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SF 3937

1st Engrossment - 90th Legislature (2017 - 2018) Posted on 07/13/2018 01:52pm

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Current Version - 1st Engrossment

A bill for an act
relating to human services; modifying provisions governing children and families,
licensing, state-operated services, chemical and mental health, community supports
and continuing care, and health care; requiring reports; appropriating money;
amending Minnesota Statutes 2016, sections 119B.011, subdivision 19, by adding
a subdivision; 119B.02, subdivision 7; 119B.03, subdivision 9; 245.4889, by adding
a subdivision; 245A.175; 245D.071, subdivision 5; 245D.091, subdivisions 2, 3,
4; 254A.035, subdivision 2; 254B.02, subdivision 1; 254B.06, subdivision 1;
256B.0625, by adding subdivisions; 256B.0659, subdivisions 3a, 11, 21, 24, 28,
by adding a subdivision; 256B.0915, subdivision 6; 256B.092, subdivisions 1b,
1g; 256B.4914, subdivision 4; 256I.04, by adding subdivisions; 256K.45,
subdivision 2; 256M.41, subdivision 3, by adding a subdivision; 256N.24, by
adding a subdivision; 260.835, subdivision 2; 626.556, by adding a subdivision;
Minnesota Statutes 2017 Supplement, sections 119B.011, subdivision 20; 119B.025,
subdivision 1; 119B.06, subdivision 1; 119B.09, subdivision 1; 119B.095,
subdivision 2; 119B.13, subdivision 1; 245.4889, subdivision 1; 245A.03,
subdivision 7; 245A.06, subdivision 8; 245A.11, subdivision 2a; 245D.03,
subdivision 1; 256B.0625, subdivision 17; 256B.0911, subdivisions 1a, 3a, 3f, 5;
256B.49, subdivision 13; 256B.4914, subdivisions 2, 3, 5, 10, 10a; 256I.03,
subdivision 8; 256I.04, subdivision 2b; 256I.05, subdivision 3; Laws 2014, chapter
312, article 27, section 76; Laws 2017, First Special Session chapter 6, article 1,
section 52; article 3, section 49; proposing coding for new law in Minnesota
Statutes, chapters 246; 260C; repealing Minnesota Statutes 2016, sections
256B.0625, subdivision 18b; 256B.0705.

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

ARTICLE 1

CHILDREN AND FAMILIES; LICENSING

Section 1.

Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision
to read:


Subd. 13b.

Homeless.

"Homeless" means a self-declared housing status as defined in
the McKinney-Vento Homeless Assistance Act and United States Code, title 42, section
11302, paragraph (a).

EFFECTIVE DATE.

This section is effective August 12, 2019.

Sec. 2.

Minnesota Statutes 2016, section 119B.011, subdivision 19, is amended to read:


Subd. 19.

Provider.

"Provider" means: (1) an individual or child care center or facility,
either licensed or unlicensed,
providing licensed legal child care services as defined under
section 245A.03; or (2) a license exempt center required to be certified under chapter 245G;

(3) an individual or child care center or facility holding that:

(i) holds a valid child care license issued by another state or a tribe and providing ;

(ii) provides child care services in the licensing state or in the area under the licensing
tribe's jurisdiction; and

(iii) is in compliance with federal health and safety requirements as certified by the
licensing state or tribe, or as determined by receipt of child care development block grant
funds in the licensing state; or

(4) a legal nonlicensed child care provider as defined under section 119B.011, subdivision
16, providing legal child care services
. A legally unlicensed family legal nonlicensed child
care provider must be at least 18 years of age, and not a member of the MFIP assistance
unit or a member of the family receiving child care assistance to be authorized under this
chapter.

EFFECTIVE DATE.

This section is effective September 24, 2018.

Sec. 3.

Minnesota Statutes 2017 Supplement, section 119B.011, subdivision 20, is amended
to read:


Subd. 20.

Transition year families.

"Transition year families" means families who have
received MFIP assistance, or who were eligible to receive MFIP assistance after choosing
to discontinue receipt of the cash portion of MFIP assistance under section 256J.31,
subdivision 12
, or families who have received DWP assistance under section 256J.95 for
at least three one of the last six months before losing eligibility for MFIP or DWP.
Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, subpart 2,
transition year child care may be used to support employment, approved education or training
programs, or job search that meets the requirements of section 119B.10. Transition year
child care is not available to families who have been disqualified from MFIP or DWP due
to fraud.

EFFECTIVE DATE.

This section is effective October 8, 2018.

Sec. 4.

Minnesota Statutes 2016, section 119B.02, subdivision 7, is amended to read:


Subd. 7.

Child care market rate survey.

Biennially, The commissioner shall conduct
the next
survey of prices charged by child care providers in Minnesota in state fiscal year
2021 and every three years thereafter
to determine the 75th percentile for like-care
arrangements in county price clusters.

Sec. 5.

Minnesota Statutes 2017 Supplement, section 119B.025, subdivision 1, is amended
to read:


Subdivision 1.

Applications.

(a) Except as provided in paragraph (c), clause (4), the
county shall verify the following at all initial child care applications using the universal
application:

(1) identity of adults;

(2) presence of the minor child in the home, if questionable;

(3) relationship of minor child to the parent, stepparent, legal guardian, eligible relative
caretaker, or the spouses of any of the foregoing;

(4) age;

(5) immigration status, if related to eligibility;

(6) Social Security number, if given;

(7) counted income;

(8) spousal support and child support payments made to persons outside the household;

(9) residence; and

(10) inconsistent information, if related to eligibility.

(b) The county must mail a notice of approval or denial of assistance to the applicant
within 30 calendar days after receiving the application. The county may extend the response
time by 15 calendar days if the applicant is informed of the extension.

(c) For an applicant who declares that the applicant is homeless and who meets the
definition of homeless in section 119B.011, subdivision 13b, the county must:

(1) if information is needed to determine eligibility, send a request for information to
the applicant within five working days after receiving the application;

(2) if the applicant is eligible, send a notice of approval of assistance within five working
days after receiving the application;

(3) if the applicant is ineligible, send a notice of denial of assistance within 30 days after
receiving the application. The county may extend the response time by 15 calendar days if
the applicant is informed of the extension;

(4) not require verifications required by paragraph (a) before issuing the notice of approval
or denial; and

(5) follow limits set by the commissioner for how frequently expedited application
processing may be used for an applicant who declares that the applicant is homeless.

(d) An applicant who declares that the applicant is homeless must submit proof of
eligibility within three months of the date the application was received. If proof of eligibility
is not submitted within three months, eligibility ends. A 15-day adverse action notice is
required to end eligibility.

EFFECTIVE DATE.

This section is effective August 12, 2019.

Sec. 6.

Minnesota Statutes 2016, section 119B.03, subdivision 9, is amended to read:


Subd. 9.

Portability pool.

(a) The commissioner shall establish a pool of up to five
percent of the annual appropriation for the basic sliding fee program to provide continuous
child care assistance for eligible families who move between Minnesota counties. At the
end of each allocation period, any unspent funds in the portability pool must be used for
assistance under the basic sliding fee program. If expenditures from the portability pool
exceed the amount of money available, the reallocation pool must be reduced to cover these
shortages.

(b) To be eligible for portable basic sliding fee assistance, A family that has moved from
a county in which it was receiving basic sliding fee assistance to a county with a waiting
list for the basic sliding fee program must:

(1) meet the income and eligibility guidelines for the basic sliding fee program; and

(2) notify the new county of residence within 60 days of moving and submit information
to the new county of residence to verify eligibility for the basic sliding fee program
the
family's previous county of residence of the family's move to a new county of residence
.

(c) The receiving county must:

(1) accept administrative responsibility for applicants for portable basic sliding fee
assistance at the end of the two months of assistance under the Unitary Residency Act;

(2) continue portability pool basic sliding fee assistance for the lesser of six months or
until the family is able to receive assistance under the county's regular basic sliding program;
and

(3) notify the commissioner through the quarterly reporting process of any family that
meets the criteria of the portable basic sliding fee assistance pool.

EFFECTIVE DATE.

This section is effective October 8, 2018.

Sec. 7.

Minnesota Statutes 2017 Supplement, section 119B.06, subdivision 1, is amended
to read:


Subdivision 1.

Commissioner to administer block grant.

The commissioner is
authorized and directed to receive, administer, and expend child care funds available under
the child care and development block grant authorized under the Child Care and Development
Block Grant Act of 2014, Public Law 113-186. From the discretionary amounts provided
for federal fiscal year 2018 and reserved for quality activities, the commissioner shall ensure
that funds are prioritized to increase the availability of training and business planning
assistance for child care providers
.

Sec. 8.

Minnesota Statutes 2017 Supplement, section 119B.09, subdivision 1, is amended
to read:


Subdivision 1.

General eligibility requirements.

(a) Child care services must be
available to families who need child care to find or keep employment or to obtain the training
or education necessary to find employment and who:

(1) have household income less than or equal to 67 percent of the state median income,
adjusted for family size, at application and redetermination, and meet the requirements of
section 119B.05; receive MFIP assistance; and are participating in employment and training
services under chapter 256J; or

(2) have household income less than or equal to 47 percent of the state median income,
adjusted for family size, at application and less than or equal to 67 percent of the state
median income, adjusted for family size, at redetermination.

(b) Child care services must be made available as in-kind services.

(c) All applicants for child care assistance and families currently receiving child care
assistance must be assisted and required to cooperate in establishment of paternity and
enforcement of child support obligations for all children in the family at application and
redetermination as a condition of program eligibility. For purposes of this section, a family
is considered to meet the requirement for cooperation when the family complies with the
requirements of section 256.741.

(d) All applicants for child care assistance and families currently receiving child care
assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition
of eligibility. The co-payment fee may include additional recoupment fees due to a child
care assistance program overpayment.

(e) If a family has one child with a child care authorization and the child turns 13 years
of age or the child has a disability and turns 15 years of age, the family remains eligible
until the redetermination.

Sec. 9.

Minnesota Statutes 2017 Supplement, section 119B.095, subdivision 2, is amended
to read:


Subd. 2.

Maintain steady child care authorizations.

(a) Notwithstanding Minnesota
Rules, chapter 3400, the amount of child care authorized under section 119B.10 for
employment, education, or an MFIP or DWP employment plan shall continue at the same
number of hours or more hours until redetermination, including:

(1) when the other parent moves in and is employed or has an education plan under
section 119B.10, subdivision 3, or has an MFIP or DWP employment plan; or

(2) when the participant's work hours are reduced or a participant temporarily stops
working or attending an approved education program. Temporary changes include, but are
not limited to, a medical leave, seasonal employment fluctuations, or a school break between
semesters.

(b) The county may increase the amount of child care authorized at any time if the
participant verifies the need for increased hours for authorized activities.

