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SF 1034

2nd Engrossment - 88th Legislature (2013 - 2014) Posted on 04/25/2013 08:31am

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

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Current Version - 2nd Engrossment

1.1A bill for an act
1.2relating to state government; establishing the health and human services budget;
1.3modifying provisions related to health care, continuing care, nursing facility
1.4admission, children and family services, human services licensing, chemical
1.5and mental health, program integrity, managed care organizations, waiver
1.6provider standards, home care, and the Department of Health; redesigning
1.7home and community-based services; establishing community first services and
1.8supports and Northstar Care for Children; providing for fraud investigations
1.9in the child care assistance program; establishing autism early intensive
1.10intervention benefits; creating a human services performance council; making
1.11technical changes; requiring a study; requiring reports; appropriating money;
1.12repealing MinnesotaCare;amending Minnesota Statutes 2012, sections 13.381,
1.13subdivisions 2, 10; 13.411, subdivision 7; 13.461, by adding subdivisions;
1.1416A.724, subdivision 3; 16C.10, subdivision 5; 16C.155, subdivision 1; 62J.692,
1.15subdivisions 1, 3, 4, 5, 7a, 9, by adding a subdivision; 62Q.19, subdivision 1;
1.16103I.005, by adding a subdivision; 103I.521; 119B.05, subdivision 1; 119B.13,
1.17subdivisions 1, 7; 144.051, by adding subdivisions; 144.0724, subdivisions
1.184, 6; 144.123, subdivision 1; 144.125, subdivision 1; 144.212; 144.213;
1.19144.215, subdivisions 3, 4; 144.216, subdivision 1; 144.217, subdivision 2;
1.20144.218, subdivision 5; 144.225, subdivisions 1, 4, 7, 8; 144.226; 144.966,
1.21subdivisions 2, 3a; 144.98, subdivisions 3, 5, by adding subdivisions; 144.99,
1.22subdivision 4; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4;
1.23145.906; 145.986; 145A.17, subdivision 1; 145C.01, subdivision 7; 148B.17,
1.24subdivision 2; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5,
1.2516, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding
1.26subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4;
1.27149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1,
1.282, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94;
1.29149A.96, subdivision 9; 151.01, subdivision 27; 151.19, subdivisions 1, 3;
1.30151.26, subdivision 1; 151.37, subdivision 4; 151.47, subdivision 1, by adding
1.31a subdivision; 151.49; 152.126; 174.30, subdivision 1; 214.12, by adding
1.32a subdivision; 214.40, subdivision 1; 243.166, subdivisions 4b, 7; 245.03,
1.33subdivision 1; 245.462, subdivision 20; 245.4661, subdivisions 5, 6; 245.4682,
1.34subdivision 2; 245.4875, subdivision 8; 245.4881, subdivision 1; 245A.02,
1.35subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04, subdivision
1.3613; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08, subdivision
1.372a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435; 245A.144;
1.38245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5; 245A.50; 245C.04,
1.39by adding a subdivision; 245C.08, subdivision 1; 245C.32, subdivision
2.12; 245D.02; 245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09;
2.2245D.10; 246.18, subdivision 8, by adding a subdivision; 252.27, subdivision
2.32a; 252.291, by adding a subdivision; 253B.10, subdivision 1; 254B.04,
2.4subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions;
2.5256.82, subdivision 3; 256.9657, subdivision 3; 256.969, subdivisions 3a,
2.629; 256.975, subdivision 7, by adding subdivisions; 256.9754, subdivision
2.75, by adding subdivisions; 256B.02, by adding subdivisions; 256B.021, by
2.8adding subdivisions; 256B.04, subdivisions 18, 21, by adding a subdivision;
2.9256B.055, subdivisions 3a, 6, 10, 14, 15, by adding a subdivision; 256B.056,
2.10subdivisions 1, 1c, 3, 4, as amended, 5c, 10, by adding a subdivision; 256B.057,
2.11subdivisions 1, 10, by adding a subdivision; 256B.059, subdivision 1; 256B.06,
2.12subdivision 4; 256B.0623, subdivision 2; 256B.0625, subdivisions 13e, 19c, 31,
2.1339, 48, 56, 58, by adding subdivisions; 256B.0631, subdivision 1; 256B.064,
2.14subdivisions 1a, 1b, 2; 256B.0659, subdivision 21; 256B.0755, subdivision 3;
2.15256B.0756; 256B.0911, subdivisions 1, 1a, 3a, 4d, 6, 7, by adding a subdivision;
2.16256B.0913, subdivision 4, by adding a subdivision; 256B.0915, subdivisions 3a,
2.175, by adding a subdivision; 256B.0916, by adding a subdivision; 256B.0917,
