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Minnesota Legislature

Office of the Revisor of Statutes

SF 2751

1st Engrossment - 89th Legislature (2015 - 2016) Posted on 04/07/2016 09:43am

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

Current Version - 1st Engrossment

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A bill for an act
relating to human services; modifying certain provisions governing autism
early intensive intervention benefit; amending Minnesota Statutes 2014, section
256B.0949.

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

Section 1.

Minnesota Statutes 2014, section 256B.0949, is amended to read:


256B.0949 deleted text beginAUTISMdeleted text end EARLY INTENSIVE new text beginDEVELOPMENTAL AND
BEHAVIORAL
new text endINTERVENTION BENEFIT.

Subdivision 1.

Purpose.

This section creates deleted text begina newdeleted text endnew text begin the early intensive
developmental and behavioral intervention (EIDBI)
new text end benefit to provide early intensive
intervention to a child with an autism spectrum disorder diagnosisnew text begin or related conditionnew text end.
This benefit must provide coverage for deleted text begindiagnosisdeleted text endnew text begin a comprehensivenew text end, multidisciplinary
assessment, ongoing progress evaluation, and medically necessary new text beginearly intensive
new text endtreatment of autism spectrum disordernew text begin or related conditionsnew text end.

Subd. 2.

Definitions.

(a) For the purposes of this section, the terms defined in
this subdivision have the meanings given.

new text begin (b) "Agency" means the legal entity that is enrolled with Minnesota health care
programs as a medical assistance provider according to Minnesota Rules, part 9505.0195,
to provide EIDBI and that has the legal responsibility to ensure that its employees or
contractors carry out the responsibilities defined in this section. The definition of "agency"
includes licensed individual professionals who practice independently and act as an agency.
new text end

deleted text begin (b)deleted text end new text begin(c) new text end"Autism spectrum disorder deleted text begindiagnosisdeleted text end" deleted text beginis defined by diagnostic code 299deleted text endnew text begin or
"ASD" has the meaning given
new text end in deleted text beginthe current version ofdeleted text end the Diagnostic and Statistical
Manual of Mental Disorders (DSM).

new text begin (d) "ASD and related conditions" means a condition that is found to be closely
related to autism spectrum disorder and may include but is not limited to autism,
Asperger's syndrome, pervasive developmental disorder-not otherwise specified, fetal
alcohol spectrum disorder, Rhett's syndrome, and autism-related diagnosis as identified
under the current version of the DSM and meets all of the following criteria:
new text end

new text begin (1) is severe and chronic;
new text end

new text begin (2) results in impairment of adaptive behavior and function similar to that of persons
with ASD;
new text end

new text begin (3) requires treatment or services similar to those required for persons with ASD;
new text end

new text begin (4) results in substantial functional limitations in three core developmental deficits
of ASD: social interaction; nonverbal or social communication; and restrictive, repetitive
behaviors or hyperreactivity or hyporeactivity to sensory input; and may include deficits
in one or more of the following related developmental domains:
new text end

new text begin (i) self-regulation;
new text end

new text begin (ii) self-care;
new text end

new text begin (iii) behavioral challenges;
new text end

new text begin (iv) expressive communication;
new text end

new text begin (v) receptive communication;
new text end

new text begin (vi) cognitive functioning;
new text end

new text begin (vii) safety; and
new text end

new text begin (viii) level of support needed; and
new text end

new text begin (5) is not attributable to mental illness as defined in section 245.462, subdivision 20,
or an emotional disturbance as defined in section 245.4871, subdivision 15. For purposes
of this section, notwithstanding section 245.462, subdivision 20, or 245.4871, subdivision
15, mental illness does not include autism or other pervasive developmental disorders.
new text end

deleted text begin (c)deleted text endnew text begin (e)new text end "Child" means a person deleted text beginunder the age of 18deleted text endnew text begin 20 years of age or youngernew text end.

new text begin (f) "Clinical supervision" means the overall responsibility for the control and
direction of EIDBI service delivery, including individual treatment planning, staff
supervision, progress monitoring, and treatment review for each client. Clinical
supervision is provided by a QSP who takes full professional responsibility for the
services provided by each of the supervisees. All EIDBI services must be billed by and
either provided by or under the clinical supervision of a QSP.
new text end

deleted text begin (d)deleted text endnew text begin (g)new text end "Commissioner" means the commissioner of human services, unless
otherwise specified.

new text begin (h) "Comprehensive multidisciplinary evaluation" or "CMDE" means a
comprehensive evaluation of a child's developmental status to determine medical necessity
for EIDBI based on the requirements in section 256B.0949, subdivision 5.
new text end

deleted text begin (e)deleted text endnew text begin (i)new text end "Early intensivenew text begin developmental and behavioralnew text end intervention benefit" new text beginor
"EIDBI"
new text endmeans deleted text beginautism treatment optionsdeleted text endnew text begin intensive interventionsnew text end based in behavioral and
developmental sciencedeleted text begin, which may include modalities such as applied behavior analysis,
developmental treatment approaches, and naturalistic and parent training models
deleted text endnew text begin that
include the services covered under subdivision 11
new text end.

deleted text begin (f)deleted text endnew text begin (j)new text end "Generalizable goals" means results or gains that are observed during a variety
of activitiesnew text begin over timenew text end with different people, such as providers, family members, other
adults, and children, and in different environments including, but not limited to, clinics,
homes, schools, and the community.

new text begin (k) "Individual treatment plan" or "ITP" means the person-centered, individualized
written plan of care that integrates and coordinates child and family information from the
comprehensive multidisciplinary evaluation for a child who meets medical necessity for
the early intensive developmental and behavioral intervention benefit. An individual
treatment plan must meet the standards in section 256B.0949, subdivision 6.
new text end

new text begin (l) "Legal representative" means the parent of a person who is under 18 years of age,
a court-appointed guardian, or other representative with legal authority to make decisions
about services for a person. 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.
new text end

new text begin (m) "Level I treatment provider" means a person who meets the EIDBI provider
qualifications under subdivision 16, paragraph (a).
new text end

new text begin (n) "Level II treatment provider" means a person who meets the EIDBI provider
qualifications under subdivision 16, paragraph (b).
new text end

new text begin (o) "Level III treatment provider" means a person who meets the EIDBI provider
qualifications under subdivision 16, paragraph (c).
new text end

deleted text begin (g)deleted text endnew text begin (p)new text end "Mental health professional" has the meaning given in section 245.4871,
subdivision 27, clauses (1) to (6).

new text begin (q) "Person-centered" means services that respond to the identified needs, interests,
values, preferences, and desired outcomes of the child and the child's legal representative.
Person-centered planning identifies what is important to the child and the child's legal
representative, respects each child's history, dignity, and cultural background, and allows
inclusion and participation in the child's community.
new text end

new text begin (r) "Qualified CMDE provider" means a person meeting the CMDE provider
qualification requirements under subdivision 5a.
new text end

new text begin (s) "Qualified EIDBI professional" means a person who is a QSP or a level I, level
II, or level III treatment provider.
new text end

new text begin (t) "Qualified supervising professional" or "QSP" means a person who meets the
EIDBI provider qualifications under subdivision 16, paragraph (d).
new text end

Subd. 3.

deleted text beginInitialdeleted text endnew text begin EIDBInew text end eligibility.

