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Capital IconMinnesota Legislature

HF 1532

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 04/09/2021 12:39pm

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

Bill Text Versions

Engrossments
Introduction Posted on 02/25/2021
1st Engrossment Posted on 04/06/2021
Division Engrossments
1st Division Engrossment Posted on 03/08/2021

Current Version - 1st Engrossment

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A bill for an act
relating to human services; modifying community supports provisions; amending
Minnesota Statutes 2020, sections 245.4874, subdivision 1; 245.697, subdivision
1; 252.43; 252A.01, subdivision 1; 252A.02, subdivisions 2, 9, 11, 12, by adding
subdivisions; 252A.03, subdivisions 3, 4; 252A.04, subdivisions 1, 2, 4; 252A.05;
252A.06, subdivisions 1, 2; 252A.07, subdivisions 1, 2, 3; 252A.081, subdivisions
2, 3, 5; 252A.09, subdivisions 1, 2; 252A.101, subdivisions 2, 3, 5, 6, 7, 8;
252A.111, subdivisions 2, 4, 6; 252A.12; 252A.16; 252A.17; 252A.19, subdivisions
2, 4, 5, 7, 8; 252A.20; 252A.21, subdivisions 2, 4; 254B.03, subdivision 2; 256.042,
subdivisions 2, 4; 256B.051, subdivisions 1, 3, 5, 6, 7, by adding a subdivision;
256B.0947, subdivision 6; 256B.4912, subdivision 13; 256B.69, subdivision 5a;
256B.85, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12, 12b, 13, 13a, 15,
17a, 18a, 20b, 23, 23a, by adding subdivisions; 256L.03, subdivision 1; repealing
Minnesota Statutes 2020, sections 252.28, subdivisions 1, 5; 252A.02, subdivisions
8, 10; 252A.21, subdivision 3.

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

Section 1.

Minnesota Statutes 2020, section 245.4874, subdivision 1, is amended to read:


Subdivision 1.

Duties of county board.

(a) The county board must:

(1) develop a system of affordable and locally available children's mental health services
according to sections 245.487 to 245.4889;

(2) consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision 5, paragraph
(b), clause (3). The county shall provide, upon request of the local children's mental health
advisory council, readily available data to assist in the determination of unmet needs;

(3) assure that parents and providers in the county receive information about how to
gain access to services provided according to sections 245.487 to 245.4889;

(4) coordinate the delivery of children's mental health services with services provided
by social services, education, corrections, health, and vocational agencies to improve the
availability of mental health services to children and the cost-effectiveness of their delivery;

(5) assure that mental health services delivered according to sections 245.487 to 245.4889
are delivered expeditiously and are appropriate to the child's diagnostic assessment and
individual treatment plan;

(6) provide for case management services to each child with severe emotional disturbance
according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions
1, 3, and 5
;

(7) provide for screening of each child under section 245.4885 upon admission to a
residential treatment facility, acute care hospital inpatient treatment, or informal admission
to a regional treatment center;

(8) prudently administer grants and purchase-of-service contracts that the county board
determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4889;

(9) assure that mental health professionals, mental health practitioners, and case managers
employed by or under contract to the county to provide mental health services are qualified
under section 245.4871;

(10) assure that children's mental health services are coordinated with adult mental health
services specified in sections 245.461 to 245.486 so that a continuum of mental health
services is available to serve persons with mental illness, regardless of the person's age;

(11) assure that culturally competent mental health consultants are used as necessary to
assist the county board in assessing and providing appropriate treatment for children of
cultural or racial minority heritage; and

(12) consistent with section 245.486, arrange for or provide a children's mental health
screening for:

(i) a child receiving child protective services;

(ii) a child in out-of-home placement;

(iii) a child for whom parental rights have been terminated;

(iv) a child found to be delinquent; or

(v) a child found to have committed a juvenile petty offense for the third or subsequent
time.

A children's mental health screening is not required when a screening or diagnostic
assessment has been performed within the previous 180 days, or the child is currently under
the care of a mental health professional.

(b) When a child is receiving protective services or is in out-of-home placement, the
court or county agency must notify a parent or guardian whose parental rights have not been
terminated of the potential mental health screening and the option to prevent the screening
by notifying the court or county agency in writing.

(c) When a child is found to be delinquent or a child is found to have committed a
juvenile petty offense for the third or subsequent time, the court or county agency must
obtain written informed consent from the parent or legal guardian before a screening is
conducted unless the court, notwithstanding the parent's failure to consent, determines that
the screening is in the child's best interest.

(d) The screening shall be conducted with a screening instrument approved by the
commissioner of human services according to criteria that are updated and issued annually
to ensure that approved screening instruments are valid and useful for child welfare and
juvenile justice populations. Screenings shall be conducted by a mental health practitioner
as defined in section 245.4871, subdivision 26, or a probation officer or local social services
agency staff person who is trained in the use of the screening instrument. Training in the
use of the instrument shall include:

(1) training in the administration of the instrument;

(2) the interpretation of its validity given the child's current circumstances;

(3) the state and federal data practices laws and confidentiality standards;

(4) the parental consent requirement; and

(5) providing respect for families and cultural values.

If the screen indicates a need for assessment, the child's family, or if the family lacks
mental health insurance, the local social services agency, in consultation with the child's
family, shall have conducted a diagnostic assessment, including a functional assessment.
The administration of the screening shall safeguard the privacy of children receiving the
screening and their families and shall comply with the Minnesota Government Data Practices
Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of
1996, Public Law 104-191. Screening results deleted text beginshall be considered private data and the
commissioner shall not collect individual screening results.
deleted text endnew text begin are classified as private data on
individuals, as defined by section 13.02, subdivision 12. The county board or tribal nation
may provide the commissioner with access to the screening results for the purposes of
program evaluation and improvement.
new text end

(e) When the county board refers clients to providers of children's therapeutic services
and supports under section 256B.0943, the county board must clearly identify the desired
services components not covered under section 256B.0943 and identify the reimbursement
source for those requested services, the method of payment, and the payment rate to the
provider.

Sec. 2.

Minnesota Statutes 2020, section 245.697, subdivision 1, is amended to read:


Subdivision 1.

Creation.

(a) A State Advisory Council on Mental Health is created. The
council must have members appointed by the governor in accordance with federal
requirements. In making the appointments, the governor shall consider appropriate
representation of communities of color. The council must be composed of:

(1) the assistant commissioner of deleted text beginmental health fordeleted text end the Department of Human Servicesnew text begin
who oversees behavioral health policy
new text end;

(2) a representative of the Department of Human Services responsible for the medical
assistance program;

new text begin (3) a representative of the Department of Health;
new text end

deleted text begin (3)deleted text endnew text begin (4)new text end one member of each of the following professions:

(i) psychiatry;

(ii) psychology;

(iii) social work;

(iv) nursing;

(v) marriage and family therapy; and

(vi) professional clinical counseling;

deleted text begin (4)deleted text endnew text begin (5)new text end one representative from each of the following advocacy groups: Mental Health
Association of Minnesota, NAMI-MN, deleted text beginMental Health Consumer/Survivor Network of
Minnesota, and
deleted text end Minnesota Disability Law Centernew text begin, American Indian Mental Health Advisory
Council, and a consumer-run mental health advocacy group
new text end;

deleted text begin (5)deleted text endnew text begin (6)new text end providers of mental health services;

deleted text begin (6)deleted text endnew text begin (7)new text end consumers of mental health services;

deleted text begin (7)deleted text endnew text begin (8)new text end family members of persons with mental illnesses;

deleted text begin (8)deleted text endnew text begin (9)new text end legislators;

deleted text begin (9)deleted text endnew text begin (10)new text end social service agency directors;

deleted text begin (10)deleted text endnew text begin (11)new text end county commissioners; and

deleted text begin (11)deleted text endnew text begin (12)new text end other members reflecting a broad range of community interests, including
family physicians, or members as the United States Secretary of Health and Human Services
may prescribe by regulation or as may be selected by the governor.

(b) The council shall select a chair. Terms, compensation, and removal of members and
filling of vacancies are governed by section 15.059. Notwithstanding provisions of section
15.059, the council and its subcommittee on children's mental health do not expire. The
commissioner of human services shall provide staff support and supplies to the council.

Sec. 3.

Minnesota Statutes 2020, section 252.43, is amended to read:


252.43 COMMISSIONER'S DUTIES.

new text begin (a) new text endThe commissioner shall supervise lead agencies' provision of day services to adults
with disabilities. The commissioner shall:

(1) determine the need for day deleted text beginservicesdeleted text endnew text begin programsnew text end under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.4914new text begin and
252.41 to 252.46
new text end;

(2) establish payment rates as provided under section 256B.4914;

(3) adopt rules for the administration and provision of day services under sections
245A.01 to 245A.16deleted text begin,deleted text endnew text begin;new text end 252.28, subdivision 2deleted text begin,deleted text endnew text begin;new text end or 252.41 to 252.46deleted text begin,deleted text endnew text begin;new text end or Minnesota Rules,
parts 9525.1200 to 9525.1330;

(4) enter into interagency agreements necessary to ensure effective coordination and
provision of day services;

(5) monitor and evaluate the costs and effectiveness of day services; and

(6) provide information and technical help to lead agencies and vendors in their
administration and provision of day services.

new text begin (b) A determination of need in paragraph (a), clause (1), shall not be required for a
change in day service provider name or ownership.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2020, section 252A.01, subdivision 1, is amended to read:


Subdivision 1.

Policy.

(a) It is the policy of the state of Minnesota to provide a
coordinated approach to the supervision, protection, and habilitation of its adult citizens
with a developmental disability. In furtherance of this policy, sections 252A.01 to 252A.21
are enacted to authorize the commissioner of human services to:

(1) supervise those adult citizens with a developmental disability who are unable to fully
provide for their own needs and for whom no qualified person is willing and able to seek
guardianship deleted text beginor conservatorshipdeleted text end under sections 524.5-101 to 524.5-502; and

(2) protect adults with a developmental disability from violation of their human and civil
rights by deleted text beginassuringdeleted text endnew text begin ensuringnew text end that they receive the full range of needed social, financial,
residential, and habilitative services to which they are lawfully entitled.

(b) Public guardianship deleted text beginor conservatorshipdeleted text end is the most restrictive form of guardianship
deleted text begin or conservatorshipdeleted text end and should be imposed only when deleted text beginno other acceptable alternative is
available
deleted text endnew text begin less restrictive alternatives have been attempted and determined to be insufficient
to meet the person's needs. Less restrictive alternatives include but are not limited to
supported decision making, community or residential services, or appointment of a health
care agent
new text end.

Sec. 5.

Minnesota Statutes 2020, section 252A.02, subdivision 2, is amended to read:


Subd. 2.

Person with a developmental disability.

"Person with a developmental
disability" refers to any person age 18 or older whonew text begin:
new text end

new text begin (1)new text end has been diagnosed as having deleted text beginsignificantly subaverage intellectual functioning existing
concurrently with demonstrated deficits in adaptive behavior such as to require supervision
and protection for the person's welfare or the public welfare.
deleted text endnew text begin a developmental disability;
new text end

new text begin (2) is impaired to the extent of lacking sufficient understanding or capacity to make
personal decisions; and
new text end

new text begin (3) is unable to meet personal needs for medical care, nutrition, clothing, shelter, or
safety, even with appropriate technological and supported decision-making assistance.
new text end

Sec. 6.

Minnesota Statutes 2020, section 252A.02, subdivision 9, is amended to read:


Subd. 9.

deleted text beginWarddeleted text endnew text begin Person subject to public guardianshipnew text end.

deleted text begin"Ward"deleted text endnew text begin "Person subject to
public guardianship"
new text end means a person with a developmental disability for whom the court
has appointed a public guardian.

Sec. 7.

Minnesota Statutes 2020, section 252A.02, subdivision 11, is amended to read:


Subd. 11.

Interested person.

"Interested person" means an interested responsible adult,
deleted text begin including, but not limited to, a public official, guardian, spouse, parent, adult sibling, legal
counsel, adult child, or next of kin of a person alleged to have a developmental disability.
deleted text endnew text begin
including but not limited to:
new text end

new text begin (1) the person subject to guardianship, the protected person, or the respondent;
new text end

new text begin (2) a nominated guardian or conservator;
new text end

new text begin (3) a legal representative;
new text end

new text begin (4) a spouse; a parent, including stepparent; adult children, including adult stepchildren
of a living spouse; and siblings. If no such persons are living or can be located, the next of
kin of the person subject to public guardianship or the respondent is an interested person;
new text end

new text begin (5) a representative of a state ombudsman's office or a federal protection and advocacy
program that has notified the commissioner or lead agency that it has a matter regarding
the protected person subject to guardianship, person subject to conservatorship, or respondent;
and
new text end

new text begin (6) a health care agent or proxy appointed pursuant to a health care directive as defined
in section 145C.01, subdivision 5a; a living will under chapter 145B; or other similar
documentation executed in another state and enforceable under the laws of this state.
new text end

Sec. 8.

Minnesota Statutes 2020, section 252A.02, subdivision 12, is amended to read:


Subd. 12.

Comprehensive evaluation.

new text begin(a) new text end"Comprehensive evaluation" deleted text beginshall consistdeleted text endnew text begin
consists
new text end of:

(1) a medical report on the health status and physical condition of the proposed deleted text beginward,deleted text endnew text begin
person subject to public guardianship
new text end prepared under the direction of a licensed physician
or advanced practice registered nurse;

(2) a report on the deleted text beginproposed ward'sdeleted text end intellectual capacity and functional abilitiesdeleted text begin, specifyingdeleted text endnew text begin
of the proposed person subject to public guardianship that specifies
new text end the tests and other data
used in reaching its conclusionsdeleted text begin,deleted text endnew text begin and isnew text end prepared by a psychologist who is qualified in the
diagnosis of developmental disability; and

(3) a report from the case manager that includes:

(i) the most current assessment of individual service needs as described in rules of the
commissioner;

(ii) the most current deleted text beginindividual servicedeleted text end new text begincoordinated service and supportnew text end plan under section
256B.092, subdivision 1b; and

(iii) a description of contacts with and responses of near relatives of the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end notifying deleted text beginthemdeleted text endnew text begin the near relativesnew text end that a nomination
for public guardianship has been made and advising deleted text beginthemdeleted text endnew text begin the near relativesnew text end that they may
seek private guardianship.

new text begin (b) new text endEach report new text beginunder paragraph (a), clause (3), new text endshall contain recommendations as to the
amount of assistance and supervision required by the proposed deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end to function as independently as possible in society. To be considered part of
the comprehensive evaluation, new text beginthe new text endreports must be completed no more than one year before
filing the petition under section 252A.05.

