Minnesota Legislature
SF 92
1st Engrossment - 91st Legislature (2019 - 2020) Posted on 05/07/2020 08:16am
2.32 2.33
2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 2.43 2.44 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 4.1 4.2
4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25
4.26 4.27 4.28 4.29 4.30 4.31 4.32 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10
5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28
5.29 5.30
5.31 5.32 5.33 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9
6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24
6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20
7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29
7.30
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22
8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 10.1 10.2 10.3 10.4 10.5 10.6 10.7
10.8
10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25
11.26
11.27 11.28 11.29 11.30
12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26
12.27 12.28 12.29 12.30
13.1 13.2 13.3 13.4 13.5 13.6
13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30
14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 14.34 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 15.35 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10
16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22
16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32
17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35
18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8
18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 20.34 20.35 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25
21.26 21.27
21.28 21.29 21.30 21.31 21.32 21.33 21.34 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 23.1 23.2 23.3 23.4
23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 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 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 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 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11
29.12
29.13 29.14 29.15 29.16 29.17 29.18
29.19
29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31
30.1 30.2 30.3 30.4 30.5 30.6
30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17
30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22
31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2
32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 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 34.30 34.31 34.32 34.33 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20
35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9
36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33
37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 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 39.31 39.32 39.33 40.1 40.2 40.3 40.4 40.5 40.6
40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 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 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 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28
43.29 43.30 43.31 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 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 45.32 45.33 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33 46.34
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 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 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 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
51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30
52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19
52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 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
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 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26
55.27 55.28 55.29 55.30 55.31
56.1 56.2 56.3 56.4 56.5
56.6 56.7 56.8 56.9 56.10 56.11
56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20
56.21 56.22 56.23 56.24
56.25 56.26 56.27 56.28 56.29 56.30 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 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 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19
60.20 60.21 60.22 60.23 60.24
60.25 60.26 60.27 60.28 60.29
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 62.1 62.2 62.3 62.4
62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12
63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 66.1 66.2 66.3 66.4 66.5 66.6
66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16
66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30
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 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11
70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 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 73.30 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 75.1 75.2 75.3 75.4 75.5 75.6
75.7
75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 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 78.32 78.33 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 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
82.1 82.2 82.3 82.4
82.5 82.6 82.7 82.8 82.9 82.10
82.11 82.12 82.13 82.14 82.15
82.16
82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 83.1 83.2 83.3 83.4 83.5 83.6 83.7
83.8 83.9
83.10 83.11 83.12 83.13 83.14
83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 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 85.29
85.30 85.31 85.32 85.33 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 87.33 87.34
88.1
88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18
88.19
88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21
89.22
89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 90.1 90.2 90.3
90.4
90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12
90.13
90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25
90.26
90.27 90.28 90.29 90.30 90.31
91.1
91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13
91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27
91.28 91.29 91.30 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13
92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28
92.29 92.30 92.31 92.32 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25
93.26 93.27 93.28 93.29 93.30 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11
94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 95.1 95.2 95.3 95.4 95.5 95.6
95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13
97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29
98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8
99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 99.33 100.1 100.2 100.3 100.4 100.5
100.6
100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18
100.19
100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 101.1 101.2 101.3 101.4
101.5
101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25
101.26 101.27 101.28
102.1 102.2
102.3 102.4 102.5 102.6 102.7 102.8
102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16
103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32
104.1 104.2 104.3
104.4 104.5 104.6
104.7 104.8
104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 106.34 106.35 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 107.34 107.35 108.1 108.2 108.3 108.4 108.5 108.6
108.7 108.8 108.9
108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 108.33 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 109.33 110.1 110.2 110.3 110.4 110.5 110.6
110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25
112.26 112.27 112.28 112.29 112.30 112.31 112.32 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 113.33 113.34 113.35 114.1 114.2 114.3 114.4
114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18
114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29
114.30 114.31 114.32 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12
116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23
117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17
118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28
118.29 118.30 118.31 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24
120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26
121.27 121.28 121.29 121.30
121.31 121.32 121.33 121.34 121.35 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 123.1 123.2
123.3 123.4 123.5 123.6
123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17
123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16
124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2 126.3 126.4 126.5 126.6
126.7
126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18
126.19
126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 128.34 128.35 129.1 129.2 129.3 129.4
129.5
129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 130.1 130.2 130.3 130.4 130.5 130.6 130.7
130.8
130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15
131.16
131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 132.33 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20
133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 134.33 134.34 134.35 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20
137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 137.34 138.1 138.2 138.3 138.4 138.5 138.6 138.7
138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18
138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 139.1 139.2 139.3
139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 140.1 140.2
140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12
140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8
141.9 141.10 141.11
141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24
142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 143.1 143.2 143.3 143.4 143.5 143.6
143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15
143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27
143.28 143.29 143.30 143.31 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9
145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 146.1 146.2 146.3
146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11
148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20
149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34
156.1 156.2 156.3 156.4
156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23
158.24
158.25 158.26 158.27 158.28 158.29 158.30 158.31 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30
161.1 161.2 161.3
161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15
161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 163.1 163.2 163.3 163.4
163.5 163.6 163.7
163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15
163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9
164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30
165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 167.1 167.2 167.3 167.4 167.5
167.6 167.7 167.8 167.9 167.10
167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14
168.15 168.16 168.17 168.18 168.19 168.20
168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16
169.17 169.18 169.19 169.20 169.21 169.22 169.23
169.24 169.25 169.26 169.27
169.28 169.29 169.30 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10
170.11
170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 171.1 171.2 171.3 171.4 171.5
171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 172.1 172.2 172.3 172.4 172.5 172.6 172.7
172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26
174.27 174.28 174.29 174.30
175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29
176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14
176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28
176.29 176.30 176.31 176.32 176.33 177.1 177.2 177.3
177.4 177.5 177.6 177.7
177.8
177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22
177.23 177.24 177.25 177.26 177.27 177.28 177.29
178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12
178.13 178.14 178.15 178.16
178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28
178.29 178.30 178.31 178.32 178.33 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14
179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29
179.30 179.31 179.32 179.33 179.34 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9
180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18
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180.21 180.22
180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22
181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30
182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11
182.12
182.13 182.14
182.15 182.16
182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26
182.27 182.28 182.29 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 184.32 184.33 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9
185.10
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185.27
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188.19
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190.28 190.29 190.30 190.31 190.32 190.33 191.1 191.2
191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11
192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21
193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 194.1 194.2
194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 195.34 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29
196.30 196.31 196.32
196.33
197.1 197.2
197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33
198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31
199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33 199.34 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22
200.23
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200.33
201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 202.1 202.2 202.3
202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 203.1 203.2
203.3 203.4
203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16
203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 204.34 204.35 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 205.33 205.34 205.35 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 206.34 206.35 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14
207.15
207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23
207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33
A bill for an act
relating to state government; establishing a portion of the health and human services
budget; modifying provisions governing program integrity, children and family
services, chemical and mental health, continuing care for older adults, disability
services, direct care and treatment, operations, and health care; modifying penalties;
establishing asset limits; establishing electronic visit verification system; eliminating
TEFRA fees; repealing MFIP child care assistance program and basic sliding fee
child care assistance program; directing the commissioner of human services to
propose a redesigned child care assistance program; directing closure of a MSOCS
residential facility; repealing statutes relating to the state-operated services account;
establishing a background study set-aside for individuals working in the substance
use disorder treatment field; requiring reports; making technical changes;
appropriating money; amending Minnesota Statutes 2018, sections 13.69,
subdivision 1; 13.851, by adding a subdivision; 15C.02; 119B.09, subdivisions 1,
4, 7, 9, 9a; 119B.125, subdivision 6, by adding subdivisions; 119B.13, subdivisions
6, 7; 144.057, subdivision 3; 144A.073, by adding a subdivision; 144A.479, by
adding a subdivision; 245.095; 245.4889, subdivision 1; 245A.03, subdivision 7;
245A.04, subdivision 7, by adding a subdivision; 245A.065; 245A.11, subdivision
2a; 245C.02, by adding a subdivision; 245C.22, subdivisions 4, 5; 245D.03,
subdivision 1; 245D.071, subdivision 5; 245D.09, subdivisions 5, 5a; 245D.091,
subdivisions 2, 3, 4; 245E.02, by adding a subdivision; 246.54, by adding a
subdivision; 252.27, subdivision 2a; 252.275, subdivision 3; 254A.03, subdivision
3; 254A.19, by adding a subdivision; 254B.02, subdivision 1; 254B.03, subdivisions
2, 4; 254B.04, subdivision 1; 254B.05, subdivision 1a; 254B.06, subdivisions 1,
2; 256.9365; 256.98, subdivisions 1, 8; 256.987, subdivisions 1, 2; 256B.02,
subdivision 7, by adding a subdivision; 256B.04, subdivision 21; 256B.056,
subdivisions 3, 4, 5c, 7a; 256B.0625, subdivisions 17, 18d, 18h, 19a, 24, 43, by
adding subdivisions; 256B.064, subdivisions 1b, 2, by adding a subdivision;
256B.0651, subdivision 17; 256B.0652, subdivision 6; 256B.0658; 256B.0659,
subdivisions 3, 3a, 11, 12, 13, 14, 19, 21, 24, 28, by adding a subdivision;
256B.0757, subdivisions 1, 2, 4, by adding subdivisions; 256B.0911, subdivisions
1a, 3a, 3f, 5, by adding a subdivision; 256B.0915, subdivisions 6, 10, by adding
a subdivision; 256B.092, subdivision 1b, by adding a subdivision; 256B.0921;
256B.14, subdivision 2; 256B.27, subdivision 3; 256B.49, subdivisions 13, 14, by
adding a subdivision; 256B.4912, by adding subdivisions; 256B.4914, subdivisions
2, 3, 5, 10, 10a; 256B.493, subdivision 1; 256B.5013, subdivisions 1, 6; 256B.5014;
256B.5015, subdivision 2; 256B.85, subdivisions 3, 8, 10; 256C.23, by adding a
subdivision; 256C.261; 256D.024, subdivision 3; 256D.0515; 256D.0516,
subdivision 2; 256I.03, subdivision 8; 256I.04, subdivisions 1, 2b, 2f, by adding
subdivisions; 256I.05, subdivision 1r; 256I.06, subdivision 8; 256J.08, subdivision
47; 256J.21, subdivision 2; 256J.26, subdivision 3; 256L.01, subdivision 5;
256M.41, subdivision 3, by adding a subdivision; 256P.04, subdivision 4; 256P.06,
subdivision 3; 256R.25; 518A.32, subdivision 3; 518A.51; 641.15, subdivision
3a; Laws 2017, First Special Session chapter 6, article 1, sections 44; 45; article
3, section 49; article 18, section 7; proposing coding for new law in Minnesota
Statutes, chapters 245A; 256; 256B; 256D; 256J; 256R; 260C; 268A; repealing
Minnesota Statutes 2018, sections 16A.724, subdivision 2; 119B.011, subdivisions
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 10a, 11, 12, 13, 13a, 14, 15, 16, 17, 18, 19, 19a, 19b,
20, 20a, 21, 22; 119B.02; 119B.025, subdivisions 1, 2, 3, 4; 119B.03, subdivisions
1, 2, 3, 4, 5, 6, 6a, 6b, 8, 9, 10; 119B.035; 119B.04; 119B.05, subdivisions 1, 4,
5; 119B.06, subdivisions 1, 2, 3; 119B.08, subdivisions 1, 2, 3; 119B.09,
subdivisions 1, 3, 4, 4a, 5, 6, 7, 8, 9, 9a, 10, 11, 12, 13; 119B.095; 119B.097;
119B.10, subdivisions 1, 2, 3; 119B.105; 119B.11, subdivisions 1, 2a, 3, 4;
119B.12, subdivisions 1, 2; 119B.125; 119B.13, subdivisions 1, 1a, 3, 3a, 3b, 3c,
4, 5, 6, 7; 119B.14; 119B.15; 119B.16; 245G.11, subdivisions 1, 4, 7; 246.18,
subdivisions 8, 9; 254B.03, subdivision 4a; 256B.0705; 256I.05, subdivision 3;
256R.53, subdivision 2; Laws 2017, First Special Session chapter 6, article 7,
section 34; Minnesota Rules, parts 3400.0010; 3400.0020, subparts 1, 4, 5, 8, 9a,
10a, 12, 17a, 18, 18a, 20, 24, 25, 26, 28, 29a, 31b, 32b, 33, 34a, 35, 37, 38, 38a,
38b, 39, 40, 40a, 44; 3400.0030; 3400.0035; 3400.0040, subparts 1, 3, 4, 5, 5a,
6a, 6b, 6c, 7, 8, 9, 10, 11, 12, 13, 14, 15, 15a, 17, 18; 3400.0060, subparts 2, 4, 5,
6, 6a, 7, 8, 9, 10; 3400.0080, subparts 1, 1a, 1b, 8; 3400.0090, subparts 1, 2, 3, 4;
3400.0100, subparts 2a, 2b, 2c, 5; 3400.0110, subparts 1, 1a, 2, 2a, 3, 4a, 7, 8, 9,
10, 11; 3400.0120, subparts 1, 1a, 2, 2a, 3, 5; 3400.0130, subparts 1, 1a, 2, 3, 3a,
3b, 5, 5a, 7; 3400.0140, subparts 1, 2, 4, 5, 6, 7, 8, 9, 9a, 10, 14; 3400.0150;
3400.0170, subparts 1, 3, 4, 6a, 7, 8, 9, 10, 11; 3400.0180; 3400.0183, subparts 1,
2, 5; 3400.0185; 3400.0187, subparts 1, 2, 3, 4, 6; 3400.0200; 3400.0220;
3400.0230, subpart 3; 3400.0235, subparts 1, 2, 3, 4, 5, 6; 9530.6800; 9530.6810.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
PROGRAM INTEGRITY
Section 1.
Minnesota Statutes 2018, section 15C.02, is amended to read:
15C.02 LIABILITY FOR CERTAIN ACTS.
(a) A person who commits any act described in clauses (1) to (7) is liable to the state or
the political subdivision for a civil penalty deleted text beginof not less than $5,500 and not more than $11,000
per false or fraudulent claimdeleted text endnew text begin in the amounts set forth in the federal False Claims Act, United
States Code, title 31, section 3729, and as modified by the federal Civil Penalties Inflation
Adjustment Act Improvements Act of 2015new text end, plus three times the amount of damages that
the state or the political subdivision sustains because of the act of that person, except as
otherwise provided in paragraph (b):
(1) knowingly presents, or causes to be presented, a false or fraudulent claim for payment
or approval;
(2) knowingly makes or uses, or causes to be made or used, a false record or statement
material to a false or fraudulent claim;
(3) knowingly conspires to commit a violation of clause (1), (2), (4), (5), (6), or (7);
(4) has possession, custody, or control of property or money used, or to be used, by the
state or a political subdivision and knowingly delivers or causes to be delivered less than
all of that money or property;
(5) is authorized to make or deliver a document certifying receipt for money or property
used, or to be used, by the state or a political subdivision and, intending to defraud the state
or a political subdivision, makes or delivers the receipt without completely knowing that
the information on the receipt is true;
(6) knowingly buys, or receives as a pledge of an obligation or debt, public property
from an officer or employee of the state or a political subdivision who lawfully may not
sell or pledge the property; or
(7) knowingly makes or uses, or causes to be made or used, a false record or statement
material to an obligation to pay or transmit money or property to the state or a political
subdivision, or knowingly conceals or knowingly and improperly avoids or decreases an
obligation to pay or transmit money or property to the state or a political subdivision.
(b) Notwithstanding paragraph (a), the court may assess not less than two times the
amount of damages that the state or the political subdivision sustains because of the act of
the person if:
(1) the person committing a violation under paragraph (a) furnished an officer or
employee of the state or the political subdivision responsible for investigating the false or
fraudulent claim violation with all information known to the person about the violation
within 30 days after the date on which the person first obtained the information;
(2) the person fully cooperated with any investigation by the state or the political
subdivision of the violation; and
(3) at the time the person furnished the state or the political subdivision with information
about the violation, no criminal prosecution, civil action, or administrative action had been
commenced under this chapter with respect to the violation and the person did not have
actual knowledge of the existence of an investigation into the violation.
(c) A person violating this section is also liable to the state or the political subdivision
for the costs of a civil action brought to recover any penalty or damages.
(d) A person is not liable under this section for mere negligence, inadvertence, or mistake
with respect to activities involving a false or fraudulent claim.
Sec. 2.
Minnesota Statutes 2018, section 119B.09, subdivision 1, is amended to read:
Subdivision 1.
General eligibility requirements.
(a) Child care services must be
available to families new text beginwith financial resources, excluding vehicles, of less than $100,000,
new text end who need child care to find or keep employment or to obtain the training or education
necessary to find employment and who:
(1) have household income less than or equal to 67 percent of the state median income,
adjusted for family size, at application and redetermination, and meet the requirements of
section 119B.05; receive MFIP assistance; and are participating in employment and training
services under chapter 256J; or
(2) have household income less than or equal to 47 percent of the state median income,
adjusted for family size, at application and less than or equal to 67 percent of the state
median income, adjusted for family size, at redetermination.
(b) Child care services must be made available as in-kind services.
(c) All applicants for child care assistance and families currently receiving child care
assistance must be assisted and required to cooperate in establishment of paternity and
enforcement of child support obligations for all children in the family at application and
redetermination as a condition of program eligibility. For purposes of this section, a family
is considered to meet the requirement for cooperation when the family complies with the
requirements of section 256.741.
(d) All applicants for child care assistance and families currently receiving child care
assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition
of eligibility. The co-payment fee may include additional recoupment fees due to a child
care assistance program overpayment.
Sec. 3.
Minnesota Statutes 2018, section 119B.09, subdivision 4, is amended to read:
Subd. 4.
Eligibility; annual income; calculation.
(a) Annual income of the applicant
family is the current monthly income of the family multiplied by 12 or the income for the
12-month period immediately preceding the date of application, or income calculated by
the method which provides the most accurate assessment of income available to the family.
(b) Self-employment income must be calculated based on gross receipts less operating
expensesnew text begin authorized by the Internal Revenue Servicenew text end.
(c) Income changes are processed under section 119B.025, subdivision 4. Included lump
sums counted as income under section 256P.06, subdivision 3, must be annualized over 12
months. new text beginIncome includes all deposits into accounts owned or controlled by the applicant,
including amounts spent on personal expenses including rent, mortgage, automobile-related
expenses, utilities, and food and amounts received as salary or draws from business accounts.
Income does not include a deposit specifically identified by the applicant as a loan or gift,
for which the applicant provides the source, date, amount, and repayment terms. new text endIncome
new text begin and assets new text endmust be verified with documentary evidence. If the applicant does not have
sufficient evidence of incomenew text begin or assetsnew text end, verification must be obtained from the source of
the incomenew text begin or assetsnew text end.
Sec. 4.
Minnesota Statutes 2018, section 119B.09, subdivision 7, is amended to read:
Subd. 7.
Date of eligibility for assistance.
(a) The date of eligibility for child care
assistance under this chapter is the later of the date the application was received by the
county; the beginning date of employment, education, or training; the date the infant is born
for applicants to the at-home infant care program; or the date a determination has been made
that the applicant is a participant in employment and training services under Minnesota
Rules, part 3400.0080, or chapter 256J.
(b) Payment ceases for a family under the at-home infant child care program when a
family has used a total of 12 months of assistance as specified under section 119B.035.
Payment of child care assistance for employed persons on MFIP is effective the date of
employment or the date of MFIP eligibility, whichever is later. Payment of child care
assistance for MFIP or DWP participants in employment and training services is effective
the date of commencement of the services or the date of MFIP or DWP eligibility, whichever
is later. Payment of child care assistance for transition year child care must be made
retroactive to the date of eligibility for transition year child care.
(c) Notwithstanding paragraph (b), payment of child care assistance for participants
eligible under section 119B.05 may only be made retroactive for a maximum of deleted text beginsixdeleted text endnew text begin zeronew text end
months from the date of application for child care assistance.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for applications processed on or after
July 1, 2019.
new text end
Sec. 5.
Minnesota Statutes 2018, section 119B.09, subdivision 9, is amended to read:
Subd. 9.
Licensed and legal nonlicensed family child care providers; assistance.
This
subdivision applies to any provider providing care in a setting other than a new text beginlicensed or
license-exempt new text endchild care center. Licensed and legal nonlicensed family child care providers
and their employees are not eligible to receive child care assistance subsidies under this
chapter for their own children or children in their family during the hours they are providing
child care or being paid to provide child care. Child care providers and their employees are
eligible to receive child care assistance subsidies for their children when they are engaged
in other activities that meet the requirements of this chapter and for which child care
assistance can be paid. The hours for which the provider or their employee receives a child
care subsidy for their own children must not overlap with the hours the provider provides
child care services.
Sec. 6.
Minnesota Statutes 2018, section 119B.09, subdivision 9a, is amended to read:
Subd. 9a.
Child care deleted text begincentersdeleted text endnew text begin authorizationsnew text end; deleted text beginassistancedeleted text endnew text begin dependents of employees
and controlling individualsnew text end.
(a) A new text beginlicensed or license-exempt new text endchild care center deleted text beginmaydeleted text endnew text begin must
notnew text end receive authorizations for deleted text begin25 or fewer childrendeleted text endnew text begin more than seven childrennew text end who are
dependents of the center's employeesnew text begin or controlling individualsnew text end. deleted text beginIf a child care center is
authorized for more than 25 children who are dependents of center employees, the county
cannot authorize additional dependents of an employee until the number of children falls
below 25.
deleted text end
deleted text begin
(b) Funds paid to providers during the period of time when a center is authorized for
more than 25 children who are dependents of center employees must not be treated as
overpayments under section 119B.11, subdivision 2a, due to noncompliance with this
subdivision.
deleted text end
deleted text begin (c)deleted text endnew text begin (b)new text end Nothing in this subdivision precludes the commissioner from conducting fraud
investigations relating to child care assistance, imposing sanctions, and obtaining monetary
recovery as otherwise provided by law.
Sec. 7.
Minnesota Statutes 2018, section 119B.125, subdivision 6, is amended to read:
Subd. 6.
Record-keeping requirement.
new text begin(a) As a condition of payment, new text endall providers
receiving child care assistance payments must keep new text beginaccurate and legible new text enddaily attendance
records at the site where services are delivered for children receiving child care assistance
and must make those records available immediately to the county or the commissioner upon
request. The attendance records must be completed daily and include the date, the first and
last name of each child in attendance, and the times when each child is dropped off and
picked up. To the extent possible, the times that the child was dropped off to and picked up
from the child care provider must be entered by the person dropping off or picking up the
child. The daily attendance records must be retained at the site where services are delivered
for six years after the date of service.
new text begin
(b) Records that are not produced immediately under paragraph (a), unless a delay is
agreed upon by the commissioner and provider, shall not be valid for purposes of establishing
a child's attendance and shall result in an overpayment under paragraph (d).
new text end
new text begin (c) new text endA county or the commissioner may deny new text beginor revoke a provider's new text endauthorization deleted text beginas a
child care provider to any applicant, rescind authorization of any provider,deleted text endnew text begin to receive child
care assistance payments under section 119B.13, subdivision 6, paragraph (d), pursue a
fraud disqualification under section 256.98, take an action against the provider under chapter
245E,new text end or establish an new text beginattendance record new text endoverpayment deleted text beginclaim in the systemdeleted text end new text beginunder paragraph
(d) new text endagainst a current or former provider, when the county or the commissioner knows or
has reason to believe that the provider has not complied with the record-keeping requirement
in this subdivision. deleted text beginA provider's failure to produce attendance records as requested on more
than one occasion constitutes grounds for disqualification as a provider.
deleted text end
new text begin
(d) To calculate an attendance record overpayment under this subdivision, the
commissioner or county agency subtracts the maximum daily rate from the total amount
paid to a provider for each day that a child's attendance record is missing, unavailable,
incomplete, illegible, inaccurate, or otherwise inadequate.
new text end
new text begin
(e) The commissioner shall develop criteria to direct a county when the county must
establish an attendance overpayment under this subdivision.
new text end
Sec. 8.
Minnesota Statutes 2018, section 119B.125, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Proof of surety bond coverage. new text end
new text begin
All licensed child care centers authorized
for reimbursement under this chapter that received child care assistance program revenue
equal to or greater than $250,000 in the previous calendar year must provide to the
commissioner at least once per year proof of surety bond coverage of $100,000 in a format
determined by the commissioner. The surety bond must be in a form approved by the
commissioner, be renewed annually, and allow for recovery of costs and fees in pursuing
a claim on the bond.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 9.
Minnesota Statutes 2018, section 119B.125, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Financial misconduct. new text end
new text begin
(a) County agencies may conduct investigations of
financial misconduct by child care providers as described in section 245E.02, subdivisions
1 and 2, only after receiving verification that the department is not investigating a provider
under chapter 245E.
new text end
new text begin
(b) If, upon investigation, a preponderance of evidence shows financial misconduct by
a provider, the county may immediately suspend the provider's authorization to receive
child care assistance payments under section 119B.13, subdivision 6, paragraph (d), prior
to pursuing other available remedies.
new text end
new text begin
(c) The county shall give immediate notice in writing to a provider and any affected
families of any suspension of the provider's child care authorization under paragraph (b).
The notice shall state:
new text end
new text begin
(1) the factual basis for the county's determination;
new text end
new text begin
(2) the date of the suspension;
new text end
new text begin
(3) the length of the suspension;
new text end
new text begin
(4) the requirements and procedures for reinstatement;
new text end
new text begin
(5) the right to dispute the county's determination and to provide evidence; and
new text end
new text begin
(6) the right to appeal the county's determination.
new text end
new text begin
(d) The county's determination under paragraph (b) is subject to the fair hearing
requirements under section 119B.16, subdivisions 1a, 1b, and 2. A provider that requests a
fair hearing is entitled to a hearing within ten days of the request.
new text end
Sec. 10.
Minnesota Statutes 2018, section 119B.13, subdivision 6, is amended to read:
Subd. 6.
Provider payments.
(a) new text beginA provider shall bill only for services documented
according to section 119B.125, subdivision 6. new text endThe provider shall bill for services provided
within ten days of the end of the service period. Payments under the child care fund shall
be made within 21 days of receiving a complete bill from the provider. Counties or the state
may establish policies that make payments on a more frequent basis.
(b) If a provider has received an authorization of care and been issued a billing form for
an eligible family, the bill must be submitted within 60 days of the last date of service on
the bill. A bill submitted more than 60 days after the last date of service must be paid if the
county determines that the provider has shown good cause why the bill was not submitted
within 60 days. Good cause must be defined in the county's child care fund plan under
section 119B.08, subdivision 3, and the definition of good cause must include county error.
Any bill submitted more than a year after the last date of service on the bill must not be
paid.
(c) If a provider provided care for a time period without receiving an authorization of
care and a billing form for an eligible family, payment of child care assistance may only be
made retroactively for a maximum of six months from the date the provider is issued an
authorization of care and billing form.
(d) A county or the commissioner may refuse to issue a child care authorization to a
licensed or legal nonlicensed provider, revoke an existing child care authorization to a
licensed or legal nonlicensed provider, stop payment issued to a licensed or legal nonlicensed
provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
(1) the provider admits to intentionally giving the county materially false information
on the provider's billing forms;
(2) a county or the commissioner finds by a preponderance of the evidence that the
provider intentionally gave the county materially false information on the provider's billing
forms, or provided false attendance records to a county or the commissioner;
(3) the provider is in violation of child care assistance program rules, until the agency
determines those violations have been corrected;
(4) the provider is operating after:
(i) an order of suspension of the provider's license issued by the commissioner;
(ii) an order of revocation of the provider's license; or
(iii) a final order of conditional license issued by the commissioner for as long as the
conditional license is in effect;
(5) the provider submits false attendance reports or refuses to provide documentation
of the child's attendance upon request; deleted text beginor
deleted text end
(6) the provider gives false child care price informationdeleted text begin.deleted text endnew text begin; or
new text end
new text begin
(7) the provider fails to report decreases in a child's attendance, as required under section
119B.125, subdivision 9.
new text end
(e) For purposes of paragraph (d), clauses (3), (5), deleted text beginanddeleted text end (6), new text beginand (7), new text endthe county or the
commissioner may withhold the provider's authorization or payment for a period of time
not to exceed three months beyond the time the condition has been corrected.
(f) A county's payment policies must be included in the county's child care plan under
section 119B.08, subdivision 3. If payments are made by the state, in addition to being in
compliance with this subdivision, the payments must be made in compliance with section
16A.124.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 11.
Minnesota Statutes 2018, section 119B.13, subdivision 7, is amended to read:
Subd. 7.
Absent days.
(a) Licensed child care providers and license-exempt centers
must not be reimbursed for more than 25 full-day absent days per child, excluding holidays,
in a deleted text beginfiscaldeleted text endnew text begin calendarnew text end year, or for more than ten consecutive full-day absent days. new text begin"Absent
day" means any day that the child is authorized and scheduled to be in care with a licensed
provider or license exempt center and the child is absent from the care for the entire day.
new text end Legal nonlicensed family child care providers must not be reimbursed for absent days. If a
child attends for part of the time authorized to be in care in a day, but is absent for part of
the time authorized to be in care in that same day, the absent time must be reimbursed but
the time must not count toward the absent days limit. Child care providers must only be
reimbursed for absent days if the provider has a written policy for child absences and charges
all other families in care for similar absences.
(b) Notwithstanding paragraph (a), children with documented medical conditions that
cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
full-day absent days limit. Absences due to a documented medical condition of a parent or
sibling who lives in the same residence as the child receiving child care assistance do not
count against the absent days limit in a deleted text beginfiscaldeleted text endnew text begin calendarnew text end year. Documentation of medical
conditions must be on the forms and submitted according to the timelines established by
the commissioner. A public health nurse or school nurse may verify the illness in lieu of a
medical practitioner. If a provider sends a child home early due to a medical reason,
including, but not limited to, fever or contagious illness, the child care center director or
lead teacher may verify the illness in lieu of a medical practitioner.