(c) The county may reduce the amount of child care authorized if a parent requests a
reduction or because of a change in:

(1) the child's school schedule;

(2) the custody schedule; or

(3) the provider's availability.

(d) The amount of child care authorized for a family subject to subdivision 1, paragraph
(b), must change when the participant's activity schedule changes. Paragraph (a) does not
apply to a family subject to subdivision 1, paragraph (b).

(e) When a child reaches 13 years of age or a child with a disability reaches 15 years of
age, the amount of child care authorized shall continue at the same number of hours or more
hours until redetermination.

Sec. 10.

Minnesota Statutes 2017 Supplement, section 119B.13, subdivision 1, is amended
to read:


Subdivision 1.

Subsidy restrictions.

(a) Beginning February 3, 2014, The maximum
rate paid for child care assistance in any county or county price cluster under the child care
fund shall be the greater of the 25th percentile calculated by the commissioner of the 2011
most recent
child care provider rate survey under section 119B.02, subdivision 7, or the
maximum rate effective November 28, 2011 rates in effect at the time of the update:

(1) for the first update on February 22, 2019, the commissioner shall determine the
percentile of the most recent child care provider rate survey, not to exceed the 25th percentile,
that can be funded using Minnesota's increase in federal child care and development funds
appropriated in the federal Consolidated Appropriations Act of 2018, Public Law 115-141,
and any subsequent federal appropriation for federal fiscal year 2019, after complying with
other requirements of the reauthorization of the Child Care Development Block Grant
(CCDBG) Act of 2014, enacted in state law in 2018; and

(2) beginning in fiscal year 2022, the commissioner, in consultation with the
commissioner of management and budget, shall determine the amount of federal funding
for child care assistance programs to use in setting maximum rates for child care programs
based on the most recent market survey, not to exceed the 25th percentile, so that the cost
of compliance with child care development block grant requirements enacted in state law
in 2018, including the rate adjustment, are paid only with federal CCDBG funds. If federal
CCDBG funds are not sufficient to maintain the enacted compliance requirements and the
maximum rates in effect at the time of the rate change, the commissioner must adjust
maximum rates to remain within the limits of available funds
.

(b) For a child care provider located within the boundaries of a city located in two or
more of the counties of Benton, Sherburne, and Stearns, the maximum rate paid for child
care assistance shall be equal to the maximum rate paid in the county with the highest
maximum reimbursement rates or the provider's charge, whichever is less.

(c) The commissioner may: (1) assign a county with no reported provider prices to a
similar price cluster; and (2) consider county level access when determining final price
clusters.

(b) (d) A rate which includes a special needs rate paid under subdivision 3 may be in
excess of the maximum rate allowed under this subdivision.

(c) (e) The department shall monitor the effect of this paragraph on provider rates. The
county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care on
an hourly, full-day, and weekly basis, including special needs and disability care.

(d) (f) If a child uses one provider, the maximum payment for one day of care must not
exceed the daily rate. The maximum payment for one week of care must not exceed the
weekly rate.

(e) (g) If a child uses two providers under section 119B.097, the maximum payment
must not exceed:

(1) the daily rate for one day of care;

(2) the weekly rate for one week of care by the child's primary provider; and

(3) two daily rates during two weeks of care by a child's secondary provider.

(f) (h) Child care providers receiving reimbursement under this chapter must not be paid
activity fees or an additional amount above the maximum rates for care provided during
nonstandard hours for families receiving assistance.

(g) (i) If the provider charge is greater than the maximum provider rate allowed, the
parent is responsible for payment of the difference in the rates in addition to any family
co-payment fee.

(h) (j) All maximum provider rates changes shall be implemented on the Monday
following the effective date of the maximum provider rate.

(i) (k) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum
registration fees in effect on January 1, 2013, shall remain in effect.

EFFECTIVE DATE.

This section is effective February 22, 2019.

Sec. 11.

Minnesota Statutes 2017 Supplement, section 245A.06, subdivision 8, is amended
to read:


Subd. 8.

Requirement to post correction order conditional license.

(a) For licensed
family child care providers and child care centers, upon receipt of any correction order or
order of conditional license issued by the commissioner under this section, and
notwithstanding a pending request for reconsideration of the correction order or order of
conditional license by the license holder, the license holder shall post the correction order
or
order of conditional license in a place that is conspicuous to the people receiving services
and all visitors to the facility for two years. When the correction order or order of conditional
license is accompanied by a maltreatment investigation memorandum prepared under section
626.556 or 626.557, the investigation memoranda must be posted with the correction order
or
order of conditional license.

(b) If the commissioner reverses or rescinds a violation in a correction order upon
reconsideration under subdivision 2, the commissioner shall issue an amended correction
order and the license holder shall post the amended order according to paragraph (a).

(c) If the correction order is rescinded or reversed in full upon reconsideration under
subdivision 2, the license holder shall remove the original correction order posted according
to paragraph (a).

Sec. 12.

Minnesota Statutes 2016, section 245A.175, is amended to read:


245A.175 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL
HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.

Prior to a nonemergency placement of a child in a foster care home, the child foster care
license holder and caregivers in foster family and treatment foster care settings, and all staff
providing care in foster residence settings must complete two hours of training that addresses
the causes, symptoms, and key warning signs of mental health disorders; cultural
considerations; and effective approaches for dealing with a child's behaviors. At least one
hour of the annual training requirement for the foster family license holder and caregivers,
and foster residence staff must be on children's mental health issues and treatment. Except
for providers and services under chapter 245D,
the annual training must also include at least
one hour of training on fetal alcohol spectrum disorders within the first 12 months of
licensure. After the first 12 months of licensure, training on fetal alcohol spectrum disorders
may count
, which must be counted toward the 12 hours of required in-service training per
year. Short-term substitute caregivers are exempt from these requirements. Training
curriculum shall be approved by the commissioner of human services.

Sec. 13.

Minnesota Statutes 2016, section 254A.035, subdivision 2, is amended to read:


Subd. 2.

Membership terms, compensation, removal and expiration.

The membership
of this council shall be composed of 17 persons who are American Indians and who are
appointed by the commissioner. The commissioner shall appoint one representative from
each of the following groups: Red Lake Band of Chippewa Indians; Fond du Lac Band,
Minnesota Chippewa Tribe; Grand Portage Band, Minnesota Chippewa Tribe; Leech Lake
Band, Minnesota Chippewa Tribe; Mille Lacs Band, Minnesota Chippewa Tribe; Bois Forte
Band, Minnesota Chippewa Tribe; White Earth Band, Minnesota Chippewa Tribe; Lower
Sioux Indian Reservation; Prairie Island Sioux Indian Reservation; Shakopee Mdewakanton
Sioux Indian Reservation; Upper Sioux Indian Reservation; International Falls Northern
Range; Duluth Urban Indian Community; and two representatives from the Minneapolis
Urban Indian Community and two from the St. Paul Urban Indian Community. The terms,
compensation, and removal of American Indian Advisory Council members shall be as
provided in section 15.059. The council expires June 30, 2018 2023.

Sec. 14.

Minnesota Statutes 2016, section 256K.45, subdivision 2, is amended to read:


Subd. 2.

Homeless youth report.

The commissioner shall prepare a biennial report,
beginning in February 2015, which provides meaningful information to the legislative
committees having jurisdiction over the issue of homeless youth, that includes, but is not
limited to: (1) a list of the areas of the state with the greatest need for services and housing
for homeless youth, and the level and nature of the needs identified; (2) details about grants
made; (3) the distribution of funds throughout the state based on population need; (4)
follow-up information, if available, on the status of homeless youth and whether they have
stable housing two years after services are provided; and (5) any other outcomes for
populations served to determine the effectiveness of the programs and use of funding. The
commissioner is exempt from preparing this report in 2019 and must instead update the
2007 report on homeless youth under section 22
.

Sec. 15.

Minnesota Statutes 2016, section 256M.41, subdivision 3, is amended to read:


Subd. 3.

Payments based on performance.

(a) The commissioner shall make payments
under this section to each county board on a calendar year basis in an amount determined
under paragraph (b)
on or before July 10 of each year.

(b) Calendar year allocations under subdivision 1 shall be paid to counties in the following
manner:

(1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties
on or before July 10 of each year;

(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

(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.

(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.

Sec. 16.

Minnesota Statutes 2016, section 256M.41, is amended by adding a subdivision
to read:


Subd. 4.

County performance on child protection measures.

The commissioner shall
set child protection measures and standards. The commissioner shall require an
underperforming county to demonstrate that the county designated sufficient funds and
implemented a reasonable strategy to improve child protection performance, including the
provision of a performance improvement plan and additional remedies identified by the
commissioner. The commissioner may redirect up to 20 percent of a county's funds under
this section toward the performance improvement plan for a county not meeting child
protection standards and not demonstrating significant improvement. Sanctions under section
256M.20, subdivision 3, related to noncompliance with federal performance standards also
apply.

Sec. 17.

Minnesota Statutes 2016, section 256N.24, is amended by adding a subdivision
to read:


Subd. 2a.

Minnesota assessment of parenting for children and youth (MAPCY)
revision.

The commissioner, in consultation with representatives from communities of
color, including but not limited to advisory councils and ombudspersons, shall review and
revise the MAPCY tool and incorporate changes that take into consideration different
cultures and the diverse needs of communities of color.

Sec. 18.

Minnesota Statutes 2016, section 260.835, subdivision 2, is amended to read:


Subd. 2.

Expiration.

The American Indian Child Welfare Advisory Council expires
June 30, 2018 2023.

Sec. 19.

[260C.008] FOSTER CARE SIBLING BILL OF RIGHTS.

Subdivision 1.

Statement of rights.

(a) A child placed in foster care who has a sibling
has the right to:

(1) be placed in foster care homes with the child's siblings, when possible and when it
is in the best interest of each sibling, in order to sustain family relationships;

(2) be placed in close geographical distance to the child's siblings, if placement together
is not possible, to facilitate frequent and meaningful contact;

(3) have frequent contact with the child's siblings in foster care and, whenever possible,
with the child's siblings who are not in foster care, unless the responsible social services
agency has documented that contact is not in the best interest of any sibling. Contact includes,
but is not limited to, telephone calls, text messaging, social media and other Internet use,
and video calls;

(4) annually receive a telephone number, address, and e-mail address for all siblings in
foster care, and receive updated photographs of siblings regularly, by regular mail or e-mail;

(5) participate in regular face-to-face visits with the child's siblings in foster care and,
whenever possible, with the child's siblings who are not in foster care. Participation in these
visits shall not be withheld or restricted as a consequence for behavior, and shall only be
restricted if the responsible social services agency documents that the visits are contrary to
the safety or well-being of any sibling. Social workers, parents, foster care providers, and
older children must cooperate to ensure regular visits and must coordinate dates, times,
transportation, and other accommodations as necessary. The timing and regularity of visits
shall be outlined in each sibling's service plan, based on the individual circumstances and
needs of each child. A social worker need not give explicit permission for each visit or
possible overnight visit, but foster care providers shall communicate with social workers
about these visits;

(6) be actively involved in each other's lives and share celebrations, if they choose to
do so, including but not limited to birthdays, holidays, graduations, school and extracurricular
activities, cultural customs in the siblings' native language, and other milestones;

(7) be promptly informed about changes in sibling placements or circumstances, including
but not limited to new placements, discharge from placements, significant life events, and
discharge from foster care;

(8) be included in permanency planning decisions for siblings, if appropriate; and

(9) be informed of the expectations for and possibility of continued contact with a sibling
after an adoption or transfer of permanent physical and legal custody to a relative.