2.18subdivisions 6, 13, by adding subdivisions; 256B.092, subdivisions 11, 12, by
2.19adding a subdivision; 256B.0943, subdivisions 1, 2, 7, by adding a subdivision;
2.20256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952, subdivisions 1,
2.215; 256B.0955; 256B.097, subdivisions 1, 3; 256B.196, subdivision 2; 256B.431,
2.22subdivision 44; 256B.434, subdivision 4; 256B.437, subdivision 6; 256B.439,
2.23subdivisions 1, 2, 3, 4, by adding a subdivision; 256B.441, subdivisions 13,
2.2453, 55, 56, 62; 256B.49, subdivisions 11a, 12, 14, 15, by adding subdivisions;
2.25256B.4912, subdivisions 1, 2, 3, 7, by adding subdivisions; 256B.4913,
2.26subdivisions 5, 6, by adding a subdivision; 256B.492; 256B.493, subdivision 2;
2.27256B.501, by adding a subdivision; 256B.5011, subdivision 2; 256B.5012, by
2.28adding subdivisions; 256B.69, subdivisions 5c, 31, by adding a subdivision;
2.29256B.694; 256B.76, subdivisions 1, 2, 4, by adding a subdivision; 256B.761;
2.30256B.764; 256B.766; 256D.44, subdivision 5; 256I.05, subdivision 1e, by
2.31adding a subdivision; 256J.08, subdivision 24; 256J.21, subdivision 3; 256J.24,
2.32subdivisions 5, 5a, 7; 256J.621; 256J.626, subdivision 7; 256K.45; 256L.01,
2.33subdivisions 3a, 5, by adding subdivisions; 256L.02, subdivision 2, by adding
2.34subdivisions; 256L.03, subdivisions 1, 1a, 3, 5, 6, by adding a subdivision;
2.35256L.04, subdivisions 1, 7, 8, 10, 12, by adding subdivisions; 256L.05,
2.36subdivisions 1, 2, 3, 3c; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3;
2.37256L.09, subdivision 2; 256L.11, subdivisions 1, 3; 256L.15, subdivisions 1, 2;
2.38256M.40, subdivision 1; 257.75, subdivision 7; 257.85, subdivision 11; 259A.05,
2.39subdivision 5; 259A.20, subdivision 4; 260B.007, subdivisions 6, 16; 260C.007,
2.40subdivisions 6, 31; 260C.635, subdivision 1; 299C.093; 471.59, subdivision 1;
2.41517.001; 518A.60; 524.5-118, subdivision 1, by adding a subdivision; 524.5-303;
2.42524.5-316; 524.5-403; 524.5-420; 626.556, subdivisions 2, 3, 10d; 626.557,
2.43subdivisions 4, 9, 9a, 9e; 626.5572, subdivision 13; Laws 1998, chapter 407,
2.44article 6, section 116; Laws 2011, First Special Session chapter 9, article 7,
2.45section 39, subdivision 14; Laws 2012, chapter 247, article 1, section 28; article
2.466, section 4; Laws 2013, chapter 1, sections 1; 6; proposing coding for new law in
2.47Minnesota Statutes, chapters 144; 144A; 145; 149A; 151; 214; 245; 245A; 245D;
2.48254B; 256B; 256J; 256L; proposing coding for new law as Minnesota Statutes,
2.49chapter 245E; repealing Minnesota Statutes 2012, sections 62J.693; 103I.005,
2.50subdivision 20; 144.123, subdivision 2; 144A.46; 144A.461; 149A.025;
2.51149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8;
2.52149A.45, subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7;
2.53149A.52, subdivision 5a; 149A.53, subdivision 9; 151.19, subdivision 2; 151.25;
2.54151.45; 151.47, subdivision 2; 151.48; 245A.655; 245B.01; 245B.02; 245B.03;
2.55245B.031; 245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06;
2.56245B.07; 245B.08; 245D.08; 256B.055, subdivisions 3, 5, 10b; 256B.056,
2.57subdivision 5b; 256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b,
2.584c; 256B.0917, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096,
3.1subdivisions 1, 2, 3, 4; 256B.49, subdivision 16a; 256B.4913, subdivisions 1, 2,
3.23, 4; 256B.5012, subdivision 13; 256J.24, subdivision 6; 256L.01, subdivisions
3.33, 4a; 256L.02, subdivision 3; 256L.03, subdivision 4; 256L.031; 256L.04,
3.4subdivisions 1b, 2a, 7a, 9; 256L.07, subdivisions 1, 4, 5, 8, 9; 256L.09,
3.5subdivisions 1, 4, 5, 6, 7; 256L.11, subdivisions 2a, 5, 6; 256L.12, subdivisions
3.61, 2, 3, 4, 5, 6, 7, 8, 9a, 9b; 256L.17, subdivisions 1, 2, 3, 4, 5; 485.14;
3.7609.093; Laws 2011, First Special Session chapter 9, article 7, section 54, as
3.8amended; Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
3.94668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035;
3.104668.0040; 4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075;
3.114668.0080; 4668.0100; 4668.0110; 4668.0120; 4668.0130; 4668.0140;
3.124668.0150; 4668.0160; 4668.0170; 4668.0180; 4668.0190; 4668.0200;
3.134668.0218; 4668.0220; 4668.0230; 4668.0240; 4668.0800; 4668.0805;
3.144668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 4668.0835;
3.154668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
3.164669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; 4669.0050.
3.17BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.18ARTICLE 1
3.19AFFORDABLE CARE ACT IMPLEMENTATION; BETTER HEALTH
3.20CARE FOR MORE MINNESOTANS