(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit
if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or
commissioner of education-selected high school equivalency certification; and (3) is a
student in a school district or another similar program that provides or arranges for child
care, parenting support, social services, career and employment supports, and academic
support to achieve high school graduation, upon request of the program and approval of the
county. If a child attends part of an authorized day, payment to the provider must be for the
full amount of care authorized for that day.
(d) Child care providers must be reimbursed for up to ten federal or state holidays or
designated holidays per year when the provider charges all families for these days and the
holiday or designated holiday falls on a day when the child is authorized to be in attendance.
Parents may substitute other cultural or religious holidays for the ten recognized state and
federal holidays. Holidays do not count toward the absent days limit.
(e) A family or child care provider must not be assessed an overpayment for an absent
day payment unless (1) there was an error in the amount of care authorized for the family,
(2) all of the allowed full-day absent payments for the child have been paid, or (3) the family
or provider did not timely report a change as required under law.
(f) The provider and family shall receive notification of the number of absent days used
upon initial provider authorization for a family and ongoing notification of the number of
absent days used as of the date of the notification.
(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days
per child, excluding holidays, in a deleted text beginfiscaldeleted text endnew text begin calendarnew text end year; and ten consecutive full-day absent
days.
new text begin
(h) For purposes of this subdivision, "holidays limit" means ten full-day holidays per
child, excluding absent days, in a calendar year.
new text end
new text begin
(i) If a day meets the criteria of an absent day or a holiday under this subdivision, the
provider must bill that day as an absent day or holiday. A provider's failure to properly bill
an absent day or a holiday results in an overpayment, regardless of whether the child reached,
or is exempt from, the absent days limit or holidays limit for the calendar year.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 12.
Minnesota Statutes 2018, section 144A.479, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Labor market reporting. new text end
new text begin
A home care provider shall comply with the labor
market reporting requirements described in section 256B.4912, subdivision 1a.
new text end
Sec. 13.
Minnesota Statutes 2018, section 245.095, is amended to read:
245.095 LIMITS ON RECEIVING PUBLIC FUNDS.
Subdivision 1.
Prohibition.
new text begin(a) new text endIf a provider, vendor, or individual enrolled, licensed,
deleted text begin ordeleted text end receiving funds under a grant contractnew text begin, or registerednew text end in any program administered by the
commissionernew text begin, including under the commissioner's powers and authorities in section 256.01,new text end
is excluded from deleted text beginanydeleted text endnew text begin thatnew text end program deleted text beginadministered by the commissioner, including under the
commissioner's powers and authorities in section 256.01deleted text end, the commissioner shallnew text begin:
new text end
new text begin (1)new text end prohibit the excluded provider, vendor, or individual from enrolling deleted text beginordeleted text endnew text begin,new text end becoming
licensednew text begin, receiving grant funds, or registeringnew text end in any other program administered by the
commissionerdeleted text begin.deleted text endnew text begin; and
new text end
new text begin
(2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider,
vendor, or individual in any other program administered by the commissioner.
new text end
new text begin (b) new text endThe duration of this prohibitionnew text begin, disenrollment, revocation, suspension,
disqualification, or debarmentnew text end must last for the longest applicable sanction or disqualifying
period in effect for the provider, vendor, or individual permitted by state or federal law.
Subd. 2.
Definitions.
(a) For purposes of this section, the following definitions have the
meanings given them.
(b) "Excluded" means disenrolled, deleted text beginsubject to license revocation or suspension,
disqualified, or subject to vendor debarmentdeleted text end new text begindisqualified, has a license that has been revoked
or suspended under chapter 245A, has been debarred or suspended new text endunder Minnesota Rules,
part 1230.1150new text begin, or terminated from participation in medical assistance under section
256B.064new text end.
(c) "Individual" means a natural person providing products or services as a provider or
vendor.
(d) "Provider" means an owner, controlling individual, license holder, director, or
managerial official.
Sec. 14.
new text begin
[245A.24] MANDATORY REPORTING.
new text end
new text begin
All licensors employed by a county or the Department of Human Services must
immediately report any suspected fraud to county human services investigators or the
Department of Human Services Office of the Inspector General.
new text end
Sec. 15.
Minnesota Statutes 2018, section 245E.02, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Provider definitions. new text end
new text begin
For the purposes of this section, "provider" includes:
new text end
new text begin
(1) individuals or entities meeting the definition of provider in section 245E.01,
subdivision 12; and
new text end
new text begin
(2) owners and controlling individuals of entities identified in clause (1).
new text end
Sec. 16.
Minnesota Statutes 2018, section 256.98, subdivision 1, is amended to read:
Subdivision 1.
Wrongfully obtaining assistance.
A person who commits any of the
following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897,
the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program
formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, new text begin256I, new text end256J, 256K, or
256L, child care assistance programs, and emergency assistance programs under section
256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses
(1) to (5):
(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willfully false statement or representation, by intentional concealment of any material fact,
or by impersonation or other fraudulent device, assistance or the continued receipt of
assistance, to include child care assistance or vouchers produced according to sections
145.891 to 145.897 and MinnesotaCare services according to sections 256.9365, 256.94,
and 256L.01 to 256L.15, to which the person is not entitled or assistance greater than that
to which the person is entitled;
(2) knowingly aids or abets in buying or in any way disposing of the property of a
recipient or applicant of assistance without the consent of the county agency; or
(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments
to which the individual is not entitled as a provider of subsidized child care, or by furnishing
or concurring in a willfully false claim for child care assistance.
The continued receipt of assistance to which the person is not entitled or greater than
that to which the person is entitled as a result of any of the acts, failure to act, or concealment
described in this subdivision shall be deemed to be continuing offenses from the date that
the first act or failure to act occurred.
Sec. 17.
Minnesota Statutes 2018, section 256.98, subdivision 8, is amended to read:
Subd. 8.
Disqualification from program.
(a) Any person found to be guilty of
wrongfully obtaining assistance by a federal or state court or by an administrative hearing
determination, or waiver thereof, through a disqualification consent agreement, or as part
of any approved diversion plan under section 401.065, or any court-ordered stay which
carries with it any probationary or other conditions, in the Minnesota family investment
program and any affiliated program to include the diversionary work program and the work
participation cash benefit program, the food stamp or food support program, the general
assistance program, housing support under chapter 256I, or the Minnesota supplemental
aid program shall be disqualified from that program. new text beginThe disqualification based on a finding
or action by a federal or state court is a permanent disqualification. The disqualification
based on an administrative hearing, or waiver thereof, through a disqualification consent
agreement, or as part of any approved diversion plan under section 401.065, or any
court-ordered stay which carries with it any probationary or other conditions must be for a
period of two years for the first offense and a permanent disqualification for the second
offense. new text endIn addition, any person disqualified from the Minnesota family investment program
shall also be disqualified from the food stamp or food support program. The needs of that
individual shall not be taken into consideration in determining the grant level for that
assistance unitdeleted text begin:deleted text endnew text begin.
new text end
deleted text begin
(1) for one year after the first offense;
deleted text end
deleted text begin
(2) for two years after the second offense; and
deleted text end
deleted text begin
(3) permanently after the third or subsequent offense.
deleted text end
The period of program disqualification shall begin on the date stipulated on the advance
notice of disqualification without possibility of postponement for administrative stay or
administrative hearing and shall continue through completion unless and until the findings
upon which the sanctions were imposed are reversed by a court of competent jurisdiction.
The period for which sanctions are imposed is not subject to review. The sanctions provided
under this subdivision are in addition to, and not in substitution for, any other sanctions that
may be provided for by law for the offense involved. A disqualification established through
hearing or waiver shall result in the disqualification period beginning immediately unless
the person has become otherwise ineligible for assistance. If the person is ineligible for
assistance, the disqualification period begins when the person again meets the eligibility
criteria of the program from which they were disqualified and makes application for that
program.
(b) A family receiving assistance through child care assistance programs under chapter
119B with a family member who is found to be guilty of wrongfully obtaining child care
assistance by a federal court, state court, or an administrative hearing determination or
waiver, through a disqualification consent agreement, as part of an approved diversion plan
under section 401.065, or a court-ordered stay with probationary or other conditions, is
disqualified from child care assistance programs. The disqualifications deleted text beginmust be for periods
of one year and two years for the first and second offenses, respectively. Subsequent
violations must result indeleted text end new text beginbased on a finding or action by a federal or state court is a new text endpermanent
disqualification. new text beginThe disqualification based on an administrative hearing determination or
waiver, through a disqualification consent agreement, as part of an approved diversion plan
under section 401.065, or a court-ordered stay with probationary or other conditions must
be for a period of two years for the first offense and a permanent disqualification for the
second offense. new text endDuring the disqualification period, disqualification from any child care
program must extend to all child care programs and must be immediately applied.
(c) A provider caring for children receiving assistance through child care assistance
programs under chapter 119B is disqualified from receiving payment for child care services
from the child care assistance program under chapter 119B when the provider is found to
have wrongfully obtained child care assistance by a federal court, state court, or an
administrative hearing determination or waiver under section 256.046, through a
disqualification consent agreement, as part of an approved diversion plan under section
401.065, or a court-ordered stay with probationary or other conditions. The disqualification
deleted text begin must be for a period of one year for the first offense and two years for the second offense.
Any subsequent violation must result indeleted text endnew text begin based on a finding or action by a federal or state
court is anew text end permanent disqualification. new text beginThe disqualification based on an administrative hearing
determination or waiver under section 256.045, as part of an approved diversion plan under
section 401.065, or a court-ordered stay with probationary or other conditions must be for
a period of two years for the first offense and a permanent disqualification for the second
offense. new text endThe disqualification period must be imposed immediately after a determination is
made under this paragraph. During the disqualification period, the provider is disqualified
from receiving payment from any child care program under chapter 119B.
(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults
without children and upon federal approval, all categories of medical assistance and
remaining categories of MinnesotaCare, except for children through age 18, by a federal or
state court or by an administrative hearing determination, or waiver thereof, through a
disqualification consent agreement, or as part of any approved diversion plan under section
401.065, or any court-ordered stay which carries with it any probationary or other conditions,
is disqualified from that program. The period of disqualification is one year after the first
offense, two years after the second offense, and permanently after the third or subsequent
offense. The period of program disqualification shall begin on the date stipulated on the
advance notice of disqualification without possibility of postponement for administrative
stay or administrative hearing and shall continue through completion unless and until the
findings upon which the sanctions were imposed are reversed by a court of competent
jurisdiction. The period for which sanctions are imposed is not subject to review. The
sanctions provided under this subdivision are in addition to, and not in substitution for, any
other sanctions that may be provided for by law for the offense involved.
Sec. 18.
Minnesota Statutes 2018, section 256.987, subdivision 1, is amended to read:
Subdivision 1.
Electronic benefit transfer (EBT) card.
Cash benefits for the general
assistance and Minnesota supplemental aid programs under chapter 256D and programs
under chapter 256J must be issued on an EBT card deleted text beginwithdeleted text endnew text begin.new text end The name new text beginand photograph new text endof the
head of household new text beginand a list of family members authorized to use the EBT card must be
new text end printed on the card. new text beginThe cardholder must show identification before making a purchase.
new text end The card must include the following statement: "It is unlawful to use this card to purchase
tobacco products or alcoholic beverages." This card must be issued within 30 calendar days
of an eligibility determination. During the initial 30 calendar days of eligibility, a recipient
may have cash benefits issued on an EBT card without a name printed on the card. This
card may be the same card on which food support benefits are issued and does not need to
meet the requirements of this section.
Sec. 19.
Minnesota Statutes 2018, section 256.987, subdivision 2, is amended to read:
Subd. 2.
Prohibited purchasesnew text begin and returnsnew text end.
new text begin(a) new text endAn individual with an EBT card issued
for one of the programs listed under subdivision 1 is prohibited from using the EBT debit
card to purchase tobacco products and alcoholic beverages, as defined in section 340A.101,
subdivision 2. Any prohibited purchases made under this subdivision shall constitute unlawful
use and result in disqualification of the cardholder from the program as provided in
subdivision 4.
new text begin
(b) An item purchased with an EBT card that is returned must be credited back to the
EBT card. It is prohibited to give the EBT cardholder cash for returned items purchased
with an EBT card.
new text end
Sec. 20.
Minnesota Statutes 2018, section 256B.02, subdivision 7, is amended to read:
Subd. 7.
Vendor of medical care.
(a) "Vendor of medical care" means any person or
persons furnishing, within the scope of the vendor's respective license, any or all of the
following goods or services: medical, surgical, hospital, ambulatory surgical center services,
optical, visual, dental and nursing services; drugs and medical supplies; appliances;
laboratory, diagnostic, and therapeutic services; nursing home and convalescent care;
screening and health assessment services provided by public health nurses as defined in
section 145A.02, subdivision 18; health care services provided at the residence of the patient
if the services are performed by a public health nurse and the nurse indicates in a statement
submitted under oath that the services were actually provided; and such other medical
services or supplies provided or prescribed by persons authorized by state law to give such
services and suppliesnew text begin, including services under section 256B.4912. For purposes of this
chapter, the term includes a person or entity that furnishes a good or service eligible for
medical assistance or federally approved waiver plan payments under this chapternew text end. The term
includes, but is not limited to, directors and officers of corporations or members of
partnerships who, either individually or jointly with another or others, have the legal control,
supervision, or responsibility of submitting claims for reimbursement to the medical
assistance program. The term only includes directors and officers of corporations who
personally receive a portion of the distributed assets upon liquidation or dissolution, and
their liability is limited to the portion of the claim that bears the same proportion to the total
claim as their share of the distributed assets bears to the total distributed assets.
(b) "Vendor of medical care" also includes any person who is credentialed as a health
professional under standards set by the governing body of a federally recognized Indian
tribe authorized under an agreement with the federal government according to United States
Code, title 25, section 450f, to provide health services to its members, and who through a
tribal facility provides covered services to American Indian people within a contract health
service delivery area of a Minnesota reservation, as defined under Code of Federal
Regulations, title 42, section 36.22.
(c) A federally recognized Indian tribe that intends to implement standards for
credentialing health professionals must submit the standards to the commissioner of human
services, along with evidence of meeting, exceeding, or being exempt from corresponding
state standards. The commissioner shall maintain a copy of the standards and supporting
evidence, and shall use those standards to enroll tribal-approved health professionals as
medical assistance providers. For purposes of this section, "Indian" and "Indian tribe" mean
persons or entities that meet the definition in United States Code, title 25, section 450b.
Sec. 21.
Minnesota Statutes 2018, section 256B.02, is amended by adding a subdivision
to read:
new text begin Subd. 20. new text end
new text begin Income. new text end
new text begin
Income is calculated using the adjusted gross income methodology
under the Affordable Care Act. Income includes funds in personal or business accounts
used to pay personal expenses including rent, mortgage, automobile-related expenses,
utilities, food, and other personal expenses not directly related to the business, unless the
funds are directly attributable to an exception to the income requirement specifically
identified by the applicant.
new text end
Sec. 22.
Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
Subd. 21.
Provider enrollment.
(a)new text begin The commissioner shall enroll providers and conduct
screening activities as required by Code of Federal Regulations, title 42, section 455, subpart
E, including database checks, unannounced pre- and post-enrollment site visits, fingerprinting,
and criminal background studies. A provider providing services from multiple licensed
locations must enroll each licensed location separately. The commissioner may deny a
provider's incomplete application for enrollment if a provider fails to respond to the
commissioner's request for additional information within 60 days of the request.
new text end
new text begin
(b) The commissioner must revalidate each provider under this subdivision at least once
every five years. The commissioner may revalidate a personal care assistance agency under
this subdivision once every three years. The commissioner shall conduct revalidation as
follows:
new text end
new text begin
(1) provide 30-day notice of revalidation due date to include instructions for revalidation
and a list of materials the provider must submit to revalidate;
new text end
new text begin
(2) notify the provider that fails to completely respond within 30 days of any deficiencies
and allow an additional 30 days to comply; and
new text end
new text begin
(3) give 60-day notice of termination and immediately suspend a provider's ability to
bill for failure to remedy any deficiencies within the 30-day time period. The commissioner's
decision to suspend the provider's ability to bill is not subject to an administrative appeal.
new text end
new text begin
(c) The commissioner shall require that an individual rendering care to a recipient for
the following covered services enroll as an individual provider and be identified on claims:
new text end
new text begin
(1) consumer directed community supports; and
new text end
new text begin
(2) qualified professionals supervising personal care assistant services according to
section 256B.0659.
new text end
new text begin
(d) The commissioner may suspend a provider's ability to bill for a failure to comply
with any individual provider requirements or conditions of participation until the provider
comes into compliance. The commissioner's decision to suspend the provider's ability to
bill is not subject to an administrative appeal.
new text end
new text begin
(e) Notwithstanding any other provision to the contrary, all correspondence and
notifications, including notifications of termination and other actions, shall be delivered
electronically to a provider's MN-ITS mailbox. For a provider that does not have a MN-ITS
account and mailbox, notice shall be sent by first class mail.
new text end
new text begin (f)new text end If the commissioner or the Centers for Medicare and Medicaid Services determines
that a provider is designated "high-risk," the commissioner may withhold payment from
providers within that category upon initial enrollment for a 90-day period. The withholding
for each provider must begin on the date of the first submission of a claim.
deleted text begin (b)deleted text endnew text begin (g)new text end An enrolled provider that is also licensed by the commissioner under chapter
245A, or is licensed as a home care provider by the Department of Health under chapter
144A and has a home and community-based services designation on the home care license
under section 144A.484, must designate an individual as the entity's compliance officer.
The compliance officer must:
(1) develop policies and procedures to assure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;
(2) train the employees of the provider entity, and any agents or subcontractors of the
provider entity including billers, on the policies and procedures under clause (1);
(3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services, and implement action to remediate any resulting problems;
(4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;
(5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and
(6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.
The commissioner may require, as a condition of enrollment in medical assistance, that a
provider within a particular industry sector or category establish a compliance program that
contains the core elements established by the Centers for Medicare and Medicaid Services.
deleted text begin (c)deleted text endnew text begin (h)new text end The commissioner may revoke the enrollment of an ordering or rendering provider
for a period of not more than one year, if the provider fails to maintain and, upon request
from the commissioner, provide access to documentation relating to written orders or requests
for payment for durable medical equipment, certifications for home health services, or
referrals for other items or services written or ordered by such provider, when the
commissioner has identified a pattern of a lack of documentation. A pattern means a failure
to maintain documentation or provide access to documentation on more than one occasion.
Nothing in this paragraph limits the authority of the commissioner to sanction a provider
under the provisions of section 256B.064.
deleted text begin (d)deleted text endnew text begin (i)new text end The commissioner shall terminate or deny the enrollment of any individual or
entity if the individual or entity has been terminated from participation in Medicare or under
the Medicaid program or Children's Health Insurance Program of any other state.
deleted text begin (e)deleted text endnew text begin (j)new text end As a condition of enrollment in medical assistance, the commissioner shall require
that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
Services, its agents, or its designated contractors and the state agency, its agents, or its
designated contractors to conduct unannounced on-site inspections of any provider location.
The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
and standards used to designate Medicare providers in Code of Federal Regulations, title
42, section 424.518. The list and criteria are not subject to the requirements of chapter 14.
The commissioner's designations are not subject to administrative appeal.
deleted text begin (f)deleted text endnew text begin (k)new text end As a condition of enrollment in medical assistance, the commissioner shall require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
high-risk for fraud, waste, or abuse.
deleted text begin (g)deleted text endnew text begin (l)new text end(1) Upon initial enrollment, reenrollment, and notification of revalidation, all
durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
meeting the durable medical equipment provider and supplier definition in clause (3),
operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
annually renewed and designates the Minnesota Department of Human Services as the
obligee, and must be submitted in a form approved by the commissioner. For purposes of
this clause, the following medical suppliers are not required to obtain a surety bond: a
federally qualified health center, a home health agency, the Indian Health Service, a
pharmacy, and a rural health clinic.
(2) At the time of initial enrollment or reenrollment, durable medical equipment providers
and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond must deleted text beginallow for recovery of costs and
fees in pursuing a claim on the bonddeleted text endnew text begin be in a form approved by the commissioner, renewed
annually, and must allow for recovery of costs and fees in pursing a claim on the bondnew text end.
(3) "Durable medical equipment provider or supplier" means a medical supplier that can
purchase medical equipment or supplies for sale or rental to the general public and is able
to perform or arrange for necessary repairs to and maintenance of equipment offered for
sale or rental.
deleted text begin (h)deleted text endnew text begin (m)new text end The Department of Human Services may require a provider to purchase a surety
bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
if: (1) the provider fails to demonstrate financial viability, (2) the department determines
there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
provider or category of providers is designated high-risk pursuant to paragraph deleted text begin(a)deleted text endnew text begin (e)new text end and
as per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in
an amount of $100,000 or ten percent of the provider's payments from Medicaid during the
immediately preceding 12 months, whichever is greater. The surety bond must name the
Department of Human Services as an obligee and must allow for recovery of costs and fees
in pursuing a claim on the bond. This paragraph does not apply if the provider currently
maintains a surety bond under the requirements in section 256B.0659 or 256B.85.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019, with the exception that the
amendments to paragraph (l), clause (2), are effective January 1, 2020.
new text end
Sec. 23.
Minnesota Statutes 2018, section 256B.056, subdivision 3, is amended to read:
Subd. 3.
Asset limitations for certain individuals.
(a) To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or if a member
of a household with two family members, husband and wife, or parent and child, the
household must not own more than $6,000 in assets, plus $200 for each additional legal
dependent. In addition to these maximum amounts, an eligible individual or family may
accrue interest on these amounts, but they must be reduced to the maximum at the time of
an eligibility redetermination. The accumulation of the clothing and personal needs allowance
according to section 256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not considered in determining
eligibility for medical assistance is the value of those assets excluded under the Supplemental
Security Income program for aged, blind, and disabled persons, with the following
exceptions:
(1) household goods and personal effects are not considered;
(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considerednew text begin. A bank account
that contains personal income or assets or is used to pay personal expenses is not a capital
or operating asset of a trade or businessnew text end;
(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security
Income program;
(4) assets designated as burial expenses are excluded to the same extent excluded by the
Supplemental Security Income program. Burial expenses funded by annuity contracts or
life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;
(5) for a person who no longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical assistance under section 256B.057,
subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility
as an employed person with a disability, to the extent that the person's total assets remain
within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
(6) when a person enrolled in medical assistance under section 256B.057, subdivision
9, is age 65 or older and has been enrolled during each of the 24 consecutive months before
the person's 65th birthday, the assets owned by the person and the person's spouse must be
disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when
determining eligibility for medical assistance under section 256B.055, subdivision 7. The
income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions
in section 256B.059; and
(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.
Sec. 24.
Minnesota Statutes 2018, section 256B.056, subdivision 4, is amended to read:
Subd. 4.
Income.
(a) To be eligible for medical assistance, a person eligible under section
256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of the federal
poverty guidelines. Effective January 1, 2000, and each successive January, recipients of
Supplemental Security Income may have an income up to the Supplemental Security Income
standard in effect on that date.
(b) Effective January 1, 2014, to be eligible for medical assistance, under section
256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133
percent of the federal poverty guidelines for the household size.
(c) To be eligible for medical assistance under section 256B.055, subdivision 15, a
person may have an income up to 133 percent of federal poverty guidelines for the household
size.
(d) To be eligible for medical assistance under section 256B.055, subdivision 16, a child
age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines for
the household size.
(e) To be eligible for medical assistance under section 256B.055, subdivision 3a, a child
under age 19 may have income up to 275 percent of the federal poverty guidelines for the
household size or an equivalent standard when converted using modified adjusted gross
income methodology as required under the Affordable Care Act. Children who are enrolled
in medical assistance as of December 31, 2013, and are determined ineligible for medical
assistance because of the elimination of income disregards under modified adjusted gross
income methodology as defined in subdivision 1a remain eligible for medical assistance
under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law
111-3, until the date of their next regularly scheduled eligibility redetermination as required
in subdivision 7a.
(f) In computing income to determine eligibility of persons under paragraphs (a) to (e)
who are not residents of long-term care facilities, the commissioner shallnew text begin: (1)new text end disregard
increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
Administration unusual medical expense payments are considered income to the recipientdeleted text begin.deleted text endnew text begin;
and (2) include all assets available to the applicant that are considered income according to
the Internal Revenue Service. Income includes all deposits into accounts owned or controlled
by the applicant, including amounts spent on personal expenses, including rent, mortgage,
automobile-related expenses, utilities, and food and amounts received as salary or draws
from business accounts and not otherwise excluded by federal or state laws. Income does
not include a deposit specifically identified by the applicant as a loan or gift, for which the
applicant provides the source, date, amount, and repayment terms.
new text end
Sec. 25.
Minnesota Statutes 2018, section 256B.056, subdivision 7a, is amended to read:
Subd. 7a.
Periodic renewal of eligibility.
(a) The commissioner shall make an annual
redetermination of eligibility deleted text beginbased on information contained in the enrollee's case file and
other information available to the agency, including but not limited to information accessed
through an electronic database, without requiring the enrollee to submit any information
when sufficient data is available for the agency to renew eligibilitydeleted text end.
(b) deleted text beginIf the commissioner cannot renew eligibility in accordance with paragraph (a),deleted text end The
commissioner must provide the enrollee with a prepopulated renewal form containing
eligibility information available to the agency and deleted text beginpermitdeleted text end the enrollee deleted text begintodeleted text endnew text begin mustnew text end submit the
form with any corrections or additional information to the agency and sign the renewal form
via any of the modes of submission specified in section 256B.04, subdivision 18.
(c) An enrollee who is terminated for failure to complete the renewal process may
subsequently submit the renewal form and required information within four months after
the date of termination and have coverage reinstated without a lapse, if otherwise eligible
under this chapter.
(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
required to renew eligibility every six months.
Sec. 26.
Minnesota Statutes 2018, section 256B.0625, subdivision 17, is amended to read:
Subd. 17.
Transportation costs.
(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:
(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;
(2) ambulances, as defined in section 144E.001, subdivision 2;
(3) taxicabs that meet the requirements of this subdivision;
(4) public transit, as defined in section 174.22, subdivision 7; or
(5) not-for-hire vehicles, including volunteer drivers.
(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840deleted text begin, and in consultation with the Minnesota Department of
Transportationdeleted text end. new text beginAll drivers providing nonemergency medical transportation must be
individually enrolled with the commissioner if the driver is a subcontractor for or employed
by a provider that both has a base of operation located within a metropolitan county listed
in section 473.121, subdivision 4, and is listed in paragraph (b), clause (1) or (3). new text endAll
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.
(d) An organization may be terminated, denied, or suspended from enrollment if:
(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and
(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.
(e) The administrative agency of nonemergency medical transportation must:
(1) adhere to the policies defined by the commissioner in consultation with the
Nonemergency Medical Transportation Advisory Committee;
(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;
(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and
(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.
(f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
(g) The commissioner may use an order by the recipient's attending physician or a medical
or mental health professional to certify that the recipient requires nonemergency medical
transportation services. Nonemergency medical transportation providers shall perform
driver-assisted services for eligible individuals, when appropriate. Driver-assisted service
includes passenger pickup at and return to the individual's residence or place of business,
assistance with admittance of the individual to the medical facility, and assistance in
passenger securement or in securing of wheelchairs, child seats, or stretchers in the vehicle.
Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.
Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.
(h) The administrative agency shall use the level of service process established by the
commissioner in consultation with the Nonemergency Medical Transportation Advisory
Committee to determine the client's most appropriate mode of transportation. If public transit
or a certified transportation provider is not available to provide the appropriate service mode
for the client, the client may receive a onetime service upgrade.
(i) The covered modes of transportation are:
(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;
(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;
(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;
(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;
(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;
(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and
(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.
(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.
(k) The commissioner shall:
(1) in consultation with the Nonemergency Medical Transportation Advisory Committee,
verify that the mode and use of nonemergency medical transportation is appropriate;
(2) verify that the client is going to an approved medical appointment; and
(3) investigate all complaints and appeals.
(l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:
(1) $0.22 per mile for client reimbursement;
(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;
(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;
(4) $13 for the base rate and $1.30 per mile for assisted transport;
(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
(6) $75 for the base rate and $2.40 per mile for protected transport; and
(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.
(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:
(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and
(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).
(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.
(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.
(q) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 27.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 17d. new text end
new text begin Transportation services oversight. new text end
new text begin
The commissioner shall contract with
a vendor or dedicate staff for oversight of providers of nonemergency medical transportation
services pursuant to the commissioner's authority in section 256B.04 and Minnesota Rules,
parts 9505.2160 to 9505.2245.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 28.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 17e. new text end
new text begin Transportation provider termination. new text end
new text begin
(a) A terminated nonemergency
medical transportation provider, including all named individuals on the current enrollment
disclosure form and known or discovered affiliates of the nonemergency medical
transportation provider, is not eligible to enroll as a nonemergency medical transportation
provider for five years following the termination.
new text end
new text begin
(b) After the five-year period in paragraph (a), if a provider seeks to reenroll as a
nonemergency medical transportation provider, the nonemergency medical transportation
provider must be placed on a one-year probation period. During a provider's probation
period, the commissioner shall complete unannounced site visits and request documentation
to review compliance with program requirements.
new text end
Sec. 29.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 17f. new text end
new text begin Transportation provider training. new text end
new text begin
The commissioner shall make available
to providers of nonemergency medical transportation and all drivers training materials and
online training opportunities regarding documentation requirements, documentation
procedures, and penalties for failing to meet documentation requirements.
new text end
Sec. 30.