Sec. 9.

Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision to
read:


new text begin Subd. 16. new text end

new text begin Protected person. new text end

new text begin "Protected person" means a person for whom a guardian
or conservator has been appointed or other protective order has been sought. A protected
person may be a minor.
new text end

Sec. 10.

Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision
to read:


new text begin Subd. 17. new text end

new text begin Respondent. new text end

new text begin "Respondent" means an individual for whom the appointment
of a guardian or conservator or other protective order is sought.
new text end

Sec. 11.

Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision
to read:


new text begin Subd. 18. new text end

new text begin Supported decision making. new text end

new text begin "Supported decision making" means assistance
to an individual with understanding the nature and consequences of personal and financial
decisions from one or more persons of the individual's choosing to enable the individual to
make personal and financial decisions and, when consistent with the individual's wishes,
to communicate the individual's decisions.
new text end

Sec. 12.

Minnesota Statutes 2020, section 252A.03, subdivision 3, is amended to read:


Subd. 3.

Standard for acceptance.

The commissioner shall accept the nomination ifnew text begin:new text end
deleted text begin the comprehensive evaluation concludes that:
deleted text end

deleted text begin (1) the person alleged to have developmental disability is, in fact, developmentally
disabled;
deleted text end new text begin (1) the person's assessment confirms that they are a person with a developmental
disability under section 252A.02, subdivision 2;
new text end

(2) the person is in need of the supervision and protection of a deleted text beginconservator ordeleted text end guardian;
deleted text begin and
deleted text end

(3) no qualified person is willing to assume guardianship deleted text beginor conservatorshipdeleted text end under
sections 524.5-101 to 524.5-502deleted text begin.deleted text endnew text begin; and
new text end

new text begin (4) the person subject to public guardianship was included in the process prior to the
submission of the nomination.
new text end

Sec. 13.

Minnesota Statutes 2020, section 252A.03, subdivision 4, is amended to read:


Subd. 4.

Alternatives.

new text begin(a) new text endPublic guardianship deleted text beginor conservatorshipdeleted text end may be imposed only
whennew text begin:
new text end

new text begin (1) the person subject to guardianship is impaired to the extent of lacking sufficient
understanding or capacity to make personal decisions;
new text end

new text begin (2) the person subject to guardianship is unable to meet personal needs for medical care,
nutrition, clothing, shelter, or safety, even with appropriate technological and supported
decision-making assistance; and
new text end

new text begin (3)new text end no acceptable, less restrictive form of guardianship deleted text beginor conservatorshipdeleted text end is available.

new text begin (b)new text end The commissioner shall seek parents, near relatives, and other interested persons to
assume guardianship for persons with developmental disabilities who are currently under
public guardianship. If a person seeks to become a guardian deleted text beginor conservatordeleted text end, costs to the
person may be reimbursed under section 524.5-502. The commissioner must provide technical
assistance to parents, near relatives, and interested persons seeking to become guardians deleted text beginor
conservators
deleted text end.

Sec. 14.

Minnesota Statutes 2020, section 252A.04, subdivision 1, is amended to read:


Subdivision 1.

Local agency.

Upon receipt of a written nomination, the commissioner
shall promptly order the local agency of the county in which the proposed deleted text beginwarddeleted text endnew text begin person
subject to public guardianship
new text end resides to coordinate or arrange for a comprehensive evaluation
of the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end.

Sec. 15.

Minnesota Statutes 2020, section 252A.04, subdivision 2, is amended to read:


Subd. 2.

Medication; treatment.

A proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
who, at the time the comprehensive evaluation is to be performed, has been under medical
care shall not be so under the influence or so suffer the effects of drugs, medication, or other
treatment as to be hampered in the testing or evaluation process. When in the opinion of
the licensed physician or advanced practice registered nurse attending the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end, the discontinuance of medication or other treatment
is not in the deleted text beginproposed ward'sdeleted text end best interestnew text begin of the proposed person subject to public
guardianship
new text end, the physician or advanced practice registered nurse shall record a list of all
drugs, medicationnew text begin,new text end or other treatment deleted text beginwhichdeleted text endnew text begin thatnew text end the proposed deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end received 48 hours immediately prior to any examination, testnew text begin,new text end or interview
conducted in preparation for the comprehensive evaluation.

Sec. 16.

Minnesota Statutes 2020, section 252A.04, subdivision 4, is amended to read:


Subd. 4.

File.

The comprehensive evaluation shall be kept on file at the Department of
Human Services and shall be open to the inspection of the proposed deleted text beginwarddeleted text endnew text begin person subject to
public guardianship
new text end and deleted text beginsuchdeleted text end other persons deleted text beginas may be given permissiondeleted text endnew text begin permittednew text end by the
commissioner.

Sec. 17.

Minnesota Statutes 2020, section 252A.05, is amended to read:


252A.05 COMMISSIONER'S PETITION FOR APPOINTMENT AS PUBLIC
GUARDIAN deleted text beginOR PUBLIC CONSERVATORdeleted text end.

In every case in which the commissioner agrees to accept a nomination, the local agency,
within 20 working days of receipt of the commissioner's acceptance, shall petition on behalf
of the commissioner in the county or court of the county of residence of the person with a
developmental disability for appointment to act as deleted text beginpublic conservator ordeleted text end public guardian of
the person with a developmental disability.

Sec. 18.

Minnesota Statutes 2020, section 252A.06, subdivision 1, is amended to read:


Subdivision 1.

Who may file.

deleted text beginThe commissioner, the local agency, a person with a
developmental disability or any parent, spouse or relative of a person with a developmental
disability may file
deleted text end A verified petition alleging that the appointment of a deleted text beginpublic conservator
or
deleted text end public guardian is requirednew text begin may be filed by: the commissioner; the local agency; a person
with a developmental disability; or a parent, stepparent, spouse, or relative of a person with
a developmental disability
new text end.

Sec. 19.

Minnesota Statutes 2020, section 252A.06, subdivision 2, is amended to read:


Subd. 2.

Contents.

The petition shall set forth:

(1) the name and address of the petitionerdeleted text begin,deleted text end and, in the case of a petition brought by a
person other than the commissioner, whether the petitioner is a parent, spouse, or relative
deleted text begin of the proposed warddeleted text endnew text begin of the proposed person subject to guardianshipnew text end;

(2) whether the commissioner has accepted a nomination to act as deleted text beginpublic conservator
or
deleted text end public guardian;

(3) the name, address, and date of birth of the proposed deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end;

(4) the names and addresses of the nearest relatives and spouse, if any, of the proposed
deleted text begin warddeleted text endnew text begin person subject to public guardianshipnew text end;

(5) the probable value and general character of the deleted text beginproposed ward'sdeleted text end real and personal
propertynew text begin of the proposed person subject to public guardianshipnew text end and the probable amount of
the deleted text beginproposed ward'sdeleted text end debtsnew text begin of the proposed person subject to public guardianshipnew text end;new text begin and
new text end

(6) the facts supporting the establishment of public deleted text beginconservatorship ordeleted text end guardianship,
including that no family member or other qualified individual is willing to assume
guardianship deleted text beginor conservatorshipdeleted text end responsibilities under sections 524.5-101 to 524.5-502deleted text begin;
and
deleted text endnew text begin.
new text end

deleted text begin (7) if conservatorship is requested, the powers the petitioner believes are necessary to
protect and supervise the proposed conservatee.
deleted text end

Sec. 20.

Minnesota Statutes 2020, section 252A.07, subdivision 1, is amended to read:


Subdivision 1.

With petition.

When a petition is brought by the commissioner or local
agency, a copy of the comprehensive evaluation shall be filed with the petition. If a petition
is brought by a person other than the commissioner or local agency and a comprehensive
evaluation has been prepared within a year of the filing of the petition, the local agency
shall deleted text beginforwarddeleted text endnew text begin sendnew text end a copy of the comprehensive evaluation to the court upon notice of the
filing of the petition. If a comprehensive evaluation has not been prepared within a year of
the filing of the petition, the local agency, upon notice of the filing of the petition, shall
arrange for a comprehensive evaluation to be prepared and deleted text beginforwardeddeleted text endnew text begin providednew text end to the court
within 90 days.

Sec. 21.

Minnesota Statutes 2020, section 252A.07, subdivision 2, is amended to read:


Subd. 2.

Copies.

A copy of the comprehensive evaluation shall be made available by
the court to the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, the deleted text beginproposed ward'sdeleted text end
counselnew text begin of the proposed person subject to public guardianshipnew text end, the county attorney, the
attorney generalnew text begin,new text end and the petitioner.

Sec. 22.

Minnesota Statutes 2020, section 252A.07, subdivision 3, is amended to read:


Subd. 3.

Evaluation required; exception.

new text begin(a) new text endNo action for the appointment of a public
guardian may proceed to hearing unless a comprehensive evaluation has been first filed
with the courtdeleted text begin; provided, however, that an action may proceed and a guardian appointeddeleted text endnew text begin.
new text end

new text begin (b) Paragraph (a) does not applynew text end if the director of the local agency responsible for
conducting the comprehensive evaluation has filed an affidavit that the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end refused to participate in the comprehensive evaluation
and the court finds on the basis of clear and convincing evidence that the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end is developmentally disabled and in need of the
supervision and protection of a guardian.

Sec. 23.

Minnesota Statutes 2020, section 252A.081, subdivision 2, is amended to read:


Subd. 2.

Service of notice.

Service of notice on the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end or proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end must be made by a
nonuniformed personnew text begin or nonuniformed visitornew text end. To the extent possible, the deleted text beginprocess server or
visitor
deleted text endnew text begin person or visitor serving the noticenew text end shall explain the document's meaning to the
proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end. In addition to the persons required to
be served under sections 524.5-113, 524.5-205, and 524.5-304, the mailed notice of the
hearing must be served on the commissioner, the local agency, and the county attorney.

Sec. 24.

Minnesota Statutes 2020, section 252A.081, subdivision 3, is amended to read:


Subd. 3.

Attorney.

In place of the notice of attorney provisions in sections 524.5-205
and 524.5-304, the notice must state that the court will appoint an attorney for the proposed
deleted text begin warddeleted text endnew text begin person subject to public guardianshipnew text end unless an attorney is provided by other persons.

Sec. 25.

Minnesota Statutes 2020, section 252A.081, subdivision 5, is amended to read:


Subd. 5.

Defective notice of service.

A defect in the service of notice or process, other
than personal service upon the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public
guardianship
new text end or service upon the commissioner and local agency within the time allowed
and the form prescribed in this section and sections 524.5-113, 524.5-205, and 524.5-304,
does not invalidate any public guardianship deleted text beginor conservatorshipdeleted text end proceedings.

Sec. 26.

Minnesota Statutes 2020, section 252A.09, subdivision 1, is amended to read:


Subdivision 1.

Attorney appointment.

Upon the filing of the petition, the court shall
appoint an attorney for the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, unless
such counsel is provided by others.

Sec. 27.

Minnesota Statutes 2020, section 252A.09, subdivision 2, is amended to read:


Subd. 2.

Representation.

Counsel shall visit with and, to the extent possible, consult
with the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end prior to the hearing and shall
be given adequate time to prepare deleted text begintherefordeleted text endnew text begin for the hearingnew text end. Counsel shall be given the full
right of subpoena and shall be supplied with a copy of all documents filed with or issued
by the court.

Sec. 28.

Minnesota Statutes 2020, section 252A.101, subdivision 2, is amended to read:


Subd. 2.

Waiver of presence.

The proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
may waive the right to be present at the hearing only if the proposed deleted text beginwarddeleted text endnew text begin person subject
to public guardianship
new text end has met with counsel and specifically waived the right to appear.

Sec. 29.

Minnesota Statutes 2020, section 252A.101, subdivision 3, is amended to read:


Subd. 3.

Medical care.

If, at the time of the hearing, the proposed deleted text beginwarddeleted text endnew text begin person subject
to public guardianship
new text end has been under medical care, the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end has the same rights regarding limitation on the use of drugs, medication, or
other treatment before the hearing that are available under section 252A.04, subdivision 2.

Sec. 30.

Minnesota Statutes 2020, section 252A.101, subdivision 5, is amended to read:


Subd. 5.

Findings.

(a) In all cases the court shall make specific written findings of fact,
conclusions of law, and direct entry of an appropriate judgment or order. The court shall
order the appointment of the commissioner as guardian deleted text beginor conservatordeleted text end if it finds that:

(1) the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end is a person
with a developmental disability as defined in section 252A.02, subdivision 2;

(2) the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end is incapable
of exercising specific legal rights, which must be enumerated in deleted text beginitsdeleted text endnew text begin the court'snew text end findings;

(3) the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end is in need
of the supervision and protection of a new text beginpublic new text endguardian deleted text beginor conservatordeleted text end; and

(4) no appropriate alternatives to public guardianship deleted text beginor public conservatorshipdeleted text end exist
that are less restrictive of the person's civil rights and liberties, such as appointing a new text beginprivate
new text end guardiannew text begin,new text end deleted text beginor conservatordeleted text endnew text begin supported decision maker, or health care agent; or arranging
residential or community services
new text end under sections 524.5-101 to 524.5-502.

(b) The court shall grant the specific powers that are necessary for the commissioner to
act as public guardian deleted text beginor conservatordeleted text end on behalf of the deleted text beginward or conservateedeleted text endnew text begin person subject
to public guardianship
new text end.

Sec. 31.

Minnesota Statutes 2020, section 252A.101, subdivision 6, is amended to read:


Subd. 6.

Notice of order; appeal.