(b) Adult siblings of children in foster care shall have the right to be considered as foster
care providers, adoptive parents, and relative custodians for their siblings, if they choose
to do so.

Subd. 2.

Interpretation.

The rights under this section are established for the benefit of
siblings in foster care. This statement of rights does not replace or diminish other rights,
liberties, and responsibilities that may exist relative to children in foster care, adult siblings
of children in foster care, foster care providers, parents, relatives, or responsible social
services agencies.

Subd. 3.

Disclosure.

Child welfare agency staff shall provide a copy of these rights to
a child who has a sibling at the time the child enters foster care, to any adult siblings of a
child entering foster care, if known, and to the foster care provider, in a format specified
by the commissioner of human services. The copy shall contain the address and telephone
number of the Office of Ombudsman for Families and a brief statement describing how to
file a complaint with the office.

EFFECTIVE DATE.

This section is effective for children entering foster care on or
after August 1, 2018. Subdivision 3 is effective August 1, 2018, and applies to all children
in foster care on that date, regardless of when the child entered foster care.

Sec. 20.

[260C.81] CHILD WELFARE TRAINING SYSTEM.

Subdivision 1.

Child welfare training system.

(a) The commissioner of human services
shall modify the Child Welfare Training System developed pursuant to section 626.5591,
subdivision 2, as provided in this section. The new training framework shall be known as
the Child Welfare Training Academy.

(b) The Child Welfare Training Academy shall be administered through five regional
hubs in northwest, northeast, southwest, southeast, and central Minnesota. Each hub shall
deliver training targeted to the needs of its particular region, taking into account varying
demographics, resources, and practice outcomes.

(c) The Child Welfare Training Academy shall use training methods best suited to the
training content. National best practices in adult learning must be used to the greatest extent
possible, including online learning methodologies, coaching, mentoring, and simulated skill
application.

(d) Each child welfare worker and supervisor shall be required to complete a certification,
including a competency-based knowledge test and a skills demonstration, at the completion
of the worker's initial training and biennially thereafter. The commissioner shall develop
ongoing training requirements and a method for tracking certifications.

(e) Each regional hub shall have a regional organizational effectiveness specialist trained
in continuous quality improvement strategies. The specialist shall provide organizational
change assistance to counties and tribes, with priority given to efforts intended to impact
child safety.

(f) The Child Welfare Training Academy shall include training and resources that address
worker well-being and secondary traumatic stress.

(g) The Child Welfare Training Academy shall serve the primary training audiences of:
(1) county and tribal child welfare workers; (2) county and tribal child welfare supervisors;
and (3) staff at private agencies providing out-of-home placement services for children
involved in Minnesota's county and tribal child welfare system.

(h) The commissioner of human services shall enter: (1) into a partnership with the
University of Minnesota to collaborate in the administration of workforce training; and (2)
enter into a partnership with one or more agencies to provide consultation, subject matter
expertise, and capacity building in organizational resilience and child welfare workforce
well-being.

Subd. 2.

Rulemaking.

The commissioner of human services may adopt rules by
December 31, 2020, as necessary to establish the Child Welfare Training Academy. If the
commissioner of human services does not adopt rules by December 31, 2020, rulemaking
authority under this section is repealed. Rulemaking authority under this section is not
continuing authority to amend or repeal rules. Any additional action on rules after adoption
must be under specific statutory authority to take the additional action.

Sec. 21.

Minnesota Statutes 2016, section 626.556, is amended by adding a subdivision
to read:


Subd. 17.

Child protection safety and risk-based framework response system
planning initiative.

(a) The commissioner shall partner with select Minnesota counties and
tribal child welfare agencies, including Hennepin County and at least one rural county, and
other counties that must represent a balance around the state, to make recommendations for
the creation of a safety and risk-based framework that will improve appropriate, timely, and
adequate responses to a child's safety needs using a trauma-informed lens. As part of this
work, the commissioner, county, and tribal child welfare agencies shall review Minnesota's
child maltreatment statutes, administrative rules, guidelines, and practices, and make
recommendations on modifications needed to implement a safety and risk-based framework
and a response system that enhances the protection of children and best focuses county and
tribal child protection resources in accordance with the risk and safety needs of children.
In forming these recommendations, the commissioner shall consult with county attorneys,
law enforcement, parents, attorneys representing parents, the guardian ad litem program,
mental and physical health care providers, child development experts, and other stakeholders
that the commissioner deems appropriate.

(b) By January 31, 2019, the commissioner shall make recommendations regarding the
creation of a safety and risk-based framework to the relevant legislative committees.

Sec. 22. 2018 REPORT TO LEGISLATURE ON HOMELESS YOUTH.

Subdivision 1.

Report development.

In lieu of the biennial homeless youth report under
Minnesota Statutes, section 256K.45, subdivision 2, the commissioner of human services
shall update the information in the 2007 legislative report on runaway and homeless youth.
In developing the updated report, the commissioner may use existing data, studies, and
analysis provided by state, county, and other entities including, but not limited to:

(1) Minnesota Housing Finance Agency analysis on housing availability;

(2) Minnesota state plan to end homelessness;

(3) continuum of care counts of youth experiencing homelessness and assessments as
provided by Department of Housing and Urban Development (HUD)-required coordinated
entry systems;

(4) data collected through the Department of Human Services Homeless Youth Act grant
program;

(5) Wilder Research homeless study;

(6) Voices of Youth Count sponsored by Hennepin County; and

(7) privately funded analysis, including:

(i) nine evidence-based principles to support youth in overcoming homelessness;

(ii) return on investment analysis conducted for YouthLink by Foldes Consulting; and

(iii) evaluation of Homeless Youth Act resources conducted by Rainbow Research.

Subd. 2.

Key elements; due date.

(a) The report may include three key elements where
significant learning has occurred in the state since the 2007 report, including:

(1) unique causes of youth homelessness;

(2) targeted responses to youth homelessness, including significance of positive youth
development as fundamental to each targeted response; and

(3) recommendations based on existing reports and analysis on what it will take to end
youth homelessness.

(b) To the extent data is available, the report must include:

(1) general accounting of the federal and philanthropic funds leveraged to support
homeless youth activities;

(2) general accounting of the increase in volunteer responses to support youth
experiencing homelessness; and

(3) data-driven accounting of geographic areas or distinct populations that have gaps in
service or are not yet served by homeless youth responses.

(c) The commissioner of human services may consult with community-based providers
of homeless youth services and other expert stakeholders to complete the report. The
commissioner shall submit the report to the chairs and ranking minority members of the
legislative committees with jurisdiction over youth homelessness by February 15, 2019.

Sec. 23. AFRICAN AMERICAN CHILD WELFARE WORK GROUP.

The commissioner of human services shall form an African American child welfare
work group within the implementation work group for the Governor's Child Protection Task
Force to help formulate policies and procedures relating to African American child welfare
services and to ensure that African American families are provided with all possible services
and opportunities to care for their children in their homes. The work group shall include
child welfare policy and social work professionals and paraprofessionals, community
members, community leaders, and parents representing all regions of the state. By February
1, 2019, the work group shall report its findings and recommendations to the chairs and
ranking minority members of the legislative committees with jurisdiction over child
protection issues.

Sec. 24. REVIEW OF BACKGROUND STUDIES AND LICENSING PROCESSES
FOR RELATIVE FOSTER CARE.

(a) The commissioner shall work with six counties, which must include Hennepin County,
at least one rural county, and other counties that must represent a balance around the state,
to review the background study and licensing processes for relative child foster care. The
review must analyze past reports on foster care, licensing data, barriers to timely licensure
for relatives, child safety, well-being, and permanency outcomes of children placed in foster
care with relatives.

(b) By January 31, 2019, the commissioner shall make recommendations for improving
the background study and licensing processes for children placed in foster care with relatives
to the relevant legislative committees.

Sec. 25. DEPARTMENT OF LICENSING, BACKGROUND STUDIES, AND
OVERSIGHT.

(a) It is the goal of the legislature to consolidate into one new state agency the licensing,
background study, and related oversight functions currently in the Department of Human
Services and Department of Health, including the Office of Inspector General, the Minnesota
Adult Abuse Reporting Center (MAARC), and the Office of Health Facility Complaints
(OHFC).

(b) The commissioners of human services and health shall work with the revisor of
statutes to draft legislation establishing the new state agency, and provide the legislation to
the chairs and ranking minority members of the senate and house of representatives
committees with jurisdiction over health and human services by December 15, 2018, with
the goal of the new state agency to begin operations on July 1, 2019.

ARTICLE 2

STATE-OPERATED SERVICES; CHEMICAL AND MENTAL HEALTH

Section 1.

Minnesota Statutes 2017 Supplement, section 245.4889, subdivision 1, is
amended to read:


Subdivision 1.

Establishment and authority.

(a) The commissioner is authorized to
make grants from available appropriations to assist:

(1) counties;

(2) Indian tribes;

(3) children's collaboratives under section 124D.23 or 245.493; or

(4) mental health service providers.

(b) The following services are eligible for grants under this section:

(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;

(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;

(3) respite care services for children with severe emotional disturbances who are at risk
of out-of-home placement;

(4) children's mental health crisis services;

(5) mental health services for people from cultural and ethnic minorities;

(6) children's mental health screening and follow-up diagnostic assessment and treatment;

(7) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;

(8) school-linked mental health services, including transportation for children receiving
school-linked mental health services when school is not in session
;

(9) building evidence-based mental health intervention capacity for children birth to age
five;

(10) suicide prevention and counseling services that use text messaging statewide;

(11) mental health first aid training;

(12) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
Web site to share information and strategies to promote resilience and prevent trauma;

(13) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;

(14) early childhood mental health consultation;

(15) evidence-based interventions for youth at risk of developing or experiencing a first
episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis;

(16) psychiatric consultation for primary care practitioners; and

(17) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grants.

(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.

