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SF 4113

as introduced - 91st Legislature (2019 - 2020) Posted on 03/10/2020 08:45am

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

Current Version - as introduced

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A bill for an act
relating to human services; adjusting the eligibility requirements for children's
mental health respite grants; modifying provisions regarding home and
community-based services; authorizing the correction of housing support payments;
defining "qualified professional" for purposes of applying for general assistance
and housing support; amending Minnesota Statutes 2018, sections 245D.04,
subdivision 3; 245D.071, subdivision 3; 245F.02, subdivisions 7, 14; 245F.06,
subdivision 2; 245F.12, subdivisions 2, 3; 245G.02, subdivision 2; 245G.09,
subdivision 1; 256B.0652, subdivision 10; 256B.0941, subdivisions 1, 3;
256B.0949, subdivisions 2, 5, 6, 9, 13, 14, 15, 16; 256D.02, subdivision 17; 256I.03,
subdivisions 3, 14; 256I.05, subdivisions 1c, 1n, 8; 256I.06, subdivision 2, by
adding a subdivision; 256J.08, subdivision 73a; 256P.01, by adding a subdivision;
Minnesota Statutes 2019 Supplement, sections 245.4889, subdivision 1; 254A.03,
subdivision 3; 254B.05, subdivision 1; 256I.04, subdivision 2b; repealing Minnesota
Statutes 2018, section 245F.02, subdivision 20.

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

Section 1.

Minnesota Statutes 2019 Supplement, section 245.4889, subdivision 1, is
amended to read:


Subdivision 1.

Establishment and authority.

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

(1) counties;

(2) Indian tribes;

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

(4) mental health service providers.

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

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

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

(3) respite care services for children with new text beginemotional disturbances or new text endsevere emotional
disturbances who are at risk of out-of-home placementnew text begin. A child is not required to have case
management services to receive respite care services
new 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 under section 245.4901;

(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; and

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2018, section 245D.04, subdivision 3, is amended to read:


Subd. 3.

Protection-related rights.

(a) A person's protection-related rights include the
right to:

(1) have personal, financial, service, health, and medical information kept private, and
be advised of disclosure of this information by the license holder;

(2) access records and recorded information about the person in accordance with
applicable state and federal law, regulation, or rule;

(3) be free from maltreatment;

(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited
procedure identified in section 245D.06, subdivision 5, or successor provisions, except for:
(i) emergency use of manual restraint to protect the person from imminent danger to self
or others according to the requirements in section 245D.061 or successor provisions; or (ii)
the use of safety interventions as part of a positive support transition plan under section
245D.06, subdivision 8, or successor provisions;

(5) receive services in a clean and safe environment when the license holder is the owner,
lessor, or tenant of the service site;

(6) be treated with courtesy and respect and receive respectful treatment of the person's
property;

(7) reasonable observance of cultural and ethnic practice and religion;

(8) be free from bias and harassment regarding race, gender, age, disability, spirituality,
and sexual orientation;

(9) be informed of and use the license holder's grievance policy and procedures, including
knowing how to contact persons responsible for addressing problems and to appeal under
section 256.045;

(10) know the name, telephone number, and the website, e-mail, and street addresses of
protection and advocacy services, including the appropriate state-appointed ombudsman,
and a brief description of how to file a complaint with these offices;

(11) assert these rights personally, or have them asserted by the person's family,
authorized representative, or legal representative, without retaliation;

(12) give or withhold written informed consent to participate in any research or
experimental treatment;

(13) associate with other persons of the person's choicenew text begin, in the communitynew text end;

(14) personal privacy, including the right to use the lock on the person's bedroom or unit
door;

(15) engage in chosen activities; and

(16) access to the person's personal possessions at any time, including financial resources.

(b) For a person residing in a residential site licensed according to chapter 245A, or
where the license holder is the owner, lessor, or tenant of the residential service site,
protection-related rights also include the right to:

(1) have daily, private access to and use of a non-coin-operated telephone for local calls
and long-distance calls made collect or paid for by the person;

(2) receive and send, without interference, uncensored, unopened mail or electronic
correspondence or communication;

(3) have use of and free access to common areas in the residence and the freedom to
come and go from the residence at will;

(4) choose the person's visitors and time of visits and have privacy for visits with the
person's spouse, next of kin, legal counsel, religious adviser, or others, in accordance with
section 363A.09 of the Human Rights Act, including privacy in the person's bedroom;

(5) have access to three nutritionally balanced meals and nutritious snacks between
meals each day;

(6) have freedom and support to access food and potable water at any time;

(7) have the freedom to furnish and decorate the person's bedroom or living unit;

(8) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling
paint, mold, vermin, and insects;

(9) a setting that is free from hazards that threaten the person's health or safety; and

(10) a setting that meets the definition of a dwelling unit within a residential occupancy
as defined in the State Fire Code.

(c) Restriction of a person's rights under paragraph (a), clauses (13) to (16), or paragraph
(b) is allowed only if determined necessary to ensure the health, safety, and well-being of
the person. Any restriction of those rights must be documented in the person's coordinated
service and support plan or coordinated service and support plan addendum. The restriction
must be implemented in the least restrictive alternative manner necessary to protect the
person and provide support to reduce or eliminate the need for the restriction in the most
integrated setting and inclusive manner. The documentation must include the following
information:

(1) the justification for the restriction based on an assessment of the person's vulnerability
related to exercising the right without restriction;

(2) the objective measures set as conditions for ending the restriction;

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

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

Sec. 3.

Minnesota Statutes 2018, section 245D.071, subdivision 3, is amended to read:


Subd. 3.

Assessment and initial service planning.

(a) Within 15 days of service initiation
the license holder must complete a preliminary coordinated service and support plan
addendum based on the coordinated service and support plan.

(b) Within the scope of services, the license holder must, at a minimum, complete
assessments in the following areas before the 45-day planning meeting:

(1) the person's ability to self-manage health and medical needs to maintain or improve
physical, mental, and emotional well-being, including, when applicable, allergies, seizures,
choking, special dietary needs, chronic medical conditions, self-administration of medication
or treatment orders, preventative screening, and medical and dental appointments;

(2) the person's ability to self-manage personal safety to avoid injury or accident in the
service setting, including, when applicable, risk of falling, mobility, regulating water
temperature, community survival skills, water safety skills, and sensory disabilities; and

(3) the person's ability to self-manage symptoms or behavior that may otherwise result
in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension
or termination of services by the license holder, or other symptoms or behaviors that may
jeopardize the health and welfare of the person or others.