This benefit is available to a child enrolled in
medical assistance who:

(1) has deleted text beginan autism spectrum disorderdeleted text end new text begina new text enddiagnosisnew text begin of ASD or a related condition that
meets the criteria of subdivision 4
new text end;

(2) deleted text beginhas had a diagnostic assessment described in subdivision 5, which recommends
early intensive intervention services
deleted text endnew text begin is medically stablenew text end; deleted text beginand
deleted text end

(3) deleted text beginmeets the criteria for medically necessary autism early intensive intervention
services.
deleted text endnew text begin does not need 24-hour medical or nursing monitoring or procedures; and
new text end

new text begin (4) received a comprehensive multidisciplinary evaluation as described in
subdivision 5 that recommends EIDBI services based on medical necessity criteria
published by the commissioner.
new text end

new text begin Subd. 3a. new text end

new text begin Culturally and linguistically appropriate requirement. new text end

new text begin The child's
and family's primary spoken language, culture, preferences, goals, and values must
be reflected throughout the process of diagnosis, CMDE, ITP development, progress
monitoring, family or caregiver training and counseling services, and coordination of
care. The qualified CMDE provider and QSP must determine the most effective way to
adapt the evaluation, treatment recommendations, and ITP to the culture, language, and
values of the child and family. A language interpreter who is fluent in both languages,
with training or knowledge of related diagnostic and medical treatment terminology,
must be provided when the child or child's legal representative is not able to speak, read,
write, or understand the English language at a level that allows the child or child's legal
representative to interact with the CMDE provider, QSP, or a level I, level II, or level
III treatment provider. The language interpreter must be fluent in both languages, with
training or knowledge of related diagnostic and medical treatment terminology.
new text end

Subd. 4.

Diagnosis.

(a) A diagnosisnew text begin of ASD or a related condition new text end must:

(1) be based upon current DSM criteria including direct observations of the child and
deleted text beginreportsdeleted text endnew text begin informationnew text end from deleted text beginparentsdeleted text endnew text begin the child's legal representative new text end or primary caregivers; deleted text beginand
deleted text end

(2) be completed by either (i) a licensed physician or advanced practice registered
nurse or (ii) a mental health professionalnew text begin; and
new text end

new text begin (3) meet the requirements of Minnesota Rules, part 9505.0372, subpart 1, items
B and C
new text end.

(b) Additional deleted text begindiagnosticdeleted text end assessment information may be considered new text begin to complete
a diagnostic assessment
new text endincluding deleted text beginfromdeleted text endnew text begin specialized tests administered through new text endspecial
education evaluations and licensed school personnel, and from professionals licensed
in the fields of medicine, speech and language, psychology, occupational therapy, and
physical therapy.new text begin A diagnostic assessment may include treatment recommendations.
new text end

Subd. 5.

deleted text beginDiagnostic assessmentdeleted text endnew text begin Comprehensive multidisciplinary evaluation
(CMDE)
new text end.

deleted text begin The following information and assessments must be performed, reviewed, and
relied upon for the eligibility determination, treatment and services recommendations, and
treatment plan development for the child:
deleted text end

deleted text begin (1) an assessment of the child's developmental skills, functional behavior, needs, and
capacities based on direct observation of the child which must be administered by a licensed
mental health professional, must include medical or assessment information from the
child's physician or advanced practice registered nurse, and may also include observations
from family members, school personnel, child care providers, or other caregivers, as
well as any medical or assessment information from other licensed professionals such as
rehabilitation therapists, licensed school personnel, or mental health professionals; and
deleted text end

deleted text begin (2) an assessment of parental or caregiver capacity to participate in therapy including
the type and level of parental or caregiver involvement and training recommended.
deleted text end

new text begin (a) A CMDE must be completed to determine medical necessity of EIDBI services.
The CMDE must be administered by a qualified CMDE provider. Nothing prohibits a
child or the child's legal representative from requesting an independent qualified CMDE
provider of their choice. An agency shall not require a child to receive a CMDE from a
particular qualified CMDE provider. The CMDE must include and document information
from medical and mental health professionals.
new text end

new text begin (b) The CMDE must include and document the following:
new text end

new text begin (1) information from a diagnostic assessment that meets the requirements under
subdivision 4;
new text end

new text begin (2) information gathered from family members and primary child care providers;
new text end

new text begin (3) a face-to-face assessment of the child's degree of severity of core features of
ASD and related conditions, as well as other areas of functional development, including
cognition, learning and play, social or interpersonal interaction, verbal and nonverbal
communication, self-care, behavioral challenges and self-regulation, safety, and level
of support needed;
new text end

new text begin (4) a review and consideration of diagnostic and other related assessment
information from other qualified or licensed health care or other professionals working
with the child, including medical and pharmacological information from a licensed
physician or advanced practice nurse; the child's rehabilitation therapists; licensed school
personnel; and other mental health professionals;
new text end

new text begin (5) referrals to other needed clinical, medical, educational, rehabilitation, or social
services;
new text end

new text begin (6) the child's legal representative or caregiver preferences for involvement in
the child's treatment that is culturally and linguistically appropriate as required under
subdivision 3a;
new text end

new text begin (7) a discussion with the child's legal representative and family of the options and
recommendations for the type and level of the child's legal representative or caregiver
training and preferred involvement in the child's treatment;
new text end

new text begin (8) a discussion with the child and the child's legal representative of the
recommendations for EIDBI medical necessity, including recommendations for a
minimum and maximum range of suggested EIDBI treatment intensity;
new text end

new text begin (9) a discussion with the child and the child's legal representative of all EIDBI
treatment modalities recognized by the Department of Human Services available at the
time of the CMDE, including differences in how the treatment modalities are implemented;
new text end

new text begin (10) a summary of information provided to the child's legal representative in a
manner by which they can understand the results and recommendations of the CMDE and
can make informed decisions about treatment options. The provision of information may
include a coordinated conference, as requested by the child's legal representative;
new text end

new text begin (11) a determination regarding how frequently to monitor the child's progress if
monitoring is required more frequently than every six months; and
new text end

new text begin (12) a determination of the most effective way to adapt the recommendations of
the CMDE to the culture, language, and values of the family irrespective of whence
the child and family.
new text end

new text begin (c) The CMDE must be updated after each 12 months of treatment, or more
frequently as determined by a qualified CMDE provider. The CMDE update must:
new text end

new text begin (1) consider the agency's progress evaluation results and make a determination of
the child's progress toward achieving generalizable and functional goals contained in
the treatment plan;
new text end

new text begin (2) identify any significant changes in the child's condition or family circumstances;
new text end

new text begin (3) document and provide rationale for any recommended changes in EIDBI services,
including the need for continuation or discontinuation of medically necessary EIDBI; and
new text end

new text begin (4) be submitted to the commissioner in a manner determined by the commissioner
for the authorization of EIDBI services.
new text end

new text begin Subd. 5a. new text end

new text begin CMDE provider qualification requirements. new text end

new text begin A qualified CMDE
provider must:
new text end

new text begin (1) be a licensed physician or advanced practice registered nurse or a mental health
professional or a mental health practitioner who meets the requirements of a clinical
trainee as defined in Minnesota Rules, part 9505.0371, subpart 5, item C;
new text end

new text begin (2) have at least 2,000 hours of clinical experience in the evaluation and treatment
of children with ASD or equivalent documented coursework at the graduate level by an
accredited university in the following content areas: ASD diagnosis, ASD treatment
strategies, and child development;
new text end

new text begin (3) be able to diagnose, evaluate, or provide treatment within the provider's scope
of practice and professional license; and
new text end

new text begin (4) have knowledge and provide information about the range of current EIDBI
treatment modalities recognized by the commissioner.
new text end

Subd. 6.

new text beginIndividual new text endtreatment plannew text begin (ITP)new text end.