A copy of the order shall be served by mail upon the
deleted text begin ward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end and the deleted text beginward'sdeleted text end counselnew text begin of the
person subject to public guardianship
new text end. The order must be accompanied by a notice that
advises the deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end of the right to appeal
the guardianship deleted text beginor conservatorshipdeleted text end appointment within 30 days.

Sec. 32.

Minnesota Statutes 2020, section 252A.101, subdivision 7, is amended to read:


Subd. 7.

Letters of guardianship.

new text begin(a) new text endLetters of guardianship deleted text beginor conservatorshipdeleted text end must
be issued by the court and contain:

(1) the name, address, and telephone number of the deleted text beginward or conservateedeleted text endnew text begin person subject
to public guardianship
new text end; and

(2) the powers to be exercised on behalf of the deleted text beginward or conservateedeleted text endnew text begin person subject to
public guardianship
new text end.

new text begin (b) new text endThe lettersnew text begin under paragraph (a)new text end must be served by mail upon the deleted text beginward or conservateedeleted text endnew text begin
person subject to public guardianship
new text end, the deleted text beginward'sdeleted text end counselnew text begin of the person subject to public
guardianship
new text end, the commissioner, and the local agency.

Sec. 33.

Minnesota Statutes 2020, section 252A.101, subdivision 8, is amended to read:


Subd. 8.

Dismissal.

If upon the completion of the hearing and consideration of the record,
the court finds that the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end is not
developmentally disabled or is developmentally disabled but not in need of the supervision
and protection of a deleted text beginconservator ordeleted text endnew text begin publicnew text end guardian, deleted text beginitdeleted text endnew text begin the courtnew text end shall dismiss the application
and shall notify the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, the deleted text beginward'sdeleted text end counselnew text begin
of the person subject to public guardianship
new text end, and the petitionernew text begin of the court's findingsnew text end.

Sec. 34.

Minnesota Statutes 2020, section 252A.111, subdivision 2, is amended to read:


Subd. 2.

Additional powers.

In addition to the powers contained in sections 524.5-207
and 524.5-313, the powers of a public guardian that the court may grant include:

(1) the power to permit or withhold permission for the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end to marry;

(2) the power to begin legal action or defend against legal action in the name of the deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end; and

(3) the power to consent to the adoption of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
as provided in section 259.24.

Sec. 35.

Minnesota Statutes 2020, section 252A.111, subdivision 4, is amended to read:


Subd. 4.

Appointment of conservator.

If the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
has a personal estate beyond that which is necessary for the deleted text beginward'sdeleted text end personal and immediate
needsnew text begin of the person subject to public guardianshipnew text end, the commissioner shall determine whether
a conservator should be appointed. The commissioner shall consult with the parents, spouse,
or nearest relative of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end. The commissioner
may petition the court for the appointment of a private conservator of the deleted text beginwarddeleted text endnew text begin person
subject to public guardianship
new text end. The commissioner cannot act as conservator for public deleted text beginwardsdeleted text endnew text begin
persons subject to public guardianship
new text end or public protected persons.

Sec. 36.

Minnesota Statutes 2020, section 252A.111, subdivision 6, is amended to read:


Subd. 6.

Special duties.

In exercising powers and duties under this chapter, the
commissioner shall:

(1) maintain close contact with the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, visiting
at least twice a year;

(2) protect and exercise the legal rights of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end;

(3) take actions and make decisions on behalf of the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end that encourage and allow the maximum level of independent functioning in a
manner least restrictive of the deleted text beginward'sdeleted text end personal freedom new text beginof the person subject to public
guardianship
new text endconsistent with the need for supervision and protection; and

(4) permit and encourage maximum self-reliance on the part of the deleted text beginwarddeleted text endnew text begin person subject
to public guardianship
new text end and permit and encourage input by the nearest relative of the deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end in planning and decision making on behalf of the
deleted text begin warddeleted text endnew text begin person subject to public guardianshipnew text end.

Sec. 37.

Minnesota Statutes 2020, section 252A.12, is amended to read:


252A.12 APPOINTMENT OF deleted text beginCONSERVATORdeleted text endnew text begin PUBLIC GUARDIANnew text end NOT A
FINDING OF INCOMPETENCY.

An appointment of the commissioner as deleted text beginconservatordeleted text endnew text begin public guardiannew text end shall not constitute
a judicial finding that the person with a developmental disability is legally incompetent
except for the restrictions deleted text beginwhichdeleted text endnew text begin thatnew text end the deleted text beginconservatorshipdeleted text endnew text begin public guardianshipnew text end places on the
deleted text begin conservateedeleted text endnew text begin person subject to public guardianshipnew text end. The appointment of a deleted text beginconservatordeleted text endnew text begin public
guardian
new text end shall not deprive the deleted text beginconservateedeleted text endnew text begin person subject to public guardianshipnew text end of the right
to vote.

Sec. 38.

Minnesota Statutes 2020, section 252A.16, is amended to read:


252A.16 ANNUAL REVIEW.

Subdivision 1.

Review required.

The commissioner shall require an annual review of
the physical, mental, and social adjustment and progress of every deleted text beginward and conservateedeleted text endnew text begin
person subject to public guardianship
new text end. A copy of this review shall be kept on file at the
Department of Human Services and may be inspected by the deleted text beginward or conservateedeleted text endnew text begin person
subject to public guardianship
new text end, the deleted text beginward's or conservatee'sdeleted text end parents, spouse, or relatives new text beginof
the person subject to public guardianship,
new text endand other persons who receive the permission of
the commissioner. The review shall contain information required under Minnesota Rules,
part 9525.3065, subpart 1.

Subd. 2.

Assessment of need for continued guardianship.

The commissioner shall
annually review the legal status of each deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end in light
of the progress indicated in the annual review. If the commissioner determines the deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end is no longer in need of public guardianship deleted text beginor
conservatorship
deleted text end or is capable of functioning under a less restrictive deleted text beginconservatorshipdeleted text endnew text begin
guardianship
new text end, the commissioner or local agency shall petition the court pursuant to section
252A.19 to restore the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end to capacity or for a
modification of the court's previous order.

Sec. 39.

Minnesota Statutes 2020, section 252A.17, is amended to read:


252A.17 EFFECT OF SUCCESSION IN OFFICE.

The appointment by the court of the commissioner deleted text beginof human servicesdeleted text end as public
deleted text begin conservator ordeleted text end guardian shall be by the title of the commissioner's office. The authority of
the commissioner as public deleted text beginconservator ordeleted text end guardian shall cease upon the termination of the
commissioner's term of office and shall vest in a successor or successors in office without
further court proceedings.

Sec. 40.

Minnesota Statutes 2020, section 252A.19, subdivision 2, is amended to read:


Subd. 2.

Petition.

The commissioner, deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, or
any interested person may petition the appointing court or the court to which venue has
been transferred deleted text beginfor an order todeleted text endnew text begin:
new text end

new text begin (1) for an order tonew text end remove the guardianship deleted text beginor todeleted text endnew text begin;
new text end

new text begin (2) for an order tonew text end limit or expand the powers of the guardianship deleted text beginor todeleted text endnew text begin;
new text end

new text begin (3) for an order tonew text end appoint a guardian deleted text beginor conservatordeleted text end under sections 524.5-101 to
524.5-502 deleted text beginor todeleted text endnew text begin;
new text end

new text begin (4) for an order tonew text end restore the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected
person to full legal capacity deleted text beginor todeleted text endnew text begin;
new text end

new text begin (5) tonew text end review de novo any decision made by the public guardian deleted text beginor public conservatordeleted text end
for or on behalf of a deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected personnew text begin;new text end or

new text begin (6) new text endfor any other order as the court may deem just and equitable.

Sec. 41.

Minnesota Statutes 2020, section 252A.19, subdivision 4, is amended to read:


Subd. 4.

Comprehensive evaluation.

The commissioner shall, at the court's request,
arrange for the preparation of a comprehensive evaluation of the deleted text beginwarddeleted text endnew text begin person subject to
public guardianship
new text end or protected person.

Sec. 42.

Minnesota Statutes 2020, section 252A.19, subdivision 5, is amended to read:


Subd. 5.

Court order.

Upon proof of the allegations of the petition the court shall enter
an order removing the guardianship or limiting or expanding the powers of the guardianship
or restoring the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected person to full legal
capacity or may enter such other order as the court may deem just and equitable.

Sec. 43.

Minnesota Statutes 2020, section 252A.19, subdivision 7, is amended to read:


Subd. 7.

Attorney general's role; commissioner's role.

The attorney general may
appear and represent the commissioner in such proceedings. The commissioner shall support
or oppose the petition if the commissioner deems such action necessary for the protection
and supervision of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected person.

Sec. 44.

Minnesota Statutes 2020, section 252A.19, subdivision 8, is amended to read:


Subd. 8.

deleted text beginCourt appointeddeleted text endnew text begin Court-appointednew text end counsel.

In all such proceedings, the
protected person or deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end shall be afforded an
opportunity to be represented by counsel, and if neither the protected person or deleted text beginwarddeleted text endnew text begin person
subject to public guardianship
new text end nor others provide counsel the court shall appoint counsel to
represent the protected person or deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end.

Sec. 45.

Minnesota Statutes 2020, section 252A.20, is amended to read:


252A.20 COSTS OF HEARINGS.

Subdivision 1.

Witness and attorney fees.

In each proceeding under sections 252A.01
to 252A.21, the court shall allow and order paid to each witness subpoenaed the fees and
mileage prescribed by law; to each physician, advanced practice registered nurse,
psychologist, or social worker who assists in the preparation of the comprehensive evaluation
and who is not deleted text beginin the employ ofdeleted text endnew text begin employed bynew text end the local agency or the state Department of
Human Services, a reasonable sum for services and for travel; and to the deleted text beginward'sdeleted text end counselnew text begin of
the person subject to public guardianship
new text end, when appointed by the court, a reasonable sum
for travel and for each day or portion of a day actually employed in court or actually
consumed in preparing for the hearing. Upon order the county auditor shall issue a warrant
on the county treasurer for payment of the amount allowed.

Subd. 2.

Expenses.

When the settlement of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
is found to be in another county, the court shall transmit to the county auditor a statement
of the expenses incurred pursuant to subdivision 1. The auditor shall transmit the statement
to the auditor of the county of the deleted text beginward'sdeleted text end settlement new text beginof the person subject to public
guardianship
new text endand this claim shall be paid as other claims against that county. If the auditor
to whom this claim is transmitted denies the claim, the auditor shall transmit it, together
with the objections thereto, to the commissioner, who shall determine the question of
settlement and certify findings to each auditor. If the claim is not paid within 30 days after
such certification, an action may be maintained thereon in the district court of the claimant
county.

Subd. 3.

Change of venue; cost of proceedings.

Whenever venue of a proceeding has
been transferred under sections 252A.01 to 252A.21, the costs of such proceedings shall be
reimbursed to the county of the deleted text beginward'sdeleted text end settlement new text beginof the person subject to public guardianship
new text end by the state.

Sec. 46.

Minnesota Statutes 2020, section 252A.21, subdivision 2, is amended to read:


Subd. 2.

Rules.

The commissioner shall adopt rules to implement this chapter. The rules
must include standards for performance of guardianship deleted text beginor conservatorshipdeleted text end duties includingdeleted text begin,deleted text end
but not limited to: twice a year visits with the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end;
a requirement that the duties of guardianship deleted text beginor conservatorshipdeleted text end and case management not
be performed by the same person; specific standards for action on "do not resuscitate" orders
as recommended by a physician, an advanced practice registered nurse, or a physician
assistant; sterilization requests; and the use of psychotropic medication and aversive
procedures.

Sec. 47.

Minnesota Statutes 2020, section 252A.21, subdivision 4, is amended to read:


Subd. 4.

Private guardianships deleted text beginand conservatorshipsdeleted text end.

Nothing in sections 252A.01
to 252A.21 shall impair the right of individuals to establish private guardianships deleted text beginor
conservatorships
deleted text end in accordance with applicable law.

Sec. 48.

Minnesota Statutes 2020, 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, deleted text beginthat, 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,
deleted text endnew text begin services
identified in section 254B.05,
new text end 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 meeting the criteria under
section 254B.05, subdivision 1a, 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. The 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 services.

Sec. 49.

Minnesota Statutes 2020, section 256.042, subdivision 2, is amended to read:


Subd. 2.

Membership.

(a) The council shall consist of the following 19 voting members,
appointed by the commissioner of human services except as otherwise specified, and three
nonvoting members:

(1) two members of the house of representatives, appointed in the following sequence:
the first from the majority party appointed by the speaker of the house and the second from
the minority party appointed by the minority leader. Of these two members, one member
must represent a district outside of the seven-county metropolitan area, and one member
must represent a district that includes the seven-county metropolitan area. The appointment
by the minority leader must ensure that this requirement for geographic diversity in
appointments is met;

(2) two members of the senate, appointed in the following sequence: the first from the
majority party appointed by the senate majority leader and the second from the minority
party appointed by the senate minority leader. Of these two members, one member must
represent a district outside of the seven-county metropolitan area and one member must
represent a district that includes the seven-county metropolitan area. The appointment by
the minority leader must ensure that this requirement for geographic diversity in appointments
is met;

(3) one member appointed by the Board of Pharmacy;

(4) one member who is a physician appointed by the Minnesota Medical Association;

(5) one member representing opioid treatment programs, sober living programs, or
substance use disorder programs licensed under chapter 245G;

(6) one member appointed by the Minnesota Society of Addiction Medicine who is an
addiction psychiatrist;

(7) one member representing professionals providing alternative pain management
therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;

(8) one member representing nonprofit organizations conducting initiatives to address
the opioid epidemic, with the commissioner's initial appointment being a member
representing the Steve Rummler Hope Network, and subsequent appointments representing
this or other organizations;

(9) one member appointed by the Minnesota Ambulance Association who is serving
with an ambulance service as an emergency medical technician, advanced emergency
medical technician, or paramedic;

(10) one member representing the Minnesota courts who is a judge or law enforcement
officer;

(11) one public member who is a Minnesota resident and who is in opioid addiction
recovery;

(12) two members representing Indian tribes, one representing the Ojibwe tribes and
one representing the Dakota tribes;

(13) one public member who is a Minnesota resident and who is suffering from chronic
pain, intractable pain, or a rare disease or condition;

(14) one mental health advocate representing persons with mental illness;

(15) one member appointed by the Minnesota Hospital Association;

(16) one member representing a local health department; and

(17) the commissioners of human services, health, and corrections, or their designees,
who shall be ex officio nonvoting members of the council.