Assessments must produce information about the person that describes the person's overall
strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be
based on the person's status within the last 12 months at the time of service initiation.
Assessments based on older information must be documented and justified. Assessments
must be conducted annually at a minimum or within 30 days of a written request from the
person or the person's legal representative or case manager. The results must be reviewed
by the support team or expanded support team as part of a service plan review.

(c) Within 45 days of service initiation, the license holder must meet with the person,
the person's legal representative, the case manager, and other members of the support team
or expanded support team to determine the following based on information obtained from
the assessments identified in paragraph (b), the person's identified needs in the coordinated
service and support plan, and the requirements in subdivision 4 and section 245D.07,
subdivision 1a
:

(1) the scope of the services to be provided to support the person's daily needs and
activities;

(2) the person's desired outcomes and the supports necessary to accomplish the person's
desired outcomes;

(3) the person's preferences for how services and supports are provided, including how
the provider will support the person to have control of the person's schedule;

(4) whether the current service setting is the most integrated setting available and
appropriate for the person; deleted text beginand
deleted text end

new text begin (5) opportunities to develop and maintain essential and life-enriching skills, abilities,
strengths, interests, and preferences;
new text end

new text begin (6) opportunities for community access, participation, and inclusion in preferred
community activities;
new text end

new text begin (7) opportunities to develop and strengthen personal relationships with other persons of
the person's choice in the community;
new text end

new text begin (8) opportunities to seek competitive employment and work at competitively paying
jobs in the community; and
new text end

deleted text begin (5)deleted text end new text begin(9) new text endhow services must be coordinated across other providers licensed under this
chapter serving the person and members of the support team or expanded support team to
ensure continuity of care and coordination of services for the person.

(d) A discussion of how technology might be used to meet the person's desired outcomes
must be included in the 45-day planning meeting. The coordinated service and support plan
or support plan addendum must include a summary of this discussion. The summary must
include a statement regarding any decision that is made regarding the use of technology
and a description of any further research that needs to be completed before a decision
regarding the use of technology can be made. Nothing in this paragraph requires that the
coordinated service and support plan include the use of technology for the provision of
services.

Sec. 4.

Minnesota Statutes 2018, section 245F.02, subdivision 7, is amended to read:


Subd. 7.

Clinically managed program.

"Clinically managed program" means a
residential setting with staff comprised of a medical director and a licensed practical nurse.
A licensed practical nurse must be on site 24 hours a day, seven days a week. A deleted text beginqualified
medical professional
deleted text endnew text begin licensed practitionernew text end must be available by telephone or in person for
consultation 24 hours a day. Patients admitted to this level of service receive medical
observation, evaluation, and stabilization services during the detoxification process; access
to medications administered by trained, licensed staff to manage withdrawal; and a
comprehensive assessment pursuant to section deleted text begin245G.05deleted text endnew text begin 245F.06new text end.

Sec. 5.

Minnesota Statutes 2018, section 245F.02, subdivision 14, is amended to read:


Subd. 14.

Medically monitored program.

"Medically monitored program" means a
residential setting with staff that includes a registered nurse and a medical director. A
registered nurse must be on site 24 hours a day. A deleted text beginmedical directordeleted text endnew text begin licensed practitionernew text end
must be deleted text beginon sitedeleted text endnew text begin availablenew text end seven days a week, and patients must have the ability to be seen
by a deleted text beginmedical directordeleted text endnew text begin licensed practitionernew text end within 24 hours. Patients admitted to this level
of service receive medical observation, evaluation, and stabilization services during the
detoxification process; medications administered by trained, licensed staff to manage
withdrawal; and a comprehensive assessment pursuant to deleted text beginMinnesota Rules, part 9530.6422deleted text endnew text begin
section 245F.06
new text end.

Sec. 6.

Minnesota Statutes 2018, section 245F.06, subdivision 2, is amended to read:


Subd. 2.

Comprehensive assessmentnew text begin and assessment summarynew text end.

(a) Prior to a medically
stable discharge, but not later than 72 hours following admission, a license holder must
provide a comprehensive assessment new text beginand assessment summary new text endaccording to sections
245.4863, paragraph (a), and 245G.05, for each patient who has a positive screening for a
substance use disorder. If a patient's medical condition prevents a comprehensive assessment
from being completed within 72 hours, the license holder must document why the assessment
was not completed. The comprehensive assessment must include documentation of the
appropriateness of an involuntary referral through the civil commitment process.

(b) If available to the program, a patient's previous comprehensive assessment may be
used in the patient record. If a previously completed comprehensive assessment is used, its
contents must be reviewed to ensure the assessment is accurate and current and complies
with the requirements of this chapter. The review must be completed by a staff person
qualified according to section 245G.11, subdivision 5. The license holder must document
that the review was completed and that the previously completed assessment is accurate
and current, or the license holder must complete an updated or new assessment.

Sec. 7.

Minnesota Statutes 2018, section 245F.12, subdivision 2, is amended to read:


Subd. 2.

Services provided at clinically managed programs.

In addition to the services
listed in subdivision 1, clinically managed programs must:

(1) have a licensed practical nurse on site 24 hours a day and a medical director;

(2) provide an initial health assessment conducted by a nurse upon admission;

(3) provide daily on-site medical evaluation by a nurse;

(4) have a registered nurse available by telephone or in person for consultation 24 hours
a day;

(5) have a deleted text beginqualified medical professionaldeleted text endnew text begin licensed practitionernew text end available by telephone
or in person for consultation 24 hours a day; and

(6) have appropriately licensed staff available to administer medications according to
prescriber-approved orders.

Sec. 8.

Minnesota Statutes 2018, section 245F.12, subdivision 3, is amended to read:


Subd. 3.

Services provided at medically monitored programs.

In addition to the
services listed in subdivision 1, medically monitored programs must have a registered nurse
on site 24 hours a day and a medical director. Medically monitored programs must provide
intensive inpatient withdrawal management services which must include:

(1) an initial health assessment conducted by a registered nurse upon admission;

(2) the availability of a medical evaluation and consultation with a registered nurse 24
hours a day;

(3) the availability of a deleted text beginqualified medical professionaldeleted text endnew text begin licensed practitionernew text end by telephone
or in person for consultation 24 hours a day;

(4) the ability to be seen within 24 hours or sooner by a deleted text beginqualified medical professionaldeleted text endnew text begin
licensed practitioner
new text end if the initial health assessment indicates the need to be seen;

(5) the availability of on-site monitoring of patient care seven days a week by a deleted text beginqualified
medical professional
deleted text endnew text begin licensed practitionernew text end; and

(6) appropriately licensed staff available to administer medications according to
prescriber-approved orders.

