograph and
description ofdeleted text end new text begin wherenew text end each child who has been legally freed for adoptionnew text begin is listed. The state
adoption exchange is an information and matching toolnew text end . The new text begin state adoption new text end exchange deleted text begin service
shalldeleted text end new text begin mustnew text end be available to all deleted text begin local social service agencies and licenseddeleted text end new text begin authorizednew text end
child-placing agencies new text begin in Minnesota, as defined in section 257.065, new text end whose purpose is to
assist in the adoptive placement of children.
Subd. 2.
deleted text begin Photograph and descriptiondeleted text end new text begin Submission of child's informationnew text end .
deleted text begin All local
social service agencies, and licenseddeleted text end new text begin An authorized new text end child-placing deleted text begin agenciesdeleted text end new text begin agencynew text end shall
deleted text begin send todeleted text end new text begin register onnew text end the state adoption exchangedeleted text begin , within 45 days of the time a child becomes
free for adoption, a recent photograph and description ofdeleted text end each child in deleted text begin itsdeleted text end new text begin the agency'snew text end care
who has been legally freed for adoption deleted text begin by the termination of parental rightsdeleted text end , and for whom
no adoptive home has been foundnew text begin , within 45 days of the date the child became legally free
for adoption and in a format specified by the commissionernew text end .
Subd. 2a.
Listing deadline.
All children identified under subdivision 2 must be listed
on the state adoption exchange within 20 days of the receipt of the information from the
deleted text begin local social service agency or licenseddeleted text end new text begin authorizednew text end child-placing agency.
Subd. 3.
Changes in status.
new text begin The authorized child-placing agency shall report to the state
adoption exchange, in a format specified by the commissioner, new text end changes in the status of a
child deleted text begin listed in the state adoption exchange shall be reported by the local social service agency
and the licensed child-placing agency to the exchangedeleted text end within ten working days after the
change occurs.
Subd. 4.
Updated information.
Children remaining registered for 12 months shall have
deleted text begin their photographs and written descriptionsdeleted text end updated new text begin registration completed new text end by the deleted text begin local social
service agency and the licenseddeleted text end new text begin authorizednew text end child-placing agency within ten working days
of the expiration of the 12 months, and deleted text begin every 12 monthsdeleted text end new text begin annuallynew text end thereafter.new text begin The authorized
child-placing agency shall submit the registration update to the commissioner in a format
specified by the commissioner.
new text end
Subd. 5.
Withdrawal of registration.
A child's registration shall be withdrawn when
the deleted text begin exchange servicedeleted text end new text begin commissionernew text end has been notified in writing by the deleted text begin local social service
agency or the licenseddeleted text end new text begin authorizednew text end child-placing agency that the child has been placed in an
adoptive home deleted text begin ordeleted text end new text begin ;new text end has diednew text begin ; or is no longer under guardianship of the commissioner and is
no longer seeking a permanency resourcenew text end .
Subd. 6.
Periodic review of status.
new text begin (a) new text end The deleted text begin exchange servicedeleted text end new text begin commissionernew text end shall
deleted text begin semiannually checkdeleted text end new text begin reviewnew text end the new text begin state adoption exchange new text end status of deleted text begin listeddeleted text end children deleted text begin for whom
inquiries have been received.deleted text end new text begin , including a child whose registration was withdrawn pursuant
to subdivision 5. The commissioner may determine that a child who is unregistered or whose
registration has been deferred must be registered and require the authorized child-placing
agency to register the child on the state adoption exchange within ten working days of the
commissioner's determination.
new text end
new text begin (b) new text end Periodic deleted text begin checksdeleted text end new text begin reviewsnew text end shall be made deleted text begin by the servicedeleted text end to determine the progress
toward adoption of deleted text begin thosedeleted text end children deleted text begin and the status of childrendeleted text end registered deleted text begin but never listed indeleted text end new text begin
onnew text end the deleted text begin exchange book because of placement in an adoptive home prior to or at the time of
registrationdeleted text end new text begin state adoption exchangenew text end .
Subd. 7.
Voluntary referral; required registration.
deleted text begin A local social service agency and
a licenseddeleted text end new text begin An authorizednew text end child-placing agency may voluntarily refer any child legally freed
for adoption to the exchange service; or the deleted text begin exchange servicedeleted text end new text begin commissionernew text end may determine
that the recruitment of an adoptive family through the new text begin state adoption new text end exchange deleted text begin bookdeleted text end is
appropriate for a child not registered with the service and require the child to be registered
with the new text begin state adoption new text end exchange service within ten working daysnew text begin of the commissioner's
determinationnew text end .
Subd. 8.
Reasons for deferral.
deleted text begin Deferral of the listing ofdeleted text end new text begin (a) An authorized child-placing
agency may defernew text end a child deleted text begin withdeleted text end new text begin from registration onnew text end the state adoption exchange deleted text begin shall be
only for one or more of the following reasons:
deleted text end
deleted text begin
(a) the child is in an adoptive placement but is not legally adopted;
deleted text end
deleted text begin (b)deleted text end new text begin ifnew text end the child's foster parents or other individuals are now considering adoptiondeleted text begin ;deleted text end new text begin .
new text end
deleted text begin
(c) diagnostic study or testing is required to clarify the child's problem and provide an
adequate description; or
deleted text end
deleted text begin
(d) the child is currently in a hospital and continuing need for daily professional care
will not permit placement in a family setting.
deleted text end
new text begin (b) new text end Approval of a request to defer deleted text begin listing for any of the reasons specified in paragraph
(b) or (c)deleted text end new text begin registrationnew text end shall be valid for a period not to exceed 90 days, with no subsequent
deferrals deleted text begin for those reasons.deleted text end new text begin unless determined by the commissioner to be in the best interests
of the child. The authorized child-placing agency shall submit a deferral request to the
commissioner in a format specified by the commissioner.
new text end
Subd. 9.
Rules; staff.
The commissioner of human services shall make rulesnew text begin , procedures,
requirements, and deadlinesnew text end as necessary to administer this section and shall employ
necessary staff to carry out the purposes of this section.new text begin The commissioner may contract
for portions of these services.
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. 31.
Minnesota Statutes 2018, section 259.83, subdivision 1, is amended to read:
Subdivision 1.
Services provided.
Agencies shall provide assistance and counseling
services upon receiving a request for current informationnew text begin , to share information, or to facilitate
contactnew text end from adoptive parents, birth parents, new text begin genetic siblings, new text end or adopted persons aged 19
years and over. The agency shall contact the other adult persons or the adoptive parents of
a minor child in a personal and confidential manner to determine whether there is a desire
to receive or share information or to have contact. If there is such a desire, the agency shall
provide the services requested. The agency shall provide services to adult genetic siblings
if there is no known violation of the confidentiality of a birth parent or if the birth parent
gives written consent.new text begin Any service provided by the agency shall be discontinued upon
request of any party receiving the service.
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. 32.
Minnesota Statutes 2018, section 259.83, subdivision 1a, is amended to read:
Subd. 1a.
deleted text begin Social and medical historydeleted text end new text begin Nonidentifying informationnew text end .
(a) If a person aged
19 years and over deleted text begin who was adopted on or after August 1, 1994,deleted text end or the adoptive parent
requests the detailed nonidentifying social and medical history of the adopted person's birth
family that was provided at the time of the adoption, agencies must provide the information
to the adopted person or adoptive parent on the new text begin applicable new text end form required under deleted text begin sectiondeleted text end new text begin
sectionsnew text end 259.43new text begin and 260C.609new text end .
(b) If an adopted person aged 19 years and over or the adoptive parent requests the
agency to contact the adopted person's birth parents to request current nonidentifying social
and medical history of the adopted person's birth family, agencies must use the new text begin applicable
new text end form required under deleted text begin sectiondeleted text end new text begin sectionsnew text end 259.43new text begin and 260C.609new text end when obtaining the information
for the adopted person or adoptive parent.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 33.
Minnesota Statutes 2018, section 259.83, subdivision 3, is amended to read:
Subd. 3.
deleted text begin Identifying informationdeleted text end new text begin Affidavit of disclosure or nondisclosurenew text end .
deleted text begin
In adoptive
placements made on and after August 1, 1982, the agency responsible for or supervising
the placement shall obtain from the birth parents named on the original birth record an
affidavit attesting to the following:
deleted text end
deleted text begin
(a) that the birth parent has been informed of the right of the adopted person at the age
specified in section 259.89 to request from the agency the name, last known address, birthdate
and birthplace of the birth parents named on the adopted person's original birth record;
deleted text end
deleted text begin
(b) that each birth parent may file in the agency record an affidavit objecting to the
release of any or all of the information listed in clause (a) about that birth parent, and that
parent only, to the adopted person;
deleted text end
deleted text begin
(c) that if the birth parent does not file an affidavit objecting to release of information
before the adopted person reaches the age specified in section 259.89, the agency will
provide the adopted person with the information upon request;
deleted text end
deleted text begin
(d) that notwithstanding the filing of an affidavit, the adopted person may petition the
court according to section 259.61 for release of identifying information about a birth parent;
deleted text end
deleted text begin
(e) that the birth parent shall then have the opportunity to present evidence to the court
that nondisclosure of identifying information is of greater benefit to the birth parent than
disclosure to the adopted person; and
deleted text end
deleted text begin
(f) that any objection filed by the birth parent shall become invalid when withdrawn by
the birth parent or when the birth parent dies. Upon receipt of a death record for the birth
parent, the agency shall release the identifying information to the adopted person if requested.
deleted text end
new text begin
(a) Access to the original birth record of an adopted person is governed by section 259.89.
Upon receiving notice from the commissioner of a request for release of birth records, an
agency shall determine whether an affidavit of disclosure has been filed in the agency records
according to section 259.37, subdivision 2, paragraph (b).
new text end
new text begin
(b) If an affidavit of disclosure was filed and no affidavit of nondisclosure was filed by
either birth parent according to section 259.37, subdivision 2, paragraph (b), the agency
shall provide the name, last known address, birthdate, and birthplace of the birth parents
named on the adopted person's original birth record. The agency shall not release a birth
parent's information if an affidavit of nondisclosure was filed by that birth parent, unless
authorized by court order.
new text end
new text begin
(c) If an affidavit of disclosure was not filed, the agency shall make reasonable efforts
to locate and notify each birth parent of the request, of the right to file an affidavit of
nondisclosure according to section 259.37, subdivision 2, paragraph (b), clause (2), with
the state registrar, and of how filing or not filing an affidavit of disclosure or affidavit of
nondisclosure affects the release of the original birth record. For a birth parent who has
been located, an agency must follow the procedures outlined in section 259.37, subdivision
2, paragraph (b).
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. 34.
Minnesota Statutes 2018, section 259A.75, subdivision 1, is amended to read:
Subdivision 1.
General information.
(a) Subject to the procedures required by the
commissioner and the provisions of this section, a Minnesota county new text begin or tribal agency new text end shall
receive a reimbursement from the commissioner equal to 100 percent of the reasonable and
appropriate cost for contracted adoption placement services identified for a specific child
that are not reimbursed under other federal or state funding sources.
(b) The commissioner may spend up to $16,000 for each purchase of service contract.
Only one contract per child per adoptive placement is permitted. Funds encumbered and
obligated under the contract for the child remain available until the terms of the contract
are fulfilled or the contract is terminated.
(c) The commissioner shall set aside an amount not to exceed five percent of the total
amount of the fiscal year appropriation from the state for the adoption assistance program
to reimburse a Minnesota county or tribal social services placing agency for child-specific
adoption placement services. When adoption assistance payments for children's needs exceed
95 percent of the total amount of the fiscal year appropriation from the state for the adoption
assistance program, the amount of reimbursement available to placing agencies for adoption
services is reduced correspondingly.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 35.
Minnesota Statutes 2018, section 259A.75, subdivision 2, is amended to read:
Subd. 2.
Purchase of service contract child eligibility criteria.
deleted text begin (a)deleted text end A child who is the
subject of a purchase of service contract must:
(1) have the goal of adoption, which may include an adoption in accordance with tribal
law;
(2) be under the guardianship of the commissioner of human services or be a ward of
tribal court pursuant to section 260.755, subdivision 20; and
(3) deleted text begin meet all of thedeleted text end new text begin be a child withnew text end special needs deleted text begin criteriadeleted text end according to section deleted text begin 259A.10deleted text end new text begin
256N.23new text end , subdivision 2.
deleted text begin
(b) A child under the guardianship of the commissioner must have an identified adoptive
parent and a fully executed adoption placement agreement according to section 260C.613,
subdivision 1, paragraph (a).
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 36.
Minnesota Statutes 2018, section 259A.75, subdivision 3, is amended to read:
Subd. 3.
Agency eligibility criteria.
(a) A Minnesota county new text begin or tribal new text end social services
agency shall deleted text begin receive reimbursement fordeleted text end new text begin enter into anew text end child-specific new text begin agreement for new text end adoption
placement services for an eligible child that it purchases from a private adoption agency
licensed in Minnesota or any other state or tribal social services agency.
(b) Reimbursement for adoption services is available only for services new text begin approved through
a fully executed child-specific contract for adoption services and new text end provided prior to the date
of the adoption decree.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 37.
Minnesota Statutes 2018, section 259A.75, subdivision 4, is amended to read:
Subd. 4.
Application and eligibility determination.
(a) A county new text begin or tribal new text end social services
agency may request reimbursement of costs for adoption placement services by submitting
a complete purchase of service application, according to the requirements and procedures
and on forms prescribed by the commissioner.
(b) The commissioner shall determine eligibility for reimbursement of adoption placement
services. If determined eligible, the commissioner of human services shall sign the purchase
of service agreement, making this a fully executed contract. No reimbursement under this
section shall be made to an agency for services provided prior to the fully executed contract.
(c) Separate purchase of service agreements shall be made, and separate records
maintained, on each child. Only one agreement per child per adoptive placement is permitted.
For siblings who are placed together, services shall be planned and provided to best maximize
efficiency of the contracted hours.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 38.
Minnesota Statutes 2018, section 259A.75, subdivision 5, is amended to read:
Subd. 5.
Reimbursement process.
(a) The agency providing adoption services is
responsible to track and record all service activity, including billable hours, on a form
prescribed by the commissioner. The agency shall submit this form to the state for
reimbursement after services have been completed.new text begin Reimbursement may be made directly
to the county or tribal social services agency or private child-placing agency.
new text end
(b) The commissioner shall make the final determination whether or not the requested
reimbursement costs are reasonable and appropriate and if the services have been completed
according to the terms of the purchase of service agreement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 39.
Minnesota Statutes 2018, section 260.761, subdivision 2, is amended to read:
Subd. 2.
Agency and court notice to tribes.
(a) When a local social services agency
has information that a family assessment or investigation being conducted may involve an
Indian child, the local social services agency shall notify the Indian child's tribe of the family
assessment or investigation according to section 626.556, subdivision 10, paragraph deleted text begin (a)deleted text end new text begin (b)new text end ,
clause (5). Initial notice shall be provided by telephone and by e-mail or facsimile. The
local social services agency shall request that the tribe or a designated tribal representative
participate in evaluating the family circumstances, identifying family and tribal community
resources, and developing case plans.
(b) When a local social services agency has information that a child receiving services
may be an Indian child, the local social services agency shall notify the tribe by telephone
and by e-mail or facsimile of the child's full name and date of birth, the full names and dates
of birth of the child's biological parents, and, if known, the full names and dates of birth of
the child's grandparents and of the child's Indian custodian. This notification must be provided
so the tribe can determine if the child is enrolled in the tribe or eligible for membership,
and must be provided within seven days. If information regarding the child's grandparents
or Indian custodian is not available within the seven-day period, the local social services
agency shall continue to request this information and shall notify the tribe when it is received.
Notice shall be provided to all tribes to which the child may have any tribal lineage. If the
identity or location of the child's parent or Indian custodian and tribe cannot be determined,
the local social services agency shall provide the notice required in this paragraph to the
United States secretary of the interior.
(c) In accordance with sections 260C.151 and 260C.152, when a court has reason to
believe that a child placed in emergency protective care is an Indian child, the court
administrator or a designee shall, as soon as possible and before a hearing takes place, notify
the tribal social services agency by telephone and by e-mail or facsimile of the date, time,
and location of the emergency protective case hearing. The court shall make efforts to allow
appearances by telephone for tribal representatives, parents, and Indian custodians.
(d) A local social services agency must provide the notices required under this subdivision
at the earliest possible time to facilitate involvement of the Indian child's tribe. Nothing in
this subdivision is intended to hinder the ability of the local social services agency and the
court to respond to an emergency situation. Lack of participation by a tribe shall not prevent
the tribe from intervening in services and proceedings at a later date. A tribe may participate
at any time. At any stage of the local social services agency's involvement with an Indian
child, the agency shall provide full cooperation to the tribal social services agency, including
disclosure of all data concerning the Indian child. Nothing in this subdivision relieves the
local social services agency of satisfying the notice requirements in the Indian Child Welfare
Act.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 40.
Minnesota Statutes 2018, section 260C.101, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Provisions inapplicable to a child in foster care. new text end
new text begin
If the court orders a child
placed under the protective care or legal custody of the responsible social services agency
pursuant to section 260C.151, subdivision 6; 260C.178; or 260C.201, then the provisions
of section 524.5-211 and chapter 257B have no force and effect and any delegation of power
by parent or guardian or designation of standby custodian are terminated by the court's
order.
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. 41.
Minnesota Statutes 2018, section 260C.139, subdivision 3, is amended to read:
Subd. 3.
Status of child.
For purposes of proceedings under this chapter and adoption
proceedings, a newborn left at a safe place, pursuant to subdivision 3 and section 145.902,
is considered an abandoned child under section 626.556, subdivision 2, paragraph deleted text begin (o)deleted text end new text begin (r)new text end ,
clause (2). The child is abandoned under sections 260C.007, subdivision 6, clause (1), and
260C.301, subdivision 1, paragraph (b), clause (1).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 42.
Minnesota Statutes 2018, section 260C.171, subdivision 2, is amended to read:
Subd. 2.
Public inspection of records.
(a) The records from proceedings or portions of
proceedings involving a child in need of protection or services, permanency, or termination
of parental rights are accessible to the public as authorized by the Minnesota Rules of
Juvenile Protection Proceduredeleted text begin .deleted text end new text begin , except that the court shall maintain the confidentiality of a
child's education, physical health, and mental health records or information. A petition filed
alleging a child to be habitually truant under section 260C.007, subdivision 6, clause (14),
is not part of the child's education record or information. The court shall maintain the
confidentiality of any record filed in proceedings under chapter 260D.
new text end
(b) None of the records relating to an appeal from a nonpublic juvenile court proceeding,
except the written appellate opinion, shall be open to public inspection or their contents
disclosed except by order of a court.
(c) The records of juvenile probation officers are records of the court for the purposes
of this subdivision. This subdivision applies to all proceedings under this chapter, including
appeals from orders of the juvenile court. The court shall maintain the confidentiality of
adoption files and records in accordance with the provisions of laws relating to adoptions.
In juvenile court proceedings any report or social history furnished to the court shall be
open to inspection by the attorneys of record and the guardian ad litem a reasonable time
before it is used in connection with any proceeding before the court.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 43.
Minnesota Statutes 2018, section 260C.178, subdivision 1, is amended to read:
Subdivision 1.
Hearing and release requirements.
(a) If a child was taken into custody
under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a
hearing within 72 hours of the time the child was taken into custody, excluding Saturdays,
Sundays, and holidays, to determine whether the child should continue in custody.
(b) Unless there is reason to believe that the child would endanger self or others or not
return for a court hearing, or that the child's health or welfare would be immediately
endangered, the child shall be released to the custody of a parent, guardian, custodian, or
other suitable person, subject to reasonable conditions of release including, but not limited
to, a requirement that the child undergo a chemical use assessment as provided in section
260C.157, subdivision 1.
(c) If the court determines there is reason to believe that the child would endanger self
or others or not return for a court hearing, or that the child's health or welfare would be
immediately endangered if returned to the care of the parent or guardian who has custody
and from whom the child was removed, the court shall order the child into foster care under
the legal responsibility of the responsible social services agency or responsible probation
or corrections agency for the purposes of protective care as that term is used in the juvenile
court rules or into the home of a noncustodial parent and order the noncustodial parent to
comply with any conditions the court determines to be appropriate to the safety and care of
the child, including cooperating with paternity establishment proceedings in the case of a
man who has not been adjudicated the child's father. The court shall not give the responsible
social services legal custody and order a trial home visit at any time prior to adjudication
and disposition under section 260C.201, subdivision 1, paragraph (a), clause (3), but may
order the child returned to the care of the parent or guardian who has custody and from
whom the child was removed and order the parent or guardian to comply with any conditions
the court determines to be appropriate to meet the safety, health, and welfare of the child.
(d) In determining whether the child's health or welfare would be immediately
endangered, the court shall consider whether the child would reside with a perpetrator of
domestic child abuse.
(e) The court, before determining whether a child should be placed in or continue in
foster care under the protective care of the responsible agency, shall also make a
determination, consistent with section 260.012 as to whether reasonable efforts were made
to prevent placement or whether reasonable efforts to prevent placement are not required.
In the case of an Indian child, the court shall determine whether active efforts, according
to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25,
section 1912(d), were made to prevent placement. The court shall enter a finding that the
responsible social services agency has made reasonable efforts to prevent placement when
the agency establishes either:
(1) that it has actually provided services or made efforts in an attempt to prevent the
child's removal but that such services or efforts have not proven sufficient to permit the
child to safely remain in the home; or
(2) that there are no services or other efforts that could be made at the time of the hearing
that could safely permit the child to remain home or to return home. When reasonable efforts
to prevent placement are required and there are services or other efforts that could be ordered
which would permit the child to safely return home, the court shall order the child returned
to the care of the parent or guardian and the services or efforts put in place to ensure the
child's safety. When the court makes a prima facie determination that one of the
circumstances under paragraph (g) exists, the court shall determine that reasonable efforts
to prevent placement and to return the child to the care of the parent or guardian are not
required.
If the court finds the social services agency's preventive or reunification efforts have
not been reasonable but further preventive or reunification efforts could not permit the child
to safely remain at home, the court may nevertheless authorize or continue the removal of
the child.
(f) The court may not order or continue the foster care placement of the child unless the
court makes explicit, individualized findings that continued custody of the child by the
parent or guardian would be contrary to the welfare of the child and that placement is in the
best interest of the child.
(g) At the emergency removal hearing, or at any time during the course of the proceeding,
and upon notice and request of the county attorney, the court shall determine whether a
petition has been filed stating a prima facie case that:
(1) the parent has subjected a child to egregious harm as defined in section 260C.007,
subdivision 14;
(2) the parental rights of the parent to another child have been involuntarily terminated;
(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
(a), clause (2);
(4) the parents' custodial rights to another child have been involuntarily transferred to a
relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (e),
clause (1); section 260C.515, subdivision 4; or a similar law of another jurisdiction;
(5) the parent has committed sexual abuse as defined in section 626.556, subdivision 2,
against the child or another child of the parent;
(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or
(7) the provision of services or further services for the purpose of reunification is futile
and therefore unreasonable.
(h) When a petition to terminate parental rights is required under section 260C.301,
subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to
proceed with a termination of parental rights petition, and has instead filed a petition to
transfer permanent legal and physical custody to a relative under section 260C.507, the
court shall schedule a permanency hearing within 30 days of the filing of the petition.
(i) If the county attorney has filed a petition under section 260C.307, the court shall
schedule a trial under section 260C.163 within 90 days of the filing of the petition except
when the county attorney determines that the criminal case shall proceed to trial first under
section 260C.503, subdivision 2, paragraph (c).
(j) If the court determines the child should be ordered into foster care and the child's
parent refuses to give information to the responsible social services agency regarding the
child's father or relatives of the child, the court may order the parent to disclose the names,
addresses, telephone numbers, and other identifying information to the responsible social
services agency for the purpose of complying with sections 260C.151, 260C.212, 260C.215,
and 260C.221.
(k) If a child ordered into foster care has siblingsdeleted text begin , whether full, half, or step,deleted text end who are
also ordered into foster care, the court shall inquire of the responsible social services agency
of the efforts to place the children together as required by section 260C.212, subdivision 2,
paragraph (d), if placement together is in each child's best interests, unless a child is in
placement for treatment or a child is placed with a previously noncustodial parent who is
not a parent to all siblings. If the children are not placed together at the time of the hearing,
the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place
the siblings together, as required under section 260.012. If any sibling is not placed with
another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing
contact among the siblings as required under section 260C.212, subdivision 1, unless it is
contrary to the safety or well-being of any of the siblings to do so.
(l) When the court has ordered the child into foster care or into the home of a noncustodial
parent, the court may order a chemical dependency evaluation, mental health evaluation,
medical examination, and parenting assessment for the parent as necessary to support the
development of a plan for reunification required under subdivision 7 and section 260C.212,
subdivision 1, or the child protective services plan under section 626.556, subdivision 10,
and Minnesota Rules, part 9560.0228.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 44.
Minnesota Statutes 2018, section 260C.212, subdivision 1, is amended to read:
Subdivision 1.
Out-of-home placement; plan.
(a) An out-of-home placement plan shall
be prepared within 30 days after any child is placed in foster care by court order or a
voluntary placement agreement between the responsible social services agency and the
child's parent pursuant to section 260C.227 or chapter 260D.
(b) An out-of-home placement plan means a written document which is prepared by the
responsible social services agency jointly with the parent or parents or guardian of the child
and in consultation with the child's guardian ad litem, the child's tribe, if the child is an
Indian child, the child's foster parent or representative of the foster care facility, and, where
appropriate, the child. When a child is age 14 or older, the child may include two other
individuals on the team preparing the child's out-of-home placement plan. The child may
select one member of the case planning team to be designated as the child's deleted text begin advisordeleted text end new text begin advisernew text end
and to advocate with respect to the application of the reasonable and prudent parenting
standards. The responsible social services agency may reject an individual selected by the
child if the agency has good cause to believe that the individual would not act in the best
interest of the child. For a child in voluntary foster care for treatment under chapter 260D,
preparation of the out-of-home placement plan shall additionally include the child's mental
health treatment provider. For a child 18 years of age or older, the responsible social services
agency shall involve the child and the child's parents as appropriate. As appropriate, the
plan shall be:
(1) submitted to the court for approval under section 260C.178, subdivision 7;
(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and
(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem,
a representative of the child's tribe, the responsible social services agency, and, if possible,
the child.
(c) The out-of-home placement plan shall be explained to all persons involved in its
implementation, including the child who has signed the plan, and shall set forth:
(1) a description of the foster care home or facility selected, including how the
out-of-home placement plan is designed to achieve a safe placement for the child in the
least restrictive, most family-like, setting available which is in close proximity to the home
of the parent or parents or guardian of the child when the case plan goal is reunification,
and how the placement is consistent with the best interests and special needs of the child
according to the factors under subdivision 2, paragraph (b);
(2) the specific reasons for the placement of the child in foster care, and when
reunification is the plan, a description of the problems or conditions in the home of the
parent or parents which necessitated removal of the child from home and the changes the
parent or parents must make for the child to safely return home;
(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:
(i) the specific actions to be taken by the parent or parents of the child to eliminate or
correct the problems or conditions identified in clause (2), and the time period during which
the actions are to be taken; and
(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to
achieve a safe and stable home for the child including social and other supportive services
to be provided or offered to the parent or parents or guardian of the child, the child, and the
residential facility during the period the child is in the residential facility;
(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if not,
the basis for the denial of the services or resources;
(5) the visitation plan for the parent or parents or guardian, other relatives as defined in
section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not
placed together in foster care, and whether visitation is consistent with the best interest of
the child, during the period the child is in foster care;
(6) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize adoption as the permanency plan for the child through reasonable efforts
to place the child for adoption. At a minimum, the documentation must include consideration
of whether adoption is in the best interests of the child, child-specific recruitment efforts
such as relative search and the use of state, regional, and national adoption exchanges to
facilitate orderly and timely placements in and outside of the state. A copy of this
documentation shall be provided to the court in the review required under section 260C.317,
subdivision 3, paragraph (b);
(7) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize the transfer of permanent legal and physical custody to a relative as the
permanency plan for the child. This documentation must support the requirements of the
kinship placement agreement under section 256N.22 and must include the reasonable efforts
used to determine that it is not appropriate for the child to return home or be adopted, and
reasons why permanent placement with a relative through a Northstar kinship assistance
arrangement is in the child's best interest; how the child meets the eligibility requirements
for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's
relative foster parent and reasons why the relative foster parent chose not to pursue adoption,
if applicable; and agency efforts to discuss with the child's parent or parents the permanent
transfer of permanent legal and physical custody or the reasons why these efforts were not
made;
(8) efforts to ensure the child's educational stability while in foster care for a child who
attained the minimum age for compulsory school attendance under state law and is enrolled
full time in elementary or secondary school, or instructed in elementary or secondary
education at home, or instructed in an independent study elementary or secondary program,
or incapable of attending school on a full-time basis due to a medical condition that is
documented and supported by regularly updated information in the child's case plan.
Educational stability efforts include:
(i) efforts to ensure that the child remains in the same school in which the child was
enrolled prior to placement or upon the child's move from one placement to another, including
efforts to work with the local education authorities to ensure the child's educational stability
and attendance; or
(ii) if it is not in the child's best interest to remain in the same school that the child was
enrolled in prior to placement or move from one placement to another, efforts to ensure
immediate and appropriate enrollment for the child in a new school;
(9) the educational records of the child including the most recent information available
regarding:
(i) the names and addresses of the child's educational providers;
(ii) the child's grade level performance;
(iii) the child's school record;
(iv) a statement about how the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of placement; and
(v) any other relevant educational information;
(10) the efforts by the responsible social services agency to ensure the oversight and
continuity of health care services for the foster child, including:
(i) the plan to schedule the child's initial health screens;
(ii) how the child's known medical problems and identified needs from the screens,
including any known communicable diseases, as defined in section 144.4172, subdivision
2, shall be monitored and treated while the child is in foster care;
(iii) how the child's medical information shall be updated and shared, including the
child's immunizations;
(iv) who is responsible to coordinate and respond to the child's health care needs,
including the role of the parent, the agency, and the foster parent;
(v) who is responsible for oversight of the child's prescription medications;
(vi) how physicians or other appropriate medical and nonmedical professionals shall be
consulted and involved in assessing the health and well-being of the child and determine
the appropriate medical treatment for the child; and
(vii) the responsibility to ensure that the child has access to medical care through either
medical insurance or medical assistance;
(11) the health records of the child including information available regarding:
(i) the names and addresses of the child's health care and dental care providers;
(ii) a record of the child's immunizations;
(iii) the child's known medical problems, including any known communicable diseases
as defined in section 144.4172, subdivision 2;
(iv) the child's medications; and
(v) any other relevant health care information such as the child's eligibility for medical
insurance or medical assistance;
(12) an independent living plan for a child 14 years of age or older, developed in
consultation with the child. The child may select one member of the case planning team to
be designated as the child's deleted text begin advisordeleted text end new text begin advisernew text end and to advocate with respect to the application
of the reasonable and prudent parenting standards in subdivision 14. The plan should include,
but not be limited to, the following objectives:
(i) educational, vocational, or employment planning;
(ii) health care planning and medical coverage;
(iii) transportation including, where appropriate, assisting the child in obtaining a driver's
license;
(iv) money management, including the responsibility of the responsible social services
agency to ensure that the child annually receives, at no cost to the child, a consumer report
as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies
in the report;
(v) planning for housing;
(vi) social and recreational skills;
(vii) establishing and maintaining connections with the child's family and community;
and
(viii) regular opportunities to engage in age-appropriate or developmentally appropriate
activities typical for the child's age group, taking into consideration the capacities of the
individual child;
(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic
and assessment information, specific services relating to meeting the mental health care
needs of the child, and treatment outcomes; and
(14) for a child 14 years of age or older, a signed acknowledgment that describes the
child's rights regarding education, health care, visitation, safety and protection from
exploitation, and court participation; receipt of the documents identified in section 260C.452;
and receipt of an annual credit report. The acknowledgment shall state that the rights were
explained in an age-appropriate manner to the child.
(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time of
placement of the child. The child shall also have the right to a guardian ad litem. If unable
to employ counsel from their own resources, the court shall appoint counsel upon the request
of the parent or parents or the child or the child's legal guardian. The parent or parents may
also receive assistance from any person or social services agency in preparation of the case
plan.
After the plan has been agreed upon by the parties involved or approved or ordered by
the court, the foster parents shall be fully informed of the provisions of the case plan and
shall be provided a copy of the plan.
Upon discharge from foster care, the parent, adoptive parent, or permanent legal and
physical custodian, deleted text begin as appropriate,deleted text end and the childdeleted text begin ,deleted text end if deleted text begin appropriatedeleted text end new text begin 14 years of age or oldernew text end ,
must be provided with a current copy of the child's health and education recorddeleted text begin .deleted text end new text begin and, for a
child who meets the conditions in subdivision 15, paragraph (b), the child's social and
medical history. A child younger than 14 years of age may be given a copy of the child's
health and education record and social and medical history, if appropriate and applicable
according to subdivision 15, paragraph (b).
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. 45.
Minnesota Statutes 2018, section 260C.212, subdivision 2, is amended to read:
Subd. 2.
Placement decisions based on best interests of the child.
(a) The policy of
the state of Minnesota is to ensure that the child's best interests are met by requiring an
individualized determination of the needs of the child and of how the selected placement
will serve the needs of the child being placed. The authorized child-placing agency shall
new text begin assess a noncustodial or nonadjudicated parent's capacity and willingness to provide for the
day-to-day care of a child pursuant to section 260C.219. Upon assessment, if a noncustodial
or nonadjudicated parent cannot provide for the day-to-day care of a child, the authorized
child-placing agency shall new text end place a child, released by court order or by voluntary release by
the parent or parents, in a family foster home selected by considering placement with relatives
and important friends in the following order:
(1) with an individual who is related to the child by blood, marriage, or adoptionnew text begin ,
including the legal parent, guardian, or custodian of the child's siblingnew text end ; or
(2) with an individual who is an important friend with whom the child has resided or
had significant contact.
For an Indian child, the agency shall follow the order of placement preferences in the Indian
Child Welfare Act of 1978, United States Code, title 25, section 1915.
(b) Among the factors the agency shall consider in determining the needs of the child
are the following:
(1) the child's current functioning and behaviors;
(2) the medical needs of the child;
(3) the educational needs of the child;
(4) the developmental needs of the child;
(5) the child's history and past experience;
(6) the child's religious and cultural needs;
(7) the child's connection with a community, school, and faith community;
(8) the child's interests and talents;
(9) the child's relationship to current caretakers, parents, siblings, and relatives;
(10) the reasonable preference of the child, if the court, or the child-placing agency in
the case of a voluntary placement, deems the child to be of sufficient age to express
preferences; and
(11) for an Indian child, the best interests of an Indian child as defined in section 260.755,
subdivision 2a.
(c) Placement of a child cannot be delayed or denied based on race, color, or national
origin of the foster parent or the child.
(d) Siblings should be placed together for foster care and adoption at the earliest possible
time unless it is documented that a joint placement would be contrary to the safety or
well-being of any of the siblings or unless it is not possible after reasonable efforts by the
responsible social services agency. In cases where siblings cannot be placed together, the
agency is required to provide frequent visitation or other ongoing interaction between
siblings unless the agency documents that the interaction would be contrary to the safety
or well-being of any of the siblings.
(e) Except for emergency placement as provided for in section 245A.035, the following
requirements must be satisfied before the approval of a foster or adoptive placement in a
related or unrelated home: (1) a completed background study under section 245C.08; and
(2) a completed review of the written home study required under section 260C.215,
subdivision 4, clause (5), or 260C.611, to assess the capacity of the prospective foster or
adoptive parent to ensure the placement will meet the needs of the individual child.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 46.
Minnesota Statutes 2018, section 260C.212, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Social and medical history. new text end
new text begin
(a) The commissioner shall develop forms for
the responsible social services agency to complete a child's social and medical history. The
responsible social services agency shall work with the child's birth family, foster family,
medical and treatment providers, and school to ensure each child has a detailed and up-to-date
social and medical history on the forms provided by the commissioner.
new text end
new text begin
(b) If the child continues in foster care, the responsible social services agency must begin
reasonable efforts to complete the child's social and medical history no later than the
permanency progress review hearing required in section 260C.204 or six months after the
child's placement in foster care, whichever occurs earlier.
new text end
new text begin
(c) A child's social and medical history must include background and health history
specific to the child, the child's birth parents, and the child's other birth relatives. Applicable
background and health information about the child includes the child's current health
condition, behavior, and demeanor; placement history; education history; sibling information;
and birth, medical, dental, and immunization information. Redacted copies of pertinent
records, assessments, and evaluations must be attached to the child's social and medical
history. Applicable background information about the child's birth parents and other birth
relatives includes general background information; education and employment histories;
physical and mental health histories; and reasons for the child's placement.
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. 47.
Minnesota Statutes 2018, section 260C.219, is amended to read:
260C.219 AGENCY RESPONSIBILITIES FOR PARENTS AND CHILDREN IN
PLACEMENT.
(a) When a child is in foster care, the responsible social services agency shall make
diligent efforts to identify, locate, and, where appropriate, offer services to both parents of
the child.
(1) The responsible social services agency shall assess whether a noncustodial or
nonadjudicated parent is willing and capable of providing for the day-to-day care of the
child temporarily or permanently. An assessment under this clause may include, but is not
limited to, obtaining information under section 260C.209. If after assessment, the responsible
social services agency determines that a noncustodial or nonadjudicated parent is willing
and capable of providing day-to-day care of the child, the responsible social services agency
may seek authority from the custodial parent or the court to have that parent assume
day-to-day care of the child. If a parent is not an adjudicated parent, the responsible social
services agency shall require the nonadjudicated parent to cooperate with paternity
establishment procedures as part of the case plan.
(2) If, after assessment, the responsible social services agency determines that the child
cannot be in the day-to-day care of either parent, the agency shall:
(i) prepare an out-of-home placement plan addressing the conditions that each parent
must meet before the child can be in that parent's day-to-day care; and
(ii) provide a parent who is the subject of a background study under section 260C.209
15 days' notice that it intends to use the study to recommend against putting the child with
that parent, and the court shall afford the parent an opportunity to be heard concerning the
study.
The results of a background study of a noncustodial parent shall not be used by the
agency to determine that the parent is incapable of providing day-to-day care of the child
unless the agency reasonably believes that placement of the child into the home of that
parent would endanger the child's health, safety, or welfare.
(3) If, after the provision of services following an out-of-home placement plan under
this section, the child cannot return to the care of the parent from whom the child was
removed or who had legal custody at the time the child was placed in foster care, the agency
may petition on behalf of a noncustodial parent to establish legal custody with that parent
under section 260C.515, subdivision 4. If paternity has not already been established, it may
be established in the same proceeding in the manner provided for under chapter 257.
(4) The responsible social services agency may be relieved of the requirement to locate
and offer services to both parents by the juvenile court upon a finding of good cause after
the filing of a petition under section 260C.141.
(b) The responsible social services agency shall give notice to the parent or guardian of
each child in foster care, other than a child in voluntary foster care for treatment under
chapter 260D, of the following information:
(1) that the child's placement in foster care may result in termination of parental rights
or an order permanently placing the child out of the custody of the parent, but only after
notice and a hearing as required under this chapter and the juvenile court rules;
(2) time limits on the length of placement and of reunification services, including the
date on which the child is expected to be returned to and safely maintained in the home of
the parent or parents or placed for adoption or otherwise permanently removed from the
care of the parent by court order;
(3) the nature of the services available to the parent;
(4) the consequences to the parent and the child if the parent fails or is unable to use
services to correct the circumstances that led to the child's placement;
(5) the first consideration for placement with relatives;
(6) the benefit to the child in getting the child out of foster care as soon as possible,
preferably by returning the child home, but if that is not possible, through a permanent legal
placement of the child away from the parent;
(7) when safe for the child, the benefits to the child and the parent of maintaining
visitation with the child as soon as possible in the course of the case and, in any event,
according to the visitation plan under this section; and
(8) the financial responsibilities and obligations, if any, of the parent or parents for the
support of the child during the period the child is in foster care.
(c) The responsible social services agency shall inform a parent considering voluntary
placement of a child under section 260C.227 of the following information:
(1) the parent and the child each has a right to separate legal counsel before signing a
voluntary placement agreement, but not to counsel appointed at public expense;
(2) the parent is not required to agree to the voluntary placement, and a parent who enters
a voluntary placement agreement may at any time request that the agency return the child.
If the parent so requests, the child must be returned within 24 hours of the receipt of the
request;
(3) evidence gathered during the time the child is voluntarily placed may be used at a
later time as the basis for a petition alleging that the child is in need of protection or services
or as the basis for a petition seeking termination of parental rights or other permanent
placement of the child away from the parent;
(4) if the responsible social services agency files a petition alleging that the child is in
need of protection or services or a petition seeking the termination of parental rights or other
permanent placement of the child away from the parent, the parent would have the right to
appointment of separate legal counsel and the child would have a right to the appointment
of counsel and a guardian ad litem as provided by law, and that counsel will be appointed
at public expense if they are unable to afford counsel; and
(5) the timelines and procedures for review of voluntary placements under section
260C.212, subdivision 3, and the effect the time spent in voluntary placement on the
scheduling of a permanent placement determination hearing under sections 260C.503 to
260C.521.
(d) When an agency accepts a child for placement, the agency shall determine whether
the child has had a physical examination by or under the direction of a licensed physician
within the 12 months immediately preceding the date when the child came into the agency's
care. If there is documentation that the child has had an examination within the last 12
months, the agency is responsible for seeing that the child has another physical examination
within one year of the documented examination and annually in subsequent years. If the
agency determines that the child has not had a physical examination within the 12 months
immediately preceding placement, the agency shall ensure that the child has an examination
within 30 days of coming into the agency's care and once a year in subsequent years.
(e) Whether under state guardianship or not, if a child leaves foster care by reason of
having attained the age of majority under state law, the child must be given at no cost a
copy of the child's social and medical history, as defined in section deleted text begin 259.43deleted text end new text begin 260C.212,
subdivision 15new text end , deleted text begin anddeleted text end new text begin including the child's health andnew text end education report.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 48.
Minnesota Statutes 2018, section 260C.451, subdivision 9, is amended to read:
Subd. 9.
Administrative or court review of placements.
(a) The court shall conduct
reviews at least annually to ensure the responsible social services agency is making
reasonable efforts to finalize the permanency plan for the childnew text begin , including reasonable efforts
to finalize an adoption, if applicablenew text end .
(b) The court shall find that the responsible social services agency is making reasonable
efforts to finalize the permanency plan for the child when the responsible social services
agency:
(1) provides appropriate support to the child and foster care provider to ensure continuing
stability and success in placement;
(2) works with the child to plan for transition to adulthood and assists the child in
demonstrating progress in achieving related goals;
(3) works with the child to plan for independent living skills and assists the child in
demonstrating progress in achieving independent living goals; and
(4) prepares the child for independence according to sections 260C.203, paragraph (d),
and 260C.452, subdivision 4.
(c) The responsible social services agency must ensure that an administrative review
that meets the requirements of this section and section 260C.203 is completed at least six
months after each of the court's annual reviews.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 49.
Minnesota Statutes 2018, section 260C.503, subdivision 2, is amended to read:
Subd. 2.
Termination of parental rights.
(a) The responsible social services agency
must ask the county attorney to immediately file a termination of parental rights petition
when:
(1) the child has been subjected to egregious harm as defined in section 260C.007,
subdivision 14;
(2) the child is determined to be the sibling of a child who was subjected to egregious
harm;
(3) the child is an abandoned infant as defined in section 260C.301, subdivision 2,
paragraph (a), clause (2);
(4) the child's parent has lost parental rights to another child through an order involuntarily
terminating the parent's rights;
(5) the parent has committed sexual abuse as defined in section 626.556, subdivision 2,
against the child or another child of the parent;
(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or
(7) another child of the parent is the subject of an order involuntarily transferring
permanent legal and physical custody of the child to a relative under this chapter or a similar
law of another jurisdiction;
The county attorney shall file a termination of parental rights petition unless the conditions
of paragraph (d) are met.
(b) When the termination of parental rights petition is filed under this subdivision, the
responsible social services agency shall identify, recruit, and approve an adoptive family
for the child. If a termination of parental rights petition has been filed by another party, the
responsible social services agency shall be joined as a party to the petition.
(c) If criminal charges have been filed against a parent arising out of the conduct alleged
to constitute egregious harm, the county attorney shall determine which matter should
proceed to trial first, consistent with the best interests of the child and subject to the
defendant's right to a speedy trial.
(d) The requirement of paragraph (a) does not apply if the responsible social services
agency and the county attorney determine and file with the court:
(1) a petition for transfer of permanent legal and physical custody to a relative under
sections 260C.505 and 260C.515, subdivision deleted text begin 3deleted text end new text begin 4new text end , including a determination that adoption
is not in the child's best interests and that transfer of permanent legal and physical custody
is in the child's best interests; or
(2) a petition under section 260C.141 alleging the child, and where appropriate, the
child's siblings, to be in need of protection or services accompanied by a case plan prepared
by the responsible social services agency documenting a compelling reason why filing a
termination of parental rights petition would not be in the best interests of the child.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 50.
Minnesota Statutes 2018, section 260C.515, subdivision 3, is amended to read:
Subd. 3.
Guardianship; commissioner.
The court may order guardianship to the
commissioner of human services under the following procedures and conditions:
(1) there is an identified prospective adoptive parent agreed to by the responsible social
services agency having legal custody of the child pursuant to court order under this chapter
and that prospective adoptive parent has agreed to adopt the child;
(2) the court accepts the parent's voluntary consent to adopt in writing on a form
prescribed by the commissioner, executed before two competent witnesses and confirmed
by the consenting parent before the court or executed before the court. The consent shall
contain notice that consent given under this chapter:
(i) is irrevocable upon acceptance by the court unless fraud is established and an order
is issued permitting revocation as stated in clause (9) unless the matter is governed by the
Indian Child Welfare Act, United States Code, title 25, section 1913(c); and
(ii) will result in an order that the child is under the guardianship of the commissioner
of human services;
(3) a consent executed and acknowledged outside of this state, either in accordance with
the law of this state or in accordance with the law of the place where executed, is valid;
(4) the court must review the matter at least every 90 days under section 260C.317;
(5) a consent to adopt under this subdivision vests guardianship of the child with the
commissioner of human services and makes the child a ward of the commissioner of human
services under section 260C.325;
(6) the court must forward to the commissioner a copy of the consent to adopt, together
with a certified copy of the order transferring guardianship to the commissioner;
(7) if an adoption is not finalized by the identified prospective adoptive parent within
six months of the execution of the consent to adopt under this clause, the responsible social
services agency shall pursue adoptive placement in another home unless the court finds in
a hearing under section 260C.317 that the failure to finalize is not due to either an action
or a failure to act by the prospective adoptive parent;
(8) notwithstanding clause (7), the responsible social services agency must pursue
adoptive placement in another home as soon as the agency determines that finalization of
the adoption with the identified prospective adoptive parent is not possible, that the identified
prospective adoptive parent is not willing to adopt the child, or that the identified prospective
adoptive parent is not cooperative in completing the steps necessary to finalize the adoptionnew text begin .
The court may order a termination of parental rights under subdivision 2new text end ; and
(9) unless otherwise required by the Indian Child Welfare Act, United States Code, title
25, section 1913(c), a consent to adopt executed under this section shall be irrevocable upon
acceptance by the court except upon order permitting revocation issued by the same court
after written findings that consent was obtained by fraud.
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 260C.515, subdivision 4, is amended to read:
Subd. 4.
Custody to relative.
The court may order permanent legal and physical custody
to a fit and willing relative in the best interests of the child according to the following
requirements:
(1) an order for transfer of permanent legal and physical custody to a relative shall only
be made after the court has reviewed the suitability of the prospective legal and physical
custodian;
(2) in transferring permanent legal and physical custody to a relative, the juvenile court
shall follow the standards applicable under this chapter and chapter 260, and the procedures
in the Minnesota Rules of Juvenile Protection Procedure;
(3) a transfer of legal and physical custody includes responsibility for the protection,
education, care, and control of the child and decision making on behalf of the child;
(4) a permanent legal and physical custodian may not return a child to the permanent
care of a parent from whom the court removed custody without the court's approval and
without notice to the responsible social services agency;
(5) the social services agency may file a petition naming a fit and willing relative as a
proposed permanent legal and physical custodian. A petition for transfer of permanent legal
and physical custody to a relative who is not a parent shall be accompanied by a kinship
placement agreement under section 256N.22, subdivision 2, between the agency and proposed
permanent legal and physical custodian;
(6) another party to the permanency proceeding regarding the child may file a petition
to transfer permanent legal and physical custody to a relative. The petition must include
facts upon which the court can make the determination required under clause (7) and must
be filed not later than the date for the required admit-deny hearing under section 260C.507;
or if the agency's petition is filed under section 260C.503, subdivision 2, the petition must
be filed not later than 30 days prior to the trial required under section 260C.509;
(7) where a petition is for transfer of permanent legal and physical custody to a relative
who is not a parent, the court must find that:
(i) transfer of permanent legal and physical custody and receipt of Northstar kinship
assistance under chapter 256N, when requested and the child is eligible, are in the child's
best interests;
(ii) adoption is not in the child's best interests based on the determinations in the kinship
placement agreement required under section 256N.22, subdivision 2;
(iii) the agency made efforts to discuss adoption with the child's parent or parents, or
the agency did not make efforts to discuss adoption and the reasons why efforts were not
made; and
(iv) there are reasons to separate siblings during placement, if applicabledeleted text begin ;deleted text end new text begin . The court
may find there is a reason to separate siblings when the court finds both (A) that the
responsible social services agency made reasonable efforts to place siblings together, and
(B) that placing siblings together is not in the best interest of one or more of the siblings;
new text end
(8) the court may defer finalization of an order transferring permanent legal and physical
custody to a relative when deferring finalization is necessary to determine eligibility for
Northstar kinship assistance under chapter 256N;
(9) the court may finalize a permanent transfer of physical and legal custody to a relative
regardless of eligibility for Northstar kinship assistance under chapter 256N; deleted text begin and
deleted text end
(10) the juvenile court may maintain jurisdiction over the responsible social services
agency, the parents or guardian of the child, the child, and the permanent legal and physical
custodian for purposes of ensuring appropriate services are delivered to the child and
permanent legal custodian for the purpose of ensuring conditions ordered by the court related
to the care and custody of the child are metdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(11) after finalization of the transfer of permanent legal and physical custody to a relative
who is not a parent, the court administrator must mail a copy of the final order to the
commissioner of human services.
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. 52.
Minnesota Statutes 2018, section 260C.605, subdivision 1, is amended to read:
Subdivision 1.
Requirements.
(a) Reasonable efforts to finalize the adoption of a child
under the guardianship of the commissioner shall be made by the responsible social services
agency responsible for permanency planning for the child.
(b) Reasonable efforts to make a placement in a home according to the placement
considerations under section 260C.212, subdivision 2, with a relative or foster parent who
will commit to being the permanent resource for the child in the event the child cannot be
reunified with a parent are required under section 260.012 and may be made concurrently
with reasonable, or if the child is an Indian child, active efforts to reunify the child with the
parent.
(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the
child is in foster care under this chapter, but not later than the hearing required under section
260C.204.
(d) Reasonable efforts to finalize the adoption of the child includenew text begin but are not limited
tonew text end :
(1) using age-appropriate engagement strategies to plan for adoption with the child;
(2) deleted text begin identifying an appropriate prospective adoptive parent for the child bydeleted text end updating the
child's identified needs using the factors in section 260C.212, subdivision 2;
(3) deleted text begin making an adoptive placement that meets the child's needs by:
deleted text end
deleted text begin (i)deleted text end completing or updating the relative search required under section 260C.221 and giving
notice of the need for an adoptive home for the child tonew text begin a child's relative whonew text end :
deleted text begin (A) relatives who havedeleted text end new text begin (i)new text end kept the agency or the court apprised of deleted text begin theirdeleted text end new text begin the relative'snew text end
whereabouts and who deleted text begin havedeleted text end new text begin hasnew text end indicated an interest in adopting the child; or
deleted text begin (B) relatives of the child who aredeleted text end new text begin (ii) isnew text end located in an updated searchdeleted text begin ;deleted text end new text begin .
new text end
deleted text begin (ii)deleted text end An updated search is required whenever:
(A) there is no identified prospective adoptive placement for the child notwithstanding
a finding by the court that the agency made diligent efforts under section 260C.221, in a
hearing required under section 260C.202;
(B) the child is removed from the home of an adopting parent; or
(C) the court determines a relative search by the agency is in the best interests of the
child;
deleted text begin (iii)deleted text end new text begin (4)new text end engaging the child's foster parent and the child's deleted text begin relativesdeleted text end new text begin relativenew text end identified as
an adoptive resource during the search conducted under section 260C.221, to commit to
being the prospective adoptive parent of the child; deleted text begin or
deleted text end
deleted text begin (iv)deleted text end new text begin (5)new text end when there is no identified prospective adoptive parent:
deleted text begin (A)deleted text end new text begin (i)new text end registering the child on the state adoption exchange as required in section 259.75
unless the agency documents to the court an exception to placing the child on the state
adoption exchange reported to the commissioner;
deleted text begin (B)deleted text end new text begin (ii)new text end reviewing all families with approved adoption home studies associated with the
responsible social services agency;
deleted text begin (C)deleted text end new text begin (iii)new text end presenting the child to adoption agencies and adoption personnel who may assist
with finding an adoptive home for the child;
deleted text begin (D)deleted text end new text begin (iv)new text end using deleted text begin newspapers and otherdeleted text end media new text begin as appropriate new text end to promote the particular child;
deleted text begin (E)deleted text end new text begin (v)new text end using a private agency under grant contract with the commissioner to provide
adoption services for intensive child-specific recruitment efforts; and
deleted text begin (F)deleted text end new text begin (vi)new text end making any other efforts or using any other resources reasonably calculated to
identify a prospective adoption parent for the child;
deleted text begin (4)deleted text end new text begin (6)new text end updating and completing the social and medical history required under sections
deleted text begin 259.43deleted text end new text begin 260C.212, subdivision 15,new text end and 260C.609;
deleted text begin (5)deleted text end new text begin (7)new text end making, and keeping updated, appropriate referrals required by section 260.851,
the Interstate Compact on the Placement of Children;
deleted text begin (6)deleted text end new text begin (8)new text end giving notice regarding the responsibilities of an adoptive parent to any prospective
adoptive parent as required under section deleted text begin 259.35deleted text end new text begin 260C.611, paragraph (b)new text end ;
deleted text begin (7)deleted text end new text begin (9)new text end offering the adopting parent the opportunity to apply for or decline adoption
assistance under chapter deleted text begin 259Adeleted text end new text begin 256Nnew text end ;
deleted text begin (8)deleted text end new text begin (10)new text end certifying the child for adoption assistance, assessing the amount of adoption
assistance, and ascertaining the status of the commissioner's decision on the level of payment
if the adopting parent has applied for adoption assistance;
deleted text begin (9)deleted text end new text begin (11)new text end placing the child with siblings. If the child is not placed with siblings, the agency
must document reasonable efforts to place the siblings together, as well as the reason for
separation. The agency may not cease reasonable efforts to place siblings together for final
adoption until the court finds further reasonable efforts would be futile or that placement
together for purposes of adoption is not in the best interests of one of the siblings; and
deleted text begin (10)deleted text end new text begin (12)new text end working with the adopting parent to file a petition to adopt the child and with
the court administrator to obtain a timely hearing to finalize the adoption.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 53.