3.21    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
3.22    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
3.23participation pertaining to administrative costs of the Minnesota health care reform waiver
3.24shall be deposited as nondedicated revenue in the health care access fund. Receipts
3.25received as a result of federal participation pertaining to grants shall be deposited in the
3.26federal fund and shall offset health care access funds for payments to providers. All federal
3.27funding received by Minnesota for implementation and administration of MinnesotaCare
3.28as a basic health program, as authorized in section 1331 of the Affordable Care Act,
3.29Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and
3.30shall be deposited into the health care access fund. Federal funding that is received for
3.31implementing and administering MinnesotaCare as a basic health program and deposited in
3.32the fund shall be used only for that program to purchase health care coverage for enrollees
3.33and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.
3.34EFFECTIVE DATE.This section is effective January 1, 2015.

3.35    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
3.36    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
3.37Regulations, title 25, part 20, persons eligible for medical assistance benefits under
3.38sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
3.39the income standards of section 256B.056, subdivision 4, and persons eligible for general
4.1assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
4.2dependency fund services. State money appropriated for this paragraph must be placed in
4.3a separate account established for this purpose.
4.4Persons with dependent children who are determined to be in need of chemical
4.5dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
4.6a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
4.7local agency to access needed treatment services. Treatment services must be appropriate
4.8for the individual or family, which may include long-term care treatment or treatment in a
4.9facility that allows the dependent children to stay in the treatment facility. The county
4.10shall pay for out-of-home placement costs, if applicable.
4.11(b) A person not entitled to services under paragraph (a), but with family income
4.12that is less than 215 percent of the federal poverty guidelines for the applicable family
4.13size, shall be eligible to receive chemical dependency fund services within the limit
4.14of funds appropriated for this group for the fiscal year. If notified by the state agency
4.15of limited funds, a county must give preferential treatment to persons with dependent
4.16children who are in need of chemical dependency treatment pursuant to an assessment
4.17under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
4.186
, or 260C.212. A county may spend money from its own sources to serve persons under
4.19this paragraph. State money appropriated for this paragraph must be placed in a separate
4.20account established for this purpose.
4.21(c) Persons whose income is between 215 percent and 412 percent of the federal
4.22poverty guidelines for the applicable family size shall be eligible for chemical dependency
4.23services on a sliding fee basis, within the limit of funds appropriated for this group for the
4.24fiscal year. Persons eligible under this paragraph must contribute to the cost of services
4.25according to the sliding fee scale established under subdivision 3. A county may spend
4.26money from its own sources to provide services to persons under this paragraph. State
4.27money appropriated for this paragraph must be placed in a separate account established
4.28for this purpose.