Sec. 9.

Minnesota Statutes 2018, section 245G.02, subdivision 2, is amended to read:


Subd. 2.

Exemption from license requirement.

This chapter does not apply to a county
or recovery community organization that is providing a service for which the county or
recovery community organization is an eligible vendor under section 254B.05. This chapter
does not apply to an organization whose primary functions are information, referral,
diagnosis, case management, and assessment for the purposes of client placement, education,
support group services, or self-help programs. This chapter does not apply to the activities
of a licensed professional in private practice.new text begin An individual referred to a licensed
nonresidential substance use disorder treatment program after a positive screen for alcohol
or substance misuse when receiving the initial set of substance use disorder services allowable
under section 254A.03, subdivision 3, paragraph (c), is exempt from sections 245G.05;
245G.06, subdivisions 1, 2, and 4; 245G.07, subdivisions 1, paragraph (a), clauses (2) to
(4), and 2, clauses (1) to (7); and 245G.17.
new text end

Sec. 10.

Minnesota Statutes 2018, section 245G.09, subdivision 1, is amended to read:


Subdivision 1.

Client records required.

(a) A license holder must maintain a file of
current and accurate client records on the premises where the treatment service is provided
or coordinated. For services provided off site, client records must be available at the program
and adhere to the same clinical and administrative policies and procedures as services
provided on site. The content and format of client records must be uniform and entries in
each record must be signed and dated by the staff member making the entry. Client records
must be protected against loss, tampering, or unauthorized disclosure according to section
254A.09, chapter 13, and Code of Federal Regulations, title 42, chapter 1, part 2, subpart
B, sections 2.1 to 2.67, and title 45, parts 160 to 164.

(b) The program must have a policy and procedure that identifies how the program will
track and record client attendance at treatment activities, including the date, duration, and
nature of each treatment service provided to the client.

new text begin (c) The program must identify in the client record designation of an individual who is
receiving services under section 254A.03, subdivision 3, including the start date and end
date of services eligible under section 254A.03, subdivision 3. The requirements of sections
245G.05 and 245G.06 become effective upon the end date identified.
new text end

Sec. 11.

Minnesota Statutes 2019 Supplement, 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.

(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 any combination of up to 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 begin Minnesota Rules,
parts 9530.6600 to 9530.6655, and a comprehensive assessment pursuant to section 245G.05
are not applicable to the initial set of services allowed under this subdivision. A positive
screen result establishes eligibility for the initial set of services allowed under this
subdivision.
new text end

Sec. 12.

Minnesota Statutes 2019 Supplement, section 254B.05, subdivision 1, is amended
to read:


Subdivision 1.

Licensure required.

(a) Programs licensed by the commissioner are
eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
notwithstanding the provisions of section 245A.03. American Indian programs that provide
substance use disorder treatment, extended care, transitional residence, or outpatient treatment
services, and are licensed by tribal government are eligible vendors.

(b) A licensed professional in private practice new text begin as defined in section 245G.01, subdivision
17,
new text endwho meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible
vendor of a comprehensive assessment and assessment summary provided according to
section 245G.05, and treatment services provided according to sections 245G.06 and
245G.07, subdivision 1, paragraphs (a), clauses (1) to (4), and (b); and subdivision 2.

(c) A county is an eligible vendor for a comprehensive assessment and assessment
summary when provided by an individual who meets the staffing credentials of section
245G.11, subdivisions 1 and 5, and completed according to the requirements of section
245G.05. A county is an eligible vendor of care coordination services when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and
provided according to the requirements of section 245G.07, subdivision 1, paragraph (a),
clause (5).

(d) A recovery community organization that meets certification requirements identified
by the commissioner is an eligible vendor of peer support services.

(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, are not eligible vendors. Programs that are not licensed as a residential or
nonresidential substance use disorder treatment or withdrawal management program by the
commissioner or by tribal government or do not meet the requirements of subdivisions 1a
and 1b are not eligible vendors.

Sec. 13.

Minnesota Statutes 2018, section 256B.0652, subdivision 10, is amended to read:


Subd. 10.

Authorization for foster care setting.

(a) Home care services provided in
an adult or child foster care setting must receive authorization by the commissioner according
to the limits established in subdivision 11.

(b) The commissioner may not authorize:

(1) home care services that are the responsibility of the foster care provider under the
terms of the foster care placement agreement, deleted text begindifficulty of care rate as of January 1, 2010deleted text endnew text begin
assessment under sections 256N.24 and 260C.4411
new text end, and administrative rules;

(2) personal care assistance services when the foster care license holder is also the
personal care provider or personal care assistant, unless the foster home is the licensed
provider's primary residence as defined in section 256B.0625, subdivision 19a; or

(3) personal care assistant and home care nursing services when the licensed capacity
is greater than deleted text beginfourdeleted text endnew text begin six, unless all conditions for a variance under section 245A.04,
subdivision 9a, are satisfied for a sibling, as defined in section 260C.007, subdivision 32
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 14.

Minnesota Statutes 2018, section 256B.0941, subdivision 1, is amended to read:


Subdivision 1.

Eligibility.

(a) An individual who is eligible for mental health treatment
services in a psychiatric residential treatment facility must meet all of the following criteria:

(1) before admission, services are determined to be medically necessary deleted text beginby the state's
medical review agent
deleted text end according to Code of Federal Regulations, title 42, section 441.152;

(2) is younger than 21 years of age at the time of admission. Services may continue until
the individual meets criteria for discharge or reaches 22 years of age, whichever occurs
first;

(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic
and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression,
or a finding that the individual is a risk to self or others;

(4) has functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; an inability to adequately care for
one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill
the individual's needs;

(5) requires psychiatric residential treatment under the direction of a physician to improve
the individual's condition or prevent further regression so that services will no longer be
needed;

(6) utilized and exhausted other community-based mental health services, or clinical
evidence indicates that such services cannot provide the level of care needed; and

(7) was referred for treatment in a psychiatric residential treatment facility by a qualified
mental health professional licensed as defined in section 245.4871, subdivision 27, clauses
(1) to (6).