Minnesota Statutes 2018, section 260C.607, subdivision 6, is amended to read:
Subd. 6.
Motion and hearing to order adoptive placement.
(a) At any time after the
district court orders the child under the guardianship of the commissioner of human services,
but not later than 30 days after receiving notice required under section 260C.613, subdivision
1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's
foster parent may file a motion for an order for adoptive placement of a child who is under
the guardianship of the commissioner if the relative or the child's foster parent:
(1) has an adoption home study under section deleted text begin 259.41deleted text end new text begin 260C.611new text end approving the relative
or foster parent for adoption and has been a resident of Minnesota for at least six months
before filing the motion; the court may waive the residency requirement for the moving
party if there is a reasonable basis to do so; or
(2) is not a resident of Minnesota, but has an approved adoption home study by an agency
licensed or approved to complete an adoption home study in the state of the individual's
residence and the study is filed with the motion for adoptive placement.
(b) The motion shall be filed with the court conducting reviews of the child's progress
toward adoption under this section. The motion and supporting documents must make a
prima facie showing that the agency has been unreasonable in failing to make the requested
adoptive placement. The motion must be served according to the requirements for motions
under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all
individuals and entities listed in subdivision 2.
(c) If the motion and supporting documents do not make a prima facie showing for the
court to determine whether the agency has been unreasonable in failing to make the requested
adoptive placement, the court shall dismiss the motion. If the court determines a prima facie
basis is made, the court shall set the matter for evidentiary hearing.
(d) At the evidentiary hearing, the responsible social services agency shall proceed first
with evidence about the reason for not making the adoptive placement proposed by the
moving party. The moving party then has the burden of proving by a preponderance of the
evidence that the agency has been unreasonable in failing to make the adoptive placement.
(e) At the conclusion of the evidentiary hearing, if the court finds that the agency has
been unreasonable in failing to make the adoptive placement and that the relative or the
child's foster parent is the most suitable adoptive home to meet the child's needs using the
factors in section 260C.212, subdivision 2, paragraph (b), the court may order the responsible
social services agency to make an adoptive placement in the home of the relative or the
child's foster parent.
(f) If, in order to ensure that a timely adoption may occur, the court orders the responsible
social services agency to make an adoptive placement under this subdivision, the agency
shall:
(1) make reasonable efforts to obtain a fully executed adoption placement agreement;
(2) work with the moving party regarding eligibility for adoption assistance as required
under chapter deleted text begin 259Adeleted text end new text begin 256Nnew text end ; and
(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval
of the adoptive placement through the Interstate Compact on the Placement of Children.
(g) Denial or granting of a motion for an order for adoptive placement after an evidentiary
hearing is an order which may be appealed by the responsible social services agency, the
moving party, the child, when age ten or over, the child's guardian ad litem, and any
individual who had a fully executed adoption placement agreement regarding the child at
the time the motion was filed if the court's order has the effect of terminating the adoption
placement agreement. An appeal shall be conducted according to the requirements of the
Rules of Juvenile Protection Procedure.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 54.
Minnesota Statutes 2018, section 260C.609, is amended to read:
260C.609 SOCIAL AND MEDICAL HISTORY.
deleted text begin
(a) The responsible social services agency shall work with the birth family of the child,
foster family, medical and treatment providers, and the child's school to ensure there is a
detailed, thorough, and currently up-to-date social and medical history of the child as required
under section 259.43 on the forms required by the commissioner.
deleted text end
deleted text begin
(b) When the child continues in foster care, the agency's reasonable efforts to complete
the history shall begin no later than the permanency progress review hearing required under
section 260C.204 or six months after the child's placement in foster care.
deleted text end
deleted text begin (c)deleted text end new text begin (a)new text end The agency shall thoroughly discuss the child's history with the deleted text begin adoptingdeleted text end new text begin
prospective adoptivenew text end parent of the child and shall give anew text begin redactednew text end copy of the report of the
child's social and medical history new text begin including redacted attachments as described in section
260C.212, subdivision 15, new text end to the deleted text begin adoptingdeleted text end new text begin prospective adoptivenew text end parent.new text begin If the prospective
adoptive parent does not pursue adoption of the child, the prospective adoptive parent must
return to the agency the child's social and medical history including redacted attachments.new text end
A new text begin redacted new text end copy of the child's social and medical history may also be given to the childdeleted text begin , as
appropriatedeleted text end new text begin according to section 260C.212, subdivision 1new text end .
deleted text begin (d)deleted text end new text begin (b)new text end The report shall not include information that identifies birth relatives. Redacted
copies of all the child's relevant evaluations, assessments, and records must be attached to
the social and medical history.
new text begin
(c) The agency must: (1) submit the child's social and medical history to the Department
of Human Services at the time the adoption placement agreement is submitted; and (2) file
the child's social and medical history with the court when the adoption petition is filed.
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. 55.
Minnesota Statutes 2018, section 260C.611, is amended to read:
260C.611 ADOPTION STUDY REQUIRED.
(a) An adoption study under section 259.41 approving placement of the child in the
home of the prospective adoptive parent shall be completed before placing any child under
the guardianship of the commissioner in a home for adoption. If a prospective adoptive
parent has a current child foster care license under chapter 245A and is seeking to adopt a
foster child who is placed in the prospective adoptive parent's home and is under the
guardianship of the commissioner according to section 260C.325, subdivision 1, the child
foster care home study meets the requirements of this section for an approved adoption
home study if:
(1) the written home study on which the foster care license was based is completed in
the commissioner's designated format, consistent with the requirements in sections 259.41,
subdivision 2; and 260C.215, subdivision 4, clause (5); and Minnesota Rules, part 2960.3060,
subpart 4;
(2) the background studies on each prospective adoptive parent and all required household
members were completed according to section 245C.33;
(3) the commissioner has not issued, within the last three years, a sanction on the license
under section 245A.07 or an order of a conditional license under section 245A.06; and
(4) the legally responsible agency determines that the individual needs of the child are
being met by the prospective adoptive parent through an assessment under section 256N.24,
subdivision 2, or a documented placement decision consistent with section 260C.212,
subdivision 2.
new text begin
(b) Before investigating the suitability of a prospective adoptive parent for a child under
guardianship of the commissioner, a child-placing agency shall give the prospective adoptive
parent the following written notice in all capital letters at least one-eighth inch high:
"Minnesota Statutes, section 260C.635, provides that upon legally adopting a child under
guardianship of the commissioner, an adoptive parent assumes all the rights and
responsibilities of a birth parent. The responsibilities include providing for the child's
financial support and caring for the child's health and emotional and behavioral problems.
Except for a subsidized adoption under Minnesota Statutes, chapter 256N, or any other
provision of law that expressly applies to an adoptive parent and child, an adoptive parent
is not eligible for state or federal financial subsidies aside from those that a birth parent
would be eligible to receive for a child. An adoptive parent may not terminate the adoptive
parent's parental rights to a legally adopted child for a reason that would not apply to a birth
parent seeking to terminate rights to a child."
new text end
deleted text begin (b)deleted text end new text begin (c)new text end If a prospective adoptive parent has previously held a foster care license or
adoptive home study, any update necessary to the foster care license, or updated or new
adoptive home study, if not completed by the licensing authority responsible for the previous
license or home study, shall include collateral information from the previous licensing or
approving agency, if available.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 56.
Minnesota Statutes 2018, section 260C.613, subdivision 6, is amended to read:
Subd. 6.
Death notification.
(a) The agency shall inform the adoptive parents that the
adoptive parents of an adopted child under age 19 or an adopted person age 19 or older may
maintain a current address on file with the agency and indicate a desire to be notified if the
agency receives information of the death of a birth parent. The agency shall notify birth
parents of the child's death and the cause of death, if known, provided that the birth parents
desire notice and maintain current addresses on file with the agency. The agency shall inform
birth parents entitled to notice under section deleted text begin 259.27deleted text end new text begin 259.49new text end that they may designate
individuals to notify the agency if a birth parent dies and that the agency receiving
information of the birth parent's death will share the information with adoptive parents, if
the adopted person is under age 19, or an adopted person age 19 or older who has indicated
a desire to be notified of the death of a birth parent and who maintains a current address on
file with the agency.
(b) Notice to a birth parent that a child has died or to the adoptive parents or an adopted
person age 19 or older that a birth parent has died shall be provided by an employee of the
agency through personal and confidential contact, but not by mail.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 57.
Minnesota Statutes 2018, section 260C.615, subdivision 1, is amended to read:
Subdivision 1.
Duties.
(a) For any child who is under the guardianship of the
commissioner, the commissioner has the exclusive rights to consent to:
(1) the medical care plan for the treatment of a child who is at imminent risk of death
or who has a chronic disease that, in a physician's judgment, will result in the child's death
in the near future including a physician's order not to resuscitate or intubate the child; and
(2) the child donating a part of the child's body to another person while the child is living;
the decision to donate a body part under this clause shall take into consideration the child's
wishes and the child's culture.
(b) In addition to the exclusive rights under paragraph (a), the commissioner has a duty
to:
(1) process any complete and accurate request for home study and placement through
the Interstate Compact on the Placement of Children under section 260.851;
(2) process any complete and accurate application for adoption assistance forwarded by
the responsible social services agency according to deleted text begin chapterdeleted text end new text begin chaptersnew text end new text begin 256N andnew text end 259A;
(3) deleted text begin complete the execution ofdeleted text end new text begin review and processnew text end an adoption placement agreement
forwarded to the commissioner by the responsible social services agency and return it to
the agency in a timely fashion; and
(4) maintain records as required in chapter 259.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 58.
Minnesota Statutes 2018, section 260C.623, subdivision 3, is amended to read:
Subd. 3.
Requirements of petition.
(a) The petition shall be captioned in the legal name
of the child as that name is reflected on the child's birth record prior to adoption and shall
be entitled "Petition to Adopt Child under the Guardianship of the Commissioner of Human
Services." The actual name of the child shall be supplied to the court by the responsible
social services agency if unknown to the individual with whom the agency has made the
adoptive placement.
(b) The adoption petition shall be verified as required in section 260C.141, subdivision
4, and, if filed by the responsible social services agency, signed and approved by the county
attorney.
(c) The petition shall state:
(1) the full name, age, and place of residence of the adopting parent;
(2) if the adopting parents are married, the date and place of marriage;
(3) the date the new text begin child was physically placed in the home of the new text end adopting parent deleted text begin acquired
physical custody of the childdeleted text end new text begin , if applicablenew text end ;
(4) the date of the adoptive placement by the responsible social services agency;
(5) the date of the birth of the child, if known, and the county, state, and country where
born;
(6) the name to be given the child, if a change of name is desired;
(7) the description and value of any real or personal property owned by the child;
(8) the relationship of the adopting parent to the child prior to adoptive placement, if
any;
(9) whether the Indian Child Welfare Act does or does not apply; and
(10) the name and address of:
(i) the child's guardian ad litem;
(ii) the adoptee, if age ten or older;
(iii) the child's Indian tribe, if the child is an Indian child; and
(iv) the responsible social services agency.
(d) A petition may ask for the adoption of two or more children.
(e) If a petition is for adoption by a married person, both spouses must sign the petition
indicating willingness to adopt the child and the petition must ask for adoption by both
spouses unless the court approves adoption by only one spouse when spouses do not reside
together or for other good cause shown.
(f) If the petition is for adoption by a person residing outside the state, the adoptive
placement must have been approved by the state where the person is a resident through the
Interstate Compact on the Placement of Children, sections 260.851 to 260.92.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 59.
Minnesota Statutes 2018, section 260C.623, subdivision 4, is amended to read:
Subd. 4.
Attachments to the petition.
The following must be filed with the petition:
(1) the adoption study report required under section deleted text begin 259.41deleted text end new text begin 260C.611new text end ;
(2) the social and medical history required under deleted text begin sections 259.43 anddeleted text end new text begin section new text end 260C.609;
and
(3) a document prepared by the petitioner that establishes who must be given notice
under section 260C.627, subdivision 1, that includes the names and mailing addresses of
those to be served by the court administrator.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 60.
Minnesota Statutes 2018, section 260C.625, is amended to read:
260C.625 DOCUMENTS FILED BY SOCIAL SERVICES AGENCY.
(a) The following shall be filed new text begin with the court new text end by the responsible social services agency
prior to finalization of the adoption:
(1) deleted text begin a certifieddeleted text end new text begin an electronicnew text end copy of the child's new text begin certified new text end birth record;
(2) deleted text begin a certifieddeleted text end new text begin an electronicnew text end copy of the new text begin certified new text end findings and order terminating parental
rights or order accepting the parent's consent to adoption under section 260C.515, subdivision
3, and for guardianship to the commissioner;
(3) a copy of any communication or contact agreement under section 260C.619;
(4) certification that the Minnesota Fathers' Adoption Registry has been searched which
requirement may be met according to the requirements of the Minnesota Rules of Adoption
Procedure, Rule 32.01, subdivision 2;
(5) new text begin an electronic copy of new text end the original of each consent to adoption required, if any, unless
the original was filed in the permanency proceeding conducted under section 260C.515,
subdivision 3, and the order filed under clause (2) has a copy of the consent attached; and
(6) the postplacement assessment report required under section 259.53, subdivision 2.
(b) The responsible social services agency shall provide any known aliases of the child
to the court.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 61.
Minnesota Statutes 2018, section 260C.629, subdivision 2, is amended to read:
Subd. 2.
Required documents.
In order to issue a decree for adoption and enter judgment
accordingly, the court must have the following documents in the record:
(1) new text begin an electronic copy of new text end the original birth record of the child;
(2) an adoption study report including a background study required under section deleted text begin 259.41deleted text end new text begin
260C.611new text end ;
(3) deleted text begin adeleted text end new text begin an electronic copy of thenew text end certified deleted text begin copy of thedeleted text end findings and order terminating parental
rights or order accepting the parent's consent to adoption under section 260C.515, subdivision
3, and for guardianship to the commissioner;
(4) any consents required under subdivision 1;
(5) the child's social and medical history under section 260C.609;
(6) the postplacement assessment report required under section 259.53, subdivision 2,
unless waived by the court on the record at a hearing under section 260C.607; and
(7) a report from the child's guardian ad litem.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 62.
Minnesota Statutes 2018, section 518A.53, subdivision 11, is amended to read:
Subd. 11.
Lump-sum payments.
Before transmittal to the obligor of a lump-sum payment
of $500 or more including, but not limited to, severance pay, accumulated sick pay, vacation
pay, bonuses, commissions, or other pay or benefits, a payor of funds:
(1) who has been served with an order for or notice of income withholding under this
section shall:
(i) notify the public authority of the lump-sum payment that is to be paid to the obligor;
(ii) hold the lump-sum payment for 30 days after the date on which the lump-sum payment
would otherwise have been paid to the obligor, notwithstanding sections 176.221, 176.225,
176.521, 181.08, 181.101, 181.11, 181.13, and 181.145; and
(iii) upon order of the court, and after a showing of past willful nonpayment of support,
pay any specified amount of the lump-sum payment to the public authority for future support;
or
(2) shall pay the lessor of the amount of the lump-sum payment or the total amount of
the judgment and arrearages upon service by United States mail of a sworn affidavit from
the public authority or a court order that includes the following information:
(i) that a judgment entered pursuant to section 548.091, subdivision 1a, exists against
the obligor, or that other support arrearages exist;
(ii) the current balance of the judgment or arrearage; and
(iii) that a portion of the judgment or arrearage remains unpaid.
deleted text begin
The Consumer Credit Protection Act, title 15 of the United States Code, section 1673(b),
does not apply to lump-sum payments.
deleted text end
Sec. 63.
Minnesota Statutes 2018, section 518A.685, is amended to read:
518A.685 CONSUMER REPORTING AGENCY; REPORTING ARREARS.
(a) If a public authority determines that an obligor has not paid the current monthly
support obligation plus any required arrearage payment for three months, the public authority
must report this information to a consumer reporting agency.
(b) Before reporting that an obligor is in arrears for court-ordered child support, the
public authority must:
(1) provide written notice to the obligor that the public authority intends to report the
arrears to a consumer reporting agency; and
(2) mail the written notice to the obligor's last known mailing address at least 30 days
before the public authority reports the arrears to a consumer reporting agency.
(c) The obligor may, within 21 days of receipt of the notice, do the following to prevent
the public authority from reporting the arrears to a consumer reporting agency:
(1) pay the arrears in full; or
(2) request an administrative review. An administrative review is limited to issues of
mistaken identity, a pending legal action involving the arrears, or an incorrect arrears balance.
deleted text begin
(d) If the public authority has reported that an obligor is in arrears for court-ordered
child support and subsequently determines that the obligor has paid the court-ordered child
support arrears in full, or is paying the current monthly support obligation plus any required
arrearage payment, the public authority must report to the consumer reporting agency that
the obligor is currently paying child support as ordered by the court.
deleted text end
deleted text begin (e)deleted text end new text begin (d)new text end A public authority that reports arrearage information under this section must
make monthly reports to a consumer reporting agency. The monthly report must be consistent
with credit reporting industry standards for child support.
deleted text begin (f)deleted text end new text begin (e)new text end For purposes of this section, "consumer reporting agency" has the meaning given
in section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f).
Sec. 64.
new text begin
[518A.80] MOTION TO TRANSFER TO TRIBAL COURT.
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 terms defined in this
subdivision have the meanings given them.
new text end
new text begin
(b) "Case participant" means a party to the case that is a natural person.
new text end
new text begin
(c) "District court" means a district court of the state of Minnesota.
new text end
new text begin
(d) "Party" means a person or entity named or admitted as a party or seeking to be
admitted as a party in the district court action, including the county IV-D agency, whether
or not named in the caption.
new text end
new text begin
(e) "Tribal court" means a tribal court of a federally recognized Indian tribe located in
Minnesota that is receiving funding from the federal government to operate a child support
program under United States Code, title 42, chapter 7, subchapter IV, part D, sections 654
to 669b.
new text end
new text begin
(f) "Tribal IV-D agency" has the meaning given to "tribal IV-D agency" in Code of
Federal Regulations, title 45, part 309.05.
new text end
new text begin
(g) "Title IV-D child support case" has the meaning given to "IV-D case" in section
518A.26, subdivision 10.
new text end
new text begin Subd. 2. new text end
new text begin Actions eligible for transfer. new text end
new text begin
For purposes of this section, a postjudgment
child support, custody, or parenting time action is eligible for transfer to tribal court. A child
protection action or a dissolution action involving a child is not eligible for transfer to tribal
court pursuant to this section.
new text end
new text begin Subd. 3. new text end
new text begin Motion to transfer. new text end
new text begin
(a) A party's or tribal IV-D agency's motion to transfer to
tribal court shall state and allege:
new text end
new text begin
(1) the address of each case participant;
new text end
new text begin
(2) the tribal affiliation of each case participant, if any;
new text end
new text begin
(3) the name, tribal affiliation, if any, and date of birth of each living minor or dependent
child of a case participant who is subject to the action; and
new text end
new text begin
(4) the legal and factual basis for the court to make a finding that there is concurrent
jurisdiction in the case.
new text end
new text begin
(b) A party or tribal IV-D agency bringing a motion to transfer to tribal court must file
with the court and serve the required documents on each party and the tribal IV-D agency,
regardless of whether the tribal IV-D agency is a party.
new text end
new text begin
(c) A party's or tribal IV-D agency's motion to transfer must be accompanied by an
affidavit setting forth facts in support of its motion.
new text end
new text begin
(d) When a motion to transfer is not brought by the tribal IV-D agency, an affidavit of
the tribal IV-D agency stating whether the tribal IV-D agency provides services to a party
must be filed and served on each party within 15 days from the date of service of the motion.
new text end
new text begin Subd. 4. new text end
new text begin Order to transfer to tribal court. new text end
new text begin
(a) Unless a hearing is held under subdivision
6, upon motion of a party or a tribal IV-D agency, a district court must transfer a
postjudgment child support, custody, or parenting time action to a tribal court when the
district court finds:
new text end
new text begin
(1) the district court and tribal court have concurrent jurisdiction;
new text end
new text begin
(2) a case participant is receiving services from the tribal IV-D agency; and
new text end
new text begin
(3) no party or tribal IV-D agency files and serves a timely objection to the transfer.
new text end
new text begin
(b) When the requirements of this subdivision are satisfied, the district court is not
required to hold a hearing. The district court's order transferring the action to tribal court
must contain written findings on each requirement of this subdivision.
new text end
new text begin Subd. 5. new text end
new text begin Objection to motion to transfer. new text end
new text begin
(a) To object to a motion to transfer to a
tribal court, a party or tribal IV-D agency must file with the court and serve on each party
and the tribal IV-D agency a responsive motion objecting to the motion to transfer within
30 days from the date of service of the motion to transfer.
new text end
new text begin
(b) If a party or tribal IV-D agency files with the court and properly serves a timely
objection to the motion to transfer to a tribal court, the district court must conduct a hearing.
new text end
new text begin Subd. 6. new text end
new text begin Hearing. new text end
new text begin
If a hearing is held under this section, the district court must evaluate
and make written findings on all relevant factors, including:
new text end
new text begin
(1) whether an issue requires interpretation of tribal law, including the tribal constitution,
statutes, bylaws, ordinances, resolutions, treaties, or case law;
new text end
new text begin
(2) whether the action involves tribal traditional or cultural matters;
new text end
new text begin
(3) whether the tribe is a party;
new text end
new text begin
(4) whether tribal sovereignty, jurisdiction, or territory is an issue;
new text end
new text begin
(5) the tribal membership status of each case participant;
new text end
new text begin
(6) where the claim arises;
new text end
new text begin
(7) the location of the residence of each case participant and the child;
new text end
new text begin
(8) whether the parties have by contract chosen a forum or the law to be applied in the
event of a dispute;
new text end
new text begin
(9) the timing of any motion to transfer to tribal court, considering each party's and the
court's expenditure of time and resources, and the district court's scheduling order;
new text end
new text begin
(10) the court in which the action can be heard and decided most expeditiously;
new text end
new text begin
(11) the burdens on each party, including cost, access to and admissibility of evidence,
and matters of procedure; and
new text end
new text begin
(12) any other factor the court determines relevant.
new text end
new text begin Subd. 7. new text end
new text begin Future exercise of jurisdiction. new text end
new text begin
Nothing in this section shall be construed to
limit the district court's exercise of jurisdiction where the tribal court waives jurisdiction,
transfers the action back to district court, or otherwise declines to exercise jurisdiction over
the action.
new text end
new text begin Subd. 8. new text end
new text begin Transfer to Red Lake Nation Tribal Court. new text end
new text begin
When a party or tribal IV-D
agency brings a motion to transfer to the Red Lake Nation Tribal Court, the court must
transfer the action if the case participants and child resided within the boundaries of the
Red Lake Reservation for the preceding six months.
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. 65.
Minnesota Statutes 2018, section 626.556, subdivision 2, is amended to read:
Subd. 2.
Definitions.
As used in this section, the following terms have the meanings
given them unless the specific content indicates otherwise:
(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence
or event which:
(1) is not likely to occur and could not have been prevented by exercise of due care; and
(2) if occurring while a child is receiving services from a facility, happens when the
facility and the employee or person providing services in the facility are in compliance with
the laws and rules relevant to the occurrence or event.
(b) "Commissioner" means the commissioner of human services.
(c) "Facility" means:
(1) a licensed or unlicensed day care facilitynew text begin or providernew text end , certified license-exempt child
care center, residential facility, agency, hospital, sanitarium, or other facility or institution
required to be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16,
or chapter 144Hdeleted text begin , 245D,deleted text end or 245H;
(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E;
or
(3) a nonlicensed personal care provider organization as defined in section deleted text begin 256B.0625,
subdivision 19adeleted text end new text begin 256B.0659new text end .
(d) "Family assessment" means a comprehensive assessment of child safety, risk of
subsequent child maltreatment, and family strengths and needs that is applied to a child
maltreatment report that does not allege sexual abuse or substantial child endangerment.
Family assessment does not include a determination as to whether child maltreatment
occurred but does determine the need for services to address the safety of family members
and the risk of subsequent maltreatment.
(e) "Investigation" means fact gathering related to the current safety of a child and the
risk of subsequent maltreatment that determines whether child maltreatment occurred and
whether child protective services are needed. An investigation must be used when reports
involve sexual abuse or substantial child endangerment, and for reports of maltreatment in
facilities required to be licensed or certified under chapter 245Adeleted text begin , 245D,deleted text end or 245H; under
sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05,
subdivisions 9, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider
association as defined in section deleted text begin 256B.0625, subdivision 19adeleted text end new text begin 256B.0659new text end .
(f) "Mental injury" means an injury to the psychological capacity or emotional stability
of a child as evidenced by an observable or substantial impairment in the child's ability to
function within a normal range of performance and behavior with due regard to the child's
culture.
(g) "Neglect" means the commission or omission of any of the acts specified under
clauses (1) to deleted text begin (9)deleted text end new text begin (10)new text end , other than by accidental means:
(1) failure by a person responsible for a child's care to supply a child with necessary
food, clothing, shelter, health, medical, or other care required for the child's physical or
mental health when reasonably able to do so;
(2) failure to protect a child from conditions or actions that seriously endanger the child's
physical or mental health when reasonably able to do so, including a growth delay, which
may be referred to as a failure to thrive, that has been diagnosed by a physician and is due
to parental neglect;
(3) failure to provide for necessary supervision or child care arrangements appropriate
for a child after considering factors as the child's age, mental ability, physical condition,
length of absence, or environment, when the child is unable to care for the child's own basic
needs or safety, or the basic needs or safety of another child in their care;
(4) failure to ensure that the child is educated as defined in sections 120A.22 and
260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
child with sympathomimetic medications, consistent with section 125A.091, subdivision
5;
(5) nothing in this section shall be construed to mean that a child is neglected solely
because the child's parent, guardian, or other person responsible for the child's care in good
faith selects and depends upon spiritual means or prayer for treatment or care of disease or
remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker,
or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of
medical care may cause serious danger to the child's health. This section does not impose
upon persons, not otherwise legally responsible for providing a child with necessary food,
clothing, shelter, education, or medical care, a duty to provide that care;
(6) prenatal exposure to new text begin alcohol or new text end a controlled substance, as defined in section 253B.02,
subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
symptoms in the child at birth, results of a toxicology test performed on the mother at
delivery or the child at birth, medical effects or developmental delays during the child's first
year of life that medically indicate prenatal exposure to a controlled substance, or the
presence of a fetal alcohol spectrum disorder;
(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
(8) chronic and severe use of alcohol or a controlled substance by a parent or person
responsible for the care of the child that adversely affects the child's basic needs and safety;
deleted text begin or
deleted text end
(9) emotional harm from a pattern of behavior which contributes to impaired emotional
functioning of the child which may be demonstrated by a substantial and observable effect
in the child's behavior, emotional response, or cognition that is not within the normal range
for the child's age and stage of development, with due regard to the child's culturedeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(10) abandonment of the child in which a parent does not have regular contact with the
child and has failed to demonstrate consistent interest in the child's well-being, unless the
parent establishes an extreme financial hardship, physical hardship, treatment for mental
disability or chemical dependency, or other good cause that prevented the parent from
making contact with the child. A child custody determination under chapter 257 or 518 is
not abandonment of the child.
new text end
(h) "Nonmaltreatment mistake" means:
(1) at the time of the incident, the individual was performing duties identified in the
center's child care program plan required under Minnesota Rules, part 9503.0045;
(2) the individual has not been determined responsible for a similar incident that resulted
in a finding of maltreatment for at least seven years;
(3) the individual has not been determined to have committed a similar nonmaltreatment
mistake under this paragraph for at least four years;
(4) any injury to a child resulting from the incident, if treated, is treated only with
remedies that are available over the counter, whether ordered by a medical professional or
not; and
(5) except for the period when the incident occurred, the facility and the individual
providing services were both in compliance with all licensing requirements relevant to the
incident.
This definition only applies to child care centers licensed under Minnesota Rules, chapter
9503. If clauses (1) to (5) apply, rather than making a determination of substantiated
maltreatment by the individual, the commissioner of human services shall determine that a
nonmaltreatment mistake was made by the individual.
(i) "Operator" means an operator or agency as defined in section 245A.02.
(j) "Person responsible for the child's care" means (1) an individual functioning within
the family unit and having responsibilities for the care of the child such as a parent, guardian,
or other person having similar care responsibilities, or (2) an individual functioning outside
the family unit and having responsibilities for the care of the child such as a teacher, school
administrator, other school employees or agents, or other lawful custodian of a child having
either full-time or short-term care responsibilities including, but not limited to, day care,
babysitting whether paid or unpaid, counseling, teaching, and coaching.
(k) "Physical abuse" means any physical injury, mental injury, or threatened injury,
inflicted by a person responsible for the child's care on a child other than by accidental
means, or any physical or mental injury that cannot reasonably be explained by the child's
history of injuries, or any aversive or deprivation procedures, or regulated interventions,
that have not been authorized under section 125A.0942 or 245.825.
Abuse does not include reasonable and moderate physical discipline of a child
administered by a parent or legal guardian which does not result in an injury. Abuse does
not include the use of reasonable force by a teacher, principal, or school employee as allowed
by section 121A.582. Actions which are not reasonable and moderate include, but are not
limited to, any of the following:
(1) throwing, kicking, burning, biting, or cutting a child;
(2) striking a child with a closed fist;
(3) shaking a child under age three;
(4) striking or other actions which result in any nonaccidental injury to a child under 18
months of age;
(5) unreasonable interference with a child's breathing;
(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
(7) striking a child under age one on the face or head;
(8) striking a child who is at least age one but under age four on the face or head, which
results in an injury;
(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
substances which were not prescribed for the child by a practitioner, in order to control or
punish the child; or other substances that substantially affect the child's behavior, motor
coordination, or judgment or that results in sickness or internal injury, or subjects the child
to medical procedures that would be unnecessary if the child were not exposed to the
substances;
(10) unreasonable physical confinement or restraint not permitted under section 609.379,
including but not limited to tying, caging, or chaining; or
(11) in a school facility or school zone, an act by a person responsible for the child's
care that is a violation under section 121A.58.
new text begin
(l) "Position of authority" has the meaning given in section 609.341, subdivision 10.
new text end
deleted text begin (l)deleted text end new text begin (m)new text end "Practice of social services," for the purposes of subdivision 3, includes but is
not limited to employee assistance counseling and the provision of guardian ad litem and
parenting time expeditor services.
deleted text begin (m)deleted text end new text begin (n)new text end "Report" means any communication received by the local welfare agency, police
department, county sheriff, or agency responsible for child protection pursuant to this section
that describes neglect or physical or sexual abuse of a child and contains sufficient content
to identify the child and any person believed to be responsible for the neglect or abuse, if
known.
new text begin
(o) "Safety plan" means any written or oral plan made with the child's parent or legal
custodian or ordered by the court that sets out the conditions necessary to keep the child
safe.
new text end
deleted text begin (n)deleted text end new text begin (p)new text end "Sexual abuse" meansnew text begin :
new text end
new text begin (1)new text end the subjection of a child by a person responsible for the child's care, by a person who
has a significant relationship to the child, deleted text begin as defined in section 609.341,deleted text end or by a person in
a position of authority, deleted text begin as defined in section 609.341, subdivision 10,deleted text end to any act which
constitutes a violation of deleted text begin section 609.342 (criminal sexual conduct in the first degree),
609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual conduct
in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 609.3451
(criminal sexual conduct in the fifth degree). Sexual abuse also includes any act which
involves a minor which constitutes a violation of prostitution offenses under sections 609.321
to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports of known
or suspected child sex trafficking involving a child who is identified as a victim of sex
trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321,
subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the
status of a parent or household member who has committed a violation which requires
registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or
required registration under section 243.166, subdivision 1b, paragraph (a) or (b).deleted text end new text begin any of the
following: (i) criminal sexual conduct in the first degree as defined in section 609.342; (ii)
criminal sexual conduct in the second degree as defined in section 609.343; (iii) criminal
sexual conduct in the third degree as defined in section 609.344; (iv) criminal sexual conduct
in the fourth degree as defined in section 609.345; (v) criminal sexual conduct in the fifth
degree as defined in section 609.3451; (vi) solicitation, promotion, or inducement of
prostitution in the first degree as defined in section 609.322; (vii) prostitution-related offenses
as defined in section 609.324; and (viii) use of a minor in sexual performance as defined in
section 617.246; or
new text end
new text begin
(2) the known or suspected subjection of a child by any person to acts of sex trafficking
as defined in sections 609.321 and 609.322.
new text end
new text begin
(q) "Significant relationship to the child" means a situation in which the alleged offender
is:
new text end
new text begin
(1) the child's parent, stepparent, or guardian;
new text end
new text begin
(2) any of the following persons related to the child by blood, marriage, or adoption:
brother, sister, first cousin, aunt, uncle, nephew, niece, grandparent, great-grandparent,
great-uncle, great-aunt; or
new text end
new text begin
(3) any person who jointly resides intermittently or regularly in the same dwelling as
the child and who is not the child's spouse.
new text end
deleted text begin (o)deleted text end new text begin (r)new text end "Substantial child endangerment" means a person responsible for a child's care,
by act or omission, commits or attempts to commit an act against a child under their care
that constitutes any of the following:
(1) egregious harm as defined in section 260C.007, subdivision 14;
(2) abandonment under section 260C.301, subdivision 2new text begin , paragraph (a), clause (2)new text end ;
(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's
physical or mental health, including a growth delay, which may be referred to as failure to
thrive, that has been diagnosed by a physician and is due to parental neglect;
(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
(5) manslaughter in the first or second degree under section 609.20 or 609.205;
(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
(7) solicitation, inducement, and promotion of prostitution under section 609.322;
(8) criminal sexual conduct under sections 609.342 to 609.3451;
(9) solicitation of children to engage in sexual conduct under section 609.352;
(10) malicious punishment or neglect or endangerment of a child under section 609.377
or 609.378;
(11) use of a minor in sexual performance under section 617.246; or
(12) parental behavior, status, or condition which mandates that the county attorney file
a termination of parental rights petition under section 260C.503, subdivision 2.
deleted text begin (p)deleted text end new text begin (s)new text end "Threatened injury" means a statement, overt act, condition, or status that
represents a substantial risk of physical or sexual abuse or mental injury. Threatened injury
includes, but is not limited to, exposing a child to a person responsible for the child's care,
as defined in paragraph (j), clause (1), who has:
(1) subjected a child to, or failed to protect a child from, an overt act or condition that
constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law
of another jurisdiction;
(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph
(b), clause (4), or a similar law of another jurisdiction;
(3) committed an act that has resulted in an involuntary termination of parental rights
under section 260C.301, or a similar law of another jurisdiction; deleted text begin or
deleted text end
(4) committed an act that has resulted in the involuntary transfer of permanent legal and
physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201,
subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law
of another jurisdictiondeleted text begin .deleted text end new text begin ;
new text end
deleted text begin A child is the subject ofdeleted text end new text begin (5) subjected a child to a status or condition requiringnew text end a report
of deleted text begin threatened injury when the responsible social services agency receivesdeleted text end birth match data
under paragraph deleted text begin (q)deleted text end new text begin (t)new text end from the Department of Human Servicesdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(6) committed a violation that required registration as an offender under section 243.166,
subdivision 1b, paragraph (a) or (b), or required registration under section 243.166,
subdivision 1b, paragraph (a) or (b), and is a parent or a household member.
new text end
deleted text begin (q)deleted text end new text begin (t)new text end Upon receiving data under section 144.225, subdivision 2b, contained in a birth
record or recognition of parentage identifying a child who is subject to threatened injury
under paragraph deleted text begin (p)deleted text end new text begin (s)new text end , the Department of Human Services shall send the data to the
responsible social services agency. The data is known as "birth match" data. Unless the
responsible social services agency has already begun an investigation or assessment of the
report due to the birth of the child or execution of the recognition of parentage and the
parent's previous history with child protection, the agency shall accept the birth match data
as a report under this section. The agency deleted text begin maydeleted text end new text begin shallnew text end use deleted text begin either a family assessment ordeleted text end new text begin annew text end
investigation to determine whether the child is safe. All of the provisions of this section
apply. If the child is determined to be safe, the agency shall consult with the county attorney
to determine the appropriateness of filing a petition alleging the child is in need of protection
or services under section 260C.007, subdivision 6, clause (16), in order to deliver needed
services. If the child is determined not to be safe, the agency and the county attorney shall
take appropriate action as required under section 260C.503, subdivision 2.
deleted text begin (r)deleted text end new text begin (u)new text end Persons who conduct assessments or investigations under this section shall take
into account accepted child-rearing practices of the culture in which a child participates and
accepted teacher discipline practices, which are not injurious to the child's health, welfare,
and safety.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 66.
Minnesota Statutes 2018, section 626.556, subdivision 3, is amended to read:
Subd. 3.
Persons mandated to report; persons voluntarily reporting.
(a) A person
who knows or has reason to believe a child is being neglected or physically or sexually
abused, as defined in subdivision 2, or has been neglected or physically or sexually abused
within the preceding three years, shall immediately report the information to the local welfare
agency, agency responsible for assessing or investigating the report, police department,
county sheriff, tribal social services agency, or tribal police department if the person is:
(1) a professional or professional's delegate deleted text begin who isdeleted text end new text begin whilenew text end engaged in the practice of the
healing arts, social services, hospital administration, psychological or psychiatric treatment,
child care, education, correctional supervision, probation and correctional services, or law
enforcement; or
(2) employed as a member of the clergy and received the information while engaged in
ministerial duties, provided that a member of the clergy is not required by this subdivision
to report information that is otherwise privileged under section 595.02, subdivision 1,
paragraph (c).
(b) Any person may voluntarily report to the local welfare agency, agency responsible
for assessing or investigating the report, police department, county sheriff, tribal social
services agency, or tribal police department if the person knows, has reason to believe, or
suspects a child is being or has been neglected or subjected to physical or sexual abuse.
(c) A person mandated to report physical or sexual child abuse or neglect occurring
within a licensed facility shall report the information to the agency responsible for licensing
or certifying the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16;
or chapter 144Hdeleted text begin , 245D,deleted text end or 245H; or a nonlicensed personal care provider organization as
defined in section deleted text begin 256B.0625, subdivision 19adeleted text end new text begin 256B.0659new text end . A health or corrections agency
receiving a report may request the local welfare agency to provide assistance pursuant to
subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work within
a school facility, upon receiving a complaint of alleged maltreatment, shall provide
information about the circumstances of the alleged maltreatment to the commissioner of
education. Section 13.03, subdivision 4, applies to data received by the commissioner of
education from a licensing entity.
(d) Notification requirements under subdivision 10 apply to all reports received under
this section.
(e) For purposes of this section, "immediately" means as soon as possible but in no event
longer than 24 hours.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 67.
Minnesota Statutes 2018, section 626.556, subdivision 3c, is amended to read:
Subd. 3c.
Local welfare agency, Department of Human Services or Department of
Health responsible for assessing or investigating reports of maltreatment.
(a) new text begin The local
welfare agency is the agency responsible for assessing or investigating allegations of
maltreatment by a parent, guardian, or person responsible for the child's care as defined in
subdivision 2, paragraph (j). new text end The local welfare agency is deleted text begin the agencydeleted text end new text begin alsonew text end responsible for
assessing or investigating allegations of maltreatment in child foster care, family child care,
legally nonlicensed child care, and reports involving children served by an unlicensed
personal care provider organization under section 256B.0659. Copies of findings related to
personal care provider organizations under section 256B.0659 must be forwarded to the
Department of Human Services provider enrollment.
new text begin
(b) The local welfare agency is the agency responsible for investigating allegations of
substantial child endangerment by a parent, guardian, or person responsible for the child's
care as defined in subdivision 2, paragraph (j).
new text end
deleted text begin (b)deleted text end new text begin (c)new text end The Department of Human Services is the agency responsible for assessing or
investigating allegations of maltreatment in juvenile correctional facilities listed under
section 241.021 located in the local welfare agency's county and in facilities licensed or
certified under chapters 245Adeleted text begin , 245D,deleted text end and 245H, except for child foster care and family
child care.
deleted text begin (c)deleted text end new text begin (d)new text end The Department of Health is the agency responsible for assessing or investigating
allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and
144A.43 to 144A.482 or chapter 144H.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 68.
Minnesota Statutes 2018, section 626.556, subdivision 3e, is amended to read:
Subd. 3e.
Agency responsible for assessing or investigating reports of sexual
abuse.
The local welfare agency is the agency responsible for investigating allegations of
sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual
functioning within the family unit as a person responsible for the child's care, or a person
with a significant relationship to the child if that person resides in the child's household.
deleted text begin Effective May 29, 2017,deleted text end The local welfare agency is also responsible for investigating
new text begin allegations involving any person new text end when a child is identified as a new text begin known or suspected new text end victim
of sex trafficking.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 69.
Minnesota Statutes 2018, section 626.556, subdivision 4, is amended to read:
Subd. 4.
Immunity from liability.
(a) The following persons are immune from any civil
or criminal liability that otherwise might result from their actions, if they are acting in good
faith:
(1) any person making a voluntary or mandated report under subdivision 3 or under
section 626.5561 or assisting in an assessment under this section or under section 626.5561;
(2) any person with responsibility for performing duties under this section or supervisor
employed by a local welfare agency, the commissioner of an agency responsible for operating
or supervising a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed or certified under sections
144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245B or 245H; or a school as
defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed
personal care provider organization as defined in section 256B.0625, subdivision 19a,
complying with subdivision 10d; and
(3) any public or private school, facility as defined in subdivision 2, or the employee of
any public or private school or facility who permits access by a local welfare agency, the
Department of Education, or a local law enforcement agency and assists in an investigation
or assessment pursuant to subdivision 10 or under section 626.5561.
(b) A person who is a supervisor or person with responsibility for performing duties
under this section employed by a local welfare agency, the commissioner of human services,
or the commissioner of education complying with subdivisions 10 and 11 or section 626.5561
or any related rule or provision of law is immune from any civil or criminal liability that
might otherwise result from the person's actions, if the person is (1) acting in good faith
and exercising due care, or (2) acting in good faith and following the information collection
procedures established under subdivision 10, paragraphs deleted text begin (h), (i), anddeleted text end (j)new text begin , (k), (l), and (m)new text end .
(c) This subdivision does not provide immunity to any person for failure to make a
required report or for committing neglect, physical abuse, or sexual abuse of a child.
(d) If a person who makes a voluntary or mandatory report under subdivision 3 prevails
in a civil action from which the person has been granted immunity under this subdivision,
the court may award the person attorney fees and costs.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 70.
Minnesota Statutes 2018, section 626.556, subdivision 7, is amended to read:
Subd. 7.
Report; information provided to parent; reporter.
(a) An oral report shall
be made immediately by telephone or otherwise. deleted text begin An oral report made by a person required
under subdivision 3 to report shall be followed within 72 hours, exclusive of weekends and
holidays, by a report in writing to the appropriate police department, the county sheriff, the
agency responsible for assessing or investigating the report, or the local welfare agency.
deleted text end
(b) The local welfare agency shall determine if the report is to be screened in or out as
soon as possible but in no event longer than 24 hours after the report is received. When
determining whether a report will be screened in or out, the agency receiving the report
must consider, when relevant, all previous history, including reports that were screened out.
The agency may communicate with treating professionals and individuals specified under
subdivision 10, paragraph deleted text begin (i)deleted text end new text begin (k)new text end , clause (3), item (iii).new text begin A treating professional or individual
required to provide information under this paragraph is immune from liability as specified
under subdivision 4.
new text end
(c) Any report shall be of sufficient content to identify the child, any person believed to
be responsible for the abuse or neglect of the child if the person is known, the nature and
extent of the abuse or neglect and the name and address of the reporter. The local welfare
agency or agency responsible for assessing or investigating the report shall accept a report
made under subdivision 3 notwithstanding refusal by a reporter to provide the reporter's
name or address as long as the report is otherwise sufficient under this paragraph. deleted text begin Written
reports received by a police department or the county sheriff shall be forwarded immediately
to the local welfare agency or the agency responsible for assessing or investigating the
report. The police department or the county sheriff may keep copies of reports received by
them. Copies of written reports received by a local welfare department or the agency
responsible for assessing or investigating the report shall be forwarded immediately to the
local police department or the county sheriff.
deleted text end
(d) deleted text begin When requested,deleted text end The agency responsible for assessing or investigating a report shall
inform the reporter within ten days after the new text begin initial new text end report was made, either orally or in
writing, whether the report was accepted or notnew text begin , unless release would be detrimental to the
best interests of the childnew text end . deleted text begin If the responsible agency determines the report does not constitute
a report under this section, the agency shall advise the reporter the report was screened out.deleted text end
Any person mandated to report shall receive a summary of the new text begin final new text end disposition of any report
made by that reporter, including whether the case has been opened for child protection or
other services, or if a referral has been made to a community organization, unless release
would be detrimental to the best interests of the child. Any person who is not mandated to
report shall, upon request to the local welfare agency, receive a concise summary of the
disposition of any report made by that reporter, unless release would be detrimental to the
best interests of the child.
(e) Reports that are screened out must be maintained in accordance with subdivision
11c, paragraph (a).
(f) A local welfare agency or agency responsible for investigating or assessing a report
may use a screened-out report for making an offer of social services to the subjects of the
screened-out report. deleted text begin A local welfare agency or agency responsible for evaluating a report
alleging maltreatment of a child shall consider prior reports, including screened-out reports,
to determine whether an investigation or family assessment must be conducted.deleted text end new text begin The local
welfare agency may inform the child-placing agency or the child foster care licensing agency
of the screened-out report when the report alleges child maltreatment by a child or adult
who resides intermittently or regularly in the same dwelling as a child placed in foster care.
new text end
(g) Notwithstanding paragraph (a), the commissioner of education must inform the
parent, guardian, or legal custodian of the child who is the subject of a report of alleged
maltreatment in a school facility within ten days of receiving the report, either orally or in
writing, whether the commissioner is assessing or investigating the report of alleged
maltreatment.
(h) Regardless of whether a report is made under this subdivision, as soon as practicable
after a school receives information regarding an incident that may constitute maltreatment
of a child in a school facility, the school shall inform the parent, legal guardian, or custodian
of the child that an incident has occurred that may constitute maltreatment of the child,
when the incident occurred, and the nature of the conduct that may constitute maltreatment.
(i) A written copy of a report maintained by personnel of agencies, other than welfare
or law enforcement agencies, which are subject to chapter 13 shall be confidential. An
individual subject of the report may obtain access to the original report as provided by
subdivision 11.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 71.
Minnesota Statutes 2018, section 626.556, subdivision 10, is amended to read:
Subd. 10.
Duties of local welfare agency and local law enforcement agency upon
receipt of report; mandatory notification between police or sheriff and agency.
(a) The
police department or the county sheriff shall immediately notify the local welfare agency
or agency responsible for child protection reports under this section orally deleted text begin anddeleted text end new text begin ornew text end in writing
when a report is received. The local welfare agency or agency responsible for child protection
reports shall immediately notify the local police department or the county sheriff orally deleted text begin anddeleted text end new text begin
ornew text end in writing when a report is received. The county sheriff and the head of every local welfare
agency, agency responsible for child protection reports, and police department shall each
designate a person within their agency, department, or office who is responsible for ensuring
that the notification duties of this paragraph are carried out. When the alleged maltreatment
new text begin of an Indian child new text end occurred on tribal land, the local welfare agency or agency responsible
for child protection reports and the local police department or the county sheriff shall
immediately notify the tribe's social services agency and tribal law enforcement orally deleted text begin anddeleted text end new text begin
ornew text end in writing when a report is received.new text begin When the alleged maltreatment occurred in another
state involving a child residing in Minnesota, the local welfare agency shall assume
responsibility for child protection assessment or investigation.
new text end
(b) Upon receipt of a report, the local welfare agency shall determine whether to conduct
a family assessment or an investigation as appropriate to prevent or provide a remedy for
child maltreatment. The local welfare agency:
(1) shall conduct an investigation on reports involving sexual abuse new text begin according to
subdivision 3e new text end or substantial child endangermentnew text begin according to subdivision 3c, paragraph
(b)new text end ;
(2) shall begin an immediate investigation if, at any time when it is using a family
assessment response, it determines that there is reason to believe that sexual abuse or
substantial child endangerment or a serious threat to the child's safety exists;
(3) may conduct a family assessment for reports that do not allege sexual abuse or
substantial child endangerment. In determining that a family assessment is appropriate, the
local welfare agency may consider issues of child safety, parental cooperation, and the need
for an immediate response;
(4) may conduct a family assessment on a report that was initially screened and assigned
for an investigation. In determining that a complete investigation is not required, the local
welfare agency must document the reason for terminating the investigation and notify the
local law enforcement agency if the local law enforcement agency is conducting a joint
investigation; and
(5) shall provide immediate notice, according to section 260.761, subdivision 2, to an
Indian child's tribe when the agency has reason to believe the family assessment or
investigation may involve an Indian child. For purposes of this clause, "immediate notice"
means notice provided within 24 hours.
deleted text begin If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, or
individual functioning within the family unit as a person responsible for the child's care, or
sexual abuse by a person with a significant relationship to the child when that person resides
in the child's household or by a sibling, the local welfare agency shall immediately conduct
a family assessment or investigation as identified in clauses (1) to (4).deleted text end new text begin (c)new text end In conducting a
family assessment or investigation, the local welfare agency shall gather information on the
existence of substance abuse and domestic violence and offer services for purposes of
preventing future child maltreatment, safeguarding and enhancing the welfare of the abused
or neglected minor, and supporting and preserving family life whenever possible. If the
report alleges a violation of a criminal statute involving sexual abuse, physical abuse, or
neglect or endangerment, under section 609.378, the local law enforcement agency and
local welfare agency shall coordinate the planning and execution of their respective
investigation and assessment efforts to avoid a duplication of fact-finding efforts and multiple
interviews. Each agency shall prepare a separate report of the results of its investigation or
assessment. In cases of alleged child maltreatment resulting in death, the local agency may
rely on the fact-finding efforts of a law enforcement investigation to make a determination
of whether or not maltreatment occurred. When necessary the local welfare agency shall
seek authority to remove the child from the custody of a parent, guardian, or adult with
whom the child is living. In performing any of these duties, the local welfare agency shall
maintain appropriate records.