(a) new text beginThe qualified EIDBI professional,
except a level III treatment provider, who integrates and coordinates child and family
information from the CMDE and progress-monitoring process to develop the ITP must
develop and monitor the ITP.
new text end

new text begin (b) The ITP must be individualized, person-centered, and culturally and linguistically
appropriate, as required under subdivision 3a. The ITP must specify the medically
necessary treatment and services, including baseline data, primary goals and target
objectives, progress-monitoring results and goal mastery data, and any significant changes
in the child's condition or family circumstances.
new text endEach child's deleted text begintreatment plandeleted text endnew text begin ITPnew text end must bedeleted text begin:
deleted text end

deleted text begin (1)deleted text end based on the diagnostic assessment new text beginand CMDE summary new text endinformation specified
in subdivisions 4 and 5deleted text begin;
deleted text end

deleted text begin (2) coordinated with medically necessary occupational, physical, and speech and
language therapies, special education, and other services the child and family are receiving;
deleted text end

deleted text begin (3) family-centered;
deleted text end

deleted text begin (4) culturally sensitive; and
deleted text end

deleted text begin (5) individualized based on the child's developmental status and the child's and
family's identified needs
deleted text end.

deleted text begin (b)deleted text endnew text begin (c)new text end The deleted text begintreatment plandeleted text endnew text begin ITPnew text end must specify thenew text begin primary treatment goals and target
objectives, including baseline measures and projected dates of accomplishment. The
ITP must include
new text end:

deleted text begin (1) child's goals which are developmentally appropriate, functional, and
generalizable;
deleted text end

deleted text begin (2) treatment modality;
deleted text end

deleted text begin (3) treatment intensity;
deleted text end

deleted text begin (4) setting; and
deleted text end

deleted text begin (5) level and type of parental or caregiver involvement.
deleted text end

new text begin (1) the treatment method to meet the goals and objectives, including:
new text end

new text begin (i) frequency, intensity, location, and duration of each service provided;
new text end

new text begin (ii) level of parent or caregiver training and counseling;
new text end

new text begin (iii) any changes or modifications to the physical and social environments necessary
when the services are provided;
new text end

new text begin (iv) any specialized equipment and materials required;
new text end

new text begin (v) techniques that support and are consistent with the child's communication mode
and learning style; and
new text end

new text begin (vi) names of staff with overall responsibility for supervising staff and implementing
the service or services;
new text end

new text begin (2) the discharge criteria that shall be used and a defined transition plan to assist
the child and the child's legal representative to transition to other services. The transition
plan shall include:
new text end

new text begin (i) protocols for changing service when medically necessary;
new text end

new text begin (ii) how the transition will occur;
new text end

new text begin (iii) the time allowed to make the transition. Up to 30 days of continued service
is allowed while the transition plan is being developed. Services during this plan
development period shall be consistent with the ITP. The plan development period begins
when the child or the child's legal representative receives notice of termination of EIDBI
and ends when EIDBI is terminated; and
new text end

new text begin (iv) a description of how the parent or guardian will be informed of and involved in
the transition.
new text end

deleted text begin (c)deleted text endnew text begin (d) Implementation ofnew text end the deleted text begintreatmentdeleted text endnew text begin ITPnew text end must be supervised by a new text beginqualified
supervising
new text endprofessional deleted text beginwith expertise and training in autism and child development who
is a licensed physician, advanced practice registered nurse, or mental health professional
deleted text endnew text begin(QSP)new text end.

deleted text begin (d)deleted text endnew text begin (e)new text end The deleted text begintreatment plandeleted text endnew text begin ITPnew text end must be submitted to the commissioner for approval
in a manner determined by the commissioner for this purpose.

deleted text begin (e) Services authorized must be consistent with the child's approved treatment plan.
deleted text end

new text begin (f) new text endServices included in the deleted text begintreatment plandeleted text endnew text begin ITPnew text end must meet all applicable requirements
for medical necessity and coverage.

new text begin Subd. 6a. new text end

new text begin Coordination with other benefits. new text end

new text begin (a) Services provided under this
benefit do not replace services provided in a child's individualized education plan. Each
child's ITP must document that EIDBI services supplement, but do not include or replace
special education and related services defined in the child's individualized education
plan when the service is available under the Individuals with Disabilities Education
Improvement Act of 2004 through a local education agency. Birth to three programs and
additional resources shall also coordinate with EIDBI services.
new text end

new text begin (b) The commissioner shall integrate medical authorization procedures for this
benefit with authorization procedures for other health and mental health services and
home and community-based services to ensure that the child receives services that are the
most appropriate and effective in meeting the child's needs.
new text end

Subd. 7.

deleted text beginOngoing eligibilitydeleted text endnew text begin Progress evaluation monitoringnew text end.

(a) deleted text beginAn independent
deleted text endnew text beginAnew text end progress evaluation deleted text beginconducted by a licensed mental health professional with expertise
and training in autism spectrum disorder and child development
deleted text end must be completed after
each six months of treatment, or more frequently as determined by the deleted text begincommissioner
deleted text endnew text beginqualified CMDE providernew text end, to determine if progress is being made toward deleted text beginachieving
deleted text endnew text begintargeted functional andnew text end generalizable goals deleted text beginand meeting functional goals contained
deleted text endnew text beginspecifiednew text end in the deleted text begintreatment plandeleted text endnew text begin ITPnew text end.new text begin Based on the results of progress monitoring and
evaluation, the ITP must be adjusted as needed and must document that the child continues
to meet medical necessity for EIDBI or is referred to other services.
new text end

(b) new text beginThe progress evaluation must be overseen and signed by the qualified supervising
professional.
new text endThe progress evaluation must include:

(1) the treating provider's report;

(2) deleted text beginparental or caregiverdeleted text end inputnew text begin from the child's caregiver or the child's legal
representative
new text end;

(3) an deleted text beginindependentdeleted text end observation of the child deleted text beginwhich can bedeleted text endnew text begin that is new text end performed by deleted text beginthe
child's
deleted text end new text begina QSP or a level I or level II treatment provider and may include observation
information from
new text endlicensed special education staffnew text begin or other licensed health care providersnew text end;

new text begin (4) documentation of current level of performance on primary treatment goal
domains including when goals and objectives are achieved, changed, or discontinued;
new text end

new text begin (5) any significant changes in the child's condition or family circumstances;
new text end

deleted text begin (4)deleted text end new text begin(6) new text endany treatment plan modificationsnew text begin and the rationale for any changes made
including treatment modality, intensity, frequency, and duration
new text end; and

deleted text begin (5)deleted text end new text begin(7) new text endrecommendations for continued treatment deleted text beginservicesdeleted text end.