(b) A mental health professional making a referral shall submit documentation to the
state's medical review agent containing all information necessary to determine medical
necessity, including a standard diagnostic assessment completed within 180 days of the
individual's admission. Documentation shall include evidence of family participation in the
individual's treatment planning and signed consent for services.

Sec. 15.

Minnesota Statutes 2018, section 256B.0941, subdivision 3, is amended to read:


Subd. 3.

Per diem rate.

(a) The commissioner shall establish a statewide per diem rate
for psychiatric residential treatment facility services for individuals 21 years of age or
younger. The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers. Payment must not be made to more than one entity for each
individual for services provided under this section on a given day. The commissioner shall
set rates prospectively for the annual rate period. The commissioner shall require providers
to submit annual cost reports on a uniform cost reporting form and shall use submitted cost
reports to inform the rate-setting process. The cost reporting shall be done according to
federal requirements for Medicare cost reports.

(b) The following are included in the rate:

(1) costs necessary for licensure and accreditation, meeting all staffing standards for
participation, meeting all service standards for participation, meeting all requirements for
active treatment, maintaining medical records, conducting utilization review, meeting
inspection of care, and discharge planning. The direct services costs must be determined
using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
and service-related transportation; and

(2) payment for room and board provided by facilities meeting all accreditation and
licensing requirements for participation.

(c) A facility may submit a claim for payment outside of the per diem for professional
services arranged by and provided at the facility by an appropriately licensed professional
who is enrolled as a provider with Minnesota health care programs. Arranged services deleted text beginmust
be billed by the facility on a separate claim, and the facility shall be responsible for payment
to the provider
deleted text endnew text begin may be billed by either the facility or the licensed professionalnew text end. These services
must be included in the individual plan of care and are subject to prior authorization deleted text beginby the
state's medical review agent
deleted text end.

(d) Medicaid shall reimburse for concurrent services as approved by the commissioner
to support continuity of care and successful discharge from the facility. "Concurrent services"
means services provided by another entity or provider while the individual is admitted to a
psychiatric residential treatment facility. Payment for concurrent services may be limited
and these services are subject to prior authorization by the state's medical review agent.
Concurrent services may include targeted case management, assertive community treatment,
clinical care consultation, team consultation, and treatment planning.

(e) Payment rates under this subdivision shall not include the costs of providing the
following services:

(1) educational services;

(2) acute medical care or specialty services for other medical conditions;

(3) dental services; and

(4) pharmacy drug costs.

(f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
reasonable, and consistent with federal reimbursement requirements in Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
Management and Budget Circular Number A-122, relating to nonprofit entities.

Sec. 16.

Minnesota Statutes 2018, section 256B.0949, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) The terms used in this section have the meanings given in this
subdivision.

(b) "Agency" means the legal entity that is enrolled with Minnesota health care programs
as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide
EIDBI services and that has the legal responsibility to ensure that its employees or contractors
carry out the responsibilities defined in this section. Agency includes a licensed individual
professional who practices independently and acts as an agency.

(c) "Autism spectrum disorder or a related condition" or "ASD or a related condition"
means either autism spectrum disorder (ASD) as defined in the current version of the
Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found
to be closely related to ASD, as identified under the current version of the DSM, and meets
all of the following criteria:

(1) is severe and chronic;

(2) results in impairment of adaptive behavior and function similar to that of a person
with ASD;

(3) requires treatment or services similar to those required for a person with ASD; and

(4) results in substantial functional limitations in three core developmental deficits of
ASD: social new text beginor interpersonal new text endinteraction; new text beginfunctional communication, including new text endnonverbal
or social communication; and restrictivedeleted text begin,deleted text endnew text begin ornew text end repetitive behaviors or hyperreactivity or
hyporeactivity to sensory input; and may include deficits or a high level of support in one
or more of the following domains:

(i) self-regulation;

(ii) self-care;

(iii) behavioral challenges;

(iv) expressive communication;

(v) receptive communication;

(vi) cognitive functioning; or

(vii) safety.

(d) "Person" means a person under 21 years of age.

(e) "Clinical supervision" means the overall responsibility for the control and direction
of EIDBI service delivery, including individual treatment planning, staff supervision,
individual treatment plan progress monitoring, and treatment review for each person. Clinical
supervision is provided by a qualified supervising professional (QSP) who takes full
professional responsibility for the service provided by each supervisee.

(f) "Commissioner" means the commissioner of human services, unless otherwise
specified.

(g) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive
evaluation of a person to determine medical necessity for EIDBI services based on the
requirements in subdivision 5.

(h) "Department" means the Department of Human Services, unless otherwise specified.

(i) "Early intensive developmental and behavioral intervention benefit" or "EIDBI
benefit" means a variety of individualized, intensive treatment modalities approved by the
commissioner that are based in behavioral and developmental science consistent with best
practices on effectivenessnew text begin, including applied behavioral analysisnew text end.

(j) "Generalizable goals" means results or gains that are observed during a variety of
activities over time with different people, such as providers, family members, other adults,
and people, and in different environments including, but not limited to, clinics, homes,
schools, and the community.

(k) "Incident" means when any of the following occur:

(1) an illness, accident, or injury that requires first aid treatment;

(2) a bump or blow to the head; or

(3) an unusual or unexpected event that jeopardizes the safety of a person or staff,
including a person leaving the agency unattended.

(l) "Individual treatment plan" or "ITP" means the person-centered, individualized written
plan of care that integrates and coordinates person and family information from the CMDE
for a person who meets medical necessity for the EIDBI benefit. An individual treatment
plan must meet the standards in subdivision 6.

(m) "Legal representative" means the parent of a child who is under 18 years of age, a
court-appointed guardian, or other representative with legal authority to make decisions
about service for a person. For the purpose of this subdivision, "other representative with
legal authority to make decisions" includes a health care agent or an attorney-in-fact
authorized through a health care directive or power of attorney.

(n) "Mental health professional" has the meaning given in section 245.4871, subdivision
27, clauses (1) to (6).

(o) "Person-centered" means a service that both responds to the identified needs, interests,
values, preferences, and desired outcomes of the person or the person's legal representative
and respects the person's history, dignity, and cultural background and allows inclusion and
participation in the person's community.

(p) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II, or
level III treatment provider.

Sec. 17.

Minnesota Statutes 2018, section 256B.0949, subdivision 5, is amended to read:


Subd. 5.

Comprehensive multidisciplinary evaluation.