If the family assessment or investigation indicates there is a potential for abuse of alcohol
or other drugs by the parent, guardian, or person responsible for the child's care, the local
welfare agency shall conduct a chemical use assessment pursuant to Minnesota Rules, part
9530.6615.
deleted text begin (c)deleted text end new text begin (d)new text end When a local agency receives a report or otherwise has information indicating
that a child who is a client, as defined in section 245.91, has been the subject of physical
abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section
245.91, it shall, in addition to its other duties under this section, immediately inform the
ombudsman established under sections 245.91 to 245.97. The commissioner of education
shall inform the ombudsman established under sections 245.91 to 245.97 of reports regarding
a child defined as a client in section 245.91 that maltreatment occurred at a school as defined
in section 120A.05, subdivisions 9, 11, and 13, and chapter 124E.
deleted text begin (d)deleted text end new text begin (e)new text end Authority of the local welfare agency responsible for assessing or investigating
the child abuse or neglect report, the agency responsible for assessing or investigating the
report, and of the local law enforcement agency for investigating the alleged abuse or neglect
includes, but is not limited to, authority to interview, without parental consent, the alleged
victim and any other minors who currently reside with or who have resided with the alleged
offender. The interview may take place at school or at any facility or other place where the
alleged victim or other minors might be found or the child may be transported to, and the
interview conducted at, a place appropriate for the interview of a child designated by the
local welfare agency or law enforcement agency. The interview may take place outside the
presence of the alleged offender or parent, legal custodian, guardian, or school official. For
family assessments, it is the preferred practice to request a parent or guardian's permission
to interview the child prior to conducting the child interview, unless doing so would
compromise the safety assessment. Except as provided in this paragraph, the parent, legal
custodian, or guardian shall be notified by the responsible local welfare or law enforcement
agency no later than the conclusion of the investigation or assessment that this interview
has occurred. Notwithstanding rule 32 of the Minnesota Rules of Procedure for Juvenile
Courts, the juvenile court may, after hearing on an ex parte motion by the local welfare
agency, order that, where reasonable cause exists, the agency withhold notification of this
interview from the parent, legal custodian, or guardian. If the interview took place or is to
take place on school property, the order shall specify that school officials may not disclose
to the parent, legal custodian, or guardian the contents of the notification of intent to interview
the child on school property, as provided under this paragraph, and any other related
information regarding the interview that may be a part of the child's school record. A copy
of the order shall be sent by the local welfare or law enforcement agency to the appropriate
school official.
deleted text begin (e)deleted text end new text begin (f)new text end When the local welfare, local law enforcement agency, or the agency responsible
for assessing or investigating a report of maltreatment determines that an interview should
take place on school property, written notification of intent to interview the child on school
property must be received by school officials prior to the interview. The notification shall
include the name of the child to be interviewed, the purpose of the interview, and a reference
to the statutory authority to conduct an interview on school property. For interviews
conducted by the local welfare agency, the notification shall be signed by the chair of the
local social services agency or the chair's designee. The notification shall be private data
on individuals subject to the provisions of this paragraph. School officials may not disclose
to the parent, legal custodian, or guardian the contents of the notification or any other related
information regarding the interview until notified in writing by the local welfare or law
enforcement agency that the investigation or assessment has been concluded, unless a school
employee or agent is alleged to have maltreated the child. Until that time, the local welfare
or law enforcement agency or the agency responsible for assessing or investigating a report
of maltreatment shall be solely responsible for any disclosures regarding the nature of the
assessment or investigation.
new text begin (g) new text end Except where the alleged offender is believed to be a school official or employee,
the time and place, and manner of the interview on school premises shall be within the
discretion of school officials, but the local welfare or law enforcement agency shall have
the exclusive authority to determine who may attend the interview. The conditions as to
time, place, and manner of the interview set by the school officials shall be reasonable and
the interview shall be conducted not more than 24 hours after the receipt of the notification
unless another time is considered necessary by agreement between the school officials and
the local welfare or law enforcement agency. Where the school fails to comply with the
provisions of this paragraph, the juvenile court may order the school to comply. Every effort
must be made to reduce the disruption of the educational program of the child, other students,
or school staff when an interview is conducted on school premises.
deleted text begin (f)deleted text end new text begin (h)new text end Where the alleged offender or a person responsible for the care of the alleged
victim or other minor prevents access to the victim or other minor by the local welfare
agency, the juvenile court may order the parents, legal custodian, or guardian to produce
the alleged victim or other minor for questioning by the local welfare agency or the local
law enforcement agency outside the presence of the alleged offender or any person
responsible for the child's care at reasonable places and times as specified by court order.
deleted text begin (g)deleted text end new text begin (i)new text end Before making an order under paragraph deleted text begin (f)deleted text end new text begin (h)new text end , the court shall issue an order to
show cause, either upon its own motion or upon a verified petition, specifying the basis for
the requested interviews and fixing the time and place of the hearing. The order to show
cause shall be served personally and shall be heard in the same manner as provided in other
cases in the juvenile court. The court shall consider the need for appointment of a guardian
ad litem to protect the best interests of the child. If appointed, the guardian ad litem shall
be present at the hearing on the order to show cause.
deleted text begin (h)deleted text end new text begin (j)new text end The commissioner of human services, the ombudsman for mental health and
developmental disabilities, the local welfare agencies responsible for investigating reports,
the commissioner of education, and the local law enforcement agencies have the right to
enter facilities as defined in subdivision 2 and to inspect and copy the facility's records,
including medical records, as part of the investigation. Notwithstanding the provisions of
chapter 13, they also have the right to inform the facility under investigation that they are
conducting an investigation, to disclose to the facility the names of the individuals under
investigation for abusing or neglecting a child, and to provide the facility with a copy of
the report and the investigative findings.
deleted text begin (i)deleted text end new text begin (k)new text end The local welfare agency responsible for conducting a family assessment or
investigation shall collect available and relevant information to determine child safety, risk
of subsequent child maltreatment, and family strengths and needs and share not public
informationnew text begin , including the name of the reporter of child maltreatment and any other
information collected under this subdivision,new text end with an Indian's tribal social services agency
without violating any law of the state that may otherwise impose duties of confidentiality
on the local welfare agency in order to implement the tribal state agreement. The local
welfare agency or the agency responsible for investigating the report shall collect available
and relevant information to ascertain whether maltreatment occurred and whether protective
services are needed. Information collected includes, when relevant, information with regard
to the person reporting the alleged maltreatment, including the nature of the reporter's
relationship to the child and to the alleged offender, and the basis of the reporter's knowledge
for the report; the child allegedly being maltreated; the alleged offender; the child's caretaker;
and other collateral sources having relevant information related to the alleged maltreatment.
The local welfare agency or the agency responsible for investigating the report may make
a determination of no maltreatment early in an investigation, and close the case and retain
immunity, if the collected information shows no basis for a full investigation.
Information relevant to the assessment or investigation must be asked for, and may
include:
(1) the child's sex and age; prior reports of maltreatment, including any maltreatment
reports that were screened out and not accepted for assessment or investigation; information
relating to developmental functioning; credibility of the child's statement; and whether the
information provided under this clause is consistent with other information collected during
the course of the assessment or investigation;
(2) the alleged offender's age, a record check for prior reports of maltreatment, and
criminal charges and convictions. The local welfare agency or the agency responsible for
assessing or investigating the report must provide the alleged offender with an opportunity
to make a statement. The alleged offender may submit supporting documentation relevant
to the assessment or investigation;
(3) collateral source information regarding the alleged maltreatment and care of the
child. Collateral information includes, when relevant: (i) a medical examination of the child;
(ii) prior medical records relating to the alleged maltreatment or the care of the child
maintained by any facility, clinic, or health care professional and an interview with the
treating professionals; and (iii) interviews with the child's caretakers, including the child's
parent, guardian, foster parent, child care provider, teachers, counselors, family members,
relatives, and other persons who may have knowledge regarding the alleged maltreatment
and the care of the child; and
(4) information on the existence of domestic abuse and violence in the home of the child,
and substance abuse.
Nothing in this paragraph precludes the local welfare agency, the local law enforcement
agency, or the agency responsible for assessing or investigating the report from collecting
other relevant information necessary to conduct the assessment or investigation.
Notwithstanding sections 13.384 or 144.291 to 144.298, the local welfare agency has access
to medical data and records for purposes of clause (3). Notwithstanding the data's
classification in the possession of any other agency, data acquired by the local welfare
agency or the agency responsible for assessing or investigating the report during the course
of the assessment or investigation are private data on individuals and must be maintained
in accordance with subdivision 11. Data of the commissioner of education collected or
maintained during and for the purpose of an investigation of alleged maltreatment in a school
are governed by this section, notwithstanding the data's classification as educational,
licensing, or personnel data under chapter 13.
In conducting an assessment or investigation involving a school facility as defined in
subdivision 2, paragraph (c), the commissioner of education shall collect investigative
reports and data that are relevant to a report of maltreatment and are from local law
enforcement and the school facility.
deleted text begin (j)deleted text end new text begin (l)new text end Upon deleted text begin receipt ofdeleted text end a reportnew text begin made under subdivision 7, paragraph (a)new text end , the local welfare
agency shall conduct a face-to-face contact with the child reported to be maltreated and
with the child's primary caregiver sufficient to complete a safety assessment and ensure the
immediate safety of the child. new text begin A safety plan is developed, when required, after a safety
assessment. new text end The face-to-face contact with the child and primary caregiver shall occur
immediately if sexual abuse or substantial child endangerment is alleged and within five
calendar days for all other reports. If the alleged offender was not already interviewed as
the primary caregiver, the local welfare agency shall also conduct a face-to-face interview
with the alleged offender in the early stages of the assessment or investigation. At the initial
contact, the local child welfare agency or the agency responsible for assessing or investigating
the report must inform the alleged offender of the complaints or allegations made against
the individual in a manner consistent with laws protecting the rights of the person who made
the reportnew text begin or the person who provided information under subdivision 7, paragraph (b)new text end . The
interview with the alleged offender may be postponed if it would jeopardize an active law
enforcement investigation.
deleted text begin (k)deleted text end new text begin (m)new text end When conducting an investigation, the local welfare agency shall use a question
and answer interviewing format with questioning as nondirective as possible to elicit
spontaneous responses. For investigations only, the following interviewing methods and
procedures must be used whenever possible when collecting information:
(1) audio recordings of all interviews with witnesses and collateral sources; and
(2) in cases of alleged sexual abuse, audio-video recordings of each interview with the
alleged victim and child witnesses.
deleted text begin (l)deleted text end new text begin (n)new text end In conducting an assessment or investigation involving a school facility as defined
in subdivision 2, paragraph (c), the commissioner of education shall collect available and
relevant information and use the procedures in paragraphs deleted text begin (j)deleted text end new text begin (l)new text end and deleted text begin (k)deleted text end new text begin (m)new text end , and subdivision
3d, except that the requirement for face-to-face observation of the child and face-to-face
interview of the alleged offender is to occur in the initial stages of the assessment or
investigation provided that the commissioner may also base the assessment or investigation
on investigative reports and data received from the school facility and local law enforcement,
to the extent those investigations satisfy the requirements of paragraphs deleted text begin (j)deleted text end new text begin (l)new text end and deleted text begin (k)deleted text end new text begin (m)new text end ,
and subdivision 3d.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 72.
Minnesota Statutes 2018, section 626.556, subdivision 10a, is amended to read:
Subd. 10a.
Law enforcement agency responsibility for investigation; welfare agency
reliance on law enforcement fact-finding; welfare agency offer of services.
(a) If the
report alleges neglect, physical abuse, or sexual abuse by a person who is not a parent,
guardian, sibling, person responsible for the child's care functioning within the family unit,
or a person who lives in the child's household and who has a significant relationship to the
child, in a setting other than a facility as defined in subdivision 2, the local welfare agency
shall immediately notify the appropriate law enforcement agency, which shall conduct an
investigation of the alleged abuse or neglect if a violation of a criminal statute is alleged.new text begin
If the report alleges known or suspected child sex trafficking by any person, both the local
child welfare agency and the appropriate law enforcement agency shall conduct an
investigation.
new text end
(b) The local agency may rely on the fact-finding efforts of the law enforcement
investigation conducted under this subdivision to make a determination whether or not
threatened injury or other maltreatment has occurred under subdivision 2 if an alleged
offender has minor children or lives with minors.
(c) If a child is the victim of an alleged crime under paragraph (a), the law enforcement
agency shall immediately notify the local welfare agency, which shall offer appropriate
social services for the purpose of safeguarding and enhancing the welfare of the abused or
neglected minor.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 73.
Minnesota Statutes 2018, section 626.556, subdivision 10b, is amended to read:
Subd. 10b.
Duties of commissioner; neglect or abuse in facility.
(a) This section applies
to the commissioners of human services, health, and education. The commissioner of the
agency responsible for assessing or investigating the report shall immediately assess or
investigate if the report alleges that:
(1) a child who is in the care of a facility as defined in subdivision 2 is neglected,
physically abused, sexually abused, or is the victim of maltreatment in a facility by an
individual in that facility, or has been so neglected or abused, or been the victim of
maltreatment in a facility by an individual in that facility within the three years preceding
the report; or
(2) a child was neglected, physically abused, sexually abused, or is the victim of
maltreatment in a facility by an individual in a facility defined in subdivision 2, while in
the care of that facility within the three years preceding the report.
The commissioner of the agency responsible for assessing or investigating the report
shall arrange for the transmittal to the commissioner of reports received by local agencies
and may delegate to a local welfare agency the duty to investigate reports. In conducting
an investigation under this section, the commissioner has the powers and duties specified
for local welfare agencies under this section. The commissioner of the agency responsible
for assessing or investigating the report or local welfare agency may interview any children
who are or have been in the care of a facility under investigation and their parents, guardians,
or legal custodians.
(b) Prior to any interview, the commissioner of the agency responsible for assessing or
investigating the report or local welfare agency shall notify the parent, guardian, or legal
custodian of a child who will be interviewed in the manner provided for in subdivision 10d,
paragraph (a). If reasonable efforts to reach the parent, guardian, or legal custodian of a
child in an out-of-home placement have failed, the child may be interviewed if there is
reason to believe the interview is necessary to protect the child or other children in the
facility. The commissioner of the agency responsible for assessing or investigating the report
or local agency must provide the information required in this subdivision to the parent,
guardian, or legal custodian of a child interviewed without parental notification as soon as
possible after the interview. When the investigation is completed, any parent, guardian, or
legal custodian notified under this subdivision shall receive the written memorandum
provided for in subdivision 10d, paragraph (c).
(c) In conducting investigations under this subdivision the commissioner or local welfare
agency shall obtain access to information consistent with subdivision 10, paragraphs deleted text begin (h)deleted text end new text begin
(j)new text end , deleted text begin (i)deleted text end new text begin (k)new text end , and deleted text begin (j)deleted text end new text begin (l)new text end . In conducting assessments or investigations under this subdivision,
the commissioner of education shall obtain access to reports and investigative data that are
relevant to a report of maltreatment and are in the possession of a school facility as defined
in subdivision 2, paragraph (c), notwithstanding the classification of the data as educational
or personnel data under chapter 13. This includes, but is not limited to, school investigative
reports, information concerning the conduct of school personnel alleged to have committed
maltreatment of students, information about witnesses, and any protective or corrective
action taken by the school facility regarding the school personnel alleged to have committed
maltreatment.
(d) The commissioner may request assistance from the local social services agency.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 74.
Minnesota Statutes 2018, section 626.556, subdivision 10d, is amended to read:
Subd. 10d.
Notification of neglect or abuse in facility.
(a) When a report is received
that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the
care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed or certified according to
sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 144Hdeleted text begin , 245D,deleted text end or
245H, or a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter
124E; or a nonlicensed personal care provider organization as defined in section 256B.0625,
subdivision 19a, the commissioner of the agency responsible for assessing or investigating
the report or local welfare agency investigating the report shall provide the following
information to the parent, guardian, or legal custodian of a child alleged to have been
neglected, physically abused, sexually abused, or the victim of maltreatment of a child in
the facility: the name of the facility; the fact that a report alleging neglect, physical abuse,
sexual abuse, or maltreatment of a child in the facility has been received; the nature of the
alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; that
the agency is conducting an assessment or investigation; any protective or corrective measures
being taken pending the outcome of the investigation; and that a written memorandum will
be provided when the investigation is completed.
(b) The commissioner of the agency responsible for assessing or investigating the report
or local welfare agency may also provide the information in paragraph (a) to the parent,
guardian, or legal custodian of any other child in the facility if the investigative agency
knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or
maltreatment of a child in the facility has occurred. In determining whether to exercise this
authority, the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency shall consider the seriousness of the alleged neglect, physical
abuse, sexual abuse, or maltreatment of a child in the facility; the number of children
allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a
child in the facility; the number of alleged perpetrators; and the length of the investigation.
The facility shall be notified whenever this discretion is exercised.
(c) When the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency has completed its investigation, every parent, guardian, or
legal custodian previously notified of the investigation by the commissioner or local welfare
agency shall be provided with the following information in a written memorandum: the
name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual
abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the
investigation findings; a statement whether maltreatment was found; and the protective or
corrective measures that are being or will be taken. The memorandum shall be written in a
manner that protects the identity of the reporter and the child and shall not contain the name,
or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed
during the investigation. If maltreatment is determined to exist, the commissioner or local
welfare agency shall also provide the written memorandum to the parent, guardian, or legal
custodian of each child in the facility who had contact with the individual responsible for
the maltreatment. When the facility is the responsible party for maltreatment, the
commissioner or local welfare agency shall also provide the written memorandum to the
parent, guardian, or legal custodian of each child who received services in the population
of the facility where the maltreatment occurred. This notification must be provided to the
parent, guardian, or legal custodian of each child receiving services from the time the
maltreatment occurred until either the individual responsible for maltreatment is no longer
in contact with a child or children in the facility or the conclusion of the investigation. In
the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions
9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification
to parents, guardians, or legal custodians of each child in the facility, but shall, within ten
days after the investigation is completed, provide written notification to the parent, guardian,
or legal custodian of any student alleged to have been maltreated. The commissioner of
education may notify the parent, guardian, or legal custodian of any student involved as a
witness to alleged maltreatment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 75.
Minnesota Statutes 2018, section 626.556, subdivision 10e, is amended to read:
Subd. 10e.
Determinations.
(a) The local welfare agency shall conclude the family
assessment or the investigation within 45 days of the receipt of a report. The conclusion of
the assessment or investigation may be extended to permit the completion of a criminal
investigation or the receipt of expert information requested within 45 days of the receipt of
the report.
(b) After conducting a family assessment, the local welfare agency shall determine
whether services are needed to address the safety of the child and other family members
and the risk of subsequent maltreatment.
(c) After conducting an investigation, the local welfare agency shall make two
determinations: first, whether maltreatment has occurred; and second, whether child
protective services are needed. No determination of maltreatment shall be made when the
alleged perpetrator is a child under the age of ten.
(d) If the commissioner of education conducts an assessment or investigation, the
commissioner shall determine whether maltreatment occurred and what corrective or
protective action was taken by the school facility. If a determination is made that
maltreatment has occurred, the commissioner shall report to the employer, the school board,
and any appropriate licensing entity the determination that maltreatment occurred and what
corrective or protective action was taken by the school facility. In all other cases, the
commissioner shall inform the school board or employer that a report was received, the
subject of the report, the date of the initial report, the category of maltreatment alleged as
defined in paragraph (f), the fact that maltreatment was not determined, and a summary of
the specific reasons for the determination.
(e) When maltreatment is determined in an investigation involving a facility, the
investigating agency shall also determine whether the facility or individual was responsible,
or whether both the facility and the individual were responsible for the maltreatment using
the mitigating factors in paragraph (i). Determinations under this subdivision must be made
based on a preponderance of the evidence and are private data on individuals or nonpublic
data as maintained by the commissioner of education.
(f) For the purposes of this subdivision, "maltreatment" means any of the following acts
or omissions:
(1) physical abuse as defined in subdivision 2, paragraph (k);
(2) neglect as defined in subdivision 2, paragraph (g);
(3) sexual abuse as defined in subdivision 2, paragraph deleted text begin (n)deleted text end new text begin (p)new text end ;
(4) mental injury as defined in subdivision 2, paragraph (f); or
(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (c).
(g) For the purposes of this subdivision, a determination that child protective services
are needed means that the local welfare agency has documented conditions during the
assessment or investigation sufficient to cause a child protection worker, as defined in
section 626.559, subdivision 1, to conclude that a child is at significant risk of maltreatment
if protective intervention is not provided and that the individuals responsible for the child's
care have not taken or are not likely to take actions to protect the child from maltreatment
or risk of maltreatment.
(h) This subdivision does not mean that maltreatment has occurred solely because the
child's parent, guardian, or other person responsible for the child's care in good faith selects
and depends upon spiritual means or prayer for treatment or care of disease or remedial care
of the child, in lieu of medical care. However, if lack of medical care may result in serious
danger to the child's health, the local welfare agency may ensure that necessary medical
services are provided to the child.
(i) When determining whether the facility or individual is the responsible party, or
whether both the facility and the individual are responsible for determined maltreatment in
a facility, the investigating agency shall consider at least the following mitigating factors:
(1) whether the actions of the facility or the individual caregivers were according to,
and followed the terms of, an erroneous physician order, prescription, individual care plan,
or directive; however, this is not a mitigating factor when the facility or caregiver was
responsible for the issuance of the erroneous order, prescription, individual care plan, or
directive or knew or should have known of the errors and took no reasonable measures to
correct the defect before administering care;
(2) comparative responsibility between the facility, other caregivers, and requirements
placed upon an employee, including the facility's compliance with related regulatory standards
and the adequacy of facility policies and procedures, facility training, an individual's
participation in the training, the caregiver's supervision, and facility staffing levels and the
scope of the individual employee's authority and discretion; and
(3) whether the facility or individual followed professional standards in exercising
professional judgment.
The evaluation of the facility's responsibility under clause (2) must not be based on the
completeness of the risk assessment or risk reduction plan required under section 245A.66,
but must be based on the facility's compliance with the regulatory standards for policies
and procedures, training, and supervision as cited in Minnesota Statutes and Minnesota
Rules.
(j) Notwithstanding paragraph (i), when maltreatment is determined to have been
committed by an individual who is also the facility license or certification holder, both the
individual and the facility must be determined responsible for the maltreatment, and both
the background study disqualification standards under section 245C.15, subdivision 4, and
the licensing or certification actions under section 245A.06, 245A.07, 245H.06, or 245H.07
apply.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 76.
Minnesota Statutes 2018, section 626.556, subdivision 10f, is amended to read:
Subd. 10f.
Notice of determinations.
Within ten working days of the conclusion of a
family assessment, the local welfare agency shall notify the parent or guardian of the child
of the need for services to address child safety concerns or significant risk of subsequent
child maltreatment. The local welfare agency and the family may also jointly agree that
family support and family preservation services are needed. Within ten working days of the
conclusion of an investigation, the local welfare agency or agency responsible for
investigating the report shall notify the parent or guardian of the child, the person determined
to be maltreating the child, and, if applicable, the director of the facility, of the determination
and a summary of the specific reasons for the determination. When the investigation involves
a child foster care setting that is monitored by a private licensing agency under section
245A.16, the local welfare agency responsible for investigating the report shall notify the
private licensing agency of the determination and shall provide a summary of the specific
reasons for the determination. The notice to the private licensing agency must include
identifying private data, but not the identity of the reporter of maltreatment. The notice must
also include a certification that the information collection procedures under subdivision 10,
paragraphs deleted text begin (h)deleted text end new text begin (j)new text end , deleted text begin (i)deleted text end new text begin (k)new text end , and deleted text begin (j)deleted text end new text begin (l)new text end , were followed and a notice of the right of a data subject
to obtain access to other private data on the subject collected, created, or maintained under
this section. In addition, the notice shall include the length of time that the records will be
kept under subdivision 11c. new text begin When the investigation involves a nonlicensed personal care
provider agency as defined in section 256B.0659, regardless of the relationship of the victim
to the nonlicensed personal care attendant, the local welfare agency responsible for
investigating the report shall notify the personal care provider agency of the determination
and shall provide a summary of the specific reasons for the determination. The notice to
the personal care provider agency must include identifying private data, but cannot identify
the reporter of maltreatment. The notice must also include a certification that the procedures
under subdivision 10, paragraphs (i), (j), and (k), were followed and a notice of the right of
a data subject to obtain access to other private data on the subject collected, created, or
maintained under this section. In addition, the notice shall include the length of time that
the records will be kept according to subdivision 11c. new text end The investigating agency shall notify
the parent or guardian of the child who is the subject of the report, and any person or facility
determined to have maltreated a child, of their appeal or review rights under this section.
The notice must also state that a finding of maltreatment may result in denial of a license
or certification application or background study disqualification under chapter 245C related
to employment or services that are licensed or certified by the Department of Human Services
under chapter 245A or 245H, the Department of Health under chapter 144 or 144A, the
Department of Corrections under section 241.021, and from providing services related to
an unlicensed personal care provider organization under chapter 256B.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 77.
Minnesota Statutes 2018, section 626.556, subdivision 10m, is amended to read:
Subd. 10m.
Provision of child protective services; new text begin safety planning; new text end consultation with
county attorney.
(a) The local welfare agency shall create a written plan, in collaboration
with the family whenever possible, within 30 days of the determination that child protective
services are needed or upon joint agreement of the local welfare agency and the family that
family support and preservation services are needed. new text begin The plan may be part of a child
protective services plan, out-of-home placement plan, or reunification plan when the child
leaves foster care. new text end Child protective services for a family are voluntary deleted text begin unlessdeleted text end new text begin on the part of
the family unlessnew text end ordered by the courtdeleted text begin .deleted text end new text begin after a petition under section 260C.141 has been
filed. Family support and preservation services for a family are voluntary on the part of the
family unless the services are ordered by the court.
new text end
(b)new text begin When a child's removal from the care of a parent or guardian is necessary as part of
a safety plan, the removal must occur pursuant to a voluntary placement agreement under
section 260C.227; a court order under section 260C.151, subdivision 6, 260C.178 or
260C.201; or peace officer action authorized under section 260C.175, subdivision 1, clause
(2). The local agency must not use a delegation of power by a parent or guardian under
section 524.5-211 or the standby custodian provisions of chapter 257B as authority to support
removal of a child from the care of a parent or guardian.
new text end
new text begin (c)new text end The local welfare agency shall consult with the county attorney to determine the
appropriateness of filing a petition alleging the child is in need of protection or services
under section 260C.007, subdivision 6, if:
(1) the family does not accept or comply with a plan for child protective servicesnew text begin or
safety plannew text end ;
(2) voluntary child protective services new text begin on the part of the family new text end may not provide sufficient
protection for the child; deleted text begin or
deleted text end
(3) the family is not cooperating with an investigation or assessmentdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(4) removal of the child from the care of a parent or guardian is necessary and a voluntary
placement agreement under section 260C.227 may not provide sufficient protection for the
child.
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. 78.
Minnesota Statutes 2018, section 626.556, subdivision 11, is amended to read:
Subd. 11.
Records.
(a) Except as provided in paragraph (b) and subdivisions 10b, 10d,
10g, and 11b, all records concerning individuals maintained by a local welfare agency or
agency responsible for assessing or investigating the report under this section, including
new text begin not public information shared with an Indian's tribal social service agency under subdivision
10 and new text end any written reports filed under subdivision 7, shall be private data on individuals,
except insofar as copies of reports are required by subdivision 7 to be sent to the local police
department or the county sheriff. All records concerning determinations of maltreatment
by a facility are nonpublic data as maintained by the Department of Education, except insofar
as copies of reports are required by subdivision 7 to be sent to the local police department
or the county sheriff. Reports maintained by any police department or the county sheriff
shall be private data on individuals except the reports shall be made available to the
investigating, petitioning, or prosecuting authority, including county medical examiners or
county coroners. Section 13.82, subdivisions 8, 9, and 14, apply to law enforcement data
other than the reports. The local social services agency or agency responsible for assessing
or investigating the report shall make available to the investigating, petitioning, or prosecuting
authority, including county medical examiners or county coroners or their professional
delegates, any records which contain information relating to a specific incident of neglect
or abuse which is under investigation, petition, or prosecution and information relating to
any prior incidents of neglect or abuse involving any of the same persons. The records shall
be collected and maintained in accordance with the provisions of chapter 13. In conducting
investigations and assessments pursuant to this section, the notice required by section 13.04,
subdivision 2, need not be provided to a minor under the age of ten who is the alleged victim
of abuse or neglect. An individual subject of a record shall have access to the record in
accordance with those sections, except that the name of the reporter shall be confidential
while the report is under assessment or investigation except as otherwise permitted by this
subdivision. Any person conducting an investigation or assessment under this section new text begin or
who has received not public information as permitted by this subdivision and new text end who
intentionally discloses the identity of a reporter prior to the completion of the investigation
or assessment is guilty of a misdemeanor. After the assessment or investigation is completed,
the name of the reporter shall be confidential. The subject of the report may compel disclosure
of the name of the reporter only with the consent of the reporter or upon a written finding
by the court that the report was false and that there is evidence that the report was made in
bad faith. This subdivision does not alter disclosure responsibilities or obligations under
the Rules of Criminal Procedure.
(b) Upon request of the legislative auditor, data on individuals maintained under this
section must be released to the legislative auditor in order for the auditor to fulfill the auditor's
duties under section 3.971. The auditor shall maintain the data in accordance with chapter
13.
(c) The commissioner of education must be provided with all requested data that are
relevant to a report of maltreatment and are in possession of a school facility as defined in
subdivision 2, paragraph (c), when the data is requested pursuant to an assessment or
investigation of a maltreatment report of a student in a school. If the commissioner of
education makes a determination of maltreatment involving an individual performing work
within a school facility who is licensed by a board or other agency, the commissioner shall
provide necessary and relevant information to the licensing entity to enable the entity to
fulfill its statutory duties. Notwithstanding section 13.03, subdivision 4, data received by a
licensing entity under this paragraph are governed by section 13.41 or other applicable law
governing data of the receiving entity, except that this section applies to the classification
of and access to data on the reporter of the maltreatment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 79.
Minnesota Statutes 2018, section 626.556, subdivision 11c, is amended to read:
Subd. 11c.
Welfare, court services agency, and school records
maintained.
Notwithstanding sections 138.163 and 138.17, records maintained or records
derived from reports of abuse by local welfare agencies, agencies responsible for assessing
or investigating the report, court services agencies, or schools under this section shall be
destroyed as provided in paragraphs (a) to (d) by the responsible authority.
(a) For reports alleging child maltreatment that were not accepted for assessment or
investigation, family assessment cases, and cases where an investigation results in no
determination of maltreatment or the need for child protective services, the records must
be maintained for a period of five years after the date the report was not accepted for
assessment or investigation or of the final entry in the case record. Records of reports that
were not accepted must contain sufficient information to identify the subjects of the report,
the nature of the alleged maltreatment, and the reasons as to why the report was not accepted.
Records under this paragraph may not be used for employment, background checks, or
purposes other than to assist in future screening decisions and risk and safety assessments.
(b) All records relating to reports which, upon investigation, indicate either maltreatment
or a need for child protective services shall be maintained for ten years after the date of the
final entry in the case record.
(c) All records regarding a report of maltreatment, including any notification of intent
to interview which was received by a school under subdivision 10, paragraph deleted text begin (d)deleted text end new text begin (e)new text end , shall
be destroyed by the school when ordered to do so by the agency conducting the assessment
or investigation. The agency shall order the destruction of the notification when other records
relating to the report under investigation or assessment are destroyed under this subdivision.
(d) Private or confidential data released to a court services agency under subdivision
10h must be destroyed by the court services agency when ordered to do so by the local
welfare agency that released the data. The local welfare agency or agency responsible for
assessing or investigating the report shall order destruction of the data when other records
relating to the assessment or investigation are destroyed under this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 80.
Minnesota Statutes 2018, section 626.5561, subdivision 1, is amended to read:
Subdivision 1.
Reports required.
(a) Except as provided in paragraph (b), a person
mandated to report under section 626.556, subdivision 3, shall immediately report to the
local welfare agency if the person knows or has reason to believe that a woman is pregnant
and has used a controlled substance for a nonmedical purpose during the pregnancy,
including, but not limited to, tetrahydrocannabinol, or has consumed alcoholic beverages
during the pregnancy in any way that is habitual or excessive.
(b) A health care professional or a social service professional who is mandated to report
under section 626.556, subdivision 3, is exempt from reporting under paragraph (a) a
woman's use or consumption of tetrahydrocannabinol or alcoholic beverages during
pregnancy if the professional is providing the woman with prenatal care or other healthcare
services.
(c) Any person may make a voluntary report if the person knows or has reason to believe
that a woman is pregnant and has used a controlled substance for a nonmedical purpose
during the pregnancy, including, but not limited to, tetrahydrocannabinol, or has consumed
alcoholic beverages during the pregnancy in any way that is habitual or excessive.
(d) An oral report shall be made immediately by telephone or otherwise. deleted text begin An oral report
made by a person required to report shall be followed within 72 hours, exclusive of weekends
and holidays, by a report in writing to the local welfare agency.deleted text end Any report shall be of
sufficient content to identify the pregnant woman, the nature and extent of the use, if known,
and the name and address of the reporter. The local welfare agency shall accept a report
made under paragraph (c) notwithstanding refusal by a voluntary reporter to provide the
reporter's name or address as long as the report is otherwise sufficient.
(e) For purposes of this section, "prenatal care" means the comprehensive package of
medical and psychological support provided throughout the pregnancy.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 81.
Minnesota Statutes 2018, section 626.558, subdivision 2, is amended to read:
Subd. 2.
Duties of team.
A multidisciplinary child protection team may provide public
and professional education, develop resources for prevention, intervention, and treatment,
and provide case consultationnew text begin including but not limited to screening,new text end to the local welfare
agency or other interested community-based agencies. The community-based agencies may
request case consultation from the multidisciplinary child protection team regarding a child
or family for whom the community-based agency is providing services. As used in this
section, "case consultation" means a case review process in which recommendations are
made concerning services to be provided to the identified children and familynew text begin and which
may include screeningnew text end . Case consultation may be performed by a committee or subcommittee
of members representing human services, including mental health and chemical dependency;
law enforcement, including probation and parole; the county attorney; a children's advocacy
center; health care; education; community-based agencies and other necessary agencies;
and persons directly involved in an individual case as designated by other members
performing case consultation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 82. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, sections 119B.125, subdivision 8; and 256J.751, subdivision
1,
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 6
DIRECT CARE AND TREATMENT
Section 1.
Minnesota Statutes 2018, section 253B.18, is amended by adding a subdivision
to read:
new text begin Subd. 6a. new text end
new text begin Transfer; voluntary readmission to secure treatment facility. new text end
new text begin
(a) After a
patient has been transferred out of a secure treatment facility pursuant to subdivision 6, the
patient with the medical director's consent may voluntarily return to a secure treatment
facility for a period of up to 60 days.
new text end
new text begin
(b) If the patient is not returned to the facility to which the person was originally
transferred pursuant to subdivision 6 within 60 days of being readmitted to a secure treatment
facility, the transfer is revoked and the patient shall remain in a secure treatment facility.
The patient shall immediately be notified by the medical director in writing of the revocation.
new text end
new text begin
(c) Within 15 days of receiving notice of the revocation, the patient may petition the
special review board for a review of the revocation. The special review board shall review
the circumstances of the revocation and shall recommend to the commissioner whether or
not the revocation shall be upheld. The special review board may also recommend a new
transfer at the time of the revocation hearing.
new text end
new text begin
(d) If the transfer has not been revoked and the patient is to be returned to the facility
to which the patient was originally transferred pursuant to subdivision 6 with no substantive
change to the conditions of the transfer ordered pursuant to subdivision 6, no action by the
special review board or commissioner is required.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to any patient who is or retroactively to any patient who has been transferred out of
a secure treatment facility pursuant to Minnesota Statutes, section 253B.18, subdivision 6,
on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2018, section 253B.18, is amended by adding a subdivision to
read:
new text begin Subd. 6b. new text end
new text begin Transfer; revocation. new text end
new text begin
(a) The medical director may revoke a transfer made
pursuant to subdivision 6 and require a patient to return to a secure treatment facility if:
new text end
new text begin
(1) remaining in a nonsecure setting will not provide a reasonable degree of safety to
the patient or others; or
new text end
new text begin
(2) the facility to which the patient transferred is no longer sufficient to meet the patient's
treatment needs.
new text end
new text begin
(b) Upon the revocation of the transfer, the patient shall be immediately returned to a
secure treatment facility. The medical director shall issue a report documenting the reasons
for revocation within seven days after the patient is returned to the secure treatment facility.
Advance notice to the patient of the revocation is not required.
new text end
new text begin
(c) The medical director must provide a copy of the revocation report to the patient and
inform the patient, orally and in writing, of the rights of a patient under this subdivision.
The revocation report shall be served upon the patient and the patient's counsel by the
medical director. The report shall outline the specific reasons for the revocation including
but not limited to the specific facts upon which the revocation is based.
new text end
new text begin
(d) If a patient's transfer is revoked, the patient may re-petition for transfer according to
subdivision 5.
new text end
new text begin
(e) A patient aggrieved by a transfer revocation decision may petition the special review
board within seven days, excluding Saturdays, Sundays, and holidays as defined in section
645.44, subdivision 5, after receipt of the revocation report for a review of the revocation.
The matter shall be scheduled within 30 days. The special review board shall review the
circumstances leading to the revocation and, after considering the factors in paragraph (a),
shall recommend to the commissioner whether or not the revocation shall be upheld. The
special review board may also recommend a new transfer out of a secure treatment facility
pursuant to subdivision 6 at the time of the revocation hearing.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to any patient who is or retroactively to any patient who has been transferred out of
a secure treatment facility pursuant to Minnesota Statutes, section 253B.18, subdivision 6,
on or after that date.
new text end
Sec. 3.
Minnesota Statutes 2018, section 253B.18, subdivision 13, is amended to read:
Subd. 13.
Appeal.
Any patient aggrieved by a new text begin provisional discharge new text end revocation decision
or any interested person may petition the special review board within seven days, exclusive
of Saturdays, Sundays, and deleted text begin legaldeleted text end holidaysnew text begin as defined in section 645.44, subdivision 5new text end , after
receipt of the revocation report for a review of the revocation. The matter shall be scheduled
within 30 days. The special review board shall review the circumstances leading to the
revocation and shall recommend to the commissioner whether or not the revocation shall
be upheld. The special review board may also recommend a new provisional discharge at
the time of a revocation hearing.
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 253D.28, subdivision 3, is amended to read:
Subd. 3.
Decision.
A majority of the judicial appeal panel shall rule upon the petition.
The panel shall consider the petition de novo. No order of the judicial appeal panel granting
a transferdeleted text begin , discharge, or provisional dischargedeleted text end shall be made effective sooner than 15 days
after it is issued. new text begin No order of the judicial appeal panel granting provisional discharge or
discharge shall be made effective sooner than 30 days after it is issued. new text end The panel may not
consider petitions for relief other than those considered by the special review board from
which the appeal is taken. The judicial appeal panel may not grant a transfer or provisional
discharge on terms or conditions that were not presented to the special review board.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to any judicial appeal panel order granting provisional discharge or discharge that
is issued on or after that date.
new text end
Sec. 5.
Minnesota Statutes 2018, section 609.2231, subdivision 3a, is amended to read:
Subd. 3a.
Secure treatment facility personnel.
(a) As used in this subdivision, "secure
treatment facility" includes facilities listed in sections 253B.02, subdivision 18a, and
253D.02, subdivision 13.
(b) Whoever, while committed under chapter 253D, Minnesota Statutes 2012, section
253B.185, or Minnesota Statutes 1992, section 526.10, commits either of the following acts
against an employee or other individual who provides care or treatment at a secure treatment
facility while the person is engaged in the performance of a duty imposed by law, policy,
or rule is guilty of a felony and may be sentenced to imprisonment for not more than two
years or to payment of a fine of not more than $4,000, or both:
(1) assaults the person and inflicts demonstrable bodily harm; or
(2) intentionally throws or otherwise transfers bodily fluids or feces at or onto the person.
(c) Whoever, while committed under section 253B.18, or admitted under the provision
of section 253B.10, subdivision 1, commits either of the following acts against an employee
or other individual who supervises and works directly with patients at a secure treatment
facility while the person is engaged in the performance of a duty imposed by law, policy,
or rule, is guilty of a felony and may be sentenced to imprisonment for not more than two
years or to payment of a fine of not more than $4,000, or both:
(1) assaults the person and inflicts demonstrable bodily harm; or
(2) intentionally throws or otherwise transfers deleted text begin urine, blood, semen,deleted text end new text begin bodily fluidsnew text end or feces
onto the person.
(d) The court shall commit a person convicted of violating paragraph (b) to the custody
of the commissioner of corrections for not less than one year and one day. The court may
not, on its own motion or the prosecutor's motion, sentence a person without regard to this
paragraph. A person convicted and sentenced as required by this paragraph is not eligible
for probation, parole, discharge, work release, or supervised release, until that person has
served the full term of imprisonment as provided by law, notwithstanding the provisions of
sections 241.26, 242.19, 243.05, 244.04, 609.12, and 609.135.
(e) Notwithstanding the statutory maximum sentence provided in paragraph (b), when
a court sentences a person to the custody of the commissioner of corrections for a violation
of paragraph (b), the court shall provide that after the person has been released from prison,
the commissioner shall place the person on conditional release for five years. The terms of
conditional release are governed by sections 244.05 and 609.3455, subdivision 6, 7, or 8;
and Minnesota Statutes 2004, section 609.109.
ARTICLE 7
OPERATIONS
Section 1.
Minnesota Statutes 2018, section 13.46, subdivision 3, is amended to read:
Subd. 3.
Investigative data.
(a) Data on persons, including data on vendors of services,
licensees, and applicants that is collected, maintained, used, or disseminated by the welfare
system in an investigation, authorized by statute, and relating to the enforcement of rules
or law are confidential data on individuals pursuant to section 13.02, subdivision 3, or
protected nonpublic data not on individuals pursuant to section 13.02, subdivision 13, and
shall not be disclosed except:
(1) pursuant to section 13.05;
(2) pursuant to statute or valid court order;
(3) to a party named in a civil or criminal proceeding, administrative or judicial, for
preparation of defense; deleted text begin or
deleted text end
new text begin
(4) to an agent of the welfare system or an investigator acting on behalf of a county,
state, or federal government, including a law enforcement officer or attorney in the
investigation or prosecution of a criminal, civil, or administrative proceeding, unless the
commissioner of human services determines that disclosure may compromise a department
of human services ongoing investigation; or
new text end
deleted text begin (4)deleted text end new text begin (5)new text end to provide notices required or permitted by statute.
The data referred to in this subdivision shall be classified as public data upon submission
to an administrative law judge or court in an administrative or judicial proceeding. Inactive
welfare investigative data shall be treated as provided in section 13.39, subdivision 3.
(b) Notwithstanding any other provision in law, the commissioner of human services
shall provide all active and inactive investigative data, including the name of the reporter
of alleged maltreatment under section 626.556 or 626.557, to the ombudsman for mental
health and developmental disabilities upon the request of the ombudsman.
(c) Notwithstanding paragraph (a) and section 13.39, the existence of an investigation
by the commissionernew text begin of human servicesnew text end of possible overpayments of public funds to a service
provider or recipient may be disclosed if the commissioner determines that it will not
compromise the investigation.
Sec. 2.
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, having a license that has been
revoked or suspended under chapter 245A, or debarred or suspendednew text end under Minnesota Rules,
part 1230.1150new text begin , or excluded pursuant to section 256B.064, subdivision 3new text end .
(c) "Individual" means a natural person providing products or services as a provider or
vendor.
(d) "Provider" deleted text begin meansdeleted text end new text begin includes any entity or individual receiving payment from a program
administered by the Department of Human Services, andnew text end an owner, controlling individual,
license holder, director, or managerial officialnew text begin of an entity receiving payment from a program
administered by the Department of Human Servicesnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 3.
Minnesota Statutes 2018, section 245A.02, subdivision 3, is amended to read:
Subd. 3.
Applicant.
"Applicant" means an individual, deleted text begin corporation, partnership, voluntary
association, controlling individual, or otherdeleted text end organizationnew text begin , or government entity, as defined
in section 13.02, subdivision 7a,new text end that deleted text begin has applied for licensure under this chapter and the
rules of the commissionerdeleted text end new text begin is subject to licensure under this chapter and that has applied for
but not yet been granted a license under this chapternew 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.
Minnesota Statutes 2018, section 245A.02, is amended by adding a subdivision to
read:
new text begin Subd. 3b. new text end
new text begin Authorized agent. new text end
new text begin
"Authorized agent" means the controlling individual
designated by the license holder responsible for communicating with the commissioner of
human services on all matters related to this chapter and on whom service of all notices and
orders must be made pursuant to section 245A.04, subdivision 1.
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.02, subdivision 8, is amended to read:
Subd. 8.
License.
"License" means a certificate issued by the commissioner new text begin under section
245A.04 new text end authorizing the license holder to provide a specified program for a specified period
of time and in accordance with the terms of the license and the rules of the commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 6.
Minnesota Statutes 2018, section 245A.02, subdivision 9, is amended to read:
Subd. 9.
License holder.
"License holder" means an individual, deleted text begin corporation, partnership,
voluntary association, or otherdeleted text end organizationnew text begin , or government entitynew text end that is legally responsible
for the operation of the programnew text begin or servicenew text end , new text begin and new text end has been granted a license by the
commissioner under this chapter deleted text begin or chapter 245Ddeleted text end and the rules of the commissionerdeleted text begin , and
is a controlling individualdeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 7.
Minnesota Statutes 2018, section 245A.02, is amended by adding a subdivision to
read:
new text begin Subd. 10c. new text end
new text begin Organization. new text end
new text begin
"Organization" means a domestic or foreign corporation,
nonprofit corporation, limited liability company, partnership, limited partnership, limited
liability partnership, association, voluntary association, and any other legal or commercial
entity. For purposes of this chapter, organization does not include a government entity.
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 245A.02, subdivision 12, is amended to read:
Subd. 12.
Private agency.
"Private agency" means an deleted text begin individual, corporation, partnership,
voluntary association or otherdeleted text end organization, other than a county agency, or a court with
jurisdiction, that places persons who cannot remain in their own homes in residential
programs, foster care, or adoptive homes.
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 245A.02, subdivision 14, is amended to read:
Subd. 14.
Residential program.
new text begin (a) Except as provided in paragraph (b), new text end "residential
program" means a program that provides 24-hour-a-day care, supervision, food, lodging,
rehabilitation, training, education, habilitation, or treatment outside a person's own home,
including a program in an intermediate care facility for four or more persons with
developmental disabilities; and chemical dependency or chemical abuse programs that are
located in a hospital or nursing home and receive public funds for providing chemical abuse
or chemical dependency treatment services under chapter 254B. deleted text begin Residential programs
include home and community-based services for persons with disabilities or persons age
65 and older that are provided in or outside of a person's own home under chapter 245D.
deleted text end
new text begin
(b) For a residential program under chapter 245D, "residential program" means a single
or multifamily dwelling that is under the control, either directly or indirectly, of the service
provider licensed under chapter 245D and in which at least one person receives services
under chapter 245D, including residential supports and services under section 245D.03,
subdivision 1, paragraph (c), clause (3); out-of-home crisis respite services under section
245D.03, subdivision 1, paragraph (c), clause (1), item (ii); and out-of-home respite services
under section 245D.03, subdivision 1, paragraph (b), clause (1). A residential program does
not include out-of-home respite services when a case manager has determined that an
unlicensed site meets the assessed needs of the person. A residential program also does not
include multifamily dwellings where persons receive integrated community supports, even
if authorization to provide these supports is granted under chapter 245D and approved in
the federal waiver.
new text end
Sec. 10.
Minnesota Statutes 2018, section 245A.03, subdivision 1, is amended to read:
Subdivision 1.
License required.
Unless licensed by the commissionernew text begin under this chapternew text end ,
an individual, deleted text begin corporation, partnership, voluntary association, otherdeleted text end organization, or
deleted text begin controlling individualdeleted text end new text begin government entitynew text end must not:
(1) operate a residential or a nonresidential program;
(2) receive a child or adult for care, supervision, or placement in foster care or adoption;
(3) help plan the placement of a child or adult in foster care or adoption or engage in
placement activities as defined in section 259.21, subdivision 9, in this state, whether or not
the adoption occurs in this state; or
(4) advertise a residential or nonresidential program.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 11.
Minnesota Statutes 2018, section 245A.03, subdivision 3, is amended to read:
Subd. 3.
Unlicensed programs.
(a) It is a misdemeanor for an individual, deleted text begin corporation,
partnership, voluntary association, otherdeleted text end organization, or deleted text begin a controlling individualdeleted text end new text begin government
entitynew text end to provide a residential or nonresidential program without a license new text begin issued under this
chapter new text end and in willful disregard of this chapter unless the program is excluded from licensure
under subdivision 2.
(b) The commissioner may ask the appropriate county attorney or the attorney general
to begin proceedings to secure a court order against the continued operation of the program,
if an individual, deleted text begin corporation, partnership, voluntary association, otherdeleted text end organization, or
deleted text begin controlling individualdeleted text end new text begin government entitynew text end has:
(1) failed to apply for a license new text begin under this chapter new text end after receiving notice that a license is
required or continues to operate without a license after receiving notice that a license is
required;
(2) continued to operate without a license after deleted text begin thedeleted text end new text begin anew text end license new text begin issued under this chapter
new text end has been revoked or suspended under deleted text begin section 245A.07deleted text end new text begin this chapternew text end , and the commissioner
has issued a final order affirming the revocation or suspension, or the license holder did not
timely appeal the sanction; or
(3) continued to operate without a license after deleted text begin thedeleted text end new text begin a temporary immediate suspension
of anew text end license has been deleted text begin temporarily suspended under section 245A.07deleted text end new text begin issued under this chapternew text end .
new text begin (c) new text end The county attorney and the attorney general have a duty to cooperate with the
commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 12.
Minnesota Statutes 2018, section 245A.04, subdivision 1, is amended to read:
Subdivision 1.
Application for licensure.
(a) An individual, deleted text begin corporation, partnership,
voluntary association, otherdeleted text end organization deleted text begin or controlling individualdeleted text end new text begin , or government entitynew text end
that is subject to licensure under section 245A.03 must apply for a license. The application
must be made on the forms and in the manner prescribed by the commissioner. The
commissioner shall provide the applicant with instruction in completing the application and
provide information about the rules and requirements of other state agencies that affect the
applicant. An applicant seeking licensure in Minnesota with headquarters outside of
Minnesota must have a program office located within new text begin 30 miles of new text end the new text begin Minnesota new text end statenew text begin bordernew text end .new text begin
An applicant who intends to buy or otherwise acquire a program or services licensed under
this chapter that is owned by another license holder must apply for a license under this
chapter and comply with the application procedures in this section and section 245A.03.
new text end
The commissioner shall act on the application within 90 working days after a complete
application and any required reports have been received from other state agencies or
departments, counties, municipalities, or other political subdivisions. The commissioner
shall not consider an application to be complete until the commissioner receives all of the
deleted text begin informationdeleted text end required deleted text begin under section 245C.05deleted text end new text begin informationnew text end .
When the commissioner receives an application for initial licensure that is incomplete
because the applicant failed to submit required documents or that is substantially deficient
because the documents submitted do not meet licensing requirements, the commissioner
shall provide the applicant written notice that the application is incomplete or substantially
deficient. In the written notice to the applicant the commissioner shall identify documents
that are missing or deficient and give the applicant 45 days to resubmit a second application
that is substantially complete. An applicant's failure to submit a substantially complete
application after receiving notice from the commissioner is a basis for license denial under
section 245A.05.
(b) An application for licensure must identify all controlling individuals new text begin as defined in
section 245A.02, subdivision 5a, new text end and must deleted text begin specify andeleted text end new text begin designate one individual to be the
authorizednew text end agent deleted text begin who is responsible for dealing with the commissioner of human services
on all matters provided for in this chapter and on whom service of all notices and orders
must be madedeleted text end . new text begin The application must be signed by the authorized agent and must include
the authorized agent's first, middle, and last name; mailing address; and e-mail address. By
submitting an application for licensure, the authorized agent consents to electronic
communication with the commissioner throughout the application process. new text end The new text begin authorized
new text end agent must be authorized to accept service on behalf of all of the controlling individuals deleted text begin of
the programdeleted text end .new text begin A government entity that holds multiple licenses under this chapter may
designate one authorized agent for all licenses issued under this chapter or may designate
a different authorized agent for each license.new text end Service on the new text begin authorized new text end agent is service on
all of the controlling individuals deleted text begin of the programdeleted text end . It is not a defense to any action arising
under this chapter that service was not made on each controlling individual deleted text begin of the programdeleted text end .
The designation of deleted text begin one or moredeleted text end new text begin anew text end controlling deleted text begin individualsdeleted text end new text begin individualnew text end as deleted text begin agentsdeleted text end new text begin the authorized
agentnew text end under this paragraph does not affect the legal responsibility of any other controlling
individual under this chapter.
(c) An applicant or license holder must have a policy that prohibits license holders,
employees, subcontractors, and volunteers, when directly responsible for persons served
by the program, from abusing prescription medication or being in any manner under the
influence of a chemical that impairs the individual's ability to provide services or care. The
license holder must train employees, subcontractors, and volunteers about the program's
drug and alcohol policy.
(d) An applicant and license holder must have a program grievance procedure that permits
persons served by the program and their authorized representatives to bring a grievance to
the highest level of authority in the program.
(e) deleted text begin The applicant must be able to demonstrate competent knowledge of the applicable
requirements of this chapter and chapter 245C, and the requirements of other licensing
statutes and rules applicable to the program or services for which the applicant is seeking
to be licensed. Effective January 1, 2013,deleted text end new text begin The commissioner may limit communication
during the application process to the authorized agent or the controlling individuals identified
on the license application and for whom a background study was initiated under chapter
245C.new text end The commissioner may require the applicant, except for child foster care, to
demonstrate competence in the applicable licensing requirements by successfully completing
a written examination. The commissioner may develop a prescribed written examination
format.
(f) When an applicant is an individual, the deleted text begin individualdeleted text end new text begin applicantnew text end must provide:
(1) the applicant's taxpayer identification numbers including the Social Security numbernew text begin
or Minnesota tax identification numbernew text end , and federal employer identification number if the
applicant has employees;
(2) new text begin at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes new text end the complete business name, if anydeleted text begin , anddeleted text end new text begin ;
new text end
new text begin (3) new text end if doing business under a different name, the doing business as (DBA) name, as
registered with the secretary of state; deleted text begin and
deleted text end
deleted text begin
(3) a notarized signature of the applicant.
deleted text end
new text begin
(4) if applicable, the applicant's National
Provider Identifier (NPI) number and Unique Minnesota Provider Identifier (UMPI) number;
and
new text end
new text begin
(5) at the request of the commissioner, the notarized signature of the applicant or
authorized agent.
new text end
(g) When an applicant is deleted text begin a nonindividualdeleted text end new text begin an organizationnew text end , the applicant must provide
deleted text begin thedeleted text end :
(1) new text begin the new text end applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
(2) new text begin at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the new text end complete business name, and if doing business under a different
name, the doing business as (DBA) name, as registered with the secretary of state;
(3) new text begin the new text end first, middle, and last name, and address for all individuals who will be controlling
individuals, including all officers, owners, and managerial officials as defined in section
245A.02, subdivision 5a, and the date that the background study was initiated by the applicant
for each controlling individual; deleted text begin and
deleted text end
deleted text begin
(4) first, middle, and last name, mailing address, and notarized signature of the agent
authorized by the applicant to accept service on behalf of the controlling individuals.
deleted text end
new text begin
(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique
Minnesota Provider Identifier (UMPI) number;
new text end
new text begin
(5) the documents that created the organization and that determine the organization's
internal governance and the relations among the persons that own the organization, have
an interest in the organization, or are members of the organization, in each case as provided
or authorized by the organization's governing statute, which may include a partnership
agreement, bylaws, articles of organization, organizational chart, and operating agreement,
or comparable documents as provided in the organization's governing statute; and
new text end
new text begin
(6) the notarized signature of the applicant or authorized agent.
new text end
new text begin
(h) When the applicant is a government entity, the applicant must provide:
new text end
new text begin
(1) the name of the government agency, political subdivision, or other unit of government
seeking the license and the name of the program or services that will be licensed;
new text end
new text begin
(2) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
new text end
new text begin
(3) a letter signed by the manager, administrator, or other executive of the government
entity authorizing the submission of the license application; and
new text end
new text begin
(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique
Minnesota Provider Identifier (UMPI) number.
new text end
deleted text begin (h)deleted text end new text begin (i)new text end At the time of application for licensure or renewal of a licensenew text begin under this chapternew text end ,
the applicant or license holder must acknowledge on the form provided by the commissioner
if the applicant or license holder elects to receive any public funding reimbursement from
the commissioner for services provided under the license that:
(1) the applicant's or license holder's compliance with the provider enrollment agreement
or registration requirements for receipt of public funding may be monitored by the
commissioner as part of a licensing investigation or licensing inspection; and
(2) noncompliance with the provider enrollment agreement or registration requirements
for receipt of public funding that is identified through a licensing investigation or licensing
inspection, or noncompliance with a licensing requirement that is a basis of enrollment for
reimbursement for a service, may result in:
(i) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;
(ii) nonpayment of claims submitted by the license holder for public program
reimbursement;
(iii) recovery of payments made for the service;
(iv) disenrollment in the public payment program; or
(v) other administrative, civil, or criminal penalties as provided by law.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 13.