(c) Progress evaluations must be submitted to the commissioner in a manner
determined by the commissioner for deleted text beginthis purposedeleted text endnew text begin the reauthorization of EIDBI servicesnew text end.

(d) A child who continues to deleted text beginachieve generalizable goals anddeleted text endnew text begin make reasonable
progress toward
new text end treatment goals as specified in the deleted text begintreatment plandeleted text endnew text begin ITPnew text end is eligible to
continue receiving deleted text beginthis benefitdeleted text endnew text begin EIDBI servicesnew text end.

(e) A child's treatment shall continue during the progress evaluation using the
process determined under deleted text beginsubdivision 8, clause (8)deleted text endnew text begin this subdivisionnew text end. Treatment may
continue during an appeal pursuant to section 256.045.

Subd. 8.

Refining the benefit with stakeholders.

The commissioner must deleted text begindevelop
the implementation
deleted text endnew text begin refine thenew text end details of the benefit in consultation with stakeholders and
consider recommendations from deleted text beginthe Health Services Advisory Council,deleted text end the Department
of Human Services deleted text beginAutism Spectrum Disorderdeleted text endnew text begin Early Intensive Developmental and
Behavioral Intervention Benefit
new text end Advisory Council, deleted text beginthe Legislative Autism Spectrum
Disorder Task Force,
deleted text end new text beginthe EIDBI learning collaborative, new text endand the new text beginASD new text endInteragency Task
Force of the Departments of Health, Education,new text begin Employment and Economic Development,
new text endand Human Services. deleted text beginThe commissioner must release these details for a 30-day public
comment period prior to submission to the federal government for approval.
deleted text end The
deleted text beginimplementationdeleted text end details must include, but are not limited to, the following components:

(1) a definition of the qualifications, standards, and roles of the treatment team,
including recommendations after stakeholder consultation on whether board-certified
behavior analysts and other deleted text begintypes ofdeleted text end professionalsnew text begin certified in other treatment approaches
recognized by the Department of Human Services or
new text end trained in autism spectrum disorder
and child development should be added as deleted text beginmental health or otherdeleted text end professionals deleted text beginfordeleted text endnew text begin qualified
to provide EIDBI
new text end treatment supervision or other functions under medical assistance;

(2) deleted text begindevelopment of initial,deleted text end new text beginrefinement of new text enduniform parameters for comprehensive
multidisciplinary deleted text begindiagnostic assessment informationdeleted text endnew text begin evaluationnew text end and deleted text beginprogress evaluation
deleted text endnew text beginongoing progress-monitoringnew text end standards;

(3) the design of an effective and consistent process for assessing deleted text beginparentdeleted text endnew text begin the child's
legal representative's
new text end and deleted text begincaregiver capacitydeleted text endnew text begin caregiver's preferences and optionsnew text end to
participate in the child's early intervention treatment and new text beginefficacy of new text endmethods deleted text beginof involving
the parents
deleted text end new text begin to involve and educate the child's legal representative new text endand caregivers in the
treatment of the child;

(4) formulation of a collaborative process in which professionals have
opportunities to collectively informnew text begin provider standards and qualifications; standards for new text enda
comprehensivedeleted text begin,deleted text end multidisciplinary deleted text begindiagnostic assessmentdeleted text end new text beginevaluation; medical necessity
determination; efficacy of treatment apparatus, including modality, intensity, frequency,
and duration;
new text endand deleted text beginprogress evaluationdeleted text endnew text begin progress-monitoringnew text end processes deleted text beginand standardsdeleted text end to
support quality improvement of deleted text beginearly intensive interventiondeleted text end new text beginEIDBI new text endservices;

(5) coordination of this benefit and its interaction with other services provided by
the Departments of Human Services, Health,new text begin Employment and Economic Development,
new text endand Education;

(6) evaluation, on an ongoing basis, of deleted text beginresearch regarding thedeleted text end programnew text begin EIDBI
outcomes
new text end and new text beginefficacy of new text endtreatment deleted text beginmodalitiesdeleted text endnew text begin methodsnew text end provided to children under this
benefit;new text begin and
new text end

(7) determination of the availability of deleted text beginlicensed physicians, nurse practitioners,
and mental health professionals
deleted text endnew text begin qualified EIDBI providersnew text end with new text beginnecessary new text endexpertise and
training in autism spectrum disorder new text beginand related conditions new text endthroughout the state to assess
whether there are sufficient professionals deleted text beginto require involvement of both a physician or
nurse practitioner and a mental health professional
deleted text end to provide new text begintimely new text endaccess and prevent
delay in the deleted text begindiagnosis anddeleted text end new text begin CMDE and new text endtreatment of deleted text beginyoung children, so as to implement
subdivision 4, and to ensure treatment is effective, timely, and accessible; and
deleted text endnew text begin ASD and
related conditions.
new text end

deleted text begin (8) development of the process for the progress evaluation that will be used to
determine the ongoing eligibility, including necessary documentation, timelines, and
responsibilities of all parties.
deleted text end

Subd. 9.

Revision of treatment options.

(a) The commissioner may revise covered
treatment options as needed based on outcome data and other evidence.new text begin EIDBI treatment
methods approved by the Department of Human Services must:
new text end

new text begin (1) cause no harm to the individual child or family;
new text end

new text begin (2) be provided in an individualized manner to meet the varied needs of each child
and family;
new text end

new text begin (3) be developmentally appropriate and highly structured, with well-defined goals
and objectives that provide a strategic direction for treatment;
new text end

new text begin (4) be regularly evaluated and adjusted as needed;
new text end

new text begin (5) be based in recognized principles of developmental and behavioral science;
new text end

new text begin (6) utilize sound practices that are replicable across providers and maintain the
fidelity of the specific approach;
new text end

new text begin (7) demonstrate an evidentiary basis;
new text end

new text begin (8) have goals and objectives that are measurable, achievable, and regularly
evaluated to ensure that adequate progress is being made;
new text end

new text begin (9) be provided intensively with a high adult-to-child ratio;
new text end

new text begin (10) include active family participation in decision-making, knowledge and capacity
building, and developing and implementing the child's ITP; and
new text end

new text begin (11) be provided in a culturally and linguistically appropriate manner as required
under subdivision 3a.
new text end

(b) Before deleted text beginthe changesdeleted text endnew text begin revisions in Department of Human Services recognized
treatment modalities
new text end become effective, the commissioner must provide public notice of
the changes, the reasons for the change, and a 30-day public comment period to those
who request notice through an electronic list accessible to the public on the department's
Web site.