(d) As a condition of receiving grant funds, a grantee must obtain all available third-party
reimbursement sources, if applicable.

Sec. 2.

Minnesota Statutes 2016, section 245.4889, is amended by adding a subdivision
to read:


Subd. 1a.

School-linked mental health services grants.

(a) An eligible applicant for
school-linked mental health services grants under subdivision 1, paragraph (b), clause (8),
is an entity that is:

(1) certified under Minnesota Rules, parts 9520.0750 to 9520.0870;

(2) a community mental health center under section 256B.0625, subdivision 5;

(3) an Indian health service facility or facility owned and operated by a tribe or tribal
organization operating under United States Code, title 25, section 5321;

(4) a provider of children's therapeutic services and supports as defined in section
256B.0943; or

(5) enrolled in medical assistance as a mental health or substance use disorder provider
agency and employs at least two full-time equivalent mental health professionals as defined
in section 245.4871, subdivision 27, clauses (1) to (6), or two alcohol and drug counselors
licensed or exempt from licensure under chapter 148F who are qualified to provide clinical
services to children and families.

(b) Allowable grant expenses include transportation for children receiving school-linked
mental health services when school is not in session, and may be used to purchase equipment,
connection charges, set-up fees, and site fees in order to deliver school-linked mental health
services defined in subdivision 1a, via telemedicine consistent with section 256B.0625,
subdivision 3b.

Sec. 3.

[246.0415] PLACEMENT OF CLIENTS WHO EXHIBIT ASSAULTIVE OR
VIOLENT BEHAVIOR.

Clients who exhibit assaultive or violent behavior, have severe behavior issues, or are
involved with or are at risk of being involved with the criminal justice system must be placed
in or moved to a setting that meets the client's needs and ensures the safety of the public.
The commissioner shall balance the needs of the client to live in the most integrated setting
with public safety. The commissioner shall provide an appropriate placement for clients
who have a medium or high risk for committing violent acts, and clients must not be placed
in a residential setting that jeopardizes the safety of others until the commissioner determines
that the client is low risk for committing violent acts.

Sec. 4.

Minnesota Statutes 2016, section 254B.02, subdivision 1, is amended to read:


Subdivision 1.

Chemical dependency treatment allocation.

The chemical dependency
treatment appropriation shall be placed in a special revenue account. The commissioner
shall annually transfer funds from the chemical dependency fund to pay for operation of
the drug and alcohol abuse normative evaluation system and to pay for all costs incurred
by adding two positions for licensing of chemical dependency treatment and rehabilitation
programs located in hospitals for which funds are not otherwise appropriated.
The remainder
of the
money in the special revenue account must be used according to the requirements in
this chapter.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 5.

Minnesota Statutes 2016, section 254B.06, subdivision 1, is amended to read:


Subdivision 1.

State collections.

The commissioner is responsible for all collections
from persons determined to be partially responsible for the cost of care of an eligible person
receiving services under Laws 1986, chapter 394, sections 8 to 20. The commissioner may
initiate, or request the attorney general to initiate, necessary civil action to recover the unpaid
cost of care. The commissioner may collect all third-party payments for chemical dependency
services provided under Laws 1986, chapter 394, sections 8 to 20, including private insurance
and federal Medicaid and Medicare financial participation. The commissioner shall deposit
in a dedicated account a percentage of collections to pay for the cost of operating the chemical
dependency consolidated treatment fund invoice processing and vendor payment system,
billing, and collections.
The remaining receipts must be deposited in the chemical dependency
fund.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 6. PERSON-CENTERED TELEPRESENCE PLATFORM EXPANSION WORK
GROUP.

Subdivision 1.

Membership.

(a) The commissioner of human services shall convene a
work group for the purpose of exploring opportunities to collaborate and expand strategies
for person-centered innovation using Internet telepresence in delivering health and human
services, as well as related educational and correctional services. The commissioner, in
consultation with the commissioner of health, shall appoint the following members:

(1) three members representing county services in the areas of human services, health,
and corrections or law enforcement. These members must represent counties outside the
metropolitan area defined in Minnesota Statutes, section 473.121;

(2) one member representing public health;

(3) one member recommended by the Minnesota American Indian Mental Health
Advisory Council;

(4) one member recommended by the Minnesota Medical Association who is a primary
care provider practicing in outstate Minnesota;

(5) one member recommended by NAMI of Minnesota;

(6) two members recommended by the Minnesota School Boards Association;

(7) one member recommended by the Minnesota Hospital Association representing rural
hospital emergency departments;

(8) one member representing community mental health centers;

(9) one member representing adolescent treatment centers;

(10) one member representing child advocacy centers; and

(11) one member recommended by the chief justice of the Supreme Court representing
the judicial system.

(b) In addition to the members identified in paragraph (a), the work group shall include:

(1) the commissioner of MN.IT services or a designee;

(2) the commissioner of corrections or a designee;

(3) the commissioner of health or a designee; and

(4) the commissioner of education or a designee.

Subd. 2.

First meeting; chair.

The commissioner shall serve as the chair, and make
appointments and convene the first meeting of the work group by September 1, 2018.

Subd. 3.

Duties.

The work group shall:

(1) explore opportunities for improving behavioral health and other health care service
delivery through the use of a common interoperable person-centered telepresence platform
that provides connectivity and technical support to potential users;

(2) review and coordinate state and local innovation initiatives and investments designed
to leverage telepresence connectivity and collaboration;

(3) identify standards and capabilities for a single interoperable telepresence platform;

(4) identify barriers to providing a telepresence technology, including limited availability
of bandwidth, limitations in providing certain services via telepresence, and broadband
infrastructure needs;

(5) identify and make recommendations for governance to assure person-centered
responsiveness;

(6) identify how the business model itself can be innovated to provide an incentive for
ongoing innovation in Minnesota's health and human service ecosystems;

(7) evaluate and make recommendations for a potential vendor that could provide a
single telepresence platform in terms of delivering the identified standards and capabilities;

(8) identify sustainable financial support for a single telepresence platform, including
infrastructure costs and start-up costs for potential users; and

(9) identify the benefits to the state, political subdivisions, and tribal governments, and
the constituents they serve in using a common person-centered telepresence platform for
delivering behavioral health services.

Subd. 4.

Report.

The commissioner shall report to the chairs and ranking minority
members of the committees in the senate and the house of representatives with primary
jurisdiction over health and state information technology by January 15, 2019, with
recommendations related to expanding the state's telepresence platform and any legislation
required to implement the recommendations.

Subd. 5.

Expiration.

The work group expires January 16, 2019.

ARTICLE 3

COMMUNITY SUPPORTS AND CONTINUING CARE

Section 1.

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


Subd. 7.

Licensing moratorium.

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

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

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

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

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

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

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

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

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

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

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

(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.

EFFECTIVE DATE.

This section is effective June 29, 2018.

Sec. 2.

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


Subd. 2a.

Adult foster care and community residential setting license capacity.

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

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

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

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

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

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

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

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

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

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

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

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

(i) individualized plan of care;

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

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

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

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

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

Sec. 3.

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


Subdivision 1.

Applicability.

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

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

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

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

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

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

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

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

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

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

(2) in-home support services, including:

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

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

(iii) semi-independent living services; and

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

(3) residential supports and services, including:

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

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

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

(4) day services, including:

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

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

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

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

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

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

Sec. 4.

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


Subd. 5.

Service plan review and evaluation.

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

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

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

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

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

Sec. 5.

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


Subd. 2.

Behavior Positive support professional qualifications.

A behavior positive
support
professional providing behavioral positive 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 and , community access for disability
inclusion, community alternative care, and developmental disability 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); or

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

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

Sec. 6.

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


Subd. 3.

Behavior Positive support analyst qualifications.

(a) A behavior positive
support
analyst providing behavioral positive 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 and , community access for disability
inclusion, community alternative care, and developmental disability waiver plans or successor
plans:

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

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

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

(b) In addition, a behavior positive support analyst must:

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

conducting functional behavior assessments and designing, implementing, and evaluating
effectiveness of positive practices behavior support strategies for people who exhibit
challenging behaviors as well as co-occurring mental disorders and neurocognitive disorder
;

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

(i) ten hours of instruction in functional assessment and functional analysis;

(ii) 20 hours of instruction in the understanding of the function of behavior;

(iii) ten hours of instruction on design of positive practices behavior support strategies;

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

(v) eight hours of instruction on principles of person-centered thinking;

(3) have received 20 hours of instruction in the understanding of the function of behavior;

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

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

(6) (3) be determined by a behavior positive support 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 behavioral positive
support; and

(7) (4) be under the direct supervision of a behavior positive support professional.

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

Sec. 7.

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


Subd. 4.

Behavior Positive support specialist qualifications.

(a) A behavior positive
support
specialist providing behavioral positive 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 and , community access for disability
inclusion, community alternative care, and developmental disability waiver plans or successor
plans:

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

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

(b) In addition, a behavior specialist must:

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

(i) a minimum of four hours of training in functional assessment;

(2) have received (ii) 20 hours of instruction in the understanding of the function of
behavior;

(3) have received (iii) ten hours of instruction on design of positive practices behavioral
support strategies; and

(iv) eight hours of instruction on principles of person-centered thinking;

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

(5) (3) be under the direct supervision of a behavior positive support professional.

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

Sec. 8.

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


Subd. 3a.

Assessment; defined.

(a) "Assessment" means a review and evaluation of a
recipient's need for personal care assistance services conducted in person. Assessments for
personal care assistance services shall be conducted by the county public health nurse or a
certified public health nurse under contract with the county except when a long-term care
consultation assessment is being conducted for the purposes of determining a person's
eligibility for home and community-based waiver services including personal care assistance
services according to section 256B.0911. 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.

Sec. 9.

Minnesota Statutes 2016, section 256B.0659, subdivision 11, is amended to read:


Subd. 11.

Personal care assistant; requirements.

(a) A personal care assistant must
meet the following requirements:

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of
age with these additional requirements:

(i) supervision by a qualified professional every 60 days; and

(ii) employment by only one personal care assistance provider agency responsible for
compliance with current labor laws;

(2) be employed by a personal care assistance provider agency;

(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:

(i) not disqualified under section 245C.14; or

(ii) is disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;

(4) be able to effectively communicate with the recipient and personal care assistance
provider agency;

(5) be able to provide covered personal care assistance services according to the recipient's
personal care assistance care plan, respond appropriately to recipient needs, and report
changes in the recipient's condition to the supervising qualified professional or physician;

(6) not be a consumer of personal care assistance services;

(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;

(8) effective January 1, 2010, complete standardized training as determined by the
commissioner before completing enrollment. The training must be available in languages
other than English and to those who need accommodations due to disabilities. Personal care
assistant training must include successful completion of the following training components:
basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic
roles and responsibilities of personal care assistants including information about assistance
with lifting and transfers for recipients, emergency preparedness, orientation to positive
behavioral practices, fraud issues, and completion of time sheets. Upon completion of the
training components, the personal care assistant must demonstrate the competency to provide
assistance to recipients;

(9) complete training and orientation on the needs of the recipient; and

(10) be limited to providing and being paid for up to 275 hours per month of personal
care assistance services regardless of the number of recipients being served or the number
of personal care assistance provider agencies enrolled with. The number of hours worked
per day shall not be disallowed by the department unless in violation of the law.