Minnesota Statutes 2018, section 245A.04, subdivision 2, is amended to read:
Subd. 2.
Notification of affected municipality.
The commissioner must not issue a
license new text begin under this chapter new text end without giving 30 calendar days' written notice to the affected
municipality or other political subdivision unless the program is considered a permitted
single-family residential use under sections 245A.11 and 245A.14. new text begin The commissioner may
provide notice through electronic communication. new text end The notification must be given before
the first issuance of a license new text begin under this chapter new text end and annually after that time if annual
notification is requested in writing by the affected municipality or other political subdivision.
State funds must not be made available to or be spent by an agency or department of state,
county, or municipal government for payment to a residential or nonresidential program
licensed under this chapter until the provisions of this subdivision have been complied with
in full. The provisions of this subdivision shall not apply to programs located in hospitals.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 14.
Minnesota Statutes 2018, section 245A.04, subdivision 4, is amended to read:
Subd. 4.
Inspections; waiver.
(a) Before issuing deleted text begin an initialdeleted text end new text begin anew text end licensenew text begin under this chapternew text end ,
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) deleted text begin an evaluation of the program by consumers of the program;
deleted text end
deleted text begin (4)deleted text end observation of the program in operation; and
deleted text begin (5)deleted text end new text begin (4)new text end an inspection for the health, safety, and fire standards in licensing requirements
for a child care license holder.
deleted text begin
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.
deleted text end
(b) The deleted text begin evaluation required in paragraph (a), clause (3), or thedeleted text end observation in paragraph
(a), clause deleted text begin (4)deleted text end new text begin (3)new text end , is not required prior to issuing deleted text begin an initialdeleted text end new text begin anew text end license under subdivision 7. If
the commissioner issues deleted text begin an initialdeleted text end new text begin anew text end license under deleted text begin subdivision 7deleted text end new text begin this chapternew text end , these
requirements must be completed within one year after the issuance of deleted text begin an initialdeleted text end new text begin thenew text end 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
violations of law or rule observed during the inspection and offer technical assistance on
how to comply with applicable laws and rules. Nothing in this paragraph limits the ability
of the commissioner to issue a correction order or negative action for violations of law or
rule not discussed in an exit interview or in the event that a license holder chooses not to
participate in an exit interview.
(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.
(e) No later than November 19, 2017, 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 year.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 15.
Minnesota Statutes 2018, section 245A.04, subdivision 6, is amended to read:
Subd. 6.
Commissioner's evaluation.
new text begin (a) new text end Before issuing, denying, suspending, revoking,
or making conditional a license, the commissioner shall evaluate information gathered under
this section. The commissioner's evaluation shall consider new text begin the applicable requirements of
statutes and rules for the program or services for which the applicant seeks a license,
including the disqualification standards set forth in chapter 245C, and shall evaluate new text end facts,
conditions, or circumstances concerningnew text begin :
new text end
new text begin (1) new text end the program's operationdeleted text begin ,deleted text end new text begin ;
new text end
new text begin (2) new text end the well-being of persons served by the programdeleted text begin ,deleted text end new text begin ;
new text end
new text begin (3) new text end available deleted text begin consumerdeleted text end evaluations of the programdeleted text begin , anddeleted text end new text begin by persons receiving services;
new text end
new text begin (4) new text end information about the qualifications of the personnel employed by the applicant or
license holderdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(5) the applicant's or license holder's ability to demonstrate competent knowledge of the
applicable requirements of statutes and rules including this chapter and chapter 245C for
which the applicant seeks a license or the license holder is licensed.
new text end
new text begin (b) new text end The commissioner shall new text begin also new text end evaluate the results of the study required in subdivision
3 and determine whether a risk of harm to the persons served by the program exists. In
conducting this evaluation, the commissioner shall apply the disqualification standards set
forth in chapter 245C.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 16.
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
licensenew 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), deleted text begin clauses (3) anddeleted text end new text begin clausenew text end (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 new text begin under this chapter, new text end 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 deleted text begin or 245Ddeleted text end 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 chapter new 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 chapter new 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 chapter new 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 chapter new 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. 17.
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, in
a manner prescribed by 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) A license holder must also notify the commissioner, in a manner prescribed by the
commissioner, before making any change:
new text end
new text begin
(1) to the license holder's authorized agent as defined in section 245A.02, subdivision
3b;
new text end
new text begin
(2) to the license holder's controlling individual as defined in section 245A.02, subdivision
5a;
new text end
new text begin
(3) to the license holder information on file with the secretary of state;
new text end
new text begin
(4) in the location of the program or service licensed under this chapter; and
new text end
new text begin
(5) in the federal or state tax identification number associated with the license holder.
new text end
new text begin
(c) When, for reasons beyond the license holder's control, a license holder cannot provide
the commissioner with prior notice of the changes in paragraph (b), clauses (1) to (3), the
license holder must notify the commissioner by the tenth business day after the change and
must provide any additional information requested by the commissioner.
new text end
new text begin
(d) When a license holder notifies the commissioner of a change to the license holder
information on file with the secretary of state, the license holder must provide amended
articles of incorporation and other documentation of the change.
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. 18.
Minnesota Statutes 2018, section 245A.04, subdivision 10, is amended to read:
Subd. 10.
Adoption agency; additional requirements.
In addition to the other
requirements of this section, an individualdeleted text begin , corporation, partnership, voluntary association,
otherdeleted text end new text begin ornew text end organizationdeleted text begin , or controlling individualdeleted text end applying for a license to place children for
adoption must:
(1) incorporate as a nonprofit corporation under chapter 317A;
(2) file with the application for licensure a copy of the disclosure form required under
section 259.37, subdivision 2;
(3) provide evidence that a bond has been obtained and will be continuously maintained
throughout the entire operating period of the agency, to cover the cost of transfer of records
to and storage of records by the agency which has agreed, according to rule established by
the commissioner, to receive the applicant agency's records if the applicant agency voluntarily
or involuntarily ceases operation and fails to provide for proper transfer of the records. The
bond must be made in favor of the agency which has agreed to receive the records; and
(4) submit a certified audit to the commissioner each year the license is renewed as
required under section 245A.03, subdivision 1.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 19.
new text begin
[245A.043] LICENSE APPLICATION AFTER A 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 in ownership. new text end
new text begin
(a) If the commissioner determines that there is a change
in ownership, the commissioner shall require submission of a new license application. This
subdivision does not apply to a licensed program or service located in a home where the
license holder resides. A change in 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) all controlling individuals associated with the original application have changed.
new text end
new text begin
(b) Notwithstanding paragraph (a), clauses (1) and (5), no change in ownership has
occurred if at least one controlling individual has been listed as a controlling individual for
the license for at least the previous 12 months.
new text end
new text begin Subd. 3. new text end
new text begin Change of ownership process. new text end
new text begin
(a) When a change in ownership is proposed
and the party intends to assume operation without an interruption in service longer than 60
days after acquiring the program or service, the license holder must provide the commissioner
with written notice of the proposed 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 in ownership
is complete, and must include documentation to support the upcoming change. The party
must comply with background study requirements under chapter 245C and shall pay the
application fee required under 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 streamline 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. For purposes of this subdivision,
"substantial compliance" means within the previous 12 months the commissioner did not
(1) issue a sanction under section 245A.07 against a license held by the party, or (2) 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 in ownership license is issued pursuant to
subdivision 4, the existing license holder is solely responsible for operating the program
according to applicable laws and rules 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 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 (1)
proof that the premises was inspected by a fire marshal or that the fire marshal deemed an
inspection was not warranted, and (2) proof that the premises was inspected for compliance
with the building code or 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 action
under section 245A.06 or 245A.07, the party must submit a letter as part of the application
process identifying how the party has or will come into full compliance with the licensing
requirements.
new text end
new text begin
(g) The commissioner shall evaluate the party's application according to section 245A.04,
subdivision 6. If the commissioner determines that the party has remedied or demonstrates
the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has
determined that the program otherwise complies with all applicable laws and rules, the
commissioner shall issue a license or conditional license under this chapter. The conditional
license remains 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 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
(i) 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 in ownership license. new text end
new text begin
(a) After receiving the party's
application pursuant to subdivision 3, upon the written request of the existing license holder
and the party, the commissioner may issue a temporary change in 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 existing 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 issue a temporary change in ownership license when a license
holder's death, divorce, or other event affects the ownership of the program and 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.
new text end
new text begin
(c) 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. 20.
Minnesota Statutes 2018, section 245A.05, is amended to read:
245A.05 DENIAL OF APPLICATION.
(a) The commissioner may deny a license if an applicant or controlling individual:
(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;
(2) fails to comply with applicable laws or rules;
(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;
(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;
(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;
(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted; deleted text begin or
deleted text end
(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g)deleted text begin .deleted text end new text begin ;
new text end
new text begin
(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;
new text end
new text begin
(9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules including but not limited to this chapter and chapters 119B and
245C; or
new text end
new text begin
(10) is prohibited from holding a license according to section 245.095.
new text end
(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial, which must state the reasons for the denial in plain language. Notice
must be given by certified mail or personal service. The notice must state the reasons the
application was denied and must inform the applicant of the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may
appeal the denial by notifying the commissioner in writing by certified mail or personal
service. If mailed, the appeal must be postmarked and sent to the commissioner within 20
calendar days after the applicant received the notice of denial. If an appeal request is made
by personal service, it must be received by the commissioner within 20 calendar days after
the applicant received the notice of denial. Section 245A.08 applies to hearings held to
appeal the commissioner's denial of an application.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 21.
new text begin
[245A.055] CLOSING A LICENSE.
new text end
new text begin Subdivision 1. new text end
new text begin Inactive programs. new text end
new text begin
The commissioner shall close a license if the
commissioner determines that a licensed program has not been serving any client for a
consecutive period of 12 months or longer. The license holder is not prohibited from
reapplying for a license if the license holder's license was closed under this chapter.
new text end
new text begin Subd. 2. new text end
new text begin Reconsideration of closure. new text end
new text begin
If a license is closed, the commissioner must
notify the license holder of closure by certified mail or personal service. If mailed, the notice
of closure must be mailed to the last known address of the license holder and must inform
the license holder why the license was closed and that the license holder has the right to
request reconsideration of the closure. If the license holder believes that the license was
closed in error, the license holder may ask the commissioner to reconsider the closure. The
license holder's request for reconsideration must be made in writing and must include
documentation that the licensed program has served a client in the previous 12 months. The
request for reconsideration must be postmarked and sent to the commissioner within 20
calendar days after the license holder receives the notice of closure. A timely request for
reconsideration stays imposition of the license closure until the commissioner issues a
decision on the request for reconsideration.
new text end
new text begin Subd. 3. new text end
new text begin Reconsideration final. new text end
new text begin
The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14.
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. 22.
Minnesota Statutes 2018, section 245A.07, subdivision 1, is amended to read:
Subdivision 1.
Sanctions; appeals; license.
(a) In addition to making a license conditional
under section 245A.06, the commissioner may suspend or revoke the license, impose a fine,
or secure an injunction against the continuing operation of the program of a license holder
who does not comply with applicable law or rule. When applying sanctions authorized under
this section, 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.
(b) If a license holder appeals the suspension or revocation of a license and the license
holder continues to operate the program pending a final order on the appeal, the commissioner
shall issue the license holder a temporary provisional license. Unless otherwise specified
by the commissioner, variances in effect on the date of the license sanction under appeal
continue under the temporary provisional license. If a license holder fails to comply with
applicable law or rule while operating under a temporary provisional license, the
commissioner may impose additional sanctions under this section and section 245A.06, and
may terminate any prior variance. If a temporary provisional license is set to expire, a new
temporary provisional license shall be issued to the license holder upon payment of any fee
required under section 245A.10. The temporary provisional license shall expire on the date
the final order is issued. If the license holder prevails on the appeal, a new nonprovisional
license shall be issued for the remainder of the current license period.
(c) If a license holder is under investigation and the license new text begin issued under this chapter new text end is
due to expire before completion of the investigation, the program shall be issued a new
license upon completion of the reapplication requirements and payment of any applicable
license fee. Upon completion of the investigation, a licensing sanction may be imposed
against the new license under this section, section 245A.06, or 245A.08.
(d) Failure to reapply or closure of a license new text begin issued under this chapter new text end by the license
holder prior to the completion of any investigation shall not preclude the commissioner
from issuing a licensing sanction under this sectiondeleted text begin ,deleted text end new text begin ornew text end section 245A.06deleted text begin , or 245A.08deleted text end at the
conclusion of the investigation.
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.07, subdivision 2, is amended to read:
Subd. 2.
Temporary immediate suspension.
(a) The commissioner shall act immediately
to temporarily suspend a license new text begin issued under this chapter new text end if:
(1) the license holder's actions or failure to comply with applicable law or rule, or the
actions of other individuals or conditions in the program, pose an imminent risk of harm to
the health, safety, or rights of persons served by the program; deleted text begin or
deleted text end
(2) while the program continues to operate pending an appeal of an order of revocation,
the commissioner identifies one or more subsequent violations of law or rule which may
adversely affect the health or safety of persons served by the programdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(3) the license holder is criminally charged in state or federal court with an offense that
involves fraud or theft against a program administered by the commissioner.
new text end
(b) No state funds shall be made available or be expended by any agency or department
of state, county, or municipal government for use by a license holder regulated under this
chapter while a license new text begin issued under this chapter new text end is under immediate suspension. A notice
stating the reasons for the immediate suspension and informing the license holder of the
right to an expedited hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
1400.8612, must be delivered by personal service to the address shown on the application
or the last known address of the license holder. The license holder may appeal an order
immediately suspending a license. The appeal of an order immediately suspending a license
must be made in writing by certified mail deleted text begin ordeleted text end new text begin ,new text end personal servicenew text begin , or other means expressly set
forth in the commissioner's ordernew text end . If mailed, the appeal must be postmarked and sent to the
commissioner within five calendar days after the license holder receives notice that the
license has been immediately suspended. If a request is made by personal service, it must
be received by the commissioner within five calendar days after the license holder received
the order. A license holder and any controlling individual shall discontinue operation of the
program upon receipt of the commissioner's order to immediately suspend the license.
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.07, subdivision 2a, is amended to read:
Subd. 2a.
Immediate suspension expedited hearing.
(a) Within five working days of
receipt of the license holder's timely appeal, the commissioner shall request assignment of
an administrative law judge. The request must include a proposed date, time, and place of
a hearing. A hearing must be conducted by an administrative law judge within 30 calendar
days of the request for assignment, unless an extension is requested by either party and
granted by the administrative law judge for good cause. The commissioner shall issue a
notice of hearing by certified mail or personal service at least ten working days before the
hearing. The scope of the hearing shall be limited solely to the issue of whether the temporary
immediate suspension should remain in effect pending the commissioner's final order under
section 245A.08, regarding a licensing sanction issued under subdivision 3 following the
immediate suspension. For suspensions under subdivision 2, paragraph (a), clause (1), the
burden of proof in expedited hearings under this subdivision shall be limited to the
commissioner's demonstration that reasonable cause exists to believe that the license holder's
actions or failure to comply with applicable law or rule poses, or the actions of other
individuals or conditions in the program poses an imminent risk of harm to the health, safety,
or rights of persons served by the program. "Reasonable cause" means there exist specific
articulable facts or circumstances which provide the commissioner with a reasonable
suspicion that there is an imminent risk of harm to the health, safety, or rights of persons
served by the program. When the commissioner has determined there is reasonable cause
to order the temporary immediate suspension of a license based on a violation of safe sleep
requirements, as defined in section 245A.1435, the commissioner is not required to
demonstrate that an infant died or was injured as a result of the safe sleep violations. For
suspensions under subdivision 2, paragraph (a), clause (2), the burden of proof in expedited
hearings under this subdivision shall be limited to the commissioner's demonstration by a
preponderance of evidence that, since the license was revoked, the license holder committed
additional violations of law or rule which may adversely affect the health or safety of persons
served by the program.
(b) The administrative law judge shall issue findings of fact, conclusions, and a
recommendation within ten working days from the date of hearing. The parties shall have
ten calendar days to submit exceptions to the administrative law judge's report. The record
shall close at the end of the ten-day period for submission of exceptions. The commissioner's
final order shall be issued within ten working days from the close of the record. When an
appeal of a temporary immediate suspension is withdrawn or dismissed, the commissioner
shall issue a final order affirming the temporary immediate suspension within ten calendar
days of the commissioner's receipt of the withdrawal or dismissal. Within 90 calendar days
after a final order affirming an immediate suspension, the commissioner shall make a
determination regarding whether a final licensing sanction shall be issued under subdivision
3. The license holder shall continue to be prohibited from operation of the program during
this 90-day period.
(c) When the final order under paragraph (b) affirms an immediate suspension, and a
final licensing sanction is issued under subdivision 3 and the license holder appeals that
sanction, the license holder continues to be prohibited from operation of the program pending
a final commissioner's order under section 245A.08, subdivision 5, regarding the final
licensing sanction.
new text begin
(d) For suspensions under subdivision 2, paragraph (a), clause (3), the burden of proof
in expedited hearings under this subdivision shall be limited to the commissioner's
demonstration by a preponderance of evidence that a criminal complaint and warrant or
summons was issued for the license holder that was not dismissed, and that the criminal
charge is an offense that involves fraud or theft against a program administered by the
commissioner.
new text end
Sec. 25.
Minnesota Statutes 2018, section 245A.07, subdivision 3, is amended to read:
Subd. 3.
License suspension, revocation, or fine.
(a) The commissioner may suspend
or revoke a license, or impose a fine if:
(1) a license holder fails to comply fully with applicable laws or rulesnew text begin including but not
limited to the requirements of this chapter and chapter 245Cnew text end ;
(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
deleted text begin adeleted text end new text begin been disqualified and thenew text end disqualification deleted text begin which hasdeleted text end new text begin wasnew text end not deleted text begin beendeleted text end set aside deleted text begin under section
245C.22deleted text end new text begin and no variance has been grantednew text end ;
(3) a license holder knowingly withholds relevant information from or gives false or
misleading information to the commissioner in connection with an application for a license,
in connection with the background study status of an individual, during an investigation,
or regarding compliance with applicable laws or rules; deleted text begin or
deleted text end
(4) deleted text begin after July 1, 2012, and upon request by the commissioner, a license holder fails to
submit the information required of an applicant under section 245A.04, subdivision 1,
paragraph (f) or (g).deleted text end new text begin a license holder is excluded from any program administered by the
commissioner under section 245.095; or
new text end
new text begin
(5) revocation is required under section 245A.04, subdivision 7, paragraph (d).
new text end
A license holder who has had a license new text begin issued under this chapter new text end suspended, revoked,
or has been ordered to pay a fine must be given notice of the action by certified mail or
personal service. If mailed, the notice must be mailed to the address shown on the application
or the last known address of the license holder. The notice must state in plain language the
reasons the license was suspended or revoked, or a fine was ordered.
(b) If the license was suspended or revoked, the notice must inform the license holder
of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
a license. The appeal of an order suspending or revoking a license must be made in writing
by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
the commissioner within ten calendar days after the license holder receives notice that the
license has been suspended or revoked. If a request is made by personal service, it must be
received by the commissioner within ten calendar days after the license holder received the
order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a
timely appeal of an order suspending or revoking a license, the license holder may continue
to operate the program as provided in section 245A.04, subdivision 7, paragraphs 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 , until the commissioner issues a final order on the suspension or revocation.
(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
holder of the responsibility for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
order to pay a fine must be made in writing by certified mail or personal service. If mailed,
the appeal must be postmarked and sent to the commissioner within ten calendar days after
the license holder receives notice that the fine has been ordered. If a request is made by
personal service, it must be received by the commissioner within ten calendar days after
the license holder received the order.
(2) The license holder shall pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies. If the license holder
receives state funds, the state, county, or municipal agencies or departments responsible for
administering the funds shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.
(3) A license holder shall promptly notify the commissioner of human services, in writing,
when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected as indicated by the order
to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
the license holder by certified mail or personal service that a second fine has been assessed.
The license holder may appeal the second fine as provided under this subdivision.
(4) Fines shall be assessed as follows:
(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c);
(ii) if the commissioner determines that a determination of maltreatment for which the
license holder is responsible is the result of maltreatment that meets the definition of serious
maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
$5,000;
(iii) for a program that operates out of the license holder's home and a program licensed
under Minnesota Rules, parts 9502.0300 to deleted text begin 9502.0495deleted text end new text begin 9502.0445new text end , the fine assessed against
the license holder shall not exceed $1,000 for each determination of maltreatment;
(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule
governing matters of health, safety, or supervision, including but not limited to the provision
of adequate staff-to-child or adult ratios, and failure to comply with background study
requirements under chapter 245C; and
(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule
other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iv).
For purposes of this section, "occurrence" means each violation identified in the
commissioner's fine order. Fines assessed against a license holder that holds a license to
provide home and community-based services, as identified in section 245D.03, subdivision
1, and a community residential setting or day services facility license under chapter 245D
where the services are provided, may be assessed against both licenses for the same
occurrence, but the combined amount of the fines shall not exceed the amount specified in
this clause for that occurrence.
(5) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the case of a corporation, each
controlling individual is personally and jointly liable for payment.
(d) Except for background study violations involving the failure to comply with an order
to immediately remove an individual or an order to provide continuous, direct supervision,
the commissioner shall not issue a fine under paragraph (c) relating to a background study
violation to a license holder who self-corrects a background study violation before the
commissioner discovers the violation. A license holder who has previously exercised the
provisions of this paragraph to avoid a fine for a background study violation may not avoid
a fine for a subsequent background study violation unless at least 365 days have passed
since the license holder self-corrected the earlier background study violation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 26.
Minnesota Statutes 2018, section 245E.01, subdivision 8, is amended to read:
Subd. 8.
Financial misconduct or misconduct.
"Financial misconduct" or "misconduct"
means an entity's or individual's acts or omissions that result in fraud and abuse or error
against the Department of Human Services. Financial misconduct includesnew text begin : (1)new text end acting as a
recruiter offering conditional employment on behalf of a provider that has received funds
from the child care assistance programnew text begin ; and (2) committing an act or acts that meet the
definition of offenses listed in section 609.817new text end .
Sec. 27.
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. 28.
Minnesota Statutes 2018, section 245E.02, subdivision 4, is amended to read:
Subd. 4.
Actions or administrative sanctions.
(a) After completing the determination
under subdivision 3, the department may take one or more of the actions or sanctions
specified in this subdivision.
(b) The department may take the following actions:
(1) refer the investigation to law enforcement or a county attorney for possible criminal
prosecution;
(2) refer relevant information to the department's licensing division, the child care
assistance program, the Department of Education, the federal Child and Adult Care Food
Program, or appropriate child or adult protection agency;
(3) enter into a settlement agreement with a provider, license holder, controlling
individual, or recipient; or
(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction
for possible civil action under the Minnesota False Claims Act, chapter 15C.
(c) In addition to section 256.98, the department may impose sanctions by:
(1) pursuing administrative disqualification deleted text begin through hearings or waiversdeleted text end ;
(2) establishing and seeking monetary recovery or recoupment;
(3) issuing an order of corrective action that states the practices that are violations of
child care assistance program policies, laws, or regulations, and that they must be corrected;
or
(4) suspending, denying, or terminating payments to a provider.
(d) Upon a finding by the commissioner that any child care provider, center owner,
director, manager, license holder, or other controlling individual of a child care center has
employed, used, or acted as a recruiter offering conditional employment for a child care
center that has received child care assistance program funding, the commissioner shall:
(1) immediately suspend all program payments to all child care centers in which the
person employing, using, or acting as a recruiter offering conditional employment is an
owner, director, manager, license holder, or other controlling individual. The commissioner
shall suspend program payments under this clause even if services have already been
provided; and
(2) immediately and permanently revoke the licenses of all child care centers of which
the person employing, using, or acting as a recruiter offering conditional employment is an
owner, director, manager, license holder, or other controlling individual.
Sec. 29.
Minnesota Statutes 2018, section 245E.02, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Administrative disqualifications. new text end
new text begin
(a) The department shall pursue an
administrative disqualification in subdivision 4, paragraph (c), clause (1), if the provider
committed an intentional program violation. Intentional program violations include
intentionally making false or misleading statements; intentionally misrepresenting,
concealing, or withholding facts; and intentionally violating program regulations. Intent
may be proven by demonstrating a pattern or conduct that violates program rules.
new text end
new text begin
(b) To initiate an administrative disqualification, the department must issue a notice to
the provider under section 245E.06, subdivision 2.
new text end
new text begin
(c) The provider may appeal the department's administrative disqualification according
to section 256.045. The appeal must be made in writing and must be received by the
department no later than 30 days after the issuance of the notice to the provider. On appeal
the department bears the burden of proof to demonstrate by a preponderance of the evidence
that the provider committed an intentional program violation.
new text end
new text begin
(d) The human services judge may combine a fair hearing and administrative
disqualification hearing into a single hearing if the factual issues arise out of the same or
related circumstances and the provider receives prior notice that the hearings will be
combined.
new text end
new text begin
(e) A provider found to have committed an intentional program violation and is
administratively disqualified shall be disqualified, for a period of three years for the first
offense and permanently for any subsequent offense, from receiving any payments from
any child care program under chapter 119B. Unless a timely and proper appeal made under
this section is received by the department, the administrative determination of the department
is final and binding.
new text end
Sec. 30.
Minnesota Statutes 2018, section 256.045, subdivision 3, is amended to read:
Subd. 3.
State agency hearings.
(a) State agency hearings are available for the following:
(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food Stamp Act whose application for assistance is denied, not acted upon with
reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed
to have been incorrectly paid;
(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;
(3) a party aggrieved by a ruling of a prepaid health plan;
(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;
(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section 626.556 is denied or not
acted upon with reasonable promptness, regardless of funding source;
(6) any person to whom a right of appeal according to this section is given by other
provision of law;
(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;
(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under section 626.556, after the individual or facility has exercised the
right to administrative reconsideration under section 626.556;
(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;
(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;
(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, from residential supports and services as defined in section 245D.03, subdivision 1,
paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a;
(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914; deleted text begin or
deleted text end
(14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4adeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(15) pursuant to Minnesota Rules, part 9510.1140, a provider or county aggrieved by
an order of the commissioner regarding a request for a special needs rate exception. Appeals
under this clause are not subject to an evidentiary hearing and proceed by desk review.
new text end
(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.new text begin If the
district court action is a juvenile protection proceeding under chapter 260C, the matter may
also be considered in an administrative hearing if: (1) an adjudication was made under
section 260C.513 and the only actions still before the district court are status review hearings;
and (2) the person involved wishes to proceed with an administrative hearing.
new text end
(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.
(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.
(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision deleted text begin 2adeleted text end new text begin 11new text end ,
paragraphs (d) to deleted text begin (f)deleted text end new text begin (g)new text end , were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.
(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.
(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.
(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.
(i) Unless federal or Minnesota law specifies a different time frame new text begin or method new text end in which
to file an appeal, an individual or organization specified in this section may contest the
specified action, decision, or final disposition before the state agency by submitting a written
request for a hearing to the state agency within deleted text begin 30deleted text end new text begin 90new text end days deleted text begin after receivingdeleted text end new text begin from the date of
thenew text end written notice of the action, decision, or final dispositiondeleted text begin , or within 90 days of such
written notice if the applicant, recipient, patient, or relative shows good cause, as defined
in section 256.0451, subdivision 13, why the request was not submitted within the 30-day
time limit. The individual filing the appeal has the burden of proving good cause by a
preponderance of the evidencedeleted text end .
new text begin
(j) Notwithstanding paragraph (i), a hearing request to contest the imposition of a medical
assistance lien under section 514.981 must be submitted within 30 days after receiving
written notice of the agency's lien rights.
new text end
Sec. 31.
Minnesota Statutes 2018, section 256.045, subdivision 4, is amended to read:
Subd. 4.
Conduct of hearings.
(a) All hearings held pursuant to subdivision 3, 3a, 3b,
or 4a shall be conducted according to the provisions of the federal Social Security Act and
the regulations implemented in accordance with that act to enable this state to qualify for
federal grants-in-aid, and according to the rules and written policies of the commissioner
of human services. County agencies shall install equipment necessary to conduct telephone
hearings. deleted text begin A state human services judgedeleted text end new text begin The Appeals Divisionnew text end may schedule a telephone
conference hearing when the distance or time required to travel to the county agency offices
will cause a delay in the issuance of an order, or to promote efficiency, or at the mutual
request of the parties. Hearings may be conducted by telephone conferences unless the
applicant, recipient, former recipient, person, or facility contesting maltreatment objects.
deleted text begin A human services judgedeleted text end new text begin The Appeals Divisionnew text end may grant a request for a hearing in person
by holding the hearing by interactive video technology or in person. The human services
judge must hear the case in person if the person asserts that either the person or a witness
has a physical or mental disability that would impair the person's or witness's ability to fully
participate in a hearing held by interactive video technology. The hearing shall not be held
earlier than five days after filing of the required notice with the county or state agency. deleted text begin The
state human services judgedeleted text end new text begin The Appeals Divisionnew text end shall notify all interested persons of the
time, date, and location of the hearing at least five days before the date of the hearing.
Interested persons may be represented by legal counsel or other representative of their
choice, including a provider of therapy services, at the hearing and may appear personally,
testify and offer evidence, and examine and cross-examine witnesses. The applicant, recipient,
former recipient, person, or facility contesting maltreatment shall have the opportunity to
examine the contents of the case file and all documents and records to be used by the county
or state agency at the hearing at a reasonable time before the date of the hearing and during
the hearing. In hearings under subdivision 3, paragraph (a), clauses (4), (9), and (10), either
party may subpoena the private data relating to the investigation prepared by the agency
under section 626.556 or 626.557 that is not otherwise accessible under section 13.04,
provided the identity of the reporter may not be disclosed.
(b) The private data obtained by subpoena in a hearing under subdivision 3, paragraph
(a), clause (4), (9), or (10), must be subject to a protective order which prohibits its disclosure
for any other purpose outside the hearing provided for in this section without prior order of
the district court. Disclosure without court order is punishable by a sentence of not more
than 90 days imprisonment or a fine of not more than $1,000, or both. These restrictions on
the use of private data do not prohibit access to the data under section 13.03, subdivision
6. Except for appeals under subdivision 3, paragraph (a), clauses (4), (5), (9), and (10), upon
request, the county agency shall provide reimbursement for transportation, child care,
photocopying, medical assessment, witness fee, and other necessary and reasonable costs
incurred by the applicant, recipient, or former recipient in connection with the appeal. All
evidence, except that privileged by law, commonly accepted by reasonable people in the
conduct of their affairs as having probative value with respect to the issues shall be submitted
at the hearing and such hearing shall not be "a contested case" within the meaning of section
14.02, subdivision 3. The agency must present its evidence prior to or at the hearingdeleted text begin , and
may not submit evidence after the hearing except by agreement of the parties at the hearing,
provided the petitioner has the opportunity to responddeleted text end .new text begin A party shall not submit evidence
after the hearing except: (1) by agreement at the hearing between the appellant, the agency,
and the human services judge; (2) in response to new evidence; or (3) when the human
services judge determines that additional evidence is needed to sufficiently complete the
appeal file and make a fair and accurate decision. If a party submits evidence after the
hearing, consistent with an exception, the other party must be allowed sufficient opportunity
to respond to the evidence.
new text end
(c) In hearings under subdivision 3, paragraph (a), clauses (4), (9), and (10), involving
determinations of maltreatment or disqualification made by more than one county agency,
by a county agency and a state agency, or by more than one state agency, the hearings may
be consolidated into a single fair hearing upon the consent of all parties and the state human
services judge.
(d) For hearings under subdivision 3, paragraph (a), clause (4) or (10), involving a
vulnerable adult, the deleted text begin human services judgedeleted text end new text begin Appeals Divisionnew text end shall notify the vulnerable
adult who is the subject of the maltreatment determination and, if known, a guardian of the
vulnerable adult appointed under section 524.5-310, or a health care agent designated by
the vulnerable adult in a health care directive that is currently effective under section 145C.06
and whose authority to make health care decisions is not suspended under section 524.5-310,
of the hearing. The notice must be sent by certified mail and inform the vulnerable adult of
the right to file a signed written statement in the proceedings. A guardian or health care
agent who prepares or files a written statement for the vulnerable adult must indicate in the
statement that the person is the vulnerable adult's guardian or health care agent and sign the
statement in that capacity. The vulnerable adult, the guardian, or the health care agent may
file a written statement with the deleted text begin human services judge hearing the casedeleted text end new text begin Appeals Divisionnew text end
no later than five business days before commencement of the hearing. The human services
judge shall include the written statement in the hearing record and consider the statement
in deciding the appeal. This subdivision does not limit, prevent, or excuse the vulnerable
adult from being called as a witness testifying at the hearing or grant the vulnerable adult,
the guardian, or health care agent a right to participate in the proceedings or appeal the
deleted text begin human services judge'sdeleted text end new text begin commissioner'snew text end decision in the case. The lead investigative agency
must consider including the vulnerable adult victim of maltreatment as a witness in the
hearing. If the lead investigative agency determines that participation in the hearing would
endanger the well-being of the vulnerable adult or not be in the best interests of the vulnerable
adult, the lead investigative agency shall inform the human services judge of the basis for
this determination, which must be included in the final order. If the deleted text begin human services judgedeleted text end new text begin
Appeals Divisionnew text end is not reasonably able to determine the address of the vulnerable adult,
the guardian, or the health care agent, the deleted text begin human services judgedeleted text end new text begin Appeals Divisionnew text end is not
required to send a hearing notice under this subdivision.
Sec. 32.
Minnesota Statutes 2018, section 256.045, subdivision 5, is amended to read:
Subd. 5.
Orders of the commissioner of human services.
new text begin (a) new text end A state human services
judge shall conduct a hearing on the appeal and shall recommend an order to the
commissioner of human services. The recommended order must be based on all relevant
evidence and must not be limited to a review of the propriety of the state or county agency's
action. A human services judge may take official notice of adjudicative facts. The
commissioner of human services may accept the recommended order of a state human
services judge and issue the order to the county agency and the applicant, recipient, former
recipient, or prepaid health plan. The commissioner on refusing to accept the recommended
order of the state human services judge, shall notify the petitioner, the agency, or prepaid
health plan of that fact and shall state reasons therefor and shall allow each party new text begin at least
new text end ten days' time to submit additional written argument on the matter. After the expiration of
the deleted text begin ten-daydeleted text end new text begin commentnew text end period, the commissioner shall issue an order on the matter to the
petitioner, the agency, or prepaid health plan.
new text begin (b) new text end A party aggrieved by an order of the commissioner may appeal under subdivision
7, or request reconsideration by the commissioner within 30 days after the date the
commissioner issues the order. The commissioner may reconsider an order upon request of
any party or on the commissioner's own motion. A request for reconsideration does not stay
implementation of the commissioner's order. The person seeking reconsideration has the
burden to demonstrate why the matter should be reconsidered. The request for reconsideration
may include legal argument and proposed additional evidence supporting the request. If
proposed additional evidence is submitted, the person must explain why the proposed
additional evidence was not provided at the time of the hearing. If reconsideration is granted,
the other participants must be sent a copy of all material submitted in support of the request
for reconsideration and must be given new text begin at least new text end ten days to respond. Upon reconsideration,
the commissioner may issue an amended order or an order affirming the original order.
new text begin (c) new text end Any order of the commissioner issued under this subdivision shall be conclusive
upon the parties unless appeal is taken in the manner provided by subdivision 7. Any order
of the commissioner is binding on the parties and must be implemented by the state agency,
a county agency, or a prepaid health plan according to subdivision 3a, until the order is
reversed by the district court, or unless the commissioner or a district court orders monthly
assistance or aid or services paid or provided under subdivision 10.
new text begin (d) new text end A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing or seek judicial review of an order issued under this section, unless assisting
a recipient as provided in subdivision 4. A prepaid health plan is a party to an appeal under
subdivision 3a, but cannot seek judicial review of an order issued under this section.
Sec. 33.
Minnesota Statutes 2018, section 256.045, subdivision 6, is amended to read:
Subd. 6.
Additional powers of commissioner; subpoenas.
(a) The commissioner of
human services, or the commissioner of health for matters within the commissioner's
jurisdiction under subdivision 3b, may initiate a review of any action or decision of a county
agency and direct that the matter be presented to a state human services judge for a hearing
held under subdivision 3, 3a, 3b, or 4a. In all matters dealing with human services committed
by law to the discretion of the county agency, the commissioner's judgment may be
substituted for that of the county agency. The commissioner may order an independent
examination when appropriate.
(b) Any party to a hearing held pursuant to subdivision 3, 3a, 3b, or 4a may request that
the commissioner issue a subpoena to compel the attendance of witnesses and the production
of records at the hearing. A local agency may request that the commissioner issue a subpoena
to compel the release of information from third parties prior to a request for a hearing under
section 256.046 upon a showing of relevance to such a proceeding. The issuance, service,
and enforcement of subpoenas under this subdivision is governed by section 357.22 and
the Minnesota Rules of Civil Procedure.
(c) The commissioner may issue a temporary order staying a proposed demission by a
residential facility licensed under chapter 245A:
(1) while an appeal by a recipient under subdivision 3 is pending;
(2) for the period of time necessary for the case management provider to implement the
commissioner's order; or
(3) for appeals under subdivision 3, paragraph (a), deleted text begin clausedeleted text end new text begin clausesnew text end (12)new text begin and (14)new text end , when
the individual is seeking a temporary stay of demission on the basis that the county has not
yet finalized an alternative arrangement for a residential facility, a program, or services that
will meet the assessed needs of the individual by the effective date of the service termination,
a temporary stay of demission may be issued for no more than 30 calendar days to allow
for such arrangements to be finalized.
Sec. 34.
Minnesota Statutes 2018, section 256.045, subdivision 10, is amended to read:
Subd. 10.
Payments pending appeal.
If the commissioner of human services or district
court orders monthly assistance or aid or services paid or provided in any proceeding under
this section, it shall be paid or provided pending appeal to the commissioner of human
services, district court, court of appeals, or supreme court. The deleted text begin human services judgedeleted text end new text begin
commissionernew text end may order the local human services agency to reduce or terminate medical
assistance to a recipient before a final order is issued under this section if: (1) the human
services judge determines at the hearing that the sole issue on appeal is one of a change in
state or federal law; and (2) the commissioner or the local agency notifies the recipient
before the action. The state or county agency has a claim for food stamps, food support,
cash payments, medical assistance, and MinnesotaCare program payments made to or on
behalf of a recipient or former recipient while an appeal is pending if the recipient or former
recipient is determined ineligible for the food stamps, food support, cash payments, medical
assistance, or MinnesotaCare as a result of the appeal, except for medical assistance made
on behalf of a recipient pursuant to a court order. In enforcing a claim on MinnesotaCare
program payments, the state or county agency shall reduce the claim amount by the value
of any premium payments made by a recipient or former recipient during the period for
which the recipient or former recipient has been determined to be ineligible. Provision of
a health care service by the state agency under medical assistance or MinnesotaCare pending
appeal shall not render moot the state agency's position in a court of law.
Sec. 35.
Minnesota Statutes 2018, section 256.0451, subdivision 1, is amended to read:
Subdivision 1.
Scope.
new text begin (a) new text end The requirements in this section apply to all fair hearings and
appeals under section 256.045, subdivision 3, paragraph (a), clauses (1), (2), (3), (5), (6),
(7), (8), (11), and (13). Except as provided in subdivisions 3 and 19, the requirements under
this section apply to fair hearings and appeals under section 256.045, subdivision 3, paragraph
(a), clauses (4), (9), (10), deleted text begin anddeleted text end (12)new text begin , (14), and (15)new text end .
deleted text begin The termdeleted text end new text begin (b) For purposes of this section,new text end "person" deleted text begin is used in this section to meandeleted text end new text begin meansnew text end
an individual who, on behalf of themselves or their household, is appealing or disputing or
challenging an action, a decision, or a failure to act, by an agency in the human services
system. When a person involved in a proceeding under this section is represented by an
attorney deleted text begin or by andeleted text end new text begin ,new text end authorized representative, deleted text begin the term "person"deleted text end new text begin or other advocate for whom
the person gave clear consent to contest the matter on the person's behalf; personnew text end also deleted text begin refers
todeleted text end new text begin meansnew text end the person's attorney deleted text begin ordeleted text end new text begin ,new text end authorized representativenew text begin , or other advocatenew text end . Any notice
sent to the person involved in the hearing must also be sent to the person's attorney deleted text begin ordeleted text end new text begin ,new text end
authorized representativenew text begin , or other advocatenew text end .
deleted text begin The term "Agency"deleted text end new text begin (c) For the purpose of an appeal under section 256.045, subdivision
3, paragraph (a), clauses (12) and (14), "agency" means the provider who issued the notice
of service termination. Agencynew text end includes the county human services agency, the state human
services agency, and, where applicable, any entity involved under a contract, subcontract,
grant, or subgrant with the state agency or with a county agency, that provides or operates
programs or services in which appeals are governed by section 256.045.
Sec. 36.
Minnesota Statutes 2018, section 256.0451, subdivision 3, is amended to read:
Subd. 3.
Agency appeal summary.
(a) Except in fair hearings and appeals under section
256.045, subdivision 3, paragraph (a), clauses (4), (9), deleted text begin anddeleted text end (10), new text begin (12), (14), and (15), new text end the
agency involved in an appeal must prepare a state agency appeal summary for each fair
hearing appeal. The state agency appeal summary shall be deleted text begin mailed or otherwisedeleted text end delivered
to the person who is involved in the appeal at least three working days before the date of
the hearing. The state agency appeal summary must also be deleted text begin mailed or otherwisedeleted text end delivered
to the department's Appeals deleted text begin Officedeleted text end new text begin Divisionnew text end at least three working days before the date of
the fair hearing appeal.
(b) In addition, the human services judge shall confirm that the state agency appeal
summary is deleted text begin mailed or otherwisedeleted text end delivered to the person involved in the appeal as required
under paragraph (a). The person involved in the fair hearing should be provided, through
the state agency appeal summary or other reasonable methods, appropriate information
about the procedures for the fair hearing and an adequate opportunity to prepare. These
requirements apply equally to the state agency or an entity under contract when involved
in the appeal.
(c) The contents of the state agency appeal summary must be adequate to inform the
person involved in the appeal of the evidence on which the agency relies and the legal basis
for the agency's action or determination.
Sec. 37.
Minnesota Statutes 2018, section 256.0451, subdivision 5, is amended to read:
Subd. 5.
Prehearing conferences.
(a) deleted text begin The human services judge prior todeleted text end new text begin Beforenew text end a fair
hearing appealnew text begin , the Appeals Divisionnew text end may hold a prehearing conference to further the
interests of justice or efficiency and must include the person involved in the appeal. A person
involved in a fair hearing appeal or the agency may request a prehearing conference. The
prehearing conference may be conducted by telephone, in person, or in writing. The
prehearing conference may address the following:
(1) disputes regarding access to files, evidence, subpoenas, or testimony;
(2) the time required for the hearing or any need for expedited procedures or decision;
(3) identification or clarification of legal or other issues that may arise at the hearing;
(4) identification of and possible agreement to factual issues; and
(5) scheduling and any other matter which will aid in the proper and fair functioning of
the hearing.
(b) The deleted text begin human services judgedeleted text end new text begin Appeals Divisionnew text end shall make a record or otherwise
contemporaneously summarize the prehearing conference in writing, which shall be sent
to both the person involved in the hearing, the person's attorney or authorized representative,
and the agency. A human services judge may make and issue rulings and orders while the
appeal is pending. During the pendency of the appeal, these rulings and orders are not subject
to a request for reconsideration or appeal. These rulings and orders are subject to review
under subdivision 24 and section 256.045, subdivision 7.
Sec. 38.
Minnesota Statutes 2018, section 256.0451, subdivision 6, is amended to read:
Subd. 6.
Appeal request for emergency assistance or urgent matter.
(a) When an
appeal involves an application for emergency assistance, the agency involved shall deleted text begin mail or
otherwisedeleted text end deliver the state agency appeal summary to the department's Appeals deleted text begin Officedeleted text end new text begin
Divisionnew text end within two working days of receiving the request for an appeal. A person may also
request that a fair hearing be held on an emergency basis when the issue requires an
immediate resolution. The deleted text begin human services judgedeleted text end new text begin Appeals Divisionnew text end shall schedule the fair
hearing on the earliest available date according to the urgency of the issue involved. Issuance
of the recommended decision after an emergency hearing shall be expedited.
(b) The commissioner shall issue a written decision within five working days of receiving
the recommended decisiondeleted text begin , shall immediately inform the parties of the outcome by telephone,deleted text end
and shall deleted text begin maildeleted text end new text begin sendnew text end the decision new text begin to each party new text end no later than two working days following the
date of the decision.
Sec. 39.
Minnesota Statutes 2018, section 256.0451, subdivision 7, is amended to read:
Subd. 7.
Continuance, rescheduling, or adjourning a hearing.
(a) A person involved
in a fair hearing, or the agency, may request a continuance, a rescheduling, or an adjournment
of a hearing for a reasonable period of time. The grounds for granting a request for a
continuance, a rescheduling, or adjournment of a hearing include, but are not limited to, the
following:
(1) to reasonably accommodate the appearance of a witness;
(2) to ensure that the person new text begin or agency new text end has adequate opportunity for preparation and for
presentation of evidence and argument;
(3) to ensure that the person or deleted text begin thedeleted text end agency has adequate opportunity to review, evaluate,
and respond to new evidence, or where appropriate, to require that the person or agency
review, evaluate, and respond to new evidence;
(4) to permit the person involved and the agency to negotiate toward resolution of some
or all of the issues where both agree that additional time is needed;
(5) to permit the agency to reconsider a previous action or determination;
(6) to permit or to require the performance of actions not previously taken; deleted text begin and
deleted text end
new text begin
(7) to accommodate a person's or agency's conflict of previously scheduled appointments;
new text end
new text begin
(8) to accommodate a person's physical or mental illness;
new text end
new text begin
(9) to accommodate an interpreter, translator, or other service when necessary to
accommodate a person with a disability; or
new text end
deleted text begin (7)deleted text end new text begin (10)new text end to provide additional time or to permit or require additional activity by the person
or agency as the interests of fairness may require.
(b) Requests for continuances or for rescheduling may be made orally or in writing. deleted text begin The
person or agency requesting the continuance or rescheduling must first make reasonable
efforts to contact the other participants in the hearing or their representatives and seek to
obtain an agreement on the request. Requests for continuance or rescheduling should be
made no later than three working days before the scheduled date of the hearing, unless there
is a good cause as specified in subdivision 13.deleted text end new text begin When a request to reschedule a hearing is
received less than five calendar days before the scheduled hearing date, the requesting party
must attempt to notify the other party of the request and provide the other party an opportunity
to object. When a request to reschedule a hearing is received less than 24 hours before the
scheduled hearing date, the Appeals Division must consider the potential prejudicial effect
and burdens on the parties in reviewing the request. Unless the Appeals Division makes a
written determination that a request to reschedule a hearing was made to unnecessarily delay
the proceeding or that a party's objection and the reason for the objection outweighs the
need to reschedule, the hearing must be rescheduled for good cause.new text end Granting a continuance
or rescheduling may be conditioned upon a waiver by the requester of applicable time limits
but should not cause unreasonable delay.
Sec. 40.
Minnesota Statutes 2018, section 256.0451, subdivision 9, is amended to read:
Subd. 9.
No ex parte contact.
The human services judge shall not have ex parte contact
on substantive issues with the agency or with any person or witness in a fair hearing appeal.
No employee of the department or agency shall review, interfere with, change, or attempt
to influence the recommended decision of the human services judge in any fair hearing
appeal, except through the procedure allowed in subdivision 18. The limitations in this
subdivision do not affect the commissioner's authority tonew text begin : (1)new text end review or reconsider decisions
or make final decisionsdeleted text begin .deleted text end new text begin ; (2) establish policies and procedures to process and administer
fair hearing appeals; or (3) require human services judges to address deficiencies in
recommended decisions.
new text end
Sec. 41.
Minnesota Statutes 2018, section 256.0451, subdivision 10, is amended to read:
Subd. 10.
Telephone or face-to-face hearing.
A fair hearing appeal may be conducted
by telephone, by other electronic media, or by an in-person, face-to-face hearing. deleted text begin At the
request of the person involved in a fair hearing appeal or their representative, a face-to-face
hearing shall be conducted with all participants personally present before the human services
judge.deleted text end new text begin A human services judge may satisfy a request for an in-person hearing by holding
the hearing using interactive video technology or in person. However, the human services
judge must hold an in-person hearing if a party asserts that either the party or a witness has
a physical or mental disability that would impair the party's or witness's ability to fully
participate in a hearing held using interactive video technology.
new text end
Sec. 42.
Minnesota Statutes 2018, section 256.0451, subdivision 11, is amended to read:
Subd. 11.
Hearing facilities and equipment.
new text begin (a) If an in-person hearing is held, new text end the
human services judge shall conduct the hearing in the county where the person involved
resides, unless an alternate location is mutually agreed upon before the hearingdeleted text begin , or unless
the person has agreed to a hearing by telephonedeleted text end . new text begin In-person new text end hearings under section 256.045,
subdivision 3, paragraph (a), clauses (4), (9), and (10), must be conducted in the county
where the determination was made, unless an alternate location is mutually agreed upon
before the hearing. The hearing room new text begin used for an in-person hearing new text end shall be of sufficient
size and layout to adequately accommodate both the number of individuals participating in
the hearing and any identified special needs of any individual participating in the hearing.
new text begin (b) new text end The human services judge shall ensure that all communication and recording
equipment that is necessary to conduct the hearing and to create an adequate record is present
and functioning properly. If any necessary communication or recording equipment fails or
ceases to operate effectively, the human services judge shall take any steps necessary,
including stopping or adjourning the hearing, until the necessary equipment is present and
functioning properly. All reasonable efforts shall be undertaken to prevent and avoid any
delay in the hearing process caused by defective communication or recording equipment.
Sec. 43.
Minnesota Statutes 2018, section 256.0451, subdivision 12, is amended to read:
Subd. 12.
Interpreter and translation services.
The human services judge has a duty
to inquire and to determine whether any participant in the hearing needs the services of an
interpreter or translator in order to participate in or to understand the hearing process.
Necessary interpreter or translation services must be provided new text begin by the agency taking the
action in the appeal new text end at no charge to the person involved in the hearing. If it appears that
interpreter or translation services are needed but are not available for the scheduled hearing,
the human services judge shall continue or postpone the hearing until appropriate services
can be provided.
Sec. 44.
Minnesota Statutes 2018, section 256.0451, subdivision 13, is amended to read:
Subd. 13.
Failure to appear; new text begin withdrawal; new text end good cause.
new text begin (a) new text end If a person involved in a
fair hearing appeal fails to appear at the hearing, the human services judge may dismiss the
appeal.new text begin The human services judge may also dismiss the appeal if the person clearly indicates,
orally or in writing, the person's wish to withdraw the appeal.
new text end
new text begin (b)new text end The deleted text begin human services judgedeleted text end new text begin Appeals Divisionnew text end may reopen the appeal if within deleted text begin ten
workingdeleted text end new text begin 30new text end days after the date of the dismissal the person files information in writing with
the deleted text begin human services judgedeleted text end new text begin Appeals Divisionnew text end to show good cause for new text begin withdrawing or new text end not
appearing. Good cause can be shown when there is:
(1) a death or serious illness in the person's family;
(2) a personal injury or illness which reasonably prevents the person from attending the
hearing;
(3) an emergency, crisis, or unforeseen event which reasonably prevents the person from
attending the hearing;
(4) an obligation or responsibility of the person which a reasonable person, in the conduct
of one's affairs, could reasonably determine takes precedence over attending the hearing;
(5) lack of or failure to receive timely notice of the hearing in the preferred language of
the person involved in the hearing; deleted text begin and
deleted text end
new text begin
(6) erroneous belief that the matter on appeal had been resolved in the person's favor;
and
new text end
deleted text begin (6)deleted text end new text begin (7)new text end excusable neglect, excusable inadvertence, excusable mistake, or other good
cause as determined by the deleted text begin human services judgedeleted text end new text begin Appeals Divisionnew text end .
Sec. 45.
Minnesota Statutes 2018, section 256.0451, subdivision 19, is amended to read:
Subd. 19.
Developing the record.
The human services judge shall accept all evidence,
except evidence privileged by law, that is commonly accepted by reasonable people in the
conduct of their affairs as having probative value on the issues to be addressed at the hearing.