Minnesota Statutes 2018, section 256B.0625, subdivision 18h, is amended to
read:
Subd. 18h.
Managed care.
deleted text begin(a)deleted text end The following subdivisions apply to managed care plans
and county-based purchasing plans:
(1) subdivision 17, paragraphs (a), (b), new text begin(c), new text end(i), and (n);
(2) subdivision 18; and
(3) subdivision 18a.
deleted text begin
(b) A nonemergency medical transportation provider must comply with the operating
standards for special transportation service specified in sections 174.29 to 174.30 and
Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
vehicles are exempt from the requirements in this paragraph.
deleted text end
Sec. 31.
Minnesota Statutes 2018, section 256B.0625, subdivision 43, is amended to read:
Subd. 43.
Mental health provider travel time.
new text begin(a) new text endMedical assistance covers provider
travel time if a deleted text beginrecipient's individual treatment plandeleted text endnew text begin recipientnew text end requires the provision of mental
health services outside of the provider's deleted text beginnormaldeleted text end new text beginusual new text endplace of business. deleted text beginThis does not include
any travel time which is included in other billable services, and is only covered when the
mental health service being provided to a recipient is covered under medical assistance.
deleted text end
new text begin
(b) Medical assistance covers under this subdivision the time a provider is in transit to
provide a covered mental health service to a recipient at a location that is not the provider's
usual place of business. A provider must travel the most direct route available. Mental health
provider travel time does not include time for scheduled or unscheduled stops, meal breaks,
or vehicle maintenance or repair, including refueling or vehicle emergencies. Recipient
transportation is not covered under this subdivision.
new text end
new text begin
(c) Mental health provider travel time under this subdivision is only covered when the
mental health service being provided is covered under medical assistance and only when
the covered mental health service is delivered and billed. Mental health provider travel time
is not covered when the mental health service being provided otherwise includes provider
travel time or when the service is site based.
new text end
new text begin
(d) A provider must document each trip for which the provider seeks reimbursement
under this subdivision in a compiled travel record. Required documentation may be collected
and maintained electronically or in paper form but must be made available and produced
upon request by the commissioner. The travel record must be written in English and must
be legible according to the standard of a reasonable person. The recipient's individual
identification number must be on each page of the record. The reason the provider must
travel to provide services must be included in the record, if not otherwise documented in
the recipient's individual treatment plan. Each entry in the record must document:
new text end
new text begin
(1) start and stop time (with a.m. and p.m. notations);
new text end
new text begin
(2) printed name of the recipient;
new text end
new text begin
(3) date the entry is made;
new text end
new text begin
(4) date the service is provided;
new text end
new text begin
(5) origination site and destination site;
new text end
new text begin
(6) who provided the service;
new text end
new text begin
(7) the electronic source used to calculate driving directions and distance between
locations; and
new text end
new text begin
(8) the medically necessary mental health service delivered.
new text end
new text begin
(e) Mental health providers identified by the commissioner to have submitted a fraudulent
report may be excluded from participation in Minnesota health care programs.
new text end
Sec. 32.
Minnesota Statutes 2018, section 256B.064, subdivision 1b, is amended to read:
Subd. 1b.
Sanctions available.
The commissioner may impose the following sanctions
for the conduct described in subdivision 1a: suspension or withholding of payments to a
vendor and suspending or terminating participation in the program, or imposition of a fine
under subdivision 2, paragraph (f). When imposing sanctions under this section, the
commissioner shall consider the nature, chronicity, or severity of the conduct and the effect
of the conduct on the health and safety of persons served by the vendor.new text begin The commissioner
shall suspend a vendor's participation in the program for a minimum of five years if the
vendor is convicted of a crime, received a stay of adjudication, or entered a court-ordered
diversion program for an offense related to a provision of a health service under medical
assistance or health care fraud.new text end Regardless of imposition of sanctions, the commissioner
may make a referral to the appropriate state licensing board.
Sec. 33.
Minnesota Statutes 2018, section 256B.064, subdivision 2, is amended to read:
Subd. 2.
Imposition of monetary recovery and sanctions.
(a) The commissioner shall
determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor
of medical care under this section. Except as provided in paragraphs (b) and (d), neither a
monetary recovery nor a sanction will be imposed by the commissioner without prior notice
and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed
action, provided that the commissioner may suspend or reduce payment to a vendor of
medical care, except a nursing home or convalescent care facility, after notice and prior to
the hearing if in the commissioner's opinion that action is necessary to protect the public
welfare and the interests of the program.
(b) Except when the commissioner finds good cause not to suspend payments under
Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
withhold or reduce payments to a vendor of medical care without providing advance notice
of such withholding or reduction if either of the following occurs:
(1) the vendor is convicted of a crime involving the conduct described in subdivision
1a; or
(2) the commissioner determines there is a credible allegation of fraud for which an
investigation is pending under the program. A credible allegation of fraud is an allegation
which has been verified by the state, from any source, including but not limited to:
(i) fraud hotline complaints;
(ii) claims data mining; and
(iii) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations.
Allegations are considered to be credible when they have an indicia of reliability and
the state agency has reviewed all allegations, facts, and evidence carefully and acts
judiciously on a case-by-case basis.
(c) The commissioner must send notice of the withholding or reduction of payments
under paragraph (b) within five days of taking such action unless requested in writing by a
law enforcement agency to temporarily withhold the notice. The notice must:
(1) state that payments are being withheld according to paragraph (b);
(2) set forth the general allegations as to the nature of the withholding action, but need
not disclose any specific information concerning an ongoing investigation;
(3) except in the case of a conviction for conduct described in subdivision 1a, state that
the withholding is for a temporary period and cite the circumstances under which withholding
will be terminated;
(4) identify the types of claims to which the withholding applies; and
(5) inform the vendor of the right to submit written evidence for consideration by the
commissioner.
The withholding or reduction of payments will not continue after the commissioner
determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
relating to the alleged fraud are completed, unless the commissioner has sent notice of
intention to impose monetary recovery or sanctions under paragraph (a).new text begin Upon conviction
for a crime related to the provision, management, or administration of a health service under
medical assistance, a payment held pursuant to this section by the commissioner or a managed
care organization that contracts with the commissioner under section 256B.035 is forfeited
to the commissioner or managed care organization, regardless of the amount charged in the
criminal complaint or the amount of criminal restitution ordered.
new text end
(d) The commissioner shall suspend or terminate a vendor's participation in the program
without providing advance notice and an opportunity for a hearing when the suspension or
termination is required because of the vendor's exclusion from participation in Medicare.
Within five days of taking such action, the commissioner must send notice of the suspension
or termination. The notice must:
(1) state that suspension or termination is the result of the vendor's exclusion from
Medicare;
(2) identify the effective date of the suspension or termination; and
(3) inform the vendor of the need to be reinstated to Medicare before reapplying for
participation in the program.
(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is
to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision
3, by filing with the commissioner a written request of appeal. The appeal request must be
received by the commissioner no later than 30 days after the date the notification of monetary
recovery or sanction was mailed to the vendor. The appeal request must specify:
(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount
involved for each disputed item;
(2) the computation that the vendor believes is correct;
(3) the authority in statute or rule upon which the vendor relies for each disputed item;
(4) the name and address of the person or entity with whom contacts may be made
regarding the appeal; and
(5) other information required by the commissioner.
(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
services according to standards in this chapter and Minnesota Rules, chapter 9505. The
commissioner may assess fines if specific required components of documentation are
missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is
less.new text begin If the commissioner determines that a vendor repeatedly violated this chapter or
Minnesota Rules, chapter 9505, related to the provision of services to program recipients
and the submission of claims for payment, the commissioner may order a vendor to forfeit
a fine based on the nature, severity, and chronicity of the violations, in an amount of up to
$5,000 or 20 percent of the value of the claims, whichever is greater.
new text end
(g) The vendor shall pay the fine assessed on or before the payment date specified. If
the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
recover the amount of the fine. A timely appeal shall stay payment of the fine until the
commissioner issues a final order.
Sec. 34.
Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Vendor mandates on prohibited hiring. new text end
new text begin
(a) The commissioner shall maintain
and publish a list of each excluded individual and entity that was convicted of a crime related
to the provision, management, or administration of a medical assistance health service, or
where participation in the program was suspended or terminated under subdivision 2. A
vendor that receives funding from medical assistance shall not: (1) employ an individual
or entity who is on the exclusion list; or (2) enter into or maintain a business relationship
with an individual or entity that is on the exclusion list.
new text end
new text begin
(b) Before hiring or entering into a business transaction, a vendor shall check the
exclusion list. The vendor shall check the exclusion list on a monthly basis and document
the date and time with a.m. and p.m. designations that the exclusion list was checked and
the name and title of the person who checked the exclusion list. The vendor shall: (1)
immediately terminate a current employee on the exclusion list; and (2) immediately
terminate a business relationship with an individual or entity on the exclusion list.
new text end
new text begin
(c) A vendor's requirement to check the exclusion list and to terminate an employee on
the exclusion list applies to each employee, even if the named employee is not responsible
for direct patient care or direct submission of a claim to medical assistance. A vendor's
requirement to check the exclusion list and terminate a business relationship with an
individual or entity on the exclusion list applies to each business relationship, even if the
named individual or entity is not responsible for direct patient care or direct submission of
a claim to medical assistance.
new text end
new text begin
(d) A vendor that employs or enters into or maintains a business relationship with an
individual or entity on the exclusion list shall refund any payment related to a service
rendered by an individual or entity on the exclusion list from the date the individual is
employed or the date the individual is placed on the exclusion list, whichever is later, and
a vendor may be subject to:
new text end
new text begin
(1) sanctions under subdivision 2;
new text end
new text begin
(2) a civil monetary penalty of up to $25,000 for each determination by the department
that the vendor employed or contracted with an individual or entity on the exclusion list;
and
new text end
new text begin
(3) other fines or penalties allowed by law.
new text end
Sec. 35.
new text begin
[256B.0646] CORRECTIVE ACTIONS FOR PEOPLE USING PERSONAL
CARE ASSISTANCE SERVICES; MINNESOTA RESTRICTED RECIPIENT
PROGRAM.
new text end
new text begin
(a) When there is abusive or fraudulent billing of personal care assistance services or
community first services and supports under section 256B.85, the commissioner may place
a recipient in the Minnesota restricted recipient program as defined in Minnesota Rules,
part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this
section must:
new text end
new text begin
(1) use a designated traditional personal care assistance provider agency;
new text end
new text begin
(2) obtain a new assessment as described in section 256B.0911, including consultation
with a registered or public health nurse on the long-term care consultation team under section
256B.0911, subdivision 3, paragraph (b), clause (2); and
new text end
new text begin
(3) comply with additional conditions for the use of personal care assistance services or
community first services and supports if the commissioner determines it is necessary to
prevent future misuse of personal care assistance services or abusive or fraudulent billing
related to personal care assistance services. These additional conditions may include, but
are not limited to:
new text end
new text begin
(i) the restriction of service authorizations to a duration of no more than one month; and
new text end
new text begin
(ii) requiring a qualified professional to monitor and report services on a monthly basis.
new text end
new text begin
(b) Placement in the Minnesota restricted recipient program under this section is subject
to appeal according to section 256B.045.
new text end
Sec. 36.
Minnesota Statutes 2018, section 256B.0651, subdivision 17, is amended to read:
Subd. 17.
Recipient protection.
(a) Providers of home care services must provide each
recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days
prior to terminating services to a recipient, if the termination results from provider sanctions
under section 256B.064, such as a payment withhold, a suspension of participation, or a
termination of participation. If a home care provider determines it is unable to continue
providing services to a recipient, the provider must notify the recipient, the recipient's
responsible party, and the commissioner 30 days prior to terminating services to the recipient
because of an action under section 256B.064, and must assist the commissioner and lead
agency in supporting the recipient in transitioning to another home care provider of the
recipient's choice.
(b) In the event of a payment withhold from a home care provider, a suspension of
participation, or a termination of participation of a home care provider under section
256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care
and the lead agencies for all recipients with active service agreements with the provider. At
the commissioner's request, the lead agencies must contact recipients to ensure that the
recipients are continuing to receive needed care, and that the recipients have been given
free choice of provider if they transfer to another home care provider. In addition, the
commissioner or the commissioner's delegate may directly notify recipients who receive
care from the provider that payments have been new text beginor will be new text endwithheld or that the provider's
participation in medical assistance has been new text beginor will be new text endsuspended or terminated, if the
commissioner determines that notification is necessary to protect the welfare of the recipients.
For purposes of this subdivision, "lead agencies" means counties, tribes, and managed care
organizations.
Sec. 37.
Minnesota Statutes 2018, section 256B.0659, subdivision 3, is amended to read:
Subd. 3.
deleted text beginNoncovereddeleted text end Personal care assistance servicesnew text begin not coverednew text end.
(a) Personal care
assistance services are not eligible for medical assistance payment under this section when
provided:
(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal guardian,
licensed foster provider, except as allowed under section 256B.0652, subdivision 10, or
responsible party;
(2) in order to meet staffing or license requirements in a residential or child care setting;
(3) solely as a child care or babysitting service; deleted text beginor
deleted text end
(4) without authorization by the commissioner or the commissioner's designeedeleted text begin.deleted text endnew text begin; or
new text end
new text begin
(5) on dates not within the frequency requirements of subdivision 14, paragraph (c), and
subdivision 19, paragraph (a).
new text end
(b) The following personal care services are not eligible for medical assistance payment
under this section when provided in residential settings:
(1) when the provider of home care services who is not related by blood, marriage, or
adoption owns or otherwise controls the living arrangement, including licensed or unlicensed
services; or
(2) when personal care assistance services are the responsibility of a residential or
program license holder under the terms of a service agreement and administrative rules.
(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible for
medical assistance reimbursement for personal care assistance services under this section
include:
(1) sterile procedures;
(2) injections of fluids and medications into veins, muscles, or skin;
(3) home maintenance or chore services;
(4) homemaker services not an integral part of assessed personal care assistance services
needed by a recipient;
(5) application of restraints or implementation of procedures under section 245.825;
(6) instrumental activities of daily living for children under the age of 18, except when
immediate attention is needed for health or hygiene reasons integral to the personal care
services and the need is listed in the service plan by the assessor; and
(7) assessments for personal care assistance services by personal care assistance provider
agencies or by independently enrolled registered nurses.
Sec. 38.
Minnesota Statutes 2018, section 256B.0659, subdivision 12, is amended to read:
Subd. 12.
Documentation of personal care assistance services provided.
(a) Personal
care assistance services for a recipient must be documented daily by each personal care
assistant, on a time sheet form approved by the commissioner. All documentation may be
web-based, electronic, or paper documentation. The completed form must be submitted on
a monthly basis to the provider and kept in the recipient's health record.
(b) The activity documentation must correspond to the personal care assistance care plan
and be reviewed by the qualified professional.
(c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:
(1) full name of personal care assistant and individual provider number;
(2) provider name and telephone numbers;
(3) full name of recipientnew text begin and either the recipient's medical assistance identification
number or date of birthnew text end;
(4) consecutive dates, including month, day, and year, and arrival and departure times
with a.m. or p.m. notations;
(5) signatures of recipient or the responsible party;
(6) personal signature of the personal care assistant;
(7) any shared care provided, if applicable;
(8) a statement that it is a federal crime to provide false information on personal care
service billings for medical assistance payments; and
(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
Sec. 39.
Minnesota Statutes 2018, section 256B.0659, subdivision 13, is amended to read:
Subd. 13.
Qualified professional; qualifications.
(a) The qualified professional must
work for a personal care assistance provider agency deleted text beginanddeleted text endnew text begin,new text end meet the definition new text beginof qualified
professional new text endunder section 256B.0625, subdivision 19cnew text begin, and enroll with the department as
a qualified professional after clearing a background studynew text end. Before a qualified professional
provides services, the personal care assistance provider agency must initiate a background
study on the qualified professional under chapter 245C, and the personal care assistance
provider agency must have received a notice from the commissioner that the qualified
professional:
(1) is not disqualified under section 245C.14; or
(2) is disqualified, but the qualified professional has received a set aside of the
disqualification under section 245C.22.
(b) The qualified professional shall perform the duties of training, supervision, and
evaluation of the personal care assistance staff and evaluation of the effectiveness of personal
care assistance services. The qualified professional shall:
(1) develop and monitor with the recipient a personal care assistance care plan based on
the service plan and individualized needs of the recipient;
(2) develop and monitor with the recipient a monthly plan for the use of personal care
assistance services;
(3) review documentation of personal care assistance services provided;
(4) provide training and ensure competency for the personal care assistant in the individual
needs of the recipient; and
(5) document all training, communication, evaluations, and needed actions to improve
performance of the personal care assistants.
(c) Effective July 1, 2011, the qualified professional shall complete the provider training
with basic information about the personal care assistance program approved by the
commissioner. Newly hired qualified professionals must complete the training within six
months of the date hired by a personal care assistance provider agency. Qualified
professionals who have completed the required training as a worker from a personal care
assistance provider agency do not need to repeat the required training if they are hired by
another agency, if they have completed the training within the last three years. The required
training must be available with meaningful access according to title VI of the Civil Rights
Act and federal regulations adopted under that law or any guidance from the United States
Health and Human Services Department. The required training must be available online or
by electronic remote connection. The required training must provide for competency testing
to demonstrate an understanding of the content without attending in-person training. A
qualified professional is allowed to be employed and is not subject to the training requirement
until the training is offered online or through remote electronic connection. A qualified
professional employed by a personal care assistance provider agency certified for
participation in Medicare as a home health agency is exempt from the training required in
this subdivision. When available, the qualified professional working for a Medicare-certified
home health agency must successfully complete the competency test. The commissioner
shall ensure there is a mechanism in place to verify the identity of persons completing the
competency testing electronically.
Sec. 40.
Minnesota Statutes 2018, section 256B.0659, subdivision 14, is amended to read:
Subd. 14.
Qualified professional; duties.
(a) Effective January 1, deleted text begin2010deleted text endnew text begin 2020new text end, all personal
care assistants must be supervised by a qualified professionalnew text begin who is enrolled as an individual
provider with the commissioner under section 256B.04, subdivision 21, paragraph (c)new text end.
(b) Through direct training, observation, return demonstrations, and consultation with
the staff and the recipient, the qualified professional must ensure and document that the
personal care assistant is:
(1) capable of providing the required personal care assistance services;
(2) knowledgeable about the plan of personal care assistance services before services
are performed; and
(3) able to identify conditions that should be immediately brought to the attention of the
qualified professional.
(c) The qualified professional shall evaluate the personal care assistant within the first
14 days of starting to provide regularly scheduled services for a recipient, or sooner as
determined by the qualified professional, except for the personal care assistance choice
option under subdivision 19, paragraph (a), clause (4). For the initial evaluation, the qualified
professional shall evaluate the personal care assistance services for a recipient through direct
observation of a personal care assistant's work. The qualified professional may conduct
additional training and evaluation visits, based upon the needs of the recipient and the
personal care assistant's ability to meet those needs. Subsequent visits to evaluate the personal
care assistance services provided to a recipient do not require direct observation of each
personal care assistant's work and shall occur:
(1) at least every 90 days thereafter for the first year of a recipient's services;
(2) every 120 days after the first year of a recipient's service or whenever needed for
response to a recipient's request for increased supervision of the personal care assistance
staff; and
(3) after the first 180 days of a recipient's service, supervisory visits may alternate
between unscheduled phone or Internet technology and in-person visits, unless the in-person
visits are needed according to the care plan.
(d) Communication with the recipient is a part of the evaluation process of the personal
care assistance staff.
(e) At each supervisory visit, the qualified professional shall evaluate personal care
assistance services including the following information:
(1) satisfaction level of the recipient with personal care assistance services;
(2) review of the month-to-month plan for use of personal care assistance services;
(3) review of documentation of personal care assistance services provided;
(4) whether the personal care assistance services are meeting the goals of the service as
stated in the personal care assistance care plan and service plan;
(5) a written record of the results of the evaluation and actions taken to correct any
deficiencies in the work of a personal care assistant; and
(6) revision of the personal care assistance care plan as necessary in consultation with
the recipient or responsible party, to meet the needs of the recipient.
(f) The qualified professional shall complete the required documentation in the agency
recipient and employee files and the recipient's home, including the following documentation:
(1) the personal care assistance care plan based on the service plan and individualized
needs of the recipient;
(2) a month-to-month plan for use of personal care assistance services;
(3) changes in need of the recipient requiring a change to the level of service and the
personal care assistance care plan;
(4) evaluation results of supervision visits and identified issues with personal care
assistance staff with actions taken;
(5) all communication with the recipient and personal care assistance staff; and
(6) hands-on training or individualized training for the care of the recipient.
(g) The documentation in paragraph (f) must be done on agency templates.
(h) The services that are not eligible for payment as qualified professional services
include:
(1) direct professional nursing tasks that could be assessed and authorized as skilled
nursing tasks;
(2) agency administrative activities;
(3) training other than the individualized training required to provide care for a recipient;
and
(4) any other activity that is not described in this section.
new text begin
(i) The qualified professional shall notify the commissioner on a form prescribed by the
commissioner, within 30 days of when a qualified professional is no longer employed by
or otherwise affiliated with the personal care assistance agency for whom the qualified
professional previously provided qualified professional services.
new text end
Sec. 41.
Minnesota Statutes 2018, section 256B.0659, subdivision 19, is amended to read:
Subd. 19.
Personal care assistance choice option; qualifications; duties.
(a) Under
personal care assistance choice, the recipient or responsible party shall:
(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);
(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;
(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;
(4) effective January 1, 2010, supervise and evaluate the personal care assistant with the
qualified professional, who is required to visit the recipient at least every 180 days;
(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;
(6) engage in an annual face-to-face reassessment to determine continuing eligibility
and service authorization; and
(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being used.
(b) The personal care assistance choice provider agency shall:
(1) meet all personal care assistance provider agency standards;
(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;
(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and
(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.
(c) The duties of the personal care assistance choice provider agency are to:
(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations including, but not limited to, purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation including, but not
limited to, workers' compensation deleted text beginanddeleted text endnew text begin,new text end unemployment insurancenew text begin, and labor market data
required under section 256B.4912, subdivision 1anew text end;
(2) bill the medical assistance program for personal care assistance services and qualified
professional services;
(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;
(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;
(5) withhold and pay all applicable federal and state taxes;
(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;
(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;
(8) enroll in the medical assistance program as a personal care assistance choice agency;
and
(9) enter into a written agreement as specified in subdivision 20 before services are
provided.
Sec. 42.
Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
Subd. 21.
Requirements for provider enrollment of personal care assistance provider
agencies.
(a) All personal care assistance provider agencies must provide, at the time of
enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
a format determined by the commissioner, information and documentation that includes,
but is not limited to, the following:
(1) the personal care assistance provider agency's current contact information including
address, telephone number, and e-mail address;
(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid
revenue in the previous calendar year is up to and including $300,000, the provider agency
must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is
over $300,000, the provider agency must purchase a surety bond of $100,000. The surety
bond must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
(3) proof of fidelity bond coverage in the amount of $20,000;
(4) proof of workers' compensation insurance coverage;
(5) proof of liability insurance;
(6) a description of the personal care assistance provider agency's organization identifying
the names of all owners, managing employees, staff, board of directors, and the affiliations
of the directors, owners, or staff to other service providers;
(7) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery;
new text begin identification, prevention, detection, and reporting of fraud or any billing, record-keeping,
or other administrative noncompliance; new text endand employee and consumer safety including process
for notification and resolution of consumer grievances, identification and prevention of
communicable diseases, and employee misconduct;
(8) copies of all other forms the personal care assistance provider agency uses in the
course of daily business including, but not limited to:
(i) a copy of the personal care assistance provider agency's time sheet if the time sheet
varies from the standard time sheet for personal care assistance services approved by the
commissioner, and a letter requesting approval of the personal care assistance provider
agency's nonstandard time sheet;
(ii) the personal care assistance provider agency's template for the personal care assistance
care plan; and
(iii) the personal care assistance provider agency's template for the written agreement
in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
(9) a list of all training and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;
(10) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this section;
(11) documentation of the agency's marketing practices;
(12) disclosure of ownership, leasing, or management of all residential properties that
is used or could be used for providing home care services;
(13) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services for
employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
care assistance choice option and 72.5 percent of revenue from other personal care assistance
providers. The revenue generated by the qualified professional and the reasonable costs
associated with the qualified professional shall not be used in making this calculation; deleted text beginand
deleted text end
(14) effective May 15, 2010, documentation that the agency does not burden recipients'
free exercise of their right to choose service providers by requiring personal care assistants
to sign an agreement not to work with any particular personal care assistance recipient or
for another personal care assistance provider agency after leaving the agency and that the
agency is not taking action on any such agreements or requirements regardless of the date
signednew text begin; and
new text end
new text begin (15) a copy of the personal care assistance provider agency's self-auditing policy and
other materials demonstrating the personal care assistance provider agency's internal program
integrity proceduresnew text end.
(b) new text beginPersonal care assistance provider agencies enrolling for the first time must also
provide, at the time of enrollment as a personal care assistance provider agency in a format
determined by the commissioner, information and documentation that includes proof of
sufficient initial operating capital to support the infrastructure necessary to allow for ongoing
compliance with the requirements of this section. Sufficient operating capital can be
demonstrated as follows:
new text end
new text begin
(1) copies of business bank account statements with at least $5,000 in cash reserves;
new text end
new text begin
(2) proof of a cash reserve or business line of credit sufficient to equal three payrolls of
the agency's current or projected business; and
new text end
new text begin
(3) any other manner proscribed by the commissioner.
new text end
new text begin (c) new text endPersonal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider agency
enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
the information specified in paragraph (a) from all personal care assistance providers
beginning July 1, 2009.
deleted text begin (c)deleted text endnew text begin (d)new text end All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before enrollment of the agency as a provider. Employees
in management and supervisory positions and owners who are active in the day-to-day
operations of an agency who have completed the required training as an employee with a
personal care assistance provider agency do not need to repeat the required training if they
are hired by another agency, if they have completed the training within the past three years.
By September 1, 2010, the required training must be available with meaningful access
according to title VI of the Civil Rights Act and federal regulations adopted under that law
or any guidance from the United States Health and Human Services Department. The
required training must be available online or by electronic remote connection. The required
training must provide for competency testing. Personal care assistance provider agency
billing staff shall complete training about personal care assistance program financial
management. This training is effective July 1, 2009. Any personal care assistance provider
agency enrolled before that date shall, if it has not already, complete the provider training
within 18 months of July 1, 2009. Any new owners or employees in management and
supervisory positions involved in the day-to-day operations are required to complete
mandatory training as a requisite of working for the agency. Personal care assistance provider
agencies certified for participation in Medicare as home health agencies are exempt from
the training required in this subdivision. When available, Medicare-certified home health
agency owners, supervisors, or managers must successfully complete the competency test.
new text begin
(e) All personal care assistance provider agencies must provide, at the time of revalidation
as a personal care assistance provider agency in a format determined by the commissioner,
information and documentation that includes, but is not limited to, the following:
new text end
new text begin
(1) documentation of the payroll paid for the preceding 12 months or other period as
proscribed by the commissioner; and
new text end
new text begin
(2) financial statements demonstrating compliance with paragraph (a), clause (13).
new text end
Sec. 43.
Minnesota Statutes 2018, section 256B.0659, subdivision 24, is amended to read:
Subd. 24.
Personal care assistance provider agency; general duties.
A personal care
assistance provider agency shall:
(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;
(2) comply with general medical assistance coverage requirements;
(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;
(4) comply with background study requirements;
(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;
(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;
(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;
(8) withhold and pay all applicable federal and state taxes;
(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent
of the revenue generated by the medical assistance rate for personal care assistance services
for employee personal care assistant wages and benefits. The revenue generated by the
qualified professional and the reasonable costs associated with the qualified professional
shall not be used in making this calculation;
(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;
(11) enter into a written agreement under subdivision 20 before services are provided;
(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;
(13) provide the recipient with a copy of the home care bill of rights at start of service;
deleted text begin and
deleted text end
(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissionerdeleted text begin.deleted text endnew text begin; and
new text end
new text begin
(15) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a.
new text end
Sec. 44.
Minnesota Statutes 2018, section 256B.27, subdivision 3, is amended to read:
Subd. 3.
Access to medical records.
The commissioner of human services, with the
written consent of the recipient, on file with the local welfare agency, shall be allowed
access to all personal medical records of medical assistance recipients solely for the purposes
of investigating whether or not: (a) a vendor of medical care has submitted a claim for
reimbursement, a cost report or a rate application which is duplicative, erroneous, or false
in whole or in part, or which results in the vendor obtaining greater compensation than the
vendor is legally entitled to; or (b) the medical care was medically necessary. deleted text beginThe vendor
of medical care shall receive notification from the commissioner at least 24 hours before
the commissioner gains access to such records.deleted text endnew text begin When the commissioner is investigating a
suspected overpayment of Medicaid funds, only after first conferring with the department's
Office of Inspector General, and documenting the evidentiary basis for any decision to
demand immediate access to medical records, the commissioner must be given immediate
access without prior notice to the vendor's office during regular business hours and to
documentation and records related to services provided and submission of claims for services
provided. Denying the commissioner access to records is cause for the vendor's immediate
suspension of payment or termination according to section 256B.064.new text end The determination
of provision of services not medically necessary shall be made by the commissioner.
Notwithstanding any other law to the contrary, a vendor of medical care shall not be subject
to any civil or criminal liability for providing access to medical records to the commissioner
of human services pursuant to this section.