(a) A CMDE must be completed
to determine medical necessity of EIDBI services. For the commissioner to authorize EIDBI
services, the CMDE provider must submit the CMDE to the commissioner and the person
or the person's legal representative as determined by the commissioner. Information and
assessments must be performed, reviewed, and relied upon for the eligibility determination,
treatment and services recommendations, and treatment plan development for the person.

(b) The CMDE must:

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

(2) include and document the person's legal representative's or primary caregiver's
preferences for involvement in the person's treatmentdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (3) provide information about the range of current EIDBI treatment modalities recognized
by the commissioner.
deleted text end

Sec. 18.

Minnesota Statutes 2018, section 256B.0949, subdivision 6, is amended to read:


Subd. 6.

Individual treatment plan.

(a) The QSP, level I treatment provider, or level
II treatment provider who integrates and coordinates person and family information from
the CMDE and ITP progress monitoring process to develop the ITP must develop and
monitor the ITP.

(b) Each person's ITP must be:

(1) culturally and linguistically appropriate, as required under subdivision 3a,
individualized, and person-centered; and

(2) based on the diagnosis and CMDE information specified in subdivisions 4 and 5.

(c) The ITP must specify:

(1) the medically necessary treatment and service;

(2) the treatment deleted text beginmodalitydeleted text endnew text begin methodnew text end that deleted text beginshalldeleted text endnew text begin mustnew text end be used to meet the goals and objectives,
including:

(i) baseline measures and projected dates of accomplishment;

(ii) the frequency, intensity, location, and duration of each service provided;

(iii) the level of legal representative or primary caregiver training and counseling;

(iv) any change or modification to the physical and social environments necessary to
provide a service;

(v) significant changes in the person's condition or family circumstance;

deleted text begin (vi) any specialized equipment or material required;
deleted text end

deleted text begin (vii)deleted text endnew text begin (vi)new text end techniques that support and are consistent with the person's communication
mode and learning style;

deleted text begin (viii)deleted text endnew text begin (vii)new text end the name of the QSP; and

deleted text begin (ix)deleted text endnew text begin (viii)new text end progress monitoring results and goal mastery data; and

(3) the discharge criteria that deleted text beginshalldeleted text endnew text begin mustnew text end be used and a defined transition plan that meets
the requirement of paragraph (g).

(d) Implementation of the ITP must be supervised by a QSP.

(e) The ITP must be submitted to the commissioner and the person or the person's legal
representative for approval in a manner determined by the commissioner for this purpose.

(f) A service included in the ITP must meet all applicable requirements for medical
necessity and coverage.

(g) To terminate service, the provider must send notice of termination to the person or
the person's legal representative. The transition period begins when the person or the person's
legal representative receives notice of termination from the EIDBI service and ends when
the EIDBI service is terminated. Up to 30 days of continued service is allowed during the
transition period. Services during the transition period shall be consistent with the ITP. The
transition plan deleted text beginshalldeleted text endnew text begin mustnew text end include:

(1) protocols for changing service when medically necessary;

(2) how the transition will occur;

(3) the time allowed to make the transition; and

(4) a description of how the person or the person's legal representative will be informed
of and involved in the transition.

Sec. 19.

Minnesota Statutes 2018, section 256B.0949, subdivision 9, is amended to read:


Subd. 9.

Revision of treatment options.

deleted text begin(a)deleted text end The commissioner may revise covered
treatment deleted text beginoptionsdeleted text endnew text begin methods and practicesnew text end as needed based on outcome data and other evidence.
EIDBI treatment modalities approved by the department must:

(1) cause no harm to the person or the person's family;

(2) be individualized and person-centered;

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

(4) be based in recognized principles of developmental and behavioral science;

(5) utilize sound practices that are replicable across providers and maintain the fidelity
of the deleted text beginspecific modalitydeleted text endnew text begin treatment methodnew text end;

(6) demonstrate an evidentiary basis;

(7) have goals and objectives that are measurable, achievable, and regularly evaluated
and adjusted to ensure that adequate progress is being made;

(8) be provided intensively with a high staff-to-person ratio; and

(9) include participation by the person and the person's legal representative in decision
making, knowledge building and capacity building, and developing and implementing the
person's ITP.

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

Sec. 20.

Minnesota Statutes 2018, section 256B.0949, subdivision 13, is amended to read:


Subd. 13.

Covered services.

(a) The services described in paragraphs (b) to (i) are
eligible for reimbursement by medical assistance under this section. Services must be
provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must
address the person's medically necessary treatment goals and must be targeted to develop,
enhance, or maintain the individual developmental skills of a person with ASD or a related
condition to improve functional communication, new text beginincluding nonverbal or social
communication,
new text endsocial or interpersonal interaction, new text beginrestrictive or repetitive behaviors,
hyperreactivity or hyporeactivity to sensory input,
new text endbehavioral challenges and self-regulation,
cognition, learning and play, self-care, and safety.

(b) EIDBI deleted text beginmodalities include, but are not limited to:deleted text endnew text begin treatment must be based in
developmental and behavioral evidence-based practices or practice-based evidence and
meet the requirements outlined in subdivision 9.
new text end

deleted text begin (1) applied behavior analysis (ABA);
deleted text end

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

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

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

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

deleted text begin (c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b),
clauses (1) to (5), as the primary modality for treatment as a covered service, or several
EIDBI modalities in combination as the primary modality of treatment, as approved by the
commissioner. An EIDBI provider that identifies and provides assurance of qualifications
for a single specific treatment modality must document the required qualifications to meet
fidelity to the specific model. Additional EIDBI modalities not listed in paragraph (b) may
be covered upon approval by the commissioner.
deleted text end

new text begin (c) A qualified EIDBI provider is a person who identifies and provides assurance of
qualifications for professional licensure certification, or training in evidence-based treatment
methods, and who must document the required qualifications outlined in subdivision 15 in
a manner determined by the commissioner.
new text end

(d) CMDE is a comprehensive evaluation of the person's developmental status to
determine medical necessity for EIDBI services and meets the requirements of subdivision
5. The services must be provided by a qualified CMDE provider.