4.29    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
4.30to read:
4.31    Subd. 35. Federal approval. (a) The commissioner shall seek federal authority
4.32from the U.S. Department of Health and Human Services necessary to operate a health
4.33coverage program for Minnesotans with incomes up to 275 percent of the federal poverty
4.34guidelines (FPG). The proposal shall seek to secure all federal funding available from at
4.35least the following services:
5.1(1) all premium tax credits and cost sharing subsidies available under United States
5.2Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
5.3with incomes above 133 percent and at or below 275 percent of the federal poverty
5.4guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as
5.5defined in section 62V.02;
5.6(2) Medicaid funding; and
5.7(3) other funding sources identified by the commissioner that support coverage or
5.8care redesign in Minnesota.
5.9(b) Funding received shall be used to design and implement a health coverage
5.10program that creates a single streamlined program and meets the needs of Minnesotans with
5.11incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
5.12(1) payment reform characteristics included in the health care delivery system and
5.13accountable care organization payment models;
5.14(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
5.15needs in different income and health status situations and can provide a more seamless
5.16transition from public to private health care coverage;
5.17(3) flexibility in co-payment or premium structures to incent patients to seek
5.18high-quality, low-cost care settings; and
5.19(4) flexibility in premium structures to ease the transition from public to private
5.20health care coverage.
5.21(c) The commissioner shall develop and submit a proposal consistent with the above
5.22criteria and shall seek all federal authority necessary to implement the health coverage
5.23program. In developing the request, the commissioner shall consult with appropriate
5.24stakeholder groups and consumers.
5.25(d) The commissioner is authorized to seek any available waivers or federal
5.26approvals to accomplish the goals under paragraph (b) prior to 2017.
5.27(e) The commissioner shall report to the chairs and ranking minority members of
5.28the legislative committees with jurisdiction over health and human services policy and
5.29financing by January 15, 2015, on the progress of receiving a federal waiver and shall
5.30make recommendations on any legislative changes necessary to accomplish the project
5.31in this subdivision. Any implementation of the waiver that requires a state financial
5.32contribution shall be contingent on legislative action approving the contribution.
5.33(f) The commissioner is authorized to accept and expend federal funds that support
5.34the purposes of this subdivision.

6.1    Sec. 4. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.2to read:
6.3    Subd. 18. Caretaker relative. "Caretaker relative" means a relative, by blood,
6.4adoption, or marriage, of a child under age 19 with whom the child is living and who
6.5assumes primary responsibility for the child's care.
6.6EFFECTIVE DATE.This section is effective January 1, 2014.

6.7    Sec. 5. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.8to read:
6.9    Subd. 19. Insurance affordability program. "Insurance affordability program"
6.10means one of the following programs:
6.11(1) medical assistance under this chapter;
6.12(2) a program that provides advance payments of the premium tax credits established
6.13under section 36B of the Internal Revenue Code or cost-sharing reductions established
6.14under section 1402 of the Affordable Care Act;
6.15(3) MinnesotaCare as defined in chapter 256L; and
6.16(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.
6.17EFFECTIVE DATE.This section is effective the day following final enactment.

6.18    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
6.19    Subd. 18. Applications for medical assistance. (a) The state agency may take
6.20 shall accept applications for medical assistance and conduct eligibility determinations for
6.21MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web
6.22site, and through other commonly available electronic means.
6.23    (b) The commissioner of human services shall modify the Minnesota health care
6.24programs application form to add a question asking applicants whether they have ever
6.25served in the United States military.
6.26    (c) For each individual who submits an application or whose eligibility is subject to
6.27renewal or whose eligibility is being redetermined pursuant to a change in circumstances,
6.28if the agency determines the individual is not eligible for medical assistance, the agency
6.29shall determine potential eligibility for other insurance affordability programs.
6.30EFFECTIVE DATE.This section is effective January 1, 2014.

6.31    Sec. 7. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
7.1    Subd. 3a. Families with children. Beginning July 1, 2002, Medical assistance may
7.2be paid for a person who is a child under the age of 18, or age 18 if a full-time student
7.3in a secondary school, or in the equivalent level of vocational or technical training, and
7.4reasonably expected to complete the program before reaching age 19; the parent or
7.5stepparent of a dependent child under the age of 19, including a pregnant woman; or a
7.6caretaker relative of a dependent child under the age of 19.
7.7EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
7.8approval, whichever is later. The commissioner of human services shall notify the revisor
7.9of statutes when federal approval is obtained.