Sec. 45.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Annual labor market reporting. new text end
new text begin
(a) As determined by the commissioner, a
provider of home and community-based services for the elderly under sections 256B.0913
and 256B.0915, home and community-based services for people with developmental
disabilities under section 256B.092, and home and community-based services for people
with disabilities under section 256B.49 shall submit data to the commissioner on the
following:
new text end
new text begin
(1) number of direct-care staff;
new text end
new text begin
(2) wages of direct-care staff;
new text end
new text begin
(3) hours worked by direct-care staff;
new text end
new text begin
(4) overtime wages of direct-care staff;
new text end
new text begin
(5) overtime hours worked by direct-care staff;
new text end
new text begin
(6) benefits paid and accrued by direct-care staff;
new text end
new text begin
(7) direct-care staff retention rates;
new text end
new text begin
(8) direct-care staff job vacancies;
new text end
new text begin
(9) amount of travel time paid;
new text end
new text begin
(10) program vacancy rates; and
new text end
new text begin
(11) other related data requested by the commissioner.
new text end
new text begin
(b) The commissioner may adjust reporting requirements for a self-employed direct-care
staff.
new text end
new text begin
(c) For the purposes of this subdivision, "direct-care staff" means employees, including
self-employed individuals and individuals directly employed by a participant in a
consumer-directed service delivery option, providing direct service provision to people
receiving services under this section. Direct-care staff does not include executive, managerial,
or administrative staff.
new text end
new text begin
(d) This subdivision also applies to a provider of personal care assistance services under
section 256B.0625, subdivision 19a; community first services and supports under section
256B.85; nursing services and home health services under section 256B.0625, subdivision
6a; home care nursing services under section 256B.0625, subdivision 7; or day training and
habilitation services for residents of intermediate care facilities for persons with
developmental disabilities under section 256B.501.
new text end
new text begin
(e) This subdivision also applies to financial management services providers for
participants who directly employ direct-care staff through consumer support grants under
section 256.476; the personal care assistance choice program under section 256B.0657,
subdivisions 18 to 20; community first services and supports under section 256B.85; and
the consumer-directed community supports option available under the alternative care
program, the brain injury waiver, the community alternative care waiver, the community
alternatives for disabled individuals waiver, the developmental disabilities waiver, the
elderly waiver, and the Minnesota senior health option, except financial management services
providers are not required to submit the data listed in paragraph (a), clauses (7) to (11).
new text end
new text begin
(f) The commissioner shall ensure that data submitted under this subdivision is not
duplicative of data submitted under any other section of this chapter or any other chapter.
new text end
new text begin
(g) A provider shall submit the data annually on a date specified by the commissioner.
The commissioner shall give a provider at least 30 calendar days to submit the data. If a
provider fails to submit the requested data by the date specified by the commissioner, the
commissioner may delay medical assistance reimbursement until the requested data is
submitted.
new text end
new text begin
(h) Individually identifiable data submitted to the commissioner in this section are
considered private data on an individual, as defined by section 13.02, subdivision 12.
new text end
new text begin
(i) The commissioner shall analyze data annually for workforce assessments and how
the data impact service access.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
Sec. 46.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Home and community-based service billing requirements. new text end
new text begin
(a) A home and
community-based service is eligible for reimbursement if:
new text end
new text begin
(1) it is a service provided as specified in a federally approved waiver plan, as authorized
under sections 256B.0913, 256B.0915, 256B.092, and 256B.49;
new text end
new text begin
(2) if applicable, it is provided on days and times during the days and hours of operation
specified on any license that is required under chapter 245A or 245D; or
new text end
new text begin
(3) the home and community-based service provider has met the documentation
requirements under section 256B.4912, subdivision 12, 13, 14, or 15.
new text end
new text begin
A service that does not meet the criteria in this subdivision may be recovered by the
department according to section 256B.064 and Minnesota Rules, parts 9505.2160 to
9505.2245.
new text end
new text begin
(b) The provider must maintain documentation that all individuals providing service
have attested to reviewing and understanding the following statement upon employment
and annually thereafter.
new text end
new text begin
"It is a federal crime to provide materially false information on service billings for
medical assistance or services provided under a federally approved waiver plan, as authorized
under Minnesota Statutes, sections 256B.0913, 256B.0915, 256B.092, and 256B.49."
new text end
Sec. 47.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Home and community-based service documentation requirements. new text end
new text begin
(a)
Documentation may be collected and maintained electronically or in paper form by providers,
but must be made available and produced upon the request of the commissioner.
Documentation of delivered services that comply with the electronic visit verification
requirements under Laws 2017, First Special Session chapter 6, article 3, section 49, satisfy
the requirements of this subdivision.
new text end
new text begin
(b) Documentation of a delivered service must be in English and must be legible according
to the standard of a reasonable person.
new text end
new text begin
(c) If the service is reimbursed at an hourly or specified minute-based rate, each
documentation of the provision of a service, unless otherwise specified, must include:
new text end
new text begin
(1) the date the documentation occurred;
new text end
new text begin
(2) the day, month, and year when the service was provided;
new text end
new text begin
(3) the start and stop times with a.m. and p.m. designations, except for case management
services as defined under sections 256B.0913, subdivision 7, 256B.0915, subdivision 1a,
256B.092, subdivision 1a, and 256B.49, subdivision 13;
new text end
new text begin
(4) the service name or description of the service provided; and
new text end
new text begin
(5) the name, signature, and title, if any, of the provider of service. If the service is
provided by multiple staff members, the provider may designate a staff member responsible
for verifying services and completing the documentation required by this paragraph.
new text end
new text begin
(d) If the service is reimbursed at a daily rate or does not meet the requirements of
subdivision 12, paragraph (c), each documentation of the provision of a service, unless
otherwise specified, must include:
new text end
new text begin
(1) the date the documentation occurred;
new text end
new text begin
(2) the day, month, and year when the service was provided;
new text end
new text begin
(3) the service name or description of the service provided; and
new text end
new text begin
(4) the name, signature, and title, if any, of the person providing the service. If the service
is provided by multiple staff, the provider may designate a staff person responsible for
verifying services and completing the documentation required by this paragraph.
new text end
Sec. 48.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Waiver transportation documentation and billing requirements. new text end
new text begin
(a) A
waiver transportation service must meet the billing requirements under section 256B.4912,
subdivision 11, to be eligible for reimbursement and must:
new text end
new text begin
(1) be a waiver transportation service that is not covered by medical transportation under
the Medicaid state plan; and
new text end
new text begin
(2) be a waiver transportation service that is not included as a component of another
waiver service.
new text end
new text begin
(b) A waiver transportation service provider must meet the documentation requirements
under section 256B.4912, subdivision 12, and must maintain:
new text end
new text begin
(1) odometer and other records as provided in section 256B.0625, subdivision 17b,
paragraph (b), clause (3), sufficient to distinguish an individual trip with a specific vehicle
and driver for a waiver transportation service that is billed directly by the mile, except if
the provider is a common carrier as defined by Minnesota Rules, part 9505.0315, subpart
1, item B, or a publicly operated transit system; and
new text end
new text begin
(2) documentation demonstrating that a vehicle and a driver meets the standards
determined by the Department of Human Services on vehicle and driver qualifications as
described in section 256B.0625, subdivision 17, paragraph (c).
new text end
Sec. 49.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Equipment and supply documentation requirements. new text end
new text begin
(a) An equipment
and supply services provider must meet the documentation requirements under section
256B.4912, subdivision 12, and must, for each documentation of the provision of a service,
include:
new text end
new text begin
(1) the recipient's assessed need for the equipment or supply and the reason the equipment
or supply is not covered by the Medicaid state plan;
new text end
new text begin
(2) the type and brand name of the equipment or supply delivered to or purchased by
the recipient, including whether the equipment or supply was rented or purchased;
new text end
new text begin
(3) the quantity of the equipment or supplies delivered or purchased; and
new text end
new text begin
(4) the cost of equipment or supplies if the amount paid for the service depends on the
cost.
new text end
new text begin
(b) A provider must maintain a copy of the shipping invoice or a delivery service tracking
log or other documentation showing the date of delivery that proves the equipment or supply
was delivered to the recipient or a receipt if the equipment or supply was purchased by the
recipient.
new text end
Sec. 50.
Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Adult day service documentation and billing requirements. new text end
new text begin
(a) A service
defined as "adult day care" under section 245A.02, subdivision 2a, and licensed under
Minnesota Rules, parts 9555.9600 to 9555.9730, must meet the documentation requirements
under section 256B.4912, subdivision 12, and must maintain documentation of:
new text end
new text begin
(1) a needs assessment and current plan of care according to section 245A.143,
subdivisions 4 to 7, or Minnesota Rules, part 9555.9700, if applicable, for each recipient;
new text end
new text begin
(2) attendance records as specified under section 245A.14, subdivision 14, paragraph
(c); the date of attendance must be documented on the attendance record with the day,
month, and year; and the pickup and drop-off time must be noted on the attendance record
in hours and minutes with a.m. and p.m. designations;
new text end
new text begin
(3) the monthly and quarterly program requirements in Minnesota Rules, part 9555.9710,
subparts 1, items E and H, 3, 4, and 6, if applicable;
new text end
new text begin
(4) the names and qualifications of the registered physical therapists, registered nurses,
and registered dietitians who provide services to the adult day care or nonresidential program;
and
new text end
new text begin
(5) the location where the service was provided and, if the location is an alternate location
from the primary place of service, the address, or if an address is not available, a description
of both the origin and destination location, the length of time at the alternate location with
a.m. and p.m. designations, and a list of participants who went to the alternate location.
new text end
new text begin
(b) A provider cannot exceed its licensed capacity; if licensed capacity is exceeded, all
Minnesota health care program payments for that date shall be recovered by the department.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2019.
new text end
Sec. 51.
Minnesota Statutes 2018, section 256B.5014, is amended to read:
256B.5014 deleted text beginFINANCIALdeleted text end REPORTINGnew text begin REQUIREMENTSnew text end.
new text begin Subdivision 1. new text end
new text begin Financial reporting. new text end
All facilities shall maintain financial records and
shall provide annual income and expense reports to the commissioner of human services
on a form prescribed by the commissioner no later than April 30 of each year in order to
receive medical assistance payments. The reports for the reporting year ending December
31 must include:
(1) salaries and related expenses, including program salaries, administrative salaries,
other salaries, payroll taxes, and fringe benefits;
(2) general operating expenses, including supplies, training, repairs, purchased services
and consultants, utilities, food, licenses and fees, real estate taxes, insurance, and working
capital interest;
(3) property related costs, including depreciation, capital debt interest, rent, and leases;
and
(4) total annual resident days.
new text begin Subd. 2. new text end
new text begin Labor market reporting. new text end
new text begin
All intermediate care facilities shall comply with
the labor market reporting requirements described in section 256B.4912, subdivision 1a.
new text end
Sec. 52.
Minnesota Statutes 2018, section 256B.85, subdivision 10, is amended to read:
Subd. 10.
Agency-provider and FMS provider qualifications and duties.
(a)
Agency-providers identified in subdivision 11 and FMS providers identified in subdivision
13a shall:
(1) enroll as a medical assistance Minnesota health care programs provider and meet all
applicable provider standards and requirements;
(2) demonstrate compliance with federal and state laws and policies for CFSS as
determined by the commissioner;
(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results;
(4) verify and maintain records of all services and expenditures by the participant,
including hours worked by support workers;
(5) not engage in any agency-initiated direct contact or marketing in person, by telephone,
or other electronic means to potential participants, guardians, family members, or participants'
representatives;
(6) directly provide services and not use a subcontractor or reporting agent;
(7) meet the financial requirements established by the commissioner for financial
solvency;
(8) have never had a lead agency contract or provider agreement discontinued due to
fraud, or have never had an owner, board member, or manager fail a state or FBI-based
criminal background check while enrolled or seeking enrollment as a Minnesota health care
programs provider; and
(9) have an office located in Minnesota.
(b) In conducting general duties, agency-providers and FMS providers shall:
(1) pay support workers based upon actual hours of services provided;
(2) pay for worker training and development services based upon actual hours of services
provided or the unit cost of the training session purchased;
(3) withhold and pay all applicable federal and state payroll taxes;
(4) make arrangements and pay unemployment insurance, taxes, workers' compensation,
liability insurance, and other benefits, if any;
(5) enter into a written agreement with the participant, participant's representative, or
legal representative that assigns roles and responsibilities to be performed before services,
supports, or goods are provided;
(6) report maltreatment as required under sections 626.556 and 626.557; deleted text beginand
deleted text end
(7) new text begincomply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a; and
new text end
new text begin (8) new text endcomply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13.
Sec. 53.
Minnesota Statutes 2018, section 256D.024, subdivision 3, is amended to read:
Subd. 3.
Fleeing deleted text beginfelonsdeleted text endnew text begin offendersnew text end.
An individual who is fleeing to avoid prosecution,
or custody, or confinement after conviction for a crime deleted text beginthat is a felonydeleted text end under the laws of
the jurisdiction from which the individual fleesdeleted text begin, or in the case of New Jersey, is a high
misdemeanor,deleted text end is ineligible to receive benefits under this chapter.
Sec. 54.
new text begin
[256D.0245] DRUG TESTING INFORMATION FROM PROBATION
OFFICERS.
new text end
new text begin
The local probation agency shall regularly provide a list of probationers who tested
positive for an illegal controlled substance to the local social services agency, specifically
the welfare fraud division, for purposes of section 256D.024.
new text end
Sec. 55.
Minnesota Statutes 2018, section 256D.0515, is amended to read:
256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
All food stamp households must be determined eligible for the benefit discussed under
section 256.029. Food stamp households must demonstrate thatnew text begin: (1)new text end their gross income is
equal to or less than 165 percent of the federal poverty guidelines for the same family sizenew text begin;
and (2) they have financial resources, excluding vehicles, of less than $100,000new text end.
Sec. 56.
Minnesota Statutes 2018, section 256D.0516, subdivision 2, is amended to read:
Subd. 2.
Food support reporting requirements.
The commissioner of human services
shall implement simplified reporting as permitted under the Food Stamp Act of 1977, as
amended, and the food stamp regulations in Code of Federal Regulations, title 7, part 273.
Food support recipient households new text beginare new text endrequired to report deleted text beginperiodically shall not be required
to report more often than one timedeleted text end every six monthsnew text begin, and must report any changes in income,
assets, or employment that affects eligibility within ten days of the date the change occursnew text end.
This provision shall not apply to households receiving food benefits under the Minnesota
family investment program waiver.
Sec. 57.
Minnesota Statutes 2018, section 256J.08, subdivision 47, is amended to read:
Subd. 47.
Income.
"Income" means cash or in-kind benefit, whether earned or unearned,
received by or available to an applicant or participant that is not property under section
256P.02.new text begin An applicant must document that the property is not available to the applicant.
new text end
Sec. 58.
Minnesota Statutes 2018, section 256J.21, subdivision 2, is amended to read:
Subd. 2.
Income exclusions.
The following must be excluded in determining a family's
available income:
(1) payments for basic care, difficulty of care, and clothing allowances received for
providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
to 9555.6265, 9560.0521, and 9560.0650 to 9560.0654, payments for family foster care for
children under section 260C.4411 or chapter 256N, and payments received and used for
care and maintenance of a third-party beneficiary who is not a household member;
(2) reimbursements for employment training received through the Workforce Investment
Act of 1998, United States Code, title 20, chapter 73, section 9201;
(3) reimbursement for out-of-pocket expenses incurred while performing volunteer
services, jury duty, employment, or informal carpooling arrangements directly related to
employment;
(4) all educational assistance, except the county agency must count graduate student
teaching assistantships, fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary educational expenses, shall count
scholarships or grants awarded to graduate students that do not require teaching or research
as unearned income;
(5) loans, regardless of purpose, from public or private lending institutions, governmental
lending institutions, or governmental agencies;
(6) loans from private individuals, regardless of purpose, provided an applicant or
participant deleted text begindocuments that the lender expects repaymentdeleted text endnew text begin provides documentation of the
source of the loan, dates, amount of the loan, and terms of repaymentnew text end;
(7)(i) state income tax refunds; and
(ii) federal income tax refunds;
(8)(i) federal earned income credits;
(ii) Minnesota working family credits;
(iii) state homeowners and renters credits under chapter 290A; and
(iv) federal or state tax rebates;
(9) funds received for reimbursement, replacement, or rebate of personal or real property
when these payments are made by public agencies, awarded by a court, solicited through
public appeal, or made as a grant by a federal agency, state or local government, or disaster
assistance organizations, subsequent to a presidential declaration of disaster;
(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial
expenses, or to repair or replace insured property;
(11) reimbursements for medical expenses that cannot be paid by medical assistance;
(12) payments by a vocational rehabilitation program administered by the state under
chapter 268A, except those payments that are for current living expenses;
(13) in-kind income, including any payments directly made by a third party to a provider
of goods and servicesnew text begin. In-kind income does not include in-kind payments of living expensesnew text end;
(14) assistance payments to correct underpayments, but only for the month in which the
payment is received;
(15) payments for short-term emergency needs under section 256J.626, subdivision 2;
(16) funeral and cemetery payments as provided by section 256.935;
(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar
month;
(18) any form of energy assistance payment made through Public Law 97-35,
Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
providers by other public and private agencies, and any form of credit or rebate payment
issued by energy providers;
(19) Supplemental Security Income (SSI), including retroactive SSI payments and other
income of an SSI recipient;
(20) Minnesota supplemental aid, including retroactive payments;
(21) proceeds from the sale of real or personal property;
(22) adoption or kinship assistance payments under chapter 256N or 259A and Minnesota
permanency demonstration title IV-E waiver payments;
(23) state-funded family subsidy program payments made under section 252.32 to help
families care for children with developmental disabilities, consumer support grant funds
under section 256.476, and resources and services for a disabled household member under
one of the home and community-based waiver services programs under chapter 256B;
(24) interest payments and dividends from property that is not excluded from and that
does not exceed the asset limit;
(25) rent rebates;
(26) income earned by a minor caregiver, minor child through age 6, or a minor child
who is at least a half-time student in an approved elementary or secondary education program;
(27) income earned by a caregiver under age 20 who is at least a half-time student in an
approved elementary or secondary education program;
(28) MFIP child care payments under section 119B.05;
(29) all other payments made through MFIP to support a caregiver's pursuit of greater
economic stability;
(30) income a participant receives related to shared living expenses;
(31) reverse mortgages;
(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42,
chapter 13A, sections 1771 to 1790;
(33) benefits provided by the women, infants, and children (WIC) nutrition program,
United States Code, title 42, chapter 13A, section 1786;
(34) benefits from the National School Lunch Act, United States Code, title 42, chapter
13, sections 1751 to 1769e;
(35) relocation assistance for displaced persons under the Uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter
61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12,
chapter 13, sections 1701 to 1750jj;
(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part
2, sections 2271 to 2322;
(37) war reparations payments to Japanese Americans and Aleuts under United States
Code, title 50, sections 1989 to 1989d;
(38) payments to veterans or their dependents as a result of legal settlements regarding
Agent Orange or other chemical exposure under Public Law 101-239, section 10405,
paragraph (a)(2)(E);
(39) income that is otherwise specifically excluded from MFIP consideration in federal
law, state law, or federal regulation;
(40) security and utility deposit refunds;
(41) American Indian tribal land settlements excluded under Public Laws 98-123, 98-124,
and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and
Mille Lacs reservations and payments to members of the White Earth Band, under United
States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
(42) all income of the minor parent's parents and stepparents when determining the grant
for the minor parent in households that include a minor parent living with parents or
stepparents on MFIP with other children;
(43) income of the minor parent's parents and stepparents equal to 200 percent of the
federal poverty guideline for a family size not including the minor parent and the minor
parent's child in households that include a minor parent living with parents or stepparents
not on MFIP when determining the grant for the minor parent. The remainder of income is
deemed as specified in section 256J.37, subdivision 1b;
(44) payments made to children eligible for relative custody assistance under section
257.85;
(45) vendor payments for goods and services made on behalf of a client unless the client
has the option of receiving the payment in cash;
(46) the principal portion of a contract for deed payment;
(47) cash payments to individuals enrolled for full-time service as a volunteer under
AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
National, and AmeriCorps NCCC;
(48) housing assistance grants under section 256J.35, paragraph (a); and
(49) child support payments of up to $100 for an assistance unit with one child and up
to $200 for an assistance unit with two or more children.
Sec. 59.
Minnesota Statutes 2018, section 256J.26, subdivision 3, is amended to read:
Subd. 3.
Fleeing deleted text beginfelonsdeleted text endnew text begin offendersnew text end.
An individual who is fleeing to avoid prosecution,
or custody, or confinement after conviction for a crime deleted text beginthat is a felonydeleted text end under the laws of
the jurisdiction from which the individual fleesdeleted text begin, or in the case of New Jersey, is a high
misdemeanor,deleted text end is disqualified from receiving MFIP.
Sec. 60.
new text begin
[256J.265] DRUG TESTING INFORMATION FROM PROBATION
OFFICERS.
new text end
new text begin
The local probation agency shall regularly provide a list of probationers who tested
positive for an illegal controlled substance to the local social services agency, specifically
the welfare fraud division, for purposes of section 256J.26.
new text end
Sec. 61.
Minnesota Statutes 2018, section 256L.01, subdivision 5, is amended to read:
Subd. 5.
Income.
"Income" has the meaning given for modified adjusted gross income,
as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's
current income, or if income fluctuates month to month, the income for the 12-month
eligibility period.new text begin Income includes amounts deposited into checking and savings accounts
for personal expenses including rent, mortgage, automobile-related expenses, utilities, and
food.
new text end
Sec. 62.
Minnesota Statutes 2018, section 256P.04, subdivision 4, is amended to read:
Subd. 4.
Factors to be verified.
(a) The agency shall verify the following at application:
(1) identity of adults;
(2) age, if necessary to determine eligibility;
(3) immigration status;
(4) income;
(5) spousal support and child support payments made to persons outside the household;
(6) vehicles;
(7) checking and savings accountsdeleted text begin;deleted text endnew text begin. Verification of checking and savings accounts must
include the source of deposits into accounts; identification of any loans, including the date,
source, amount, and terms of repayment; identification of deposits for personal expenses
including rent, mortgage, automobile-related expenses, utilities, and food;
new text end
(8) inconsistent information, if related to eligibility;
(9) residence;
(10) Social Security number; deleted text beginand
deleted text end
(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), item
(ix), for the intended purpose for which it was given and receiveddeleted text begin.deleted text endnew text begin;
new text end
new text begin
(12) loans. Verification of loans must include the source, the full amount, and repayment
terms; and
new text end
new text begin
(13) direct or indirect gifts of money.
new text end
(b) Applicants who are qualified noncitizens and victims of domestic violence as defined
under section 256J.08, subdivision 73, clause (7), are not required to verify the information
in paragraph (a), clause (10). When a Social Security number is not provided to the agency
for verification, this requirement is satisfied when each member of the assistance unit
cooperates with the procedures for verification of Social Security numbers, issuance of
duplicate cards, and issuance of new numbers which have been established jointly between
the Social Security Administration and the commissioner.
Sec. 63.
Minnesota Statutes 2018, section 256P.06, subdivision 3, is amended to read:
Subd. 3.
Income inclusions.
The following must be included in determining the income
of an assistance unit:
(1) earned incomenew text begin:
new text end
new text begin
(i) calculated according to Minnesota Rules, part 3400.0170, subpart 7, for earned income
from self-employment, except if the participant is drawing a salary, taking a draw from the
business, or using the business account to pay personal expenses including rent, mortgage,
automobile-related expenses, utilities, or food, not directly related to the business, the salary
or payment must be treated as earned income; and
new text end
new text begin (ii) excluding expenses listed in Minnesota Rules, part 3400.0170, subpart 8, items A
to I and M to Pnew text end; and
(2) unearned income, which includes:
(i) interest and dividends from investments and savings;
(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;
(iii) proceeds from rent and contract for deed payments in excess of the principal and
interest portion owed on property;
(iv) income from trusts, excluding special needs and supplemental needs trusts;
(v) interest income from loans made by the participant or household;
(vi) cash prizes and winnings;
(vii) unemployment insurance income;
(viii) retirement, survivors, and disability insurance payments;
(ix) nonrecurring income over $60 per quarter unless earmarked and used for the purpose
for which it is intended. Income and use of this income is subject to verification requirements
under section 256P.04;
(x) retirement benefits;
(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I,
and 256J;
(xii) tribal per capita payments unless excluded by federal and state law;
(xiii) income and payments from service and rehabilitation programs that meet or exceed
the state's minimum wage rate;
(xiv) income from members of the United States armed forces unless excluded from
income taxes according to federal or state law;
(xv) all child support payments for programs under chapters 119B, 256D, and 256I;
(xvi) the amount of child support received that exceeds $100 for assistance units with
one child and $200 for assistance units with two or more children for programs under chapter
256J; and
(xvii) spousal support.
Sec. 64.
Laws 2017, First Special Session chapter 6, article 3, section 49, is amended to
read:
Sec. 49. ELECTRONIC deleted text beginSERVICE DELIVERY DOCUMENTATION SYSTEMdeleted text endnew text begin
VISIT VERIFICATIONnew text end.
Subdivision 1.
Documentation; establishment.
The commissioner of human services
shall establish implementation requirements and standards for deleted text beginandeleted text end electronic deleted text beginservice delivery
documentation systemdeleted text endnew text begin visit verificationnew text end to comply with the 21st Century Cures Act, Public
Law 114-255. Within available appropriations, the commissioner shall take steps to comply
with the electronic visit verification requirements in the 21st Century Cures Act, Public
Law 114-255.
Subd. 2.
Definitions.
(a) For purposes of this section, the terms in this subdivision have
the meanings given them.
(b) "Electronic deleted text beginservice delivery documentationdeleted text endnew text begin visit verificationnew text end" means the electronic
documentation of the:
(1) type of service performed;
(2) individual receiving the service;
(3) date of the service;
(4) location of the service delivery;
(5) individual providing the service; and
(6) time the service begins and ends.
(c) "Electronic deleted text beginservice delivery documentationdeleted text endnew text begin visit verificationnew text end system" means a system
that provides electronic deleted text beginservice delivery documentationdeleted text endnew text begin verification of servicesnew text end that complies
with the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision
3.
(d) "Service" means one of the following:
(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625,
subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; deleted text beginor
deleted text end
(2) community first services and supports under Minnesota Statutes, section 256B.85new text begin;
new text end
new text begin
(3) home health services under Minnesota Statutes, section 256B.0625, subdivision 6a;
or
new text end
new text begin (4) other medical supplies and equipment or home and community-based services that
are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255new text end.
Subd. 3.
new text beginSystemnew text end requirements.
(a) In developing implementation requirements for deleted text beginandeleted text end
electronic deleted text beginservice delivery documentation systemdeleted text endnew text begin visit verificationnew text end, the commissioner shall
deleted text begin consider electronic visit verification systems and other electronic service delivery
documentation methods. The commissioner shall convene stakeholders that will be impacted
by an electronic service delivery system, including service providers and their representatives,
service recipients and their representatives, and, as appropriate, those with expertise in the
development and operation of an electronic service delivery documentation system, todeleted text end ensure
that the requirements:
(1) are minimally administratively and financially burdensome to a provider;
(2) are minimally burdensome to the service recipient and the least disruptive to the
service recipient in receiving and maintaining allowed services;
(3) consider existing best practices and use of electronic deleted text beginservice delivery documentationdeleted text endnew text begin
visit verificationnew text end;
(4) are conducted according to all state and federal laws;
(5) are effective methods for preventing fraud when balanced against the requirements
of clauses (1) and (2); and
(6) are consistent with the Department of Human Services' policies related to covered
services, flexibility of service use, and quality assurance.
(b) The commissioner shall make training available to providers on the electronic deleted text beginservice
delivery documentationdeleted text endnew text begin visit verificationnew text end system requirements.