(e) EIDBI intervention observation and direction is the clinical direction and oversight
of EIDBI services by the QSP, level I treatment provider, or level II treatment provider,
including developmental and behavioral techniques, progress measurement, data collection,
function of behaviors, and generalization of acquired skills for the direct benefit of a person.
EIDBI intervention observation and direction deleted text begininforms anydeleted text endnew text begin requiresnew text end modification of the
deleted text begin methodsdeleted text endnew text begin current treatment protocolnew text end to support the outcomes new text beginoutlined new text endin the ITP. deleted text beginEIDBI
intervention observation and direction provides a real-time response to EIDBI interventions
to maximize the benefit to the person.
deleted text end

new text begin (f) Intervention is medically necessary direct treatment provided to a person with ASD
or a related condition as outlined in their ITP. All intervention services must be provided
under the direction of a QSP. Intervention may take place across multiple settings. The
frequency and intensity of intervention services are provided based on the number of
treatment goals, person and family or caregiver preferences, and other factors. Intervention
services may be provided individually or in a group. Intervention with a higher provider
ratio may occur when deemed medically necessary through the person's ITP.
new text end

new text begin (1) Individual intervention is treatment by protocol administered by a single qualified
EIDBI provider delivered face-to-face to one person.
new text end

new text begin (2) Group intervention is treatment by protocol provided by one or more qualified EIDBI
providers, delivered to at least two people who receive EIDBI services.
new text end

deleted text begin (f)deleted text endnew text begin (g)new text end ITP development and ITP progress monitoring is development of the initial,
annual, and progress monitoring of an ITP. ITP development and ITP progress monitoring
documentsdeleted text begin, providesdeleted text endnew text begin providenew text end oversight and ongoing evaluation of a person's treatment and
progress on targeted goals and objectivesdeleted text begin,deleted text end and deleted text beginintegratesdeleted text endnew text begin integratenew text end and deleted text begincoordinatesdeleted text endnew text begin coordinatenew text end
the person's and the person's legal representative's information from the CMDE and ITP
progress monitoring. This service must be reviewed and completed by the QSP, and may
include input from a level I deleted text begintreatmentdeleted text end provider or a level II deleted text begintreatmentdeleted text end provider.

deleted text begin (g)deleted text endnew text begin (h)new text end Family caregiver training and counseling is specialized training and education
for a family or primary caregiver to understand the person's developmental status and help
with the person's needs and development. This service must be provided by the QSP, level
I deleted text begintreatmentdeleted text end provider, or level II deleted text begintreatmentdeleted text end provider.

deleted text begin (h)deleted text endnew text begin (i)new text end A coordinated care conference is a voluntary face-to-face meeting with the person
and the person's family to review the CMDE or ITP progress monitoring and to integrate
and coordinate services across providers and service-delivery systems to develop the ITP.
This service must be provided by the QSP and may include the CMDE provider or a level
I deleted text begintreatmentdeleted text end provider or a level II deleted text begintreatmentdeleted text end provider.

deleted text begin (i)deleted text endnew text begin (j)new text end Travel time is allowable billing for traveling to and from the person's home, school,
a community setting, or place of service outside of an EIDBI center, clinic, or office from
a specified location to provide face-to-face EIDBI intervention, observation and direction,
or family caregiver training and counseling. The person's ITP must specify the reasons the
provider must travel to the person.

deleted text begin (j)deleted text endnew text begin (k)new text end Medical assistance covers medically necessary EIDBI services and consultations
delivered by a licensed health care provider via telemedicine, as defined under section
256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered
in person. deleted text beginMedical assistance coverage is limited to three telemedicine services per person
per calendar week.
deleted text end

Sec. 21.

Minnesota Statutes 2018, section 256B.0949, subdivision 14, is amended to read:


Subd. 14.

Person's rights.

A person or the person's legal representative has the right to:

(1) protection as defined under the health care bill of rights under section 144.651;

(2) designate an advocate to be present in all aspects of the person's and person's family's
services at the request of the person or the person's legal representative;

(3) be informed of the agency policy on assigning staff to a person;

(4) be informed of the opportunity to observe the person while receiving services;

(5) be informed of services in a manner that respects and takes into consideration the
person's and the person's legal representative's culture, values, and preferences in accordance
with subdivision 3a;

(6) be free from seclusion and restraint, except for emergency use of manual restraint
in emergencies as defined in section 245D.02, subdivision 8a;

(7) be under the supervision of a responsible adult at all times;

(8) be notified by the agency within 24 hours if an incident occurs or the person is injured
while receiving services, including what occurred and how agency staff responded to the
incident;

(9) request a voluntary coordinated care conference; deleted text beginand
deleted text end

(10) request a CMDE provider of the person's or the person's legal representative's
choicedeleted text begin.deleted text endnew text begin; and
new text end

new text begin (11) be free of all prohibitions as defined in Minnesota Rules, part 9544.0060.
new text end

Sec. 22.

Minnesota Statutes 2018, section 256B.0949, subdivision 15, is amended to read:


Subd. 15.

EIDBI provider qualifications.

(a) A QSP must be employed by an agency
and be:

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

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

(b) A level I treatment provider must be employed by an agency and:

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

(2) have or be at least one of the following:

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

(ii) a bachelor's degree in a behavioral health, child development, or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy, from an accredited college or university, and
advanced certification in a treatment modality recognized by the department;

(iii) a board-certified behavior analyst; or

(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical
experience that meets all registration, supervision, and continuing education requirements
of the certification.

(c) A level II treatment provider must be employed by an agency and must be:

(1) a person who has a bachelor's degree from an accredited college or university in a
behavioral or child development science or related field including, but not limited to, mental
health, special education, social work, psychology, speech pathology, or occupational
therapy; and deleted text beginmeetdeleted text endnew text begin meetsnew text end at least one of the following:

(i) has at least 1,000 hours of supervised clinical experience or training in examining or
treating people with ASD or a related condition or equivalent documented coursework at
the graduate level by an accredited university in ASD diagnostics, ASD developmental and
behavioral treatment strategies, and typical child development or a combination of
coursework or hours of experience;

(ii) has certification as a board-certified assistant behavior analyst from the Behavior
Analyst Certification Board;

(iii) is a registered behavior technician as defined by the Behavior Analyst Certification
Board; or

(iv) is certified in one of the other treatment modalities recognized by the department;
or

(2) a person who has:

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

(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people
with ASD or a related condition. Hours worked as a mental health behavioral aide or level
III treatment provider may be included in the required hours of experience; or

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

(4) a person who is a graduate student in a behavioral science, child development science,
or related field and is receiving clinical supervision by a QSP affiliated with an agency to
meet the clinical training requirements for experience and training with people with ASD
or a related condition; or

(5) a person who is at least 18 years of age and who:

(i) is fluent in a non-English language;

(ii) completed the level III EIDBI training requirements; and

(iii) receives observation and direction from a QSP or level I treatment provider at least
once a week until the person meets 1,000 hours of supervised clinical experience.