7.10    Sec. 8. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
7.11    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
7.12for a pregnant woman who has written verification of a positive pregnancy test from a
7.13physician or licensed registered nurse, who meets the other eligibility criteria of this
7.14section and whose unborn child would be eligible as a needy child under subdivision 10 if
7.15born and living with the woman. In accordance with Code of Federal Regulations, title
7.1642, section 435.956, the commissioner must accept self-attestation of pregnancy unless
7.17the agency has information that is not reasonably compatible with such attestation. For
7.18purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
7.19EFFECTIVE DATE.This section is effective January 1, 2014.

7.20    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
7.21    Subd. 10. Infants. Medical assistance may be paid for an infant less than one year
7.22of age, whose mother was eligible for and receiving medical assistance at the time of birth
7.23or who is less than two years of age and is in a family with countable income that is equal
7.24to or less than the income standard established under section 256B.057, subdivision 1.
7.25EFFECTIVE DATE.This section is effective January 1, 2014.

7.26    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
7.27    Subd. 15. Adults without children. Medical assistance may be paid for a person
7.28who is:
7.29(1) at least age 21 and under age 65;
7.30(2) not pregnant;
7.31(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
7.32of the Social Security Act;
8.1(4) not an adult in a family with children as defined in section 256L.01, subdivision
8.23a
; and not otherwise eligible under subdivision 7 as a person who meets the categorical
8.3eligibility requirements of the supplemental security income program;
8.4(5) not enrolled under subdivision 7 as a person who would meet the categorical
8.5eligibility requirements of the supplemental security income program except for excess
8.6income or assets; and
8.7(5) (6) not described in another subdivision of this section.
8.8EFFECTIVE DATE.This section is effective January 1, 2014.

8.9    Sec. 11. Minnesota Statutes 2012, section 256B.055, is amended by adding a
8.10subdivision to read:
8.11    Subd. 17. Adults who were in foster care at the age of 18. Medical assistance may
8.12be paid for a person under 26 years of age who was in foster care under the commissioner's
8.13responsibility on the date of attaining 18 years of age, and who was enrolled in medical
8.14assistance under the state plan or a waiver of the plan while in foster care, in accordance
8.15with section 2004 of the Affordable Care Act.
8.16EFFECTIVE DATE.This section is effective January 1, 2014.

8.17    Sec. 12. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
8.18    Subdivision 1. Residency. To be eligible for medical assistance, a person must
8.19reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
8.20 in accordance with the rules of the state agency Code of Federal Regulations, title 42,
8.21section 435.403.
8.22EFFECTIVE DATE.This section is effective January 1, 2014.

8.23    Sec. 13. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
8.24    Subd. 1c. Families with children income methodology. (a)(1) [Expired, 1Sp2003
8.25c 14 art 12 s 17]
8.26(2) For applications processed within one calendar month prior to July 1, 2003,
8.27eligibility shall be determined by applying the income standards and methodologies in
8.28effect prior to July 1, 2003, for any months in the six-month budget period before July
8.291, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
8.30months in the six-month budget period on or after that date. The income standards for
8.31each month shall be added together and compared to the applicant's total countable income
8.32for the six-month budget period to determine eligibility.
9.1(3) For children ages one through 18 whose eligibility is determined under section
9.2256B.057, subdivision 2, the following deductions shall be applied to income counted
9.3toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
9.416, 1996: $90 work expense, dependent care, and child support paid under court order.
9.5This clause is effective October 1, 2003.
9.6(b) For families with children whose eligibility is determined using the standard
9.7specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
9.8earned income shall be disregarded for up to four months and the following deductions
9.9shall be applied to each individual's income counted toward eligibility as allowed under
9.10the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
9.11under court order.
9.12(c) If the four-month disregard in paragraph (b) has been applied to the wage
9.13earner's income for four months, the disregard shall not be applied again until the wage
9.14earner's income has not been considered in determining medical assistance eligibility for
9.1512 consecutive months.
9.16(d)(b) The commissioner shall adjust the income standards under this section each
9.17July 1 by the annual update of the federal poverty guidelines following publication by the
9.18United States Department of Health and Human Services except that the income standards
9.19shall not go below those in effect on July 1, 2009.
9.20(e) (c) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
9.21organization to or for the benefit of the child with a life-threatening illness must be
9.22disregarded from income.