Except in fair hearings and appeals under section 256.045, subdivision 3, paragraph (a),
clauses (4), (9), (10), deleted text begin anddeleted text end (12), new text begin (14), and (15), new text end in cases involving medical issues such as a
diagnosis, a physician's report, or a review team's decision, the human services judge shall
consider whether it is necessary to have a medical assessment other than that of the individual
making the original decision. When necessary, the human services judge shall require an
additional assessment be obtained at agency expense and made part of the hearing record.
The human services judge shall ensure for all cases that the record is sufficiently complete
to make a fair and accurate decision.
Sec. 46.
Minnesota Statutes 2018, section 256.0451, subdivision 21, is amended to read:
Subd. 21.
Closing of the record.
The agency must present its evidence prior to or at the
hearing. deleted text begin The agency shall not be permitted to submit evidence after the hearing except by
agreement at the hearing between the person involved, the agency, and the human services
judge. If evidence is submitted after the hearing, based on such an agreement, the person
involved and the agency must be allowed sufficient opportunity to respond to the evidence.
When necessary, the record shall remain open to permit a person to submit additional
evidence on the issues presented at the hearing.deleted text end new text begin A party shall not submit evidence after the
hearing except: (1) by agreement at the hearing between the appellant, the agency, and the
human services judge; (2) in response to new evidence; or (3) when the human services
judge determines that additional evidence is needed to sufficiently complete the appeal
record and make a fair and accurate decision. If a party submits evidence after the hearing,
consistent with an exception, the other party must be allowed sufficient opportunity to
respond to the evidence.
new text end
Sec. 47.
Minnesota Statutes 2018, section 256.0451, subdivision 22, is amended to read:
Subd. 22.
Decisions.
A timely, written decision must be issued in every appeal. Each
decision must contain a clear ruling on the issues presented in the appeal hearing and should
contain a ruling only on questions directly presented by the appeal and the arguments raised
in the appeal.
(a) A written decision must be issued within 90 days of the date the person involved
requested the appeal unless a shorter time is required by law. An additional 30 days is
provided in those cases where the commissioner refuses to accept the recommended decision.new text begin
Unless otherwise required by federal or state law, the time to issue the decision is extended
by the number of days a hearing is continued or the record held open in response to a
documented request by the person involved, and by the time the appeal is suspended pursuant
to section 256.045, subdivision 3, paragraph (b).new text end In appeals of maltreatment determinations
or disqualifications filed pursuant to section 256.045, subdivision 3, paragraph (a), clause
(4), (9), or (10), that also give rise to possible licensing actions, the 90-day period for issuing
final decisions does not begin until the later of the date that the licensing authority provides
notice to the appeals division that the authority has made the final determination in the
matter or the date the appellant files the last appeal in the consolidated matters.
(b) The decision must contain both findings of fact and conclusions of law, clearly
separated and identified. The findings of fact must be based on the entire record. Each
finding of fact made by the human services judge shall be supported by a preponderance
of the evidence unless a different standard is required under the regulations of a particular
program. The "preponderance of the evidence" means, in light of the record as a whole, the
evidence leads the human services judge to believe that the finding of fact is more likely to
be true than not true. The legal claims or arguments of a participant do not constitute either
a finding of fact or a conclusion of law, except to the extent the human services judge adopts
an argument as a finding of fact or conclusion of law.
The decision shall contain at least the following:
(1) a listing of the date and place of the hearing and the participants at the hearing;
(2) a clear and precise statement of the issues, including the dispute under consideration
and the specific points which must be resolved in order to decide the case;
(3) a listing of the material, including exhibits, records, reports, placed into evidence at
the hearing, and upon which the hearing decision is based;
(4) the findings of fact based upon the entire hearing record. The findings of fact must
be adequate to inform the participants and any interested person in the public of the basis
of the decision. If the evidence is in conflict on an issue which must be resolved, the findings
of fact must state the reasoning used in resolving the conflict;
(5) conclusions of law that address the legal authority for the hearing and the ruling, and
which give appropriate attention to the claims of the participants to the hearing;
(6) a clear and precise statement of the decision made resolving the dispute under
consideration in the hearing; and
(7) written notice of the right to appeal to district court or to request reconsideration,
and of the actions required and the time limits for taking appropriate action to appeal to
district court or to request a reconsideration.
(c) The human services judge shall not independently investigate facts or otherwise rely
on information not presented at the hearing. The human services judge may not contact
other agency personnel, except as provided in subdivision 18. The human services judge's
recommended decision must be based exclusively on the testimony and evidence presented
at the hearing, and legal arguments presented, and the human services judge's research and
knowledge of the law.
(d) The commissioner deleted text begin willdeleted text end new text begin shallnew text end review the recommended decision and accept or refuse
to accept the decision according to section 256.045, subdivision 5.new text begin The commissioner may
return the recommended decision to the human services judge to address deficiencies before
accepting or refusing to accept the decision. The commissioner may include a memorandum
with an accepted decision to clarify or distinguish how the commissioner's findings of fact
or conclusions of law differ from the recommended decision. If the commissioner refuses
to accept a human services judge's recommended decision that recommends dismissal of
the appeal on procedural grounds, the commissioner may remand the case back to the human
services judge to make a recommended decision on the merits instead of requiring the parties
to follow the process described in subdivision 23.
new text end
Sec. 48.
Minnesota Statutes 2018, section 256.0451, subdivision 23, is amended to read:
Subd. 23.
Refusal to accept recommended orders.
(a) If the commissioner refuses to
accept the recommended order from the human services judge, the person involved, the
person's attorney deleted text begin ordeleted text end new text begin ,new text end authorized representative, new text begin or advocate, new text end and the agency shall be sent a
copy of the recommended order, a detailed explanation of the basis for refusing to accept
the recommended order, and the proposed modified order.
(b) The person involved and the agency shall have at least ten business days to respond
to the proposed modification of the recommended order. The person involved and the agency
may submit a legal argument concerning the proposed modification, and may propose to
submit additional evidence that relates to the proposed modified order.
Sec. 49.
Minnesota Statutes 2018, section 256.0451, subdivision 24, is amended to read:
Subd. 24.
Reconsideration.
(a) Reconsideration may be requested within 30 days of
the date of the commissioner's final order. If reconsideration is requested under section
256.045, subdivision 5, the other participants in the appeal shall be informed of the request.
The person seeking reconsideration has the burden to demonstrate why the matter should
be reconsidered. The request for reconsideration may include legal argument and may
include proposed additional evidence supporting the request. The other participants shall
be sent a copy of all material submitted in support of the request for reconsideration and
must be given new text begin at least new text end ten days to respond.
(b) When the requesting party raises a question as to the appropriateness of the findings
of fact, the commissioner shall review the entire record.
(c) When the requesting party questions the appropriateness of a conclusion of law, the
commissioner shall consider the recommended decision, the decision under reconsideration,
and the material submitted in connection with the reconsideration. The commissioner shall
review the remaining record as necessary to issue a reconsidered decision.
(d) The commissioner shall issue a written decision on reconsideration in a timely fashion.
The decision must clearly inform the parties that this constitutes the final administrative
decision, advise the participants of the right to seek judicial review, and the deadline for
doing so.
Sec. 50.
Minnesota Statutes 2018, section 256.046, subdivision 1, is amended to read:
Subdivision 1.
Hearing authority.
A local agency must initiate an administrative fraud
disqualification hearing for individualsdeleted text begin , including child care providers caring for children
receiving child care assistance,deleted text end accused of wrongfully obtaining assistance or intentional
program violations, in lieu of a criminal action when it has not been pursued, in the Minnesota
family investment program and any affiliated program to include the diversionary work
program and the work participation cash benefit program, child care assistance programs,
general assistance, family general assistance program formerly codified in section 256D.05,
subdivision 1, clause (15), Minnesota supplemental aid, food stamp programs, 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. The
Department of Human Services, in lieu of a local agency, may initiate an administrative
fraud disqualification hearing when the state agency is directly responsible for administration
or investigation of the program for which benefits were wrongfully obtained. The hearing
is subject to the requirements of deleted text begin sectiondeleted text end new text begin sectionsnew text end 256.045 new text begin and 256.0451, new text end and the requirements
in Code of Federal Regulations, title 7, section 273.16.
Sec. 51.
Minnesota Statutes 2018, section 256.9685, subdivision 1, is amended to read:
Subdivision 1.
Authority.
new text begin (a)new text end The commissioner shall establish procedures for
determining medical assistance payment rates under a prospective payment system for
inpatient hospital services in hospitals that qualify as vendors of medical assistance. The
commissioner shall establish, by rule, procedures for implementing this section and sections
256.9686, 256.969, and 256.9695. Services must meet the requirements of section 256B.04,
subdivision 15, to be eligible for payment.
new text begin
(b) The commissioner shall publish in the Minnesota Health Care Program Provider
Manual the industry standard, evidence-based clinical decision tool used for determining
the medical necessity of a recipient's hospital admission. The tool must be used in conjunction
with the recipient's medical conditions and records. The commissioner's tool designation is
not subject to administrative appeal and is not subject to the requirements of chapter 14,
including section 14.386. This paragraph supersedes any contrary rule or law.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 52.
Minnesota Statutes 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 deleted text begin medicaldeleted text end
services or supplies provided or prescribed by persons authorized by state law to give such
services and supplies. 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. 53.
Minnesota Statutes 2018, section 256B.064, subdivision 1a, is amended to read:
Subd. 1a.
Grounds for sanctions against vendors.
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; deleted text begin anddeleted text end (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 Actdeleted text begin .deleted text end new text begin ; and (9) there is a preponderance of
evidence that the vendor committed an act or acts that meet the definition of offenses listed
in section 609.817.
new text end
Sec. 54.
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. 55.
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
by 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. 56.
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
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 must check the
exclusion list. The vendor must 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 must: (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 must 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. 57.
Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Notice. new text end
new text begin
(a) The notice required under subdivision 2 shall be served by first class
mail at the address submitted to the department by the vendor. Service is complete upon
mailing. The commissioner shall place an affidavit of the first class mailing in the vendor's
file as an indication of the address and the date of mailing.
new text end
new text begin
(b) The department shall give notice in writing to a recipient placed in the Minnesota
restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200.
The notice shall be sent by first class mail to the recipient's current address on file with the
department. A recipient placed in the Minnesota restricted recipient program may contest
the placement by submitting a written request for a hearing to the department within 90
days of the notice being mailed.
new text end
Sec. 58.
Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Immunity; good faith reporters. new text end
new text begin
(a) A person who makes a good faith report
is immune from any civil or criminal liability that might otherwise arise from reporting or
participating in the investigation. Nothing in this subdivision affects a vendor's responsibility
for an overpayment established under this subdivision.
new text end
new text begin
(b) A person employed by a lead investigative agency who is conducting or supervising
an investigation or enforcing the law according to the applicable law or rule is immune from
any civil or criminal liability that might otherwise arise from the person's actions, if the
person is acting in good faith and exercising due care.
new text end
new text begin
(c) For purposes of this subdivision, "person" includes a natural person or any form of
a business or legal entity.
new text end
new text begin
(d) After an investigation is complete, the reporter's name must be kept confidential.
The subject of the report may compel disclosure of the reporter's name only with the consent
of the reporter or upon a written finding by a district court that the report was false and there
is evidence that the report was made in bad faith. This subdivision does not alter disclosure
responsibilities or obligations under the Rules of Criminal Procedure, except when the
identity of the reporter is relevant to a criminal prosecution the district court shall conduct
an in-camera review before determining whether to order disclosure of the reporter's identity.
new text end
Sec. 59.
new text begin
[256B.0646] MINNESOTA RESTRICTED RECIPIENT PROGRAM;
PERSONAL CARE ASSISTANCE SERVICES.
new text end
new text begin
(a) When a recipient's use of personal care assistance services or community first services
and supports under section 256B.85 results in abusive or fraudulent billing, the commissioner
may place a recipient in the Minnesota restricted recipient program under Minnesota Rules,
part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this
section must: (1) use a designated traditional personal care assistance provider agency; and
(2) obtain a new assessment under section 256B.0911, including consultation with a registered
or public health nurse on the long-term care consultation team pursuant to section 256B.0911,
subdivision 3, paragraph (b), clause (2).
new text end
new text begin
(b) A recipient must 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. Additional conditions may include but are not limited to restricting service
authorizations to a duration of no more than one month, and requiring a qualified professional
to monitor and report services on a monthly basis.
new text end
new text begin
(c) A recipient placed in the Minnesota restricted recipient program under this section
may appeal the placement according to section 256B.045.
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. 60.
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 may be new text end withheld or that the provider's
participation in medical assistance has been new text begin or may 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.
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.
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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 62.
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
possible overpayment of Medicaid funds, 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. 63.
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) the service is provided according to 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, the service is provided on days and times during the days and hours of
operation specified on any license required under chapter 245A or 245D; and
new text end
new text begin
(3) the provider complies with subdivisions 12 to 15, if applicable.
new text end
new text begin
(b) The provider must maintain documentation that, upon employment and annually
thereafter, staff providing a service have attested to reviewing and understanding the
following statement: "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
new text begin
(c) The department may recover payment, according to section 256B.064 and Minnesota
Rules, parts 9505.2160 to 9505.2245, for a service that does not satisfy this subdivision.
new text end
Sec. 64.
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
and must be produced upon request of the commissioner.
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 in
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 member responsible for
verifying services and completing the documentation required by this paragraph.
new text end
Sec. 65.
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 be a waiver transportation service that: (1) is not covered
by medical transportation under the Medicaid state plan; and (2) is not included as a
component of another waiver service.
new text end
new text begin
(b) In addition to the documentation requirements in subdivision 12, a waiver
transportation service provider must maintain:
new text end
new text begin
(1) odometer and other records pursuant to 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. A common carrier as
defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or a publicly operated transit
system provider are exempt from this clause; and
new text end
new text begin
(2) documentation demonstrating that a vehicle and a driver meet the standards determined
by the Department of Human Services on vehicle and driver qualifications in section
256B.0625, subdivision 17, paragraph (c).
new text end
Sec. 66.
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) In addition to the
requirements in subdivision 12, an equipment and supply services provider 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;
new text end
new text begin
(2) the reason the equipment or supply is not covered by the Medicaid state plan;
new text end
new text begin
(3) 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
(4) the quantity of the equipment or supplies delivered or purchased; and
new text end
new text begin
(5) 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. 67.
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) In addition
to the requirements in subdivision 12, a provider of adult day services as defined in section
245A.02, subdivision 2a, and licensed under Minnesota Rules, parts 9555.9600 to 9555.9730,
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, for each recipient, if applicable;
new text end
new text begin
(2) attendance records as specified under section 245A.14, subdivision 14, paragraph
(c), including the date of attendance with the day, month, and year; and the pickup and
drop-off time 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 name and qualification of each registered physical therapist, registered nurse,
and registered dietitian who provides services to the adult day services or nonresidential
program; and
new text end
new text begin
(5) the location where the service was provided. If the location is an alternate location
from the usual place of service, the documentation must include the address, or a description
if the address is not available, of both the origin site and destination site; 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 the provider's licensed capacity. If a provider exceeds the
provider's licensed capacity, the department must recover all Minnesota health care programs
payments from the date the provider exceeded licensed capacity.
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. 68.
Minnesota Statutes 2018, section 402A.16, subdivision 3, is amended to read:
Subd. 3.
Membership.
(a) Human Services Performance Council membership shall be
equally balanced among the following five stakeholder groups: the Association of Minnesota
Counties, the Minnesota Association of County Social Service Administrators, the
Department of Human Services, tribes and communities of color, and service providers and
advocates for persons receiving human services. The Association of Minnesota Counties
and the Minnesota Association of County Social Service Administrators shall appoint their
own respective representatives. The commissioner of human services shall appoint
representatives of the Department of Human Services, tribes and communities of color, and
social services providers and advocates. Minimum council membership shall be 15 members,
with at least three representatives from each stakeholder group, and maximum council
membership shall be 20 members, with four representatives from each stakeholder group.
(b) Notwithstanding section 15.059, Human Services Performance Council members
shall be appointed for a deleted text begin minimum of two years, but may serve longer termsdeleted text end new text begin four-year term.
Council members may serve more than one termnew text end at the discretion of their appointing
authority.
(c) Notwithstanding section 15.059, members of the council shall receive no compensation
for their services.
(d) A commissioner's representative and a county representative from either the
Association of Minnesota Counties or the Minnesota Association of County Social Service
Administrators shall serve as Human Services Performance Council cochairs.
Sec. 69.
new text begin
[609.817] CRIMINAL PENALTIES FOR ACTS INVOLVING HUMAN
SERVICES PROGRAMS.
new text end
new text begin Subdivision 1. new text end
new text begin Payments made relating to human services programs. new text end
new text begin
A person who
with intent offers or pays any remuneration, including any kickback, bribe, or rebate, directly
or indirectly, overtly or covertly, in cash or in kind, to a person to induce the person:
new text end
new text begin
(1) to apply for, receive, or induce another person to apply for or receive a human services
benefit, service, or grant related to a program funded in whole or in part by the Department
of Human Services or administered by the commissioner of human services, including but
not limited to a human services benefit, service, or grant funded in whole or in part by a
local social services agency, the Department of Human Services, or the United States
Department of Health and Human Services; or
new text end
new text begin
(2) to apply for or to use a particular vendor providing a service administered or funded
in whole or in part by the Department of Human Services, a local social services agency,
or the United States Department of Health and Human Services,
new text end
new text begin
is guilty of a felony and upon conviction shall be sentenced to not more than five years'
imprisonment or to payment of a fine of not more than $15,000, or both.
new text end
new text begin Subd. 2. new text end
new text begin Payments received relating to human services programs. new text end
new text begin
A person who
with intent solicits or receives any remuneration, including any kickback, bribe, or rebate,
directly or indirectly, overtly or covertly, in cash or in kind:
new text end
new text begin
(1) in return for applying for or receiving a human services benefit, service, or grant
administered or funded in whole or in part by the Department of Human Services or
administered by the commissioner of human services, including but not limited to a human
services benefit, service, or grant funded in whole or in part by a local social services agency,
the Department of Human Services, or the United States Department of Health and Human
Services;
new text end
new text begin
(2) in return for applying for or using a particular vendor providing a service administered
or funded in whole or in part by the Department of Human Services, a local social services
agency, or the United States Department of Health and Human Services; or
new text end
new text begin
(3) in return for receiving or agreeing to receive payments in excess of fair and reasonable
market value for services or supplies provided to a company or person who is being paid
in whole or in part by the Department of Human Services, a local social services agency,
or the United States Department of Health and Human Services to provide a human services
benefit to a person,
new text end
new text begin
is guilty of a felony and upon conviction shall be sentenced to not more than five years'
imprisonment or to payment of a fine of not more than $15,000, or both.
new text end
new text begin Subd. 3. new text end
new text begin Defense. new text end
new text begin
It is not a defense under this section for the person or company
receiving or making the payments in excess of fair and reasonable market value to claim
the person did not have knowledge of the source of the payments.
new text end
new text begin Subd. 4. new text end
new text begin Persons exempt. new text end
new text begin
This section does not apply if:
new text end
new text begin
(1) the employee receiving the remuneration is a bona fide employee of the company
receiving payment for providing care or services;
new text end
new text begin
(2) the remuneration received by the employee is for work performed by the employee
and is paid via a standard payroll check or a direct deposit from the company payroll account
to the bank designated by the employee; and
new text end
new text begin
(3) the company making the payment complies with all state and federal laws relating
to tax withholding, Social Security and Medicare withholding, and wage reporting to the
Department of Employment and Economic Development.
new text end
new text begin Subd. 5. new text end
new text begin Additional sanctions. new text end
new text begin
(a) Claims or payments for any service rendered or
claimed to have been rendered by a provider or individual who violated this section in regard
to the person for whom such services were rendered or claimed to have been rendered are
noncompensable, unenforceable as a matter of law, and constitute the value of any restitution
owed to the Department of Human Services, a county, or the United States Department of
Health and Human Services.
new text end
new text begin
(b) For the purposes of this section, service includes any benefit, service, or grant,
administered or funded in whole or in part by the Department of Human Services, a county,
or the United States Department of Health and Human Services.
new text end
new text begin
(c) A person convicted under this section is subject to prohibitions described under
section 245.095.
new text end
ARTICLE 8
DISABILITY SERVICES
Section 1.
Minnesota Statutes 2018, section 144A.471, subdivision 8, is amended to read:
Subd. 8.
Exemptions from home care services licensure.
(a) Except as otherwise
provided in this chapter, home care services that are provided by the state, counties, or other
units of government must be licensed under this chapter.
(b) An exemption under this subdivision does not excuse the exempted individual or
organization from complying with applicable provisions of the home care bill of rights in
section 144A.44. The following individuals or organizations are exempt from the requirement
to obtain a home care provider license:
(1) an individual or organization that offers, provides, or arranges for personal care
assistance services under the medical assistance program deleted text begin as authorized under sections
256B.0625, subdivision 19a, and 256B.0659deleted text end ;
(2) a provider that is licensed by the commissioner of human services to provide
semi-independent living services for persons with developmental disabilities under section
252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
(3) a provider that is licensed by the commissioner of human services to provide home
and community-based services for persons with developmental disabilities under section
256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
(4) an individual or organization that provides only home management services, if the
individual or organization is registered under section 144A.482; or
(5) an individual who is licensed in this state as a nurse, dietitian, social worker,
occupational therapist, physical therapist, or speech-language pathologist who provides
health care services in the home independently and not through any contractual or
employment relationship with a home care provider or other organization.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 2.
Minnesota Statutes 2018, section 144A.475, subdivision 6, is amended to read:
Subd. 6.
Owners and managerial officials; refusal to grant license.
(a) The owner
and managerial officials of a home care provider whose Minnesota license has not been
renewed or that has been revoked because of noncompliance with applicable laws or rules
shall not be eligible to apply for nor will be granted a home care license, including other
licenses under this chapter, or be given status as an enrolled personal care assistance provider
agency or personal care assistant by the Department of Human Services deleted text begin under section
256B.0659deleted text end for five years following the effective date of the nonrenewal or revocation. If
the owner and managerial officials already have enrollment status, their enrollment will be
terminated by the Department of Human Services.
(b) The commissioner shall not issue a license to a home care provider for five years
following the effective date of license nonrenewal or revocation if the owner or managerial
official, including any individual who was an owner or managerial official of another home
care provider, had a Minnesota license that was not renewed or was revoked as described
in paragraph (a).
(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend
or revoke, the license of any home care provider that includes any individual as an owner
or managerial official who was an owner or managerial official of a home care provider
whose Minnesota license was not renewed or was revoked as described in paragraph (a) for
five years following the effective date of the nonrenewal or revocation.
(d) The commissioner shall notify the home care provider 30 days in advance of the date
of nonrenewal, suspension, or revocation of the license. Within ten days after the receipt
of the notification, the home care provider may request, in writing, that the commissioner
stay the nonrenewal, revocation, or suspension of the license. The home care provider shall
specify the reasons for requesting the stay; the steps that will be taken to attain or maintain
compliance with the licensure laws and regulations; any limits on the authority or
responsibility of the owners or managerial officials whose actions resulted in the notice of
nonrenewal, revocation, or suspension; and any other information to establish that the
continuing affiliation with these individuals will not jeopardize client health, safety, or
well-being. The commissioner shall determine whether the stay will be granted within 30
days of receiving the provider's request. The commissioner may propose additional
restrictions or limitations on the provider's license and require that the granting of the stay
be contingent upon compliance with those provisions. The commissioner shall take into
consideration the following factors when determining whether the stay should be granted:
(1) the threat that continued involvement of the owners and managerial officials with
the home care provider poses to client health, safety, and well-being;
(2) the compliance history of the home care provider; and
(3) the appropriateness of any limits suggested by the home care provider.
If the commissioner grants the stay, the order shall include any restrictions or limitation
on the provider's license. The failure of the provider to comply with any restrictions or
limitations shall result in the immediate removal of the stay and the commissioner shall
take immediate action to suspend, revoke, or not renew the license.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 3.
Minnesota Statutes 2018, section 176.011, subdivision 9, is amended to read:
Subd. 9.
Employee.
(a) "Employee" means any person who performs services for another
for hire including the following:
(1) an alien;
(2) a minor;
(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and
peace officer while engaged in the enforcement of peace or in the pursuit or capture of a
person charged with or suspected of crime;
(4) a person requested or commanded to aid an officer in arresting or retaking a person
who has escaped from lawful custody, or in executing legal process, in which cases, for
purposes of calculating compensation under this chapter, the daily wage of the person shall
be the prevailing wage for similar services performed by paid employees;
(5) a county assessor;
(6) an elected or appointed official of the state, or of a county, city, town, school district,
or governmental subdivision in the state. An officer of a political subdivision elected or
appointed for a regular term of office, or to complete the unexpired portion of a regular
term, shall be included only after the governing body of the political subdivision has adopted
an ordinance or resolution to that effect;
(7) an executive officer of a corporation, except those executive officers excluded by
section 176.041;
(8) a voluntary uncompensated worker, other than an inmate, rendering services in state
institutions under the commissioners of human services and corrections similar to those of
officers and employees of the institutions, and whose services have been accepted or
contracted for by the commissioner of human services or corrections as authorized by law.
In the event of injury or death of the worker, the daily wage of the worker, for the purpose
of calculating compensation under this chapter, shall be the usual wage paid at the time of
the injury or death for similar services in institutions where the services are performed by
paid employees;
(9) a voluntary uncompensated worker engaged in emergency management as defined
in section 12.03, subdivision 4, who is:
(i) registered with the state or any political subdivision of it, according to the procedures
set forth in the state or political subdivision emergency operations plan; and
(ii) acting under the direction and control of, and within the scope of duties approved
by, the state or political subdivision.
The daily wage of the worker, for the purpose of calculating compensation under this chapter,
shall be the usual wage paid at the time of the injury or death for similar services performed
by paid employees;
(10) a voluntary uncompensated worker participating in a program established by a local
social services agency. For purposes of this clause, "local social services agency" means
any agency established under section 393.01. In the event of injury or death of the worker,
the wage of the worker, for the purpose of calculating compensation under this chapter,
shall be the usual wage paid in the county at the time of the injury or death for similar
services performed by paid employees working a normal day and week;
(11) a voluntary uncompensated worker accepted by the commissioner of natural
resources who is rendering services as a volunteer pursuant to section 84.089. The daily
wage of the worker for the purpose of calculating compensation under this chapter, shall
be the usual wage paid at the time of injury or death for similar services performed by paid
employees;
(12) a voluntary uncompensated worker in the building and construction industry who
renders services for joint labor-management nonprofit community service projects. The
daily wage of the worker for the purpose of calculating compensation under this chapter
shall be the usual wage paid at the time of injury or death for similar services performed by
paid employees;
(13) a member of the military forces, as defined in section 190.05, while in state active
service, as defined in section 190.05, subdivision 5a. The daily wage of the member for the
purpose of calculating compensation under this chapter shall be based on the member's
usual earnings in civil life. If there is no evidence of previous occupation or earning, the
trier of fact shall consider the member's earnings as a member of the military forces;
(14) a voluntary uncompensated worker, accepted by the director of the Minnesota
Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily
wage of the worker, for the purposes of calculating compensation under this chapter, shall
be the usual wage paid at the time of injury or death for similar services performed by paid
employees;
(15) a voluntary uncompensated worker, other than a student, who renders services at
the Minnesota State Academy for the Deaf or the Minnesota State Academy for the Blind,
and whose services have been accepted or contracted for by the commissioner of education,
as authorized by law. In the event of injury or death of the worker, the daily wage of the
worker, for the purpose of calculating compensation under this chapter, shall be the usual
wage paid at the time of the injury or death for similar services performed in institutions
by paid employees;
(16) a voluntary uncompensated worker, other than a resident of the veterans home, who
renders services at a Minnesota veterans home, and whose services have been accepted or
contracted for by the commissioner of veterans affairs, as authorized by law. In the event
of injury or death of the worker, the daily wage of the worker, for the purpose of calculating
compensation under this chapter, shall be the usual wage paid at the time of the injury or
death for similar services performed in institutions by paid employees;
(17) a worker performing services deleted text begin under section deleted text end deleted text begin 256B.0659deleted text end for a recipient in the home
of the recipient or in the community deleted text begin under section 256B.0625, subdivision 19a,deleted text end who is paid
from government funds through a fiscal intermediary deleted text begin under section 256B.0659, subdivision
33deleted text end . For purposes of maintaining workers' compensation insurance, the employer of the
worker is as designated in law by the commissioner of the Department of Human Services,
notwithstanding any other law to the contrary;
(18) students enrolled in and regularly attending the Medical School of the University
of Minnesota in the graduate school program or the postgraduate program. The students
shall not be considered employees for any other purpose. In the event of the student's injury
or death, the weekly wage of the student for the purpose of calculating compensation under
this chapter, shall be the annualized educational stipend awarded to the student, divided by
52 weeks. The institution in which the student is enrolled shall be considered the "employer"
for the limited purpose of determining responsibility for paying benefits under this chapter;
(19) a faculty member of the University of Minnesota employed for an academic year
is also an employee for the period between that academic year and the succeeding academic
year if:
(i) the member has a contract or reasonable assurance of a contract from the University
of Minnesota for the succeeding academic year; and
(ii) the personal injury for which compensation is sought arises out of and in the course
of activities related to the faculty member's employment by the University of Minnesota;
(20) a worker who performs volunteer ambulance driver or attendant services is an
employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other
entity for which the worker performs the services. The daily wage of the worker for the
purpose of calculating compensation under this chapter shall be the usual wage paid at the
time of injury or death for similar services performed by paid employees;
(21) a voluntary uncompensated worker, accepted by the commissioner of administration,
rendering services as a volunteer at the Department of Administration. In the event of injury
or death of the worker, the daily wage of the worker, for the purpose of calculating
compensation under this chapter, shall be the usual wage paid at the time of the injury or
death for similar services performed in institutions by paid employees;
(22) a voluntary uncompensated worker rendering service directly to the Pollution
Control Agency. The daily wage of the worker for the purpose of calculating compensation
payable under this chapter is the usual going wage paid at the time of injury or death for
similar services if the services are performed by paid employees;
(23) a voluntary uncompensated worker while volunteering services as a first responder
or as a member of a law enforcement assistance organization while acting under the
supervision and authority of a political subdivision. The daily wage of the worker for the
purpose of calculating compensation payable under this chapter is the usual going wage
paid at the time of injury or death for similar services if the services are performed by paid
employees;
(24) a voluntary uncompensated member of the civil air patrol rendering service on the
request and under the authority of the state or any of its political subdivisions. The daily
wage of the member for the purposes of calculating compensation payable under this chapter
is the usual going wage paid at the time of injury or death for similar services if the services
are performed by paid employees; and
(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in sections
145A.04 and 145A.06, responding at the request of or engaged in training conducted by the
commissioner of health. The daily wage of the volunteer for the purposes of calculating
compensation payable under this chapter is established in section 145A.06. A person who
qualifies under this clause and who may also qualify under another clause of this subdivision
shall receive benefits in accordance with this clause.
If it is difficult to determine the daily wage as provided in this subdivision, the trier of
fact may determine the wage upon which the compensation is payable.
(b) For purposes of this chapter "employee" does not include farmers or members of
their family who exchange work with other farmers in the same community.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 4.
Minnesota Statutes 2018, section 216C.435, subdivision 13, is amended to read:
Subd. 13.
Vulnerable adult.
"Vulnerable adult" means any person 18 years of age or
older who:
(1) receives services from a home care provider required to be licensed under sections
144A.43 to 144A.482, or from a person or organization that offers, provides, or arranges
for personal care assistance services under the medical assistance program as authorized
under section deleted text begin 256B.0625, subdivision 19a,deleted text end 256B.0651, 256B.0653, 256B.0654, deleted text begin 256B.0659,deleted text end
or 256B.85;
(2) possesses a physical or mental infirmity or other physical, mental, or emotional
dysfunction that impairs the individual's ability to provide adequately for the individual's
own care without assistance, including the provision of food, shelter, clothing, health care,
or supervision;
(3) possesses a physical or mental infirmity or other physical, mental, or emotional
dysfunction that impairs the individual's ability to knowingly contract or otherwise protect
the individual's own self-interest; or
(4) identifies as having dementia or Alzheimer's disease, or who exhibits behaviors that
a reasonable person would suspect indicates the adult has Alzheimer's disease or other
dementia.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 5.
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;
deleted text begin
(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;
deleted text end
deleted text begin (6)deleted text end new text begin (5)new text end 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
deleted text begin (7)deleted text end new text begin (6)new text end new foster care licenses or community residential setting licenses for people
receiving services under chapter 245D and residing in an unlicensed setting before May 1,
2017, and for which a license is required. This exception does not apply to people living in
their own home. For purposes of this clause, there is a presumption that a foster care or
community residential setting license is required for services provided to three or more
people in a dwelling unit when the setting is controlled by the provider. A license holder
subject to this exception may rebut the presumption that a license is required by seeking a
reconsideration of the commissioner's determination. The commissioner's disposition of a
request for reconsideration is final and not subject to appeal under chapter 14. The exception
is available until June 30, 2018. This exception is available when:
(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.
(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 the day following final enactment.
new text end
Sec. 6.
Minnesota Statutes 2018, section 245C.03, subdivision 2, is amended to read:
Subd. 2.
Personal care provider organizations.
The commissioner shall conduct
background studies on any individual required under sections 256B.0651 to 256B.0654 deleted text begin and
256B.0659deleted text end to have a background study completed under this chapter.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 7.
Minnesota Statutes 2018, section 245C.04, subdivision 3, is amended to read:
Subd. 3.
Personal care provider organizations.
(a) The commissioner shall conduct
a background study of an individual required to be studied under section 245C.03, subdivision
2, at least upon application for initial enrollment under sections 256B.0651 to 256B.0654
deleted text begin and 256B.0659deleted text end .
(b) Organizations required to initiate background studies under sections 256B.0651 to
256B.0654 deleted text begin and 256B.0659deleted text end for individuals described in section 245C.03, subdivision 2,
must submit a completed background study request to the commissioner using the electronic
system known as NETStudy before those individuals begin a position allowing direct contact
with persons served by the organization.
(c) Organizations required to initiate background studies under sections 256B.0651 to
256B.0654 deleted text begin and 256B.0659deleted text end for individuals described in section 245C.03, subdivision 2,
must initiate a new background study through NETStudy when an individual returns to a
position requiring a background study following an absence of 120 or more consecutive
days.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 8.
Minnesota Statutes 2018, section 245C.10, subdivision 3, is amended to read:
Subd. 3.
Personal care provider organizations.
The commissioner shall recover the
cost of background studies initiated by a personal care provider organization under sections
256B.0651 to 256B.0654 deleted text begin and 256B.0659deleted text end through a fee of no more than $20 per study
charged to the organization responsible for submitting the background study form. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 9.
Minnesota Statutes 2018, section 245C.16, subdivision 1, is amended to read:
Subdivision 1.
Determining immediate risk of harm.
(a) If the commissioner determines
that the individual studied has a disqualifying characteristic, the commissioner shall review
the information immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will have direct
contact with, or access to, people receiving services.
(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:
(1) the recency of the disqualifying characteristic;
(2) the recency of discharge from probation for the crimes;
(3) the number of disqualifying characteristics;
(4) the intrusiveness or violence of the disqualifying characteristic;
(5) the vulnerability of the victim involved in the disqualifying characteristic;
(6) the similarity of the victim to the persons served by the program where the individual
studied will have direct contact;
(7) whether the individual has a disqualification from a previous background study that
has not been set aside; and
(8) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 1, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense in
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with, or access to, persons receiving services from
the program.
(c) This section does not apply when the subject of a background study is regulated by
a health-related licensing board as defined in chapter 214, and the subject is determined to
be responsible for substantiated maltreatment under section 626.556 or 626.557.
(d) This section does not apply to a background study related to an initial application
for a child foster care license.
deleted text begin
(e) Except for paragraph (f), this section does not apply to a background study that is
also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
personal care assistant or a qualified professional as defined in section 256B.0659,
subdivision 1.
deleted text end
deleted text begin (f)deleted text end new text begin (e)new text end If the commissioner has reason to believe, based on arrest information or an active
maltreatment investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously supervised
or immediately removed pending the conclusion of the maltreatment investigation or criminal
proceedings.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 10.
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 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 injurynew text begin , community access for
disability inclusion, community alternative care, and developmental disabilitynew 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 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 behavioraldeleted text end new text begin positivenew text end support services as defined 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 disabilitynew 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
disability 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 disability 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 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. 11.
Minnesota Statutes 2018, section 245D.071, subdivision 1, is amended to read:
Subdivision 1.
Requirements for intensive support services.
Except for services
identified in section 245D.03, subdivision 1, paragraph (c), clauses (1) and (2),new text begin item (ii),new text end a
license holder providing intensive support services identified in section 245D.03, subdivision
1, paragraph (c), must comply with the requirements in this section and section 245D.07,
subdivisions 1new text begin , 1a,new text end and 3. Services identified in section 245D.03, subdivision 1, paragraph
(c), clauses (1) and (2),new text begin item (ii),new text end must comply with the requirements in section 245D.07,
subdivision 2.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 12.
Minnesota Statutes 2018, section 245D.071, subdivision 3, is amended to read:
Subd. 3.
Assessment and initial service planning.
(a) Within 15 days of service initiation
the license holder must complete a preliminary coordinated service and support plan
addendum based on the coordinated service and support plan.
(b) Within the scope of services, the license holder must, at a minimum, complete
assessments in the following areas before the 45-day planning meeting:
(1) the person's ability to self-manage health and medical needs to maintain or improve
physical, mental, and emotional well-being, including, when applicable, allergies, seizures,
choking, special dietary needs, chronic medical conditions, self-administration of medication
or treatment orders, preventative screening, and medical and dental appointments;
(2) the person's ability to self-manage personal safety to avoid injury or accident in the
service setting, including, when applicable, risk of falling, mobility, regulating water
temperature, community survival skills, water safety skills, and sensory disabilities; and
(3) the person's ability to self-manage symptoms or behavior that may otherwise result
in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension
or termination of services by the license holder, or other symptoms or behaviors that may
jeopardize the health and welfare of the person or others.
Assessments must produce information about the person that describes the person's overall
strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be
based on the person's status within the last 12 months at the time of service initiation.
Assessments based on older information must be documented and justified. Assessments
must be conducted annually at a minimum or within 30 days of a written request from the
person or the person's legal representative or case manager. The results must be reviewed
by the support team or expanded support team as part of a service plan review.
(c) Within 45 days of service initiation, the license holder must meet with the person,
the person's legal representative, the case manager, and other members of the support team
or expanded support team to determine the following based on information obtained from
the assessments identified in paragraph (b), the person's identified needs in the coordinated
service and support plan, and the requirements in subdivision 4 and section 245D.07,
subdivision 1a:
(1) the scope of the services to be provided to support the person's daily needs and
activities;
(2) the person's desired outcomes and the supports necessary to accomplish the person's
desired outcomes;
(3) the person's preferences for how services and supports are provided, including how
the provider will support the person to have control of the person's schedule;
(4) whether the current service setting is the most integrated setting available and
appropriate for the person; and
(5) how services must be coordinated across other providers licensed under this chapter
serving the person and members of the support team or expanded support team to ensure
continuity of care and coordination of services for the person.
(d) A discussion of how technology might be used to meet the person's desired outcomes
must be included in the 45-day planning meetingnew text begin and at least annually thereafternew text end . The
deleted text begin coordinated service and support plan ordeleted text end support plan addendum must include a summary
of this discussion. The summary must include a statement regarding any decision that is
made regarding the use of technology and a description of any further research that needs
to be completed before a decision regarding the use of technology can be made. Nothing
in this paragraph requires that the coordinated service and support plan include the use of
technology for the provision of services.
Sec. 13.
Minnesota Statutes 2018, section 245D.09, subdivision 4a, is amended to read:
Subd. 4a.
Orientation to individual service recipient needs.
(a) Before having
unsupervised direct contact with a person served by the program, or for whom the staff
person has not previously provided direct support, or any time the plans or procedures
identified in paragraphs (b) to (f) are revised, the staff person must review and receive
instruction on the requirements in paragraphs (b) to (f) as they relate to the staff person's
job functions for that person.
(b) For community residential services, training and competency evaluations must include
the following, if identified in the coordinated service and support plan:
(1) appropriate and safe techniques in personal hygiene and grooming, including hair
care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of daily
living (ADLs) deleted text begin as defined under section 256B.0659, subdivision 1deleted text end ;
(2) an understanding of what constitutes a healthy diet according to data from the Centers
for Disease Control and Prevention and the skills necessary to prepare that diet; and
(3) skills necessary to provide appropriate support in instrumental activities of daily
living (IADLs) deleted text begin as defined under section 256B.0659, subdivision 1deleted text end .
(c) The staff person must review and receive instruction on the person's coordinated
service and support plan or coordinated service and support plan addendum as it relates to
the responsibilities assigned to the license holder, and when applicable, the person's individual
abuse prevention plan, to achieve and demonstrate an understanding of the person as a
unique individual, and how to implement those plans.
(d) The staff person must review and receive instruction on medication setup, assistance,
or administration procedures established for the person when assigned to the license holder
according to section 245D.05, subdivision 1, paragraph (b). Unlicensed staff may perform
medication setup or medication administration only after successful completion of a
medication setup or medication administration training, from a training curriculum developed
by a registered nurse or appropriate licensed health professional. The training curriculum
must incorporate an observed skill assessment conducted by the trainer to ensure unlicensed
staff demonstrate the ability to safely and correctly follow medication procedures.
Medication administration must be taught by a registered nurse, clinical nurse specialist,
certified nurse practitioner, physician assistant, or physician if, at the time of service initiation
or any time thereafter, the person has or develops a health care condition that affects the
service options available to the person because the condition requires:
(1) specialized or intensive medical or nursing supervision; and
(2) nonmedical service providers to adapt their services to accommodate the health and
safety needs of the person.
(e) The staff person must review and receive instruction on the safe and correct operation
of medical equipment used by the person to sustain life or to monitor a medical condition
that could become life-threatening without proper use of the medical equipment, including
but not limited to ventilators, feeding tubes, or endotracheal tubes. The training must be
provided by a licensed health care professional or a manufacturer's representative and
incorporate an observed skill assessment to ensure staff demonstrate the ability to safely
and correctly operate the equipment according to the treatment orders and the manufacturer's
instructions.
(f) The staff person must review and receive instruction on mental health crisis response,
de-escalation techniques, and suicide intervention when providing direct support to a person
with a serious mental illness.
(g) In the event of an emergency service initiation, the license holder must ensure the
training required in this subdivision occurs within 72 hours of the direct support staff person
first having unsupervised contact with the person receiving services. The license holder
must document the reason for the unplanned or emergency service initiation and maintain
the documentation in the person's service recipient record.
(h) License holders who provide direct support services themselves must complete the
orientation required in subdivision 4, clauses (3) to (10).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 14.
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 development disabilitynew 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
new text begin
(vi) person with a master's degree or PhD in one of the behavioral sciences or related
field with demonstrated expertise in positive support services, as determined by the person's
case manager based on the person's needs as outlined in the person's community support
plan; or
new text end
deleted text begin (vi)deleted 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. 15.
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 disabilitynew 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 17deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(3) certification as a board-certified behavior analyst or board-certified assistant behavior
analyst by the Behavior Analyst Certification Board.
new 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 disorder;deleted text end new text begin
conducting functional behavior assessments and designing, implementing, and evaluating
the 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
deleted text begin
(2) have received ten hours of instruction in functional assessment and functional analysis;
deleted 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
new text begin
(2) have 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 behavior support
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 (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. 16.
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 disabilitynew 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:
deleted text begin
(1) have received a minimum of four hours of training in functional assessment;
deleted text end
deleted text begin
(2) have received 20 hours of instruction in the understanding of the function of behavior;
deleted text end
deleted text begin
(3) have received ten hours of instruction on design of positive practices behavioral
support strategies;
deleted text end
new text begin
(1) have received training prior to hire or within 90 calendar days of hire that includes:
new text end
new text begin
(i) a minimum of four hours of training in functional assessment;
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;
and
new text end
new text begin
(iv) eight hours of instruction on person-centered thinking principles;
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 new text begin behavior support new text end 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. 17.
Minnesota Statutes 2018, section 252.32, subdivision 1a, is amended to read:
Subd. 1a.
Support grants.
(a) Provision of support grants must be limited to families
who require support and whose dependents are under the age of 21 and who have been
certified disabled under section 256B.055, subdivision 12, paragraphs (a), (b), (c), (d), and
(e). Families who are receiving: home and community-based waivered services for persons
with disabilities authorized under section 256B.092 or 256B.49deleted text begin ;deleted text end new text begin ornew text end personal care assistance
under section 256B.0652deleted text begin ; or a consumer support grant under section 256.476deleted text end are not eligible
for support grants.
Families whose annual adjusted gross income is $60,000 or more are not eligible for
support grants except in cases where extreme hardship is demonstrated. Beginning in state
fiscal year 1994, the commissioner shall adjust the income ceiling annually to reflect the
projected change in the average value in the United States Department of Labor Bureau of
Labor Statistics Consumer Price Index (all urban) for that year.
(b) Support grants may be made available as monthly subsidy grants and lump-sum
grants.
(c) Support grants may be issued in the form of cash, voucher, and direct county payment
to a vendor.
(d) Applications for the support grant shall be made by the legal guardian to the county
social service agency. The application shall specify the needs of the families, the form of
the grant requested by the families, and the items and services to be reimbursed.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 18.
Minnesota Statutes 2018, section 252.32, subdivision 3a, is amended to read:
Subd. 3a.
Reports and allocations.
(a) The commissioner shall specify requirements
for quarterly fiscal and annual program reports according to section 256.01, subdivision 2,
paragraph (p). Program reports shall include data which will enable the commissioner to
evaluate program effectiveness and to audit compliance. The commissioner shall reimburse
county costs on a quarterly basis.
(b) The commissioner shall allocate state funds made available under this section to
county social service agencies on a calendar year basis. The commissioner shall allocate to
each county first in amounts equal to each county's guaranteed floor as described in clause
(1), and second, any remaining funds will be allocated to county agencies to support children
in their family homes.
(1) Each county's guaranteed floor shall be calculated as follows:
(i) 95 percent of the county's allocation received in the preceding calendar year;
(ii) when the amount of funds available for allocation is less than the amount available
in the preceding year, each county's previous year allocation shall be reduced in proportion
to the reduction in statewide funding, for the purpose of establishing the guaranteed floor.
(2) The commissioner shall regularly review the use of family support fund allocations
by county. The commissioner may reallocate unexpended or unencumbered money at any
time to those counties that have a demonstrated need for additional funding.
(c) County allocations under this section will be adjusted deleted text begin for transfers that occur according
to section 256.476 ordeleted text end when the county of financial responsibility changes according to
chapter 256G for eligible recipients.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 19.
Minnesota Statutes 2018, section 256B.038, is amended to read:
256B.038 PROVIDER RATE INCREASES AFTER JUNE 30, 1999.
(a) For fiscal years beginning on or after July 1, 1999, the commissioner of management
and budget shall include an annual inflationary adjustment in payment rates for the services
listed in paragraph (b) as a budget change request in each biennial detailed expenditure
budget submitted to the legislature under section 16A.11. The adjustment shall be
accomplished by indexing the rates in effect for inflation based on the change in the
Consumer Price Index-All Items (United States city average)(CPI-U) as forecasted by Data
Resources, Inc., in the fourth quarter of the prior year for the calendar year during which
the rate increase occurs.
(b) Within the limits of appropriations specifically for this purpose, the commissioner
shall apply the rate increases in paragraph (a) to home and community-based waiver services
for persons with developmental disabilities under section 256B.501; home and
community-based waiver services for the elderly under section 256B.0915; waivered services
under community access for disability inclusion under section 256B.49; community
alternative care waivered services under section 256B.49; brain injury waivered services
under section 256B.49; nursing services and home health services under section 256B.0625,
subdivision 6a; personal care services and nursing supervision of personal care services
deleted text begin under section 256B.0625, subdivision 19adeleted text end ; home care nursing services under section
256B.0625, subdivision 7; day training and habilitation services for adults with developmental
disabilities under sections 252.41 to 252.46; physical therapy services under section
256B.0625, subdivision 8; occupational therapy services under section 256B.0625,
subdivision 8a; speech-language therapy services under Minnesota Rules, part 9505.0390;
respiratory therapy services under Minnesota Rules, part 9505.0295; physician services
under section 256B.0625, subdivision 3; dental services under section 256B.0625, subdivision
9; alternative care services under section 256B.0913; adult residential program grants under
section 245.73; adult and family community support grants under Minnesota Rules, parts
9535.1700 to 9535.1760; and semi-independent living services under section 252.275,
including SILS funding under county social services grants formerly funded under chapter
256I.
(c) The commissioner shall increase prepaid medical assistance program capitation rates
as appropriate to reflect the rate increases in this section.
(d) In implementing this section, the commissioner shall consider proposing a schedule
to equalize rates paid by different programs for the same service.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. 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 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.
(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 deleted text begin 256B.0659 ordeleted text end 256B.85.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 21.
Minnesota Statutes 2018, section 256B.0621, subdivision 2, is amended to read:
Subd. 2.
Targeted case management; definitions.
For purposes of subdivisions 3 to
10, the following terms have the meanings given them:
(1) "home care service recipients" means those individuals receiving the following
services under sections 256B.0651 to 256B.0654 deleted text begin and 256B.0659deleted text end : skilled nursing visits,
home health aide visits, home care nursing, personal care assistants, or therapies provided
through a home health agency;
(2) "home care targeted case management" means the provision of targeted case
management services for the purpose of assisting home care service recipients to gain access
to needed services and supports so that they may remain in the community;
(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title 42,
section 440.10; regional treatment center inpatient services, consistent with section 245.474;
nursing facilities; and intermediate care facilities for persons with developmental disabilities;
(4) "relocation targeted case management" includes the provision of both county targeted
case management and public or private vendor service coordination services for the purpose
of assisting recipients to gain access to needed services and supports if they choose to move
from an institution to the community. Relocation targeted case management may be provided
during the lesser of:
(i) the last 180 consecutive days of an eligible recipient's institutional stay; or
(ii) the limits and conditions which apply to federal Medicaid funding for this service;
and
(5) "targeted case management" means case management services provided to help
recipients gain access to needed medical, social, educational, and other services and supports.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 22.
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 Community first services and supports. new text end
new text begin
Medical assistance covers community
first services and supports as determined by section 256B.85.
new text end
Sec. 23.
Minnesota Statutes 2018, section 256B.0651, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For the purposes of sections 256B.0651 to 256B.0654deleted text begin
and 256B.0659deleted text end , the terms in paragraphs (b) to deleted text begin (g)deleted text end new text begin (f)new text end have the meanings given.
deleted text begin
(b) "Activities of daily living" has the meaning given in section 256B.0659, subdivision
1, paragraph (b).
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end "Assessment" means a review and evaluation of a recipient's need for home care
services conducted in person.
deleted text begin (d)deleted text end new text begin (c)new text end "Home care services" means medical assistance covered services that are home
health agency services, including skilled nurse visits; home health aide visits; physical
therapy, occupational therapy, respiratory therapy, and language-speech pathology therapy;
home care nursing; and personal care assistance.
deleted text begin (e)deleted text end new text begin (d)new text end "Home residence," effective January 1, 2010, means a residence owned or rented
by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid
responsible party or legal representative; or a family foster home where the license holder
lives with the recipient and is not paid to provide home care services for the recipient except
as allowed under sections 256B.0652, subdivision 10, and 256B.0654, subdivision 4.
deleted text begin (f)deleted text end new text begin (e)new text end "Medically necessary" has the meaning given in Minnesota Rules, parts 9505.0170
to 9505.0475.
deleted text begin (g)deleted text end new text begin (f)new text end "Ventilator-dependent" means an individual who receives mechanical ventilation
for life support at least six hours per day and is expected to be or has been dependent on a
ventilator for at least 30 consecutive days.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 24.
Minnesota Statutes 2018, section 256B.0651, subdivision 2, is amended to read:
Subd. 2.
Services covered.
Home care services covered under this section and sections
256B.0652 to 256B.0654 deleted text begin and 256B.0659deleted text end include:
(1) nursing services under sections 256B.0625, subdivision 6a, and 256B.0653;
(2) home care nursing services under sections 256B.0625, subdivision 7, and 256B.0654;
(3) home health services under sections 256B.0625, subdivision 6a, and 256B.0653;
(4) personal care assistance services deleted text begin under sections 256B.0625, subdivision 19a, and
256B.0659deleted text end ;
(5) supervision of personal care assistance services provided by a qualified professional
deleted text begin under sections 256B.0625, subdivision 19a, and 256B.0659deleted text end ;
(6) face-to-face assessments by county public health nurses for services deleted text begin under sections
256B.0625, subdivision 19a, and 256B.0659deleted text end ; and
(7) service updates and review of temporary increases for personal care assistance
services by the county public health nurse for services deleted text begin under sections 256B.0625, subdivision
19a, and 256B.0659deleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 25.
Minnesota Statutes 2018, section 256B.0651, subdivision 12, is amended to read:
Subd. 12.
Approval of home care services.
The commissioner or the commissioner's
designee shall determine the medical necessity of home care services, the level of caregiver
according to subdivision 2, and the institutional comparison according to this subdivision
and deleted text begin sectionsdeleted text end new text begin sectionnew text end 256B.0652, subdivisions 3a, 4 to 11, 13, and 14, deleted text begin and 256B.0659,deleted text end the
cost-effectiveness of services, and the amount, scope, and duration of home care services
reimbursable by medical assistance, based on the assessment, primary payer coverage
determination information as required, the service plan, the recipient's age, the cost of
services, the recipient's medical condition, and diagnosis or disability. The commissioner
may publish additional criteria for determining medical necessity according to section
256B.04.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 26.
Minnesota Statutes 2018, section 256B.0651, subdivision 13, is amended to read:
Subd. 13.
Recovery of excessive payments.
The commissioner shall seek monetary
recovery from providers of payments made for services which exceed the limits established
in this section and sections 256B.0653deleted text begin ,deleted text end new text begin andnew text end 256B.0654deleted text begin , and 256B.0659deleted text end . This subdivision
does not apply to services provided to a recipient at the previously authorized level pending
an appeal under section 256.045, subdivision 10.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 27.