Subd. 10.

Coordination between agencies.

The commissioners of human services
and education must develop the capacity to coordinate services and information including
diagnostic, functional, developmental, medical, and educational assessments; service
delivery; and progress evaluations across health and education sectors.

Subd. 11.

Federal approval of the autism benefit.

(a) This section shall apply
to state plan services under title XIX of the Social Security Act when federal approval
is granted under a 1915(i) waiver or other authority which allows children eligible for
medical assistance through the TEFRA option under section 256B.055, subdivision 12, to
qualify and includes children eligible for medical assistance in families over 150 percent
of the federal poverty guidelines.

(b) The commissioner may use the federal authority for a Medicaid state plan
amendment under Early and Periodic Screening Diagnosis and Treatment (EPSDT),
United States Code, title 42, section 1396D(R)(5), or other Medicaid provision for any
aspect or type of treatment covered in this section if new federal guidance is helpful
in achieving one or more of the purposes of this section in a cost-effective manner.
Notwithstanding subdivisions 2 and 3, any treatment services submitted for federal
approval under EPSDT shall include appropriate medical criteria to qualify for the service
and shall cover children through age 20.

Subd. 12.

Autism benefit; training provided.

After approval of the autism early
intensive intervention benefit under this section by the Centers for Medicare and Medicaid
Services, the commissioner shall provide statewide training on the benefit for culturally
and linguistically diverse communities. Training for autism service providers on culturally
appropriate practices must be online, accessible, and available in multiple languages. The
training for families, lead agencies, advocates, and other interested parties must provide
information about the benefit and how to access it.

new text begin Subd. 13. new text end

new text begin Covered services. new text end

new text begin (a) The following services are eligible for
reimbursement by medical assistance under this section:
new text end

new text begin (1) EIDBI interventions. EIDBI interventions are a variety of individualized,
intensive treatment methods approved by the department that are based in behavioral
and developmental science consistent with best practices on effectiveness. Services
must address the participant's medically necessary treatment goals and be provided by
a qualified supervising professional or a level I, level II, or level III treatment provider.
Services are targeted to develop, enhance, or maintain the individual developmental skills
of a child with ASD and related conditions to improve functional communication, social
or interpersonal interaction, behavioral challenges and self-regulation, cognition, learning
and play, self-care, safety, and level of support needed;
new text end

new text begin (2) EIDBI intervention observation and direction. EIDBI intervention observation
and direction is the clinical direction and oversight by a QSP or a level I or level
II treatment provider regarding provision of EIDBI services to a child, including
developmental and behavioral techniques, progress measurement, data collection, function
of behaviors, and generalization of acquired skills for the direct benefit of a child. EIDBI
intervention observation and direction informs any modifications of the methods to
support the accomplishment of outcomes in the ITP. Observation and direction provides a
real-time response to EIDBI interventions to maximize the benefit to the child;
new text end

new text begin (3) CMDE. CMDE is a comprehensive evaluation of the child's developmental
status to determine medical necessity for EIDBI services and meets the requirements of
subdivision 5. The services must be provided by a qualified CMDE provider;
new text end

new text begin (4) ITP development and monitoring. ITP development and monitoring is
development of the initial, annual, and progress monitoring of ITPs. This service
documents, provides oversight and on-going evaluation of child treatment and progress
on targeted goals and objectives, and integrates and coordinates child and family
information from the CMDE and progress monitoring evaluations. The ITP must meet
the requirements of subdivision 6. Progress monitoring must meet the requirements of
subdivision 7. This service must be reviewed and completed by a QSP, and may include
input from a level I or level II treatment provider;
new text end

new text begin (5) Family caregiver training and counseling. Family caregiver training and
counseling is specialized training and education a family or primary caregiver receives
to understand their child's developmental status and help with their child's needs and
development. This service must be provided by a QSP or a level I or level II treatment
provider;
new text end

new text begin (6) Coordinated care conferences. A coordinated care conference is a face-to-face
meeting with the child and family to review the CMDE or progress monitoring results
and to coordinate and integrate services across providers and service-delivery systems to
develop the ITP. This service must be provided by a QSP and may include the CMDE
provider or the level I or level II treatment provider;
new text end

new text begin (7) Allowable travel time. Travel time is allowable billing for traveling to and from
the recipient's home, a community setting, or place of service outside of an EIDBI center,
clinic, or office from a specified location to provide face-to-face EIDBI intervention,
observation and direction, or family caregiver training and counseling. EIDBI recipients
must have an ITP specifying why the provider must travel to the recipient's home, a
community setting, or place of service outside of an EIDBI center, clinic, or office; and
new text end

new text begin (8) medically necessary EIDBI services and consultations delivered by a licensed
health care provider via telemedicine in the same manner as if the service or consultation
was delivered in person. Coverage is limited to three telemedicine services per enrollee
per calendar week.
new text end

new text begin (b) EIDBI interventions under paragraph (a), clause (1), include, but are not limited to:
new text end

new text begin (1) applied behavioral analysis (ABA);
new text end

new text begin (2) developmental individual-difference relationship-based model (DIR/Floortime);
new text end

new text begin (3) early start Denver model (ESDM);
new text end

new text begin (4) PLAY project; or
new text end

new text begin (5) relationship development intervention (RDI).
new text end

new text begin (c) A provider may use one or more of the treatment interventions in paragraph
(b) as the primary modality for treatment as a covered service, or several treatment
interventions in combination as the primary modality of treatment, as approved by the
commissioner. Additional treatment interventions may be used upon approval by the
commissioner. A provider that identifies and provides assurance of qualifications for a
single specific treatment modality must document the required qualifications to meet
fidelity to the specific model.
new text end

new text begin Subd. 14. new text end

new text begin Noncovered services. new text end

new text begin The following services are not eligible for medical
assistance payment as EIDBI under this section:
new text end

new text begin (1) service components of EIDBI simultaneously provided by more than one
provider entity unless prior authorization is obtained;
new text end

new text begin (2) provision of the same service by multiple providers within the same agency
at the same clock time;
new text end

new text begin (3) EIDBI provided in violation of medical assistance policy in Minnesota Rules,
part 9505.0220;
new text end

new text begin (4) service components of EIDBI that are the responsibility of a residential or
program license holder, including foster care providers under the terms of a service
agreement or administrative rules governing licensure;
new text end

new text begin (5) adjunctive activities that may be offered by a provider entity but are not
otherwise covered by medical assistance, including:
new text end

new text begin (i) a service that is primarily recreation oriented or that is provided in a setting that is
not medically supervised. This includes sports activities, exercise groups, activities such
as craft hours, leisure time, social hours, meal or snack time, trips to community activities,
and tours, unless the activities in this item are primarily treatment oriented and provided
pursuant to an ITP;
new text end

new text begin (ii) a social or educational service that does not have or cannot reasonably be
expected to have a therapeutic outcome related to the child's diagnosis; or
new text end