(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).

(c) Persons who do not qualify as a personal care assistant include parents, stepparents,
and legal guardians of minors; spouses; paid legal guardians of adults; family foster care
providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of
a residential setting.

(d) Personal care services qualify for the enhanced rate described in subdivision 17a if
the personal care assistant providing the services:

(1) provides services, according to the care plan in subdivision 7, to a recipient who
qualifies for 12 or more hours per day of PCA 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.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 10.

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


Subd. 17a.

Enhanced rate.

An enhanced rate of 105 percent of the rate paid for PCA
services shall be paid for services provided to persons who qualify for 12 or more hours of
PCA service per day when provided by a PCA who meets the requirements of subdivision
11, paragraph (d). The enhanced rate for PCA services includes, and is not in addition to,
any rate adjustments implemented by the commissioner on July 1, 2018, to comply with
the terms of a collective bargaining agreement between the state of Minnesota and an
exclusive representative of individual providers under section 179A.54 that provides for
wage increases for individual providers who serve participants assessed to need 12 or more
hours of PCA services per day.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 11.

Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:


Subd. 21.

Requirements for provider enrollment of personal care assistance provider
agencies.

(a) All personal care assistance provider agencies must provide, at the time of
enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
a format determined by the commissioner, information and documentation that includes,
but is not limited to, the following:

(1) the personal care assistance provider agency's current contact information including
address, telephone number, and e-mail address;

(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid
revenue in the previous calendar year is up to and including $300,000, the provider agency
must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is
over $300,000, the provider agency must purchase a surety bond of $100,000. The surety
bond must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;

(3) proof of fidelity bond coverage in the amount of $20,000;

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

(6) a description of the personal care assistance provider agency's organization identifying
the names of all owners, managing employees, staff, board of directors, and the affiliations
of the directors, owners, or staff to other service providers;

(7) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety including process for notification and resolution of consumer
grievances, identification and prevention of communicable diseases, and employee
misconduct;

(8) copies of all other forms the personal care assistance provider agency uses in the
course of daily business including, but not limited to:

(i) a copy of the personal care assistance provider agency's time sheet if the time sheet
varies from the standard time sheet for personal care assistance services approved by the
commissioner, and a letter requesting approval of the personal care assistance provider
agency's nonstandard time sheet;

(ii) the personal care assistance provider agency's template for the personal care assistance
care plan; and

(iii) the personal care assistance provider agency's template for the written agreement
in subdivision 20 for recipients using the personal care assistance choice option, if applicable;

(9) a list of all training and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;

(10) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this section, including the requirements
under subdivision 11, paragraph (d), if enhanced PCA services are provided and submitted
for an enhanced rate under subdivision 17a
;

(11) documentation of the agency's marketing practices;

(12) disclosure of ownership, leasing, or management of all residential properties that
is used or could be used for providing home care services;

(13) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services for
employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
care assistance choice option and 72.5 percent of revenue from other personal care assistance
providers. The revenue generated by the qualified professional and the reasonable costs
associated with the qualified professional shall not be used in making this calculation; and

(14) effective May 15, 2010, documentation that the agency does not burden recipients'
free exercise of their right to choose service providers by requiring personal care assistants
to sign an agreement not to work with any particular personal care assistance recipient or
for another personal care assistance provider agency after leaving the agency and that the
agency is not taking action on any such agreements or requirements regardless of the date
signed.

(b) Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider agency
enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
the information specified in paragraph (a) from all personal care assistance providers
beginning July 1, 2009.

(c) All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before enrollment of the agency as a provider. Employees
in management and supervisory positions and owners who are active in the day-to-day
operations of an agency who have completed the required training as an employee with a
personal care assistance provider agency do not need to repeat the required training if they
are hired by another agency, if they have completed the training within the past three years.
By September 1, 2010, the required training must be available with meaningful access
according to title VI of the Civil Rights Act and federal regulations adopted under that law
or any guidance from the United States Health and Human Services Department. The
required training must be available online or by electronic remote connection. The required
training must provide for competency testing. Personal care assistance provider agency
billing staff shall complete training about personal care assistance program financial
management. This training is effective July 1, 2009. Any personal care assistance provider
agency enrolled before that date shall, if it has not already, complete the provider training
within 18 months of July 1, 2009. Any new owners or employees in management and
supervisory positions involved in the day-to-day operations are required to complete
mandatory training as a requisite of working for the agency. Personal care assistance provider
agencies certified for participation in Medicare as home health agencies are exempt from
the training required in this subdivision. When available, Medicare-certified home health
agency owners, supervisors, or managers must successfully complete the competency test.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 12.

Minnesota Statutes 2016, section 256B.0659, subdivision 24, is amended to read:


Subd. 24.

Personal care assistance provider agency; general duties.

A personal care
assistance provider agency shall:

(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;

(2) comply with general medical assistance coverage requirements;

(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;

(4) comply with background study requirements;

(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;

(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(8) withhold and pay all applicable federal and state taxes;

(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent
of the revenue generated by the medical assistance rate for personal care assistance services
for employee personal care assistant wages and benefits. The revenue generated by the
qualified professional and the reasonable costs associated with the qualified professional
shall not be used in making this calculation;

(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;

(11) enter into a written agreement under subdivision 20 before services are provided;

(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;

(13) provide the recipient with a copy of the home care bill of rights at start of service;
and

(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; and

(15) document that the agency uses the additional revenue due to the enhanced rate under
subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements
under subdivision 11, paragraph (d)
.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 13.

Minnesota Statutes 2016, section 256B.0659, subdivision 28, is amended to read:


Subd. 28.

Personal care assistance provider agency; required documentation.

(a)
Required documentation must be completed and kept in the personal care assistance provider
agency file or the recipient's home residence. The required documentation consists of:

(1) employee files, including:

(i) applications for employment;

(ii) background study requests and results;

(iii) orientation records about the agency policies;

(iv) trainings completed with demonstration of competence, including verification of
the completion of training required under subdivision 11, paragraph (d), for any billing of
the enhanced rate 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.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 14.

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


Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

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

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

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

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

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

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

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

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

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

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

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

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

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

(ii) consumer support grants under section 256.476; or

(iii) section 256B.85;

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

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

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

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

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

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

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

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

Sec. 15.

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


Subd. 3a.

Assessment and support planning.

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

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

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

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

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

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

(g) The written community support plan must include:

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

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

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

(4) referral information; and

(5) informal caregiver supports, if applicable.

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

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

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

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

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

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

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

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

(5) information about Minnesota health care programs;

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

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

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

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

(k) Face-to-face assessment completed as part of eligibility determination for the
alternative care, elderly waiver, developmental disabilities, community access for disability
inclusion, community alternative care, and brain injury waiver programs under sections
256B.0913, 256B.0915, 256B.092, 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. 16.

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


Subd. 3f.

Long-term care reassessments and community support plan updates.

(a)
Prior to a face-to-face reassessment, the certified assessor must review the person's most
recent assessment.
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 require a review of the most recent
assessment, review of
the current coordinated service and 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
reassessments
must be conducted annually or as required by federal and state laws and rules.
For reassessments, the certified assessor and the individual responsible for developing the
coordinated service and support plan must ensure the continuity of care for the person
receiving services and complete the updated community support plan and the updated
coordinated service and support plan within the timelines established by the commissioner.

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

Sec. 17.

Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 5, is
amended to read:


Subd. 5.

Administrative activity.

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

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

(c) The commissioner shall work with lead agencies responsible for conducting long-term
consultation services to develop a set of measurable benchmarks sufficient to demonstrate
quarterly improvement in the average time per assessment and other mutually agreed upon
measures of increasing efficiency. The commissioner shall collect data on these benchmarks
and provide to the lead agencies and the chairs and ranking minority members of the
legislative committees with jurisdiction over human services an annual trend analysis of
the data in order to demonstrate the commissioner's compliance with the requirements of
this subdivision.

Sec. 18.

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


Subd. 6.

Implementation of coordinated service and support plan.

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

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

(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. 19.

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


Subd. 1b.

Coordinated service and support plan.

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

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

(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. 20.

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


Subd. 1g.

Conditions not requiring development of coordinated service and support
plan.

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

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

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

(b) Unless otherwise required by federal law, the county agency is not required to conduct
or arrange for an annual needs reassessment by a certified assessor. The case manager who
works on behalf of the person to identify the person's needs and to minimize the impact of
the disability on the person's life must develop a person-centered service plan based on the
person's assessed needs and preferences. The person-centered service plan must be reviewed
annually. This paragraph applies to persons with developmental disabilities who are receiving
case management services under Minnesota Rules, part 9525.0036, and who make an
informed choice to decline an assessment under section 256B.0911.

Sec. 21.

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


Subd. 13.

Case management.

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

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

(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. 22.

Minnesota Statutes 2017 Supplement, 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) "Direct care staff" means employees providing direct service provision to people
receiving services under this section. Direct care staff does not include executive, managerial,
and administrative staff.

(f) "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) (g) "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) (h) "Lead agency" means a county, partnership of counties, or tribal agency charged
with administering waivered services under sections 256B.092 and 256B.49.

(h) (i) "Median" means the amount that divides distribution into two equal groups,
one-half above the median and one-half below the median.

(i) (j) "Payment or rate" means reimbursement to an eligible provider for services
provided to a qualified individual based on an approved service authorization.

(j) (k) "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) (l) "Recipient" means a person receiving home and community-based services funded
under any of the disability waivers.

(l) (m) "Shared staffing" means time spent by employees, not defined under paragraph
(f) (g), providing or available to provide more than one individual with direct support and
assistance with activities of daily living as defined under section 256B.0659, subdivision
1
, paragraph (b); instrumental activities of daily living as defined under section 256B.0659,
subdivision 1, paragraph (i); ancillary activities needed to support individual services; and
training to participants, and is based on the requirements in each individual's coordinated
service and support plan under section 245D.02, subdivision 4b; any coordinated service
and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and
provider observation of an individual's service need. Total shared staffing hours are divided
proportionally by the number of individuals who receive the shared service provisions.

(m) (n) "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) (o) "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.

Sec. 23.

Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 3, is
amended to read:


Subd. 3.

Applicable services.