(d) A level III treatment provider must be employed by an agency, have completed the
level III training requirement, be at least 18 years of age, and have at least one of the
following:

(1) a high school diploma or commissioner of education-selected high school equivalency
certification;

(2) fluency in a non-English language; deleted text beginor
deleted text end

(3) one year of experience as a primary personal care assistant, community health worker,
waiver service provider, or special education assistant to a person with ASD or a related
condition within the previous five yearsdeleted text begin.deleted text endnew text begin; or
new text end

new text begin (4) completion of all required EIDBI training within six months of employment.
new text end

Sec. 23.

Minnesota Statutes 2018, section 256B.0949, subdivision 16, is amended to read:


Subd. 16.

Agency duties.

(a) An agency delivering an EIDBI service under this section
must:

(1) enroll as a medical assistance Minnesota health care program provider according to
Minnesota Rules, part 9505.0195, and section 256B.04, subdivision 21, and meet all
applicable provider standards and requirements;

(2) demonstrate compliance with federal and state laws for EIDBI service;

(3) verify and maintain records of a service provided to the person or the person's legal
representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;

(4) demonstrate that while enrolled or seeking enrollment as a Minnesota health care
program provider the agency did not have a lead agency contract or provider agreement
discontinued because of a conviction of fraud; or did not have an owner, board member, or
manager fail a state or federal criminal background check or appear on the list of excluded
individuals or entities maintained by the federal Department of Human Services Office of
Inspector General;

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

(6) have an office located in Minnesotanew text begin or a border statenew text end;

(7) conduct a criminal background check on an individual who has direct contact with
the person or the person's legal representative;

(8) report maltreatment according to sections 626.556 and 626.557;

(9) comply with any data requests consistent with the Minnesota Government Data
Practices Act, sections 256B.064 and 256B.27;

(10) provide training for all agency staff on the requirements and responsibilities listed
in the Maltreatment of Minors Act, section 626.556, and the Vulnerable Adult Protection
Act, section 626.557, including mandated and voluntary reporting, nonretaliation, and the
agency's policy for all staff on how to report suspected abuse and neglect;

(11) have a written policy to resolve issues collaboratively with the person and the
person's legal representative when possible. The policy must include a timeline for when
the person and the person's legal representative will be notified about issues that arise in
the provision of services;

(12) provide the person's legal representative with prompt notification if the person is
injured while being served by the agency. An incident report must be completed by the
agency staff member in charge of the person. A copy of all incident and injury reports must
remain on file at the agency for at least five years from the report of the incident; and

(13) before starting a service, provide the person or the person's legal representative a
description of the treatment modality that the person shall receive, including the staffing
certification levels and training of the staff who shall provide a treatment.

(b) When delivering the ITP, and annually thereafter, an agency must provide the person
or the person's legal representative with:

(1) a written copy and a verbal explanation of the person's or person's legal
representative's rights and the agency's responsibilities;

(2) documentation in the person's file the date that the person or the person's legal
representative received a copy and explanation of the person's or person's legal
representative's rights and the agency's responsibilities; and

(3) reasonable accommodations to provide the information in another format or language
as needed to facilitate understanding of the person's or person's legal representative's rights
and the agency's responsibilities.

Sec. 24.

Minnesota Statutes 2018, section 256D.02, subdivision 17, is amended to read:


Subd. 17.

Professional certification.

"Professional certification" means a statement
about a person's illness, injury, or incapacity that is signed by a "qualified professional" as
defined in section deleted text begin256J.08, subdivision 73adeleted text endnew text begin 256P.01, subdivision 6anew text end.

Sec. 25.

Minnesota Statutes 2018, section 256I.03, subdivision 3, is amended to read:


Subd. 3.

Housing support.

"Housing support" means deleted text begina group living situationdeleted text endnew text begin assistancenew text end
that provides at a minimum room and board to deleted text beginunrelateddeleted text end persons who meet the eligibility
requirements of section 256I.04. To receive payment for deleted text begina group residence ratedeleted text endnew text begin housing
support
new text end, the residence must meet the requirements under section 256I.04, subdivisions 2a
to 2f.

Sec. 26.

Minnesota Statutes 2018, section 256I.03, subdivision 14, is amended to read:


Subd. 14.

Qualified professional.

"Qualified professional" means an individual as
defined in section deleted text begin256J.08, subdivision 73a, ordeleted text end 245G.11, subdivision 3, 4, or 5new text begin, or 256P.01,
subdivision 6a
new text end; or an individual approved by the director of human services or a designee
of the director.

Sec. 27.

Minnesota Statutes 2019 Supplement, section 256I.04, subdivision 2b, is amended
to read:


Subd. 2b.

Housing support agreements.

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

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

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

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

(3) the provision of housing support;

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

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

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

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

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

Sec. 28.

Minnesota Statutes 2018, section 256I.05, subdivision 1c, is amended to read:


Subd. 1c.

Rate increases.

An agency may not increase the rates negotiated for housing
support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).

(a) An agency may increase the rates for room and board to the MSA equivalent rate
for those settings whose current rate is below the MSA equivalent rate.

(b) An agency may increase the rates for residents in adult foster care whose difficulty
of care has increased. The total housing support rate for these residents must not exceed the
maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase
difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding
by home and community-based waiver programs under title XIX of the Social Security Act.

(c) The room and board rates will be increased each year when the MSA equivalent rate
is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less
the amount of the increase in the medical assistance personal needs allowance under section
256B.35.

(d) When housing support pays for an individual's room and board, or other costs
necessary to provide room and board, the rate payable to the residence must continue for
up to 18 calendar days per incident that the person is temporarily absent from the residence,
not to exceed 60 days in a calendar year, if the absence or absences deleted text beginhave received the prior
approval of
deleted text endnew text begin are reported in advance tonew text end the county agency's social service staff. deleted text beginPrior approvaldeleted text endnew text begin
Advance reporting
new text end is not required for emergency absences due to crisis, illness, or injury.

(e) For facilities meeting substantial change criteria within the prior year. Substantial
change criteria exists if the establishment experiences a 25 percent increase or decrease in
the total number of its beds, if the net cost of capital additions or improvements is in excess
of 15 percent of the current market value of the residence, or if the residence physically
moves, or changes its licensure, and incurs a resulting increase in operation and property
costs.