new text begin (iii) prevention or education programs provided to the community;
new text end

new text begin (6) a service that is not identified in the child's ITP;
new text end

new text begin (7) a service provided pursuant to an ITP that has not been approved or updated as
required by this section;
new text end

new text begin (8) a service not documented in the child's health service record or not documented
in the manner required by this chapter or by Minnesota Rules, part 9505.2175;
new text end

new text begin (9) a service provided by an individual who does not meet the qualifications to
render the service or by an individual for whom the provider does not have documentation
showing that the individual meets the required qualifications;
new text end

new text begin (10) a service that is primarily respite, custodial, day care, or educational;
new text end

new text begin (11) a service that replaces special education or related services defined in the child's
individualized education plan (IEP) or individual family service plan (IFSP) when the
service is available under the Individuals with Disabilities Education Improvement Act of
2004 through a local education agency;
new text end

new text begin (12) children's therapeutic services and supports reimbursed under section
256B.0943; or
new text end

new text begin (13) physical, speech, occupational therapies, or personal care assistance reimbursed
under section 256B.0625.
new text end

new text begin Subd. 15. new text end

new text begin Service recipient rights. new text end

new text begin (a) A child or the child's legal representative
has the right to:
new text end

new text begin (1) participate in the development, implementation, and evaluation of all aspects of
the child's and family's services;
new text end

new text begin (2) designate an advocate of the child's or the child's legal representative's choice to
be present in all aspects of the child's and family's services at the request of the child's
legal representative;
new text end

new text begin (3) know, in advance, the limits to services available from the provider to meet the
child's and family's service and support needs, including limits in the knowledge, skills,
and abilities of the agency;
new text end

new text begin (4) know the agency policy on assigning staff to individual children;
new text end

new text begin (5) know if the legal representative or another private party may have to pay for any
charges;
new text end

new text begin (6) know the charges for services before the child or family receives services and
receive advance notice if the charges change;
new text end

new text begin (7) know who shall pay for the services before services begin;
new text end

new text begin (8) know who is the qualified supervising professional with clinical responsibility
for the child's ITP;
new text end

new text begin (9) know who to contact within the agency if the child or the child's legal
representative has any concerns about the child's or family's services;
new text end

new text begin (10) receive a copy of the agency's admission criteria and policies and procedures
related to temporary service suspension and service termination;
new text end

new text begin (11) receive reasonable accommodations to observe the child while receiving
services;
new text end

new text begin (12) receive services from qualified and competent staff identified in the child's ITP;
new text end

new text begin (13) receive services in a manner that respects and takes into consideration the
child's and family's culture, values, religion, and preferences;
new text end

new text begin (14) receive reasonable accommodations for observance of cultural and ethnic
practices or religion;
new text end

new text begin (15) refuse or stop services and receive information about what might happen if the
child or the child's legal representative refuses or stops services;
new text end

new text begin (16) access the child's and family's records as defined in federal and state law,
regulation, or rule;
new text end

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

new text begin (18) be free from physical, verbal and sexual abuse, and neglect;
new text end

new text begin (19) be free from restraint, time out, or seclusion, except when in imminent danger
to self or others;
new text end

new text begin (20) be in the company of or under the supervision of a responsible adult at all
times and ensure the hand-to-hand or eye-to-eye exchange of responsibility, as needed,
from the staff member to the legal representative or adults designated by the child's legal
representative;
new text end

new text begin (21) be safe at all times;
new text end

new text begin (22) be treated with courtesy and respect;
new text end

new text begin (23) give or withhold written informed consent to participate in any research or
experimental treatment without penalty or retaliation;
new text end

new text begin (24) have personal, financial, service, health, and medical information kept private;
new text end

new text begin (25) know if the agency gives the child's or family's private information to any
other person or agency;
new text end

new text begin (26) assert all the rights in this subdivision without retaliation;
new text end

new text begin (27) receive respectful treatment of the child's or family's property;
new text end

new text begin (28) receive services in a clean and safe environment when the agency is the owner,
lessor, or tenant of the property;
new text end

new text begin (29) receive a copy of the provider's written grievance policies and procedures;
new text end

new text begin (30) receive information about how to file a complaint regarding the child's or
family's services, including how to file an appeal under section 256.045;
new text end

new text begin (31) receive contact information for disability advocacy services and the appropriate
state-appointed ombudsman including the name, telephone number, Web site, e-mail,
and street addresses;
new text end

new text begin (32) receive information about how to get a second opinion for medical necessity
recommendations for EIDBI services and the child's ITP;
new text end

new text begin (33) receive prompt and reasonable response to questions and requests related to
the child's or family's services;
new text end

new text begin (34) protect the recipient's personal privacy including, for children older than
preschool, and younger children based on individual needs, the right to privacy when
toileting and having personal cares performed; and
new text end

new text begin (35) receive notification from the agency within 24 hours if the child is injured while
receiving services, including what occurred and how agency staff responded to the injury.
new text end

new text begin Subd. 16. new text end

new text begin EIDBI provider qualifications. new text end

new text begin (a) A level I treatment provider must be
employed by an EIDBI agency and:
new text end

new text begin (1) have at least 2,000 hours of supervised clinical experience or training in
examining or treating children with ASD or equivalent documented coursework at the
graduate level by an accredited university in ASD diagnostics, ASD developmental
and behavioral treatment strategies, and typical child development or an equivalent
combination of documented coursework or hours of experience; and
new text end

new text begin (2) have at least one of the following:
new text end

new text begin (i) a master's degree in behavioral health or child development or allied fields,
including, but not limited to mental health, special education, social work, psychology,
speech pathology, or occupational therapy from an accredited college or university;
new text end

new text begin (ii) a bachelor's degree in a behavioral health or child development field from
an accredited college or university and advanced certification in a treatment method
recognized by the Department of Human Services; or
new text end

new text begin (iii) a board-certified assistant behavioral analyst with 4,000 hours of supervised
clinical experience including meeting all registration, supervision, and continuing
education requirements of the certification.
new text end

new text begin (b) A level II treatment provider must be employed by an EIDBI provider agency
and be either:
new text end

new text begin (1) a person who:
new text end

new text begin (i) has a bachelor's degree from an accredited college or university in a behavioral or
child development science or allied field including but not limited to mental health, special
education, social work, psychology, speech pathology, or occupational therapy; and
new text end

new text begin (ii) has at least 1,000 hours of clinical experience or training in examining or
treating children with ASD or equivalent documented coursework at the graduate level
by an accredited university in ASD diagnostics, ASD developmental and behavioral
treatment strategies, and typical child development or a combination of coursework or
hours of experience, or certification as a board-certified assistant behavior analyst from the
National Behavior Analyst Certification Board or is a registered behavior technician as
defined by the National Behavior Analyst Certification Board or is certified in one of the
other treatment modalities recognized by the Department of Human Services;
new text end

new text begin (2) a person who:
new text end

new text begin (i) has an associate's degree in a behavioral or child development science or allied
field including but not limited to mental health, special education, social work, psychology,
speech pathology, or occupational therapy from an accredited college or university; and
new text end