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

(1) 24-hour customized living;

(2) adult day care;

(3) adult day care bath;

(4) behavioral programming;

(5) (4) companion services;

(6) (5) customized living;

(7) (6) day training and habilitation;

(7) employment development services;

(8) employment exploration services;

(9) employment support services;

(8) (10) housing access coordination;

(9) (11) independent living skills;

(12) independent living skills specialist services;

(13) individualized home supports;

(10) (14) in-home family support;

(11) (15) night supervision;

(12) (16) personal support;

(17) positive support service;

(13) (18) prevocational services;

(14) (19) residential care services;

(15) (20) residential support services;

(16) (21) respite services;

(17) (22) structured day services;

(18) (23) supported employment services;

(19) (24) supported living services;

(20) (25) 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. 24.

Minnesota Statutes 2016, section 256B.4914, subdivision 4, is amended to read:


Subd. 4.

Data collection for rate determination.

(a) Rates for applicable home and
community-based waivered services, including rate exceptions under subdivision 12, are
set by the rates management system.

(b) Data for services under section 256B.4913, subdivision 4a, shall be collected in a
manner prescribed by the commissioner.

(c) Data and information in the rates management system may be used to calculate an
individual's rate.

(d) Service providers, with information from the community support plan and oversight
by lead agencies, shall provide values and information needed to calculate an individual's
rate into the rates management system. The determination of service levels must be part of
a discussion with members of the support team as defined in section 245D.02, subdivision
34
. This discussion must occur prior to the final establishment of each individual's rate. The
values and information include:

(1) shared staffing hours;

(2) individual staffing hours;

(3) direct registered nurse hours;

(4) direct licensed practical nurse hours;

(5) staffing ratios;

(6) information to document variable levels of service qualification for variable levels
of reimbursement in each framework;

(7) shared or individualized arrangements for unit-based services, including the staffing
ratio;

(8) number of trips and miles for transportation services; and

(9) service hours provided through monitoring technology.

(e) Updates to individual data must include:

(1) data for each individual that is updated annually when renewing service plans; and

(2) requests by individuals or lead agencies to update a rate whenever there is a change
in an individual's service needs, with accompanying documentation.

(f) Lead agencies shall review and approve all services reflecting each individual's needs,
and the values to calculate the final payment rate for services with variables under
subdivisions 6, 7, 8, and 9 for each individual. Lead agencies must notify the individual and
the service provider of the final agreed-upon values and rate, and provide information that
is identical to what was entered into the rates management system. If a value used was
mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead
agencies to correct it. Lead agencies must respond to these requests. When responding to
the request, the lead agency must consider:

(1) meeting the health and welfare needs of the individual or individuals receiving
services by service site, identified in their coordinated service and support plan under section
245D.02, subdivision 4b, and any addendum under section 245D.02, subdivision 4c;

(2) meeting the requirements for staffing under subdivision 2, paragraphs (f) (g), (i) (m),
and (m) (n); and meeting or exceeding the licensing standards for staffing required under
section 245D.09, subdivision 1; and

(3) meeting the staffing ratio requirements under subdivision 2, paragraph (n), and
meeting or exceeding the licensing standards for staffing required under section 245D.31.

Sec. 25.

Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 5, is
amended to read:


Subd. 5.

Base wage index and standard component values.

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

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

(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home
health aide (SOC code 39-9021); 30 percent of the median wage for nursing assistant (SOC
code 31-1014); and 20 percent of the median wage for social and human services aide (SOC
code 21-1093); and

(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code
31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 20 percent of the median wage for social and human services aide (SOC code 21-1093);

(2) for day services, 20 percent of the median wage for nursing assistant (SOC code
31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 60 percent of the median wage for social and human services aide (SOC code 21-1093);

(3) for residential asleep-overnight staff, the wage is the minimum wage in Minnesota
for large employers, except in a family foster care setting, the wage is 36 percent of the
minimum wage in Minnesota for large employers;

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

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

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

(7) for supportive living services staff, 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code
21-1093);

(8) for housing access coordination staff, 100 percent of the median wage for community
and social services specialist (SOC code 21-1099);

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

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

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

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

(13) for supported employment staff, 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code
21-1093);

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

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

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

(17) for adult companion staff, 50 percent of the median wage for personal and home
care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant
(SOC code 31-1014);

(18) for night supervision staff, 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code
31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 20 percent of the median wage for social and human services aide (SOC code 21-1093);

(19) for respite staff, 50 percent of the median wage for personal and home care aide
(SOC code 39-9021); and 50 percent of the median wage for nursing assistant (SOC code
31-1014);

(20) for personal support staff, 50 percent of the median wage for personal and home
care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant
(SOC code 31-1014);

(21) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of behavior
professional, behavior analyst, and behavior specialists, which is 100 percent of the median
wage for clinical counseling and school psychologist (SOC code 19-3031);

(22) for registered nurse staff, 100 percent of the median wage for registered nurses
(SOC code 29-1141); and

(23) for licensed practical nurse staff, 100 percent of the median wage for licensed
practical nurses (SOC code 29-2061).

(b) Component values for residential support services are:

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

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

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

(4) general administrative support ratio: 13.25 percent;

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

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

(c) Component values for family foster care are:

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

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

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

(4) general administrative support ratio: 3.3 percent;

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

(6) absence factor: 1.7 percent.

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

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

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

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

(4) program plan support ratio: 5.6 percent;

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

(6) general administrative support ratio: 13.25 percent;

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

(8) absence and utilization factor ratio: 9.4 percent.

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

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

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

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

(4) program plan supports ratio: 15.5 percent;

(5) client programming and supports ratio: 4.7 percent;

(6) general administrative support ratio: 13.25 percent;

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

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

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

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

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

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

(4) program plan support ratio: 7.0 percent;

(5) client programming and support ratio: 2.3 percent;

(6) general administrative support ratio: 13.25 percent;

(7) program-related expense ratio: 2.9 percent; and

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

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

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

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

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

(4) general administrative support ratio: 13.25 percent;

(5) program-related expense ratio: 2.9 percent; and

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

(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor
Statistics available on December 31, 2016. The commissioner shall publish these updated
values and load them into the rate management system. On July 1, 2022, and every five
years thereafter, the commissioner shall update the base wage index in paragraph (a) based
on the most recently available wage data by SOC from the Bureau of Labor Statistics. The
commissioner shall publish these updated values and load them into the rate management
system.

(i) On July 1, 2017, the commissioner shall update the framework components in
paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision
6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the
Consumer Price Index. The commissioner will adjust these values higher or lower by the
percentage change in the Consumer Price Index-All Items, United States city average
(CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall publish these
updated values and load them into the rate management system. On July 1, 2022, and every
five years thereafter, the commissioner shall update the framework components in paragraph
(d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision 6, clauses
(8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the Consumer
Price Index. The commissioner shall adjust these values higher or lower by the percentage
change in the CPI-U from the date of the previous update to the date of the data most recently
available prior to the scheduled update. The commissioner shall publish these updated values
and load them into the rate management system.

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

(k) The commissioner shall increase the updated base wage index in paragraph (h) with
a competitive workforce factor as follows:

(1) effective January 1, 2019, the competitive workforce factor is 8.35 percent;

(2) effective July 1, 2019, the competitive workforce factor is decreased to 5.5 percent;
and

(3) effective July 1, 2020, the competitive workforce factor is decreased to 1.8 percent.

The lead agencies must implement changes to the competitive workforce factor on the dates
listed in clauses (1) to (3), and not as reassessments and reauthorizations occur.

EFFECTIVE DATE.

This section is effective January 1, 2019, or upon federal approval,
whichever occurs later. The commissioner shall inform the revisor of statutes when federal
approval is obtained.

Sec. 26.

Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 10, is
amended to read:


Subd. 10.

Updating payment values and additional information.

(a) From January
1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform
procedures to refine terms and adjust values used to calculate payment rates in this section.

(b) No later than July 1, 2014, the commissioner shall, within available resources, begin
to conduct research and gather data and information from existing state systems or other
outside sources on the following items:

(1) differences in the underlying cost to provide services and care across the state; and

(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and
units of transportation for all day services, which must be collected from providers using
the rate management worksheet and entered into the rates management system; and

(3) the distinct underlying costs for services provided by a license holder under sections
245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided
by a license holder certified under section 245D.33.

(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid
set of rates management system data, the commissioner, in consultation with stakeholders,
shall analyze for each service the average difference in the rate on December 31, 2013, and
the framework rate at the individual, provider, lead agency, and state levels. The
commissioner shall issue semiannual reports to the stakeholders on the difference in rates
by service and by county during the banding period under section 256B.4913, subdivision
4a
. The commissioner shall issue the first report by October 1, 2014, and the final report
shall be issued by December 31, 2018.

(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall
begin the review and evaluation of the following values already in subdivisions 6 to 9, or
issues that impact all services, including, but not limited to:

(1) values for transportation rates;

(2) values for services where monitoring technology replaces staff time;

(3) values for indirect services;

(4) values for nursing;

(5) values for the facility use rate in day services, and the weightings used in the day
service ratios and adjustments to those weightings;

(6) values for workers' compensation as part of employee-related expenses;

(7) values for unemployment insurance as part of employee-related expenses;

(8) any changes in state or federal law with a direct impact on the underlying cost of
providing home and community-based services; and

(9) direct care staff labor market measures; and

(10) outcome measures, determined by the commissioner, for home and community-based
services rates determined under this section.

(e) The commissioner shall report to the chairs and the ranking minority members of
the legislative committees and divisions with jurisdiction over health and human services
policy and finance with the information and data gathered under paragraphs (b) to (d), and
subdivision 10, paragraph (g), clause (6),
on the following dates:

(1) January 15, 2015, with preliminary results and data;

(2) January 15, 2016, with a status implementation update, and additional data and
summary information;

(3) January 15, 2017, with the full report; and

(4) January 15, 2020, with another full report, and a full report once every four years
thereafter.

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

(g) The commissioner shall provide a public notice via LISTSERV in October of each
year beginning October 1, 2014, containing information detailing legislatively approved
changes in:

(1) calculation values including derived wage rates and related employee and
administrative factors;

(2) service utilization;

(3) county and tribal allocation changes; and

(4) information on adjustments made to calculation values and the timing of those
adjustments.

The information in this notice must be effective January 1 of the following year.

(h) When the available shared staffing hours in a residential setting are insufficient to
meet the needs of an individual who enrolled in residential services after January 1, 2014,
or insufficient to meet the needs of an individual with a service agreement adjustment
described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours
shall be used.

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

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

Sec. 27.

Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 10a, is
amended to read:


Subd. 10a.

Reporting and analysis of cost data.