9.23    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
9.24    Subd. 3. Asset limitations for certain individuals and families. (a) To be
9.25eligible for medical assistance, a person must not individually own more than $3,000 in
9.26assets, or if a member of a household with two family members, husband and wife, or
9.27parent and child, the household must not own more than $6,000 in assets, plus $200 for
9.28each additional legal dependent. In addition to these maximum amounts, an eligible
9.29individual or family may accrue interest on these amounts, but they must be reduced to the
9.30maximum at the time of an eligibility redetermination. The accumulation of the clothing
9.31and personal needs allowance according to section 256B.35 must also be reduced to the
9.32maximum at the time of the eligibility redetermination. The value of assets that are not
9.33considered in determining eligibility for medical assistance is the value of those assets
9.34excluded under the supplemental security income program for aged, blind, and disabled
9.35persons, with the following exceptions:
10.1(1) household goods and personal effects are not considered;
10.2(2) capital and operating assets of a trade or business that the local agency determines
10.3are necessary to the person's ability to earn an income are not considered;
10.4(3) motor vehicles are excluded to the same extent excluded by the supplemental
10.5security income program;
10.6(4) assets designated as burial expenses are excluded to the same extent excluded by
10.7the supplemental security income program. Burial expenses funded by annuity contracts
10.8or life insurance policies must irrevocably designate the individual's estate as contingent
10.9beneficiary to the extent proceeds are not used for payment of selected burial expenses;
10.10(5) for a person who no longer qualifies as an employed person with a disability due
10.11to loss of earnings, assets allowed while eligible for medical assistance under section
10.12256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
10.13of ineligibility as an employed person with a disability, to the extent that the person's total
10.14assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
10.15    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
10.169
, is age 65 or older and has been enrolled during each of the 24 consecutive months
10.17before the person's 65th birthday, the assets owned by the person and the person's spouse
10.18must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
10.19when determining eligibility for medical assistance under section 256B.055, subdivision
10.207
. The income of a spouse of a person enrolled in medical assistance under section
10.21256B.057, subdivision 9 , during each of the 24 consecutive months before the person's
10.2265th birthday must be disregarded when determining eligibility for medical assistance
10.23under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
10.24the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
10.25is required to have qualified for medical assistance under section 256B.057, subdivision 9,
10.26prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
10.27(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
10.28required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
10.29Law 111-5. For purposes of this clause, an American Indian is any person who meets the
10.30definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
10.31(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
10.3215.
10.33EFFECTIVE DATE.This section is effective January 1, 2014.

10.34    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by
10.35Laws 2013, chapter 1, section 5, is amended to read:
11.1    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
11.2section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
11.3the federal poverty guidelines. Effective January 1, 2000, and each successive January,
11.4recipients of supplemental security income may have an income up to the supplemental
11.5security income standard in effect on that date.
11.6(b) To be eligible for medical assistance, families and children may have an income
11.7up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
11.8AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
11.91996, shall be increased by three percent.
11.10(c) (b) Effective January 1, 2014, to be eligible for medical assistance, under section
11.11256B.055, subdivision 3a , a parent or caretaker relative may have an income up to 133
11.12percent of the federal poverty guidelines for the household size.
11.13(d) (c) To be eligible for medical assistance under section 256B.055, subdivision
11.1415
, a person may have an income up to 133 percent of federal poverty guidelines for
11.15the household size.
11.16(e) (d) To be eligible for medical assistance under section 256B.055, subdivision
11.1716
, a child age 19 to 20 may have an income up to 133 percent of the federal poverty
11.18guidelines for the household size.
11.19(f) (e) To be eligible for medical assistance under section 256B.055, subdivision 3a,
11.20a child under age 19 may have income up to 275 percent of the federal poverty guidelines
11.21for the household size or an equivalent standard when converted using modified adjusted
11.22gross income methodology as required under the Affordable Care Act. Children who are
11.23enrolled in medical assistance as of December 31, 2013, and are determined ineligible
11.24for medical assistance because of the elimination of income disregards under modified
11.25adjusted gross income methodology as defined in subdivision 1a remain eligible for
11.26medical assistance under the Children's Health Insurance Program Reauthorization Act
11.27of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility
11.28redetermination as required in section 256B.056, subdivision 7a.
11.29(f) In computing income to determine eligibility of persons under paragraphs (a) to
11.30(e) who are not residents of long-term care facilities, the commissioner shall disregard
11.31increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
11.32For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
11.33Administration unusual medical expense payments are considered income to the recipient.
11.34EFFECTIVE DATE.This section is effective January 1, 2014.