(c) The commissioner shall establish baseline measurements related to preventing fraud
and establish measures to determine the effect of electronic deleted text beginservice delivery documentationdeleted text endnew text begin
visit verificationnew text end requirements on program integrity.
new text begin
(d) The commissioner shall make a state-selected electronic visit verification system
available to providers of services.
new text end
new text begin Subd. 3a. new text end
new text begin Provider requirements. new text end
new text begin
(a) Providers of services may select their own
electronic visit verification system that meets the requirements established by the
commissioner.
new text end
new text begin
(b) All electronic visit verification systems used by providers to comply with the
requirements established by the commissioner must provide data to the commissioner in a
format and at a frequency to be established by the commissioner.
new text end
new text begin
(c) Providers must implement the electronic visit verification systems required under
this section by January 1, 2020, for personal care services and by January 1, 2023, for home
health services in accordance with the 21st Century Cures Act, Public Law 114-255, and
the Centers for Medicare and Medicaid Services guidelines. For the purposes of this
paragraph, "personal care services" and "home health services" have the meanings given
in United States Code, title 42, section 1396b(l)(5). Reimbursement rates for providers must
not be reduced as a result of federal action to reduce the federal medical assistance percentage
under the 21st Century Cures Act, Public Law 114.255, Code of Federal Regulations, title
32, section 310.32.
new text end
deleted text begin Subd. 4. deleted text end
deleted text begin Legislative report. deleted text end
deleted text begin
(a) The commissioner shall submit a report by January 15,
2018, to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services with recommendations, based on the requirements of
subdivision 3, to establish electronic service delivery documentation system requirements
and standards. The report shall identify:
deleted text end
deleted text begin
(1) the essential elements necessary to operationalize a base-level electronic service
delivery documentation system to be implemented by January 1, 2019; and
deleted text end
deleted text begin
(2) enhancements to the base-level electronic service delivery documentation system to
be implemented by January 1, 2019, or after, with projected operational costs and the costs
and benefits for system enhancements.
deleted text end
deleted text begin
(b) The report must also identify current regulations on service providers that are either
inefficient, minimally effective, or will be unnecessary with the implementation of an
electronic service delivery documentation system.
deleted text end
Sec. 65. new text beginDIRECTIONS TO COMMISSIONER; NEMT DRIVER ENROLLMENT
IMPACT.
new text end
new text begin
By August 1, 2021, the commissioner of human services shall issue a report to the chairs
and ranking minority members of the house of representatives and senate committees with
jurisdiction over health and human services. The commissioner must include in the report
the commissioner's findings regarding the impact of driver enrollment under Minnesota
Statutes, section 256B.0625, subdivision 17, paragraph (c), on the program integrity of the
nonemergency medical transportation program. The commissioner must include a
recommendation, based on the findings in the report, regarding expanding the driver
enrollment requirement.
new text end
Sec. 66. new text beginUNIVERSAL IDENTIFICATION NUMBER FOR CHILDREN IN EARLY
CHILDHOOD PROGRAMS.
new text end
new text begin
By July 1, 2020, the commissioners of the Departments of Education, Health, and Human
Services shall identify a process to establish and implement a universal identification number
for children participating in early childhood programs to eliminate potential duplication in
programs. The commissioners shall report the identified process and any associated fiscal
cost to the chairs and ranking minority members of the legislative committees with
jurisdiction over health, human services, and education. A universal identification number
established and implemented under this section is private data on individuals, as defined in
Minnesota Statutes, section 13.02, subdivision 12, except that the commissioners of
education, health, and human services may share the universal identification number with
each other pursuant to their data sharing authority under Minnesota Statutes, section 13.46,
subdivision 2, clause (9), and Minnesota Statutes, section 145A.17, subdivision 3, paragraph
(e).
new text end
Sec. 67. new text beginDIRECTION TO COMMISSIONER; FEDERAL WAIVER FOR MEDICAL
ASSISTANCE SELF-ATTESTATION REMOVAL.
new text end
new text begin
The commissioner of human services shall seek all necessary federal waivers to
implement the removal of the self-attestation when establishing eligibility for medical
assistance.
new text end
Sec. 68. new text beginREVISOR'S INSTRUCTION.
new text end
new text begin
The revisor of statutes shall codify Laws 2017, First Special Session chapter 6, article
3, section 49, as amended in this act, in Minnesota Statutes, chapter 256B.
new text end
Sec. 69. new text beginREPEALER.
new text end
new text begin
Minnesota Statutes 2018, section 256B.0705,
new text end
new text begin
is repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020.
new text end
ARTICLE 2
CHILDREN AND FAMILIES SERVICES
Section 1.
Minnesota Statutes 2018, section 252.27, subdivision 2a, is amended to read:
Subd. 2a.
Contribution amount.
(a) The natural or adoptive parents of a minor child, new text begin
not new text endincluding a child determined eligible for medical assistance without consideration of
parental incomenew text begin under the TEFRA option or for the purposes of accessing home and
community-based waiver servicesnew text end, must contribute to the cost of services used by making
monthly payments on a sliding scale based on income, unless the child is married or has
been married, parental rights have been terminated, or the child's adoption is subsidized
according to chapter 259A or through title IV-E of the Social Security Act. The parental
contribution is a partial or full payment for medical services provided for diagnostic,
therapeutic, curing, treating, mitigating, rehabilitation, maintenance, and personal care
services as defined in United States Code, title 26, section 213, needed by the child with a
chronic illness or disability.
(b) For households with adjusted gross income equal to or greater than 275 percent of
federal poverty guidelines, the parental contribution shall be computed by applying the
following schedule of rates to the adjusted gross income of the natural or adoptive parents:
(1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty
guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at 1.94 percent of adjusted gross income at 275 percent of
federal poverty guidelines and increases to 5.29 percent of adjusted gross income for those
with adjusted gross income up to 545 percent of federal poverty guidelines;
(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines
and less than 675 percent of federal poverty guidelines, the parental contribution shall be
5.29 percent of adjusted gross income;
(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty
guidelines and less than 975 percent of federal poverty guidelines, the parental contribution
shall be determined using a sliding fee scale established by the commissioner of human
services which begins at 5.29 percent of adjusted gross income at 675 percent of federal
poverty guidelines and increases to 7.05 percent of adjusted gross income for those with
adjusted gross income up to 975 percent of federal poverty guidelines; and
(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty
guidelines, the parental contribution shall be 8.81 percent of adjusted gross income.
If the child lives with the parent, the annual adjusted gross income is reduced by $2,400
prior to calculating the parental contribution. If the child resides in an institution specified
in section 256B.35, the parent is responsible for the personal needs allowance specified
under that section in addition to the parental contribution determined under this section.
The parental contribution is reduced by any amount required to be paid directly to the child
pursuant to a court order, but only if actually paid.
(c) The household size to be used in determining the amount of contribution under
paragraph (b) includes natural and adoptive parents and their dependents, including the
child receiving services. Adjustments in the contribution amount due to annual changes in
the federal poverty guidelines shall be implemented on the first day of July following
publication of the changes.
(d) For purposes of paragraph (b), "income" means the adjusted gross income of the
natural or adoptive parents determined according to the previous year's federal tax form,
except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
have been used to purchase a home shall not be counted as income.
(e) The contribution shall be explained in writing to the parents at the time eligibility
for services is being determined. The contribution shall be made on a monthly basis effective
with the first month in which the child receives services. Annually upon redetermination
or at termination of eligibility, if the contribution exceeded the cost of services provided,
the local agency or the state shall reimburse that excess amount to the parents, either by
direct reimbursement if the parent is no longer required to pay a contribution, or by a
reduction in or waiver of parental fees until the excess amount is exhausted. All
reimbursements must include a notice that the amount reimbursed may be taxable income
if the parent paid for the parent's fees through an employer's health care flexible spending
account under the Internal Revenue Code, section 125, and that the parent is responsible
for paying the taxes owed on the amount reimbursed.
(f) The monthly contribution amount must be reviewed at least every 12 months; when
there is a change in household size; and when there is a loss of or gain in income from one
month to another in excess of ten percent. The local agency shall mail a written notice 30
days in advance of the effective date of a change in the contribution amount. A decrease in
the contribution amount is effective in the month that the parent verifies a reduction in
income or change in household size.
(g) Parents of a minor child who do not live with each other shall each pay the
contribution required under paragraph (a). An amount equal to the annual court-ordered
child support payment actually paid on behalf of the child receiving services shall be deducted
from the adjusted gross income of the parent making the payment prior to calculating the
parental contribution under paragraph (b).
(h) The contribution under paragraph (b) shall be increased by an additional five percent
if the local agency determines that insurance coverage is available but not obtained for the
child. For purposes of this section, "available" means the insurance is a benefit of employment
for a family member at an annual cost of no more than five percent of the family's annual
income. For purposes of this section, "insurance" means health and accident insurance
coverage, enrollment in a nonprofit health service plan, health maintenance organization,
self-insured plan, or preferred provider organization.
Parents who have more than one child receiving services shall not be required to pay
more than the amount for the child with the highest expenditures. There shall be no resource
contribution from the parents. The parent shall not be required to pay a contribution in
excess of the cost of the services provided to the child, not counting payments made to
school districts for education-related services. Notice of an increase in fee payment must
be given at least 30 days before the increased fee is due.
(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in
the 12 months prior to July 1:
(1) the parent applied for insurance for the child;
(2) the insurer denied insurance;
(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a
complaint or appeal, in writing, to the commissioner of health or the commissioner of
commerce, or litigated the complaint or appeal; and
(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
For purposes of this section, "insurance" has the meaning given in paragraph (h).
A parent who has requested a reduction in the contribution amount under this paragraph
shall submit proof in the form and manner prescribed by the commissioner or county agency,
including, but not limited to, the insurer's denial of insurance, the written letter or complaint
of the parents, court documents, and the written response of the insurer approving insurance.
The determinations of the commissioner or county agency under this paragraph are not rules
subject to chapter 14.
Sec. 2.
new text begin
[256.4751] PARENT-TO-PARENT PEER SUPPORT GRANTS.
new text end
new text begin
(a) The commissioner shall make available grants to organizations to support
parent-to-parent peer support programs that provide information and emotional support for
families of children and youth with special health care needs.
new text end
new text begin
(b) For the purposes of this section, "special health care needs" means disabilities, chronic
illnesses or conditions, health-related educational or behavioral problems, or the risk of
developing disabilities, conditions, illnesses, or problems.
new text end
new text begin
(c) Eligible organizations must have an established parent-to-parent program that:
new text end
new text begin
(1) conducts outreach and support to parents or guardians of a child or youth with special
health care needs;
new text end
new text begin
(2) provides to parents and guardians information, tools, and training to support their
child and to successfully navigate the health and human services systems;
new text end
new text begin
(3) facilitates ongoing peer support for parents and guardians from trained volunteer
support parents;
new text end
new text begin
(4) has staff and volunteers located statewide; and
new text end
new text begin
(5) is affiliated with and communicates regularly with other parent-to-parent programs
and national organizations to ensure best practices are implemented.
new text end
new text begin
(d) Grant recipients must use grant funds for the purposes in paragraph (c).
new text end
new text begin
(e) Grant recipients must report to the commissioner of human services annually by
January 15 on the services and programs funded by the appropriation. The report must
include measurable outcomes from the previous year, including the number of families
served and the number of volunteer support parents trained.
new text end
Sec. 3.
Minnesota Statutes 2018, section 256B.14, subdivision 2, is amended to read:
Subd. 2.
Actions to obtain payment.
The state agency shall promulgate rules to
determine the ability of responsible relatives to contribute partial or complete payment or
repayment of medical assistance furnished to recipients for whom they are responsible. All
medical assistance exclusions shall be allowed, and a resource limit of $10,000 for
nonexcluded resources shall be implemented. Above these limits, a contribution of one-third
of the excess resources shall be required. These rules shall not require payment or repayment
when payment would cause undue hardship to the responsible relative or that relative's
immediate family. These rules shall deleted text beginbe consistent with the requirements of section 252.27
fordeleted text endnew text begin not apply tonew text end parents of children whose eligibility for medical assistance was determined
without deeming of the parents' resources and incomenew text begin under the TEFRA option or for the
purposes of accessing home and community-based waiver servicesnew text end. The county agency
shall give the responsible relative notice of the amount of the payment or repayment. If the
state agency or county agency finds that notice of the payment obligation was given to the
responsible relative, but that the relative failed or refused to pay, a cause of action exists
against the responsible relative for that portion of medical assistance granted after notice
was given to the responsible relative, which the relative was determined to be able to pay.
The action may be brought by the state agency or the county agency in the county where
assistance was granted, for the assistance, together with the costs of disbursements incurred
due to the action.
In addition to granting the county or state agency a money judgment, the court may,
upon a motion or order to show cause, order continuing contributions by a responsible
relative found able to repay the county or state agency. The order shall be effective only
for the period of time during which the recipient receives medical assistance from the county
or state agency.
Sec. 4.
Minnesota Statutes 2018, section 256M.41, subdivision 3, is amended to read:
Subd. 3.
Payments deleted text beginbased on performancedeleted text end.
deleted text begin(a)deleted text end The commissioner shall make payments
under this section to each county deleted text beginboard on a calendar year basis in an amount determined
under paragraph (b)deleted text endnew text begin on or before July 10 of each yearnew text end.
deleted text begin
(b) Calendar year allocations under subdivision 1 shall be paid to counties in the following
manner:
deleted text end
deleted text begin
(1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties
on or before July 10 of each year;
deleted text end
deleted text begin
(2) ten percent of the allocation shall be withheld until the commissioner determines if
the county has met the performance outcome threshold of 90 percent based on face-to-face
contact with alleged child victims. In order to receive the performance allocation, the county
child protection workers must have a timely face-to-face contact with at least 90 percent of
all alleged child victims of screened-in maltreatment reports. The standard requires that
each initial face-to-face contact occur consistent with timelines defined in section 626.556,
subdivision 10, paragraph (i). The commissioner shall make threshold determinations in
January of each year and payments to counties meeting the performance outcome threshold
shall occur in February of each year. Any withheld funds from this appropriation for counties
that do not meet this requirement shall be reallocated by the commissioner to those counties
meeting the requirement; and
deleted text end
deleted text begin
(3) ten percent of the allocation shall be withheld until the commissioner determines
that the county has met the performance outcome threshold of 90 percent based on
face-to-face visits by the case manager. In order to receive the performance allocation, the
total number of visits made by caseworkers on a monthly basis to children in foster care
and children receiving child protection services while residing in their home must be at least
90 percent of the total number of such visits that would occur if every child were visited
once per month. The commissioner shall make such determinations in January of each year
and payments to counties meeting the performance outcome threshold shall occur in February
of each year. Any withheld funds from this appropriation for counties that do not meet this
requirement shall be reallocated by the commissioner to those counties meeting the
requirement. For 2015, the commissioner shall only apply the standard for monthly foster
care visits.
deleted text end
deleted text begin
(c) The commissioner shall work with stakeholders and the Human Services Performance
Council under section 402A.16 to develop recommendations for specific outcome measures
that counties should meet in order to receive funds withheld under paragraph (b), and include
in those recommendations a determination as to whether the performance measures under
paragraph (b) should be modified or phased out. The commissioner shall report the
recommendations to the legislative committees having jurisdiction over child protection
issues by January 1, 2018.
deleted text end
Sec. 5.
Minnesota Statutes 2018, section 256M.41, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin County performance on child protection measures. new text end
new text begin
The commissioner shall
set child protection measures and standards. The commissioner shall require an
underperforming county to demonstrate that the county designated sufficient funds and
implemented a reasonable strategy to improve child protection performance, including the
provision of a performance improvement plan and additional remedies identified by the
commissioner. The commissioner may redirect up to 20 percent of a county's funds under
this section toward the performance improvement plan. Sanctions under section 256M.20,
subdivision 3, related to noncompliance with federal performance standards also apply.
new text end
Sec. 6.
new text begin
[260C.216] FOSTER CARE RECRUITMENT GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment and authority. new text end
new text begin
The commissioner of human services
shall make grants to facilitate partnerships between counties and community groups or faith
communities to develop and utilize innovative, nontraditional shared recruitment methods
to increase and stabilize the number of available foster care families.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility. new text end
new text begin
An eligible applicant for a foster care recruitment grant under
subdivision 1 is an organization or entity that:
new text end
new text begin
(1) provides a written description identifying the county and community organizations
or faith communities that will partner to develop innovative shared methods to recruit
families through their community or faith organizations for foster care in the county;
new text end
new text begin
(2) agrees to incorporate efforts by the partnership or a third party to offer additional
support services including host families, family coaches, or resource referrals for families
in crisis such as homelessness, unemployment, hospitalization, substance abuse treatment,
incarceration, or domestic violence, as an alternative to foster care; and
new text end
new text begin
(3) describes how the proposed partnership model can be generalized to be used in other
areas of the state.
new text end
new text begin Subd. 3. new text end
new text begin Allowable grant activities. new text end
new text begin
Grant recipients may use grant funds to:
new text end
new text begin
(1) develop materials that promote the partnership's innovative methods of nontraditional
recruitment of foster care families through the partner community organizations or faith
communities;
new text end
new text begin
(2) develop an onboarding vehicle or training program for recruited foster care families
that is accessible, relatable, and easy to understand, to be used by the partner community
organizations or faith communities;
new text end
new text begin
(3) establish sustainable communication between the partnership and the recruited
families for ongoing support; or
new text end
new text begin
(4) provide support services including host families, family coaches, or resource referrals
for families in crisis such as homelessness, unemployment, hospitalization, substance abuse
treatment, incarceration, or domestic violence, as an alternative to the foster care system.
new text end
new text begin Subd. 4. new text end
new text begin Reporting new text end
new text begin
The commissioner shall report on the use of foster care recruitment
grants to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services by December 31, 2020. The report shall include the name
and location of grant recipients, the amount of each grant, the services provided, and the
effects on the foster care system. The commissioner shall determine the form required for
the report and may specify additional reporting requirements.
new text end
new text begin Subd. 5. new text end
new text begin Funding. new text end
new text begin
The commissioner of human services may use available parent support
outreach program funds for foster care recruitment grants under Minnesota Statutes, section
260C.216.
new text end
Sec. 7.
new text begin
[260C.218] PARENT SUPPORT FOR BETTER OUTCOMES GRANTS.
new text end
new text begin
The commissioner of human services may use available parent support outreach program
funds to provide mentoring, guidance, and support services to parents navigating the child
welfare system in Minnesota, in order to promote the development of safe, stable, and
healthy families, including parent mentoring, peer-to-peer support groups, housing support
services, training, staffing, and administrative costs.
new text end
Sec. 8.
Minnesota Statutes 2018, section 518A.32, subdivision 3, is amended to read:
Subd. 3.
Parent not considered voluntarily unemployed, underemployed, or employed
on a less than full-time basis.
A parent is not considered voluntarily unemployed,
underemployed, or employed on a less than full-time basis upon a showing by the parent
that:
(1) the unemployment, underemployment, or employment on a less than full-time basis
is temporary and will ultimately lead to an increase in income;
(2) the unemployment, underemployment, or employment on a less than full-time basis
represents a bona fide career change that outweighs the adverse effect of that parent's
diminished income on the child; or
(3) the unemployment, underemployment, or employment on a less than full-time basis
is because a parent is physically or mentally incapacitated or due to incarcerationdeleted text begin, except
where the reason for incarceration is the parent's nonpayment of supportdeleted text end.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 9.
Minnesota Statutes 2018, section 518A.51, is amended to read:
518A.51 FEES FOR IV-D SERVICES.
(a) When a recipient of IV-D services is no longer receiving assistance under the state's
title IV-A, IV-E foster care, or medical assistance programs, the public authority responsible
for child support enforcement must notify the recipient, within five working days of the
notification of ineligibility, that IV-D services will be continued unless the public authority
is notified to the contrary by the recipient. The notice must include the implications of
continuing to receive IV-D services, including the available services and fees, cost recovery
fees, and distribution policies relating to fees.
(b) In the case of an individual who has never received assistance under a state program
funded under title IV-A of the Social Security Act and for whom the public authority has
collected at least deleted text begin$500deleted text endnew text begin $550new text end of support, the public authority must impose an annual federal
collections fee of deleted text begin$25deleted text endnew text begin $35new text end for each case in which services are furnished. This fee must be
retained by the public authority from support collected on behalf of the individual, but not
from the first deleted text begin$500deleted text endnew text begin $550new text end collected.
(c) When the public authority provides full IV-D services to an obligee who has applied
for those services, upon written notice to the obligee, the public authority must charge a
cost recovery fee of two percent of the amount collected. This fee must be deducted from
the amount of the child support and maintenance collected and not assigned under section
256.741 before disbursement to the obligee. This fee does not apply to an obligee who:
(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, or
medical assistance programs; or
(2) has received assistance under the state's title IV-A or IV-E foster care programs,
until the person has not received this assistance for 24 consecutive months.
(d) When the public authority provides full IV-D services to an obligor who has applied
for such services, upon written notice to the obligor, the public authority must charge a cost
recovery fee of two percent of the monthly court-ordered child support and maintenance
obligation. The fee may be collected through income withholding, as well as by any other
enforcement remedy available to the public authority responsible for child support
enforcement.
(e) Fees assessed by state and federal tax agencies for collection of overdue support
owed to or on behalf of a person not receiving public assistance must be imposed on the
person for whom these services are provided. The public authority upon written notice to
the obligee shall assess a fee of $25 to the person not receiving public assistance for each
successful federal tax interception. The fee must be withheld prior to the release of the funds
received from each interception and deposited in the general fund.
(f) Federal collections fees collected under paragraph (b) and cost recovery fees collected
under paragraphs (c) and (d) retained by the commissioner of human services shall be
considered child support program income according to Code of Federal Regulations, title
45, section 304.50, and shall be deposited in the special revenue fund account established
under paragraph (h). The commissioner of human services must elect to recover costs based
on either actual or standardized costs.
(g) The limitations of this section on the assessment of fees shall not apply to the extent
inconsistent with the requirements of federal law for receiving funds for the programs under
title IV-A and title IV-D of the Social Security Act, United States Code, title 42, sections
601 to 613 and United States Code, title 42, sections 651 to 662.
(h) The commissioner of human services is authorized to establish a special revenue
fund account to receive the federal collections fees collected under paragraph (b) and cost
recovery fees collected under paragraphs (c) and (d).
(i) The nonfederal share of the cost recovery fee revenue must be retained by the
commissioner and distributed as follows:
(1) one-half of the revenue must be transferred to the child support system special revenue
account to support the state's administration of the child support enforcement program and
its federally mandated automated system;
(2) an additional portion of the revenue must be transferred to the child support system
special revenue account for expenditures necessary to administer the fees; and
(3) the remaining portion of the revenue must be distributed to the counties to aid the
counties in funding their child support enforcement programs.
(j) The nonfederal share of the federal collections fees must be distributed to the counties
to aid them in funding their child support enforcement programs.
(k) The commissioner of human services shall distribute quarterly any of the funds
dedicated to the counties under paragraphs (i) and (j) using the methodology specified in
section 256.979, subdivision 11. The funds received by the counties must be reinvested in
the child support enforcement program and the counties must not reduce the funding of
their child support programs by the amount of the funding distributed.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2019.
new text end
Sec. 10. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES; TEFRA
OPTION IMPROVEMENT MEASURES.
new text end
new text begin
(a) The commissioner of human services shall, using existing appropriations, develop
content to be included on the MNsure website explaining the TEFRA option under medical
assistance for applicants who indicate during the application process that a child in the
family has a disability.
new text end
new text begin
(b) The commissioner shall develop a cover letter explaining the TEFRA option under
medical assistance, as well as the application and renewal process, to be disseminated with
the DHS-6696A form to applicants who may qualify for medical assistance under the TEFRA
option. The commissioner shall provide the content and the form to the executive director
of MNsure for inclusion on the MNsure website. The commissioner shall also develop and
implement education and training for lead agency staff statewide to improve understanding
of the medical assistance-TEFRA enrollment and renewal processes and procedures.
new text end
new text begin
(c) The commissioner shall convene a stakeholder group that shall consider improvements
to the TEFRA option enrollment and renewal processes, including but not limited to revisions
to, or the development of, application and renewal paperwork specific to the TEFRA option;
possible technology solutions; and county processes.
new text end
new text begin
(d) The stakeholder group must include representatives from the Department of Human
Services Health Care Division, MNsure, representatives from at least two counties in the
metropolitan area and from at least one county in greater Minnesota, the Arc Minnesota,
Gillette Children's Specialty Healthcare, the Autism Society of Minnesota, Proof Alliance,
the Minnesota Consortium for Citizens with Disabilities, and other interested stakeholders
as identified by the commissioner of human services.
new text end
new text begin
(e) The stakeholder group shall submit a report of the group's recommended
improvements and any associated costs to the commissioner by December 31, 2020. The
group shall also provide copies of the report to each stakeholder group member. The
commissioner shall provide a copy of the report to the legislative committees with jurisdiction
over medical assistance.
new text end
Sec. 11. new text beginMINNESOTA PATHWAYS TO PROSPERITY AND WELL-BEING PILOT
PROJECT.
new text end
new text begin Subdivision 1. new text end
new text begin Authorization. new text end
new text begin
(a) The commissioner of human services shall develop
a pilot project that tests an alternative benefit delivery system for the distribution of public
assistance benefits. The commissioner shall work with Dakota County and Olmsted County
to develop the pilot project in accordance with this section. The commissioner shall apply
for any federal waivers necessary to implement the pilot project.
new text end
new text begin
(b) Prior to authorizing the pilot project, Dakota and Olmsted Counties must provide
the following information to the commissioner:
new text end
new text begin
(1) identification of any federal waivers required to implement the pilot project and a
timeline for obtaining the waivers;
new text end
new text begin
(2) identification of data sharing requirements between the counties and the commissioner
to administer the pilot project and evaluate the outcome measures under subdivision 4,
including the technology systems that will be developed to administer the pilot project and
a description of the elements of the technology systems that will ensure the privacy of the
data of the participants and provide financial oversight and accountability for expended
funds;
new text end
new text begin
(3) documentation that demonstrates receipt of private donations or grants totaling at
least $2,800,000 per year for three years to support implementation of the pilot project;
new text end
new text begin
(4) a complete plan for implementing the pilot project, including an assurance that each
participant's unified benefit amount is proportionate to and in no event exceeds the total
amount that the participant would have received by participating in the underlying programs
for which they are eligible upon entering the pilot project, information about the
administration of the unified benefit amount to ensure that the benefit is used by participants
for the services provided through the underlying programs included in the unified benefit,
an explanation of which funds will be issued directly to providers and which funds will be
available on an EBT card, and information about consequences and remedies for improper
use of the unified benefit;
new text end
new text begin
(5) an evaluation plan developed in consultation with the commissioner of management
and budget to ensure that the pilot project includes an evaluation using an experimental or
quasi-experimental design and a formal evaluation of the results of the pilot project; and
new text end
new text begin
(6) documentation that demonstrates the receipt of a formal commitment of grants or
contracts with the federal government to complete a comprehensive evaluation of the pilot
project.
new text end
new text begin
(c) The commissioner may authorize the pilot project only after reviewing the information
submitted under paragraph (b) and issuing a formal written approval of the proposed project.
new text end
new text begin Subd. 2. new text end
new text begin Pilot project goals. new text end
new text begin
The goals of the pilot project are to:
new text end
new text begin
(1) reduce the historical separation among the state programs and systems affecting
families who may receive public assistance;
new text end
new text begin
(2) eliminate, where possible, regulatory or program restrictions to allow a comprehensive
approach to meeting the needs of the families in the pilot project; and
new text end
new text begin
(3) focus on prevention-oriented supports and interventions.
new text end
new text begin Subd. 3. new text end
new text begin Pilot project participants. new text end
new text begin
The pilot project developed by the commissioner
must include requirements that participants:
new text end
new text begin
(1) be 30 years of age or younger with a minimum of one child and income below 200
percent of federal poverty guidelines;
new text end
new text begin
(2) voluntarily agree to participate in the pilot project;
new text end
new text begin
(3) be informed of the right to voluntarily discontinue participation in the pilot project;
new text end
new text begin
(4) be eligible for or receiving assistance under the Minnesota family investment program
under Minnesota Statutes, chapter 256J, and at least one of the following programs: (i) the
child care assistance program under Minnesota Statutes, chapter 119B; (ii) the diversionary
work program under Minnesota Statutes, section 256J.95; (iii) the supplemental nutrition
assistance program under Minnesota Statutes, chapter 256D; or (iv) state or federal housing
support;
new text end
new text begin
(5) provide informed, written consent that the participant waives eligibility for the
programs included in the unified benefit set for the duration of their participation in the
pilot project;
new text end
new text begin
(6) be enrolled in an education program that is focused on obtaining a career that will
result in a livable wage;
new text end
new text begin
(7) receive as the unified benefit only an amount that is proportionate to and does not
exceed the total value of the benefits the participant would be eligible to receive under the
underlying programs upon entering the pilot project; and
new text end
new text begin
(8) shall not have the unified benefit amount counted as income for child support or tax
purposes.
new text end
new text begin Subd. 4. new text end
new text begin Outcomes. new text end
new text begin
(a) The outcome measures for the pilot project must be developed
in consultation with the commissioner of management and budget, and must include:
new text end
new text begin
(1) improvement in the affordability, safety, and permanence of suitable housing;
new text end
new text begin
(2) improvement in family functioning and stability, including the areas of behavioral
health, incarceration, involvement with the child welfare system;
new text end
new text begin
(3) improvement in education readiness and outcomes for parents and children from
early childhood through high school, including reduction in absenteeism, preschool readiness
scores, third grade reading competency, graduation, grade point average, and standardized
test improvement;
new text end
new text begin
(4) improvement in attachment to the workforce of one or both parents, including
enhanced job stability; wage gains; career advancement; and progress in career preparation;
and
new text end
new text begin
(5) improvement in health care access and health outcomes for parents and children and
other outcomes determined in consultation with the commissioner of human services and
the commissioner of management and budget.
new text end
new text begin
(b) Dakota and Olmsted Counties shall report on the progress and outcomes of the pilot
project to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services by January 15 of each year that the pilot project operates,
beginning January 15, 2021.
new text end
Sec. 12. new text beginDIRECTION TO COMMISSIONER; CHILD CARE ASSISTANCE
PROGRAM REDESIGN.
new text end
new text begin
(a) By January 15, 2020, the commissioner of human services shall, following
consultation with families, providers, and county agencies, report to the chairs and ranking
minority members of the legislative committees having jurisdiction over child care with a
proposal, for implementation by July 1, 2020, that redesigns the child care assistance program
to meet all applicable federal requirements, achieve at least the following objectives, and
include at least the following features:
new text end
new text begin
(1) eliminates fraud;
new text end
new text begin
(2) eliminates program inefficiencies;
new text end
new text begin
(3) eliminates barriers to families entering the program;
new text end
new text begin
(4) improves accessibility to child care for families in greater Minnesota and in the
metropolitan area;
new text end
new text begin
(5) improves the quality of available child care;
new text end
new text begin
(6) eliminates assistance rate disparities between greater Minnesota and the metropolitan
area;
new text end
new text begin
(7) ensures future access to assistance and child care for families in greater Minnesota
and in the metropolitan area;
new text end
new text begin
(8) develops additional options for providers to complete required training including
through online or remote access;
new text end
new text begin
(9) improves ease of provider access to required training and quality improvement
resources;
new text end
new text begin
(10) reforms the Parent Aware program, including by removing barriers to participation
for family child care providers, by implementing a method for evaluating the quality and
effectiveness of four-star rated programs, and by incorporating licensing violations, sanctions,
or maltreatment determinations into the star-rating program standards;
new text end
new text begin
(11) proposes legislation that codifies Parent Aware program standards;
new text end
new text begin
(12) implements a licensing and inspection structure based on differential monitoring;
new text end
new text begin
(13) amends licensing requirements that have led to closure of child care programs,
especially family child care programs;
new text end
new text begin
(14) recommends business development and technical assistance resources to promote
provider recruitment and retention;
new text end
new text begin
(15) allows for family child care licensing alternatives, including permitting multiple
family child care providers to operate in a commercial or other building other than the
providers' residences; and
new text end
new text begin
(16) improves family child care licensing efficiencies, including by adding a variance
structure and updating child ratios.