Minnesota Statutes 2018, section 256B.0652, subdivision 2, is amended to read:
Subd. 2.
Duties.
(a) The commissioner may contract with or employ necessary staff, or
contract with qualified agencies, to provide home care authorization and review services
for medical assistance recipients who are receiving home care services.
(b) Reimbursement for the authorization function shall be made through the medical
assistance administrative authority. The state shall pay the nonfederal share. The functions
will be to:
(1) assess the recipient's individual need for services required to be cared for safely in
the community;
(2) ensure that a care plan that meets the recipient's needs is developed by the appropriate
agency or individual;
(3) ensure cost-effectiveness and nonduplication of medical assistance home care services;
(4) recommend the approval or denial of the use of medical assistance funds to pay for
home care services;
(5) reassess the recipient's need for and level of home care services at a frequency
determined by the commissioner;
(6) conduct on-site assessments when determined necessary by the commissioner and
recommend changes to care plans that will provide more efficient and appropriate home
care; and
(7) on the department's website:
(i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies with
the following information: main office address, contact information for the agency, counties
in which services are provided, type of home care services provided, whether the personal
care assistance choice option is offered, types of qualified professionals employed, number
of personal care assistants employed, and data on staff turnover; and
(ii) post data on home care services including information from both fee-for-service and
managed care plans on recipients as available.
(c) In addition, the commissioner or the commissioner's designee may:
(1) review care plans, service plans, and reimbursement data for utilization of services
that exceed community-based standards for home care, inappropriate home care services,
medical necessity, home care services that do not meet quality of care standards, or
unauthorized services and make appropriate referrals within the department or to other
appropriate entities based on the findings;
(2) assist the recipient in obtaining services necessary to allow the recipient to remain
safely in or return to the community;
(3) coordinate home care services with other medical assistance services under section
256B.0625;
(4) assist the recipient with problems related to the provision of home care services;
(5) assure the quality of home care services; and
(6) assure that all liable third-party payers including, but not limited to, Medicare have
been used prior to medical assistance for home care services.
(d) For the purposes of this section, "home care services" means medical assistance
services defined under section 256B.0625, subdivisions 6adeleted text begin ,deleted text end new text begin andnew text end 7deleted text begin , and 19adeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 28.
Minnesota Statutes 2018, section 256B.0652, subdivision 5, is amended to read:
Subd. 5.
Authorization; home care nursing services.
(a) All home care nursing services
shall be authorized by the commissioner or the commissioner's designee. Authorization for
home care nursing services shall be based on medical necessity and cost-effectiveness when
compared with alternative care options. The commissioner may authorize medically necessary
home care nursing services in quarter-hour units when:
(1) the recipient requires more individual and continuous care than can be provided
during a skilled nurse visit; or
(2) the cares are outside of the scope of services that can be provided by a home health
aide or personal care assistant.
(b) The commissioner may authorize:
(1) up to two times the average amount of direct care hours provided in nursing facilities
statewide for case mix classification "K" as established by the annual cost report submitted
to the department by nursing facilities in May 1992;
(2) home care nursing in combination with other home care services up to the total cost
allowed under this subdivision and subdivision 7;
(3) up to 16 hours per day if the recipient requires more nursing than the maximum
number of direct care hours as established in clause (1) and, but for the provision of the
nursing services, the recipient would require a hospital level of care as defined in Code of
Federal Regulations, title 42, section 440.10.
(c) The commissioner may authorize up to 16 hours per day of medically necessary
home care nursing services or up to 24 hours per day of medically necessary home care
nursing services until such time as the commissioner is able to make a determination of
eligibility for recipients who are cooperatively applying for home care services under the
community alternative care program developed under section 256B.49, or until it is
determined by the appropriate regulatory agency that a health benefit plan is or is not required
to pay for appropriate medically necessary health care services. Recipients or their
representatives must cooperatively assist the commissioner in obtaining this determination.
Recipients who are eligible for the community alternative care program may not receive
more hours of nursing under this section and sections 256B.0651deleted text begin ,deleted text end new text begin andnew text end 256B.0653deleted text begin , and
256B.0659deleted text end than would otherwise be authorized under section 256B.49.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 29.
Minnesota Statutes 2018, section 256B.0652, subdivision 8, is amended to read:
Subd. 8.
Authorization; time limits; amount and type.
deleted text begin (a)deleted text end The commissioner or the
commissioner's designee shall determine the time period for which an authorization shall
be effective. If the recipient continues to require home care services beyond the duration
of the authorization, the home care provider must request a new authorization. A personal
care provider agency must request a new personal care assistance services assessment, or
service update if allowed, at least 60 days prior to the end of the current authorization time
period. The request for the assessment must be made on a form approved by the
commissioner. An authorization must be valid for no more than 12 months.
deleted text begin
(b) The amount and type of personal care assistance services authorized based upon the
assessment and service plan must remain in effect for the recipient whether the recipient
chooses a different provider or enrolls or disenrolls from a managed care plan under section
256B.0659, unless the service needs of the recipient change and new assessment is warranted
under section 256B.0659, subdivision 3a.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 30.
Minnesota Statutes 2018, section 256B.0652, subdivision 10, is amended to read:
Subd. 10.
Authorization for foster care setting.
(a) Home care services provided in
an adult or child foster care setting must receive authorization by the commissioner according
to the limits established in subdivision 11.
(b) The commissioner may not authorize:
(1) home care services that are the responsibility of the foster care provider under the
terms of the foster care placement agreement, difficulty of care rate as of January 1, 2010,
and administrative rules;
(2) personal care assistance services when the foster care license holder is also the
personal care provider or personal care assistant, unless the foster home is the licensed
provider's primary residence deleted text begin as defined in section 256B.0625, subdivision 19adeleted text end ; or
(3) personal care assistant and home care nursing services when the licensed capacity
is greater than fournew text begin , unless all conditions for a variance under Minnesota Rules, part
2960.3030, subpart 3, are satisfied for a sibling, as defined in section 260C.007, subdivision
32new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment except
the amendment to paragraph (b), clause (2), is effective as determined by the commissioner
of human services following federal approval but not more than two years after federal
approval is obtained. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 31.
Minnesota Statutes 2018, section 256B.0652, subdivision 12, is amended to read:
Subd. 12.
Assessment and authorization process for persons receiving personal care
assistance and developmental disabilities services.
For purposes of providing informed
choice, coordinating of local planning decisions, and streamlining administrative
requirements, the assessment and authorization process for persons receiving both home
care and home and community-based waivered services for persons with developmental
disabilities shall meet the requirements of sections 256B.0651 to 256B.0654 deleted text begin and 256B.0659deleted text end
with the following exceptions:
(a) Upon request for home care services and subsequent assessment by the public health
nurse under sections 256B.0651 to 256B.0654 deleted text begin and 256B.0659deleted text end , the public health nurse shall
participate in the screening process, as appropriate, and, if home care services are determined
to be necessary, participate in the development of a service plan coordinating the need for
home care and home and community-based waivered services with the assigned county
case manager, the recipient of services, and the recipient's legal representative, if any.
(b) The public health nurse shall give authorization for home care services to the extent
that home care services are:
(1) medically necessary;
(2) chosen by the recipient and their legal representative, if any, from the array of home
care and home and community-based waivered services available;
(3) coordinated with other services to be received by the recipient as described in the
service plan; and
(4) provided within the county's reimbursement limits for home care and home and
community-based waivered services for persons with developmental disabilities.
(c) If the public health agency is or may be the provider of home care services to the
recipient, the public health agency shall provide the commissioner of human services with
a written plan that specifies how the assessment and authorization process will be held
separate and distinct from the provision of services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 32.
Minnesota Statutes 2018, section 256B.0653, subdivision 3, is amended to read:
Subd. 3.
Home health aide visits.
(a) Home health aide visits must be provided by a
certified home health aide using a written plan of care that is updated in compliance with
Medicare regulations. A home health aide shall provide hands-on personal care, perform
simple procedures as an extension of therapy or nursing services, and assist in instrumental
activities of daily living deleted text begin as defined in section 256B.0659deleted text end , including assuring that the person
gets to medical appointments if identified in the written plan of care. Home health aide
visits may be provided in the recipient's home or in the community where normal life
activities take the recipient.
(b) All home health aide visits must have authorization under section 256B.0652. The
commissioner shall limit home health aide visits to no more than one visit per day per
recipient.
(c) Home health aides must be supervised by a registered nurse or an appropriate therapist
when providing services that are an extension of therapy.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 33.
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 required 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. 34.
Minnesota Statutes 2018, section 256B.0705, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following deleted text begin terms havedeleted text end new text begin
term hasnew text end the deleted text begin meaningsdeleted text end new text begin meaningnew text end given deleted text begin themdeleted text end .
deleted text begin
(b) "Personal care assistance services" or "PCA services" means services provided
according to section 256B.0659.
deleted text end
deleted text begin
(c) "Personal care assistant" or "PCA" has the meaning given in section 256B.0659,
subdivision 1.
deleted text end
deleted text begin (d)deleted text end new text begin (b)new text end "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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 35.
Minnesota Statutes 2018, section 256B.0705, subdivision 2, is amended to read:
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 deleted text begin under section 256B.0659, subdivision 14 or 19deleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 36.
Minnesota Statutes 2018, section 256B.0711, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
For purposes of this section:
(a) "Commissioner" means the commissioner of human services unless otherwise
indicated.
(b) "Covered program" means a program to provide direct support services funded in
whole or in part by the state of Minnesota, including the Community First Services and
Supports program; Consumer Directed Community Supports services and extended state
plan personal care assistance services available under programs established pursuant to
home and community-based service waivers authorized under section 1915(c) of the Social
Security Act, and Minnesota Statutes, including, but not limited to, sections 256B.0915,
256B.092, and 256B.49, and under the alternative care program, as offered pursuant to
section 256B.0913; the personal care assistance choice programdeleted text begin , as established pursuant to
section 256B.0659, subdivisions 18 to 20deleted text end ; and any similar program that may provide similar
services in the future.
(c) "Direct support services" means personal care assistance services covered by medical
assistance deleted text begin under section 256B.0625, subdivisions 19a and 19cdeleted text end ; assistance with activities of
daily living deleted text begin as defined in section 256B.0659, subdivision 1, paragraph (b)deleted text end , and instrumental
activities of daily living deleted text begin as defined in section 256B.0659, subdivision 1, paragraph (i)deleted text end ; and
other similar, in-home, nonprofessional long-term services and supports provided to an
elderly person or person with a disability by the person's employee or the employee of the
person's representative to meet such person's daily living needs and ensure that such person
may adequately function in the person's home and have safe access to the community.
(d) "Individual provider" means an individual selected by and working under the direction
of a participant in a covered program, or a participant's representative, to provide direct
support services to the participant, but does not include an employee of a provider agency,
subject to the agency's direction and control commensurate with agency employee status.
(e) "Participant" means a person who receives direct support services through a covered
program.
(f) "Participant's representative" means a participant's legal guardian or an individual
having the authority and responsibility to act on behalf of a participant with respect to the
provision of direct support services through a covered program.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 37.
Minnesota Statutes 2018, section 256B.0711, subdivision 2, is amended to read:
Subd. 2.
Operation of covered programs.
All covered programs shall operate consistent
with this section, including by affording participants and participants' representatives within
the programs of the option of receiving services through individual providers as defined in
subdivision 1, paragraph (d)deleted text begin , notwithstanding any inconsistent provision of section
256B.0659deleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. 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.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 deleted text begin Linkage Linedeleted text end new text begin Hubnew text end
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 deleted text begin state plan home care services identified in:
deleted text end
deleted text begin
(i) section 256B.0625, subdivisions 7, 19a, and 19c;
deleted text end
deleted text begin
(ii) consumer support grants under section 256.476; or
deleted text end
deleted text begin (iii)deleted text end 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, paragraph (4), and 256B.0924 and Minnesota Rules,
part 9525.0016;new text begin and
new text end
deleted text begin
(3) determination of institutional level of care, home and community-based service
waiver, and other service eligibility as required under section 256B.092, determination of
eligibility for family support grants under section 252.32, semi-independent living services
under section 252.275, and day training and habilitation services under section 256B.092;
and
deleted text end
deleted text begin (4)deleted text end new text begin (3)new text end 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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019, except the amendment
striking section 256B.0625, subdivisions 19a and 19c, from paragraph (b), clause (1), item
(i), is effective as determined by the commissioner of human services following federal
approval but not more than two years after federal approval is obtained. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 39.
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 whichnew text begin the person acceptsnew text end an assessment deleted text begin was requested or recommendeddeleted text end . 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 nursingdeleted text end . The
commissioner shall provide at least a 90-day notice to lead agencies prior to the effective
date of this requirement. Face-to-face assessments must be conducted according to paragraphs
(b) to (i).
(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.
(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, person-centered assessment. The assessment must
include the health, psychological, functional, environmental, and social needs of the
deleted text begin individualdeleted text end new text begin personnew text end necessary to develop a community support plan that meets the deleted text begin individual'sdeleted text end new text begin
person'snew text end needs and preferences.
(d) The deleted text begin assessment must be conducteddeleted text end new text begin assessor must conduct the assessmentnew text end in a
face-to-face interview with the person being assessed deleted text begin and the person's legal representativedeleted text end .new text begin
The person's legal representative must provide input during the assessment interview and
may do so remotely.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 deleted text begin with at least 20 hours of service to that clientdeleted text end new text begin who is familiar with
the personnew text end . deleted text begin The person conducting the assessment or reassessment must notify the provider
of the date by which this information is to be submitted.deleted text end 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) new text begin The certified assessor and the individual responsible for developing the coordinated
service and support plan must ensure the person has timely access to needed resources and
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 deleted text begin individual'sdeleted text end new text begin person'snew text end 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
deleted text begin individualdeleted text end new text begin personnew text end . For purposes of this clause, "cost-effective" means community services
and living arrangements that cost the same as or less than institutional care. For deleted text begin an individualdeleted text end new text begin
a personnew text end 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 deleted text begin individualdeleted text end new text begin personnew text end 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, deleted text begin and state plan home care,deleted text end 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.
(k) Face-to-face assessment completed as part of eligibility determination for the
alternative care, elderly waiver, community access for disability inclusion, community
alternative care, deleted text begin anddeleted text end brain injurynew text begin , and developmental disabilitiesnew text end 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. 40.
Minnesota Statutes 2018, section 256B.0911, subdivision 3f, is amended to read:
Subd. 3f.
Long-term care reassessments and community support plan
updates.
Reassessments must be tailored using the professional judgment of the assessor
to the person's known needs, strengths, preferences, and circumstances. Reassessments
provide information to support the person's informed choice and opportunities to express
choice regarding activities that contribute to quality of life, as well as information and
opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments allow for a review of the current support plan's
effectiveness, monitoring of services, and the development of an updated person-centered
community support plan. Reassessments verify continued eligibility or offer alternatives as
warranted and provide an opportunity for quality assurance of service delivery. Face-to-face
assessments must be conducted annually or as required by federal and state laws and rules.new text begin
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
must complete the updated community support plan and the updated coordinated service
and support plan no more than 60 calendar days from the reassessment visit.
new text end
Sec. 41.
Minnesota Statutes 2018, section 256B.0911, subdivision 6, is amended to read:
Subd. 6.
Payment for long-term care consultation services.
(a) Until September 30,
2013, payment for long-term care consultation face-to-face assessment shall be made as
described in this subdivision.
(b) The total payment for each county must be paid monthly by certified nursing facilities
in the county. The monthly amount to be paid by each nursing facility for each fiscal year
must be determined by dividing the county's annual allocation for long-term care consultation
services by 12 to determine the monthly payment and allocating the monthly payment to
each nursing facility based on the number of licensed beds in the nursing facility. Payments
to counties in which there is no certified nursing facility must be made by increasing the
payment rate of the two facilities located nearest to the county seat.
(c) The commissioner shall include the total annual payment determined under paragraph
(b) for each nursing facility reimbursed under section 256B.431 or 256B.434 or chapter
256R.
(d) In the event of the layaway, delicensure and decertification, or removal from layaway
of 25 percent or more of the beds in a facility, the commissioner may adjust the per diem
payment amount in paragraph (c) and may adjust the monthly payment amount in paragraph
(b). The effective date of an adjustment made under this paragraph shall be on or after the
first day of the month following the effective date of the layaway, delicensure and
decertification, or removal from layaway.
(e) Payments for long-term care consultation services are available to the county or
counties to cover staff salaries and expenses to provide the services described in subdivision
1a. The county shall employ, or contract with other agencies to employ, within the limits
of available funding, sufficient personnel to provide long-term care consultation services
while meeting the state's long-term care outcomes and objectives as defined in subdivision
1. The county shall be accountable for meeting local objectives as approved by the
commissioner in the biennial home and community-based services quality assurance plan
on a form provided by the commissioner.
(f) Notwithstanding section 256B.0641, overpayments attributable to payment of the
screening costs under the medical assistance program may not be recovered from a facility.
(g) The commissioner of human services shall amend the Minnesota medical assistance
plan to include reimbursement for the local consultation teams.
(h) Until the alternative payment methodology in paragraph (i) is implemented, the
county may bill, as case management services, assessments, support planning, and
follow-along provided to persons determined to be eligible for case management under
Minnesota health care programs. No individual or family member shall be charged for an
initial assessment or initial support plan development provided under subdivision 3a or 3b.
(i) The commissioner shall develop an alternative payment methodology, effective on
October 1, 2013, for long-term care consultation services that includes the funding available
under this subdivision, and for assessments authorized under deleted text begin sectionsdeleted text end new text begin sectionnew text end 256B.092 deleted text begin and
256B.0659deleted text end . In developing the new payment methodology, the commissioner shall consider
the maximization of other funding sources, including federal administrative reimbursement
through federal financial participation funding, for all long-term care consultation activity.
The alternative payment methodology shall include the use of the appropriate time studies
and the state financing of nonfederal share as part of the state's medical assistance program.
Between July 1, 2017, and June 30, 2019, the state shall pay 84.3 percent of the nonfederal
share as reimbursement to the counties. Beginning July 1, 2019, the state shall pay 81.9
percent of the nonfederal share as reimbursement to the counties.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 42.
Minnesota Statutes 2018, section 256B.0913, subdivision 5a, is amended to read:
Subd. 5a.
Services; service definitions; service standards.
(a) Unless specified in
statute, the services, service definitions, and standards for alternative care services shall be
the same as the services, service definitions, and standards specified in the federally approved
elderly waiver plan, except alternative care does not cover transitional support services,
assisted living services, adult foster care services, and residential care and benefits defined
under section 256B.0625 that meet primary and acute health care needs.
(b) The lead agency must ensure that the funds are not used to supplant or supplement
services available through other public assistance or services programs, including
supplementation of client co-pays, deductibles, premiums, or other cost-sharing arrangements
for health-related benefits and services or entitlement programs and services that are available
to the person, but in which they have elected not to enroll. The lead agency must ensure
that the benefit department recovery system in the Medicaid Management Information
System (MMIS) has the necessary information on any other health insurance or third-party
insurance policy to which the client may have access. Supplies and equipment may be
purchased from a vendor not certified to participate in the Medicaid program if the cost for
the item is less than that of a Medicaid vendor.
(c) Personal care services must meet the service standards defined in the federally
approved elderly waiver plan, except that a lead agency may authorize services to be provided
by a client's relative who meets the relative hardship waiver requirements or a relative who
meets the criteria and is also the responsible party under an individual service plan that
ensures the client's health and safety and supervision of the personal care services by a
qualified professional deleted text begin as defined in section 256B.0625, subdivision 19cdeleted text end . Relative hardship
is established by the lead agency when the client's care causes a relative caregiver to do any
of the following: resign from a paying job, reduce work hours resulting in lost wages, obtain
a leave of absence resulting in lost wages, incur substantial client-related expenses, provide
services to address authorized, unstaffed direct care time, or meet special needs of the client
unmet in the formal service plan.
(d) Alternative care covers sign language interpreter services and spoken language
interpreter services for recipients eligible for alternative care when the services are necessary
to help deaf and hard-of-hearing recipients or recipients with limited English proficiency
obtain covered services. Coverage for face-to-face spoken language interpreter services
shall be provided only if the spoken language interpreter used by the enrolled health care
provider is listed in the registry or roster established under section 144.058.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 43.
Minnesota Statutes 2018, section 256B.0915, subdivision 3a, is amended to read:
Subd. 3a.
Elderly waiver cost limits.
(a) Effective on the first day of the state fiscal
year in which the resident assessment system as described in section 256R.17 for nursing
home rate determination is implemented and the first day of each subsequent state fiscal
year, the monthly limit for the cost of waivered services to an individual elderly waiver
client shall be the monthly limit of the case mix resident class to which the waiver client
would be assigned under Minnesota Rules, parts 9549.0051 to 9549.0059, in effect on the
last day of the previous state fiscal year, adjusted by any legislatively adopted home and
community-based services percentage rate adjustment. If a legislatively authorized increase
is service-specific, the monthly cost limit shall be adjusted based on the overall average
increase to the elderly waiver program.
(b) The monthly limit for the cost of waivered services under paragraph (a) to an
individual elderly waiver client assigned to a case mix classification A with:
(1) no dependencies in activities of daily living; or
(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when
the dependency score in eating is three or greater as determined by an assessment performed
under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new
participants enrolled in the program on or after July 1, 2011. This monthly limit shall be
applied to all other participants who meet this criteria at reassessment. This monthly limit
shall be increased annually as described in paragraphs (a) and (e).
(c) If extended medical supplies and equipment or environmental modifications are or
will be purchased for an elderly waiver client, the costs may be prorated for up to 12
consecutive months beginning with the month of purchase. If the monthly cost of a recipient's
waivered services exceeds the monthly limit established in paragraph (a), (b), (d), or (e),
the annual cost of all waivered services shall be determined. In this event, the annual cost
of all waivered services shall not exceed 12 times the monthly limit of waivered services
as described in paragraph (a), (b), (d), or (e).
(d) Effective July 1, 2013, the monthly cost limit of waiver services, including any
necessary home care services described in section 256B.0651, subdivision 2, for individuals
who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1,
paragraph deleted text begin (g)deleted text end new text begin (f)new text end , shall be the average of the monthly medical assistance amount established
for home care services as described in section 256B.0652, subdivision 7, and the annual
average contracted amount established by the commissioner for nursing facility services
for ventilator-dependent individuals. This monthly limit shall be increased annually as
described in paragraphs (a) and (e).
(e) Effective January 1, 2018, and each January 1 thereafter, the monthly cost limits for
elderly waiver services in effect on the previous December 31 shall be increased by the
difference between any legislatively adopted home and community-based provider rate
increases effective on January 1 or since the previous January 1 and the average statewide
percentage increase in nursing facility operating payment rates under chapter 256R, effective
the previous January 1. This paragraph shall only apply if the average statewide percentage
increase in nursing facility operating payment rates is greater than any legislatively adopted
home and community-based provider rate increases effective on January 1, or occurring
since the previous January 1.
Sec. 44.
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
which:
(1) is developednew text begin withnew 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 and section 256B.0911, subdivision 3a, paragraph (e)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. 45.
Minnesota Statutes 2018, section 256B.0916, subdivision 9, is amended to read:
Subd. 9.
Legal representative participation exception.
The commissioner, in
cooperation with representatives of counties, service providers, service recipients, family
members, legal representatives and advocates, shall develop criteria to allow legal
representatives to be reimbursed for providing specific support services to meet the person's
needs when a plan which assures health and safety has been agreed upon and carried out
by the legal representative, the person, and the county. Legal representatives providing
support under the home and community-based waiver for persons with developmental
disabilities deleted text begin or the consumer support grant program pursuant to section 256.476,deleted text end shall not
be considered to have a direct or indirect service provider interest under section 256B.092,
subdivision 7, if a health and safety plan which meets the criteria established has been agreed
upon and implemented. By August 1, 2001, the commissioner shall submit, for federal
approval, amendments to allow legal representatives to provide support and receive
reimbursement under the home and community-based waiver plan.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 46.
Minnesota Statutes 2018, section 256B.0918, subdivision 2, is amended to read:
Subd. 2.
Participating providers.
The commissioner shall publish a request for proposals
in the State Register by August 15, 2005, specifying provider eligibility requirements,
provider selection criteria, program specifics, funding mechanism, and methods of evaluation.
The commissioner may publish additional requests for proposals in subsequent years.
Providers who provide services funded through the following programs are eligible to apply
to participate in the scholarship program: home and community-based waivered services
for persons with developmental disabilities under section 256B.501; home and
community-based waivered services for the elderly under section 256B.0915; waivered
services under community access for disability inclusion under section 256B.49; community
alternative care waivered services under section 256B.49; brain injury waivered services
under section 256B.49; nursing services and home health services under section 256B.0625,
subdivision 6a; personal care services and nursing supervision of personal care services
deleted text begin under section 256B.0625, subdivision 19adeleted text end ; home care nursing services under section
256B.0625, subdivision 7; day training and habilitation services for adults with developmental
disabilities under sections 252.41 to 252.46; and intermediate care facilities for persons
with developmental disabilities under section 256B.5012.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 47.
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 which:
(1) is developednew text begin withnew 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 and section 256B.0911, subdivision 3a, paragraph (e)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. 48.
Minnesota Statutes 2018, section 256B.093, subdivision 4, is amended to read:
Subd. 4.
Definitions.
For purposes of this section, the following definitions apply:
(a) "Traumatic brain injury" means a sudden insult or damage to the brain or its coverings,
not of a degenerative or congenital nature. The insult or damage may produce an altered
state of consciousness and may result in a decrease in cognitive, behavioral, emotional, or
physical functioning resulting in partial or total disability.
(b) "Home care services" means medical assistance home care services defined under
section 256B.0625, subdivisions 6adeleted text begin ,deleted text end new text begin andnew text end 7deleted text begin , and 19adeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 49.
Minnesota Statutes 2018, section 256B.097, subdivision 1, is amended to read:
Subdivision 1.
Scope.
(a) In order to improve the quality of services provided to
Minnesotans with disabilities and to meet the requirements of the federally approved home
and community-based waivers under section 1915c of the Social Security Act, a State
Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving
disability services is enacted. This system is a partnership between the Department of Human
Services and the State Quality Council established under subdivision 3.
(b) This system is a result of the recommendations from the Department of Human
Services' licensing and alternative quality assurance study mandated under Laws 2005, First
Special Session chapter 4, article 7, section 57, and presented to the legislature in February
2007.
(c) The disability services eligible under this section include:
(1) the home and community-based services waiver programs for persons with
developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
including brain injuries and services for those who qualify for nursing facility level of care
or hospital facility level of care and any other services licensed under chapter 245D;
(2) home care services under section 256B.0651;
(3) family support grants under section 252.32;
deleted text begin
(4) consumer support grants under section 256.476;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end semi-independent living services under section 252.275; and
deleted text begin (6)deleted text end new text begin (5)new text end services provided through an intermediate care facility for the developmentally
disabled.
(d) For purposes of this section, the following definitions apply:
(1) "commissioner" means the commissioner of human services;
(2) "council" means the State Quality Council under subdivision 3;
(3) "Quality Assurance Commission" means the commission under section 256B.0951;
and
(4) "system" means the State Quality Assurance, Quality Improvement and Licensing
System under this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 50.
Minnesota Statutes 2018, section 256B.439, subdivision 1, is amended to read:
Subdivision 1.
Development and implementation of quality profiles.
(a) The
commissioner of human services, in cooperation with the commissioner of health, shall
develop and implement quality profiles for nursing facilities and, beginning not later than
July 1, 2014, for home and community-based services providers, except when the quality
profile system would duplicate requirements under section 256B.5011, 256B.5012, or
256B.5013. For purposes of this section, home and community-based services providers
are defined as providers of home and community-based services under sections 256B.0625,
subdivisions 6adeleted text begin ,deleted text end new text begin andnew text end 7deleted text begin , and 19adeleted text end ; 256B.0913; 256B.0915; 256B.092; 256B.49; and 256B.85,
and intermediate care facilities for persons with developmental disabilities providers under
section 256B.5013. To the extent possible, quality profiles must be developed for providers
of services to older adults and people with disabilities, regardless of payor source, for the
purposes of providing information to consumers. The quality profiles must be developed
using existing data sets maintained by the commissioners of health and human services to
the extent possible. The profiles must incorporate or be coordinated with information on
quality maintained by area agencies on aging, long-term care trade associations, the
ombudsman offices, counties, tribes, health plans, and other entities and the long-term care
database maintained under section 256.975, subdivision 7. The profiles must be designed
to provide information on quality to:
(1) consumers and their families to facilitate informed choices of service providers;
(2) providers to enable them to measure the results of their quality improvement efforts
and compare quality achievements with other service providers; and
(3) public and private purchasers of long-term care services to enable them to purchase
high-quality care.
(b) The profiles must be developed in consultation with the long-term care task force,
area agencies on aging, and representatives of consumers, providers, and labor unions.
Within the limits of available appropriations, the commissioners may employ consultants
to assist with this project.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 51.
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 and section 256B.0911, subdivision 3a, paragraph (e)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. 52.
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 clientdeleted text end new text begin who is familiar with the personnew text end . deleted text begin The certified assessor must notify the
provider of the date by which this information is to be submitted.deleted text end 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 reassessment.
(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. 53.
Minnesota Statutes 2018, section 256B.49, subdivision 17, is amended to read:
Subd. 17.
Cost of services and supports.
(a) The commissioner shall ensure that the
average per capita expenditures estimated in any fiscal year for home and community-based
waiver recipients does not exceed the average per capita expenditures that would have been
made to provide institutional services for recipients in the absence of the waiver.
(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
need-based methods for allocating to local agencies the home and community-based waivered
service resources available to support recipients with disabilities in need of the level of care
provided in a nursing facility or a hospital. The commissioner shall allocate resources to
single counties and county partnerships in a manner that reflects consideration of:
(1) an incentive-based payment process for achieving outcomes;
(2) the need for a state-level risk pool;
(3) the need for retention of management responsibility at the state agency level; and
(4) a phase-in strategy as appropriate.
(c) Until the allocation methods described in paragraph (b) are implemented, the annual
allowable reimbursement level of home and community-based waiver services shall be the
greater of:
(1) the statewide average payment amount which the recipient is assigned under the
waiver reimbursement system in place on June 30, 2001, modified by the percentage of any
provider rate increase appropriated for home and community-based services; or
(2) an amount approved by the commissioner based on the recipient's extraordinary
needs that cannot be met within the current allowable reimbursement level. The increased
reimbursement level must be necessary to allow the recipient to be discharged from an
institution or to prevent imminent placement in an institution. The additional reimbursement
may be used to secure environmental modifications; assistive technology and equipment;
and increased costs for supervision, training, and support services necessary to address the
recipient's extraordinary needs. The commissioner may approve an increased reimbursement
level for up to one year of the recipient's relocation from an institution or up to six months
of a determination that a current waiver recipient is at imminent risk of being placed in an
institution.
(d) Beginning July 1, 2001, medically necessary home care nursing services will be
authorized under this section as complex and regular care according to sections 256B.0651
to 256B.0654 deleted text begin and 256B.0659deleted text end . The rate established by the commissioner for registered nurse
or licensed practical nurse services under any home and community-based waiver as of
January 1, 2001, shall not be reduced.
(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009 legislature
adopts a rate reduction that impacts payment to providers of adult foster care services, the
commissioner may issue adult foster care licenses that permit a capacity of five adults. The
application for a five-bed license must meet the requirements of section 245A.11, subdivision
2a. Prior to admission of the fifth recipient of adult foster care services, the county must
negotiate a revised per diem rate for room and board and waiver services that reflects the
legislated rate reduction and results in an overall average per diem reduction for all foster
care recipients in that home. The revised per diem must allow the provider to maintain, as
much as possible, the level of services or enhanced services provided in the residence, while
mitigating the losses of the legislated rate reduction.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 54.
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.
(e) "Disability waiver rates system" means a statewide system that establishes rates that
are based on uniform processes and captures the individualized nature of waiver services
and recipient needs.
(f) "Individual staffing" means the time spent as a one-to-one interaction specific to an
individual recipient by staff to provide direct support and assistance with activities of daily
living, instrumental activities of daily living, and training to participants, and is based on
the requirements in each individual's coordinated service and support plan under section
245D.02, subdivision 4b; any coordinated service and support plan addendum under section
245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's
needs must also be considered.
(g) "Lead agency" means a county, partnership of counties, or tribal agency charged
with administering waivered services under sections 256B.092 and 256B.49.
(h) "Median" means the amount that divides distribution into two equal groups, one-half
above the median and one-half below the median.
(i) "Payment or rate" means reimbursement to an eligible provider for services provided
to a qualified individual based on an approved service authorization.
(j) "Rates management system" means a web-based software application that uses a
framework and component values, as determined by the commissioner, to establish service
rates.
(k) "Recipient" means a person receiving home and community-based services funded
under any of the disability waivers.
(l) "Shared staffing" means time spent by employees, not defined under paragraph (f),
providing or available to provide more than one individual with direct support and assistance
with activities of daily living deleted text begin as defined under section 256B.0659, subdivision 1, paragraph
(b)deleted text end ; instrumental activities of daily living deleted text begin as defined under section 256B.0659, subdivision
1, paragraph (i)deleted text end ; ancillary activities needed to support individual services; and training to
participants, and is based on the requirements in each individual's coordinated service and
support plan under section 245D.02, subdivision 4b; any coordinated service and support
plan addendum under section 245D.02, subdivision 4c; an assessment tool; and provider
observation of an individual's service need. Total shared staffing hours are divided
proportionally by the number of individuals who receive the shared service provisions.
(m) "Staffing ratio" means the number of recipients a service provider employee supports
during a unit of service based on a uniform assessment tool, provider observation, case
history, and the recipient's services of choice, and not based on the staffing ratios under
section 245D.31.
(n) "Unit of service" means the following:
(1) for residential support services under subdivision 6, a unit of service is a day. Any
portion of any calendar day, within allowable Medicaid rules, where an individual spends
time in a residential setting is billable as a day;
(2) for day services under subdivision 7:
(i) for day training and habilitation services, a unit of service is either:
(A) a day unit of service is defined as six or more hours of time spent providing direct
services and transportation; or
(B) a partial day unit of service is defined as fewer than six hours of time spent providing
direct services and transportation; and
(C) for new day service recipients after January 1, 2014, 15 minute units of service must
be used for fewer than six hours of time spent providing direct services and transportation;
(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A
day unit of service is six or more hours of time spent providing direct services;
(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service
is six or more hours of time spent providing direct service;
(3) for unit-based services with programming under subdivision 8:
(i) for supported living services, a unit of service is a day or 15 minutes. When a day
rate is authorized, any portion of a calendar day where an individual receives services is
billable as a day; and
(ii) for all other services, a unit of service is 15 minutes; and
(4) for unit-based services without programming under subdivision 9, a unit of service
is 15 minutes.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 55.
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;
(4) deleted text begin behavioral programmingdeleted text end new text begin positive support servicesnew text end ;
(5) companion services;
(6) customized living;
(7) day training and habilitation;
(8) housing access coordination;
(9) independent living skills;
(10) in-home family support;
(11) night supervision;
(12) personal support;
(13) prevocational services;
(14) residential care services;
(15) residential support services;
(16) respite services;
(17) structured day services;
(18) supported employment services;
(19) supported living services;
(20) transportation services;
(21) individualized home supports;
(22) independent living skills specialist services;
(23) employment exploration services;
(24) employment development services;
(25) employment support services; and
(26) other services as approved by the federal government in the state home and
community-based services plan.
Sec. 56.
Minnesota Statutes 2018, section 256B.4914, subdivision 14, is amended to read:
Subd. 14.
Exceptions.
(a) In a format prescribed by the commissioner, lead agencies
must identify individuals with exceptional needs that cannot be met under the disability
waiver rate system. The commissioner shall use that information to evaluate and, if necessary,
approve an alternative payment rate for those individuals. Whether granted, denied, or
modified, the commissioner shall respond to all exception requests in writing. The
commissioner shall include in the written response the basis for the action and provide
notification of the right to appeal under paragraph (h).
(b) Lead agencies must act on an exception request within 30 days deleted text begin anddeleted text end new text begin from the date
that the lead agency receives all application materials described in paragraph (d). Lead
agencies mustnew text end notify the initiator of the request of their recommendation in writing. A lead
agency shall submit all exception requests along with its recommendation to the
commissioner.
(c) An application for a rate exception may be submitted for the following criteria:
(1) an individual has service needs that cannot be met through additional units of service;
(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 is so insufficient
that it has resulted in an individual receiving a notice of discharge from the individual's
provider; or
(3) an individual's service needs, including behavioral changes, require a level of service
which necessitates a change in provider or which requires the current provider to propose
service changes beyond those currently authorized.
(d) Exception requests must include the following information:
(1) the service needs required by each individual that are not accounted for in subdivisions
6, 7, 8, and 9;
(2) the service rate requested and the difference from the rate determined in subdivisions
6, 7, 8, and 9;
(3) a basis for the underlying costs used for the rate exception deleted text begin and any accompanyingdeleted text end new text begin
based on real costs related to the individual's extraordinary needs borne by the provider,
includingnew text end documentationnew text begin of these costsnew text end ; and
(4) any contingencies for approval.
(e) Approved rate exceptions shall be managed within lead agency allocations under
sections 256B.092 and 256B.49.
(f) Individual disability waiver recipients, an interested party, or the license holder that
would receive the rate exception increase may request that a lead agency submit an exception
request. A lead agency that denies such a request shall notify the individual waiver recipient,
interested party, or license holder of its decision and the reasons for denying the request in
writing no later than 30 days after the request has been made and shall submit its denial to
the commissioner in accordance with paragraph (b). The reasons for the denial must be
based on the failure to meet the criteria in paragraph (c).
(g) The commissioner shall determine whether to approve or deny an exception request
no more than 30 days after receiving the request. If the commissioner denies the request,
the commissioner shall notify the lead agency and the individual disability waiver recipient,
the interested party, and the license holder in writing of the reasons for the denial.
(h) The individual disability waiver recipient may appeal any denial of an exception
request by either the lead agency or the commissioner, pursuant to sections 256.045 and
256.0451. When the denial of an exception request results in the proposed demission of a
waiver recipient from a residential or day habilitation program, the commissioner shall issue
a temporary stay of demission, when requested by the disability waiver recipient, consistent
with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary
stay shall remain in effect until the lead agency can provide an informed choice of
appropriate, alternative services to the disability waiver.
(i) Providers may petition lead agencies to update values that were entered incorrectly
or erroneously into the rate management system, based on past service level discussions
and determination in subdivision 4, without applying for a rate exception.
(j) The starting date for the rate exception will be the later of the date of the recipient's
change in support or the date of the request to the lead agency for an exception.
(k) The commissioner shall track all exception requests received and their dispositions.
The commissioner shall issue quarterly public exceptions statistical reports, including the
number of exception requests received and the numbers granted, denied, withdrawn, and
pending. The report shall include the average amount of time required to process exceptions.
(l) No later than January 15, 2016, the commissioner shall provide research findings on
the estimated fiscal impact, the primary cost drivers, and common population characteristics
of recipients with needs that cannot be met by the framework rates.
(m) No later than July 1, 2016, the commissioner shall develop and implement, in
consultation with stakeholders, a process to determine eligibility for rate exceptions for
individuals with rates determined under the methodology in section 256B.4913, subdivision
4a. Determination of eligibility for an exception will occur as annual service renewals are
completed.
(n) Approved rate exceptions will be implemented at such time that the individual's rate
is no longer banded and remain in effect in all cases until an individual's needs change as
defined in paragraph (c).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 57.
Minnesota Statutes 2018, section 256B.501, subdivision 4a, is amended to read:
Subd. 4a.
Inclusion of home care costs in waiver rates.
The commissioner shall adjust
the limits of the established average daily reimbursement rates for waivered services to
include the cost of home care services that may be provided to waivered services recipients.
This adjustment must be used to maintain or increase services and shall not be used by
county agencies for inflation increases for waivered services vendors. Home care services
referenced in this section are those listed in section 256B.0651, subdivision 2. The average
daily reimbursement rates established in accordance with the provisions of this subdivision
apply only to the combined average, daily costs of waivered and home care services and
do not change home care limitations under sections 256B.0651 to 256B.0654 deleted text begin and 256B.0659deleted text end .
Waivered services recipients receiving home care as of June 30, 1992, shall not have the
amount of their services reduced as a result of this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 58.
Minnesota Statutes 2018, section 256B.69, subdivision 5a, is amended to read:
Subd. 5a.
Managed care contracts.
(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.
(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.
(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.
(d) The commissioner shall require that managed care plans use the assessment and
authorization processes, forms, timelines, standards, documentation, and data reporting
requirements, protocols, billing processes, and policies consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all personal
care assistance services deleted text begin under section 256B.0659deleted text end new text begin and community first services and supports
under section 256B.85new text end .
(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
the health plan's utilization in 2009. To earn the return of the withhold each subsequent
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
in subdivisions 23 and 28, compared to the previous measurement year until the final
performance target is reached. When measuring performance, the commissioner must
consider the difference in health risk in a managed care or county-based purchasing plan's
membership in the baseline year compared to the measurement year, and work with the
managed care or county-based purchasing plan to account for differences that they agree
are significant.
The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program enrollees
is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
health plans in meeting this performance target and shall accept payment withholds that
may be returned to the hospitals if the performance target is achieved.
(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. To earn the return of the withhold each year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than five percent of the plan's hospital admission rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, compared to the previous calendar year until the final performance target is reached.
When measuring performance, the commissioner must consider the difference in health risk
in a managed care or county-based purchasing plan's membership in the baseline year
compared to the measurement year, and work with the managed care or county-based
purchasing plan to account for differences that they agree are significant.
The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
rate was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in calendar
year 2011, as determined by the commissioner. The hospital admissions in this performance
target do not include the admissions applicable to the subsequent hospital admission
performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
this performance target and shall accept payment withholds that may be returned to the
hospitals if the performance target is achieved.
(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each year,
the managed care plan or county-based purchasing plan must achieve a qualifying reduction
of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
percent compared to the previous calendar year until the final performance target is reached.
The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts commensurate
with achieved reductions in utilization less than the targeted amount.
The withhold described in this paragraph must continue for each consecutive contract
period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
2011. Hospitals shall cooperate with the plans in meeting this performance target and shall
accept payment withholds that must be returned to the hospitals if the performance target
is achieved.
(h) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.
(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.
(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
include as admitted assets under section 62D.044 any amount withheld under this section
that is reasonably expected to be returned.
(k) Contracts between the commissioner and a prepaid health plan are exempt from the
set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
7.
(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).
(m) Managed care plans and county-based purchasing plans shall maintain current and
fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 59.
Minnesota Statutes 2018, section 256B.765, is amended to read:
256B.765 PROVIDER RATE INCREASES.
(a) Effective July 1, 2001, within the limits of appropriations specifically for this purpose,
the commissioner shall provide an annual inflation adjustment for the providers listed in
paragraph (c). The index for the inflation adjustment must be based on the change in the
Employment Cost Index for Private Industry Workers - Total Compensation forecasted by
Data Resources, Inc., as forecasted in the fourth quarter of the calendar year preceding the
fiscal year. The commissioner shall increase reimbursement or allocation rates by the
percentage of this adjustment, and county boards shall adjust provider contracts as needed.
(b) The commissioner of management and budget shall include an annual inflationary
adjustment in reimbursement rates for the providers listed in paragraph (c) using the inflation
factor specified in paragraph (a) as a budget change request in each biennial detailed
expenditure budget submitted to the legislature under section 16A.11.
(c) The annual adjustment under paragraph (a) shall be provided for home and
community-based waiver services for persons with developmental disabilities under section
256B.501; home and community-based waiver services for the elderly under section
256B.0915; waivered services under community access for disability inclusion under section
256B.49; community alternative care waivered services under section 256B.49; brain injury
waivered services under section 256B.49; nursing services and home health services under
section 256B.0625, subdivision 6a; personal care services and nursing supervision of personal
care services deleted text begin under section 256B.0625, subdivision 19adeleted text end ; home care nursing services under
section 256B.0625, subdivision 7; day training and habilitation services for adults with
developmental disabilities under sections 252.41 to 252.46; physical therapy services under
section 256B.0625, subdivision 8; occupational therapy services under section 256B.0625,
subdivision 8a; speech-language therapy services under Minnesota Rules, part 9505.0390;
respiratory therapy services under Minnesota Rules, part 9505.0295; alternative care services
under section 256B.0913; adult residential program grants under section 245.73; adult and
family community support grants under Minnesota Rules, parts 9535.1700 to 9535.1760;
semi-independent living services under section 252.275 including SILS funding under
county social services grants formerly funded under chapter 256I; and community support
services for deaf and hard-of-hearing adults with mental illness who use or wish to use sign
language as their primary means of communication.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 60.
Minnesota Statutes 2018, section 256B.85, subdivision 1, is amended to read:
Subdivision 1.
Basis and scope.
(a) Upon federal approval, the commissioner shall
establish a state plan option for the provision of home and community-based personal
assistance service and supports called "community first services and supports (CFSS)."
(b) CFSS is a participant-controlled method of selecting and providing services and
supports that allows the participant maximum control of the services and supports.
Participants may choose the degree to which they direct and manage their supports by
choosing to have a significant and meaningful role in the management of services and
supports including by directly employing support workers with the necessary supports to
perform that function.
(c) CFSS is available statewide to eligible people to assist with accomplishing activities
of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related
procedures and tasks through hands-on assistance to accomplish the task or constant
supervision and cueing to accomplish the task; and to assist with acquiring, maintaining,
and enhancing the skills necessary to accomplish ADLs, IADLs, and health-related
procedures and tasks. CFSS allows payment for certain supportsnew text begin for the participantnew text end and
goods such as environmental modifications and technology that are intended to replace or
decrease the need for human assistance.
(d) deleted text begin Upon federal approval,deleted text end CFSS deleted text begin willdeleted text end new text begin shallnew text end replace the personal care assistance program
under sections deleted text begin 256.476, 256B.0625, subdivisions 19a and 19c,deleted text end new text begin 256B.0652, subdivisions 6
and 8, paragraph (b), new text end and 256B.0659.
new text begin
(e) For the purposes of this section, notwithstanding the provisions of section 144A.43,
subdivision 3, supports purchased under CFSS are not home care services.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 61.
Minnesota Statutes 2018, section 256B.85, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
(b) "Activities of daily living" or "ADLs" means deleted text begin eating, toileting, grooming, dressing,
bathing, mobility, positioning, and transferring.deleted text end new text begin :
new text end
new text begin
(1) dressing, including assistance with choosing, application, and changing of clothing
and application of special appliances, wraps, or clothing;
new text end
new text begin
(2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included,
except for recipients who are diabetic or have poor circulation;
new text end
new text begin
(3) bathing, including assistance with basic personal hygiene and skin care;
new text end
new text begin
(4) eating, including assistance with hand washing and application of orthotics required
for eating, transfers, or feeding;
new text end
new text begin
(5) transfers, including assistance with transferring the recipient from one seating or
reclining area to another;
new text end
new text begin
(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a recipient;
new text end
new text begin
(7) positioning, including assistance with positioning or turning a recipient for necessary
care and comfort; and
new text end
new text begin
(8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.
new text end
(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.
(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.
(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.
(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, and is specified in a community services and support plan,
including:
(1) tube feedings requiring:
(i) a gastrojejunostomy tube; or
(ii) continuous tube feeding lasting longer than 12 hours per day;
(2) wounds described as:
(i) stage III or stage IV;
(ii) multiple wounds;
(iii) requiring sterile or clean dressing changes or a wound vac; or
(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;
(3) parenteral therapy described as:
(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or
(ii) total parenteral nutrition (TPN) daily;
(4) respiratory interventions, including:
(i) oxygen required more than eight hours per day;
(ii) respiratory vest more than one time per day;
(iii) bronchial drainage treatments more than two times per day;
(iv) sterile or clean suctioning more than six times per day;
(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and
(vi) ventilator dependence under section 256B.0651;
(5) insertion and maintenance of catheter, including:
(i) sterile catheter changes more than one time per month;
(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or
(iii) bladder irrigations;
(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;
(7) neurological intervention, including:
(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or
(ii) swallowing disorders diagnosed by a physician and requiring specialized assistance
from another on a daily basis; and
(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.
(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.
(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the coordinated service
and support plan identified in deleted text begin sectiondeleted text end new text begin sectionsnew text end 256B.0915, subdivision 6new text begin , and 256B.092,
subdivision 1bnew text end .
(i) "Consultation services" means a Minnesota health care program enrolled provider
organization that provides assistance to the participant in making informed choices about
CFSS services in general and self-directed tasks in particular, and in developing a
person-centered CFSS service delivery plan to achieve quality service outcomes.
(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
may not be found to be dependent in an activity of daily living if, because of the child's age,
an adult would either perform the activity for the child or assist the child with the activity
and the assistance needed is the assistance appropriate for a typical child of the same age.
(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under sections 256B.0915; 256B.092,
subdivision 5; and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants.new text begin Extended CFSS excludes the purchase of goods.
new text end
(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).
(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.
(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community.
(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(e).
(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.
(r) "Level I behavior" means physical aggression towards self or others or destruction
of property that requires the immediate response of another person.
(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker may not determine medication
dose or time for medication or inject medications into veins, muscles, or skin:
(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;
(2) organizing medications as directed by the participant or the participant's representative;
and
(3) providing verbal or visual reminders to perform regularly scheduled medications.
(t) "Participant" means a person who is eligible for CFSS.
(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. deleted text begin This authorization must be in
writing or by another method that clearly indicates the participant's free choice and may be
withdrawn at any time. The participant's representative must have no financial interest in
the provision of any services included in the participant's CFSS service delivery plan and
must be capable of providing the support necessary to assist the participant in the use of
CFSS. If through the assessment process described in subdivision 5 a participant is
determined to be in need of a participant's representative, one must be selected.deleted text end If the
participant is unable to assist in the selection of a participant's representative, the legal
representative shall appoint one. deleted text begin Two persons may be designated as a participant's
representative for reasons such as divided households and court-ordered custodies. Duties
of a participant's representatives may include:
deleted text end
deleted text begin
(1) being available while services are provided in a method agreed upon by the participant
or the participant's legal representative and documented in the participant's CFSS service
delivery plan;
deleted text end
deleted text begin
(2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is
being followed; and
deleted text end
deleted text begin
(3) reviewing and signing CFSS time sheets after services are provided to provide
verification of the CFSS services.
deleted text end
(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.
(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.
(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into an agreement to receive
services at the same time and in the same setting by the same employer.
(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.
(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.
(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.
(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
mileage reimbursement, health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.
(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.
Sec. 62.
Minnesota Statutes 2018, section 256B.85, subdivision 4, is amended to read:
Subd. 4.
Eligibility for other services.
Selection of CFSS by a participant must not
restrict access to other medically necessary care and services furnished under the state plan
benefit or other services available throughnew text begin thenew text end alternative carenew text begin programnew text end .
Sec. 63.
Minnesota Statutes 2018, section 256B.85, subdivision 5, is amended to read:
Subd. 5.
Assessment requirements.
(a) The assessment of functional need must:
(1) be conducted by a certified assessor according to the criteria established in section
256B.0911, subdivision 3a;
(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
a significant change in the participant's condition or a change in the need for services and
supports, or at the request of the participant when the participant experiences a change in
condition or needs a change in the services or supports; and
(3) be completed using the format established by the commissioner.
(b) The results of the assessment and any recommendations and authorizations for CFSS
must be determined and communicated in writing by the lead agency's deleted text begin certifieddeleted text end assessor as
defined in section 256B.0911 to the participant deleted text begin and the agency-provider or FMS provider
chosen by the participantdeleted text end new text begin or participant's representative and chosen CFSS providersnew text end within
deleted text begin 40 calendardeleted text end new text begin ten businessnew text end days deleted text begin and must include the participant's right to appeal under section
256.045, subdivision 3deleted text end new text begin of the assessmentnew text end .
(c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. Authorization for a temporary level of
CFSS services under the agency-provider model is limited to the time specified by the
commissioner, but shall not exceed 45 days. The level of services authorized under this
paragraph shall have no bearing on a future authorization.
new text begin For CFSS services beyond the temporary authorization,new text end participants deleted text begin approved for a temporary
authorizationdeleted text end shall access the consultation service to complete their orientation and selection
of a service model.
Sec. 64.
Minnesota Statutes 2018, section 256B.85, subdivision 6, is amended to read:
Subd. 6.
Community first services and supports service delivery plan.
(a) The CFSS
service delivery plan must be developed and evaluated through a person-centered planning
process by the participant, or the participant's representative or legal representative who
may be assisted by a consultation services provider. The CFSS service delivery plan must
reflect the services and supports that are important to the participant and for the participant
to meet the needs assessed by the certified assessor and identified in the coordinated service
and support plan identified in deleted text begin sectiondeleted text end new text begin sectionsnew text end 256B.0915, subdivision 6new text begin , and 256B.092,
subdivision 1bnew text end . The CFSS service delivery plan must be reviewed by the participant, the
consultation services provider, and the agency-provider or FMS provider prior to starting
services and at least annually upon reassessment, or when there is a significant change in
the participant's condition, or a change in the need for services and supports.
(b) The commissioner shall establish the format and criteria for the CFSS service delivery
plan.