(b) The commissioner of human services shall coordinate the commissioner's
appointments to provide geographic, racial, and gender diversity, and shall ensure that at
least one-half of council members appointed by the commissioner reside outside of the
seven-county metropolitan area. Of the members appointed by the commissioner, to the
extent practicable, at least one member must represent a community of color
disproportionately affected by the opioid epidemic.

(c) The council is governed by section 15.059, except that members of the council shall
serve three-year terms and shall receive no compensation other than reimbursement for
expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.new text begin The
three-year term for members in paragraph (a), clauses (1), (3), (5), (7), (9), (11), (13), (15),
and (17), ends on September 30, 2022. The three-year term for members in paragraph (a),
clauses (2), (4), (6), (8), (10), (12), (14), and (16), ends on September 30, 2023.
new text end

(d) The chair shall convene the council at least quarterly, and may convene other meetings
as necessary. The chair shall convene meetings at different locations in the state to provide
geographic access, and shall ensure that at least one-half of the meetings are held at locations
outside of the seven-county metropolitan area.

(e) The commissioner of human services shall provide staff and administrative services
for the advisory council.

(f) The council is subject to chapter 13D.

Sec. 50.

Minnesota Statutes 2020, section 256.042, subdivision 4, is amended to read:


Subd. 4.

Grants.

(a) The commissioner of human services shall submit a report of the
grants proposed by the advisory council to be awarded deleted text beginfor the upcoming fiscal yeardeleted text end to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health and human services policy and finance, by deleted text beginMarchdeleted text endnew text begin Decembernew text end 1 of each year, beginning
deleted text begin March 1, 2020deleted text endnew text begin December 1, 2021, or as soon as the information becomes available thereafternew text end.

(b) The commissioner of human services shall award grants from the opiate epidemic
response fund under section 256.043. The grants shall be awarded to proposals selected by
the advisory council that address the priorities in subdivision 1, paragraph (a), clauses (1)
to (4), unless otherwise appropriated by the legislature. new text beginThe council shall determine grant
awards and funding amounts. The commissioner of human services shall administer grants
from the opiate epidemic response fund in compliance with section 16B.97.
new text endNo more than
deleted text begin threedeleted text endnew text begin tennew text end percent of the grant amount may be used by a grantee for administration.

Sec. 51.

Minnesota Statutes 2020, section 256B.051, subdivision 1, is amended to read:


Subdivision 1.

Purpose.

Housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services are established to provide
housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services to an individual with a disability that limits the
individual's ability to obtain or maintain stable housing. The services support an individual's
transition to housing in the community and increase long-term stability in housing, to avoid
future periods of being at risk of homelessness or institutionalization.

Sec. 52.

Minnesota Statutes 2020, section 256B.051, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

An individual with a disability is eligible for housing deleted text beginsupportdeleted text endnew text begin
stabilization
new text end services if the individual:

(1) is 18 years of age or older;

(2) is enrolled in medical assistance;

(3) has an assessment of functional need that determines a need for services due to
limitations caused by the individual's disability;

(4) resides in or plans to transition to a community-based setting as defined in Code of
Federal Regulations, title 42, section 441.301 (c); and

(5) has housing instability evidenced by:

(i) being homeless or at-risk of homelessness;

(ii) being in the process of transitioning from, or having transitioned in the past six
months from, an institution or licensed or registered setting;

(iii) being eligible for waiver services under chapter 256S or section 256B.092 or
256B.49; or

(iv) having been identified by a long-term care consultation under section 256B.0911
as at risk of institutionalization.

Sec. 53.

Minnesota Statutes 2020, section 256B.051, subdivision 5, is amended to read:


Subd. 5.

Housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services.

(a) Housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end
services include housing transition services and housing and tenancy sustaining services.

(b) Housing transition services are defined as:

(1) tenant screening and housing assessment;

(2) assistance with the housing search and application process;

(3) identifying resources to cover onetime moving expenses;

(4) ensuring a new living arrangement is safe and ready for move-in;

(5) assisting in arranging for and supporting details of a move; and

(6) developing a housing support crisis plan.

(c) Housing and tenancy sustaining services include:

(1) prevention and early identification of behaviors that may jeopardize continued stable
housing;

(2) education and training on roles, rights, and responsibilities of the tenant and the
property manager;

(3) coaching to develop and maintain key relationships with property managers and
neighbors;

(4) advocacy and referral to community resources to prevent eviction when housing is
at risk;

(5) assistance with housing recertification process;

(6) coordination with the tenant to regularly review, update, and modify the housing
support and crisis plan; and

(7) continuing training on being a good tenant, lease compliance, and household
management.

(d) A housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end service may include person-centered planning for
people who are not eligible to receive person-centered planning through any other service,
if the person-centered planning is provided by a consultation service provider that is under
contract with the department and enrolled as a Minnesota health care program.

Sec. 54.

Minnesota Statutes 2020, section 256B.051, subdivision 6, is amended to read:


Subd. 6.

Provider qualifications and duties.

A provider eligible for reimbursement
under this section shall:

(1) enroll as a medical assistance Minnesota health care program provider and meet all
applicable provider standards and requirements;

(2) demonstrate compliance with federal and state laws and policies for housing deleted text beginsupportdeleted text endnew text begin
stabilization
new text end services as determined by the commissioner;

(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results; deleted text beginand
deleted text end

(4) directly provide housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services and not use a subcontractor
or reporting agentdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) complete annual vulnerable adult training.
new text end

Sec. 55.

Minnesota Statutes 2020, section 256B.051, subdivision 7, is amended to read:


Subd. 7.

Housing support supplemental service rates.

Supplemental service rates for
individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph
(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year
period. This reduction only applies to supplemental service rates for individuals eligible for
housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services under this section.

Sec. 56.

Minnesota Statutes 2020, section 256B.051, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Home and community-based service documentation requirements. new text end

new text begin (a)
Documentation may be collected and maintained electronically or in paper form by providers
and must be produced upon request by the commissioner.
new text end

new text begin (b) Documentation of a delivered service must be in English and must be legible according
to the standard of a reasonable person.
new text end

new text begin (c) If the service is reimbursed at an hourly or specified minute-based rate, each
documentation of the provision of a service, unless otherwise specified, must include:
new text end

new text begin (1) the date the documentation occurred;
new text end

new text begin (2) the day, month, and year 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 person-centered
planning services described under subdivision 5, paragraph (d);
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

Sec. 57.

Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:


Subd. 6.

Service standards.

The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.

(a) The treatment team must use team treatment, not an individual treatment model.

(b) Services must be available at times that meet client needs.

(c) Services must be age-appropriate and meet the specific needs of the client.

(d) The initial functional assessment must be completed within ten days of intake and
updated at least every six months or prior to discharge from the service, whichever comes
first.

(e) new text beginThe treatment team must completenew text end an individual treatment plan new text beginfor each client and
the individual treatment plan
new text end must:

(1) be based on the information in the client's diagnostic assessment and baselines;

(2) identify goals and objectives of treatment, a treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment services and supports;

(3) be developed after completion of the client's diagnostic assessment by a mental health
professional or clinical trainee and before the provision of children's therapeutic services
and supports;

(4) be developed through a child-centered, family-driven, culturally appropriate planning
process, including allowing parents and guardians to observe or participate in individual
and family treatment services, assessments, and treatment planning;

(5) be reviewed at least once every six months and revised to document treatment progress
on each treatment objective and next goals or, if progress is not documented, to document
changes in treatment;

(6) be signed by the clinical supervisor and by the client or by the client's parent or other
person authorized by statute to consent to mental health services for the client. A client's
parent may approve the client's individual treatment plan by secure electronic signature or
by documented oral approval that is later verified by written signature;

(7) be completed in consultation with the client's current therapist and key providers and
provide for ongoing consultation with the client's current therapist to ensure therapeutic
continuity and to facilitate the client's return to the community. For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan;

(8) if a need for substance use disorder treatment is indicated by validated assessment:

(i) identify goals, objectives, and strategies of substance use disorder treatment; develop
a schedule for accomplishing treatment goals and objectives; and identify the individuals
responsible for providing treatment services and supports;

(ii) be reviewed at least once every 90 days and revised, if necessary;

(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by
the client's parent or other person authorized by statute to consent to mental health treatment
and substance use disorder treatment for the client; and

(10) provide for the client's transition out of intensive nonresidential rehabilitative mental
health services by defining the team's actions to assist the client and subsequent providers
in the transition to less intensive or "stepped down" services.

(f) The treatment team shall actively and assertively engage the client's family members
and significant others by establishing communication and collaboration with the family and
significant others and educating the family and significant others about the client's mental
illness, symptom management, and the family's role in treatment, unless the team knows or
has reason to suspect that the client has suffered or faces a threat of suffering any physical
or mental injury, abuse, or neglect from a family member or significant other.

(g) For a client age 18 or older, the treatment team may disclose to a family member,
other relative, or a close personal friend of the client, or other person identified by the client,
the protected health information directly relevant to such person's involvement with the
client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
client is present, the treatment team shall obtain the client's agreement, provide the client
with an opportunity to object, or reasonably infer from the circumstances, based on the
exercise of professional judgment, that the client does not object. If the client is not present
or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
team may, in the exercise of professional judgment, determine whether the disclosure is in
the best interests of the client and, if so, disclose only the protected health information that
is directly relevant to the family member's, relative's, friend's, or client-identified person's
involvement with the client's health care. The client may orally agree or object to the
disclosure and may prohibit or restrict disclosure to specific individuals.

(h) The treatment team shall provide interventions to promote positive interpersonal
relationships.

Sec. 58.

Minnesota Statutes 2020, section 256B.4912, subdivision 13, is amended to read:


Subd. 13.

Waiver transportation documentation and billing requirements.

(a) A
waiver transportation service must be a waiver transportation service that: (1) is not covered
by medical transportation under the Medicaid state plan; and (2) is not included as a
component of another waiver service.

(b) In addition to the documentation requirements in subdivision 12, a waiver
transportation service provider must maintain:

(1) odometer and other records pursuant to section 256B.0625, subdivision 17b, paragraph
(b), clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver
for a waiver transportation service that is billed directly by the mile. A common carrier as
defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or a publicly operated transit
system provider are exempt from this clause; and

(2) documentation demonstrating that a vehicle and a driver meet the deleted text beginstandards determined
by the Department of Human Services on vehicle and driver qualifications in section
256B.0625, subdivision 17, paragraph (c)
deleted text endnew text begin transportation waiver service provider standards
and qualifications according to the federally approved waiver plan
new text end.

Sec. 59.

Minnesota Statutes 2020, section 256B.69, subdivision 5a, is amended to read:


Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.

(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.

(d) The commissioner shall require that managed care plans use the assessment and
authorization processes, forms, timelines, standards, documentation, and data reporting
requirements, protocols, billing processes, and policies consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all personal
care assistance services under section 256B.0659new text begin and community first services and supports
under section 256B.85
new text end.

(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
the health plan's utilization in 2009. To earn the return of the withhold each subsequent
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
in subdivisions 23 and 28, compared to the previous measurement year until the final
performance target is reached. When measuring performance, the commissioner must
consider the difference in health risk in a managed care or county-based purchasing plan's
membership in the baseline year compared to the measurement year, and work with the
managed care or county-based purchasing plan to account for differences that they agree
are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program enrollees
is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
health plans in meeting this performance target and shall accept payment withholds that
may be returned to the hospitals if the performance target is achieved.

(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. To earn the return of the withhold each year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than five percent of the plan's hospital admission rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, compared to the previous calendar year until the final performance target is reached.
When measuring performance, the commissioner must consider the difference in health risk
in a managed care or county-based purchasing plan's membership in the baseline year
compared to the measurement year, and work with the managed care or county-based
purchasing plan to account for differences that they agree are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
rate was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in calendar
year 2011, as determined by the commissioner. The hospital admissions in this performance
target do not include the admissions applicable to the subsequent hospital admission
performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
this performance target and shall accept payment withholds that may be returned to the
hospitals if the performance target is achieved.

(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each year,
the managed care plan or county-based purchasing plan must achieve a qualifying reduction
of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
percent compared to the previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts commensurate
with achieved reductions in utilization less than the targeted amount.

The withhold described in this paragraph must continue for each consecutive contract
period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
2011. Hospitals shall cooperate with the plans in meeting this performance target and shall
accept payment withholds that must be returned to the hospitals if the performance target
is achieved.

(h) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.

(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
include as admitted assets under section 62D.044 any amount withheld under this section
that is reasonably expected to be returned.

(k) Contracts between the commissioner and a prepaid health plan are exempt from the
set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
7.

(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).

(m) Managed care plans and county-based purchasing plans shall maintain current and
fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.

Sec. 60.

Minnesota Statutes 2020, section 256B.85, subdivision 1, is amended to read:


Subdivision 1.

Basis and scope.

(a) Upon federal approval, the commissioner shall
establish a state plan option for the provision of home and community-based personal
assistance service and supports called "community first services and supports (CFSS)."

(b) CFSS is a participant-controlled method of selecting and providing services and
supports that allows the participant maximum control of the services and supports.
Participants may choose the degree to which they direct and manage their supports by
choosing to have a significant and meaningful role in the management of services and
supports including by directly employing support workers with the necessary supports to
perform that function.

(c) CFSS is available statewide to eligible people to assist with accomplishing activities
of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related
procedures and tasks through hands-on assistance to accomplish the task or constant
supervision and cueing to accomplish the task; and to assist with acquiring, maintaining,
and enhancing the skills necessary to accomplish ADLs, IADLs, and health-related
procedures and tasks. CFSS allows payment for new text beginthe participant for new text endcertain supports and
goods such as environmental modifications and technology that are intended to replace or
decrease the need for human assistance.

(d) Upon federal approval, CFSS will replace the personal care assistance program under
sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.

new text begin (e) For the purposes of this section, notwithstanding the provisions of section 144A.43,
subdivision 3, supports purchased under CFSS are not considered home care services.
new text end

Sec. 61.