new text end
new text begin
(b) The commissioner shall seek all necessary federal waivers to implement the proposed
redesign described in paragraph (a), including to authorize use of existing federal funding.
new text end
Sec. 13. new text beginAPPROPRIATION; CHILD CARE ASSISTANCE PROGRAM REDESIGN.
new text end
new text begin
$236,453,000 is appropriated in fiscal year 2022 from the general fund to the
commissioner of human services for the redesigned child care assistance program. This is
a onetime appropriation and is available until June 30, 2023.
new text end
Sec. 14. new text beginREVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes, in consultation with the Department of Human Services, House
Research Department, and Senate Counsel, Research and Fiscal Analysis shall change the
terms "food support" and "food stamps" to "Supplemental Nutrition Assistance Program"
or "SNAP" in Minnesota Statutes when appropriate. The revisor may make technical and
other necessary changes to sentence structure to preserve the meaning of the text.
new text end
Sec. 15. new text beginREVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall remove the terms "child care assistance program," "basic
sliding fee child care," and "MFIP child care," or similar terms wherever the terms appear
in Minnesota Statutes. The revisor shall also make technical and other necessary changes
to sentence structure to preserve the meaning of the text.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2020.
new text end
Sec. 16. new text beginREPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2018, sections 119B.011, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,
10a, 11, 12, 13, 13a, 14, 15, 16, 17, 18, 19, 19a, 19b, 20, 20a, 21, and 22; 119B.02; 119B.025,
subdivisions 1, 2, 3, and 4; 119B.03, subdivisions 1, 2, 3, 4, 5, 6, 6a, 6b, 8, 9, and 10;
119B.035; 119B.04; 119B.05, subdivisions 1, 4, and 5; 119B.06, subdivisions 1, 2, and 3;
119B.08, subdivisions 1, 2, and 3; 119B.09, subdivisions 1, 3, 4, 4a, 5, 6, 7, 8, 9, 9a, 10,
11, 12, and 13; 119B.095; 119B.097; 119B.10, subdivisions 1, 2, and 3; 119B.105; 119B.11,
subdivisions 1, 2a, 3, and 4; 119B.12, subdivisions 1 and 2; 119B.125; 119B.13, subdivisions
1, 1a, 3, 3a, 3b, 3c, 4, 5, 6, and 7; 119B.14; 119B.15; and 119B.16,
new text end
new text begin
are repealed effective
July 1, 2020.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, parts 3400.0010; 3400.0020, subparts 1, 4, 5, 8, 9a, 10a, 12, 17a,
18, 18a, 20, 24, 25, 26, 28, 29a, 31b, 32b, 33, 34a, 35, 37, 38, 38a, 38b, 39, 40, 40a, and
44; 3400.0030; 3400.0035; 3400.0040, subparts 1, 3, 4, 5, 5a, 6a, 6b, 6c, 7, 8, 9, 10, 11, 12,
13, 14, 15, 15a, 17, and 18; 3400.0060, subparts 2, 4, 5, 6, 6a, 7, 8, 9, and 10; 3400.0080,
subparts 1, 1a, 1b, and 8; 3400.0090, subparts 1, 2, 3, and 4; 3400.0100, subparts 2a, 2b,
2c, and 5; 3400.0110, subparts 1, 1a, 2, 2a, 3, 4a, 7, 8, 9, 10, and 11; 3400.0120, subparts
1, 1a, 2, 2a, 3, and 5; 3400.0130, subparts 1, 1a, 2, 3, 3a, 3b, 5, 5a, and 7; 3400.0140, subparts
1, 2, 4, 5, 6, 7, 8, 9, 9a, 10, and 14; 3400.0150; 3400.0170, subparts 1, 3, 4, 6a, 7, 8, 9, 10,
and 11; 3400.0180; 3400.0183, subparts 1, 2, and 5; 3400.0185; 3400.0187, subparts 1, 2,
3, 4, and 6; 3400.0200; 3400.0220; 3400.0230, subpart 3; and 3400.0235, subparts 1, 2, 3,
4, 5, and 6,
new text end
new text begin
are repealed are effective July 1, 2020.
new text end
new text begin
(c)
new text end
new text begin
Laws 2017, First Special Session chapter 6, article 7, section 34,
new text end
new text begin
is repealed effective
July 1, 2019.
new text end
ARTICLE 3
CHEMICAL AND MENTAL HEALTH
Section 1.
Minnesota Statutes 2018, section 13.851, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Mental health data sharing. new text end
new text begin
Section 641.15, subdivision 3a, governs the
sharing of data on prisoners who may have a mental illness or need services with county
social service agencies or welfare system personnel.
new text end
Sec. 2.
Minnesota Statutes 2018, section 245.4889, subdivision 1, is amended to read:
Subdivision 1.
Establishment and authority.
(a) The commissioner is authorized to
make grants from available appropriations to assist:
(1) counties;
(2) Indian tribes;
(3) children's collaboratives under section 124D.23 or 245.493; or
(4) mental health service providers.
(b) The following services are eligible for grants under this section:
(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;
(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;
(3) respite care services for children with severe emotional disturbances who are at risk
of out-of-home placementnew text begin, whether or not the child is receiving case management servicesnew text end;
(4) children's mental health crisis services;
(5) mental health services for people from cultural and ethnic minorities;
(6) children's mental health screening and follow-up diagnostic assessment and treatment;
(7) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;
(8) school-linked mental health services, including transportation for children receiving
school-linked mental health services when school is not in session;
(9) building evidence-based mental health intervention capacity for children birth to age
five;
(10) suicide prevention and counseling services that use text messaging statewide;
(11) mental health first aid training;
(12) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
website to share information and strategies to promote resilience and prevent trauma;
(13) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;
(14) early childhood mental health consultation;
(15) evidence-based interventions for youth at risk of developing or experiencing a first
episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis;
(16) psychiatric consultation for primary care practitioners;deleted text begin and
deleted text end
(17) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grantsdeleted text begin.deleted text endnew text begin; and
new text end
new text begin
(18) promoting and developing a provider's capacity to deliver multigenerational mental
health treatment and services.
new text end
(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.
Sec. 3.
Minnesota Statutes 2018, section 254A.03, subdivision 3, is amended to read:
Subd. 3.
Rules for substance use disorder care.
(a) The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level of
chemical dependency care for each recipient of public assistance seeking treatment for
substance misuse or substance use disorder. Upon federal approval of a comprehensive
assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding
the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of
comprehensive assessments under section 254B.05 may determine and approve the
appropriate level of substance use disorder treatment for a recipient of public assistance.
The process for determining an individual's financial eligibility for the consolidated chemical
dependency treatment fund or determining an individual's enrollment in or eligibility for a
publicly subsidized health plan is not affected by the individual's choice to access a
comprehensive assessment for placement.
(b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.
new text begin
(c) If a screen result is positive for alcohol or substance misuse, a brief screening for
alcohol or substance use disorder that is provided to a recipient of public assistance within
a primary care clinic, hospital, or other medical setting or school setting establishes medical
necessity and approval for an initial set of substance use disorder services identified in
section 254B.05, subdivision 5. The initial set of services approved for a recipient whose
screen result is positive may include four hours of individual or group substance use disorder
treatment, two hours of substance use disorder treatment coordination, or two hours of
substance use disorder peer support services provided by a qualified individual according
to chapter 245G. A recipient must obtain an assessment pursuant to paragraph (a) to be
approved for additional treatment services.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Contingent upon federal approval, this section is effective July
1, 2019. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained or denied.
new text end
Sec. 4.
Minnesota Statutes 2018, section 254A.19, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Assessment via telemedicine. new text end
new text begin
Notwithstanding Minnesota Rules, part
9530.6615, subpart 3, item A, a chemical use assessment may be conducted via telemedicine.
new text end
Sec. 5.
Minnesota Statutes 2018, section 254B.02, subdivision 1, is amended to read:
Subdivision 1.
Chemical dependency treatment allocation.
The chemical dependency
treatment appropriation shall be placed in a special revenue account. deleted text beginThe commissioner
shall annually transfer funds from the chemical dependency fund to pay for operation of
the drug and alcohol abuse normative evaluation system and to pay for all costs incurred
by adding two positions for licensing of chemical dependency treatment and rehabilitation
programs located in hospitals for which funds are not otherwise appropriated.deleted text end The deleted text beginremainder
of thedeleted text end money in the special revenue account must be used according to the requirements in
this chapter.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 6.
Minnesota Statutes 2018, section 254B.03, subdivision 2, is amended to read:
Subd. 2.
Chemical dependency fund payment.
(a) Payment from the chemical
dependency fund is limited to payments for services other than detoxification licensed under
Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally
recognized tribal lands, would be required to be licensed by the commissioner as a chemical
dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and
services other than detoxification provided in another state that would be required to be
licensed as a chemical dependency program if the program were in the state. Out of state
vendors must also provide the commissioner with assurances that the program complies
substantially with state licensing requirements and possesses all licenses and certifications
required by the host state to provide chemical dependency treatment. Vendors receiving
payments from the chemical dependency fund must not require co-payment from a recipient
of benefits for services provided under this subdivision. The vendor is prohibited from using
the client's public benefits to offset the cost of services paid under this section. The vendor
shall not require the client to use public benefits for room or board costs. This includes but
is not limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP
benefits. Retention of SNAP benefits is a right of a client receiving services through the
consolidated chemical dependency treatment fund or through state contracted managed care
entities. Payment from the chemical dependency fund shall be made for necessary room
and board costs provided by vendors deleted text begincertified according todeleted text end new text beginmeeting the criteria under new text endsection
254B.05new text begin, subdivision 1anew text end, or in a community hospital licensed by the commissioner of health
according to sections 144.50 to 144.56 to a client who is:
(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and
(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.
(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.
(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. deleted text beginThe commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment servicesdeleted text endnew text begin The commissioner
may deny vendor certification to a provider if the commissioner determines that the services
currently available in the local area are sufficient to meet local need and that the addition
of new services would be detrimental to individuals seeking these servicesnew text end.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 7.
Minnesota Statutes 2018, section 254B.03, subdivision 4, is amended to read:
Subd. 4.
Division of costs.
(a) Except for services provided by a county under section
254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out
of local money, pay the state for 22.95 percent of the cost of chemical dependency services,
deleted text begin including thosedeleted text endnew text begin except that the county shall pay the state for ten percent of the nonfederal
share of the cost of chemical dependencynew text end services provided to persons deleted text begineligible fordeleted text endnew text begin enrolled
innew text end medical assistance under chapter 256Bnew text begin, and ten percent of the cost of room and board
services under section 254B.05, subdivision 5, paragraph (b), clause (12)new text end. Counties may
use the indigent hospitalization levy for treatment and hospital payments made under this
section.
(b) 22.95 percent of any state collections from private or third-party pay, less 15 percent
for the cost of payment and collections, must be distributed to the county that paid for a
portion of the treatment under this section.
deleted text begin
(c) For fiscal year 2017 only, the 22.95 percentages under paragraphs (a) and (b) are
equal to 20.2 percent.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 8.
Minnesota Statutes 2018, section 254B.04, subdivision 1, is amended to read:
Subdivision 1.
Eligibility.
new text begin(a)new text end Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, deleted text beginand persons eligible for medical assistance benefits under
sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, ordeleted text end who meet the
income standards of section 256B.056, subdivision 4,new text begin and are not enrolled in medical
assistance,new text end are entitled to chemical dependency fund services. State money appropriated
for this paragraph must be placed in a separate account established for this purpose.
new text begin (b) new text endPersons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county shall
pay for out-of-home placement costs, if applicable.
new text begin
(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible
for room and board services under section 254B.05, subdivision 5, paragraph (b), clause
(12).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 9.
Minnesota Statutes 2018, section 254B.05, subdivision 1a, is amended to read:
Subd. 1a.
Room and board provider requirements.
(a) Effective January 1, 2000,
vendors of room and board are eligible for chemical dependency fund payment if the vendor:
(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;
(2) is determined to meet applicable health and safety requirements;
(3) is not a jail or prison;
(4) is not concurrently receiving funds under chapter 256I for the recipient;
(5) admits individuals who are 18 years of age or older;
(6) is registered as a board and lodging or lodging establishment according to section
157.17;
(7) has awake staff on site 24 hours per day;
(8) has staff who are at least 18 years of age and meet the requirements of section
245G.11, subdivision 1, paragraph (b);
(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
(10) meets the requirements of section 245G.08, subdivision 5, if administering
medications to clients;
(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;
(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;
(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;
(14) has a grievance procedure that meets the requirements of section 245G.15,
subdivision 2; and
(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.
(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).
new text begin
(c) Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
of room and board and are exempt from paragraph (a), clauses (6) to (15).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 10.
Minnesota Statutes 2018, section 254B.06, subdivision 1, is amended to read:
Subdivision 1.
State collections.
The commissioner is responsible for all collections
from persons determined to be partially responsible for the cost of care of an eligible person
receiving services under Laws 1986, chapter 394, sections 8 to 20. The commissioner may
initiate, or request the attorney general to initiate, necessary civil action to recover the unpaid
cost of care. The commissioner may collect all third-party payments for chemical dependency
services provided under Laws 1986, chapter 394, sections 8 to 20, including private insurance
and federal Medicaid and Medicare financial participation. deleted text beginThe commissioner shall deposit
in a dedicated account a percentage of collections to pay for the cost of operating the chemical
dependency consolidated treatment fund invoice processing and vendor payment system,
billing, and collections.deleted text end The remaining receipts must be deposited in the chemical dependency
fund.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 11.
Minnesota Statutes 2018, section 254B.06, subdivision 2, is amended to read:
Subd. 2.
Allocation of collections.
deleted text begin(a) The commissioner shall allocate all federal
financial participation collections to a special revenue account.deleted text end The commissioner shall
allocate 77.05 percent of patient payments and third-party payments to the special revenue
account and 22.95 percent to the county financially responsible for the patient.
deleted text begin
(b) For fiscal year 2017 only, the commissioner's allocation to the special revenue account
shall be increased from 77.05 percent to 79.8 percent and the county financial responsibility
shall be reduced from 22.95 percent to 20.2 percent.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 12.
Minnesota Statutes 2018, section 256B.0625, subdivision 24, is amended to read:
Subd. 24.
Other medical or remedial care.
Medical assistance covers any other medical
or remedial care licensed and recognized under state law unless otherwise prohibited by
lawdeleted text begin, except licensed chemical dependency treatment programs or primary treatment or
extended care treatment units in hospitals that are covered under chapter 254B. The
commissioner shall include chemical dependency services in the state medical assistance
plan for federal reporting purposes, but payment must be made under chapter 254Bdeleted text end. The
commissioner shall publish in the State Register a list of elective surgeries that require a
second medical opinion before medical assistance reimbursement, and the criteria and
standards for deciding whether an elective surgery should require a second medical opinion.
The list and criteria and standards are not subject to the requirements of sections 14.01 to
14.69.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 13.
Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 24a. new text end
new text begin Substance use disorder services. new text end
new text begin
Medical assistance covers substance use
disorder treatment services according to section 254B.05, subdivision 5, except for room
and board.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 14.
Minnesota Statutes 2018, section 256B.0757, subdivision 1, is amended to read:
Subdivision 1.
Provision of coverage.
(a) The commissioner shall provide medical
assistance coverage of health home services for eligible individuals with chronic conditions
who select a designated provider as the individual's health home.
(b) The commissioner shall implement this section in compliance with the requirements
of the state option to provide health homes for enrollees with chronic conditions, as provided
under the Patient Protection and Affordable Care Act, Public Law 111-148, sections 2703
and 3502. Terms used in this section have the meaning provided in that act.
(c) The commissioner shall establish health homes to serve populations with serious
mental illness who meet the eligibility requirements described under subdivision 2deleted text begin, clause
(4)deleted text end. The health home services provided by health homes shall focus on both the behavioral
and the physical health of these populations.
Sec. 15.
Minnesota Statutes 2018, section 256B.0757, subdivision 2, is amended to read:
Subd. 2.
Eligible individual.
new text begin
(a) The commissioner may elect to develop health home
models in accordance with United States Code, title 42, section 1396w-4.
new text end
new text begin (b) new text endAn individual is eligible for health home services under this section if the individual
is eligible for medical assistance under this chapter and has deleted text beginat least:
deleted text end
deleted text begin
(1) two chronic conditions;
deleted text end
deleted text begin
(2) one chronic condition and is at risk of having a second chronic condition;
deleted text end
deleted text begin
(3) one serious and persistent mental health condition; or
deleted text end
deleted text begin (4)deleted text end a condition that meets the definition new text beginof mental illness as described new text endin section 245.462,
subdivision 20, paragraph (a), or new text beginemotional disturbance as defined in section new text end245.4871,
subdivision 15, clause (2)deleted text begin; and has a current diagnostic assessment as defined in Minnesota
Rules, part 9505.0372, subpart 1, item B or C, as performed or reviewed by a mental health
professional employed by or under contract with the behavioral health homedeleted text end. The
commissioner shall establish criteria for determining continued eligibility.
Sec. 16.
Minnesota Statutes 2018, section 256B.0757, subdivision 4, is amended to read:
Subd. 4.
Designated provider.
deleted text begin(a)deleted text end Health home services are voluntary and an eligible
individual may choose any designated provider. The commissioner shall establish designated
providers to serve as health homes and provide the services described in subdivision 3 to
individuals eligible under subdivision 2. The commissioner shall apply for grants as provided
under section 3502 of the Patient Protection and Affordable Care Act to establish health
homes and provide capitated payments to designated providers. For purposes of this section,
"designated provider" means a provider, clinical practice or clinical group practice, rural
clinic, community health center, community mental health center, or any other entity that
is determined by the commissioner to be qualified to be a health home for eligible individuals.
This determination must be based on documentation evidencing that the designated provider
has the systems and infrastructure in place to provide health home services and satisfies the
qualification standards established by the commissioner in consultation with stakeholders
and approved by the Centers for Medicare and Medicaid Services.
deleted text begin
(b) The commissioner shall develop and implement certification standards for designated
providers under this subdivision.
deleted text end
Sec. 17.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 9. new text end
new text begin Discharge criteria. new text end
new text begin
(a) An individual may be discharged from behavioral health
home services if:
new text end
new text begin
(1) the behavioral health home services provider is unable to locate, contact, and engage
the individual for a period of greater than three months after persistent efforts by the
behavioral health home services provider; or
new text end
new text begin
(2) the individual is unwilling to participate in behavioral health home services as
demonstrated by the individual's refusal to meet with the behavioral health home services
provider, or refusal to identify the individual's goals or the activities or support necessary
to achieve the individual's health and wellness goals.
new text end
new text begin
(b) Before discharge from behavioral health home services, the behavioral health home
services provider must offer a face-to-face meeting with the individual, the individual's
identified supports, and the behavioral health home services provider to discuss options
available to the individual, including maintaining behavioral health home services.
new text end
Sec. 18.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Behavioral health home services provider requirements. new text end
new text begin
A behavioral
health home services provider must:
new text end
new text begin
(1) be an enrolled Minnesota Health Care Programs provider;
new text end
new text begin
(2) provide a medical assistance covered primary care or behavioral health service;
new text end
new text begin
(3) utilize an electronic health record;
new text end
new text begin
(4) utilize an electronic patient registry that contains data elements required by the
commissioner;
new text end
new text begin
(5) demonstrate the organization's capacity to administer screenings approved by the
commissioner for substance use disorder or alcohol and tobacco use;
new text end
new text begin
(6) demonstrate the organization's capacity to refer an individual to resources appropriate
to the individual's screening results;
new text end
new text begin
(7) have policies and procedures to track referrals to ensure that the referral met the
individual's needs;
new text end
new text begin
(8) conduct a brief needs assessment when an individual begins receiving behavioral
health home services. The brief needs assessment must be completed with input from the
individual and the individual's identified supports. The brief needs assessment must address
the individual's immediate safety and transportation needs and potential barriers to
participating in behavioral health home services;
new text end
new text begin
(9) conduct a health wellness assessment within 60 days after intake that contains all
required elements identified by the commissioner;
new text end
new text begin
(10) conduct a health action plan that contains all required elements identified by the
commissioner within 90 days after intake and updated at least once every six months or
more frequently if significant changes to an individual's needs or goals occur;
new text end
new text begin
(11) agree to cooperate and participate with the state's monitoring and evaluation of
behavioral health home services; and
new text end
new text begin
(12) utilize the form approved by the commissioner to obtain the individual's written
consent to begin receiving behavioral health home services.
new text end
Sec. 19.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Provider training and practice transformation requirements. new text end
new text begin
(a) The
behavioral health home services provider must ensure that all staff delivering behavioral
health home services receive adequate preservice and ongoing training including:
new text end
new text begin
(1) training approved by the commissioner that describes the goals and principles of
behavioral health home services; and
new text end
new text begin
(2) training on evidence-based practices to promote an individual's ability to successfully
engage with medical, behavioral health, and social services to reach the individual's health
and wellness goals.
new text end
new text begin
(b) The behavioral health home services provider must ensure that staff are capable of
implementing culturally responsive services as determined by the individual's culture,
beliefs, values, and language as identified in the individual's health wellness assessment.
new text end
new text begin
(c) The behavioral health home services provider must participate in the department's
practice transformation activities to support continued skill and competency development
in the provision of integrated medical, behavioral health, and social services.
new text end
Sec. 20.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Staff qualifications. new text end
new text begin
(a) A behavioral health home services provider must
maintain staff with required professional qualifications appropriate to the setting.
new text end
new text begin
(b) If behavioral health home services are offered in a mental health setting, the
integration specialist must be a registered nurse licensed under the Minnesota Nurse Practice
Act, sections 148.171 to 148.285.
new text end
new text begin
(c) If behavioral health home services are offered in a primary care setting, the integration
specialist must be a mental health professional as defined in section 245.462, subdivision
18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6).
new text end
new text begin
(d) If behavioral health home services are offered in either a primary care setting or
mental health setting, the systems navigator must be a mental health practitioner as defined
in section 245.462, subdivision 17, or a community health worker as defined in section
256B.0625, subdivision 49.
new text end
new text begin
(e) If behavioral health home services are offered in either a primary care setting or
mental health setting, the qualified health home specialist must be one of the following:
new text end
new text begin
(1) a peer support specialist as defined in section 256B.0615;
new text end
new text begin
(2) a family peer support specialist as defined in section 256B.0616;
new text end
new text begin
(3) a case management associate as defined in section 245.462, subdivision 4, paragraph
(g), or 245.4871, subdivision 4, paragraph (j);
new text end
new text begin
(4) a mental health rehabilitation worker as defined in section 256B.0623, subdivision
5, clause (4);
new text end
new text begin
(5) a community paramedic as defined in section 144E.28, subdivision 9;
new text end
new text begin
(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5);
or
new text end
new text begin
(7) a community health worker as defined in section 256B.0625, subdivision 49.
new text end
Sec. 21.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Service delivery standards. new text end
new text begin
(a) A behavioral health home services provider
must meet the following service delivery standards:
new text end
new text begin
(1) establish and maintain processes to support the coordination of an individual's primary
care, behavioral health, and dental care;
new text end
new text begin
(2) maintain a team-based model of care, including regular coordination and
communication between behavioral health home services team members;
new text end
new text begin
(3) use evidence-based practices that recognize and are tailored to the medical, social,
economic, behavioral health, functional impairment, cultural, and environmental factors
affecting the individual's health and health care choices;
new text end
new text begin
(4) use person-centered planning practices to ensure the individual's health action plan
accurately reflects the individual's preferences, goals, resources, and optimal outcomes for
the individual and the individual's identified supports;
new text end
new text begin
(5) use the patient registry to identify individuals and population subgroups requiring
specific levels or types of care and provide or refer the individual to needed treatment,
intervention, or service;
new text end
new text begin
(6) utilize Department of Human Services Partner Portal to identify past and current
treatment or services and to identify potential gaps in care;
new text end
new text begin
(7) deliver services consistent with standards for frequency and face-to-face contact as
required by the commissioner;
new text end
new text begin
(8) ensure that all individuals receiving behavioral health home services have a diagnostic
assessment completed within six months of when the individual begins receiving behavioral
health home services;
new text end
new text begin
(9) deliver services in locations and settings that meet the needs of the individual;
new text end
new text begin
(10) provide a central point of contact to ensure that individuals and the individual's
identified supports can successfully navigate the array of services that impact the individual's
health and well-being;
new text end
new text begin
(11) have capacity to assess an individual's readiness for change and the individual's
capacity to integrate new health care or community supports into the individual's life;
new text end
new text begin
(12) offer or facilitate the provision of wellness and prevention education on
evidenced-based curriculums specific to the prevention and management of common chronic
conditions;
new text end
new text begin
(13) help an individual set up and prepare for appointments, including accompanying
the individual to appointments as appropriate, and follow up with the individual after medical,
behavioral health, social service, or community support appointments;
new text end
new text begin
(14) offer or facilitate the provision of health coaching related to chronic disease
management and how to navigate complex systems of care to the individual, the individual's
family, and identified supports;
new text end
new text begin
(15) connect an individual, the individual's family, and identified supports to appropriate
support services that help the individual overcome access or service barriers, increase
self-sufficiency skills, and improve overall health;
new text end
new text begin
(16) provide effective referrals and timely access to services; and
new text end
new text begin
(17) establish a continuous quality improvement process for providing behavioral health
home services.
new text end
new text begin
(b) The behavioral health home services provider must also create a plan, in partnership
with the individual and the individual's identified supports, to support the individual after
discharge from a hospital, residential treatment program, or other setting. The plan must
include protocols for:
new text end
new text begin
(1) maintaining contact between the behavioral health home services team member and
the individual and the individual's identified supports during and after discharge;
new text end
new text begin
(2) linking the individual to new resources as needed;
new text end
new text begin
(3) reestablishing the individual's existing services and community and social supports;
and
new text end
new text begin
(4) following up with appropriate entities to transfer or obtain the individual's service
records as necessary for continued care.
new text end
new text begin
(c) If the individual is enrolled in a managed care plan, a behavioral health home services
provider must:
new text end
new text begin
(1) notify the behavioral health home services contact designated by the managed care
plan within 30 days of when the individual begins behavioral health home services; and
new text end
new text begin
(2) adhere to the managed care plan communication and coordination requirements
described in the behavioral health home services manual.
new text end
new text begin
(d) Before terminating behavioral health home services, the behavioral health home
services provider must:
new text end
new text begin
(1) provide a 60-day notice of termination of behavioral health home services to all
individuals receiving behavioral health home services, the department, and managed care
plans, if applicable; and
new text end
new text begin
(2) refer individuals receiving behavioral health home services to a new behavioral
health home services provider.
new text end
Sec. 22.
Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Provider variances. new text end
new text begin
(a) The commissioner may grant a variance to specific
requirements under subdivision 10, 11, 12, or 13 for a behavioral health home services
provider according to this subdivision.
new text end
new text begin
(b) The commissioner may grant a variance if the commissioner finds that (1) failure to
grant the variance would result in hardship or injustice to the applicant, (2) the variance
would be consistent with the public interest, and (3) the variance would not reduce the level
of services provided to individuals served by the organization.
new text end
new text begin
(c) The commissioner may grant a variance from one or more requirements to permit
an applicant to offer behavioral health home services of a type or in a manner that is
innovative if the commissioner finds that the variance does not impede the achievement of
the criteria in subdivision 10, 11, 12, or 13 and may improve the behavioral health home
services provided by the applicant.
new text end
new text begin
(d) The commissioner's decision to grant or deny a variance request is final and not
subject to appeal.
new text end
Sec. 23.
new text begin
[256B.0759] SUBSTANCE USE DISORDER DEMONSTRATION PROJECT.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner shall develop and implement a medical
assistance demonstration project to test reforms of Minnesota's substance use disorder
treatment system to ensure individuals with substance use disorders have access to a full
continuum of high quality care.
new text end
new text begin Subd. 2. new text end
new text begin Provider participation. new text end
new text begin
Substance use disorder treatment providers may elect
to participate in the demonstration project and fulfill the requirements under subdivision 3.
To participate, a provider must notify the commissioner of the provider's intent to participate
in a format required by the commissioner and enroll as a demonstration project provider.
new text end
new text begin Subd. 3. new text end
new text begin Provider standards. new text end
new text begin
(a) The commissioner shall establish requirements for
participating providers that are consistent with the federal requirements of the demonstration
project.
new text end
new text begin
(b) Participating residential providers must obtain applicable licensure under chapters
245F, 245G, or other applicable standards for the services provided and must:
new text end
new text begin
(1) deliver services in accordance with American Society of Addiction Medicine (ASAM)
standards;
new text end
new text begin
(2) maintain formal patient referral arrangements with providers delivering step-up or
step-down levels of care in accordance with ASAM standards; and
new text end
new text begin
(3) provide or arrange for medication-assisted treatment services if requested by a client
for whom an effective medication exists.
new text end
new text begin
(c) Participating outpatient providers must be licensed and must:
new text end
new text begin
(1) deliver services in accordance with ASAM standards; and
new text end
new text begin
(2) maintain formal patient referral arrangements with providers delivering step-up or
step-down levels of care in accordance with ASAM standards.
new text end
new text begin
(d) If the provider standards under chapter 245G or other applicable standards conflict
or are duplicative, the commissioner may grant variances to the standards if the variances
do not conflict with federal requirements. The commissioner shall publish service
components, service standards, and staffing requirements for participating providers that
are consistent with ASAM standards and federal requirements.
new text end
new text begin Subd. 4. new text end
new text begin Provider payment rates. new text end
new text begin
(a) Payment rates for participating providers must
be increased for services provided to medical assistance enrollees.
new text end
new text begin
(b) For substance use disorder services under section 254B.05, subdivision 5, paragraph
(b), clause (8), payment rates must be increased by 15 percent over the rates in effect on
January 1, 2020.
new text end
new text begin
(c) For substance use disorder services under section 254B.05, subdivision 5, paragraph
(b), clauses (1), (6), (7), and (10), payment rates must be increased by ten percent over the
rates in effect on January 1, 2021.
new text end
new text begin Subd. 5. new text end
new text begin Federal approval. new text end
new text begin
The commissioner shall seek federal approval to implement
the demonstration project under this section and to receive federal financial participation.
new text end
Sec. 24.