new text begin (ii) has at least 2,000 hours of supervised clinical experience in delivering treatment
to children with ASD. Hours worked as a behavioral aide or level III treatment provider
may be included in the required hours of experience;
new text end

new text begin (3) a person who has at least 4,000 hours of supervised clinical experience in
delivering treatment to children with ASD. Hours worked as a mental health behavioral
aide or developmental or level III treatment provider may be included in the required
hours of experience;
new text end

new text begin (4) a person who is a graduate student in a behavioral science, child development
science, or allied field and is receiving clinical supervision by a qualified supervising
professional affiliated with an agency to meet the clinical training requirements for
experience and training with children with ASD; or
new text end

new text begin (5) a person who is at least 18 years old and who:
new text end

new text begin (i) is fluent in the non-English language spoken in the child's home or works with a
tribal entity that represents the child's culture;
new text end

new text begin (ii) meets level III EIDBI training requirements; and
new text end

new text begin (iii) receives observation and direction from a qualified supervising professional or
qualified level I treatment provider at least once a week until 1,000 hours of supervised
clinical experience is met.
new text end

new text begin (c) A level III treatment provider must be employed by an EIDBI provider agency,
have completed the level III training requirement, be at least 18 years old, and have at
least one of the following:
new text end

new text begin (1) a high school diploma or general equivalency diploma (GED);
new text end

new text begin (2) fluency in the non-English language spoken in the child's home or works with a
tribal entity that represents the child's culture; or
new text end

new text begin (3) one year of experience as a primary PCA, community health worker, waiver
service provider, or special education assistant to a child with ASD within the previous
five years.
new text end

new text begin (d) A qualified supervising professional must be employed by an EIDBI agency
and be:
new text end

new text begin (1) a licensed mental health professional who has at least 2,000 hours of supervised
clinical experience or training in examining or treating children with ASD or equivalent
documented coursework at the graduate level by an accredited university in ASD
diagnostics, ASD developmental and behavioral treatment strategies, and typical child
development; or
new text end

new text begin (2) a developmental or behavioral pediatrician who has at least 2,000 hours of
supervised clinical experience or training in the examining or treating of children with
ASD or related conditions or equivalent documented coursework at the graduate level
by an accredited university in the areas of ASD diagnostics, ASD developmental and
behavioral treatment strategies, and typical child development.
new text end

new text begin Subd. 17. new text end

new text begin Agency responsibilities. new text end

new text begin (a) The agency must:
new text end

new text begin (1) exercise and protect the service recipient's rights;
new text end

new text begin (2) offer services that are person-centered and culturally and linguistically
appropriate as required under subdivision 3a;
new text end

new text begin (3) allow people to make informed decisions concerning CMDE, treatment
recommendations, alternatives considered, and possible risks of services;
new text end

new text begin (4) have a written policy that identifies steps to resolve issues collaboratively when
possible;
new text end

new text begin (5) except for emergency situations, provide a minimum of two weeks' notice of
transition from EIDBI services prior to implementing a transition plan with the family;
new text end

new text begin (6) provide notice as soon as possible when issues arise about provision of EIDBI
services;
new text end

new text begin (7) provide the legal representative with prompt notification if the child is injured
while being served by the agency. An incident report must be completed by the agency
staff member in charge of the child. Copies of all incident and injury reports must remain
on file at the agency for at least one year. An incident is when any of the following occur:
new text end

new text begin (i) an illness, accident, or injury which requires first aid treatment;
new text end

new text begin (ii) a bump or blow to the head; or
new text end

new text begin (iii) an unusual or unexpected event which jeopardizes the safety of children or staff
including a child leaving the agency unattended; and
new text end

new text begin (8) prior to starting services, provide the child or the child's legal representative a
plain-spoken description of the treatment method or methods that the child shall receive,
including the staffing certification levels and training of the staff who shall provide the
treatment or treatments.
new text end

new text begin (b) Within five working days of starting services and annually thereafter, agencies
must provide the child or the child's legal representative with:
new text end

new text begin (1) a written copy of the child's rights and agency responsibilities;
new text end

new text begin (2) a verbal explanation of rights and responsibilities;
new text end

new text begin (3) reasonable accommodations to provide the information in other formats or
languages as needed to facilitate understanding of the rights; and
new text end

new text begin (4) documentation in the child's file of the date that the child or the child's
legal representative received a copy and explanation of the client's rights and agency
responsibilities.
new text end

new text begin Subd. 18. new text end

new text begin Procedures when a child's rights are restricted. new text end

new text begin Restriction of a child's
rights under subdivision 15 is allowed only if determined necessary to ensure the health,
safety, and well-being of the child, or to support the therapeutic goals in a child's ITP. Any
restriction of those rights must be documented in the child's ITP. The restriction must be
implemented in the least restrictive alternative manner necessary to protect the child and
provide support to reduce or eliminate the need for the restriction in the most integrated
setting and inclusive manner. The documentation must include the following information:
new text end

new text begin (1) the justification for the restriction based on an assessment of the child's
vulnerability related to exercising the right without restriction;
new text end

new text begin (2) the objective measures set as conditions for ending the restriction;
new text end

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

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

new text begin Subd. 19. new text end

new text begin EIDBI agency qualifications, general requirements, and duties. new text end

new text begin (a)
EIDBI agencies delivering services under this section shall:
new text end

new text begin (1) enroll as a medical assistance Minnesota health care programs provider
according to Minnesota Rules, part 9505.0195, and meet all applicable provider standards
and requirements;
new text end

new text begin (2) demonstrate compliance with federal and state laws and policies for EIDBI;
new text end

new text begin (3) verify and maintain records of all services provided to the child or the child's
legal representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;
new text end

new text begin (4) not have had a lead agency contract or provider agreement discontinued due to
fraud, or not have 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;
new text end

new text begin (5) have established business practices that include written policies and procedures,
internal controls, and a system that demonstrates the organization's ability to deliver
quality EIDBI services; and
new text end

new text begin (6) have an office located in Minnesota.
new text end

new text begin (b) EIDBI agencies shall:
new text end

new text begin (1) report maltreatment as required under sections 626.556 and 626.557;
new text end

new text begin (2) provide the child or the child's legal representative with a copy of the
service-related rights under subdivision 15 at the start of services;
new text end

new text begin (3) comply with any data requests from the department consistent with the
Government Data Practices Act under chapter 13 and section 256B.27; and
new text end

new text begin (4) provide training for all agency staff on the Maltreatment of Minors Act
requirements and responsibilities, including mandated and voluntary reporting,
nonretaliation, and agency policy for all staff on how to report suspected abuse and neglect.
new text end

new text begin Subd. 20. new text end

new text begin Requirements for EIDBI agency infrastructure. new text end

new text begin (a) To be an eligible
agency under this section, an agency must have an administrative infrastructure that
establishes authority and accountability for decision making and oversight of functions,
including finance, personnel, system management, clinical practice, and individual
treatment outcomes measurement. The agency must have written policies and procedures
that it reviews and updates every three years and distributes to staff initially and makes
available to staff at all times.
new text end