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

(1) worker wage costs;

(2) benefits paid;

(3) supervisor wage costs;

(4) executive wage costs;

(5) vacation, sick, and training time paid;

(6) taxes, workers' compensation, and unemployment insurance costs paid;

(7) administrative costs paid;

(8) program costs paid;

(9) transportation costs paid;

(10) vacancy rates; and

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

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

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

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

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

(f) Beginning January 1, 2019, providers enrolled to provide services with rates
determined under this section shall submit labor market data to the commissioner annually.

(g) Beginning January 15, 2020, the commissioner shall publish annual reports on
provider and state-level labor market data, including, but not limited to:

(1) number of direct care staff;

(2) wages of direct care staff;

(3) benefits provided to direct care staff;

(4) direct care staff job vacancies;

(5) direct care staff retention rates; and

(6) an evaluation of the effectiveness of the competitive workforce factors.

Sec. 28.

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


Subd. 8.

Supplementary services.

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

Sec. 29.

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


Subd. 2b.

Housing support agreements.

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

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

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

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

(3) the provision of housing support;

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

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

(6) submission of residency requirements that could result in recipient eviction. ; and

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

(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. 30.

Minnesota Statutes 2016, section 256I.04, is amended by adding a subdivision
to read:


Subd. 2h.

Required supplementary services.

Providers of supplementary services shall
ensure that recipients have, at a minimum, assistance with services as identified in the
recipient's professional statement of need under section 256I.03, subdivision 12. Providers
of supplementary services shall maintain case notes with the date and description of services
provided to individual recipients.

Sec. 31.

Minnesota Statutes 2016, section 256I.04, is amended by adding a subdivision
to read:


Subd. 5.

Employment.

A provider is prohibited from limiting or restricting the number
of hours an applicant or recipient is employed.

Sec. 32.

Minnesota Statutes 2017 Supplement, section 256I.05, subdivision 3, is amended
to read:


Subd. 3.

Limits on rates.

When a room and board rate is used to pay for an individual's
room and board, the rate payable to the residence must not exceed the rate paid by an
individual not receiving a room and board rate under this chapter but who is eligible under
section 256I.04, subdivision 1
.

Sec. 33.

Laws 2014, chapter 312, article 27, section 76, is amended to read:


Sec. 76. DISABILITY WAIVER REIMBURSEMENT RATE ADJUSTMENTS.

Subdivision 1.

Historical rate.

The commissioner of human services shall adjust the
historical rates calculated in Minnesota Statutes, section 256B.4913, subdivision 4a,
paragraph (b), in effect during the banding period under Minnesota Statutes, section
256B.4913, subdivision 4a, paragraph (a), for the reimbursement rate increases effective
April 1, 2014, and any rate modification enacted during the 2014 legislative session.

Subd. 2.

Residential support services.

The commissioner of human services shall adjust
the rates calculated in Minnesota Statutes, section 256B.4914, subdivision 6, paragraphs
(b), clause (4), and (c), for the reimbursement rate increases effective April 1, 2014, and
any rate modification enacted during the 2014 legislative session.

Subd. 3.

Day programs.

The commissioner of human services shall adjust the rates
calculated in Minnesota Statutes, section 256B.4914, subdivision 7, paragraph (a), clauses
(15) to (17), for the reimbursement rate increases effective April 1, 2014, and any rate
modification enacted during the 2014 legislative session.

Subd. 4.

Unit-based services with programming.

The commissioner of human services
shall adjust the rate calculated in Minnesota Statutes, section 256B.4914, subdivision 8,
paragraph (a), clause (14), for the reimbursement rate increases effective April 1, 2014, and
any rate modification enacted during the 2014 legislative session.

Subd. 5.

Unit-based services without programming.

The commissioner of human
services shall adjust the rate calculated in Minnesota Statutes, section 256B.4914, subdivision
9
, paragraph (a), clause (23), for the reimbursement rate increases effective April 1, 2014,
and any rate modification enacted during the 2014 legislative session.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 34.

Laws 2017, First Special Session chapter 6, article 1, section 52, is amended to
read:


Sec. 52. RANDOM MOMENT TIME STUDY EVALUATION REQUIRED.

The commissioner of human services shall implement administrative efficiencies and
evaluate the random moment time study methodology for reimbursement of costs associated
with county duties required under Minnesota Statutes, section 256B.0911. The evaluation
must determine whether random moment is efficient and effective in supporting functions
of assessment and support planning and the purpose under Minnesota Statutes, section
256B.0911, subdivision 1. The commissioner shall submit a report to the chairs and ranking
minority members of the house of representatives and senate committees with jurisdiction
over health and human services by January 15, 2019. The report must include at least one
option for a flat-rate payment methodology for long-term care consultation assessment and
support planning services, draft legislation to implement the flat-rate options, a fiscal analysis
of the flat-rate options, and a policy analysis of the flat-rate options, including the
commissioner's rationale for supporting or opposing the option that is, in the commissioner's
opinion, the best of the flat-rate options.

Sec. 35.

Laws 2017, First Special Session chapter 6, article 3, section 49, is amended to
read:


Sec. 49. ELECTRONIC SERVICE DELIVERY DOCUMENTATION SYSTEM
VISIT VERIFICATION
.

Subdivision 1.

Documentation; establishment.

The commissioner of human services
shall establish implementation requirements and standards for an electronic service delivery
documentation system
visit verification to comply with the 21st Century Cures Act, Public
Law 114-255. Within available appropriations, the commissioner shall take steps to comply
with the electronic visit verification requirements in the 21st Century Cures Act, Public
Law 114-255.

Subd. 2.

Definitions.

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

(b) "Electronic service delivery documentation visit verification" means the electronic
documentation of the:

(1) type of service performed;

(2) individual receiving the service;

(3) date of the service;

(4) location of the service delivery;

(5) individual providing the service; and

(6) time the service begins and ends.

(c) "Electronic service delivery documentation visit verification system" means a system
that provides electronic service delivery documentation verification of services that complies
with the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision
3.

(d) "Service" means one of the following:

(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625,
subdivision 19a
, and provided according to Minnesota Statutes, section 256B.0659; or

(2) community first services and supports under Minnesota Statutes, section 256B.85 ;

(3) home health services under Minnesota Statutes, section 256B.0625, subdivision 6a;
or

(4) other medical supplies and equipment or home and community-based services that
are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255
.

Subd. 3.

System requirements.

(a) In developing implementation requirements for an
electronic service delivery documentation system visit verification, the commissioner shall
consider electronic visit verification systems and other electronic service delivery
documentation methods. The commissioner shall convene stakeholders that will be impacted
by an electronic service delivery system, including service providers and their representatives,
service recipients and their representatives, and, as appropriate, those with expertise in the
development and operation of an electronic service delivery documentation system, to
ensure
that the requirements:

(1) are minimally administratively and financially burdensome to a provider;

(2) are minimally burdensome to the service recipient and the least disruptive to the
service recipient in receiving and maintaining allowed services;

(3) consider existing best practices and use of electronic service delivery documentation
visit verification
;

(4) are conducted according to all state and federal laws;

(5) are effective methods for preventing fraud when balanced against the requirements
of clauses (1) and (2); and

(6) are consistent with the Department of Human Services' policies related to covered
services, flexibility of service use, and quality assurance.

(b) The commissioner shall make training available to providers on the electronic service
delivery documentation
visit verification system requirements.

(c) The commissioner shall establish baseline measurements related to preventing fraud
and establish measures to determine the effect of electronic service delivery documentation
visit verification
requirements on program integrity.

(d) The commissioner shall make a state-selected electronic visit verification system
available to providers of services.

Subd. 3a.

Provider requirements.

(a) Providers of services may select their own
electronic visit verification system that meets the requirements established by the
commissioner.

(b) All electronic visit verification systems used by providers to comply with the
requirements established by the commissioner must provide data to the commissioner in a
format and at a frequency to be established by the commissioner.

(c) Providers must implement the electronic visit verification systems required under
this section by January 1, 2019, for personal care services and by January 1, 2023, for home
health services in accordance with the 21st Century Cures Act, Public Law 114-255, and
the Centers for Medicare and Medicaid Services guidelines. For the purposes of this
paragraph, "personal care services" and "home health services" have the meanings given
in United States Code, title 42, section 1396b(l)(5).

Subd. 4.

Legislative report.

(a) The commissioner shall submit a report by January 15,
2018, to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services with recommendations, based on the requirements of
subdivision 3, to establish electronic service delivery documentation system requirements
and standards. The report shall identify:

(1) the essential elements necessary to operationalize a base-level electronic service
delivery documentation system to be implemented by January 1, 2019; and

(2) enhancements to the base-level electronic service delivery documentation system to
be implemented by January 1, 2019, or after, with projected operational costs and the costs
and benefits for system enhancements.

(b) The report must also identify current regulations on service providers that are either
inefficient, minimally effective, or will be unnecessary with the implementation of an
electronic service delivery documentation system.

Sec. 36. ANALYSIS OF LICENSING ADULT FOSTER CARE.

The commissioner shall complete an analysis of settings identified by the commissioner,
in collaboration with county licensing agencies, as needing a license under Minnesota
Statutes, section 245A.03, subdivision 7, paragraph (a), clause (7), to determine if revisions
to the definition of residential program for recipients of home and community-based waiver
services are needed. The commissioner shall engage stakeholders, including licensed
providers of services governed by Minnesota Statutes, chapter 245D, and family members
who own and maintain control of the residence in which the service recipients live, in the
process of determining if revisions are needed and developing recommendations. The
commissioner shall provide a summary of the analysis and stakeholder input along with
recommendations, if any, to revise the definition of residential program under Minnesota
Statutes, section 245A.02, subdivision 14, to the chairs and ranking minorities members of
the legislative committees with jurisdiction over human services by February 15, 2019.

Sec. 37. DIRECTION TO COMMISSIONER.

Between July 1, 2018, and December 31, 2018, the commissioner of human services
shall continue to reimburse the Centers for Medicare and Medicaid Services for the
disallowed federal share of the rate increases described in Laws 2014, chapter 312, article
27, section 76, subdivisions 2 to 5.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 38. DIRECTION TO COMMISSIONER; BI AND CADI WAIVER
CUSTOMIZED LIVING SERVICES PROVIDER LOCATED IN HENNEPIN
COUNTY.

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

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

Sec. 39. DIRECTION TO COMMISSIONER.

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

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

Sec. 40. REVISOR'S INSTRUCTION.

The revisor of statutes shall codify Laws 2017, First Special Session chapter 6, article
3, section 49, as amended in this act, in Minnesota Statutes, chapter 256B.

Sec. 41. REPEALER.

Minnesota Statutes 2016, section 256B.0705, is repealed.

EFFECTIVE DATE.

This section is effective January 1, 2019.

ARTICLE 4

HEALTH CARE

Section 1.