(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid
for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who
reside in residences that are licensed by the commissioner of health as a boarding care home,
but are not certified for the purposes of the medical assistance program. However, an increase
under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical
assistance reimbursement rate for nursing home resident class A, in the geographic grouping
in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to
9549.0058.

Sec. 29.

Minnesota Statutes 2018, section 256I.05, subdivision 1n, is amended to read:


Subd. 1n.

Supplemental rate; Mahnomen County.

Notwithstanding the provisions of
this section, for the rate period July 1, 2010, to June 30, 2011, a county agency shall negotiate
a supplemental service rate in addition to the rate specified in subdivision 1, not to exceed
$753 per month or the existing rate, including any legislative authorized inflationary
adjustments, for a deleted text begingroup residentialdeleted text endnew text begin housing supportnew text end provider located in Mahnomen County
that operates a 28-bed facility providing 24-hour care to individuals who are homeless,
disabled, chemically dependent, mentally ill, or chronically homeless.

Sec. 30.

Minnesota Statutes 2018, section 256I.05, subdivision 8, is amended to read:


Subd. 8.

State participation.

For a deleted text beginresident of a group residencedeleted text endnew text begin personnew text end who is eligible
under section 256I.04, subdivision 1, paragraph (b), state participation in the deleted text begingroup residentialdeleted text end
housingnew text begin supportnew text end payment is determined according to section 256D.03, subdivision 2. For
a deleted text beginresident of a group residencedeleted text endnew text begin personnew text end who is eligible under section 256I.04, subdivision 1,
paragraph (a), state participation in the deleted text begingroup residentialdeleted text end housingnew text begin supportnew text end rate is determined
according to section 256D.36.

Sec. 31.

Minnesota Statutes 2018, section 256I.06, subdivision 2, is amended to read:


Subd. 2.

Time of payment.

A county agency may make payments in advance for an
individual whose stay is expected to last beyond the calendar month for which the payment
is made. Housing support payments made by a county agency on behalf of an individual
who is not expected to remain in the deleted text begingroup residencedeleted text endnew text begin establishmentnew text end beyond the month for
which payment is made must be made subsequent to the individual's departure from the
residence.

Sec. 32.

Minnesota Statutes 2018, section 256I.06, is amended by adding a subdivision
to read:


new text begin Subd. 10. new text end

new text begin Correction of overpayments and underpayments. new text end

new text begin The agency shall make
an adjustment to housing support payments issued to individuals consistent with requirements
of federal law and regulation and state law and rule and shall issue or recover benefits as
appropriate. A recipient or former recipient is not responsible for overpayments due to
agency error, unless the amount of the overpayment is large enough that a reasonable person
would know it is an error.
new text end

Sec. 33.

Minnesota Statutes 2018, section 256J.08, subdivision 73a, is amended to read:


Subd. 73a.

Qualified professional.

new text begin "Qualified professional" means an individual as
defined in section 256P.01, subdivision 6a.
new text end deleted text begin (a) For physical illness, injury, or incapacity, a
"qualified professional" means a licensed physician, a physician assistant, a nurse practitioner,
or a licensed chiropractor.
deleted text end

deleted text begin (b) For developmental disability and intelligence testing, a "qualified professional"
means an individual qualified by training and experience to administer the tests necessary
to make determinations, such as tests of intellectual functioning, assessments of adaptive
behavior, adaptive skills, and developmental functioning. These professionals include
licensed psychologists, certified school psychologists, or certified psychometrists working
under the supervision of a licensed psychologist.
deleted text end

deleted text begin (c) For learning disabilities, a "qualified professional" means a licensed psychologist or
school psychologist with experience determining learning disabilities.
deleted text end

deleted text begin (d) For mental health, a "qualified professional" means a licensed physician or a qualified
mental health professional. A "qualified mental health professional" means:
deleted text end

deleted text begin (1) for children, in psychiatric nursing, a registered nurse who is licensed under sections
148.171 to 148.285, and who is certified as a clinical specialist in child and adolescent
psychiatric or 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 in the treatment of mental illness;
deleted text end

deleted text begin (2) for adults, in psychiatric nursing, a registered nurse who is licensed under sections
148.171 to 148.285, and who is certified as a clinical specialist in adult 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 in the treatment of mental illness;
deleted text end

deleted text begin (3) in clinical social work, a person 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 treatment of mental illness;
deleted text end

deleted text begin (4) in psychology, an individual licensed by the Board of Psychology under sections
148.88 to 148.98, who has stated to the Board of Psychology competencies in the diagnosis
and treatment of mental illness;
deleted text end

deleted text begin (5) in psychiatry, a physician licensed under chapter 147 and certified by the American
Board of Psychiatry and Neurology or eligible for board certification in psychiatry;
deleted text end

deleted text begin (6) in marriage and family therapy, the mental health professional must be a marriage
and family therapist licensed under sections 148B.29 to 148B.39, with at least two years of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental illness; and
deleted text end

deleted text begin (7) in licensed professional clinical counseling, the mental health professional shall be
a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental illness.
deleted text end

Sec. 34.

Minnesota Statutes 2018, section 256P.01, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Qualified professional. new text end

new text begin (a) For physical illness, injury, or incapacity, a
"qualified professional" means a licensed physician, physician assistant, nurse practitioner,
physical therapist, occupational therapist, or licensed chiropractor.
new text end

new text begin (b) For developmental disability, learning disability, and intelligence testing, a "qualified
professional" means a licensed physician, physician assistant, nurse practitioner, licensed
independent clinical social worker, licensed psychologist, certified school psychologist, or
certified psychometrist working under the supervision of a licensed psychologist.
new text end

new text begin (c) For mental health, a "qualified professional" means a licensed physician, physician
assistant, nurse practitioner, or qualified mental health professional under section 245.462,
subdivision 18, clauses (1) to (6).
new text end

new text begin (d) For substance use disorder, a "qualified professional" means an individual as defined
in section 245G.11, subdivision 3, 4, or 5.
new text end

Sec. 35. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2018, section 245F.02, subdivision 20, new text end new text begin is repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: 20-7407

245F.02 DEFINITIONS.

Subd. 20.

Qualified medical professional.

"Qualified medical professional" means an individual licensed in Minnesota as a doctor of osteopathic medicine or physician, or an individual licensed in Minnesota as an advanced practice registered nurse by the Board of Nursing and certified to practice as a clinical nurse specialist or nurse practitioner by a national nurse organization acceptable to the board.