Minnesota Statutes 2018, section 256I.04, subdivision 1, is amended to read:
Subdivision 1.
Individual eligibility requirements.
An individual is eligible for and
entitled to a housing support payment to be made on the individual's behalf if the agency
has approved the setting where the individual will receive housing support and the individual
meets the requirements in paragraph (a), (b), or (c).
(a) The individual is aged, blind, or is over 18 years of age with a disability as determined
under the criteria used by the title II program of the Social Security Act, and meets the
resource restrictions and standards of section 256P.02, and the individual's countable income
after deducting the (1) exclusions and disregards of the SSI program, (2) the medical
assistance personal needs allowance under section 256B.35, and (3) an amount equal to the
income actually made available to a community spouse by an elderly waiver participant
under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058,
subdivision 2, is less than the monthly rate specified in the agency's agreement with the
provider of housing support in which the individual resides.
(b) The individual meets a category of eligibility under section 256D.05, subdivision 1,
paragraph (a), clauses (1), (3), (4) to (8), and (13), and paragraph (b), if applicable, and the
individual's resources are less than the standards specified by section 256P.02, and the
individual's countable income as determined under section 256P.06, less the medical
assistance personal needs allowance under section 256B.35 is less than the monthly rate
specified in the agency's agreement with the provider of housing support in which the
individual resides.
(c) The individual deleted text beginreceives licensed residential crisis stabilization services under section
256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive
concurrent housing support payments if receiving licensed residential crisis stabilization
services under section 256B.0624, subdivision 7.deleted text endnew text begin lacks a fixed, adequate, nighttime residence
upon discharge from a residential behavioral health treatment program, as determined by
treatment staff from the residential behavioral health treatment program. An individual is
eligible under this paragraph for up to three months, including a full or partial month from
the individual's move-in date at a setting approved for housing support following discharge
from treatment, plus two full months.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 25.
Minnesota Statutes 2018, section 256I.04, subdivision 2f, is amended to read:
Subd. 2f.
Required services.
new text begin(a) new text endIn licensed and registered settings under subdivision
2a, providers shall ensure that participants have at a minimum:
(1) food preparation and service for three nutritional meals a day on site;
(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
(3) housekeeping, including cleaning and lavatory supplies or service; and
(4) maintenance and operation of the building and grounds, including heat, water, garbage
removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair
and maintain equipment and facilities.
new text begin
(b) Providers serving participants described in subdivision 1, paragraph (c), shall assist
participants in applying for continuing housing support payments before the end of the
eligibility period.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 26.
Minnesota Statutes 2018, section 256I.06, subdivision 8, is amended to read:
Subd. 8.
Amount of housing support payment.
(a) The amount of a room and board
payment to be made on behalf of an eligible individual is determined by subtracting the
individual's countable income under section 256I.04, subdivision 1, for a whole calendar
month from the room and board rate for that same month. The housing support payment is
determined by multiplying the housing support rate times the period of time the individual
was a resident or temporarily absent under section 256I.05, subdivision 1c, paragraph (d).
(b) For an individual with earned income under paragraph (a), prospective budgeting
must be used to determine the amount of the individual's payment for the following six-month
period. An increase in income shall not affect an individual's eligibility or payment amount
until the month following the reporting month. A decrease in income shall be effective the
first day of the month after the month in which the decrease is reported.
(c) For an individual who receives deleted text beginlicensed residential crisis stabilization services under
section 256B.0624, subdivision 7,deleted text endnew text begin housing support payments under section 256I.04,
subdivision 1, paragraph (c),new text end the deleted text beginamount ofdeleted text end housing support payment new text beginamount new text endis determined
by multiplying the housing support rate times the period of time the individual was a resident.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2019.
new text end
Sec. 27.
Minnesota Statutes 2018, section 641.15, subdivision 3a, is amended to read:
Subd. 3a.
Intake procedure; approved mental health screeningnew text begin; data sharingnew text end.
As
part of its intake procedure for new prisoners, the sheriff or local corrections shall use a
mental health screening tool approved by the commissioner of correctionsnew text begin,new text end in consultation
with the commissioner of human services and local corrections staffnew text begin,new text end to identify persons
who may have new text begina new text endmental illness.new text begin Notwithstanding section 13.85, the sheriff or local corrections
may share the names of persons who have screened positive for or may have a mental illness
with the local county social services agency. The sheriff or local corrections may refer a
person to county personnel of the welfare system, as defined in section 13.46, subdivision
1, paragraph (c), in order to arrange for services upon discharge and may share private data
on the individual as necessary to:
new text end
new text begin
(1) provide assistance in filling out an application for medical assistance or
MinnesotaCare;
new text end
new text begin
(2) make a referral for case management as provided under section 245.467, subdivision
4;
new text end
new text begin
(3) provide assistance in obtaining a state photo identification;
new text end
new text begin
(4) secure a timely appointment with a psychiatrist or other appropriate community
mental health provider;
new text end
new text begin
(5) provide prescriptions for a 30-day supply of all necessary medications; or
new text end
new text begin
(6) provide for behavioral health service coordination.
new text end
Sec. 28. new text beginREPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2018, section 254B.03, subdivision 4a,
new text end
new text begin
is repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, parts 9530.6800; and 9530.6810,
new text end
new text begin
are repealed.
new text end
ARTICLE 4
CONTINUING CARE FOR OLDER ADULTS
Section 1.
Minnesota Statutes 2018, section 144A.073, is amended by adding a subdivision
to read:
new text begin Subd. 16. new text end
new text begin Moratorium exception funding. new text end
new text begin
In fiscal year 2020, the commissioner may
approve moratorium exception projects under this section for which the full annualized state
share of medical assistance costs does not exceed $2,000,000 plus any carryover of previous
appropriations for this purpose.
new text end
Sec. 2.
Minnesota Statutes 2018, section 256R.25, is amended to read:
256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to deleted text begin(n)deleted text endnew text begin (o)new text end.
(b) For a facility licensed as a nursing home, the portion related to the provider surcharge
under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
nursing home and a boarding care home, the portion related to the provider surcharge under
section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
of nursing home beds divided by its total number of licensed beds.
(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
amount of the fee divided by the sum of the facility's resident days.
(d) The portion related to development and education of resident and family advisory
councils under section 144A.33 is $5 per resident day divided by 365.
(e) The portion related to scholarships is determined under section 256R.37.
(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
(g) The portion related to consolidation rate adjustments shall be as determined under
section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.
(h) The portion related to single-bed room incentives is as determined under section
256R.41.
(i) The portions related to real estate taxes, special assessments, and payments made in
lieu of real estate taxes directly identified or allocated to the nursing facility are the actual
amounts divided by the sum of the facility's resident days. Allowable costs under this
paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate
taxes shall not exceed the amount which the nursing facility would have paid to a city or
township and county for fire, police, sanitation services, and road maintenance costs had
real estate taxes been levied on that property for those purposes.
(j) The portion related to employer health insurance costs is the allowable costs divided
by the sum of the facility's resident days.
(k) The portion related to the Public Employees Retirement Association is actual costs
divided by the sum of the facility's resident days.
(l) The portion related to quality improvement incentive payment rate adjustments is
the amount determined under section 256R.39.
(m) The portion related to performance-based incentive payments is the amount
determined under section 256R.38.
(n) The portion related to special dietary needs is the amount determined under section
256R.51.
new text begin
(o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.
new text end
Sec. 3.
new text begin
[256R.481] RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
new text end
new text begin
(a)The commissioner shall allow each nonprofit nursing facility located within the
boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once
annually for a rate add-on to the facility's external fixed costs payment rate.
new text end
new text begin
(b) A facility seeking an add-on to its external fixed costs payment rate under this section
must apply annually to the commissioner to receive the add-on. A facility must submit the
application within 60 calendar days of the effective date of any add-on under this section.
The commissioner may waive the deadlines required by this paragraph under extraordinary
circumstances.
new text end
new text begin
(c) The commissioner shall provide the add-on to each eligible facility that applies by
the application deadline.
new text end
new text begin
(d) The add-on to the external fixed costs payment rate is the difference on January 1
of the median total payment rate for case mix classification PA1 of the nonprofit facilities
located in an adjacent city in another state and in cities contiguous to the adjacent city minus
the eligible nursing facility's total payment rate for case mix classification PA1 as determined
under section 256R.22, subdivision 4.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
The add-on to the external fixed costs payment rate described in
Minnesota Statutes, section 256R.481, is available for the rate years beginning on and after
January 1, 2021.
new text end
Sec. 4. new text beginREPEALER.
new text end
new text begin
Minnesota Statutes 2018, section 256R.53, subdivision 2,
new text end
new text begin
is repealed effective January
1, 2021.
new text end
ARTICLE 5
DISABILITY SERVICES
Section 1.
Minnesota Statutes 2018, section 245A.03, subdivision 7, is amended to read:
Subd. 7.
Licensing moratorium.
(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a license is issued during this moratorium, and the license
holder changes the license holder's primary residence away from the physical location of
the foster care license, the commissioner shall revoke the license according to section
245A.07. The commissioner shall not issue an initial license for a community residential
setting licensed under chapter 245D. When approving an exception under this paragraph,
the commissioner shall consider the resource need determination process in paragraph (h),
the availability of foster care licensed beds in the geographic area in which the licensee
seeks to operate, the results of a person's choices during their annual assessment and service
plan review, and the recommendation of the local county board. The determination by the
commissioner is final and not subject to appeal. Exceptions to the moratorium include:
(1) foster care settings that are required to be registered under chapter 144D;
(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);
(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;
(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital level care;
(5) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner for the transition of people from personal care assistance to
the home and community-based services;
(6) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner for the transition of people from the residential care waiver
services to foster care services. This exception applies only when:
(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service to help the person make an informed choice;
and
(ii) the person's foster care services are less than or equal to the cost of the person's
services delivered in the residential care waiver service setting as determined by the lead
agency; or
(7) new foster care licenses or community residential setting licenses for people receiving
services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until June 30, deleted text begin2018deleted text endnew text begin 2019new text end. This exception is available when:
(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and
(ii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the unlicensed
setting as determined by the lead agencynew text begin; or
new text end
new text begin (8) a vacancy in a setting granted an exception under clause (7), created between January
1, 2017, and the date of the exception request, by the departure of a person receiving services
under chapter 245D and residing in the unlicensed setting between January 1, 2017, and
May 1, 2017. This exception is available when the lead agency provides documentation to
the commissioner on the eligibility criteria being met. This exception is available until June
30, 2019new text end.
(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.
(c) When an adult resident deleted text beginserved by the program moves out of adeleted text end new text beginfor any reason
permanently vacates a bed in an adult new text endfoster new text begincare new text endhome that is not the primary residence of
the license holderdeleted text begin according to section 256B.49, subdivision 15, paragraph (f)deleted text end, or deleted text beginthedeleted text endnew text begin a bed
in annew text end adult community residential setting, the county shall immediately inform the
deleted text begin Department of Human Services Licensing Divisiondeleted text endnew text begin commissionernew text end. new text beginWithin six months of
the second bed being permanently vacated, new text endthe deleted text begindepartment maydeleted text end new text begincommissioner shall new text enddecrease
the statewide licensed capacity for adult foster care settingsnew text begin by one bed for every two beds
vacatednew text end.
(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.
(e) A resource need determination process, managed at the state level, using the available
reports required by section 144A.351, and other data and information shall be used to
determine where the reduced capacity determined under section 256B.493 will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet the
informed decisions of those people who want to move out of corporate foster care or
community residential settings, long-term service needs within budgetary limits, including
seeking proposals from service providers or lead agencies to change service type, capacity,
or location to improve services, increase the independence of residents, and better meet
needs identified by the long-term services and supports reports and statewide data and
information.
(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.
(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services
licensing division that the license holder provides or intends to provide these waiver-funded
services.
(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493. Annually, by August 1, the commissioner shall provide
information and data on capacity of licensed long-term services and supports, actions taken
under the subdivision to manage statewide long-term services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over the
health and human services budget.
(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019, except the amendment to
paragraph (a) adding clause (8) is effective retroactively from July 1, 2018, and applies to
exception requests made on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2018, section 245A.11, subdivision 2a, is amended to read:
Subd. 2a.
Adult foster care and community residential setting license capacity.
(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of deleted text beginfivedeleted text endnew text begin up to sixnew text end beds,
including roomers and boarders, according to paragraphs (b) to (g).
(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.
(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.
(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to five, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.
(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to five, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:
(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;
(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;
(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and
(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.
(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of deleted text beginfivedeleted text endnew text begin sixnew text end adults if the fifth deleted text beginbed doesdeleted text endnew text begin and sixth beds donew text end not increase
the overall statewide capacity of licensed adult foster care or community residential setting
beds in homes that are not the primary residence of the license holder, as identified in a plan
submitted to the commissioner by the county, when the capacity is recommended by the
county licensing agency of the county in which the facility is located and if the
recommendation verifies that:
(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;
(2) the five-bed new text beginor six-bed new text endliving arrangement is specified for each resident in the
resident's:
(i) individualized plan of care;
(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;
(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and
(4) the facility was licensed for adult foster care before deleted text beginMarch 1, 2011deleted text endnew text begin June 30, 2016new text end.
(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after June 30, deleted text begin2019deleted text endnew text begin 2021new text end. The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before June 30, deleted text begin2019deleted text endnew text begin 2021new text end, to continue with a capacity
of five new text beginor six new text endadults if the license holder continues to comply with the requirements in
paragraph (f).
Sec. 3.
Minnesota Statutes 2018, section 245D.03, subdivision 1, is amended to read:
Subdivision 1.
Applicability.
(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.
(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:
(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end, and elderly waiver plans,
excluding out-of-home respite care provided to children in a family child foster care home
licensed under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care
license holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7,
and 8, or successor provisions; and section 245D.061 or successor provisions, which must
be stipulated in the statement of intended use required under Minnesota Rules, part
2960.3000, subpart 4;
(2) adult companion services as defined under the brain injury, community access for
disability inclusion,new text begin community alternative care,new text end and elderly waiver plans, excluding adult
companion services provided under the Corporation for National and Community Services
Senior Companion Program established under the Domestic Volunteer Service Act of 1973,
Public Law 98-288;
(3) personal support as defined under the developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end waiver
plan;
(4) 24-hour emergency assistance, personal emergency response as defined under the
community access for disability inclusion and developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end waiver
plans;
(5) night supervision services as defined under the brain injurynew text begin, community access for
disability inclusion, community alternative care, and developmental disabilitiesnew text end waiver deleted text beginplandeleted text endnew text begin
plansnew text end;
(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end, and elderly
waiver plans, excluding providers licensed by the Department of Health under chapter 144A
and those providers providing cleaning services only; and
(7) individual community living support under section 256B.0915, subdivision 3j.
(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:
(1) intervention services, including:
(i) deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as defined under the brain injury and community
access for disability inclusionnew text begin, community alternative care, and developmental disabilitiesnew text end
waiver plans;
(ii) in-home or out-of-home crisis respite services as defined under thenew text begin brain injury,
community access for disability inclusion, community alternative care, andnew text end developmental
deleted text begin disabilitydeleted text endnew text begin disabilitiesnew text end waiver deleted text beginplandeleted text endnew text begin plansnew text end; and
(iii) specialist services as defined under the currentnew text begin brain injury, community access for
disability inclusion, community alternative care, andnew text end developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end
waiver deleted text beginplandeleted text endnew text begin plansnew text end;
(2) in-home support services, including:
(i) in-home family support and supported living services as defined under the
developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end waiver plan;
(ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans;
(iii) semi-independent living services; and
(iv) individualized home supports services as defined under the brain injury, community
alternative care, and community access for disability inclusion waiver plans;
(3) residential supports and services, including:
(i) supported living services as defined under the developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end
waiver plan provided in a family or corporate child foster care residence, a family adult
foster care residence, a community residential setting, or a supervised living facility;
(ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting; and
(iii) residential services provided to more than four persons with developmental
disabilities in a supervised living facility, including ICFs/DD;
(4) day services, including:
(i) structured day services as defined under the brain injury waiver plan;
(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end waiver plan; and
(iii) prevocational services as defined under the brain injury and community access for
disability inclusion waiver plans; and
(5) employment exploration services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental deleted text begindisabilitydeleted text endnew text begin
disabilitiesnew text end waiver plans;
(6) employment development services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental deleted text begindisabilitydeleted text endnew text begin
disabilitiesnew text end waiver plans; and
(7) employment support services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental deleted text begindisabilitydeleted text endnew text begin disabilitiesnew text end
waiver plans.
Sec. 4.
Minnesota Statutes 2018, section 245D.071, subdivision 5, is amended to read:
Subd. 5.
Service plan review and evaluation.
(a) The license holder must give the
person or the person's legal representative and case manager an opportunity to participate
in the ongoing review and development of the service plan and the methods used to support
the person and accomplish outcomes identified in subdivisions 3 and 4. new text beginAt least once per
year, or within 30 days of a written request by the person, the person's legal representative,
or the case manager, new text endthe license holder, in coordination with the person's support team or
expanded support team, must meet with the person, the person's legal representative, and
the case manager, and participate in service plan review meetings following stated timelines
established in the person's coordinated service and support plan or coordinated service and
support plan addendum deleted text beginor within 30 days of a written request by the person, the person's
legal representative, or the case manager, at a minimum of once per yeardeleted text end. The purpose of
the service plan review is to determine whether changes are needed to the service plan based
on the assessment information, the license holder's evaluation of progress towards
accomplishing outcomes, or other information provided by the support team or expanded
support team.
new text begin
(b) At least once per year, the license holder, in coordination with the person's support
team or expanded support team, must meet with the person, the person's legal representative,
and the case manager to discuss how technology might be used to meet the person's desired
outcomes. The coordinated service and support plan addendum must include a summary of
this discussion. The summary must include a statement regarding any decision made related
to the use of technology and a description of any further research that must be completed
before a decision regarding the use of technology can be made. Nothing in this paragraph
requires the coordinated service and support plan addendum to include the use of technology
for the provision of services.
new text end
deleted text begin (b)deleted text endnew text begin (c)new text end The license holder must summarize the person's status and progress toward
achieving the identified outcomes and make recommendations and identify the rationale
for changing, continuing, or discontinuing implementation of supports and methods identified
in subdivision 4 in a report available at the time of the progress review meeting. The report
must be sent at least five working days prior to the progress review meeting if requested by
the team in the coordinated service and support plan or coordinated service and support
plan addendum.
deleted text begin (c)deleted text endnew text begin (d)new text end The license holder must send the coordinated service and support plan addendum
to the person, the person's legal representative, and the case manager by mail within ten
working days of the progress review meeting. Within ten working days of the mailing of
the coordinated service and support plan addendum, the license holder must obtain dated
signatures from the person or the person's legal representative and the case manager to
document approval of any changes to the coordinated service and support plan addendum.
deleted text begin (d)deleted text endnew text begin (e)new text end If, within ten working days of submitting changes to the coordinated service and
support plan and coordinated service and support plan addendum, the person or the person's
legal representative or case manager has not signed and returned to the license holder the
coordinated service and support plan or coordinated service and support plan addendum or
has not proposed written modifications to the license holder's submission, the submission
is deemed approved and the coordinated service and support plan addendum becomes
effective and remains in effect until the legal representative or case manager submits a
written request to revise the coordinated service and support plan addendum.
Sec. 5.
Minnesota Statutes 2018, section 245D.09, subdivision 5, is amended to read:
Subd. 5.
Annual training.
A license holder must provide annual training to direct support
staff on the topics identified in subdivision 4, clauses (3) to (10). If the direct support staff
has a first aid certification, annual training under subdivision 4, clause (9), is not required
as long as the certification remains current. deleted text beginA license holder must provide a minimum of
24 hours of annual training to direct service staff providing intensive services and having
fewer than five years of documented experience and 12 hours of annual training to direct
service staff providing intensive services and having five or more years of documented
experience in topics described in subdivisions 4 and 4a, paragraphs (a) to (f). Training on
relevant topics received from sources other than the license holder may count toward training
requirements. A license holder must provide a minimum of 12 hours of annual training to
direct service staff providing basic services and having fewer than five years of documented
experience and six hours of annual training to direct service staff providing basic services
and having five or more years of documented experience.
deleted text end
Sec. 6.
Minnesota Statutes 2018, section 245D.09, subdivision 5a, is amended to read:
Subd. 5a.
Alternative sources of training.
deleted text begin
The commissioner may approve online
training and competency-based assessments in place of a specific number of hours of training
in the topics covered in subdivision 4. The commissioner must provide a list of preapproved
trainings that do not need approval for each individual license holder.
deleted text end
Orientation or training received by the staff person from sources other than the license
holder in the same subjects as identified in subdivision 4 may count toward the orientation
and annual training requirements if received in the 12-month period before the staff person's
date of hire. The license holder must maintain documentation of the training received from
other sources and of each staff person's competency in the required area according to the
requirements in subdivision 3.
Sec. 7.
Minnesota Statutes 2018, section 245D.091, subdivision 2, is amended to read:
Subd. 2.
deleted text beginBehaviordeleted text endnew text begin Positive supportnew text end professional qualifications.
A deleted text beginbehaviordeleted text endnew text begin positive
supportnew text end professional providing deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text beginanddeleted text endnew text begin,new text end community access for disability
inclusionnew text begin, community alternative care, and developmental disabilitiesnew text end waiver plans or
successor plans:
(1) ethical considerations;
(2) functional assessment;
(3) functional analysis;
(4) measurement of behavior and interpretation of data;
(5) selecting intervention outcomes and strategies;
(6) behavior reduction and elimination strategies that promote least restrictive approved
alternatives;
(7) data collection;
(8) staff and caregiver training;
(9) support plan monitoring;
(10) co-occurring mental disorders or neurocognitive disorder;
(11) demonstrated expertise with populations being served; and
(12) must be a:
(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board
of Psychology competencies in the above identified areas;
(ii) clinical social worker licensed as an independent clinical social worker under chapter
148D, or a person with a master's degree in social work from an accredited college or
university, with at least 4,000 hours of post-master's supervised experience in the delivery
of clinical services in the areas identified in clauses (1) to (11);
(iii) physician licensed under chapter 147 and certified by the American Board of
Psychiatry and Neurology or eligible for board certification in psychiatry with competencies
in the areas identified in clauses (1) to (11);
(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical
services who has demonstrated competencies in the areas identified in clauses (1) to (11);
(v) person with a master's degree from an accredited college or university in one of the
behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services with demonstrated competencies in the areas
identified in clauses (1) to (11); deleted text beginor
deleted text end
(vi)new text begin person with a master's degree or PhD in one of the behavioral sciences or related
fields with demonstrated expertise in positive support services; or
new text end
new text begin (vii)new text end registered nurse who is licensed under sections 148.171 to 148.285, and who is
certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
mental health nursing by a national nurse certification organization, or who has a master's
degree in nursing or one of the behavioral sciences or related fields from an accredited
college or university or its equivalent, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services.
Sec. 8.
Minnesota Statutes 2018, section 245D.091, subdivision 3, is amended to read:
Subd. 3.
deleted text beginBehaviordeleted text endnew text begin Positive supportnew text end analyst qualifications.
(a) A deleted text beginbehaviordeleted text endnew text begin positive
supportnew text end analyst providing deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text beginanddeleted text endnew text begin,new text end community access for disability
inclusionnew text begin, community alternative care, and developmental disabilitiesnew text end waiver plans or
successor plans:
(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
discipline; deleted text beginor
deleted text end
(2) meet the qualifications of a mental health practitioner as defined in section 245.462,
subdivision 17new text begin; or
new text end
new text begin (3) be a board-certified behavior analyst or board-certified assistant behavior analyst by
the Behavior Analyst Certification Board, Incorporatednew text end.
(b) In addition, a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end analyst must:
(1) have four years of supervised experience deleted text beginworking with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorderdeleted text endnew text begin
conducting functional behavior assessments and designing, implementing, and evaluating
effectiveness of positive practices behavior support strategies for people who exhibit
challenging behaviors as well as co-occurring mental disorders and neurocognitive disordernew text end;
(2) have received deleted text beginten hours of instruction in functional assessment and functional analysis;deleted text endnew text begin
training prior to hire or within 90 calendar days of hire that includes:
new text end
new text begin
(i) ten hours of instruction in functional assessment and functional analysis;
new text end
new text begin
(ii) 20 hours of instruction in the understanding of the function of behavior;
new text end
new text begin
(iii) ten hours of instruction on design of positive practices behavior support strategies;
new text end
new text begin
(iv) 20 hours of instruction preparing written intervention strategies, designing data
collection protocols, training other staff to implement positive practice strategies,
summarizing and reporting program evaluation data, analyzing program evaluation data to
identify design flaws in behavioral interventions or failures in implementation fidelity, and
recommending enhancements based on evaluation data; and
new text end
new text begin
(v) eight hours of instruction on principles of person-centered thinking;
new text end
deleted text begin
(3) have received 20 hours of instruction in the understanding of the function of behavior;
deleted text end
deleted text begin
(4) have received ten hours of instruction on design of positive practices behavior support
strategies;
deleted text end
deleted text begin
(5) have received 20 hours of instruction on the use of behavior reduction approved
strategies used only in combination with behavior positive practices strategies;
deleted text end
deleted text begin (6)deleted text endnew text begin (3)new text end be determined by a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional to have the training
and prerequisite skills required to provide positive practice strategies as well as behavior
reduction approved and permitted intervention to the person who receives deleted text beginbehavioraldeleted text endnew text begin positivenew text end
support; and
deleted text begin (7)deleted text endnew text begin (4)new text end be under the direct supervision of a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional.
new text begin
(c) Meeting the qualifications for a positive support professional under subdivision 2
shall substitute for meeting the qualifications listed in paragraph (b).
new text end
Sec. 9.
Minnesota Statutes 2018, section 245D.091, subdivision 4, is amended to read:
Subd. 4.
deleted text beginBehaviordeleted text endnew text begin Positive supportnew text end specialist qualifications.
(a) A deleted text beginbehaviordeleted text endnew text begin positive
supportnew text end specialist providing deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text beginanddeleted text endnew text begin,new text end community access for disability
inclusionnew text begin, community alternative care, and developmental disabilitiesnew text end waiver plans or
successor plans:
(1) have an associate's degree in a social services discipline; or
(2) have two years of supervised experience working with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
(b) In addition, a behavior specialist must:
(1) have receivednew text begin training prior to hire or within 90 calendar days of hire that includes:
new text end
new text begin (i)new text end a minimum of four hours of training in functional assessment;
deleted text begin (2) have receiveddeleted text endnew text begin (ii)new text end 20 hours of instruction in the understanding of the function of
behavior;
deleted text begin (3) have receiveddeleted text endnew text begin (iii)new text end ten hours of instruction on design of positive practices behavioral
support strategies;new text begin and
new text end
new text begin
(iv) eight hours of instruction on principles of person-centered thinking;
new text end
deleted text begin (4)deleted text endnew text begin (2)new text end be determined by a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional to have the training
and prerequisite skills required to provide positive practices strategies as well as behavior
reduction approved intervention to the person who receives deleted text beginbehavioraldeleted text endnew text begin positivenew text end support;
and
deleted text begin (5)deleted text endnew text begin (3)new text end be under the direct supervision of a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional.
new text begin
(c) Meeting the qualifications for a positive support professional under subdivision 2
shall substitute for meeting the qualifications listed in paragraphs (a) and (b).
new text end
Sec. 10.
Minnesota Statutes 2018, section 252.275, subdivision 3, is amended to read:
Subd. 3.
Reimbursement.
Counties shall be reimbursed for all expenditures made
pursuant to subdivision 1 at a rate of deleted text begin70deleted text endnew text begin 85new text end percent, up to the allocation determined pursuant
to subdivisions 4 and 4b. However, the commissioner shall not reimburse costs of services
for any person if the costs exceed the state share of the average medical assistance costs for
services provided by intermediate care facilities for a person with a developmental disability
for the same fiscal year, and shall not reimburse costs of a onetime living allowance for any
person if the costs exceed $1,500 in a state fiscal year. The commissioner may make
payments to each county in quarterly installments. The commissioner may certify an advance
of up to 25 percent of the allocation. Subsequent payments shall be made on a reimbursement
basis for reported expenditures and may be adjusted for anticipated spending patterns.