Minnesota Statutes 2017 Supplement, section 256B.0625, subdivision 17, is
amended to read:


Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers.

(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of
Transportation
. All drivers providing nonemergency medical transportation must be
individually enrolled with the commissioner if the driver is a subcontractor for or employed
by a provider that both has a base of operation located within a metropolitan county listed
in section 437.121, subdivision 4, and is listed in paragraph (b), clause (1) or (3).
All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(d) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner in consultation with the
Nonemergency Medical Transportation Advisory Committee;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.

(f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).

(g) The commissioner may use an order by the recipient's attending physician or a medical
or mental health professional to certify that the recipient requires nonemergency medical
transportation services. Nonemergency medical transportation providers shall perform
driver-assisted services for eligible individuals, when appropriate. Driver-assisted service
includes passenger pickup at and return to the individual's residence or place of business,
assistance with admittance of the individual to the medical facility, and assistance in
passenger securement or in securing of wheelchairs, child seats, or stretchers in the vehicle.

Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.

Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(h) The administrative agency shall use the level of service process established by the
commissioner in consultation with the Nonemergency Medical Transportation Advisory
Committee to determine the client's most appropriate mode of transportation. If public transit
or a certified transportation provider is not available to provide the appropriate service mode
for the client, the client may receive a onetime service upgrade.

(i) The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the Web-based single
administrative structure, assessment tool, and level of need assessment under subdivision
18e. The local agency's financial obligation is limited to funds provided by the state or
federal government.

(k) The commissioner shall:

(1) in consultation with the Nonemergency Medical Transportation Advisory Committee,
verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;

(4) $13 for the base rate and $1.30 per mile for assisted transport;

(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.

(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).

(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.

(q) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

EFFECTIVE DATE.

Paragraph (c) is effective January 1, 2019.

Sec. 2.

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


Subd. 17d.

Transportation services oversight.

The commissioner shall contract with
a vendor or dedicate staff for oversight of providers of nonemergency medical transportation
services pursuant to the commissioner's authority in section 256B.04 and Minnesota Rules,
parts 9505.2160 to 9505.2245.

EFFECTIVE DATE.

This section is July 1, 2018.

Sec. 3.

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


Subd. 17e.

Transportation provider termination.

(a) A terminated nonemergency
medical transportation provider, including all named individuals on the current enrollment
disclosure form and known or discovered affiliates of the nonemergency medical
transportation provider, is not eligible to enroll as a nonemergency medical transportation
provider for five years following the termination.

(b) After the five-year period in paragraph (a), if a provider seeks to reenroll as a
nonemergency medical transportation provider, the nonemergency medical transportation
provider must be placed on a one-year probation period. During a provider's probation
period, the commissioner shall complete unannounced site visits and request documentation
to review compliance with program requirements.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 4.

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


Subd. 17f.

Transportation provider training.

The commissioner shall make available
to providers of nonemergency medical transportation and all drivers training materials and
online training opportunities regarding documentation requirements, documentation
procedures, and penalties for failing to meet documentation requirements.

Sec. 5. DIRECTION TO COMMISSIONER.

By August 1, 2020, the commissioner of human services shall issue a report to the chairs
and ranking minority members of the house of representatives and senate committees with
jurisdiction over health and human services. The commissioner must include in the report
the commissioner's findings regarding the impact of driver enrollment under Minnesota
Statutes, section 256B.0625, subdivision 17, paragraph (c), on the program integrity of the
nonemergency medical transportation program. The commission must include a
recommendation, based on the findings in the report, regarding expanding the driver
enrollment requirement.

Sec. 6. REPEALER.

Minnesota Statutes 2016, section 256B.0625, subdivision 18b, is repealed.

ARTICLE 5

APPROPRIATIONS

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

The sums shown in the columns marked "Appropriations" are added to or, if shown in
parentheses, subtracted from the appropriations in Laws 2017, First Special Session chapter
6, article 18, to the agencies and for the purposes specified in this article. The appropriations
are from the general fund, or another named fund, and are available for the fiscal years
indicated for each purpose. The figures "2018" and "2019" used in this article mean that
the addition to or subtraction from appropriations listed under them are available for the
fiscal year ending June 30, 2018, or June 30, 2019, respectively. Base level adjustments
mean the addition or subtraction from the base level adjustments in Laws 2017, First Special
Session chapter 6, article 18. "The first year" is fiscal year 2018. "The second year" is fiscal
year 2019. "The biennium" is fiscal years 2018 and 2019. Supplemental appropriations and
reductions to appropriations for the fiscal year ending June 30, 2018, are effective the day
following final enactment unless a different effective date is specified.

APPROPRIATIONS
Available for the Year
Ending June 30
2018
2019

Sec. 2. COMMISSIONER OF HUMAN
SERVICES

Subdivision 1.

Total Appropriation

$
-0-
$
26,941,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2.

Central Office; Operations

-0-
5,289,000

(a) Transfers. By June 30, 2019, the
commissioner of management and budget shall
transfer $4,149,000 from the general fund to
the health care access fund. By June 30, 2020,
the commissioner of management and budget
shall transfer $4,149,000 from the health care
access fund to the general fund.

(b) Base Level Adjustment. The general fund
base is increased by $6,558,000 in fiscal year
2020 and increased by $6,581,000 in fiscal
year 2021.

Subd. 3.

Central Office; Children and Families

-0-
633,000

(a) Child Welfare Training. $1,933,000 in
fiscal year 2019 is for initial costs for the child
welfare training in Minnesota Statutes, section
260C.81. No money from this appropriation
may be used for indirect costs by an entity
under contract to implement Minnesota
Statutes, section 260C.81.

(b) Base Level Adjustment. The general fund
base is increased by $650,000 in fiscal year
2020 and increased by $650,000 in fiscal year
2021.

Subd. 4.

Central Office; Health Care

-0-
1,024,000

Base Level Adjustment. The general fund
base is increased by $1,507,000 in fiscal year
2020 and increased by $1,513,000 in fiscal
year 2021.

Subd. 5.

Central Office; Continuing Care for
Older Adults

-0-
418,000

Base Level Adjustment. The general fund
base is increased by $425,000 in fiscal year
2020 and increased by $425,000 in fiscal year
2021.

Subd. 6.

Central Office; Community Supports

-0-
4,280,000

Base Level Adjustment. The general fund
base is increased by $4,280,000 in fiscal year
2020 and increased by $4,260,000 in fiscal
year 2021.

Subd. 7.

Forecasted Programs; Medical
Assistance

-0-
25,101,000

Subd. 8.

Forecasted Programs; Alternative Care

-0-
(28,000)

Subd. 9.

Forecasted Programs; Chemical
Dependency Treatment Fund

-0-
(14,243,000)

Subd. 10.

Grant Programs; Child Mental Health
Grants

-0-
4,467,000

(a) School-Linked Mental Health Services
by Telemedicine.
$4,467,000 in fiscal year
2019 is to sustain and expand grants under
Minnesota Statutes, section 245.4889,
subdivision 1, paragraph (b), clause (8),
including the delivery of school-linked mental
health services by telemedicine. This
appropriation is available until June 30, 2021.

(b) Base Level Adjustment. The general fund
base is increased by $9,467,000 in fiscal year
2020.

Sec. 3. EXPIRATION OF UNCODIFIED LANGUAGE.

All uncodified language contained in this article expires on June 30, 2019, unless a
different expiration date is specified.

Sec. 4. EFFECTIVE DATE.

This article is effective July 1, 2018, unless a different effective date is specified.

APPENDIX

Repealed Minnesota Statutes: S3937-1

256B.0625 COVERED SERVICES.

Subd. 18b.

Broker dispatching prohibition.

Except for establishing level of service process, the commissioner shall not use a broker or coordinator for any purpose related to nonemergency medical transportation services under subdivision 18.

256B.0705 PERSONAL CARE ASSISTANCE SERVICES; MANDATED SERVICE VERIFICATION.

Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have the meanings given them.

(b) "Personal care assistance services" or "PCA services" means services provided according to section 256B.0659.

(c) "Personal care assistant" or "PCA" has the meaning given in section 256B.0659, subdivision 1.

(d) "Service verification" means a random, unscheduled telephone call made for the purpose of verifying that the individual personal care assistant is present at the location where personal care assistance services are being provided and is providing services as scheduled.

Subd. 2.

Verification schedule.

An agency that submits claims for reimbursement for PCA services under this chapter must develop and implement administrative policies and procedures by which the agency verifies the services provided by a PCA. For each service recipient, the agency must conduct at least one service verification every 90 days. If more than one PCA provides services to a single service recipient, the agency must conduct a service verification for each PCA providing services before conducting a service verification for a PCA whose services were previously verified by the agency. Service verification must occur on an ongoing basis while the agency provides PCA services to the recipient. During service verification, the agency must speak with both the PCA and the service recipient or recipient's authorized representative. Only qualified professional service verifications are eligible for reimbursement. An agency may substitute a visit by a qualified professional that is eligible for reimbursement under section 256B.0659, subdivision 14 or 19.

Subd. 3.

Documentation of verification.

An agency must fully document service verifications in a legible manner and must maintain the documentation on site for at least five years from the date of documentation. For each service verification, documentation must include:

(1) the names and signatures of the service recipient or recipient's authorized representative, the PCA and any other agency staff present with the PCA during the service verification, and the staff person conducting the service verification; and

(2) the start and end time, day, month, and year of the service verification, and the corresponding PCA time sheet.

Subd. 4.

Variance.

The Office of Inspector General at the Department of Human Services may grant a variance to the service verification requirements in this section if an agency uses an electronic monitoring system or other methods that verify a PCA is present at the location where services are provided and is providing services according to the prescribed schedule. A decision to grant or deny a variance request is final and not subject to appeal under chapter 14.

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21.24 21.25 21.26 21.27 21.28 21.29 21.30 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 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21
23.22 23.23
23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 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 26.34 26.35 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21
27.22
27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 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 29.32 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 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 32.1 32.2 32.3 32.4 32.5
32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17
33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29
35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11
36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 37.1 37.2 37.3 37.4 37.5
37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32 37.33 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 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
40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11
40.12
40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 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 42.33 42.34 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 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8
45.9
45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16
47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 48.34 48.35 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 50.31 50.32 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13
51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 52.1 52.2 52.3
52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22
52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 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 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 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 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 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 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15
59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 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 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10
62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 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 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 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 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 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9
70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 71.32 71.33 72.1 72.2
72.3 72.4 72.5 72.6 72.7 72.8 72.9
72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 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 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 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 77.31 77.32 77.33 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 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 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28
83.29
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 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 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

700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155 ♦ Phone: (651) 296-2868 ♦ TTY: 1-800-627-3529 ♦ Fax: (651) 296-0569