Minnesota Statutes 2020, section 256B.85, subdivision 2, is amended to read:


Subd. 2.

Definitions.

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

(b) "Activities of daily living" or "ADLs" means deleted text begineating, toileting, grooming, dressing,
bathing, mobility, positioning, and transferring.
deleted text endnew text begin:
new text end

new text begin (1) dressing, including assistance with choosing, applying, and changing clothing and
applying special appliances, wraps, or clothing;
new text end

new text begin (2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
care, except for recipients who are diabetic or have poor circulation;
new text end

new text begin (3) bathing, including assistance with basic personal hygiene and skin care;
new text end

new text begin (4) eating, including assistance with hand washing and applying orthotics required for
eating, transfers, or feeding;
new text end

new text begin (5) transfers, including assistance with transferring the participant from one seating or
reclining area to another;
new text end

new text begin (6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a participant;
new text end

new text begin (7) positioning, including assistance with positioning or turning a participant for necessary
care and comfort; and
new text end

new text begin (8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.
new text end

(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.

(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.

(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.

(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, new text beginadvanced practice registered nurse, or physician's assistant
new text end and is specified in a community support plan, including:

(1) tube feedings requiring:

(i) a gastrojejunostomy tube; or

(ii) continuous tube feeding lasting longer than 12 hours per day;

(2) wounds described as:

(i) stage III or stage IV;

(ii) multiple wounds;

(iii) requiring sterile or clean dressing changes or a wound vac; or

(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;

(3) parenteral therapy described as:

(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or

(ii) total parenteral nutrition (TPN) daily;

(4) respiratory interventions, including:

(i) oxygen required more than eight hours per day;

(ii) respiratory vest more than one time per day;

(iii) bronchial drainage treatments more than two times per day;

(iv) sterile or clean suctioning more than six times per day;

(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and

(vi) ventilator dependence under section 256B.0651;

(5) insertion and maintenance of catheter, including:

(i) sterile catheter changes more than one time per month;

(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or

(iii) bladder irrigations;

(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;

(7) neurological intervention, including:

(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or

(ii) swallowing disorders diagnosed by a physiciannew text begin, advanced practice registered nurse,
or physician's assistant
new text end and requiring specialized assistance from another on a daily basis;
and

(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.

(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.

(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the coordinated service
and support plan identified in deleted text beginsectiondeleted text endnew text begin sections 256B.092, subdivision 1b, andnew text end 256S.10.

(i) "Consultation services" means a Minnesota health care program enrolled provider
organization that provides assistance to the participant in making informed choices about
CFSS services in general and self-directed tasks in particular, and in developing a
person-centered CFSS service delivery plan to achieve quality service outcomes.

(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.

(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
deleted text begin maydeleted text endnew text begin mustnew text end not be found to be dependent in an activity of daily living if, because of the child's
age, an adult would either perform the activity for the child or assist the child with the
activity and the assistance needed is the assistance appropriate for a typical child of the
same age.

(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under chapter 256S and sections 256B.092,
subdivision 5
, and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants.new text begin Extended CFSS excludes the purchase of goods.
new text end

(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).

(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.

(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community.

(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(e).

(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.

(r) "Level I behavior" means physical aggression deleted text begintowardsdeleted text endnew text begin towardnew text end self or others or
destruction of property that requires the immediate response of another person.

(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker deleted text beginmaydeleted text endnew text begin mustnew text end not determine
medication dose or time for medication or inject medications into veins, muscles, or skin:

(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;

(2) organizing medications as directed by the participant or the participant's representative;
and

(3) providing verbal or visual reminders to perform regularly scheduled medications.

(t) "Participant" means a person who is eligible for CFSS.

(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. deleted text beginThis authorization must be in
writing or by another method that clearly indicates the participant's free choice and may be
withdrawn at any time. The participant's representative must have no financial interest in
the provision of any services included in the participant's CFSS service delivery plan and
must be capable of providing the support necessary to assist the participant in the use of
CFSS. If through the assessment process described in subdivision 5 a participant is
determined to be in need of a participant's representative, one must be selected.
deleted text end If the
participant is unable to assist in the selection of a participant's representative, the legal
representative shall appoint one. deleted text beginTwo persons may be designated as a participant's
representative for reasons such as divided households and court-ordered custodies. Duties
of a participant's representatives may include:
deleted text end

deleted text begin (1) being available while services are provided in a method agreed upon by the participant
or the participant's legal representative and documented in the participant's CFSS service
delivery plan;
deleted text end

deleted text begin (2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is
being followed; and
deleted text end

deleted text begin (3) reviewing and signing CFSS time sheets after services are provided to provide
verification of the CFSS services.
deleted text end

(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.

(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.

(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into deleted text beginandeleted text endnew text begin a writtennew text end agreement to
receive services at the same time deleted text beginanddeleted text endnew text begin,new text end in the same setting deleted text beginbydeleted text endnew text begin, and throughnew text end the same deleted text beginemployerdeleted text endnew text begin
agency-provider or FMS provider
new text end.

(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.

(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.

(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.

(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
mileage reimbursement, health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.

(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.

Sec. 62.

Minnesota Statutes 2020, section 256B.85, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

(a) CFSS is available to a person who deleted text beginmeets one of the followingdeleted text end:

deleted text begin (1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056,
or 256B.057, subdivisions 5 and 9;
deleted text end

new text begin (1) is determined eligible for medical assistance under this chapter, excluding those
under section 256B.057, subdivisions 3, 3a, 3b, and 4;
new text end

(2) is a participant in the alternative care program under section 256B.0913;

(3) is a waiver participant as defined under chapter 256S or section 256B.092, 256B.093,
or 256B.49; or

(4) has medical services identified in a person's individualized education program and
is eligible for services as determined in section 256B.0625, subdivision 26.

(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
meet all of the following:

(1) require assistance and be determined dependent in one activity of daily living or
Level I behavior based on assessment under section 256B.0911; and

(2) is not a participant under a family support grant under section 252.32.

(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision
6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible
for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as
determined under section 256B.0911.

Sec. 63.

Minnesota Statutes 2020, section 256B.85, subdivision 4, is amended to read:


Subd. 4.

Eligibility for other services.

Selection of CFSS by a participant must not
restrict access to other medically necessary care and services furnished under the state plan
benefit or other services available through new text beginthe new text endalternative carenew text begin programnew text end.

Sec. 64.

Minnesota Statutes 2020, section 256B.85, subdivision 5, is amended to read:


Subd. 5.

Assessment requirements.

(a) The assessment of functional need must:

(1) be conducted by a certified assessor according to the criteria established in section
256B.0911, subdivision 3a;

(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
a significant change in the participant's condition or a change in the need for services and
supports, or at the request of the participant when the participant experiences a change in
condition or needs a change in the services or supports; and

(3) be completed using the format established by the commissioner.

(b) The results of the assessment and any recommendations and authorizations for CFSS
must be determined and communicated in writing by the lead agency's deleted text begincertifieddeleted text end assessor as
defined in section 256B.0911 to the participant deleted text beginand the agency-provider or FMS provider
chosen by the participant
deleted text endnew text begin or the participant's representative and chosen CFSS providersnew text end
within deleted text begin40 calendardeleted text end new text beginten business new text enddays and must include the participant's right to appeal new text beginthe
assessment
new text endunder section 256.045, subdivision 3.

(c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. new text beginThe lead agency assessor may authorize
a temporary authorization for CFSS services to be provided under the agency-provider
model without using the assessment process described in this subdivision.
new text endAuthorization
for a temporary level of CFSS services under the agency-provider model is limited to the
time specified by the commissioner, but shall not exceed 45 days. The level of services
authorized under this paragraph shall have no bearing on a future authorization. deleted text beginParticipants
approved for a temporary authorization shall access the consultation service
deleted text endnew text begin For CFSS
services needed beyond the 45-day temporary authorization, the lead agency must conduct
an assessment as described in this subdivision and participants must use consultation services
new text end
to complete their orientation and selection of a service model.

Sec. 65.

Minnesota Statutes 2020, section 256B.85, subdivision 6, is amended to read:


Subd. 6.

Community first services and supports service delivery plan.

(a) The CFSS
service delivery plan must be developed and evaluated through a person-centered planning
process by the participant, or the participant's representative or legal representative who
may be assisted by a consultation services provider. The CFSS service delivery plan must
reflect the services and supports that are important to the participant and for the participant
to meet the needs assessed by the certified assessor and identified in the coordinated service
and support plan identified in deleted text beginsectiondeleted text endnew text begin sections 256B.092, subdivision 1b, andnew text end 256S.10. The
CFSS service delivery plan must be reviewed by the participant, the consultation services
provider, and the agency-provider or FMS provider prior to starting services and at least
annually upon reassessment, or when there is a significant change in the participant's
condition, or a change in the need for services and supports.

(b) The commissioner shall establish the format and criteria for the CFSS service delivery
plan.

(c) The CFSS service delivery plan must be person-centered and:

(1) specify the consultation services provider, agency-provider, or FMS provider selected
by the participant;

(2) reflect the setting in which the participant resides that is chosen by the participant;

(3) reflect the participant's strengths and preferences;

(4) include the methods and supports used to address the needs as identified through an
assessment of functional needs;

(5) include the participant's identified goals and desired outcomes;

(6) reflect the services and supports, paid and unpaid, that will assist the participant to
achieve identified goals, including the costs of the services and supports, and the providers
of those services and supports, including natural supports;

(7) identify the amount and frequency of face-to-face supports and amount and frequency
of remote supports and technology that will be used;

(8) identify risk factors and measures in place to minimize them, including individualized
backup plans;

(9) be understandable to the participant and the individuals providing support;

(10) identify the individual or entity responsible for monitoring the plan;

(11) be finalized and agreed to in writing by the participant and signed by deleted text beginalldeleted text end individuals
and providers responsible for its implementation;

(12) be distributed to the participant and other people involved in the plan;

(13) prevent the provision of unnecessary or inappropriate care;

(14) include a detailed budget for expenditures for budget model participants or
participants under the agency-provider model if purchasing goods; and

(15) include a plan for worker training and development provided according to
subdivision 18a detailing what service components will be used, when the service components
will be used, how they will be provided, and how these service components relate to the
participant's individual needs and CFSS support worker services.

(d) new text beginThe CFSS service delivery plan must describe the units or dollar amount available
to the participant.
new text endThe total units of agency-provider services or the service budget amount
for the budget model include both annual totals and a monthly average amount that cover
the number of months of the service agreement. The amount used each month may vary,
but additional funds must not be provided above the annual service authorization amount,
determined according to subdivision 8, unless a change in condition is assessed and
authorized by the certified assessor and documented in the coordinated service and support
plan and CFSS service delivery plan.

(e) In assisting with the development or modification of the CFSS service delivery plan
during the authorization time period, the consultation services provider shall:

(1) consult with the FMS provider on the spending budget when applicable; and

(2) consult with the participant or participant's representative, agency-provider, and case
managerdeleted text begin/deleted text endnew text begin or new text endcare coordinator.

(f) The CFSS service delivery plan must be approved by the consultation services provider
for participants without a case manager or care coordinator who is responsible for authorizing
services. A case manager or care coordinator must approve the plan for a waiver or alternative
care program participant.

Sec. 66.

Minnesota Statutes 2020, section 256B.85, subdivision 7, is amended to read:


Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;

(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;

(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:

(i) relate to a need identified in a participant's CFSS service delivery plan; and

(ii) increase independence or substitute for human assistancenew text begin,new text end to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;

(4) observation and redirection for behavior or symptoms where there is a need for
assistance;

(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;

(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;

(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. These support
workers shall notnew text begin:
new text end

new text begin (i)new text end provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and

new text begin (ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
new text end

(9) worker training and development services as described in subdivision 18a.

Sec. 67.

Minnesota Statutes 2020, section 256B.85, subdivision 8, is amended to read:


Subd. 8.

Determination of CFSS service authorization amount.

(a) All community
first services and supports must be authorized by the commissioner or the commissioner's
designee before services begin. The authorization for CFSS must be completed as soon as
possible following an assessment but no later than 40 calendar days from the date of the
assessment.

(b) The amount of CFSS authorized must be based on the participant's home care rating
described in paragraphs (d) and (e) and any additional service units for which the participant
qualifies as described in paragraph (f).

(c) The home care rating shall be determined by the commissioner or the commissioner's
designee based on information submitted to the commissioner identifying the following for
a participant:

(1) the total number of dependencies of activities of daily living;

(2) the presence of complex health-related needs; and

(3) the presence of Level I behavior.

(d) The methodology to determine the total service units for CFSS for each home care
rating is based on the median paid units per day for each home care rating from fiscal year
2007 data for the PCA program.

(e) Each home care rating is designated by the letters P through Z and EN and has the
following base number of service units assigned:

(1) P home care rating requires Level I behavior or one to three dependencies in ADLs
and qualifies the person for five service units;

(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs
and qualifies the person for six service units;

(3) R home care rating requires a complex health-related need and one to three
dependencies in ADLs and qualifies the person for seven service units;

(4) S home care rating requires four to six dependencies in ADLs and qualifies the person
for ten service units;

(5) T home care rating requires four to six dependencies in ADLs and Level I behavior
and qualifies the person for 11 service units;

(6) U home care rating requires four to six dependencies in ADLs and a complex
health-related need and qualifies the person for 14 service units;

(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the
person for 17 service units;

(8) W home care rating requires seven to eight dependencies in ADLs and Level I
behavior and qualifies the person for 20 service units;

(9) Z home care rating requires seven to eight dependencies in ADLs and a complex
health-related need and qualifies the person for 30 service units; and

(10) EN home care rating includes ventilator dependency as defined in section 256B.0651,
subdivision 1
, paragraph (g). A person who meets the definition of ventilator-dependent
and the EN home care rating and utilize a combination of CFSS and home care nursing
services is limited to a total of 96 service units per day for those services in combination.
Additional units may be authorized when a person's assessment indicates a need for two
staff to perform activities. Additional time is limited to 16 service units per day.