new text begin (b) The administrative infrastructure written policies and procedures must include:
new text end

new text begin (1) personnel procedures, including a process for:
new text end

new text begin (i) recruiting, hiring, training, and retention of culturally and linguistically competent
providers;
new text end

new text begin (ii) conducting a criminal background check on all direct service providers and
volunteers;
new text end

new text begin (iii) investigating, reporting, and acting on violations of ethical conduct standards;
new text end

new text begin (iv) investigating, reporting, and acting on violations of data privacy policies that
are compliant with federal and state laws;
new text end

new text begin (v) utilizing volunteers, including screening applicants, training and supervising
volunteers, and providing liability coverage for volunteers;
new text end

new text begin (vi) documenting staff time in a manner that allows matching of staff time records
with service delivery records;
new text end

new text begin (vii) documenting that staff meet the applicable provider qualification criteria,
training criteria, and clinical supervision requirements; and
new text end

new text begin (viii) arranging for qualified backup staff when the usual staff is not available;
new text end

new text begin (2) fiscal procedures, including internal fiscal control practices and a process for
collecting revenue that is compliant with federal and state laws;
new text end

new text begin (3) quality assurance procedures including an annual, confidential family survey of
satisfaction with services provided, including cultural appropriateness of services provided;
new text end

new text begin (4) a limited English proficiency (LEP) plan in compliance with title VI of the
Civil Rights Act of 1965;
new text end

new text begin (5) communication and language assistance in compliance with national standards
for culturally and linguistically appropriate services (CLAS), as published by the United
States Department of Health and Human Services; and
new text end

new text begin (6) a process to establish and maintain individual client records. The records must
include:
new text end

new text begin (i) the child's personal information;
new text end

new text begin (ii) forms applicable to data privacy;
new text end

new text begin (iii) the child's diagnostic assessment, if available; comprehensive multidisciplinary
evaluation under subdivision 5; updates to any assessments or the CMDE; and results of
tests, ITP, progress monitoring, and individual service plan;
new text end

new text begin (iv) documentation of service delivery, including start and stop times for each service;
new text end

new text begin (v) telephone contacts;
new text end

new text begin (vi) discharge plan;
new text end

new text begin (vii) documentation of other services received by the child, to the extent known by
the EIDBI agency;
new text end

new text begin (viii) documentation that the child or the child's legal representative received a copy
of the service recipient rights described in subdivision 15; and
new text end

new text begin (ix) insurance information, if applicable.
new text end

new text begin (c) EIDBI agencies must develop a staff orientation and training plan that documents
compliance with this paragraph. Required training includes:
new text end

new text begin (1) Culturally Relevant Direct Care Services in Diverse Populations training
recognized by the Department of Human Services. This training must be completed by all
EIDBI agency direct service staff and individual providers;
new text end

new text begin (2) EIDBI agency policies and practices training. This training must be completed by
all EIDBI direct service staff and individual providers and must cover the following topics:
new text end

new text begin (i) agency or provider policies, standards, and responsibilities;
new text end

new text begin (ii) individual provider roles and responsibilities;
new text end

new text begin (iii) client rights required under subdivision 15;
new text end

new text begin (iv) person-centered planning and service delivery;
new text end

new text begin (v) data privacy and collection;
new text end

new text begin (vi) fraud detection and prevention;
new text end

new text begin (vii) infection control;
new text end

new text begin (viii) maintaining professional boundaries;
new text end

new text begin (ix) mandated reporting of suspected maltreatment or abuse;
new text end

new text begin (x) roles and responsibilities of team members;
new text end

new text begin (xi) service documentation requirements and expectations; and
new text end

new text begin (xii) procedures related to restriction of a child's rights under subdivision 16; and
new text end

new text begin (3) EIDBI level III basic training. This training must be completed by all level III
providers within six months of the date of becoming an enrolled individual MHCP EIDBI
provider and documented in the personnel file maintained at the enrolled agency. Level
III training must include:
new text end

new text begin (i) an overview of the EIDBI benefit. This includes a history of the EIDBI benefit,
purpose, eligibility, provider standards and qualifications, and department-recognized
treatment methods;
new text end

new text begin (ii) orientation to ASD that covers the core features of ASD and related conditions
and comorbid conditions, red flags for atypical development in children, and understanding
and supporting individuals with ASD and related conditions, including strategies to
address challenges in cognition, social interaction, communication, behavior and sensory
regulation, and other key functional areas of development;
new text end

new text begin (iii) positive behavioral support strategies;
new text end

new text begin (iv) working with families and caregivers; and
new text end

new text begin (v) understanding and supporting the ITP.
new text end

new text begin (d) The training components in paragraph (c) may be developed and provided by
the agency if the components meet the requirements of paragraph (c), if the provider's
training is approved by the commissioner.
new text end

new text begin Subd. 21. new text end

new text begin Commissioner's access. new 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 provider 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 terminating the agency's enrollment according to section
256B.064.
new text end

new text begin Subd. 22. new text end

new text begin Provider shortage; commissioner authority for exceptions. new text end

new text begin (a) In
consultation with the EIDBI advisory council, the commissioner shall determine if a
shortage of qualified providers exists. A shortage means a lack of availability of providers
that results in the delay of access to diagnosis, CMDE, or treatment of children with
ASD and related conditions. The commissioner shall consider geographic factors when
determining the prevalence of a shortage. The commissioner may determine that a shortage
exists only in a specific region of the state, multiple regions of the state, or statewide.
new text end

new text begin (b) If the commissioner determines that a shortage exists under paragraph (a), the
commissioner, in consultation with the EIDBI advisory council, shall establish processes
and criteria for granting exceptions under this subdivision. The commissioner may grant
exceptions to the following requirements:
new text end

new text begin (1) QSP or level I, level II, or level III treatment provider qualification criteria in
subdivision 16; and
new text end

new text begin (2) CMDE requirements in subdivision 5a.
new text end

new text begin (c) When the commissioner determines that a provider shortage no longer exists, the
commissioner shall submit a notice to the chairs and ranking minority members of the
house of representatives and senate committees with oversight over health and human
services. This notice shall be posted for public comment for at least 30 days prior to the
termination of the exception authority. Until the shortage ends, the commissioner shall
provide an update annually to the chairs and ranking minority members of the house of
representatives and senate committees with jurisdiction over health and human services on
the status of the provider shortage and exception process.
new text end

Sec. 2. new text beginEFFECTIVE DATES.
new text end

new text begin (a) The amendments to Minnesota Statutes, section 256B.0949, subdivisions 1, 5a,
13, 14, and 22, are effective the day following final enactment.
new text end

new text begin (b) The amendments to Minnesota Statutes, section 256B.0949, subdivisions 2 to
3a, 5, 6 to 9, and 15 to 21, are effective August 1, 2016.
new text end

new text begin (c) The amendments to Minnesota Statutes, section 256B.0949, subdivision 4, are
effective January 1, 2017.
new text end