Sec. 11.
new text begin
[256.488] ADAPTIVE FITNESS ACCESS GRANT.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) "Adaptive fitness" means the practice of physical fitness
by an individual with primary physical disabilities, either as a consequence of the natural
aging process or due to a developmental disability, mental health issue, congenital condition,
trauma, injury, or disease.
new text end
new text begin
(b) "Adaptive fitness center" means a center with modified equipment, equipment
arrangement and space for access, and trainers with skills in modifying exercise programs
specific to the physical and cognitive needs of individuals with disabilities.
new text end
new text begin
(c) "Commissioner" means the commissioner of human services.
new text end
new text begin
(d) "Disability" has the meaning given in the Americans with Disabilities Act.
new text end
new text begin Subd. 2. new text end
new text begin Establishment. new text end
new text begin
A statewide adaptive fitness access grant program is established
under the Department of Human Services to award grants to promote access to adaptive
fitness for individuals with disabilities.
new text end
new text begin Subd. 3. new text end
new text begin Application and review. new text end
new text begin
(a) The commissioner must develop a grant application
that must contain, at a minimum:
new text end
new text begin
(1) a description of the purpose or project for which the grant will be used;
new text end
new text begin
(2) a description of the specific problem the grant intends to address;
new text end
new text begin
(3) a description of achievable objectives, a work plan, and a timeline for implementation
and completion of processes or projects enabled by the grant;
new text end
new text begin
(4) a description of the existing frameworks and experience providing adaptive fitness;
and
new text end
new text begin
(5) a proposed process for documenting and evaluating results of the grant.
new text end
new text begin
(b) An applicant must apply using the grant application developed by the commissioner.
new text end
new text begin
(c) The commissioner shall review each application. The commissioner shall establish
criteria to evaluate applications, including but not limited to:
new text end
new text begin
(1) the application is complete;
new text end
new text begin
(2) the eligibility of the applicant;
new text end
new text begin
(3) the thoroughness and clarity in identifying the specific problem the grant intends to
address;
new text end
new text begin
(4) a description of the population demographics and service area of the proposed project;
new text end
new text begin
(5) documentation the grant applicant has received cash or in-kind contributions of value
equal to the requested grant amount; and
new text end
new text begin
(6) the proposed project's longevity and demonstrated financial sustainability after the
initial grant period.
new text end
new text begin
(d) In evaluating applications, the commissioner may request additional information
regarding a proposed project, including information on project cost. An applicant's failure
to timely provide the information requested disqualifies an applicant.
new text end
new text begin Subd. 4. new text end
new text begin Awards. new text end
new text begin
(a) The commissioner shall award grants to eligible applicants to
provide adaptive fitness for individuals with disabilities.
new text end
new text begin
(b) The commissioner shall award grants to qualifying nonprofit organizations that
provide adaptive fitness in adaptive fitness centers. Grants must be used to assist one or
more qualified nonprofit organizations to provide adaptive fitness, including: (1) stay fit;
(2) activity-based locomotor exercise; (3) equipment necessary for adaptive fitness programs;
(4) operating expenses related to staffing of adaptive fitness programs; and (5) other adaptive
fitness programs as deemed appropriate by the commissioner.
new text end
new text begin
(c) An applicant may apply for and the commissioner may award grants for two-year
periods, and the commissioner shall determine the number of grants awarded. The
commissioner may reallocate underspending among grantees within the same grant period.
new text end
new text begin Subd. 5. new text end
new text begin Report. new text end
new text begin
Beginning December 1, 2020, and every two years thereafter, the
commissioner of human services shall submit a report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services.
The report shall, at a minimum, include the amount of funding awarded for each project, a
description of the programs and services funded, plans for the long-term sustainability of
the projects, and data on outcomes for the programs and services funded. Grantees must
provide information and data requested by the commissioner to support the development
of this report.
new text end
Sec. 12.
Minnesota Statutes 2018, section 256B.0625, subdivision 19a, is amended to
read:
Subd. 19a.
Personal care assistance services.
Medical assistance covers personal care
assistance services in a recipient's home. Effective January 1, deleted text begin2010deleted text endnew text begin 2020new text end, to qualify for
personal care assistance services, a recipient must require assistance and be determined
dependent in one new text begincritical new text endactivity of daily living as defined in section 256B.0659, subdivision
1, paragraph deleted text begin(b)deleted text endnew text begin (e)new text end, or in a Level I behavior as defined in section 256B.0659, subdivision
1, paragraph (c)new text begin, or have a behavior that shows increased vulnerability due to cognitive
deficits or socially inappropriate behavior that requires assistance at least four times per
weeknew text end. Recipients or responsible parties must be able to identify the recipient's needs, direct
and evaluate task accomplishment, and provide for health and safety. Approved hours may
be used outside the home when normal life activities take them outside the home. To use
personal care assistance services at school, the recipient or responsible party must provide
written authorization in the care plan identifying the chosen provider and the daily amount
of services to be used at school. Total hours for services, whether actually performed inside
or outside the recipient's home, cannot exceed that which is otherwise allowed for personal
care assistance services in an in-home setting according to sections 256B.0651 to 256B.0654.
Medical assistance does not cover personal care assistance services for residents of a hospital,
nursing facility, intermediate care facility, health care facility licensed by the commissioner
of health, or unless a resident who is otherwise eligible is on leave from the facility and the
facility either pays for the personal care assistance services or forgoes the facility per diem
for the leave days that personal care assistance services are used. All personal care assistance
services must be provided according to sections 256B.0651 to 256B.0654. Personal care
assistance services may not be reimbursed if the personal care assistant is the spouse or paid
guardian of the recipient or the parent of a recipient under age 18, or the responsible party
or the family foster care provider of a recipient who cannot direct the recipient's own care
unless, in the case of a foster care provider, a county or state case manager visits the recipient
as needed, but not less than every six months, to monitor the health and safety of the recipient
and to ensure the goals of the care plan are met. Notwithstanding the provisions of section
256B.0659, the unpaid guardian or conservator of an adult, who is not the responsible party
and not the personal care provider organization, may be reimbursed to provide personal
care assistance services to the recipient if the guardian or conservator meets all criteria for
a personal care assistant according to section 256B.0659, and shall not be considered to
have a service provider interest for purposes of participation on the screening team under
section 256B.092, subdivision 7.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, or upon federal approval,
whichever is later. The commissioner shall implement the modified eligibility criteria as
annual assessments occur. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end
Sec. 13.
Minnesota Statutes 2018, section 256B.0652, subdivision 6, is amended to read:
Subd. 6.
Authorization; personal care assistance and qualified professional.
(a) All
personal care assistance services, supervision by a qualified professional, and additional
services beyond the limits established in subdivision 11, must be authorized by the
commissioner or the commissioner's designee before services begin except for the
assessments established in subdivision 11 and section 256B.0911. The authorization for
personal care assistance and qualified professional services under section 256B.0659 must
be completed within 30 days after receiving a complete request.
(b) The amount of personal care assistance services authorized must be based on the
recipient's home care rating. The home care rating shall be determined by the commissioner
or the commissioner's designee based on information submitted to the commissioner
identifying the following for recipients with dependencies in two or more activities of daily
living:
(1) total number of dependencies of activities of daily living as defined in section
256B.0659;
(2) presence of complex health-related needs as defined in section 256B.0659; and
(3) presence of Level I behavior as defined in section 256B.0659.
(c) For purposes meeting the criteria in paragraph (b), the methodology to determine
total time for personal care assistance services for each home care rating is based on the
median paid units per day for each home care rating from fiscal year 2007 data for the
personal care assistance program. Each home care rating has a base level of hours assigned.
Additional time is added through the assessment and identification of the following:
(1) 30 additional minutes per day for a dependency in each critical activity of daily living
as defined in section 256B.0659;
(2) 30 additional minutes per day for each complex health-related function as defined
in section 256B.0659; and
(3) 30 additional minutes per day for each behavior issue as defined in section 256B.0659,
subdivision 4, paragraph (d).
(d) Effective July 1, 2011, the home care rating for recipients who have a dependency
in one activity of daily living or Level I behavior shall equal no more than two units per
day. new text beginEffective January 1, 2020, the home care rating for recipients who have a dependency
in one critical activity of daily living or one Level I behavior or that require assistance with
a behavior that shows increased vulnerability due to cognitive deficits or socially
inappropriate behavior at least four times per week shall equal no more than two units per
day. new text endRecipients with this home care rating are not subject to the methodology in paragraph
(c) and are not eligible for more than two units per day.
(e) A limit of 96 units of qualified professional supervision may be authorized for each
recipient receiving personal care assistance services. A request to the commissioner to
exceed this total in a calendar year must be requested by the personal care provider agency
on a form approved by the commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2020, or upon federal approval,
whichever is later. The commissioner shall implement the modified eligibility criteria as
annual assessments occur. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end
Sec. 14.
Minnesota Statutes 2018, section 256B.0658, is amended to read:
256B.0658 HOUSING ACCESS GRANTS.
The commissioner of human services shall award through a competitive process contracts
for grants to public and private agencies to support and assist individuals deleted text begineligible for publicly
funded home and community-based services, including state plan home caredeleted text endnew text begin with a disability
as defined in section 256B.051, subdivision 2, paragraph (e)new text end, to access housing. Grants may
be awarded to agencies that may include, but are not limited to, the following supports:
assessment to ensure suitability of housing, accompanying an individual to look at housing,
filling out applications and rental agreements, meeting with landlords, helping with Section
8 or other program applications, helping to develop a budget, obtaining furniture and
household goods, if necessary, and assisting with any problems that may arise with housing.
Sec. 15.
Minnesota Statutes 2018, section 256B.0659, subdivision 3a, is amended to read:
Subd. 3a.
Assessment; defined.
(a) "Assessment" means a review and evaluation of a
recipient's need for personal care assistance services conducted in person. Assessments for
personal care assistance services shall be conducted by the county public health nurse or a
certified public health nurse under contract with the county except when a long-term care
consultation assessment is being conducted for the purposes of determining a person's
eligibility for home and community-based waiver services including personal care assistance
services according to section 256B.0911. new text beginDuring the transition to MnCHOICES, a certified
assessor may complete the assessment defined in this subdivision. new text endAn in-person assessment
must include: documentation of health status, determination of need, evaluation of service
effectiveness, identification of appropriate services, service plan development or modification,
coordination of services, referrals and follow-up to appropriate payers and community
resources, completion of required reports, recommendation of service authorization, and
consumer education. Once the need for personal care assistance services is determined under
this section, the county public health nurse or certified public health nurse under contract
with the county is responsible for communicating this recommendation to the commissioner
and the recipient. An in-person assessment must occur at least annually or when there is a
significant change in the recipient's condition or when there is a change in the need for
personal care assistance services. A service update may substitute for the annual face-to-face
assessment when there is not a significant change in recipient condition or a change in the
need for personal care assistance service. A service update may be completed by telephone,
used when there is no need for an increase in personal care assistance services, and used
for two consecutive assessments if followed by a face-to-face assessment. A service update
must be completed on a form approved by the commissioner. A service update or review
for temporary increase includes a review of initial baseline data, evaluation of service
effectiveness, redetermination of service need, modification of service plan and appropriate
referrals, update of initial forms, obtaining service authorization, and on going consumer
education. Assessments or reassessments must be completed on forms provided by the
commissioner within 30 days of a request for home care services by a recipient or responsible
party.
(b) This subdivision expires when notification is given by the commissioner as described
in section 256B.0911, subdivision 3a.
Sec. 16.
Minnesota Statutes 2018, section 256B.0659, subdivision 11, is amended to read:
Subd. 11.
Personal care assistant; requirements.
(a) A personal care assistant must
meet the following requirements:
(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of
age with these additional requirements:
(i) supervision by a qualified professional every 60 days; and
(ii) employment by only one personal care assistance provider agency responsible for
compliance with current labor laws;
(2) be employed by a personal care assistance provider agency;
(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:
(i) not disqualified under section 245C.14; or
(ii) is disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;
(4) be able to effectively communicate with the recipient and personal care assistance
provider agency;
(5) be able to provide covered personal care assistance services according to the recipient's
personal care assistance care plan, respond appropriately to recipient needs, and report
changes in the recipient's condition to the supervising qualified professional or physician;
(6) not be a consumer of personal care assistance services;
(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;
(8) effective January 1, 2010, complete standardized training as determined by the
commissioner before completing enrollment. The training must be available in languages
other than English and to those who need accommodations due to disabilities. Personal care
assistant training must include successful completion of the following training components:
basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic
roles and responsibilities of personal care assistants including information about assistance
with lifting and transfers for recipients, emergency preparedness, orientation to positive
behavioral practices, fraud issues, and completion of time sheets. Upon completion of the
training components, the personal care assistant must demonstrate the competency to provide
assistance to recipients;
(9) complete training and orientation on the needs of the recipient; and
(10) be limited to providing and being paid for up to 275 hours per month of personal
care assistance services regardless of the number of recipients being served or the number
of personal care assistance provider agencies enrolled with. The number of hours worked
per day shall not be disallowed by the department unless in violation of the law.
(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).
(c) Persons who do not qualify as a personal care assistant include parents, stepparents,
and legal guardians of minors; spouses; paid legal guardians of adults; family foster care
providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of
a residential setting.
new text begin
(d) Personal care assistance services qualify for the enhanced rate described in subdivision
17a if the personal care assistant providing the services:
new text end
new text begin
(1) provides services, according to the care plan in subdivision 7, to a recipient who
qualifies for ten or more hours per day of personal care assistance services; and
new text end
new text begin
(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in Code of
Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved training
or competency requirements.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 17.
Minnesota Statutes 2018, section 256B.0659, is amended by adding a subdivision
to read:
new text begin Subd. 17a. new text end
new text begin Enhanced rate. new text end
new text begin
An enhanced rate of 110 percent of the rate paid for personal
care assistance services shall be paid for services provided to persons who qualify for ten
or more hours of personal care assistance service per day when provided by a personal care
assistant who meets the requirements of subdivision 11, paragraph (d). The enhanced rate
for personal care assistance services includes, and is not in addition to, any rate adjustments
implemented by the commissioner to comply with the terms of a collective bargaining
agreement between the state of Minnesota and an exclusive representative of individual
providers under section 179A.54 for increased financial incentives for providing services
to people with complex needs.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 18.
Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
Subd. 21.
Requirements for provider enrollment of personal care assistance provider
agencies.
(a) All personal care assistance provider agencies must provide, at the time of
enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
a format determined by the commissioner, information and documentation that includes,
but is not limited to, the following:
(1) the personal care assistance provider agency's current contact information including
address, telephone number, and e-mail address;
(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid
revenue in the previous calendar year is up to and including $300,000, the provider agency
must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is
over $300,000, the provider agency must purchase a surety bond of $100,000. The surety
bond must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
(3) proof of fidelity bond coverage in the amount of $20,000;
(4) proof of workers' compensation insurance coverage;
(5) proof of liability insurance;
(6) a description of the personal care assistance provider agency's organization identifying
the names of all owners, managing employees, staff, board of directors, and the affiliations
of the directors, owners, or staff to other service providers;
(7) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety including process for notification and resolution of consumer
grievances, identification and prevention of communicable diseases, and employee
misconduct;
(8) copies of all other forms the personal care assistance provider agency uses in the
course of daily business including, but not limited to:
(i) a copy of the personal care assistance provider agency's time sheet if the time sheet
varies from the standard time sheet for personal care assistance services approved by the
commissioner, and a letter requesting approval of the personal care assistance provider
agency's nonstandard time sheet;
(ii) the personal care assistance provider agency's template for the personal care assistance
care plan; and
(iii) the personal care assistance provider agency's template for the written agreement
in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
(9) a list of all training and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;
(10) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this sectionnew text begin, including the requirements
under subdivision 11, paragraph (d), if enhanced personal care assistance services are
provided and submitted for an enhanced rate under subdivision 17anew text end;
(11) documentation of the agency's marketing practices;
(12) disclosure of ownership, leasing, or management of all residential properties that
is used or could be used for providing home care services;
(13) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services for
employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
care assistance choice option and 72.5 percent of revenue from other personal care assistance
providers. The revenue generated by the qualified professional and the reasonable costs
associated with the qualified professional shall not be used in making this calculation; and
(14) effective May 15, 2010, documentation that the agency does not burden recipients'
free exercise of their right to choose service providers by requiring personal care assistants
to sign an agreement not to work with any particular personal care assistance recipient or
for another personal care assistance provider agency after leaving the agency and that the
agency is not taking action on any such agreements or requirements regardless of the date
signed.
(b) Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider agency
enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
the information specified in paragraph (a) from all personal care assistance providers
beginning July 1, 2009.
(c) All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before enrollment of the agency as a provider. Employees
in management and supervisory positions and owners who are active in the day-to-day
operations of an agency who have completed the required training as an employee with a
personal care assistance provider agency do not need to repeat the required training if they
are hired by another agency, if they have completed the training within the past three years.
By September 1, 2010, the required training must be available with meaningful access
according to title VI of the Civil Rights Act and federal regulations adopted under that law
or any guidance from the United States Health and Human Services Department. The
required training must be available online or by electronic remote connection. The required
training must provide for competency testing. Personal care assistance provider agency
billing staff shall complete training about personal care assistance program financial
management. This training is effective July 1, 2009. Any personal care assistance provider
agency enrolled before that date shall, if it has not already, complete the provider training
within 18 months of July 1, 2009. Any new owners or employees in management and
supervisory positions involved in the day-to-day operations are required to complete
mandatory training as a requisite of working for the agency. Personal care assistance provider
agencies certified for participation in Medicare as home health agencies are exempt from
the training required in this subdivision. When available, Medicare-certified home health
agency owners, supervisors, or managers must successfully complete the competency test.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 19.
Minnesota Statutes 2018, section 256B.0659, subdivision 24, is amended to read:
Subd. 24.
Personal care assistance provider agency; general duties.
A personal care
assistance provider agency shall:
(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;
(2) comply with general medical assistance coverage requirements;
(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;
(4) comply with background study requirements;
(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;
(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;
(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;
(8) withhold and pay all applicable federal and state taxes;
(9) deleted text begineffective January 1, 2010,deleted text end document that the agency uses a minimum of 72.5 percent
of the revenue generated by the medical assistance rate for personal care assistance services
for employee personal care assistant wages and benefits. The revenue generated by the
qualified professional and the reasonable costs associated with the qualified professional
shall not be used in making this calculation;
(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;
(11) enter into a written agreement under subdivision 20 before services are provided;
(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;
(13) provide the recipient with a copy of the home care bill of rights at start of service;
deleted text begin and
deleted text end
(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissionerdeleted text begin.deleted text endnew text begin; and
new text end
new text begin
(15) document that the agency uses the additional revenue due to the enhanced rate under
subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements
under subdivision 11, paragraph (d).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 20.
Minnesota Statutes 2018, section 256B.0659, subdivision 28, is amended to read:
Subd. 28.
Personal care assistance provider agency; required documentation.
(a)
Required documentation must be completed and kept in the personal care assistance provider
agency file or the recipient's home residence. The required documentation consists of:
(1) employee files, including:
(i) applications for employment;
(ii) background study requests and results;
(iii) orientation records about the agency policies;
(iv) trainings completed with demonstration of competencenew text begin, including verification of
the completion of training required under subdivision 11, paragraph (d), for any services
billed at the enhanced rate under subdivision 17anew text end;
(v) supervisory visits;
(vi) evaluations of employment; and
(vii) signature on fraud statement;
(2) recipient files, including:
(i) demographics;
(ii) emergency contact information and emergency backup plan;
(iii) personal care assistance service plan;
(iv) personal care assistance care plan;
(v) month-to-month service use plan;
(vi) all communication records;
(vii) start of service information, including the written agreement with recipient; and
(viii) date the home care bill of rights was given to the recipient;
(3) agency policy manual, including:
(i) policies for employment and termination;
(ii) grievance policies with resolution of consumer grievances;
(iii) staff and consumer safety;
(iv) staff misconduct; and
(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
resolution of consumer grievances;
(4) time sheets for each personal care assistant along with completed activity sheets for
each recipient served; and
(5) agency marketing and advertising materials and documentation of marketing activities
and costs.
(b) The commissioner may assess a fine of up to $500 on provider agencies that do not
consistently comply with the requirements of this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2019.
new text end
Sec. 21.
Minnesota Statutes 2018, section 256B.0911, subdivision 1a, is amended to read:
Subd. 1a.
Definitions.
For purposes of this section, the following definitions apply:
(a) Until additional requirements apply under paragraph (b), "long-term care consultation
services" means:
(1) intake for and access to assistance in identifying services needed to maintain an
individual in the most inclusive environment;
(2) providing recommendations for and referrals to cost-effective community services
that are available to the individual;
(3) development of an individual's person-centered community support plan;
(4) providing information regarding eligibility for Minnesota health care programs;
(5) face-to-face long-term care consultation assessments, which may be completed in a
hospital, nursing facility, intermediate care facility for persons with developmental disabilities
(ICF/DDs), regional treatment centers, or the person's current or planned residence;
(6) determination of home and community-based waiver and other service eligibility as
required under sections 256B.0913, 256B.0915, new text begin256B.092,new text end and 256B.49, including level
of care determination for individuals who need an institutional level of care as determined
under subdivision 4e, based on assessment and community support plan development,
appropriate referrals to obtain necessary diagnostic information, and including an eligibility
determination for consumer-directed community supports;
(7) providing recommendations for institutional placement when there are no
cost-effective community services available;
(8) providing access to assistance to transition people back to community settings after
institutional admission; and
(9) providing information about competitive employment, with or without supports, for
school-age youth and working-age adults and referrals to the Disability Linkage Line and
Disability Benefits 101 to ensure that an informed choice about competitive employment
can be made. For the purposes of this subdivision, "competitive employment" means work
in the competitive labor market that is performed on a full-time or part-time basis in an
integrated setting, and for which an individual is compensated at or above the minimum
wage, but not less than the customary wage and level of benefits paid by the employer for
the same or similar work performed by individuals without disabilities.
(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c,
and 3a, "long-term care consultation services" also means:
(1) service eligibility determination for state plan deleted text beginhome caredeleted text end services identified in:
(i) section 256B.0625, subdivisions deleted text begin7deleted text enddeleted text begin,deleted text end 19adeleted text begin,deleted text end and 19c;
(ii) consumer support grants under section 256.476; or
(iii) section 256B.85;
(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
deleted text begin determination of eligibility fordeleted text endnew text begin gaining access tonew text end case management services available under
sections 256B.0621, subdivision 2, deleted text beginparagraphdeleted text endnew text begin clausenew text end (4), deleted text beginanddeleted text end 256B.0924new text begin,new text end and Minnesota
Rules, part 9525.0016;
(3) determination deleted text beginof institutional level of care, home and community-based service
waiver, and other servicedeleted text end new text beginofnew text end eligibility deleted text beginas required under section deleted text enddeleted text begin, determination
of eligibility for family support grants under section 252.32,deleted text end new text beginfornew text end semi-independent living
services under section 252.275deleted text begin, and day training and habilitation services under section
deleted text end; and
(4) obtaining necessary diagnostic information to determine eligibility under clauses (2)
and (3).
(c) "Long-term care options counseling" means the services provided by the linkage
lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also
includes telephone assistance and follow up once a long-term care consultation assessment
has been completed.
(d) "Minnesota health care programs" means the medical assistance program under this
chapter and the alternative care program under section 256B.0913.
(e) "Lead agencies" means counties administering or tribes and health plans under
contract with the commissioner to administer long-term care consultation assessment and
support planning services.
(f) "Person-centered planning" is a process that includes the active participation of a
person in the planning of the person's services, including in making meaningful and informed
choices about the person's own goals, talents, and objectives, as well as making meaningful
and informed choices about the services the person receives. For the purposes of this section,
"informed choice" means a voluntary choice of services by a person from all available
service options based on accurate and complete information concerning all available service
options and concerning the person's own preferences, abilities, goals, and objectives. In
order for a person to make an informed choice, all available options must be developed and
presented to the person to empower the person to make decisions.
Sec. 22.
Minnesota Statutes 2018, section 256B.0911, subdivision 3a, is amended to read:
Subd. 3a.
Assessment and support planning.
(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment in order to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on which an assessment was requested or recommended. Upon statewide implementation
of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
requesting personal care assistance services deleted text beginand home care nursing. The commissioner shall
provide at least a 90-day notice to lead agencies prior to the effective date of this requirementdeleted text end.
Face-to-face assessments must be conducted according to paragraphs (b) to (i).
(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.
(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, new text beginconversation-based,new text end person-centered assessment.
The assessment must include the health, psychological, functional, environmental, and
social needs of the individual necessary to develop a community support plan that meets
the individual's needs and preferences.
(d) The assessment must be conducted in a face-to-face new text beginconversationalnew text end interview with
the person being assessed deleted text beginanddeleted text endnew text begin.new text end The person's legal representativenew text begin must provide input during
the assessment process and may do so remotely if requestednew text end. At the request of the person,
other individuals may participate in the assessment to provide information on the needs,
strengths, and preferences of the person necessary to develop a community support plan
that ensures the person's health and safety. Except for legal representatives or family members
invited by the person, persons participating in the assessment may not be a provider of
service or have any financial interest in the provision of services. For persons who are to
be assessed for elderly waiver customized living or adult day services under section
256B.0915, with the permission of the person being assessed or the person's designated or
legal representative, the client's current or proposed provider of services may submit a copy
of the provider's nursing assessment or written report outlining its recommendations regarding
the client's care needs. The person conducting the assessment must notify the provider of
the date by which this information is to be submitted. This information shall be provided
to the person conducting the assessment prior to the assessment. For a person who is to be
assessed for waiver services under section 256B.092 or 256B.49, with the permission of
the person being assessed or the person's designated legal representative, the person's current
provider of services may submit a written report outlining recommendations regarding the
person's care needs deleted text beginprepared by a direct service employee with at least 20 hours of service
to that client. The person conducting the assessment or reassessment must notify the provider
of the date by which this information is to be submitted. This information shall be provided
to the person conducting the assessment and the person or the person's legal representative,
and must be considered prior to the finalization of the assessment or reassessmentdeleted text endnew text begin the person
completed in consultation with someone who is known to the person and has interaction
with the person on a regular basis. The provider must submit the report at least 60 days
before the end of the person's current service agreement. The certified assessor must consider
the content of the submitted report prior to finalizing the person's assessment or reassessmentnew text end.
(e) new text beginThe certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit.new text end The
person or the person's legal representative must be provided with a written community
support plan within deleted text begin40 calendar days of the assessment visitdeleted text endnew text begin the timelines established by
the commissionernew text end, regardless of whether the deleted text beginindividualdeleted text end new text beginpersonnew text end is eligible for Minnesota
health care programs.
(f) For a person being assessed for elderly waiver services under section 256B.0915, a
provider who submitted information under paragraph (d) shall receive the final written
community support plan when available and the Residential Services Workbook.
(g) The written community support plan must include:
(1) a summary of assessed needs as defined in paragraphs (c) and (d);
(2) the individual's options and choices to meet identified needs, including all available
options for case management services and providers, including service provided in a
non-disability-specific setting;
(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;
(4) referral information; and
(5) informal caregiver supports, if applicable.
For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.
(h) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person must be transferred or referred to long-term care options counseling
services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
telephone assistance and follow up.
(i) The person has the right to make the final decision between institutional placement
and community placement after the recommendations have been provided, except as provided
in section 256.975, subdivision 7a, paragraph (d).
(j) The lead agency must give the person receiving assessment or support planning, or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:
(1) written recommendations for community-based services and consumer-directed
options;
(2) documentation that the most cost-effective alternatives available were offered to the
individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;
(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the individual selects nursing facility placement, the lead
agency shall forward information needed to complete the level of care determinations and
screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;
(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, and state plan home care, case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);
(5) information about Minnesota health care programs;
(6) the person's freedom to accept or reject the recommendations of the team;
(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;
(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b); and
(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3. new text beginThe certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated.
new text end
(k) Face-to-face assessment completed as part of eligibility determination for the
alternative care, elderly waiver, new text begindevelopmental disabilities, new text endcommunity access for disability
inclusion, community alternative care, and brain injury waiver programs under sections
256B.0913, 256B.0915, new text begin256B.092, new text endand 256B.49 is valid to establish service eligibility for
no more than 60 calendar days after the date of assessment.
(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.
(m) If an eligibility update is completed within 90 days of the previous face-to-face
assessment and documented in the department's Medicaid Management Information System
(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
of the previous face-to-face assessment when all other eligibility requirements are met.
(n) At the time of reassessment, the certified assessor shall assess each person receiving
waiver services currently residing in a community residential setting, or licensed adult foster
care home that is not the primary residence of the license holder, or in which the license
holder is not the primary caregiver, to determine if that person would prefer to be served in
a community-living setting as defined in section 256B.49, subdivision 23. The certified
assessor shall offer the person, through a person-centered planning process, the option to
receive alternative housing and service options.
Sec. 23.
Minnesota Statutes 2018, section 256B.0911, subdivision 3f, is amended to read:
Subd. 3f.
Long-term care reassessments and community support plan updates.
new text begin(a)
Prior to a face-to-face reassessment, the certified assessor must review the person's most
recent assessment.new text end Reassessments must be tailored using the professional judgment of the
assessor to the person's known needs, strengths, preferences, and circumstances.
Reassessments provide information to support the person's informed choice and opportunities
to express choice regarding activities that contribute to quality of life, as well as information
and opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments deleted text beginallow fordeleted text end new text beginrequirenew text end a review of new text beginthe most recent
assessment, review ofnew text end the current new text begincoordinated service and new text endsupport plan's effectiveness,
monitoring of services, and the development of an updated person-centered community
support plan. Reassessments verify continued eligibility or offer alternatives as warranted
and provide an opportunity for quality assurance of service delivery. Face-to-face deleted text beginassessmentsdeleted text endnew text begin
reassessmentsnew text end must be conducted annually or as required by federal and state laws and rules.new text begin
For reassessments, the certified assessor and the individual responsible for developing the
coordinated service and support plan must ensure the continuity of care for the person
receiving services and complete the updated community support plan and the updated
coordinated service and support plan no more than 60 days from the reassessment visit.
new text end
new text begin
(b) The commissioner shall develop mechanisms for providers and case managers to