(f) Additional service units are provided through the assessment and identification of
the following:

(1) 30 additional minutes per day for a dependency in each critical activity of daily
living;

(2) 30 additional minutes per day for each complex health-related need; and

(3) 30 additional minutes per day deleted text beginwhen thedeleted text endnew text begin for eachnew text end behavior new text beginunder this clause that
new text end requires assistance at least four times per week deleted text beginfor one or more of the following behaviorsdeleted text end:

(i) level I behaviornew text begin that requires the immediate response of another personnew text end;

(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
or

(iii) increased need for assistance for participants who are verbally aggressive or resistive
to care so that the time needed to perform activities of daily living is increased.

(g) The service budget for budget model participants shall be based on:

(1) assessed units as determined by the home care rating; and

(2) an adjustment needed for administrative expenses.

Sec. 68.

Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:


new text begin Subd. 8a. new text end

new text begin Authorization; exceptions. new text end

new text begin All CFSS services must be authorized by the
commissioner or the commissioner's designee as described in subdivision 8 except when:
new text end

new text begin (1) the lead agency temporarily authorizes services in the agency-provider model as
described in subdivision 5, paragraph (c);
new text end

new text begin (2) CFSS services in the agency-provider model were required to treat an emergency
medical condition that if not immediately treated could cause a participant serious physical
or mental disability, continuation of severe pain, or death. The CFSS agency provider must
request retroactive authorization from the lead agency no later than five working days after
providing the initial emergency service. The CFSS agency provider must be able to
substantiate the emergency through documentation such as reports, notes, and admission
or discharge histories. A lead agency must follow the authorization process in subdivision
5 after the lead agency receives the request for authorization from the agency provider;
new text end

new text begin (3) the lead agency authorizes a temporary increase to the amount of services authorized
in the agency or budget model to accommodate the participant's temporary higher need for
services. Authorization for a temporary level of CFSS services is limited to the time specified
by the commissioner, but shall not exceed 45 days. The level of services authorized under
this clause shall have no bearing on a future authorization;
new text end

new text begin (4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated,
and an authorization for CFSS services is completed based on the date of a current
assessment, eligibility, and request for authorization;
new text end

new text begin (5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization
requests must be submitted by the provider within 20 working days of the notice of denial
or adjustment. A copy of the notice must be included with the request;
new text end

new text begin (6) the commissioner has determined that a lead agency or state human services agency
has made an error; or
new text end

new text begin (7) a participant enrolled in managed care experiences a temporary disenrollment from
a health plan, in which case the commissioner shall accept the current health plan
authorization for CFSS services for up to 60 days. The request must be received within the
first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after
the 60 days and before 90 days, the provider shall request an additional 30-day extension
of the current health plan authorization, for a total limit of 90 days from the time of
disenrollment.
new text end

Sec. 69.

Minnesota Statutes 2020, section 256B.85, subdivision 9, is amended to read:


Subd. 9.

Noncovered services.

(a) Services or supports that are not eligible for payment
under this section include those that:

(1) are not authorized by the certified assessor or included in the CFSS service delivery
plan;

(2) are provided prior to the authorization of services and the approval of the CFSS
service delivery plan;

(3) are duplicative of other paid services in the CFSS service delivery plan;

(4) supplant natural unpaid supports that appropriately meet a need in the CFSS service
delivery plan, are provided voluntarily to the participant, and are selected by the participant
in lieu of other services and supports;

(5) are not effective means to meet the participant's needs; and

(6) are available through other funding sources, includingdeleted text begin,deleted text end but not limited todeleted text begin,deleted text end funding
through title IV-E of the Social Security Act.

(b) Additional services, goods, or supports that are not covered include:

(1) those that are not for the direct benefit of the participant, except that services for
caregivers such as training to improve the ability to provide CFSS are considered to directly
benefit the participant if chosen by the participant and approved in the support plan;

(2) any fees incurred by the participant, such as Minnesota health care programs fees
and co-pays, legal fees, or costs related to advocate agencies;

(3) insurance, except for insurance costs related to employee coverage;

(4) room and board costs for the participant;

(5) services, supports, or goods that are not related to the assessed needs;

(6) special education and related services provided under the Individuals with Disabilities
Education Act and vocational rehabilitation services provided under the Rehabilitation Act
of 1973;

(7) assistive technology devices and assistive technology services other than those for
back-up systems or mechanisms to ensure continuity of service and supports listed in
subdivision 7;

(8) medical supplies and equipment covered under medical assistance;

(9) environmental modifications, except as specified in subdivision 7;

(10) expenses for travel, lodging, or meals related to training the participant or the
participant's representative or legal representative;

(11) experimental treatments;

(12) any service or good covered by other state plan services, including prescription and
over-the-counter medications, compounds, and solutions and related fees, including premiums
and co-payments;

(13) membership dues or costs, except when the service is necessary and appropriate to
treat a health condition or to improve or maintain the new text beginadult new text endparticipant's health condition.
The condition must be identified in the participant's CFSS service delivery plan and
monitored by a Minnesota health care program enrolled physiciannew text begin, advanced practice
registered nurse, or physician's assistant
new text end;

(14) vacation expenses other than the cost of direct services;

(15) vehicle maintenance or modifications not related to the disability, health condition,
or physical need;

(16) tickets and related costs to attend sporting or other recreational or entertainment
events;

(17) services provided and billed by a provider who is not an enrolled CFSS provider;

(18) CFSS provided by a participant's representative or paid legal guardian;

(19) services that are used solely as a child care or babysitting service;

(20) services that are the responsibility or in the daily rate of a residential or program
license holder under the terms of a service agreement and administrative rules;

(21) sterile procedures;

(22) giving of injections into veins, muscles, or skin;

(23) homemaker services that are not an integral part of the assessed CFSS service;

(24) home maintenance or chore services;

(25) home care services, including hospice services if elected by the participant, covered
by Medicare or any other insurance held by the participant;

(26) services to other members of the participant's household;

(27) services not specified as covered under medical assistance as CFSS;

(28) application of restraints or implementation of deprivation procedures;

(29) assessments by CFSS provider organizations or by independently enrolled registered
nurses;

(30) services provided in lieu of legally required staffing in a residential or child care
setting; deleted text beginand
deleted text end

(31) services provided by deleted text beginthe residential or programdeleted text endnew text begin a foster carenew text end license holder deleted text beginin a
residence for more than four participants.
deleted text endnew text begin except when the home of the person receiving
services is the licensed foster care provider's primary residence;
new text end

new text begin (32) services that are the responsibility of the foster care provider under the terms of the
foster care placement agreement, assessment under sections 256N.24 and 260C.4411, and
administrative rules under sections 256N.24 and 260C.4411;
new text end

new text begin (33) services in a setting that has a licensed capacity greater than 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 (34) services from a provider who owns or otherwise controls the living arrangement,
except when the provider of services is related by blood, marriage, or adoption or when the
provider is a licensed foster care provider who is not prohibited from providing services
under clauses (31) to (33);
new text end

new text begin (35) instrumental activities of daily living for children younger than 18 years of age,
except when immediate attention is needed for health or hygiene reasons integral to an
assessed need for assistance with activities of daily living, health-related procedures, and
tasks or behaviors; or
new text end

new text begin (36) services provided to a resident of a nursing facility, hospital, intermediate care
facility, or health care facility licensed by the commissioner of health.
new text end

Sec. 70.

Minnesota Statutes 2020, section 256B.85, subdivision 10, is amended to read:


Subd. 10.

Agency-provider and FMS provider qualifications and duties.

(a)
Agency-providers identified in subdivision 11 and FMS providers identified in subdivision
13a shall:

(1) enroll as a medical assistance Minnesota health care programs provider and meet all
applicable provider standards and requirementsnew text begin including completion of required provider
training as determined by the commissioner
new text end;

(2) demonstrate compliance with federal and state laws and policies for CFSS as
determined by the commissioner;

(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results;

(4) verify and maintain records of all services and expenditures by the participant,
including hours worked by support workers;

(5) not engage in any agency-initiated direct contact or marketing in person, by telephone,
or other electronic means to potential participants, guardians, family members, or participants'
representatives;

(6) directly provide services and not use a subcontractor or reporting agent;

(7) meet the financial requirements established by the commissioner for financial
solvency;

(8) have never had a lead agency contract or provider agreement discontinued due to
fraud, or have never had an owner, board member, or manager fail a state or FBI-based
criminal background check while enrolled or seeking enrollment as a Minnesota health care
programs provider; and

(9) have an office located in Minnesota.

(b) In conducting general duties, agency-providers and FMS providers shall:

(1) pay support workers based upon actual hours of services provided;

(2) pay for worker training and development services based upon actual hours of services
provided or the unit cost of the training session purchased;

(3) withhold and pay all applicable federal and state payroll taxes;

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

(5) enter into a written agreement with the participant, participant's representative, or
legal representative that assigns roles and responsibilities to be performed before services,
supports, or goods are providednew text begin and that meets the requirements of subdivisions 20a, 20b,
and 20c for agency-providers
new text end;

(6) report maltreatment as required under section 626.557 and chapter 260E;

(7) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a;

(8) comply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13; deleted text beginand
deleted text end

(9) maintain documentation for the requirements under subdivision 16, paragraph (e),
clause (2), to qualify for an enhanced rate under this sectiondeleted text begin.deleted text endnew text begin; and
new text end

new text begin (10) request reassessments 60 days before the end of the current authorization for CFSS
on forms provided by the commissioner.
new text end

Sec. 71.

Minnesota Statutes 2020, section 256B.85, subdivision 11, is amended to read:


Subd. 11.

Agency-provider model.

(a) The agency-provider model includes services
provided by support workers and staff providing worker training and development services
who are employed by an agency-provider that meets the criteria established by the
commissioner, including required training.

(b) The agency-provider shall allow the participant to have a significant role in the
selection and dismissal of the support workers for the delivery of the services and supports
specified in the participant's CFSS service delivery plan.new text begin The agency must make a reasonable
effort to fulfill the participant's request for the participant's preferred worker.
new text end

(c) A participant may use authorized units of CFSS services as needed within a service
agreement that is not greater than 12 months. Using authorized units in a flexible manner
in either the agency-provider model or the budget model does not increase the total amount
of services and supports authorized for a participant or included in the participant's CFSS
service delivery plan.

(d) A participant may share CFSS services. Two or three CFSS participants may share
services at the same time provided by the same support worker.

(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated
by the medical assistance payment for CFSS for support worker wages and benefits, except
all of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The agency-provider must document how this requirement is being met. The
revenue generated by the worker training and development services and the reasonable costs
associated with the worker training and development services must not be used in making
this calculation.

(f) The agency-provider model must be used by deleted text beginindividualsdeleted text endnew text begin participantsnew text end who are restricted
by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to
9505.2245.

(g) Participants purchasing goods under this model, along with support worker services,
must:

(1) specify the goods in the CFSS service delivery plan and detailed budget for
expenditures that must be approved by the consultation services provider, case manager, or
care coordinator; and

(2) use the FMS provider for the billing and payment of such goods.

Sec. 72.

Minnesota Statutes 2020, section 256B.85, subdivision 11b, is amended to read:


Subd. 11b.

Agency-provider model; support worker competency.

(a) The
agency-provider must ensure that support workers are competent to meet the participant's
assessed needs, goals, and additional requirements as written in the CFSS service delivery
plan. deleted text beginWithin 30 days of any support worker beginning to provide services for a participant,deleted text end
The agency-provider must evaluate the competency of the worker through direct observation
of the support worker's performance of the job functions in a setting where the participant
is using CFSSdeleted text begin.deleted text endnew text begin within 30 days of:
new text end

new text begin (1) any support worker beginning to provide services for a participant; or
new text end

new text begin (2) any support worker beginning to provide shared services.
new text end

(b) The agency-provider must verify and maintain evidence of support worker
competency, including documentation of the support worker's:

(1) education and experience relevant to the job responsibilities assigned to the support
worker and the needs of the participant;

(2) relevant training received from sources other than the agency-provider;

(3) orientation and instruction to implement services and supports to participant needs
and preferences as identified in the CFSS service delivery plan; deleted text beginand
deleted text end

new text begin (4) orientation and instruction delivered by an individual competent to perform, teach,
or assign the health-related tasks for tracheostomy suctioning and services to participants
on ventilator support, including equipment operation and maintenance; and
new text end

deleted text begin (4)deleted text endnew text begin (5)new text end periodic performance reviews completed by the agency-provider at least annually,
including any evaluations required under subdivision 11a, paragraph (a). If a support worker
is a minor, all evaluations of worker competency must be completed in person and in a
setting where the participant is using CFSS.

(c) The agency-provider must develop a worker training and development plan with the
participant to ensure support worker competency. The worker training and development
plan must be updated when:

(1) the support worker begins providing services;

new text begin (2) the support worker begins providing shared services;
new text end

deleted text begin (2)deleted text endnew text begin (3)new text end there is any change in condition or a modification to the CFSS service delivery
plan; or

deleted text begin (3)deleted text endnew text begin (4)new text end a performance review indicates that additional training is needed.

Sec. 73.

Minnesota Statutes 2020, section 256B.85, subdivision 12, is amended to read:


Subd. 12.

Requirements for enrollment of CFSS agency-providers.