(c) The CFSS service delivery plan must be person-centered and:
(1) specify the consultation services provider, agency-provider, or FMS provider selected
by the participant;
(2) reflect the setting in which the participant resides that is chosen by the participant;
(3) reflect the participant's strengths and preferences;
(4) include the methods and supports used to address the needs as identified through an
assessment of functional needs;
(5) include the participant's identified goals and desired outcomes;
(6) reflect the services and supports, paid and unpaid, that will assist the participant to
achieve identified goals, including the costs of the services and supports, and the providers
of those services and supports, including natural supports;
(7) identify the amount and frequency of face-to-face supports and amount and frequency
of remote supports and technology that will be used;
(8) identify risk factors and measures in place to minimize them, including individualized
backup plans;
(9) be understandable to the participant and the individuals providing support;
(10) identify the individual or entity responsible for monitoring the plan;
(11) be finalized and agreed to in writing by the participant and signed by deleted text begin alldeleted text end individuals
and providers responsible for its implementation;
(12) be distributed to the participant and other people involved in the plan;
(13) prevent the provision of unnecessary or inappropriate care;
(14) include a detailed budget for expenditures for budget model participants or
participants under the agency-provider model if purchasing goods; and
(15) include a plan for worker training and development provided according to
subdivision 18a detailing what service components will be used, when the service components
will be used, how they will be provided, and how these service components relate to the
participant's individual needs and CFSS support worker services.
(d) new text begin The CFSS service delivery plan must describe the units or dollar amount available
to the participant. new text end The total units of agency-provider services or the service budget amount
for the budget model include both annual totals and a monthly average amount that cover
the number of months of the service agreement. The amount used each month may vary,
but additional funds must not be provided above the annual service authorization amount,
determined according to subdivision 8, unless a change in condition is assessed and
authorized by the certified assessor and documented in the coordinated service and support
plan and CFSS service delivery plan.
(e) In assisting with the development or modification of the CFSS service delivery plan
during the authorization time period, the consultation services provider shall:
(1) consult with the FMS provider on the spending budget when applicable; and
(2) consult with the participant or participant's representative, agency-provider, and case
manager/care coordinator.
(f) The CFSS service delivery plan must be approved by the consultation services provider
for participants without a case manager or care coordinator who is responsible for authorizing
services. A case manager or care coordinator must approve the plan for a waiver or alternative
care program participant.
Sec. 65.
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 P through Z and EN and has the
following base number of service units assigned:
(1) P home care rating requires Level I behavior or one to three dependencies in ADLs
and qualifies the person for five service units;
(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs
and qualifies the person for six service units;
(3) R home care rating requires a complex health-related need and one to three
dependencies in ADLs and qualifies the person for seven service units;
(4) S home care rating requires four to six dependencies in ADLs and qualifies the person
for ten service units;
(5) T home care rating requires four to six dependencies in ADLs and Level I behavior
and qualifies the person for 11 service units;
(6) U home care rating requires four to six dependencies in ADLs and a complex
health-related need and qualifies the person for 14 service units;
(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the
person for 17 service units;
(8) W home care rating requires seven to eight dependencies in ADLs and Level I
behavior and qualifies the person for 20 service units;
(9) 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
(10) 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) deleted text begin 30 additional minutes per day when the behavior requires assistance at least four
times per week for one or more of the following behaviorsdeleted text end new text begin if a behavior in this clause requires
assistance at least four times per week 30 additional minutes per categorynew text end :
(i) level I behaviornew text begin that requires the immediate response of another personnew text end ;
(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. 66.
Minnesota Statutes 2018, section 256B.85, subdivision 9, is amended to read:
Subd. 9.
Noncovered services.
(a) Services or supports that are not eligible for payment
under this section include those that:
(1) are not authorized by the certified assessor or included in the CFSS service delivery
plan;
(2) are provided prior to the authorization of services and the approval of the CFSS
service delivery plan;
(3) are duplicative of other paid services in the CFSS service delivery plan;
(4) supplant natural unpaid supports that appropriately meet a need in the CFSS service
delivery plan, are provided voluntarily to the participant, and are selected by the participant
in lieu of other services and supports;
(5) are not effective means to meet the participant's needs; and
(6) are available through other funding sources, including, but not limited to, funding
through title IV-E of the Social Security Act.
(b) Additional services, goods, or supports that are not covered include:
(1) those that are not for the direct benefit of the participant, except that services for
caregivers such as training to improve the ability to provide CFSS are considered to directly
benefit the participant if chosen by the participant and approved in the support plan;
(2) any fees incurred by the participant, such as Minnesota health care programs fees
and co-pays, legal fees, or costs related to advocate agencies;
(3) insurance, except for insurance costs related to employee coverage;
(4) room and board costs for the participant;
(5) services, supports, or goods that are not related to the assessed needs;
(6) special education and related services provided under the Individuals with Disabilities
Education Act and vocational rehabilitation services provided under the Rehabilitation Act
of 1973;
(7) assistive technology devices and assistive technology services other than those for
back-up systems or mechanisms to ensure continuity of service and supports listed in
subdivision 7;
(8) medical supplies and equipment covered under medical assistance;
(9) environmental modifications, except as specified in subdivision 7;
(10) expenses for travel, lodging, or meals related to training the participant or the
participant's representative or legal representative;
(11) experimental treatments;
(12) any service or good covered by other state plan services, including prescription and
over-the-counter medications, compounds, and solutions and related fees, including premiums
and co-payments;
(13) membership dues or costs, except when the service is necessary and appropriate to
treat a health condition or to improve or maintain thenew text begin adultnew text end participant's health condition.
The condition must be identified in the participant's CFSS service delivery plan and
monitored by a Minnesota health care program enrolled physician;
(14) vacation expenses other than the cost of direct services;
(15) vehicle maintenance or modifications not related to the disability, health condition,
or physical need;
(16) tickets and related costs to attend sporting or other recreational or entertainment
events;
(17) services provided and billed by a provider who is not an enrolled CFSS provider;
(18) CFSS provided by a participant's representative or paid legal guardian;
(19) services that are used solely as a child care or babysitting service;
(20) services that are the responsibility or in the daily rate of a residential or program
license holder under the terms of a service agreement and administrative rules;
(21) sterile procedures;
(22) giving of injections into veins, muscles, or skin;
(23) homemaker services that are not an integral part of the assessed CFSS service;
(24) home maintenance or chore services;
(25) home care services, including hospice services if elected by the participant, covered
by Medicare or any other insurance held by the participant;
(26) services to other members of the participant's household;
(27) services not specified as covered under medical assistance as CFSS;
(28) application of restraints or implementation of deprivation procedures;
(29) assessments by CFSS provider organizations or by independently enrolled registered
nurses;
(30) services provided in lieu of legally required staffing in a residential or child care
setting; deleted text begin and
deleted text end
(31) services provided deleted text begin by the residential or program license holder in a residence for
more than four participants.deleted text end new text begin in licensed foster care, except when:
new text end
new text begin
(i) the foster care home is the foster care license holder's primary residence; or
new text end
new text begin
(ii) the licensed capacity is four or fewer, or all conditions for a variance under Minnesota
Rules, part 2960.3030, subpart 3, are met for a group of siblings, as defined in section
260C.007, subdivision 32;
new text end
new text begin
(32) services from a provider who owns or otherwise controls for the living arrangement,
except when the provider of services is related by blood, marriage, or adoption or when the
provider meets the requirements under clause (31); and
new text end
new text begin
(33) instrumental activities of daily living for children younger than 18 years of age,
except when immediate attention is needed for health or hygiene reasons integral to the
personal care services and the assessor lists the need in the service plan.
new text end
Sec. 67.
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 requirementsnew text begin including completion of required provider
training as determined by the commissionernew text end ;
(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) comply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(8) request reassessments at least 60 days before the end of the current authorization for
CFSS on forms provided by the commissioner.
new text end
Sec. 68.
Minnesota Statutes 2018, section 256B.85, subdivision 11, is amended to read:
Subd. 11.
Agency-provider model.
(a) The agency-provider model includes services
provided by support workers and staff providing worker training and development services
who are employed by an agency-provider that meets the criteria established by the
commissioner, including required training.
(b) The agency-provider shall allow the participant to have a significant role in the
selection and dismissal of the support workers for the delivery of the services and supports
specified in the participant's CFSS service delivery plan.new text begin The agency must make a reasonable
effort to fulfill the participant's request for the participant's preferred worker.
new text end
(c) A participant may use authorized units of CFSS services as needed within a service
agreement that is not greater than 12 months. Using authorized units in a flexible manner
in either the agency-provider model or the budget model does not increase the total amount
of services and supports authorized for a participant or included in the participant's CFSS
service delivery plan.
(d) A participant may share CFSS services. Two or three CFSS participants may share
services at the same time provided by the same support worker.
(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated
by the medical assistance payment for CFSS for support worker wages and benefits. The
agency-provider must document how this requirement is being met. The revenue generated
by the worker training and development services and the reasonable costs associated with
the worker training and development services must not be used in making this calculation.
(f) The agency-provider model must be used by individuals who are restricted by the
Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to
9505.2245.
(g) Participants purchasing goods under this model, along with support worker services,
must:
(1) specify the goods in the CFSS service delivery plan and detailed budget for
expenditures that must be approved by the consultation services provider, case manager, or
care coordinator; and
(2) use the FMS provider for the billing and payment of such goods.
Sec. 69.
Minnesota Statutes 2018, section 256B.85, subdivision 11b, is amended to read:
Subd. 11b.
Agency-provider model; support worker competency.
(a) The
agency-provider must ensure that support workers are competent to meet the participant's
assessed needs, goals, and additional requirements as written in the CFSS service delivery
plan. Within 30 days of any support worker beginning to provide services for a participant,
the agency-provider must evaluate the competency of the worker through direct observation
of the support worker's performance of the job functions in a setting where the participant
is using CFSS.
(b) The agency-provider must verify and maintain evidence of support worker
competency, including documentation of the support worker's:
(1) education and experience relevant to the job responsibilities assigned to the support
worker and the needs of the participant;
(2) relevant training received from sources other than the agency-provider;
(3) orientation and instruction to implement services and supports to participant needs
and preferences as identified in the CFSS service delivery plan; deleted text begin and
deleted text end
(4)new text begin orientation and instruction delivered by an individual competent to perform, teach,
or assign the health-related tasks for tracheostomy suctioning and services to participants
on ventilator support, including equipment operation and maintenance; and
new text end
new text begin (5)new text end periodic performance reviews completed by the agency-provider at least annually,
including any evaluations required under subdivision 11a, paragraph (a).
If a support worker is a minor, all evaluations of worker competency must be completed in
person and in a setting where the participant is using CFSS.
(c) The agency-provider must develop a worker training and development plan with the
participant to ensure support worker competency. The worker training and development
plan must be updated when:
(1) the support worker begins providing services;
(2) there is any change in condition or a modification to the CFSS service delivery plan;
or
(3) a performance review indicates that additional training is needed.
Sec. 70.
Minnesota Statutes 2018, section 256B.85, subdivision 12, is amended to read:
Subd. 12.
Requirements for enrollment of CFSS agency-providers.
(a) All CFSS
agency-providers must provide, at the time of enrollment, reenrollment, and revalidation
as a CFSS agency-provider in a format determined by the commissioner, information and
documentation that includes, but is not limited to, the following:
(1) the CFSS agency-provider's current contact information including address, telephone
number, and e-mail address;
(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's
Medicaid revenue in the previous calendar year is less than or equal to $300,000, the
agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid
revenue in the previous calendar year is greater than $300,000, the agency-provider 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 $20,000new text begin per provider locationnew text end ;
(4) proof of workers' compensation insurance coverage;
(5) proof of liability insurance;
(6) a deleted text begin descriptiondeleted text end new text begin copynew text end of the CFSS agency-provider's deleted text begin organizationdeleted text end new text begin organizational chartnew text end
identifying the namesnew text begin and rolesnew text end of all owners, managing employees, staff, board of directors,
and deleted text begin thedeleted text end new text begin additional documentation reporting anynew text end affiliations of the directors and owners to
other service providers;
(7) deleted text begin a copy ofdeleted text end new text begin proof thatnew text end the CFSS deleted text begin agency-provider'sdeleted text end new text begin agency-provider hasnew text end written policies
and procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety, including the process for notification and resolution of
participant grievances, incident response, identification and prevention of communicable
diseases, and employee misconduct;
(8) deleted text begin copies of all other formsdeleted text end new text begin proof thatnew text end the CFSS agency-provider deleted text begin uses in the course of
daily businessdeleted text end new text begin has all of the following forms and documentsnew text end including, but not limited to:
(i) a copy of the CFSS agency-provider's time sheet; and
(ii) a copy of the participant's individual CFSS service delivery plan;
(9) a list of all training and classes that the CFSS agency-provider requires of its staff
providing CFSS services;
(10) documentation that the CFSS agency-provider and staff have successfully completed
all the training required by this section;
(11) documentation of the agency-provider's marketing practices;
(12) disclosure of ownership, leasing, or management of all residential properties that
are used or could be used for providing home care services;
(13) documentation that the agency-provider will use at least the following percentages
of revenue generated from the medical assistance rate paid for CFSS services for CFSS
support worker wages and benefits: 72.5 percent of revenue from CFSS providers. The
revenue generated by the worker training and development services and the reasonable costs
associated with the worker training and development services shall not be used in making
this calculation; and
(14) documentation that the agency-provider does not burden participants' free exercise
of their right to choose service providers by requiring CFSS support workers to sign an
agreement not to work with any particular CFSS participant or for another CFSS
agency-provider after leaving the agency and that the agency is not taking action on any
such agreements or requirements regardless of the date signed.
(b) CFSS agency-providers shall provide to the commissioner the information specified
in paragraph (a).
(c) All CFSS agency-providers 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. 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 CFSS agency-provider 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. CFSS agency-provider billing staff shall complete training about CFSS program
financial management. 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.
deleted text begin
(d) The commissioner shall send annual review notifications to agency-providers 30
days prior to renewal. The notification must:
deleted text end
deleted text begin
(1) list the materials and information the agency-provider is required to submit;
deleted text end
deleted text begin
(2) provide instructions on submitting information to the commissioner; and
deleted text end
deleted text begin
(3) provide a due date by which the commissioner must receive the requested information.
deleted text end
Agency-providers shall submit all required documentation for annual review within 30 days
of notification from the commissioner. If an agency-provider fails to submit all the required
documentation, the commissioner may take action under subdivision 23a.
Sec. 71.
Minnesota Statutes 2018, section 256B.85, subdivision 12b, is amended to read:
Subd. 12b.
CFSS agency-provider requirements; notice regarding termination of
services.
(a) An agency-provider must provide written notice when it intends to terminate
services with a participant at least deleted text begin tendeleted text end new text begin 30new text end calendar days before the proposed service
termination is to become effective, except in cases where:
(1) the participant engages in conduct that significantly alters the terms of the CFSS
service delivery plan with the agency-provider;
(2) the participant or other persons at the setting where services are being provided
engage in conduct that creates an imminent risk of harm to the support worker or other
agency-provider staff; or
(3) an emergency or a significant change in the participant's condition occurs within a
24-hour period that results in the participant's service needs exceeding the participant's
identified needs in the current CFSS service delivery plan so that the agency-provider cannot
safely meet the participant's needs.
(b) When a participant initiates a request to terminate CFSS services with the
agency-provider, the agency-provider must give the participant a written deleted text begin acknowledgementdeleted text end new text begin
acknowledgmentnew text end of the participant's service termination request that includes the date the
request was received by the agency-provider and the requested date of termination.
(c) The agency-provider must participate in a coordinated transfer of the participant to
a new agency-provider to ensure continuity of care.
Sec. 72.
Minnesota Statutes 2018, section 256B.85, subdivision 13a, is amended to read:
Subd. 13a.
Financial management services.
(a) Services provided by an FMS provider
include but are not limited to: filing and payment of federal and state payroll taxes on behalf
of the participant; initiating and complying with background study requirements under
chapter 245C and maintaining documentation of background study requests and results;
billing for approved CFSS services with authorized funds; monitoring expenditures;
accounting for and disbursing CFSS funds; providing assistance in obtaining and filing for
liability, workers' compensation, and unemployment coverage; and providing participant
instruction and technical assistance to the participant in fulfilling employer-related
requirements in accordance with section 3504 of the Internal Revenue Code and related
regulations and interpretations, including Code of Federal Regulations, title 26, section
31.3504-1.
(b) Agency-provider services shall not be provided by the FMS provider.
(c) The FMS provider shall provide service functions as determined by the commissioner
for budget model participants that include but are not limited to:
(1) assistance with the development of the detailed budget for expenditures portion of
the CFSS service delivery plan as requested by the consultation services provider or
participant;
(2) data recording and reporting of participant spending;
(3) other duties established by the department, including with respect to providing
assistance to the participant, participant's representative, or legal representative in performing
employer responsibilities regarding support workers. The support worker shall not be
considered the employee of the FMS provider; and
(4) billing, payment, and accounting of approved expenditures for goods.
(d) The FMS provider shall obtain an assurance statement from the participant employer
agreeing to follow state and federal regulations and CFSS policies regarding employment
of support workers.
(e) The FMS provider shall:
(1) not limit or restrict the participant's choice of service or support providers or service
delivery models consistent with any applicable state and federal requirements;
(2) provide the participant, consultation services provider, and case manager or care
coordinator, if applicable, with a monthly written summary of the spending for services and
supports that were billed against the spending budget;
(3) be knowledgeable of state and federal employment regulations, including those under
the Fair Labor Standards Act of 1938, and comply with the requirements under section 3504
of the Internal Revenue Code and related regulations and interpretations, including Code
of Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability
for vendor fiscal/employer agent, and any requirements necessary to process employer and
employee deductions, provide appropriate and timely submission of employer tax liabilities,
and maintain documentation to support medical assistance claims;
(4) have current and adequate liability insurance and bonding and sufficient cash flow
as determined by the commissioner and have on staff or under contract a certified public
accountant or an individual with a baccalaureate degree in accounting;
(5) assume fiscal accountability for state funds designated for the program and be held
liable for any overpayments or violations of applicable statutes or rules, including but not
limited to the Minnesota False Claims Act, chapter 15C; deleted text begin and
deleted text end
(6) maintain documentation of receipts, invoices, and bills to track all services and
supports expenditures for any goods purchased and maintain time records of support workers.
The documentation and time records must be maintained for a minimum of five years from
the claim date and be available for audit or review upon request by the commissioner. Claims
submitted by the FMS provider to the commissioner for payment must correspond with
services, amounts, and time periods as authorized in the participant's service budget and
service plan and must contain specific identifying information as determined by the
commissionerdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) provide written notice to the participant or the participant's representative at least 30
calendar days before a proposed service termination becomes effective.
new text end
(f) The commissioner of human services shall:
(1) establish rates and payment methodology for the FMS provider;
(2) identify a process to ensure quality and performance standards for the FMS provider
and ensure statewide access to FMS providers; and
(3) establish a uniform protocol for delivering and administering CFSS services to be
used by eligible FMS providers.
Sec. 73.
Minnesota Statutes 2018, section 256B.85, is amended by adding a subdivision
to read:
new text begin Subd. 14a. new text end
new text begin Participant's representative responsibilities. new text end
new text begin
(a) If a participant is unable
to direct the participant's own care, the participant must use a participant's representative
to receive CFSS services. A participant's representative is required if:
new text end
new text begin
(1) the person is under 18 years of age;
new text end
new text begin
(2) the person has a court-appointed guardian; or
new text end
new text begin
(3) an assessment according to section 256B.0659, subdivision 3a, determines that the
participant is in need of a participant's representative.
new text end
new text begin
(b) A participant's representative must:
new text end
new text begin
(1) be at least 18 years of age and actively participate in planning and directing CFSS
services;
new text end
new text begin
(2) have sufficient knowledge of the participant's circumstances to use CFSS services
consistent with the participant's health and safety needs identified in the participant's care
plan;
new text end
new text begin
(3) not have a financial interest in the provision of any services included in the
participant's CFSS service delivery plan; and
new text end
new text begin
(4) be capable of providing the support necessary to assist the participant in the use of
CFSS services.
new text end
new text begin
(c) A participant's representative must not be the:
new text end
new text begin
(1) support worker;
new text end
new text begin
(2) worker training and development service provider;
new text end
new text begin
(3) agency-provider staff, unless related to the participant by blood, marriage, or adoption;
new text end
new text begin
(4) consultation service provider, unless related to the participant by blood, marriage,
or adoption;
new text end
new text begin
(5) FMS staff, unless related to the participant by blood, marriage, or adoption;
new text end
new text begin
(6) FMS owner or manager; or
new text end
new text begin
(7) lead agency staff acting as part of employment.
new text end
new text begin
(d) A licensed family foster parent who lives with the participant may be the participant's
representative if the family foster parent meets the other participant's representative
requirements.
new text end
new text begin
(e) There may be two persons designated as the participant's representative, including
instances of divided households and court-ordered custodies. Each person named as
participant's representative must meet the program criteria and responsibilities.
new text end
new text begin
(f) The participant or the participant's legal representative shall appoint a participant's
representative. The participant's file must include written documentation that indicates the
participant's free choice. The participant's representative must be identified at the time of
assessment and listed on the participant's service agreement and CFSS service delivery plan.
new text end
new text begin
(g) A participant's representative shall enter into a written agreement with an
agency-provider or FMS, on a form determined by the commissioner, to:
new text end
new text begin
(1) be available while care is provided in a method agreed upon by the participant or
the participant's legal representative and documented in the participant's service delivery
plan;
new text end
new text begin
(2) monitor CFSS services to ensure the participant's service delivery plan is followed;
new text end
new text begin
(3) review and sign support worker time sheets after services are provided to verify the
provision of services;
new text end
new text begin
(4) review and sign vendor paperwork to verify receipt of the good; and
new text end
new text begin
(5) review and sign documentation to verify worker training after receipt of the worker
training.
new text end
new text begin
(h) A participant's representative may delegate the responsibility to another adult who
is not the support worker during a temporary absence of at least 24 hours but not more than
six months. To delegate responsibility the participant's representative must:
new text end
new text begin
(1) ensure that the delegate as the participant's representative satisfies the requirement
of the participant's representative;
new text end
new text begin
(2) ensure that the delegate performs the functions of the participant's representative;
new text end
new text begin
(3) communicate to the CFSS agency-provider or FMS about the need for a delegate by
updating the written agreement to include the name of the delegate and the delegate's contact
information; and
new text end
new text begin
(4) ensure that the delegate protects the participant's privacy according to federal and
state data privacy laws.
new text end
new text begin
(i) The designation of a participant's representative remains in place until:
new text end
new text begin
(1) the participant revokes the designation;
new text end
new text begin
(2) the participant's representative withdraws the designation or becomes unable to fulfill
the duties;
new text end
new text begin
(3) the legal authority to act as a participant's representative changes; or
new text end
new text begin
(4) the participant's representative is disqualified.
new text end
new text begin
(j) A lead agency may disqualify a participant's representative who engages in conduct
that creates an imminent risk of harm to the participant, the support workers, or other staff.
A participant's representative that fails to provide support required by the participant must
be referred to the common entry point.
new text end
Sec. 74.
Minnesota Statutes 2018, section 256B.85, subdivision 18a, is amended to read:
Subd. 18a.
Worker training and development services.
(a) The commissioner shall
develop the scope of tasks and functions, service standards, and service limits for worker
training and development services.
(b) Worker training and development costs are in addition to the participant's assessed
service units or service budget. Services provided according to this subdivision must:
(1) help support workers obtain and expand the skills and knowledge necessary to ensure
competency in providing quality services as needed and defined in the participant's CFSS
service delivery plan and as required under subdivisions 11b and 14;
(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased
by the participant employer under the budget model as identified in subdivision 13; deleted text begin and
deleted text end
(3)new text begin be delivered by an individual competent to perform, teach, or assign the tasks
identified, including health-related tasks, in the plan through education, training, and work
experience relevant to the person's assessed needs; and
new text end
new text begin (4)new text end be described in the participant's CFSS service delivery plan and documented in the
participant's file.
(c) Services covered under worker training and development shall include:
(1) support worker training on the participant's individual assessed needs and condition,
provided individually or in a group setting by a skilled and knowledgeable trainer beyond
any training the participant or participant's representative provides;
(2) tuition for professional classes and workshops for the participant's support workers
that relate to the participant's assessed needs and condition;
(3) direct observation, monitoring, coaching, and documentation of support worker job
skills and tasks, beyond any training the participant or participant's representative provides,
including supervision of health-related tasks or behavioral supports that is conducted by an
appropriate professional based on the participant's assessed needs. These services must be
provided at the start of services or the start of a new support worker except as provided in
paragraph (d) and must be specified in the participant's CFSS service delivery plan; and
(4) the activities to evaluate CFSS services and ensure support worker competency
described in subdivisions 11a and 11b.
(d) The services in paragraph (c), clause (3), are not required to be provided for a new
support worker providing services for a participant due to staffing failures, unless the support
worker is expected to provide ongoing backup staffing coverage.
(e) Worker training and development services shall not include:
(1) general agency training, worker orientation, or training on CFSS self-directed models;
(2) payment for preparation or development time for the trainer or presenter;
(3) payment of the support worker's salary or compensation during the training;
(4) training or supervision provided by the participant, the participant's support worker,
or the participant's informal supports, including the participant's representative; or
(5) services in excess of 96 units per annual service agreement, unless approved by the
department.
Sec. 75.
Minnesota Statutes 2018, section 256D.44, subdivision 5, is amended to read:
Subd. 5.
Special needs.
(a) In addition to the state standards of assistance established
in subdivisions 1 to 4, payments are allowed for the following special needs of recipients
of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a setting authorized to receive housing support payments under chapter 256I.
(b) The county agency shall pay a monthly allowance for medically prescribed diets if
the cost of those additional dietary needs cannot be met through some other maintenance
benefit. The need for special diets or dietary items must be prescribed by a licensed physician,
advanced practice registered nurse, or physician assistant. Costs for special diets shall be
determined as percentages of the allotment for a one-person household under the thrifty
food plan as defined by the United States Department of Agriculture. The types of diets and
the percentages of the thrifty food plan that are covered are as follows:
(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of
thrifty food plan;
(3) controlled protein diet, less than 40 grams and requires special products, 125 percent
of thrifty food plan;
(4) low cholesterol diet, 25 percent of thrifty food plan;
(5) high residue diet, 20 percent of thrifty food plan;
(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
(7) gluten-free diet, 25 percent of thrifty food plan;
(8) lactose-free diet, 25 percent of thrifty food plan;
(9) antidumping diet, 15 percent of thrifty food plan;
(10) hypoglycemic diet, 15 percent of thrifty food plan; or
(11) ketogenic diet, 25 percent of thrifty food plan.
(c) Payment for nonrecurring special needs must be allowed for necessary home repairs
or necessary repairs or replacement of household furniture and appliances using the payment
standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as
other funding sources are not available.
(d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated
by the county or approved by the court. This rate shall not exceed five percent of the
assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian
or conservator is a member of the county agency staff, no fee is allowed.
(e) The county agency shall continue to pay a monthly allowance of $68 for restaurant
meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and
who eats two or more meals in a restaurant daily. The allowance must continue until the
person has not received Minnesota supplemental aid for one full calendar month or until
the person's living arrangement changes and the person no longer meets the criteria for the
restaurant meal allowance, whichever occurs first.
(f) A fee of ten percent of the recipient's gross income or $25, whichever is less, is
allowed for representative payee services provided by an agency that meets the requirements
under SSI regulations to charge a fee for representative payee services. This special need
is available to all recipients of Minnesota supplemental aid regardless of their living
arrangement.
(g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half of
the maximum federal Supplemental Security Income payment amount for a single individual
which is in effect on the first day of July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify as
in need of housing assistance and are:
(i) relocating from an institution, a setting authorized to receive housing support under
chapter 256I, or an adult mental health residential treatment program under section
256B.0622;
(ii) eligible for personal care assistance deleted text begin under section 256B.0659deleted text end ; or
(iii) home and community-based waiver recipients living in their own home or rented
or leased apartment.
(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter
needy benefit under this paragraph is considered a household of one. An eligible individual
who receives this benefit prior to age 65 may continue to receive the benefit after the age
of 65.
(3) "Housing assistance" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this special
needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's
income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision
3, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy,
that limits shelter costs to a percentage of gross income, shall not be considered in need of
housing assistance for purposes of this paragraph.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 76.
Minnesota Statutes 2018, section 256I.05, subdivision 1a, is amended to read:
Subd. 1a.
Supplementary service rates.
(a) Subject to the provisions of section 256I.04,
subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other
services necessary to provide room and board if the residence is licensed by or registered
by the Department of Health, or licensed by the Department of Human Services to provide
services in addition to room and board, and if the provider of services is not also concurrently
receiving funding for services for a recipient under a home and community-based waiver
under title XIX of the Social Security Act; or funding from the medical assistance program
deleted text begin under section 256B.0659deleted text end , for personal care services for residents in the setting; or residing
in a setting which receives funding under section 245.73. If funding is available for other
necessary services through a home and community-based waiver, or personal care services
deleted text begin under section 256B.0659deleted text end , then the housing support rate is limited to the rate set in subdivision
1. Unless otherwise provided in law, in no case may the supplementary service rate exceed
$426.37. The registration and licensure requirement does not apply to establishments which
are exempt from state licensure because they are located on Indian reservations and for
which the tribe has prescribed health and safety requirements. Service payments under this
section may be prohibited under rules to prevent the supplanting of federal funds with state
funds. The commissioner shall pursue the feasibility of obtaining the approval of the Secretary
of Health and Human Services to provide home and community-based waiver services under
title XIX of the Social Security Act for residents who are not eligible for an existing home
and community-based waiver due to a primary diagnosis of mental illness or chemical
dependency and shall apply for a waiver if it is determined to be cost-effective.
(b) The commissioner is authorized to make cost-neutral transfers from the housing
support fund for beds under this section to other funding programs administered by the
department after consultation with the county or counties in which the affected beds are
located. The commissioner may also make cost-neutral transfers from the housing support
fund to county human service agencies for beds permanently removed from the housing
support census under a plan submitted by the county agency and approved by the
commissioner. The commissioner shall report the amount of any transfers under this provision
annually to the legislature.
(c) Counties must not negotiate supplementary service rates with providers of housing
support that are licensed as board and lodging with special services and that do not encourage
a policy of sobriety on their premises and make referrals to available community services
for volunteer and employment opportunities for residents.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 77.
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 documents that the lender expects repayment;
(7)(i) state income tax refunds; and
(ii) federal income tax refunds;
(8)(i) federal earned income credits;
(ii) Minnesota working family credits;
(iii) state homeowners and renters credits under chapter 290A; and
(iv) federal or state tax rebates;
(9) funds received for reimbursement, replacement, or rebate of personal or real property
when these payments are made by public agencies, awarded by a court, solicited through
public appeal, or made as a grant by a federal agency, state or local government, or disaster
assistance organizations, subsequent to a presidential declaration of disaster;
(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial
expenses, or to repair or replace insured property;
(11) reimbursements for medical expenses that cannot be paid by medical assistance;
(12) payments by a vocational rehabilitation program administered by the state under
chapter 268A, except those payments that are for current living expenses;
(13) in-kind income, including any payments directly made by a third party to a provider
of goods and services;
(14) assistance payments to correct underpayments, but only for the month in which the
payment is received;
(15) payments for short-term emergency needs under section 256J.626, subdivision 2;
(16) funeral and cemetery payments as provided by section 256.935;
(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar
month;
(18) any form of energy assistance payment made through Public Law 97-35,
Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
providers by other public and private agencies, and any form of credit or rebate payment
issued by energy providers;
(19) Supplemental Security Income (SSI), including retroactive SSI payments and other
income of an SSI recipient;
(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 disabilitiesdeleted text begin , consumer support grant funds
under section 256.476,deleted text end 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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 78.
Minnesota Statutes 2018, section 256J.45, subdivision 3, is amended to read:
Subd. 3.
Good cause exemptions for not attending orientation.
(a) The county agency
shall not impose the sanction under section 256J.46 if it determines that the participant has
good cause for failing to attend orientation. Good cause exists when:
(1) appropriate child care is not available;
(2) the participant is ill or injured;
(3) a family member is ill and needs care by the participant that prevents the participant
from attending orientation. For a caregiver with a child or adult in the household who meets
the disability or medical criteria for home care services deleted text begin under section 256B.0659deleted text end , or a home
and community-based waiver services program under chapter 256B, or meets the criteria
for severe emotional disturbance under section 245.4871, subdivision 6, or for serious and
persistent mental illness under section 245.462, subdivision 20, paragraph (c), good cause
also exists when an interruption in the provision of those services occurs which prevents
the participant from attending orientation;
(4) the caregiver is unable to secure necessary transportation;
(5) the caregiver is in an emergency situation that prevents orientation attendance;
(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
(7) the caregiver documents other verifiable impediments to orientation attendance
beyond the caregiver's control.
(b) Counties must work with clients to provide child care and transportation necessary
to ensure a caregiver has every opportunity to attend orientation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 79.
Minnesota Statutes 2018, section 394.307, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given.
(b) "Caregiver" means an individual 18 years of age or older who:
(1) provides care for a mentally or physically impaired person; and
(2) is a relative, legal guardian, or health care agent of the mentally or physically impaired
person for whom the individual is caring.
deleted text begin
(c) "Instrumental activities of daily living" has the meaning given in section 256B.0659,
subdivision 1, paragraph (i).
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end "Mentally or physically impaired person" means a person who is a resident of
this state and who requires assistance with two or more instrumental activities of daily living
as certified in writing by a physician, a physician assistant, or an advanced practice registered
nurse licensed to practice in this state.
deleted text begin (e)deleted text end new text begin (d)new text end "Relative" means a spouse, parent, grandparent, child, grandchild, sibling, uncle,
aunt, nephew, or niece of the mentally or physically impaired person. Relative includes
half, step, and in-law relationships.
deleted text begin (f)deleted text end new text begin (e)new text end "Temporary family health care dwelling" means a mobile residential dwelling
providing an environment facilitating a caregiver's provision of care for a mentally or
physically impaired person that meets the requirements of subdivision 2.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 80.
Minnesota Statutes 2018, section 462.3593, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given.
(b) "Caregiver" means an individual 18 years of age or older who:
(1) provides care for a mentally or physically impaired person; and
(2) is a relative, legal guardian, or health care agent of the mentally or physically impaired
person for whom the individual is caring.
deleted text begin
(c) "Instrumental activities of daily living" has the meaning given in section 256B.0659,
subdivision 1, paragraph (i).
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end "Mentally or physically impaired person" means a person who is a resident of
this state and who requires assistance with two or more instrumental activities of daily living
as certified in writing by a physician, a physician assistant, or an advanced practice registered
nurse licensed to practice in this state.
deleted text begin (e)deleted text end new text begin (d)new text end "Relative" means a spouse, parent, grandparent, child, grandchild, sibling, uncle,
aunt, nephew, or niece of the mentally or physically impaired person. Relative includes
half, step, and in-law relationships.
deleted text begin (f)deleted text end new text begin (e)new text end "Temporary family health care dwelling" means a mobile residential dwelling
providing an environment facilitating a caregiver's provision of care for a mentally or
physically impaired person that meets the requirements of subdivision 2.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 81.
Minnesota Statutes 2018, section 604A.33, subdivision 1, is amended to read:
Subdivision 1.
Application.
This section applies to residential treatment programs for
children or group homes for children licensed under chapter 245A, residential services and
programs for juveniles licensed under section 241.021, providers licensed pursuant to
sections 144A.01 to 144A.33 or sections 144A.43 to 144A.47, personal care provider
organizations deleted text begin under section 256B.0659deleted text end , providers of day training and habilitation services
under sections 252.41 to 252.46, board and lodging facilities licensed under chapter 157,
intermediate care facilities for persons with developmental disabilities, and other facilities
licensed to provide residential services to persons with developmental disabilities.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 82.
Minnesota Statutes 2018, section 609.232, subdivision 3, is amended to read:
Subd. 3.
Facility.
(a) "Facility" means a hospital or other entity required to be licensed
under sections 144.50 to 144.58; a nursing home required to be licensed to serve adults
under section 144A.02; a home care provider licensed or required to be licensed under
sections 144A.43 to 144A.482; a residential or nonresidential facility required to be licensed
to serve adults under sections 245A.01 to 245A.16; or a person or organization that
exclusively offers, provides, or arranges for personal care assistance services under the
medical assistance program as authorized under sections deleted text begin 256B.0625, subdivision 19a,deleted text end
256B.0651, 256B.0653, and 256B.0654.
(b) For home care providers and personal care attendants, the term "facility" refers to
the provider or person or organization that exclusively offers, provides, or arranges for
personal care services, and does not refer to the client's home or other location at which
services are rendered.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 83.
Minnesota Statutes 2018, section 609.232, subdivision 11, is amended to read:
Subd. 11.
Vulnerable adult.
"Vulnerable adult" means any person 18 years of age or
older who:
(1) is a resident inpatient of a facility;
(2) receives services at or from a facility required to be licensed to serve adults under
sections 245A.01 to 245A.15, except that a person receiving outpatient services for treatment
of chemical dependency or mental illness, or one who is committed as a sexual psychopathic
personality or as a sexually dangerous person under chapter 253B, is not considered a
vulnerable adult unless the person meets the requirements of clause (4);
(3) receives services from a home care provider required to be licensed under sections
144A.43 to 144A.482; or from a person or organization that exclusively offers, provides,
or arranges for personal care assistance services under the medical assistance program as
authorized under sections deleted text begin 256B.0625, subdivision 19a,deleted text end 256B.0651 to 256B.0654deleted text begin , and
256B.0659deleted text end ; or
(4) regardless of residence or whether any type of service is received, possesses a physical
or mental infirmity or other physical, mental, or emotional dysfunction:
(i) that impairs the individual's ability to provide adequately for the individual's own
care without assistance, including the provision of food, shelter, clothing, health care, or
supervision; and
(ii) because of the dysfunction or infirmity and the need for assistance, the individual
has an impaired ability to protect the individual from maltreatment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 84.
Minnesota Statutes 2018, section 626.556, subdivision 2, is amended to read:
Subd. 2.
Definitions.
As used in this section, the following terms have the meanings
given them unless the specific content indicates otherwise:
(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence
or event which:
(1) is not likely to occur and could not have been prevented by exercise of due care; and
(2) if occurring while a child is receiving services from a facility, happens when the
facility and the employee or person providing services in the facility are in compliance with
the laws and rules relevant to the occurrence or event.
(b) "Commissioner" means the commissioner of human services.
(c) "Facility" means:
(1) a licensed or unlicensed day care facility, certified license-exempt child care center,
residential facility, agency, hospital, sanitarium, or other facility or institution required to
be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or chapter
144H, 245D, or 245H;
(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E;
or
(3) a nonlicensed personal care provider organization deleted text begin as defined in section 256B.0625,
subdivision 19adeleted text end .
(d) "Family assessment" means a comprehensive assessment of child safety, risk of
subsequent child maltreatment, and family strengths and needs that is applied to a child
maltreatment report that does not allege sexual abuse or substantial child endangerment.
Family assessment does not include a determination as to whether child maltreatment
occurred but does determine the need for services to address the safety of family members
and the risk of subsequent maltreatment.
(e) "Investigation" means fact gathering related to the current safety of a child and the
risk of subsequent maltreatment that determines whether child maltreatment occurred and
whether child protective services are needed. An investigation must be used when reports
involve sexual abuse or substantial child endangerment, and for reports of maltreatment in
facilities required to be licensed or certified under chapter 245A, 245D, or 245H; under
sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05,
subdivisions 9, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider
association deleted text begin as defined in section 256B.0625, subdivision 19adeleted text end .
(f) "Mental injury" means an injury to the psychological capacity or emotional stability
of a child as evidenced by an observable or substantial impairment in the child's ability to
function within a normal range of performance and behavior with due regard to the child's
culture.
(g) "Neglect" means the commission or omission of any of the acts specified under
clauses (1) to (9), other than by accidental means:
(1) failure by a person responsible for a child's care to supply a child with necessary
food, clothing, shelter, health, medical, or other care required for the child's physical or
mental health when reasonably able to do so;
(2) failure to protect a child from conditions or actions that seriously endanger the child's
physical or mental health when reasonably able to do so, including a growth delay, which
may be referred to as a failure to thrive, that has been diagnosed by a physician and is due
to parental neglect;
(3) failure to provide for necessary supervision or child care arrangements appropriate
for a child after considering factors as the child's age, mental ability, physical condition,
length of absence, or environment, when the child is unable to care for the child's own basic
needs or safety, or the basic needs or safety of another child in their care;
(4) failure to ensure that the child is educated as defined in sections 120A.22 and
260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
child with sympathomimetic medications, consistent with section 125A.091, subdivision
5;
(5) nothing in this section shall be construed to mean that a child is neglected solely
because the child's parent, guardian, or other person responsible for the child's care in good
faith selects and depends upon spiritual means or prayer for treatment or care of disease or
remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker,
or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of
medical care may cause serious danger to the child's health. This section does not impose
upon persons, not otherwise legally responsible for providing a child with necessary food,
clothing, shelter, education, or medical care, a duty to provide that care;
(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision
2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in
the child at birth, results of a toxicology test performed on the mother at delivery or the
child at birth, medical effects or developmental delays during the child's first year of life
that medically indicate prenatal exposure to a controlled substance, or the presence of a
fetal alcohol spectrum disorder;
(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
(8) chronic and severe use of alcohol or a controlled substance by a parent or person
responsible for the care of the child that adversely affects the child's basic needs and safety;
or
(9) emotional harm from a pattern of behavior which contributes to impaired emotional
functioning of the child which may be demonstrated by a substantial and observable effect
in the child's behavior, emotional response, or cognition that is not within the normal range
for the child's age and stage of development, with due regard to the child's culture.
(h) "Nonmaltreatment mistake" means:
(1) at the time of the incident, the individual was performing duties identified in the
center's child care program plan required under Minnesota Rules, part 9503.0045;
(2) the individual has not been determined responsible for a similar incident that resulted
in a finding of maltreatment for at least seven years;
(3) the individual has not been determined to have committed a similar nonmaltreatment
mistake under this paragraph for at least four years;
(4) any injury to a child resulting from the incident, if treated, is treated only with
remedies that are available over the counter, whether ordered by a medical professional or
not; and
(5) except for the period when the incident occurred, the facility and the individual
providing services were both in compliance with all licensing requirements relevant to the
incident.
This definition only applies to child care centers licensed under Minnesota Rules, chapter
9503. If clauses (1) to (5) apply, rather than making a determination of substantiated
maltreatment by the individual, the commissioner of human services shall determine that a
nonmaltreatment mistake was made by the individual.
(i) "Operator" means an operator or agency as defined in section 245A.02.
(j) "Person responsible for the child's care" means (1) an individual functioning within
the family unit and having responsibilities for the care of the child such as a parent, guardian,
or other person having similar care responsibilities, or (2) an individual functioning outside
the family unit and having responsibilities for the care of the child such as a teacher, school
administrator, other school employees or agents, or other lawful custodian of a child having
either full-time or short-term care responsibilities including, but not limited to, day care,
babysitting whether paid or unpaid, counseling, teaching, and coaching.
(k) "Physical abuse" means any physical injury, mental injury, or threatened injury,
inflicted by a person responsible for the child's care on a child other than by accidental
means, or any physical or mental injury that cannot reasonably be explained by the child's
history of injuries, or any aversive or deprivation procedures, or regulated interventions,
that have not been authorized under section 125A.0942 or 245.825.
Abuse does not include reasonable and moderate physical discipline of a child
administered by a parent or legal guardian which does not result in an injury. Abuse does
not include the use of reasonable force by a teacher, principal, or school employee as allowed
by section 121A.582. Actions which are not reasonable and moderate include, but are not
limited to, any of the following:
(1) throwing, kicking, burning, biting, or cutting a child;
(2) striking a child with a closed fist;
(3) shaking a child under age three;
(4) striking or other actions which result in any nonaccidental injury to a child under 18
months of age;
(5) unreasonable interference with a child's breathing;
(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
(7) striking a child under age one on the face or head;
(8) striking a child who is at least age one but under age four on the face or head, which
results in an injury;
(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
substances which were not prescribed for the child by a practitioner, in order to control or
punish the child; or other substances that substantially affect the child's behavior, motor
coordination, or judgment or that results in sickness or internal injury, or subjects the child
to medical procedures that would be unnecessary if the child were not exposed to the
substances;
(10) unreasonable physical confinement or restraint not permitted under section 609.379,
including but not limited to tying, caging, or chaining; or
(11) in a school facility or school zone, an act by a person responsible for the child's
care that is a violation under section 121A.58.
(l) "Practice of social services," for the purposes of subdivision 3, includes but is not
limited to employee assistance counseling and the provision of guardian ad litem and
parenting time expeditor services.
(m) "Report" means any communication received by the local welfare agency, police
department, county sheriff, or agency responsible for child protection pursuant to this section
that describes neglect or physical or sexual abuse of a child and contains sufficient content
to identify the child and any person believed to be responsible for the neglect or abuse, if
known.
(n) "Sexual abuse" means the subjection of a child by a person responsible for the child's
care, by a person who has a significant relationship to the child, as defined in section 609.341,
or by a person in a position of authority, as defined in section 609.341, subdivision 10, to
any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first
degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual
conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or
609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act
which involves a minor which constitutes a violation of prostitution offenses under sections
609.321 to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports
of known or suspected child sex trafficking involving a child who is identified as a victim
of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321,
subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the
status of a parent or household member who has committed a violation which requires
registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or
required registration under section 243.166, subdivision 1b, paragraph (a) or (b).
(o) "Substantial child endangerment" means a person responsible for a child's care, by
act or omission, commits or attempts to commit an act against a child under their care that
constitutes any of the following:
(1) egregious harm as defined in section 260C.007, subdivision 14;
(2) abandonment under section 260C.301, subdivision 2;
(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's
physical or mental health, including a growth delay, which may be referred to as failure to
thrive, that has been diagnosed by a physician and is due to parental neglect;
(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
(5) manslaughter in the first or second degree under section 609.20 or 609.205;
(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
(7) solicitation, inducement, and promotion of prostitution under section 609.322;
(8) criminal sexual conduct under sections 609.342 to 609.3451;
(9) solicitation of children to engage in sexual conduct under section 609.352;
(10) malicious punishment or neglect or endangerment of a child under section 609.377
or 609.378;
(11) use of a minor in sexual performance under section 617.246; or
(12) parental behavior, status, or condition which mandates that the county attorney file
a termination of parental rights petition under section 260C.503, subdivision 2.
(p) "Threatened injury" means a statement, overt act, condition, or status that represents
a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes,
but is not limited to, exposing a child to a person responsible for the child's care, as defined
in paragraph (j), clause (1), who has:
(1) subjected a child to, or failed to protect a child from, an overt act or condition that
constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law
of another jurisdiction;
(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph
(b), clause (4), or a similar law of another jurisdiction;
(3) committed an act that has resulted in an involuntary termination of parental rights
under section 260C.301, or a similar law of another jurisdiction; or
(4) committed an act that has resulted in the involuntary transfer of permanent legal and
physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201,
subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law
of another jurisdiction.
A child is the subject of a report of threatened injury when the responsible social services
agency receives birth match data under paragraph (q) from the Department of Human
Services.
(q) Upon receiving data under section 144.225, subdivision 2b, contained in a birth
record or recognition of parentage identifying a child who is subject to threatened injury
under paragraph (p), the Department of Human Services shall send the data to the responsible
social services agency. The data is known as "birth match" data. Unless the responsible
social services agency has already begun an investigation or assessment of the report due
to the birth of the child or execution of the recognition of parentage and the parent's previous
history with child protection, the agency shall accept the birth match data as a report under
this section. The agency may use either a family assessment or investigation to determine
whether the child is safe. All of the provisions of this section apply. If the child is determined
to be safe, the agency shall consult with the county attorney to determine the appropriateness
of filing a petition alleging the child is in need of protection or services under section
260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is
determined not to be safe, the agency and the county attorney shall take appropriate action
as required under section 260C.503, subdivision 2.
(r) Persons who conduct assessments or investigations under this section shall take into
account accepted child-rearing practices of the culture in which a child participates and
accepted teacher discipline practices, which are not injurious to the child's health, welfare,
and safety.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 85.
Minnesota Statutes 2018, section 626.556, subdivision 3, is amended to read:
Subd. 3.
Persons mandated to report; persons voluntarily reporting.
(a) A person
who knows or has reason to believe a child is being neglected or physically or sexually
abused, as defined in subdivision 2, or has been neglected or physically or sexually abused
within the preceding three years, shall immediately report the information to the local welfare
agency, agency responsible for assessing or investigating the report, police department,
county sheriff, tribal social services agency, or tribal police department if the person is:
(1) a professional or professional's delegate who is engaged in the practice of the healing
arts, social services, hospital administration, psychological or psychiatric treatment, child
care, education, correctional supervision, probation and correctional services, or law
enforcement; or
(2) employed as a member of the clergy and received the information while engaged in
ministerial duties, provided that a member of the clergy is not required by this subdivision
to report information that is otherwise privileged under section 595.02, subdivision 1,
paragraph (c).
(b) Any person may voluntarily report to the local welfare agency, agency responsible
for assessing or investigating the report, police department, county sheriff, tribal social
services agency, or tribal police department if the person knows, has reason to believe, or
suspects a child is being or has been neglected or subjected to physical or sexual abuse.
(c) A person mandated to report physical or sexual child abuse or neglect occurring
within a licensed facility shall report the information to the agency responsible for licensing
or certifying the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16;
or chapter 144H, 245D, or 245H; or a nonlicensed personal care provider organization deleted text begin as
defined in section 256B.0625, subdivision 19adeleted text end . A health or corrections agency receiving a
report may request the local welfare agency to provide assistance pursuant to subdivisions
10, 10a, and 10b. A board or other entity whose licensees perform work within a school
facility, upon receiving a complaint of alleged maltreatment, shall provide information about
the circumstances of the alleged maltreatment to the commissioner of education. Section
13.03, subdivision 4, applies to data received by the commissioner of education from a
licensing entity.
(d) Notification requirements under subdivision 10 apply to all reports received under
this section.
(e) For purposes of this section, "immediately" means as soon as possible but in no event
longer than 24 hours.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 86.
Minnesota Statutes 2018, section 626.556, subdivision 3c, is amended to read:
Subd. 3c.
Local welfare agency, Department of Human Services or Department of
Health responsible for assessing or investigating reports of maltreatment.
(a) The local
welfare agency is the agency responsible for assessing or investigating allegations of
maltreatment in child foster care, family child care, legally nonlicensed child care, and
reports involving children served by an unlicensed personal care provider organization
deleted text begin under section 256B.0659deleted text end . Copies of findings related to personal care provider organizations
deleted text begin under section 256B.0659deleted text end must be forwarded to the Department of Human Services provider
enrollment.
(b) The Department of Human Services is the agency responsible for assessing or
investigating allegations of maltreatment in juvenile correctional facilities listed under
section 241.021 located in the local welfare agency's county and in facilities licensed or
certified under chapters 245A, 245D, and 245H, except for child foster care and family
child care.
(c) The Department of Health is the agency responsible for assessing or investigating
allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and
144A.43 to 144A.482 or chapter 144H.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 87.
Minnesota Statutes 2018, section 626.556, subdivision 4, is amended to read:
Subd. 4.
Immunity from liability.
(a) The following persons are immune from any civil
or criminal liability that otherwise might result from their actions, if they are acting in good
faith:
(1) any person making a voluntary or mandated report under subdivision 3 or under
section 626.5561 or assisting in an assessment under this section or under section 626.5561;
(2) any person with responsibility for performing duties under this section or supervisor
employed by a local welfare agency, the commissioner of an agency responsible for operating
or supervising a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed or certified under sections
144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245B or 245H; or a school as
defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed
personal care provider organization deleted text begin as defined in section 256B.0625, subdivision 19a,deleted text end
complying with subdivision 10d; and
(3) any public or private school, facility as defined in subdivision 2, or the employee of
any public or private school or facility who permits access by a local welfare agency, the
Department of Education, or a local law enforcement agency and assists in an investigation
or assessment pursuant to subdivision 10 or under section 626.5561.
(b) A person who is a supervisor or person with responsibility for performing duties
under this section employed by a local welfare agency, the commissioner of human services,
or the commissioner of education complying with subdivisions 10 and 11 or section 626.5561
or any related rule or provision of law is immune from any civil or criminal liability that
might otherwise result from the person's actions, if the person is (1) acting in good faith
and exercising due care, or (2) acting in good faith and following the information collection
procedures established under subdivision 10, paragraphs (h), (i), and (j).
(c) This subdivision does not provide immunity to any person for failure to make a
required report or for committing neglect, physical abuse, or sexual abuse of a child.
(d) If a person who makes a voluntary or mandatory report under subdivision 3 prevails
in a civil action from which the person has been granted immunity under this subdivision,
the court may award the person attorney fees and costs.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 88.
Minnesota Statutes 2018, section 626.556, subdivision 10d, is amended to read:
Subd. 10d.
Notification of neglect or abuse in facility.
(a) When a report is received
that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the
care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed or certified according to
sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 144H, 245D, or
245H, or a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter
124E; or a nonlicensed personal care provider organization deleted text begin as defined in section 256B.0625,
subdivision 19adeleted text end , the commissioner of the agency responsible for assessing or investigating
the report or local welfare agency investigating the report shall provide the following
information to the parent, guardian, or legal custodian of a child alleged to have been
neglected, physically abused, sexually abused, or the victim of maltreatment of a child in
the facility: the name of the facility; the fact that a report alleging neglect, physical abuse,
sexual abuse, or maltreatment of a child in the facility has been received; the nature of the
alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; that
the agency is conducting an assessment or investigation; any protective or corrective measures
being taken pending the outcome of the investigation; and that a written memorandum will
be provided when the investigation is completed.
(b) The commissioner of the agency responsible for assessing or investigating the report
or local welfare agency may also provide the information in paragraph (a) to the parent,
guardian, or legal custodian of any other child in the facility if the investigative agency
knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or
maltreatment of a child in the facility has occurred. In determining whether to exercise this
authority, the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency shall consider the seriousness of the alleged neglect, physical
abuse, sexual abuse, or maltreatment of a child in the facility; the number of children
allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a
child in the facility; the number of alleged perpetrators; and the length of the investigation.
The facility shall be notified whenever this discretion is exercised.