(a) All CFSS
agency-providers must provide, at the time of enrollment, reenrollment, and revalidation
as a CFSS agency-provider in a format determined by the commissioner, information and
documentation that includesdeleted text begin,deleted text end but is not limited todeleted text begin,deleted text end the following:

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

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

(3) proof of fidelity bond coverage in the amount of $20,000new text begin per provider locationnew text end;

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

(6) a deleted text begindescriptiondeleted text endnew text begin copynew text end of the CFSS agency-provider's deleted text beginorganizationdeleted text endnew text begin organizational chartnew text end
identifying the names new text beginand roles new text endof all owners, managing employees, staff, board of directors,
and deleted text beginthedeleted text endnew text begin additional documentation reporting anynew text end affiliations of the directors and owners to
other service providers;

(7) deleted text begina copy ofdeleted text endnew text begin proof thatnew text end the CFSS deleted text beginagency-provider'sdeleted text endnew text begin agency-provider hasnew text end written policies
and procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety, including the process for notification and resolution of
participant grievances, incident response, identification and prevention of communicable
diseases, and employee misconduct;

(8) deleted text begincopies of all other formsdeleted text endnew text begin proof thatnew text end the CFSS agency-provider deleted text beginuses in the course of
daily business including, but not limited to
deleted text endnew text begin has all of the following forms and documentsnew text end:

(i) a copy of the CFSS agency-provider's time sheet; and

(ii) a copy of the participant's individual CFSS service delivery plan;

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

(10) documentation that the CFSS agency-provider and staff have successfully completed
all the training required by this section;

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

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

(13) documentation that the agency-provider will use at least the following percentages
of revenue generated from the medical assistance rate paid for CFSS services for CFSS
support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except
100 percent of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The revenue generated by the worker training and development services and the
reasonable costs associated with the worker training and development services shall not be
used in making this calculation; and

(14) documentation that the agency-provider does not burden participants' free exercise
of their right to choose service providers by requiring CFSS support workers to sign an
agreement not to work with any particular CFSS participant or for another CFSS
agency-provider after leaving the agency and that the agency is not taking action on any
such agreements or requirements regardless of the date signed.

(b) CFSS agency-providers shall provide to the commissioner the information specified
in paragraph (a).

(c) All CFSS agency-providers shall require all employees in management and
supervisory positions and owners of the agency who are active in the day-to-day management
and operations of the agency to complete mandatory training as determined by the
commissioner. Employees in management and supervisory positions and owners who are
active in the day-to-day operations of an agency who have completed the required training
as an employee with a CFSS agency-provider do not need to repeat the required training if
they are hired by another agencydeleted text begin, ifdeleted text endnew text begin andnew text end they have completed the training within the past
three years. CFSS agency-provider billing staff shall complete training about CFSS program
financial management. Any new owners or employees in management and supervisory
positions involved in the day-to-day operations are required to complete mandatory training
as a requisite of working for the agency.

deleted text begin (d) The commissioner shall send annual review notifications to agency-providers 30
days prior to renewal. The notification must:
deleted text end

deleted text begin (1) list the materials and information the agency-provider is required to submit;
deleted text end

deleted text begin (2) provide instructions on submitting information to the commissioner; and
deleted text end

deleted text begin (3) provide a due date by which the commissioner must receive the requested information.
deleted text end

deleted text begin Agency-providers shall submit all required documentation for annual review within 30 days
of notification from the commissioner. If an agency-provider fails to submit all the required
documentation, the commissioner may take action under subdivision 23a.
deleted text end

new text begin (d) Agency-providers shall submit all required documentation in this section within 30
days of notification from the commissioner. If an agency-provider fails to submit all the
required documentation, the commissioner may take action under subdivision 23a.
new text end

Sec. 74.

Minnesota Statutes 2020, section 256B.85, subdivision 12b, is amended to read:


Subd. 12b.

CFSS agency-provider requirements; notice regarding termination of
services.

(a) An agency-provider must provide written notice when it intends to terminate
services with a participant at least deleted text begintendeleted text endnew text begin 30new text end calendar days before the proposed service
termination is to become effective, except in cases where:

(1) the participant engages in conduct that significantly alters the terms of the CFSS
service delivery plan with the agency-provider;

(2) the participant or other persons at the setting where services are being provided
engage in conduct that creates an imminent risk of harm to the support worker or other
agency-provider staff; or

(3) an emergency or a significant change in the participant's condition occurs within a
24-hour period that results in the participant's service needs exceeding the participant's
identified needs in the current CFSS service delivery plan so that the agency-provider cannot
safely meet the participant's needs.

(b) When a participant initiates a request to terminate CFSS services with the
agency-provider, the agency-provider must give the participant a written deleted text beginacknowledgementdeleted text endnew text begin
acknowledgment
new text end of the participant's service termination request that includes the date the
request was received by the agency-provider and the requested date of termination.

(c) The agency-provider must participate in a coordinated transfer of the participant to
a new agency-provider to ensure continuity of care.

Sec. 75.

Minnesota Statutes 2020, section 256B.85, subdivision 13, is amended to read:


Subd. 13.

Budget model.

(a) Under the budget model participants exercise responsibility
and control over the services and supports described and budgeted within the CFSS service
delivery plan. Participants must use services specified in subdivision 13a provided by an
FMS provider. Under this model, participants may use their approved service budget
allocation to:

(1) directly employ support workers, and pay wages, federal and state payroll taxes, and
premiums for workers' compensation, liability, and health insurance coverage; and

(2) obtain supports and goods as defined in subdivision 7.

(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may
authorize a legal representative or participant's representative to do so on their behalf.

new text begin (c) If two or more participants using the budget model live in the same household and
have the same worker, the participants must use the same FMS provider.
new text end

new text begin (d) If the FMS provider advises that there is a joint employer in the budget model, all
participants associated with that joint employer must use the same FMS provider.
new text end

deleted text begin (c)deleted text endnew text begin (e)new text end The commissioner shall disenroll or exclude participants from the budget model
and transfer them to the agency-provider model under, but not limited to, the following
circumstances:

(1) when a participant has been restricted by the Minnesota restricted recipient program,
in which case the participant may be excluded for a specified time period under Minnesota
Rules, parts 9505.2160 to 9505.2245;

(2) when a participant exits the budget model during the participant's service plan year.
Upon transfer, the participant shall not access the budget model for the remainder of that
service plan year; or

(3) when the department determines that the participant or participant's representative
or legal representative is unable to fulfill the responsibilities under the budget model, as
specified in subdivision 14.

deleted text begin (d)deleted text endnew text begin (f)new text end A participant may appeal in writing to the department under section 256.045,
subdivision 3, to contest the department's decision under paragraph deleted text begin(c)deleted text endnew text begin (e)new text end, clause (3), to
disenroll or exclude the participant from the budget model.

Sec. 76.

Minnesota Statutes 2020, section 256B.85, subdivision 13a, is amended to read:


Subd. 13a.

Financial management services.

(a) Services provided by an FMS provider
include but are not limited to: filing and payment of federal and state payroll taxes on behalf
of the participant; initiating and complying with background study requirements under
chapter 245C and maintaining documentation of background study requests and results;
billing for approved CFSS services with authorized funds; monitoring expenditures;
accounting for and disbursing CFSS funds; providing assistance in obtaining and filing for
liability, workers' compensation, and unemployment coverage; and providing participant
instruction and technical assistance to the participant in fulfilling employer-related
requirements in accordance with section 3504 of the Internal Revenue Code and related
regulations and interpretations, including Code of Federal Regulations, title 26, section
31.3504-1.

(b) Agency-provider services shall not be provided by the FMS provider.

(c) The FMS provider shall provide service functions as determined by the commissioner
for budget model participants that include but are not limited to:

(1) assistance with the development of the detailed budget for expenditures portion of
the CFSS service delivery plan as requested by the consultation services provider or
participant;

(2) data recording and reporting of participant spending;

(3) other duties established by the department, including with respect to providing
assistance to the participant, participant's representative, or legal representative in performing
employer responsibilities regarding support workers. The support worker shall not be
considered the employee of the FMS provider; and

(4) billing, payment, and accounting of approved expenditures for goods.

(d) The FMS provider shall obtain an assurance statement from the participant employer
agreeing to follow state and federal regulations and CFSS policies regarding employment
of support workers.

(e) The FMS provider shall:

(1) not limit or restrict the participant's choice of service or support providers or service
delivery models consistent with any applicable state and federal requirements;

(2) provide the participant, consultation services provider, and case manager or care
coordinator, if applicable, with a monthly written summary of the spending for services and
supports that were billed against the spending budget;

(3) be knowledgeable of state and federal employment regulations, including those under
the Fair Labor Standards Act of 1938, and comply with the requirements under section 3504
of the Internal Revenue Code and related regulations and interpretations, including Code
of Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability
for vendor fiscal/employer agent, and any requirements necessary to process employer and
employee deductions, provide appropriate and timely submission of employer tax liabilities,
and maintain documentation to support medical assistance claims;

(4) have current and adequate liability insurance and bonding and sufficient cash flow
as determined by the commissioner and have on staff or under contract a certified public
accountant or an individual with a baccalaureate degree in accounting;

(5) assume fiscal accountability for state funds designated for the program and be held
liable for any overpayments or violations of applicable statutes or rules, including but not
limited to the Minnesota False Claims Act, chapter 15C; deleted text beginand
deleted text end

(6) maintain documentation of receipts, invoices, and bills to track all services and
supports expenditures for any goods purchased and maintain time records of support workers.
The documentation and time records must be maintained for a minimum of five years from
the claim date and be available for audit or review upon request by the commissioner. Claims
submitted by the FMS provider to the commissioner for payment must correspond with
services, amounts, and time periods as authorized in the participant's service budget and
service plan and must contain specific identifying information as determined by the
commissionerdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (7) provide written notice to the participant or the participant's representative at least 30
calendar days before a proposed service termination becomes effective.
new text end

(f) The commissioner deleted text beginof human servicesdeleted text end shall:

(1) establish rates and payment methodology for the FMS provider;

(2) identify a process to ensure quality and performance standards for the FMS provider
and ensure statewide access to FMS providers; and

(3) establish a uniform protocol for delivering and administering CFSS services to be
used by eligible FMS providers.

Sec. 77.

Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:


new text begin Subd. 14a. new text end

new text begin Participant's representative responsibilities. new text end

new text begin (a) If a participant is unable
to direct the participant's own care, the participant must use a participant's representative
to receive CFSS services. A participant's representative is required if:
new text end

new text begin (1) the person is under 18 years of age;
new text end

new text begin (2) the person has a court-appointed guardian; or
new text end

new text begin (3) an assessment according to section 256B.0659, subdivision 3a, determines that the
participant is in need of a participant's representative.
new text end

new text begin (b) A participant's representative must:
new text end

new text begin (1) be at least 18 years of age;
new text end

new text begin (2) actively participate in planning and directing CFSS services;
new text end

new text begin (3) have sufficient knowledge of the participant's circumstances to use CFSS services
consistent with the participant's health and safety needs identified in the participant's service
delivery plan;
new text end

new text begin (4) not have a financial interest in the provision of any services included in the
participant's CFSS service delivery plan; and
new text end

new text begin (5) be capable of providing the support necessary to assist the participant in the use of
CFSS services.
new text end

new text begin (c) A participant's representative must not be the:
new text end

new text begin (1) support worker;
new text end

new text begin (2) worker training and development service provider;
new text end

new text begin (3) agency-provider staff, unless related to the participant by blood, marriage, or adoption;
new text end

new text begin (4) consultation service provider, unless related to the participant by blood, marriage,
or adoption;
new text end

new text begin (5) FMS staff, unless related to the participant by blood, marriage, or adoption;
new text end

new text begin (6) FMS owner or manager; or
new text end

new text begin (7) lead agency staff acting as part of employment.
new text end

new text begin (d) A licensed family foster parent who lives with the participant may be the participant's
representative if the family foster parent meets the other participant's representative
requirements.
new text end

new text begin (e) There may be two persons designated as the participant's representative, including
instances of divided households and court-ordered custodies. Each person named as the
participant's representative must meet the program criteria and responsibilities.
new text end

new text begin (f) The participant or the participant's legal representative shall appoint a participant's
representative. The participant's representative must be identified at the time of assessment
and listed on the participant's service agreement and CFSS service delivery plan.
new text end

new text begin (g) A participant's representative must enter into a written agreement with an
agency-provider or FMS on a form determined by the commissioner and maintained in the
participant's file, to:
new text end

new text begin (1) be available while care is provided using a method agreed upon by the participant
or the participant's legal representative and documented in the participant's service delivery
plan;
new text end

new text begin (2) monitor CFSS services to ensure the participant's service delivery plan is followed;
new text end

new text begin (3) review and sign support worker time sheets after services are provided to verify the
provision of services;
new text end

new text begin (4) review and sign vendor paperwork to verify receipt of goods; and
new text end

new text begin (5) in the budget model, review and sign documentation to verify worker training and
development expenditures.
new text end

new text begin (h) A participant's representative may delegate responsibility to another adult who is not
the support worker during a temporary absence of at least 24 hours but not more than six
months. To delegate responsibility, the participant's representative must:
new text end

new text begin (1) ensure that the delegate serving as the participant's representative satisfies the
requirements of the participant's representative;
new text end

new text begin (2) ensure that the delegate performs the functions of the participant's representative;
new text end

new text begin (3) communicate to the CFSS agency-provider or FMS provider about the need for a
delegate by updating the written agreement to include the name of the delegate and the
delegate's contact information; and
new text end

new text begin (4) ensure that the delegate protects the participant's privacy according to federal and
state data privacy laws.
new text end

new text begin (i) The designation of a participant's representative remains in place until:
new text end

new text begin (1) the participant revokes the designation;
new text end

new text begin (2) the participant's representative withdraws the designation or becomes unable to fulfill
the duties;
new text end

new text begin (3) the legal authority to act as a participant's representative changes; or
new text end

new text begin (4) the participant's representative is disqualified.
new text end

new text begin (j) A lead agency may disqualify a participant's representative who engages in conduct
that creates an imminent risk of harm to the participant, the support workers, or other staff.
A participant's representative who fails to provide support required by the participant must
be referred to the common entry point.
new text end

Sec. 78.

Minnesota Statutes 2020, section 256B.85, subdivision 15, is amended to read:


Subd. 15.

Documentation of support services provided; time sheets.

(a) CFSS services
provided to a participant by a support worker employed by either an agency-provider or the
participant employer must be documented daily by each support worker, on a time sheet.
Time sheets may be created, submitted, and maintained electronically. Time sheets must
be submitted by the support worker new text beginat least once per month new text endto the:

(1) agency-provider when the participant is using the agency-provider model. The
agency-provider must maintain a record of the time sheet and provide a copy of the time
sheet to the participant; or

(2) participant and the participant's FMS provider when the participant is using the
budget model. The participant and the FMS provider must maintain a record of the time
sheet.

(b) The documentation on the time sheet must correspond to the participant's assessed
needs within the scope of CFSS covered services. The accuracy of the time sheets must be
verified by the:

(1) agency-provider when the participant is using the agency-provider model; or

(2) participant employer and the participant's FMS provider when the participant is using
the budget model.

(c) The time sheet must document the time the support worker provides services to the
participant. The following elements must be included in the time sheet:

(1) the support worker's full name and individual provider number;

(2) the agency-provider's name and telephone numbers, when responsible for the CFSS
service delivery plan;

(3) the participant's full name;

(4) the dates within the pay period established by the agency-provider or FMS provider,
including month, day, and year, and arrival and departure times with a.m. or p.m. notations
for days worked within the established pay period;

(5) the covered services provided to the participant on each date of service;

(6) deleted text beginadeleted text endnew text begin thenew text end signature deleted text beginline fordeleted text endnew text begin ofnew text end the participant or the participant's representative and a
statement that the participant's or participant's representative's signature is verification of
the time sheet's accuracy;

(7) the deleted text beginpersonaldeleted text end signature of the support worker;

(8) any shared care provided, if applicable;

(9) a statement that it is a federal crime to provide false information on CFSS billings
for medical assistance payments; and

(10) dates and location of participant stays in a hospital, care facility, or incarceration
occurring within the established pay period.

Sec. 79.

Minnesota Statutes 2020, section 256B.85, subdivision 17a, is amended to read:


Subd. 17a.

Consultation services provider qualifications and
requirements.

Consultation services providers must meet the following qualifications and
requirements:

(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4)
and (5);

(2) are under contract with the department;

(3) are not the FMS provider, the lead agency, or the CFSS or home and community-based
services waiver vendor or agency-provider to the participant;

(4) meet the service standards as established by the commissioner;

new text begin (5) have proof of surety bond coverage. Upon new enrollment, or if the consultation
service provider's Medicaid revenue in the previous calendar year is less than or equal to
$300,000, the consultation service provider must purchase a surety bond of $50,000. If the
agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000,
the consultation service provider must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
new text end

deleted text begin (5)deleted text endnew text begin (6)new text end employ lead professional staff with a minimum of deleted text beginthreedeleted text end new text begintwonew text end years of experience
in providing services such as support planning, support broker, case management or care
coordination, or consultation services and consumer education to participants using a
self-directed program using FMS under medical assistance;

new text begin (7) report maltreatment as required under chapter 260E and section 626.557;
new text end

deleted text begin (6)deleted text endnew text begin (8)new text end comply with medical assistance provider requirements;

deleted text begin (7)deleted text endnew text begin (9)new text end understand the CFSS program and its policies;

deleted text begin (8)deleted text endnew text begin (10)new text end are knowledgeable about self-directed principles and the application of the
person-centered planning process;

deleted text begin (9)deleted text endnew text begin (11)new text end have general knowledge of the FMS provider duties and the vendor
fiscal/employer agent model, including all applicable federal, state, and local laws and
regulations regarding tax, labor, employment, and liability and workers' compensation
coverage for household workers; and

deleted text begin (10)deleted text endnew text begin (12)new text end have all employees, including lead professional staff, staff in management and
supervisory positions, and owners of the agency who are active in the day-to-day management
and operations of the agency, complete training as specified in the contract with the
department.

Sec. 80.

Minnesota Statutes 2020, section 256B.85, subdivision 18a, is amended to read:


Subd. 18a.

Worker training and development services.

(a) The commissioner shall
develop the scope of tasks and functions, service standards, and service limits for worker
training and development services.

(b) Worker training and development costs are in addition to the participant's assessed
service units or service budget. Services provided according to this subdivision must:

(1) help support workers obtain and expand the skills and knowledge necessary to ensure
competency in providing quality services as needed and defined in the participant's CFSS
service delivery plan and as required under subdivisions 11b and 14;

(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased
by the participant employer under the budget model as identified in subdivision 13; deleted text beginand
deleted text end

new text begin (3) be delivered by an individual competent to perform, teach, or assign the tasks,
including health-related tasks, identified in the plan through education, training, and work
experience relevant to the person's assessed needs; and
new text end

deleted text begin (3)deleted text endnew text begin (4)new text end be described in the participant's CFSS service delivery plan and documented in
the participant's file.

(c) Services covered under worker training and development shall include:

(1) support worker training on the participant's individual assessed needs and condition,
provided individually or in a group setting by a skilled and knowledgeable trainer beyond
any training the participant or participant's representative provides;

(2) tuition for professional classes and workshops for the participant's support workers
that relate to the participant's assessed needs and condition;

(3) direct observation, monitoring, coaching, and documentation of support worker job
skills and tasks, beyond any training the participant or participant's representative provides,
including supervision of health-related tasks or behavioral supports that is conducted by an
appropriate professional based on the participant's assessed needs. These services must be
provided at the start of services or the start of a new support worker except as provided in
paragraph (d) and must be specified in the participant's CFSS service delivery plan; and

(4) the activities to evaluate CFSS services and ensure support worker competency
described in subdivisions 11a and 11b.

(d) The services in paragraph (c), clause (3), are not required to be provided for a new
support worker providing services for a participant due to staffing failures, unless the support
worker is expected to provide ongoing backup staffing coverage.

(e) Worker training and development services shall not include:

(1) general agency training, worker orientation, or training on CFSS self-directed models;

(2) payment for preparation or development time for the trainer or presenter;

(3) payment of the support worker's salary or compensation during the training;

(4) training or supervision provided by the participant, the participant's support worker,
or the participant's informal supports, including the participant's representative; or

(5) services in excess of deleted text begin96 unitsdeleted text endnew text begin the rate set by the commissionernew text end per annual service
agreement, unless approved by the department.

Sec. 81.

Minnesota Statutes 2020, section 256B.85, subdivision 20b, is amended to read:


Subd. 20b.

Service-related rights under an agency-provider.

A participant receiving
CFSS from an agency-provider has service-related rights to:

(1) participate in and approve the initial development and ongoing modification and
evaluation of CFSS services provided to the participant;

(2) refuse or terminate services and be informed of the consequences of refusing or
terminating services;

(3) before services are initiated, be told the limits to the services available from the
agency-provider, including the agency-provider's knowledge, skill, and ability to meet the
participant's needs identified in the CFSS service delivery plan;

(4) a coordinated transfer of services when there will be a change in the agency-provider;

(5) before services are initiated, be told what the agency-provider charges for the services;

(6) before services are initiated, be told to what extent payment may be expected from
health insurance, public programs, or other sources, if known; and what charges the
participant may be responsible for paying;

(7) receive services from an individual who is competent and trained, who has
professional certification or licensure, as required, and who meets additional qualifications
identified in the participant's CFSS service delivery plan;

(8) have the participant's preferences for support workers identified and documented,
and have those preferences met when possible; and

(9) before services are initiated, be told the choices that are available from the
agency-provider for meeting the participant's assessed needs identified in the CFSS service
delivery plan, including but not limited to which support worker staff will be providing
services deleted text beginanddeleted text endnew text begin,new text end the proposed frequency and schedule of visitsnew text begin, and any agreements for shared
services
new text end.

Sec. 82.

Minnesota Statutes 2020, section 256B.85, subdivision 23, is amended to read:


Subd. 23.

Commissioner's access.

(a) When the commissioner is investigating a possible
overpayment of Medicaid funds, the commissioner must be given immediate access without
prior notice to the agency-provider, consultation services provider, or FMS provider's office
during regular business hours and to documentation and records related to services provided
and submission of claims for services provided. deleted text beginDenying the commissioner access to records
is cause for immediate suspension of payment and terminating
deleted text endnew text begin Ifnew text end the deleted text beginagency-provider's
enrollment or
deleted text endnew text begin agency-provider,new text end FMS deleted text beginprovider's enrollmentdeleted text endnew text begin provider, or consultation services
provider denies the commissioner access to records, the provider's payment may be
immediately suspended or the provider's enrollment may be terminated
new text end according to section
256B.064 deleted text beginor terminating the consultation services provider contractdeleted text end.

(b) The commissioner has the authority to request proof of compliance with laws, rules,
and policies from agency-providers, consultation services providers, FMS providers, and
participants.

(c) When relevant to an investigation conducted by the commissioner, the commissioner
must be given access to the business office, documents, and records of the agency-provider,
consultation services provider, or FMS provider, including records maintained in electronic
format; participants served by the program; and staff during regular business hours. The
commissioner must be given access without prior notice and as often as the commissioner
considers necessary if the commissioner is investigating an alleged violation of applicable
laws or rules. The commissioner may request and shall receive assistance from lead agencies
and other state, county, and municipal agencies and departments. The commissioner's access
includes being allowed to photocopy, photograph, and make audio and video recordings at
the commissioner's expense.

Sec. 83.

Minnesota Statutes 2020, section 256B.85, subdivision 23a, is amended to read:


Subd. 23a.

Sanctions; information for participants upon termination of services.

(a)
The commissioner may withhold payment from the provider or suspend or terminate the
provider enrollment number if the provider fails to comply fully with applicable laws or
rules. The provider has the right to appeal the decision of the commissioner under section
256B.064.

(b) Notwithstanding subdivision 13, paragraph (c), if a participant employer fails to
comply fully with applicable laws or rules, the commissioner may disenroll the participant
from the budget model. A participant may appeal in writing to the department under section
256.045, subdivision 3, to contest the department's decision to disenroll the participant from
the budget model.

(c) Agency-providers of CFSS services or FMS providers must provide each participant
with a copy of participant protections in subdivision 20c at least 30 days prior to terminating
services to a participant, if the termination results from sanctions under this subdivision or
section 256B.064, such as a payment withhold or a suspension or termination of the provider
enrollment number. If a CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services
provider
new text end determines it is unable to continue providing services to a participant because of
an action under this subdivision or section 256B.064, the agency-provider deleted text beginordeleted text endnew text begin, new text end FMS providernew text begin,
or consultation services provider
new text end must notify the participant, the participant's representative,
and the commissioner 30 days prior to terminating services to the participant, and must
assist the commissioner and lead agency in supporting the participant in transitioning to
another CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services providernew text end of the
participant's choice.

(d) In the event the commissioner withholds payment from a CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end
FMS providernew text begin, or consultation services providernew text end, or suspends or terminates a provider
enrollment number of a CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services
provider
new text end under this subdivision or section 256B.064, the commissioner may inform the
Office of Ombudsman for Long-Term Care and the lead agencies for all participants with
active service agreements with the agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation
services provider
new text end. At the commissioner's request, the lead agencies must contact participants
to ensure that the participants are continuing to receive needed care, and that the participants
have been given free choice of agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services
provider
new text end if they transfer to another CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation
services provider
new text end. In addition, the commissioner or the commissioner's delegate may directly
notify participants who receive care from the agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or
consultation services provider
new text end 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 the notification is necessary to protect the welfare of
the participants.

Sec. 84.

Minnesota Statutes 2020, section 256L.03, subdivision 1, is amended to read:


Subdivision 1.

Covered health services.

(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation
services, personal care assistance and case management services, behavioral health home
services under section 256B.0757, new text beginhousing stabilization services under section 256B.051,
new text end and nursing home or intermediate care facilities services.

(b) No public funds shall be used for coverage of abortion under MinnesotaCare except
where the life of the female would be endangered or substantial and irreversible impairment
of a major bodily function would result if the fetus were carried to term; or where the
pregnancy is the result of rape or incest.

(c) Covered health services shall be expanded as provided in this section.

(d) For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.

Sec. 85. new text beginREVISOR INSTRUCTION.
new text end

new text begin (a) In Minnesota Statutes, sections 245A.191, paragraph (a); 245G.02, subdivision 3;
246.18, subdivision 2; 246.23, subdivision 2; 246.64, subdivision 3; 254A.03, subdivision
3; 254A.19, subdivision 4; 254B.03, subdivision 2; 254B.04, subdivision 1; 254B.05,
subdivisions 1a and 4; 254B.051; 254B.06, subdivision 1; 254B.12, subdivisions 1 and 2;
254B.13, subdivisions 2a and 5; 254B.14, subdivision 5; 256L.03, subdivision 2; and 295.53,
subdivision 1, the revisor of statutes must change the term "consolidated chemical
dependency treatment fund" or similar terms to "behavioral health fund." The revisor may
make grammatical changes related to the term change.
new text end

new text begin (b) In Minnesota Statutes, sections 245C.03, subdivision 13, and 256B.051, the revisor
of statutes must change the term "housing support services" or similar terms to "housing
stabilization services." The revisor may make grammatical changes related to the term
change.
new text end

new text begin (c) In Minnesota Statutes, section 245C.03, subdivision 10, the revisor of statutes must
change the term "group residential housing" to "housing support." The revisor may make
grammatical changes related to the term change.
new text end

Sec. 86. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, section 252.28, subdivisions 1 and 5, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2020, sections 252A.02, subdivisions 8 and 10; and 252A.21,
subdivision 3,
new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective the day following final enactment.
Paragraph (b) is effective August 1, 2021.
new text end

APPENDIX

Repealed Minnesota Statutes: H1532-1

252.28 COMMISSIONER OF HUMAN SERVICES; DUTIES.

Subdivision 1.

Determinations; redeterminations.

In conjunction with the appropriate county boards, the commissioner of human services shall determine, and shall redetermine at least every four years, the need, anticipated growth or decline in need until the next anticipated redetermination, location, size, and program of public and private day training and habilitation services for persons with developmental disabilities. This subdivision does not apply to semi-independent living services and residential-based habilitation services provided to four or fewer persons at a single site funded as home and community-based services. A determination of need shall not be required for a change in ownership.

Subd. 5.

Appeals.

A county may appeal a determination of need, size, location, or program according to chapter 14. Notice of appeals must be provided to the commissioner within 30 days after the receipt of the commissioner's determination.

252A.02 DEFINITIONS.

Subd. 8.

Public conservator.

"Public conservator" means the commissioner of human services when exercising some, but not all the powers designated in section 252A.111.

Subd. 10.

Conservatee.

"Conservatee" means a person with a developmental disability for whom the court has appointed a public conservator.

252A.21 GENERAL PROVISIONS.

Subd. 3.

Terminology.

Whenever the term "guardian" is used in sections 252A.01 to 252A.21, it shall include "conservator," and the term "ward" shall include "conservatee" unless another intention clearly appears from the context.