(c) When the commissioner of the agency responsible for assessing or investigating the
report or local welfare agency has completed its investigation, every parent, guardian, or
legal custodian previously notified of the investigation by the commissioner or local welfare
agency shall be provided with the following information in a written memorandum: the
name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual
abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the
investigation findings; a statement whether maltreatment was found; and the protective or
corrective measures that are being or will be taken. The memorandum shall be written in a
manner that protects the identity of the reporter and the child and shall not contain the name,
or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed
during the investigation. If maltreatment is determined to exist, the commissioner or local
welfare agency shall also provide the written memorandum to the parent, guardian, or legal
custodian of each child in the facility who had contact with the individual responsible for
the maltreatment. When the facility is the responsible party for maltreatment, the
commissioner or local welfare agency shall also provide the written memorandum to the
parent, guardian, or legal custodian of each child who received services in the population
of the facility where the maltreatment occurred. This notification must be provided to the
parent, guardian, or legal custodian of each child receiving services from the time the
maltreatment occurred until either the individual responsible for maltreatment is no longer
in contact with a child or children in the facility or the conclusion of the investigation. In
the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions
9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification
to parents, guardians, or legal custodians of each child in the facility, but shall, within ten
days after the investigation is completed, provide written notification to the parent, guardian,
or legal custodian of any student alleged to have been maltreated. The commissioner of
education may notify the parent, guardian, or legal custodian of any student involved as a
witness to alleged maltreatment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 89.
Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:
Subd. 6.
Facility.
(a) "Facility" means a hospital or other entity required to be licensed
under sections 144.50 to 144.58; a nursing home required to be licensed to serve adults
under section 144A.02; a facility or service required to be licensed under chapter 245A; a
home care provider licensed or required to be licensed under sections 144A.43 to 144A.482;
a hospice provider licensed under sections 144A.75 to 144A.755; or a person or organization
that offers, provides, or arranges for personal care assistance services under the medical
assistance program as authorized under sections deleted text begin 256B.0625, subdivision 19a,deleted text end 256B.0651
to 256B.0654deleted text begin , 256B.0659,deleted text end or 256B.85.
(b) For services identified in paragraph (a) that are provided in the vulnerable adult's
own home or in another unlicensed location, the term "facility" refers to the provider, person,
or organization that offers, provides, or arranges for personal care services, and does not
refer to the vulnerable adult's home or other location at which services are rendered.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 90.
Minnesota Statutes 2018, section 626.5572, subdivision 21, is amended to read:
Subd. 21.
Vulnerable adult.
(a) "Vulnerable adult" means any person 18 years of age
or older who:
(1) is a resident or inpatient of a facility;
(2) receives services required to be licensed under chapter 245A, except that a person
receiving outpatient services for treatment of chemical dependency or mental illness, or one
who is served in the Minnesota sex offender program on a court-hold order for commitment,
or is committed as a sexual psychopathic personality or as a sexually dangerous person
under chapter 253B, is not considered a vulnerable adult unless the person meets the
requirements of clause (4);
(3) receives services from a home care provider required to be licensed under sections
144A.43 to 144A.482; or from a person or organization that offers, provides, or arranges
for personal care assistance services under the medical assistance program as authorized
under section deleted text begin 256B.0625, subdivision 19a,deleted text end 256B.0651, 256B.0653, 256B.0654, deleted text begin 256B.0659,deleted text end
or 256B.85; or
(4) regardless of residence or whether any type of service is received, possesses a physical
or mental infirmity or other physical, mental, or emotional dysfunction:
(i) that impairs the individual's ability to provide adequately for the individual's own
care without assistance, including the provision of food, shelter, clothing, health care, or
supervision; and
(ii) because of the dysfunction or infirmity and the need for care or services, the individual
has an impaired ability to protect the individual's self from maltreatment.
(b) For purposes of this subdivision, "care or services" means care or services for the
health, safety, welfare, or maintenance of an individual.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 91.
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. 92. new text begin DIRECTION TO COMMISSIONER; NOTICE.
new text end
new text begin
The commissioner of human services shall publish on the Department of Human Services
website notice of implementation at least 30 days before section 60 becomes effective.
new text end
Sec. 93. new text begin DIRECTION TO COMMISSIONER; PCA TRANSITION TO CFSS.
new text end
new text begin
Upon the implementation of section 60, the commissioner of human services shall
transfer an individual from personal care assistance services to community first services
and supports after the individual's reassessment. Nothing in this article prohibits a provider
from billing for personal care services according to Minnesota Statutes, chapter 256B, for
one year from the date of the provision of service.
new text end
Sec. 94. 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) In Minnesota Statutes, sections 256.01, subdivisions 2 and 24; 256.975, subdivision
7; 256B.0911, subdivisions 1a, 3b, and 4d; and 256B.439, subdivision 4, the revisor of
statutes shall substitute the term "Disability Linkage Line" or similar terms for "Disability
Hub" or similar terms. The revisor shall also make grammatical changes related to the
changes in terms.
new text end
Sec. 95. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2018, sections 256.476, subdivisions 1, 2, 3, 4, 5, 6, 8, 9, 10, and
11; 256B.0625, subdivisions 19a and 19c; 256B.0652, subdivision 6; and 256B.0659,
subdivisions 1, 2, 3, 3a, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 11a, 12, 13, 14, 15, 16, 17, 18, 19, 20,
21, 22, 23, 24, 25, 26, 27, 28, 29, 30, and 31,
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 as determined by the commissioner of
human services following federal approval but not more than two years after federal approval
is obtained. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
APPENDIX
Repealed Minnesota Statutes: 19-0019
62U.15 ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING MEASURES.
Subd. 2.
Learning collaborative.
By July 1, 2012, the commissioner shall develop a health care home learning collaborative curriculum that includes screening and education on best practices regarding identification and management of Alzheimer's and other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, care coordinators, clinic administrators, patient partners and families, and community resources including public health.
119B.125 PROVIDER REQUIREMENTS.
No active language found for: 119B.125.8
256.476 CONSUMER SUPPORT PROGRAM.
Subdivision 1.
Purpose and goals.
The commissioner of human services shall establish a consumer support grant program for individuals with functional limitations and their families who wish to purchase and secure their own supports. The program shall:
(1) make support grants available to individuals or families as an effective alternative to the family support program, personal care attendant services, home health aide services, and home care nursing services;
(2) provide consumers more control, flexibility, and responsibility over their services and supports;
(3) promote local program management and decision making; and
(4) encourage the use of informal and typical community supports.
Subd. 2.
Definitions.
For purposes of this section, the following terms have the meanings given them:
(a) "County board" means the county board of commissioners for the county of financial responsibility as defined in section 256G.02, subdivision 4, or its designated representative. When a human services board has been established under sections 402.01 to 402.10, it shall be considered the county board for the purposes of this section.
(b) "Family" means the person's birth parents, adoptive parents or stepparents, siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece, nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is at least 18 years of age.
(c) "Functional limitations" means the long-term inability to perform an activity or task in one or more areas of major life activity, including self-care, understanding and use of language, learning, mobility, self-direction, and capacity for independent living. For the purpose of this section, the inability to perform an activity or task results from a mental, emotional, psychological, sensory, or physical disability, condition, or illness.
(d) "Informed choice" means a voluntary decision made by the person, the person's legal representative, or other authorized representative after becoming familiarized with the alternatives to:
(1) select a preferred alternative from a number of feasible alternatives;
(2) select an alternative which may be developed in the future; and
(3) refuse any or all alternatives.
(e) "Local agency" means the local agency authorized by the county board or, for counties not participating in the consumer grant program by July 1, 2002, the commissioner, to carry out the provisions of this section.
(f) "Person" or "persons" means a person or persons meeting the eligibility criteria in subdivision 3.
(g) "Authorized representative" means an individual designated by the person or their legal representative to act on their behalf. This individual may be a family member, guardian, representative payee, or other individual designated by the person or their legal representative, if any, to assist in purchasing and arranging for supports. For the purposes of this section, an authorized representative is at least 18 years of age.
(h) "Screening" means the screening of a person's service needs under sections 256B.0911 and 256B.092.
(i) "Supports" means services, care, aids, environmental modifications, or assistance purchased by the person, the person's legal representative, or other authorized representative. Examples of supports include respite care, assistance with daily living, and assistive technology. For the purpose of this section, notwithstanding the provisions of section 144A.43, supports purchased under the consumer support program are not considered home care services.
(j) "Program of origination" means the program the individual transferred from when approved for the consumer support grant program.
Subd. 3.
Eligibility to apply for grants.
(a) A person is eligible to apply for a consumer support grant if the person meets all of the following criteria:
(1) the person is eligible for and has been approved to receive services under medical assistance as determined under sections 256B.055 and 256B.056 or the person has been approved to receive a grant under the family support program under section 252.32;
(2) the person is able to direct and purchase the person's own care and supports, or the person has a family member, legal representative, or other authorized representative who can purchase and arrange supports on the person's behalf;
(3) the person has functional limitations, requires ongoing supports to live in the community, and is at risk of or would continue institutionalization without such supports; and
(4) the person will live in a home. For the purpose of this section, "home" means the person's own home or home of a person's family member. These homes are natural home settings and are not licensed by the Department of Health or Human Services.
(b) Persons may not concurrently receive a consumer support grant if they are:
(1) receiving personal care attendant and home health aide services, or home care nursing under section 256B.0625; a family support grant; or alternative care services under section 256B.0913; or
(2) residing in an institutional or congregate care setting.
(c) A person or person's family receiving a consumer support grant shall not be charged a fee or premium by a local agency for participating in the program.
(d) Individuals receiving home and community-based waivers under United States Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except for individuals receiving consumer support grants before July 1, 2003, as long as other eligibility criteria are met.
(e) The commissioner shall establish a budgeted appropriation each fiscal year for the consumer support grant program. The number of individuals participating in the program will be adjusted so the total amount allocated to counties does not exceed the amount of the budgeted appropriation. The budgeted appropriation will be adjusted annually to accommodate changes in demand for the consumer support grants.
Subd. 4.
Support grants; criteria and limitations.
(a) A county board may choose to participate in the consumer support grant program. If a county has not chosen to participate by July 1, 2002, the commissioner shall contract with another county or other entity to provide access to residents of the nonparticipating county who choose the consumer support grant option. The commissioner shall notify the county board in a county that has declined to participate of the commissioner's intent to enter into a contract with another county or other entity at least 30 days in advance of entering into the contract. The local agency shall establish written procedures and criteria to determine the amount and use of support grants. These procedures must include, at least, the availability of respite care, assistance with daily living, and adaptive aids. The local agency may establish monthly or annual maximum amounts for grants and procedures where exceptional resources may be required to meet the health and safety needs of the person on a time-limited basis, however, the total amount awarded to each individual may not exceed the limits established in subdivision 11.
(b) Support grants to a person, a person's legal representative, or other authorized representative will be provided through a monthly subsidy payment and be in the form of cash, voucher, or direct county payment to vendor. Support grant amounts must be determined by the local agency. Each service and item purchased with a support grant must meet all of the following criteria:
(1) it must be over and above the normal cost of caring for the person if the person did not have functional limitations;
(2) it must be directly attributable to the person's functional limitations;
(3) it must enable the person, a person's legal representative, or other authorized representative to delay or prevent out-of-home placement of the person; and
(4) it must be consistent with the needs identified in the service agreement, when applicable.
(c) Items and services purchased with support grants must be those for which there are no other public or private funds available to the person, a person's legal representative, or other authorized representative. Fees assessed to the person or the person's family for health and human services are not reimbursable through the grant.
(d) In approving or denying applications, the local agency shall consider the following factors:
(1) the extent and areas of the person's functional limitations;
(2) the degree of need in the home environment for additional support; and
(3) the potential effectiveness of the grant to maintain and support the person in the family environment or the person's own home.
(e) At the time of application to the program or screening for other services, the person, a person's legal representative, or other authorized representative shall be provided sufficient information to ensure an informed choice of alternatives by the person, the person's legal representative, or other authorized representative, if any. The application shall be made to the local agency and shall specify the needs of the person or the person's legal representative or other authorized representative, the form and amount of grant requested, the items and services to be reimbursed, and evidence of eligibility for medical assistance.
(f) Upon approval of an application by the local agency and agreement on a support plan for the person or the person's legal representative or other authorized representative, the local agency shall make grants to the person or the person's legal representative or other authorized representative. The grant shall be in an amount for the direct costs of the services or supports outlined in the service agreement.
(g) Reimbursable costs shall not include costs for resources already available, such as special education classes, day training and habilitation, case management, other services to which the person is entitled, medical costs covered by insurance or other health programs, or other resources usually available at no cost to the person or the person's legal representative or other authorized representative.
(h) The state of Minnesota, the county boards participating in the consumer support grant program, or the agencies acting on behalf of the county boards in the implementation and administration of the consumer support grant program shall not be liable for damages, injuries, or liabilities sustained through the purchase of support by the individual, the individual's family, or the authorized representative under this section with funds received through the consumer support grant program. Liabilities include but are not limited to: workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, participating county boards and agencies acting on behalf of county boards are exempt from the provisions of section 268.035.
Subd. 5.
Reimbursement, allocations, and reporting.
(a) For the purpose of transferring persons to the consumer support grant program from the family support program and personal care assistance services, home health aide services, or home care nursing services, the amount of funds transferred by the commissioner between the family support program account, the medical assistance account, or the consumer support grant account shall be based on each county's participation in transferring persons to the consumer support grant program from those programs and services.
(b) At the beginning of each fiscal year, county allocations for consumer support grants shall be based on:
(1) the number of persons to whom the county board expects to provide consumer supports grants;
(2) their eligibility for current program and services;
(3) the monthly grant levels allowed under subdivision 11; and
(4) projected dates when persons will start receiving grants. County allocations shall be adjusted periodically by the commissioner based on the actual transfer of persons or service openings, and the monthly grant levels associated with those persons or service openings, to the consumer support grant program.
(c) The amount of funds transferred by the commissioner from the medical assistance account for an individual may be changed if it is determined by the county or its agent that the individual's need for support has changed.
(d) The authority to utilize funds transferred to the consumer support grant account for the purposes of implementing and administering the consumer support grant program will not be limited or constrained by the spending authority provided to the program of origination.
(e) The commissioner may use up to five percent of each county's allocation, as adjusted, for payments for administrative expenses, to be paid as a proportionate addition to reported direct service expenditures.
(f) The county allocation for each person or the person's legal representative or other authorized representative cannot exceed the amount allowed under subdivision 11.
(g) The commissioner may recover, suspend, or withhold payments if the county board, local agency, or grantee does not comply with the requirements of this section.
(h) Grant funds unexpended by consumers shall return to the state once a year. The annual return of unexpended grant funds shall occur in the quarter following the end of the state fiscal year.
Subd. 6.
Right to appeal.
Notice, appeal, and hearing procedures shall be conducted in accordance with section 256.045. The denial, suspension, or termination of services under this program may be appealed by a recipient or applicant under section 256.045, subdivision 3. It is an absolute defense to an appeal under this section, if the county board proves that it followed the established written procedures and criteria and determined that the grant could not be provided within the county board's allocation of money for consumer support grants.
Subd. 8.
Commissioner responsibilities.
The commissioner shall:
(1) transfer and allocate funds pursuant to subdivision 11;
(2) determine allocations based on projected and actual local agency use;
(3) monitor and oversee overall program spending;
(4) evaluate the effectiveness of the program;
(5) provide training and technical assistance for local agencies and consumers to help identify potential applicants to the program; and
(6) develop guidelines for local agency program administration and consumer information.
Subd. 9.
County board responsibilities.
County boards receiving funds under this section shall:
(1) determine the needs of persons and families for services and supports;
(2) determine the eligibility for persons proposed for program participation;
(3) approve items and services to be reimbursed and inform families of their determination;
(4) issue support grants directly to or on behalf of persons;
(5) submit quarterly financial reports and an annual program report to the commissioner;
(6) coordinate services and supports with other programs offered or made available to persons or their families; and
(7) provide assistance to persons or their families in securing or maintaining supports, as needed.
Subd. 10.
Consumer responsibilities.
Persons receiving grants under this section shall:
(1) spend the grant money in a manner consistent with their agreement with the local agency;
(2) notify the local agency of any necessary changes in the grant or the items on which it is spent;
(3) notify the local agency of any decision made by the person, a person's legal representative, or other authorized representative that would change their eligibility for consumer support grants;
(4) arrange and pay for supports; and
(5) inform the local agency of areas where they have experienced difficulty securing or maintaining supports.
Subd. 11.
Consumer support grant program after July 1, 2001.
Effective July 1, 2001, the commissioner shall allocate consumer support grant resources to serve additional individuals based on a review of Medicaid authorization and payment information of persons eligible for a consumer support grant from the most recent fiscal year. The commissioner shall use the following methodology to calculate maximum allowable monthly consumer support grant levels:
(1) For individuals whose program of origination is medical assistance home care under sections 256B.0651, 256B.0653, and 256B.0654, the maximum allowable monthly grant levels are calculated by:
(i) determining the service authorization for each individual based on the individual's home care assessment;
(ii) calculating the overall ratio of actual payments to service authorizations by program;
(iii) applying the overall ratio to 50 percent of the service authorization level of each home care rating; and
(iv) adjusting the result for any authorized rate changes provided by the legislature.
(2) The commissioner shall ensure the methodology is consistent with the home care programs.
256B.057 ELIGIBILITY REQUIREMENTS FOR SPECIAL CATEGORIES.
Subd. 8.
Children under age two.
Medical assistance may be paid for a child under two years of age whose countable household income is above 275 percent of the federal poverty guidelines for the same household size but less than or equal to 280 percent of the federal poverty guidelines for the same household size or an equivalent standard when converted using modified adjusted gross income methodology as required under the Affordable Care Act.
256B.0625 COVERED SERVICES.
Subd. 3a.
Sex reassignment surgery.
Sex reassignment surgery is not covered.
Subd. 19a.
Personal care assistance services.
Medical assistance covers personal care assistance services in a recipient's home. Effective January 1, 2010, to qualify for personal care assistance services, a recipient must require assistance and be determined dependent in one activity of daily living as defined in section 256B.0659, subdivision 1, paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1, paragraph (c). 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.
Subd. 19c.
Personal care.
Medical assistance covers personal care assistance services provided by an individual who is qualified to provide the services according to subdivision 19a and sections 256B.0651 to 256B.0654, provided in accordance with a plan, and supervised by a qualified professional.
"Qualified professional" means 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); a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker as defined in sections 148E.010 and 148E.055, or a qualified designated coordinator under section 245D.081, subdivision 2. The qualified professional shall perform the duties required in section 256B.0659.
256B.0652 AUTHORIZATION AND REVIEW OF HOME CARE SERVICES.
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. 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.
256B.0659 PERSONAL CARE ASSISTANCE PROGRAM.
Subdivision 1.
Definitions.
(a) For the purposes of this section, the terms defined in paragraphs (b) to (r) have the meanings given unless otherwise provided in text.
(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility, positioning, eating, and toileting.
(c) "Behavior," effective January 1, 2010, means a category to determine the home care rating and is based on the criteria found in this section. "Level I behavior" means physical aggression towards self, others, or destruction of property that requires the immediate response of another person.
(d) "Complex health-related needs," effective January 1, 2010, means a category to determine the home care rating and is based on the criteria found in this section.
(e) "Critical activities of daily living," effective January 1, 2010, means transferring, mobility, eating, and toileting.
(f) "Dependency in activities of daily living" means a person requires assistance to begin and complete one or more of the activities of daily living.
(g) "Extended personal care assistance service" means personal care assistance services included in a service plan under one of the home and community-based services waivers authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state plan personal care assistance services for participants who:
(1) need assistance provided periodically during a week, but less than daily will not be able to remain in their homes without the assistance, and other replacement services are more expensive or are not available when personal care assistance services are to be reduced; or
(2) need additional personal care assistance services beyond the amount authorized by the state plan personal care assistance assessment in order to ensure that their safety, health, and welfare are provided for in their homes.
(h) "Health-related procedures and tasks" means procedures and tasks that can be delegated or assigned by a licensed health care professional under state law to be performed by a personal care assistant.
(i) "Instrumental activities of daily living" means activities to include meal planning and preparation; basic assistance with paying bills; shopping for food, clothing, and other essential items; performing household tasks integral to the personal care assistance services; communication by telephone and other media; and traveling, including to medical appointments and to participate in the community.
(j) "Managing employee" has the same definition as Code of Federal Regulations, title 42, section 455.
(k) "Qualified professional" means a professional providing supervision of personal care assistance services and staff as defined in section 256B.0625, subdivision 19c.
(l) "Personal care assistance provider agency" means a medical assistance enrolled provider that provides or assists with providing personal care assistance services and includes a personal care assistance provider organization, personal care assistance choice agency, class A licensed nursing agency, and Medicare-certified home health agency.
(m) "Personal care assistant" or "PCA" means an individual employed by a personal care assistance agency who provides personal care assistance services.
(n) "Personal care assistance care plan" means a written description of personal care assistance services developed by the personal care assistance provider according to the service plan.
(o) "Responsible party" means an individual who is capable of providing the support necessary to assist the recipient to live in the community.
(p) "Self-administered medication" means medication taken orally, by injection, nebulizer, or insertion, or applied topically without the need for assistance.
(q) "Service plan" means a written summary of the assessment and description of the services needed by the recipient.
(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage reimbursement, health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, and contributions to employee retirement accounts.
Subd. 2.
Personal care assistance services; covered services.
(a) The personal care assistance services eligible for payment include services and supports furnished to an individual, as needed, to assist in:
(1) activities of daily living;
(2) health-related procedures and tasks;
(3) observation and redirection of behaviors; and
(4) instrumental activities of daily living.
(b) Activities of daily living include the following covered services:
(1) dressing, including assistance with choosing, application, and changing of clothing and application of special appliances, wraps, or clothing;
(2) grooming, including assistance with basic hair care, oral care, shaving, applying cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, except for recipients who are diabetic or have poor circulation;
(3) bathing, including assistance with basic personal hygiene and skin care;
(4) eating, including assistance with hand washing and application of orthotics required for eating, transfers, and feeding;
(5) transfers, including assistance with transferring the recipient from one seating or reclining area to another;
(6) mobility, including assistance with ambulation, including use of a wheelchair. Mobility does not include providing transportation for a recipient;
(7) positioning, including assistance with positioning or turning a recipient for necessary care and comfort; and
(8) toileting, including assistance with helping recipient with bowel or bladder elimination and care including transfers, mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and adjusting clothing.
(c) Health-related procedures and tasks include the following covered services:
(1) range of motion and passive exercise to maintain a recipient's strength and muscle functioning;
(2) assistance with self-administered medication as defined by this section, including reminders to take medication, bringing medication to the recipient, and assistance with opening medication under the direction of the recipient or responsible party, including medications given through a nebulizer;
(3) interventions for seizure disorders, including monitoring and observation; and
(4) other activities considered within the scope of the personal care service and meeting the definition of health-related procedures and tasks under this section.
(d) A personal care assistant may provide health-related procedures and tasks associated with the complex health-related needs of a recipient if the procedures and tasks meet the definition of health-related procedures and tasks under this section and the personal care assistant is trained by a qualified professional and demonstrates competency to safely complete the procedures and tasks. Delegation of health-related procedures and tasks and all training must be documented in the personal care assistance care plan and the recipient's and personal care assistant's files. A personal care assistant must not determine the medication dose or time for medication.
(e) Effective January 1, 2010, for a personal care assistant to provide the health-related procedures and tasks of tracheostomy suctioning and services to recipients on ventilator support there must be:
(1) delegation and training by a registered nurse, certified or licensed respiratory therapist, or a physician;
(2) utilization of clean rather than sterile procedure;
(3) specialized training about the health-related procedures and tasks and equipment, including ventilator operation and maintenance;
(4) individualized training regarding the needs of the recipient; and
(5) supervision by a qualified professional who is a registered nurse.
(f) Effective January 1, 2010, a personal care assistant may observe and redirect the recipient for episodes where there is a need for redirection due to behaviors. Training of the personal care assistant must occur based on the needs of the recipient, the personal care assistance care plan, and any other support services provided.
(g) Instrumental activities of daily living under subdivision 1, paragraph (i).
Subd. 3.
Noncovered personal care assistance services.
(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; or
(4) without authorization by the commissioner or the commissioner's designee.
(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.
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. During the transition to MnCHOICES, a certified assessor may complete the assessment defined in this subdivision. 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.
Subd. 4.
Assessment for personal care assistance services; limitations.
(a) An assessment as defined in subdivision 3a must be completed for personal care assistance services.
(b) The following limitations apply to the assessment:
(1) a person must be assessed as dependent in an activity of daily living based on the person's daily need or need on the days during the week the activity is completed for:
(i) cuing and constant supervision to complete the task; or
(ii) hands-on assistance to complete the task; and
(2) a child may not be found to be dependent in an activity of daily living if because of the child's age an adult would either perform the activity for the child or assist the child with the activity. Assistance needed is the assistance appropriate for a typical child of the same age.
(c) Assessment for complex health-related needs must meet the criteria in this paragraph. A recipient qualifies as having complex health-related needs if the recipient has one or more of the interventions that are ordered by a physician, specified in a personal care assistance care plan or community support plan developed under section 256B.0911, and found in the following:
(1) tube feedings requiring:
(i) a gastrojejunostomy tube; or
(ii) continuous tube feeding lasting longer than 12 hours per day;
(2) wounds described as:
(i) stage III or stage IV;
(ii) multiple wounds;
(iii) requiring sterile or clean dressing changes or a wound vac; or
(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized care;
(3) parenteral therapy described as:
(i) IV therapy more than two times per week lasting longer than four hours for each treatment; or
(ii) total parenteral nutrition (TPN) daily;
(4) respiratory interventions, including:
(i) oxygen required more than eight hours per day;
(ii) respiratory vest more than one time per day;
(iii) bronchial drainage treatments more than two times per day;
(iv) sterile or clean suctioning more than six times per day;
(v) dependence on another to apply respiratory ventilation augmentation devices such as BiPAP and CPAP; and
(vi) ventilator dependence under section 256B.0652;
(5) insertion and maintenance of catheter, including:
(i) sterile catheter changes more than one time per month;
(ii) clean intermittent catheterization, and including self-catheterization more than six times per day; or
(iii) bladder irrigations;
(6) bowel program more than two times per week requiring more than 30 minutes to perform each time;
(7) neurological intervention, including:
(i) seizures more than two times per week and requiring significant physical assistance to maintain safety; or
(ii) swallowing disorders diagnosed by a physician and requiring specialized assistance from another on a daily basis; and
(8) other congenital or acquired diseases creating a need for significantly increased direct hands-on assistance and interventions in six to eight activities of daily living.
(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient qualifies as having a need for assistance due to behaviors if the recipient's behavior requires assistance at least four times per week and shows one or more of the following behaviors:
(1) physical aggression towards self or others, or destruction of property that requires the immediate response of another person;
(2) increased vulnerability due to cognitive deficits or socially inappropriate behavior; or
(3) increased need for assistance for recipients who are verbally aggressive or resistive to care so that the time needed to perform activities of daily living is increased.
Subd. 5.
Service, support planning, and referral.
(a) The assessor, with the recipient or responsible party, shall review the assessment information and determine referrals for other payers, services, and community supports as appropriate.
(b) The recipient must be referred for evaluation, services, or supports that are appropriate to help meet the recipient's needs including, but not limited to, the following circumstances:
(1) when there is another payer who is responsible to provide the service to meet the recipient's needs;
(2) when the recipient qualifies for assistance due to mental illness or behaviors under this section, a referral for a mental health diagnostic and functional assessment must be completed, or referral must be made for other specific mental health services or other community services;
(3) when the recipient is eligible for medical assistance and meets medical assistance eligibility for a home health aide or skilled nurse visit;
(4) when the recipient would benefit from an evaluation for another service; and
(5) when there is a more appropriate service to meet the assessed needs.
(c) The reimbursement rates for public health nurse visits that relate to the provision of personal care assistance services under this section and section 256B.0625, subdivision 19a, are:
(1) $210.50 for a face-to-face assessment visit;
(2) $105.25 for each service update; and
(3) $105.25 for each request for a temporary service increase.
(d) The rates specified in paragraph (c) must be adjusted to reflect provider rate increases for personal care assistance services that are approved by the legislature for the fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied by the legislature to provider rate increases for personal care assistance services also apply to adjustments under this paragraph.
(e) Effective July 1, 2008, the payment rate for an assessment under this section and section 256B.0651 shall be reduced by 25 percent when the assessment is not completed on time and the service agreement documentation is not submitted in time to continue services. The commissioner shall reduce the amount of the claim for those assessments that are not submitted on time.
Subd. 6.
Service plan.
The service plan must be completed by the assessor with the recipient and responsible party on a form determined by the commissioner and include a summary of the assessment with a description of the need, authorized amount, and expected outcomes and goals of personal care assistance services. The recipient and the provider chosen by the recipient or responsible party must be given a copy of the completed service plan within ten working days of the assessment. The recipient or responsible party must be given information by the assessor about the options in the personal care assistance program to allow for review and decision making.
Subd. 7.
Personal care assistance care plan.
(a) Each recipient must have a current personal care assistance care plan based on the service plan in subdivision 6 that is developed by the qualified professional with the recipient and responsible party. A copy of the most current personal care assistance care plan is required to be in the recipient's home and in the recipient's file at the provider agency.
(b) The personal care assistance care plan must have the following components:
(1) start and end date of the care plan;
(2) recipient demographic information, including name and telephone number;
(3) emergency numbers, procedures, and a description of measures to address identified safety and vulnerability issues, including a backup staffing plan;
(4) name of responsible party and instructions for contact;
(5) description of the recipient's individualized needs for assistance with activities of daily living, instrumental activities of daily living, health-related tasks, and behaviors; and
(6) dated signatures of recipient or responsible party and qualified professional.
(c) The personal care assistance care plan must have instructions and comments about the recipient's needs for assistance and any special instructions or procedures required, including whether or not the recipient has requested a personal care assistant of the same gender. The month-to-month plan for the use of personal care assistance services is part of the personal care assistance care plan. The personal care assistance care plan must be completed within the first week after start of services with a personal care provider agency and must be updated as needed when there is a change in need for personal care assistance services. A new personal care assistance care plan is required annually at the time of the reassessment.
Subd. 7a.
Special instructions; gender.
If a recipient requests a personal care assistant of the same gender as the recipient, the personal care assistance agency must make a reasonable effort to fulfill the request.
Subd. 8.
Communication with recipient's physician.
The personal care assistance program requires communication with the recipient's physician about a recipient's assessed needs for personal care assistance services. The commissioner shall work with the state medical director to develop options for communication with the recipient's physician.
Subd. 9.
Responsible party; generally.
(a) "Responsible party" means an individual who is capable of providing the support necessary to assist the recipient to live in the community.
(b) A responsible party must be 18 years of age, actively participate in planning and directing of personal care assistance services, and attend all assessments for the recipient.
(c) A responsible party must not be the:
(1) personal care assistant;
(2) qualified professional;
(3) home care provider agency owner or manager;
(4) home care provider agency staff unless staff who are not listed in clauses (1) to (3) are related to the recipient by blood, marriage, or adoption; or
(5) county staff acting as part of employment.
(d) A licensed family foster parent who lives with the recipient may be the responsible party as long as the family foster parent meets the other responsible party requirements.
(e) A responsible party is required when:
(1) the person is a minor according to section 524.5-102, subdivision 10;
(2) the person is an incapacitated adult according to section 524.5-102, subdivision 6, resulting in a court-appointed guardian; or
(3) the assessment according to subdivision 3a determines that the recipient is in need of a responsible party to direct the recipient's care.
(f) There may be two persons designated as the responsible party for reasons such as divided households and court-ordered custodies. Each person named as responsible party must meet the program criteria and responsibilities.
(g) The recipient or the recipient's legal representative shall appoint a responsible party if necessary to direct and supervise the care provided to the recipient. The responsible party must be identified at the time of assessment and listed on the recipient's service agreement and personal care assistance care plan.
Subd. 10.
Responsible party; duties; delegation.
(a) A responsible party shall enter into a written agreement with a personal care assistance provider agency, on a form determined by the commissioner, to perform the following duties:
(1) be available while care is provided in a method agreed upon by the individual or the individual's legal representative and documented in the recipient's personal care assistance care plan;
(2) monitor personal care assistance services to ensure the recipient's personal care assistance care plan is being followed; and
(3) review and sign personal care assistance time sheets after services are provided to provide verification of the personal care assistance services.
Failure to provide the support required by the recipient must result in a referral to the county common entry point.
(b) Responsible parties who are parents of minors or guardians of minors or incapacitated persons may delegate the responsibility to another adult who is not the personal care assistant during a temporary absence of at least 24 hours but not more than six months. The person delegated as a responsible party must be able to meet the definition of the responsible party. The responsible party must ensure that the delegate performs the functions of the responsible party, is identified at the time of the assessment, and is listed on the personal care assistance care plan. The responsible party must communicate to the personal care assistance provider agency about the need for a delegated responsible party, including the name of the delegated responsible party and contact numbers.
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) 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.
(d) Personal care assistance services qualify for the enhanced rate described in subdivision 17a if the personal care assistant providing the services:
(1) provides covered services to a recipient who qualifies for 12 or more hours per day of personal care assistance services; and
(2) satisfies the current requirements of Medicare for training and competency or competency evaluation of home health aides or nursing assistants, as provided in the Code of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved training or competency requirements.
Subd. 11a.
Exception to personal care assistant; requirements.
The personal care assistant for a recipient may be allowed to enroll with a different personal care assistant provider agency upon initiation of a new background study according to chapter 245C, if all of the following are met:
(1) the commissioner determines that a change in enrollment or affiliation of the personal care assistant is needed in order to ensure continuity of services and protect the health and safety of the recipient;
(2) the chosen agency has been continuously enrolled as a personal care assistance provider agency for at least two years;
(3) the recipient chooses to transfer to the personal care assistance provider agency;
(4) the personal care assistant has been continuously enrolled with the former personal care assistance provider agency since the last background study was completed; and
(5) the personal care assistant continues to meet requirements of subdivision 11, excluding paragraph (a), clause (3).
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 recipient and either the recipient's medical assistance identification number or date of birth;
(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.
Subd. 13.
Qualified professional; qualifications.
(a) The qualified professional must work for a personal care assistance provider agency, meet the definition of qualified professional under section 256B.0625, subdivision 19c, and enroll with the department as a qualified professional after clearing a background study. 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.
Subd. 14.
Qualified professional; duties.
(a) Effective January 1, 2010, all personal care assistants must be supervised by a qualified professional.
(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.
Subd. 15.
Flexible use.
(a) "Flexible use" means the scheduled use of authorized hours of personal care assistance services, which vary within a service authorization period covering no more than six months, in order to more effectively meet the needs and schedule of the recipient. Each 12-month service agreement is divided into two six-month authorization date spans. No more than 75 percent of the total authorized units for a 12-month service agreement may be used in a six-month date span.
(b) Authorization of flexible use occurs during the authorization process under section 256B.0652. The flexible use of authorized hours does not increase the total amount of authorized hours available to a recipient. The commissioner shall not authorize additional personal care assistance services to supplement a service authorization that is exhausted before the end date under a flexible service use plan, unless the assessor determines a change in condition and a need for increased services is established. Authorized hours not used within the six-month period must not be carried over to another time period.
(c) A recipient who has terminated personal care assistance services before the end of the 12-month authorization period must not receive additional hours upon reapplying during the same 12-month authorization period, except if a change in condition is documented. Services must be prorated for the remainder of the 12-month authorization period based on the first six-month assessment.
(d) The recipient, responsible party, and qualified professional must develop a written month-to-month plan of the projected use of personal care assistance services that is part of the personal care assistance care plan and ensures:
(1) that the health and safety needs of the recipient are met throughout both date spans of the authorization period; and
(2) that the total authorized amount of personal care assistance services for each date span must not be used before the end of each date span in the authorization period.
(e) The personal care assistance provider agency shall monitor the use of personal care assistance services to ensure health and safety needs of the recipient are met throughout both date spans of the authorization period. The commissioner or the commissioner's designee shall provide written notice to the provider and the recipient or responsible party when a recipient is at risk of exceeding the personal care assistance services prior to the end of the six-month period.
(f) Misuse and abuse of the flexible use of personal care assistance services resulting in the overuse of units in a manner where the recipient will not have enough units to meet their needs for assistance and ensure health and safety for the entire six-month date span may lead to an action by the commissioner. The commissioner may take action including, but not limited to: (1) restricting recipients to service authorizations of no more than one month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring a qualified professional to monitor and report services on a monthly basis.
Subd. 16.
Shared services.
(a) Medical assistance payments for shared personal care assistance services are limited according to this subdivision.
(b) Shared service is the provision of personal care assistance services by a personal care assistant to two or three recipients, eligible for medical assistance, who voluntarily enter into an agreement to receive services at the same time and in the same setting.
(c) For the purposes of this subdivision, "setting" means:
(1) the home residence or family foster care home of one or more of the individual recipients; or
(2) a child care program licensed under chapter 245A or operated by a local school district or private school.
(d) Shared personal care assistance services follow the same criteria for covered services as subdivision 2.
(e) Noncovered shared personal care assistance services include the following:
(1) services for more than three recipients by one personal care assistant at one time;
(2) staff requirements for child care programs under chapter 245C;
(3) caring for multiple recipients in more than one setting;
(4) additional units of personal care assistance based on the selection of the option; and
(5) use of more than one personal care assistance provider agency for the shared care services.
(f) The option of shared personal care assistance is elected by the recipient or the responsible party with the assistance of the assessor. The option must be determined appropriate based on the ages of the recipients, compatibility, and coordination of their assessed care needs. The recipient or the responsible party, in conjunction with the qualified professional, shall arrange the setting and grouping of shared services based on the individual needs and preferences of the recipients. The personal care assistance provider agency shall offer the recipient or the responsible party the option of shared or one-on-one personal care assistance services or a combination of both. The recipient or the responsible party may withdraw from participating in a shared services arrangement at any time.
(g) Authorization for the shared service option must be determined by the commissioner based on the criteria that the shared service is appropriate to meet all of the recipients' needs and their health and safety is maintained. The authorization of shared services is part of the overall authorization of personal care assistance services. Nothing in this subdivision must be construed to reduce the total number of hours authorized for an individual recipient.
(h) A personal care assistant providing shared personal care assistance services must:
(1) receive training specific for each recipient served; and
(2) follow all required documentation requirements for time and services provided.
(i) A qualified professional shall:
(1) evaluate the ability of the personal care assistant to provide services for all of the recipients in a shared setting;
(2) visit the shared setting as services are being provided at least once every six months or whenever needed for response to a recipient's request for increased supervision of the personal care assistance staff;
(3) provide ongoing monitoring and evaluation of the effectiveness and appropriateness of the shared services;
(4) develop a contingency plan with each of the recipients which accounts for absence of the recipient in a shared services setting due to illness or other circumstances;
(5) obtain permission from each of the recipients who are sharing a personal care assistant for number of shared hours for services provided inside and outside the home residence; and
(6) document the training completed by the personal care assistants specific to the shared setting and recipients sharing services.
Subd. 17.
Shared services; rates.
The commissioner shall provide a rate system for shared personal care assistance services. For two persons sharing services, the rate paid to a provider must not exceed one and one-half times the rate paid for serving a single individual, and for three persons sharing services, the rate paid to a provider must not exceed twice the rate paid for serving a single individual. These rates apply only when all of the criteria for the shared care personal care assistance service have been met.
Subd. 18.
Personal care assistance choice option; generally.
(a) The commissioner may allow a recipient of personal care assistance services to use a fiscal intermediary to assist the recipient in paying and accounting for medically necessary covered personal care assistance services. Unless otherwise provided in this section, all other statutory and regulatory provisions relating to personal care assistance services apply to a recipient using the personal care assistance choice option.
(b) Personal care assistance choice is an option of the personal care assistance program that allows the recipient who receives personal care assistance services to be responsible for the hiring, training, scheduling, and firing of personal care assistants according to the terms of the written agreement with the personal care assistance choice agency required under subdivision 20, paragraph (a). This program offers greater control and choice for the recipient in who provides the personal care assistance service and when the service is scheduled. The recipient or the recipient's responsible party must choose a personal care assistance choice provider agency as a fiscal intermediary. This personal care assistance choice provider agency manages payroll, invoices the state, is responsible for all payroll-related taxes and insurance, and is responsible for providing the consumer training and support in managing the recipient's personal care assistance services.
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, unemployment insurance, and labor market data required under section 256B.4912, subdivision 1a;
(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.
Subd. 20.
Personal care assistance choice option; administration.
(a) Before services commence under the personal care assistance choice option, and annually thereafter, the personal care assistance choice provider agency and the recipient or responsible party shall enter into a written agreement. The annual agreement must be provided to the recipient or responsible party, each personal care assistant, and the qualified professional when completed, and include at a minimum:
(1) duties of the recipient, qualified professional, personal care assistant, and personal care assistance choice provider agency;
(2) salary and benefits for the personal care assistant and the qualified professional;
(3) administrative fee of the personal care assistance choice provider agency and services paid for with that fee, including background study fees;
(4) grievance procedures to respond to complaints;
(5) procedures for hiring and terminating the personal care assistant; and
(6) documentation requirements including, but not limited to, time sheets, activity records, and the personal care assistance care plan.
(b) Effective January 1, 2010, except for the administrative fee of the personal care assistance choice provider agency as reported on the written agreement, the remainder of the rates paid to the personal care assistance choice provider agency must be used to pay for the salary and benefits for the personal care assistant or the qualified professional. The provider agency must use 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.
(c) The commissioner shall deny, revoke, or suspend the authorization to use the personal care assistance choice option if:
(1) it has been determined by the qualified professional or public health nurse that the use of this option jeopardizes the recipient's health and safety;
(2) the parties have failed to comply with the written agreement specified in this subdivision;
(3) the use of the option has led to abusive or fraudulent billing for personal care assistance services; or
(4) the department terminates the personal care assistance choice option.
(d) The recipient or responsible party may appeal the commissioner's decision in paragraph (c) according to section 256.045. The denial, revocation, or suspension to use the personal care assistance choice option must not affect the recipient's authorized level of personal care assistance services.
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 for each business location providing services. 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 for each business location providing service;
(4) proof of workers' compensation insurance coverage identifying the business location where personal care assistance services are provided;
(5) proof of liability insurance coverage identifying the business location where personal care assistance services are provided and naming the department as a certificate holder;
(6) 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;
(7) 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;
(8) a list of all training and classes that the personal care assistance provider agency requires of its staff providing personal care assistance services;
(9) documentation that the personal care assistance provider agency and staff have successfully completed all the training required by this section, including the requirements under subdivision 11, paragraph (d), if enhanced personal care assistance services are provided and submitted for an enhanced rate under subdivision 17a;
(10) documentation of the agency's marketing practices;
(11) disclosure of ownership, leasing, or management of all residential properties that is used or could be used for providing home care services;
(12) 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
(13) 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 submitting an application for enrollment of the agency as a provider. All personal care assistance provider agencies shall also require qualified professionals to complete the training required by subdivision 13 before submitting an application for 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.
(d) All surety bonds, fidelity bonds, workers' compensation insurance, and liability insurance required by this subdivision must be maintained continuously. After initial enrollment, a provider must submit proof of bonds and required coverages at any time at the request of the commissioner. Services provided while there are lapses in coverage are not eligible for payment. Lapses in coverage may result in sanctions, including termination. The commissioner shall send instructions and a due date to submit the requested information to the personal care assistance provider agency.
No active language found for: 256B.0659.22
Subd. 23.
Enrollment requirements following termination.
(a) A terminated personal care assistance provider agency, including all named individuals on the current enrollment disclosure form and known or discovered affiliates of the personal care assistance provider agency, is not eligible to enroll as a personal care assistance provider agency for two years following the termination.
(b) After the two-year period in paragraph (a), if the provider seeks to reenroll as a personal care assistance provider agency, the personal care assistance provider agency must be placed on a one-year probation period, beginning after completion of the following:
(1) the department's provider trainings under this section; and
(2) initial enrollment requirements under subdivision 21.
(c) During the probationary period the commissioner shall complete site visits and request submission of documentation to review compliance with program policy.
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) 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;
(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 commissioner;
(15) comply with the labor market reporting requirements described in section 256B.4912, subdivision 1a; and
(16) 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).
Subd. 25.
Personal care assistance provider agency; background studies.
Personal care assistance provider agencies enrolled to provide personal care assistance services under the medical assistance program shall comply with the following:
(1) owners who have a five percent interest or more and all managing employees are subject to a background study as provided in chapter 245C. This applies to currently enrolled personal care assistance provider agencies and those agencies seeking enrollment as a personal care assistance provider agency. "Managing employee" has the same meaning as Code of Federal Regulations, title 42, section 455. An organization is barred from enrollment if:
(i) the organization has not initiated background studies on owners and managing employees; or
(ii) the organization has initiated background studies on owners and managing employees, but the commissioner has sent the organization a notice that an owner or managing employee of the organization has been disqualified under section 245C.14, and the owner or managing employee has not received a set aside of the disqualification under section 245C.22;
(2) a background study must be initiated and completed for all qualified professionals; and
(3) a background study must be initiated and completed for all personal care assistants.
Subd. 26.
Personal care assistance provider agency; communicable disease prevention.
A personal care assistance provider agency shall establish and implement policies and procedures for prevention, control, and investigation of infections and communicable diseases according to current nationally recognized infection control practices or guidelines established by the United States Centers for Disease Control and Prevention, as well as applicable regulations of other federal or state agencies.
Subd. 27.
Personal care assistance provider agency.
(a) The personal care assistance provider agency is required to provide training for the personal care assistant responsible for working with a recipient who is ventilator dependent. All training must be administered by a respiratory therapist, nurse, or physician. Qualified professional supervision by a nurse must be completed and documented on file in the personal care assistant's employment record and the recipient's health record. If offering personal care services to a ventilator-dependent recipient, the personal care assistance provider agency shall demonstrate and document the ability to:
(1) train the personal care assistant;
(2) supervise the personal care assistant in the care of a ventilator-dependent recipient;
(3) supervise the recipient and responsible party in the care of a ventilator-dependent recipient; and
(4) provide documentation of the training and supervision in clauses (1) to (3) upon request.
(b) A personal care assistant shall not undertake any clinical services, patient assessment, patient evaluation, or clinical education regarding the ventilator or the patient on the ventilator. These services may only be provided by health care professionals licensed or registered in this state.
(c) A personal care assistant may only perform tasks associated with ventilator maintenance that are approved by the Board of Medical Practice in consultation with the Respiratory Care Practitioner Advisory Council and the Department of Human Services.
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 competence, including verification of the completion of training required under subdivision 11, paragraph (d), if personal care assistance services eligible for the enhanced rate are provided and submitted for reimbursement under subdivision 17a;
(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.
Subd. 29.
Transitional assistance.
The commissioner, counties, health plans, tribes, and personal care assistance providers shall work together to provide transitional assistance for recipients and families to come into compliance with the new requirements of this section that may require a change in living arrangement no later than August 10, 2010.
Subd. 30.
Notice of service changes to recipients.
The commissioner must provide:
(1) by October 31, 2009, information to recipients likely to be affected that (i) describes the changes to the personal care assistance program that may result in the loss of access to personal care assistance services, and (ii) includes resources to obtain further information; and
(2) a service agreement authorizing personal care assistance hours of service at the previously authorized level, throughout the appeal process period, when a recipient requests services pending an appeal.
Subd. 31.
Commissioner's access.
When the commissioner is investigating a possible overpayment of Medicaid funds, the commissioner must be given immediate access without prior notice to the 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 immediate suspension of payment and/or terminating the personal care provider organization's enrollment according to section 256B.064.
256B.0752 HEALTH CARE HOME REPORTING REQUIREMENTS.
Subdivision 1.
Annual reports on implementation and administration.
The commissioners shall report annually to the legislature on the implementation and administration of the health care home model for state health care program enrollees in the fee-for-service, managed care, and county-based purchasing sectors beginning December 15, 2009, and each December 15 thereafter.
Subd. 2.
Evaluation reports.
The commissioners shall provide to the legislature comprehensive evaluations of the health care home model three years and five years after implementation. The report must include:
(1) the number of state health care program enrollees in health care homes and the number and characteristics of enrollees with complex or chronic conditions, identified by income, race, ethnicity, and language;
(2) the number and geographic distribution of health care home providers;
(3) the performance and quality of care of health care homes;
(4) measures of preventive care;
(5) health care home payment arrangements, and costs related to implementation and payment of care coordination fees;
(6) the estimated impact of health care homes on health disparities; and
(7) estimated savings from implementation of the health care home model for the fee-for-service, managed care, and county-based purchasing sectors.
256B.79 INTEGRATED CARE FOR HIGH-RISK PREGNANT WOMEN.
No active language found for: 256B.79.7
256I.05 MONTHLY RATES.
No active language found for: 256I.05.3
256J.751 COUNTY PERFORMANCE MANAGEMENT.
Subdivision 1.
Monthly county caseload report.
The commissioner shall report monthly to each county the following caseload information:
(1) total number of cases receiving MFIP, and subtotals of cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent;
(2) total number of child only assistance cases;
(3) total number of eligible adults and children receiving an MFIP grant, and subtotals for cases with one eligible parent, two eligible parents, an eligible caregiver who is not a parent, and child only cases;
(4) number of cases with an exemption from the 60-month time limit based on a family violence waiver;
(5) number of MFIP cases with work hours, and subtotals for cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent;
(6) number of employed MFIP cases, and subtotals for cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent;
(7) average monthly gross earnings, and averages for subgroups of cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent;
(8) number of employed cases receiving only the food portion of assistance;
(9) number of parents or caregivers exempt from work activity requirements, with subtotals for each exemption type; and
(10) number of cases with a sanction, with subtotals by level of sanction for cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent.
256L.04 ELIGIBLE PERSONS.
Subd. 13.
Families with relative caretakers, foster parents, or legal guardians.
Beginning January 1, 1999, in families that include a relative caretaker as defined in the medical assistance program, foster parent, or legal guardian, the relative caretaker, foster parent, or legal guardian may apply as a family or may apply separately for the children. If the caretaker applies separately for the children, only the children's income is counted and the provisions of subdivision 1, paragraph (b), do not apply. If the relative caretaker, foster parent, or legal guardian applies with the children, their income is included in the gross family income for determining eligibility and premium amount.
256R.08 REPORTING OF FINANCIAL STATEMENTS.
Subd. 2.
Extensions.
The commissioner may grant up to a 15-day extension of the reporting deadline to a nursing facility for good cause. To receive such an extension, a nursing facility shall submit a written request by January 1. The commissioner shall notify the nursing facility of the decision by January 15. Between January 1 and February 1, the nursing facility may request a reporting extension for good cause by telephone and followed by a written request.
256R.49 RATE ADJUSTMENTS FOR COMPENSATION-RELATED COSTS FOR MINIMUM WAGE CHANGES.
Subdivision 1.
Rate adjustments for compensation-related costs.
(a) Rate increases provided under this section before October 1, 2016, expire effective January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective January 1, 2019.
(b) Nursing facilities that receive approval of the applications in subdivision 2 must receive rate adjustments according to subdivision 4. The rate adjustments must be used to pay compensation costs for nursing facility employees paid less than $14 per hour.
Subd. 2.
Application process.
To receive a rate adjustment, nursing facilities must submit applications to the commissioner in a form and manner determined by the commissioner. The applications for the rate adjustments shall include specified data, and spending plans that describe how the funds from the rate adjustments will be allocated for compensation to employees paid less than $14 per hour. The applications must be submitted within three months of the effective date of any operating payment rate adjustment under this section. The commissioner may request any additional information needed to determine the rate adjustment within three weeks of receiving a complete application. The nursing facility must provide any additional information requested by the commissioner within six months of the effective date of any operating payment rate adjustment under this section. The commissioner may waive the deadlines in this section under extraordinary circumstances.
Subd. 3.
Additional application requirements for facilities with employees represented by an exclusive bargaining representative.
For nursing facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the applications submitted under subdivision 2 only upon receipt of a letter or letters of acceptance of the spending plans in regard to members of the bargaining unit, signed by the exclusive bargaining agent and dated after May 31, 2014. Upon receipt of the letter or letters of acceptance, the commissioner shall deem all requirements of this section as having been met in regard to the members of the bargaining unit.
Subd. 4.
Determination of the rate adjustments for compensation-related costs.
Based on the application in subdivision 2, the commissioner shall calculate the allowable annualized compensation costs by adding the totals of clauses (1), (2), and (3). The result must be divided by the standardized or resident days from the most recently available cost report to determine per day amounts, which must be included in the operating portion of the total payment rate and allocated to direct care or other operating as determined by the commissioner:
(1) the sum of the difference between $9.50 and any hourly wage rate less than $9.50 for October 1, 2016; and between the indexed value of the minimum wage, as defined in section 177.24, subdivision 1, paragraph (f), and any hourly wage less than that indexed value for rate years beginning on and after October 1, 2017; multiplied by the number of compensated hours at that wage rate;
(2) using wages and hours in effect during the first three months of calendar year 2014, beginning with the first pay period beginning on or after January 1, 2014; 22.2 percent of the sum of items (i) to (viii) for October 1, 2016;
(i) for all compensated hours from $8 to $8.49 per hour, the number of compensated hours is multiplied by $0.13;
(ii) for all compensated hours from $8.50 to $8.99 per hour, the number of compensated hours is multiplied by $0.25;
(iii) for all compensated hours from $9 to $9.49 per hour, the number of compensated hours is multiplied by $0.38;
(iv) for all compensated hours from $9.50 to $10.49 per hour, the number of compensated hours is multiplied by $0.50;
(v) for all compensated hours from $10.50 to $10.99 per hour, the number of compensated hours is multiplied by $0.40;
(vi) for all compensated hours from $11 to $11.49 per hour, the number of compensated hours is multiplied by $0.30;
(vii) for all compensated hours from $11.50 to $11.99 per hour, the number of compensated hours is multiplied by $0.20; and
(viii) for all compensated hours from $12 to $13 per hour, the number of compensated hours is multiplied by $0.10; and
(3) the sum of the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, pensions, and contributions to employee retirement accounts attributable to the amounts in clauses (1) and (2).