11.35    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
12.1    Subd. 5c. Excess income standard. (a) The excess income standard for families
12.2with children parents and caretaker relatives, pregnant women, infants, and children ages
12.3two through 20 is the standard specified in subdivision 4, paragraph (b).
12.4(b) The excess income standard for a person whose eligibility is based on blindness,
12.5disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
12.6family size. Effective July 1, 2002, the excess income standard for this paragraph shall
12.7equal 75 percent of the federal poverty guidelines.
12.8EFFECTIVE DATE.This section is effective January 1, 2014.

12.9    Sec. 17. Minnesota Statutes 2012, section 256B.056, is amended by adding a
12.10subdivision to read:
12.11    Subd. 7a. Periodic renewal of eligibility. (a) The commissioner shall make an
12.12annual redetermination of eligibility based on information contained in the enrollee's case
12.13file and other information available to the agency, including but not limited to information
12.14accessed through an electronic database, without requiring the enrollee to submit any
12.15information when sufficient data is available for the agency to renew eligibility.
12.16(b) If the commissioner cannot renew eligibility in accordance with paragraph (a),
12.17the commissioner must provide the enrollee with a prepopulated renewal form containing
12.18eligibility information available to the agency and permit the enrollee to submit the form
12.19with any corrections or additional information to the agency and sign the renewal form via
12.20any of the modes of submission specified in section 256B.04, subdivision 18.
12.21(c) An enrollee who is terminated for failure to complete the renewal process may
12.22subsequently submit the renewal form and required information within four months after
12.23the date of termination and have coverage reinstated without a lapse, if otherwise eligible
12.24under this chapter.
12.25(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
12.26required to renew eligibility every six months.
12.27EFFECTIVE DATE.This section is effective January 1, 2014.

12.28    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
12.29    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
12.30are applying for the continuation of medical assistance coverage following the end of the
12.3160-day postpartum period to update their income and asset information and to submit
12.32any required income or asset verification.
13.1    (b) The commissioner shall determine the eligibility of private-sector health care
13.2coverage for infants less than one year of age eligible under section 256B.055, subdivision
13.310
, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
13.4if this is determined to be cost-effective.
13.5    (c) The commissioner shall verify assets and income for all applicants, and for all
13.6recipients upon renewal.
13.7    (d) The commissioner shall utilize information obtained through the electronic
13.8service established by the secretary of the United States Department of Health and Human
13.9Services and other available electronic data sources in Code of Federal Regulations, title
13.1042, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner
13.11shall establish standards to define when information obtained electronically is reasonably
13.12compatible with information provided by applicants and enrollees, including use of
13.13self-attestation, to accomplish real-time eligibility determinations and maintain program
13.14integrity.
13.15EFFECTIVE DATE.This section is effective January 1, 2014.

13.16    Sec. 19. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
13.17    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year
13.18 two years of age or a pregnant woman who has written verification of a positive pregnancy
13.19test from a physician or licensed registered nurse is eligible for medical assistance if the
13.20individual's countable family household income is equal to or less than 275 percent of the
13.21federal poverty guideline for the same family household size or an equivalent standard
13.22when converted using modified adjusted gross income methodology as required under
13.23the Affordable Care Act. For purposes of this subdivision, "countable family income"
13.24means the amount of income considered available using the methodology of the AFDC
13.25program under the state's AFDC plan as of July 16, 1996, as required by the Personal
13.26Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
13.27Law 104-193, except for the earned income disregard and employment deductions.
13.28    (2) For applications processed within one calendar month prior to the effective date,
13.29eligibility shall be determined by applying the income standards and methodologies in
13.30effect prior to the effective date for any months in the six-month budget period before
13.31that date and the income standards and methodologies in effect on the effective date for
13.32any months in the six-month budget period on or after that date. The income standards
13.33for each month shall be added together and compared to the applicant's total countable
13.34income for the six-month budget period to determine eligibility.
13.35    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
14.1    (2) For applications processed within one calendar month prior to July 1, 2003,
14.2eligibility shall be determined by applying the income standards and methodologies in
14.3effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
14.42003, and the income standards and methodologies in effect on the expiration date for any
14.5months in the six-month budget period on or after July 1, 2003. The income standards
14.6for each month shall be added together and compared to the applicant's total countable
14.7income for the six-month budget period to determine eligibility.
14.8    (3) An amount equal to the amount of earned income exceeding 275 percent of
14.9the federal poverty guideline, up to a maximum of the amount by which the combined
14.10total of 185 percent of the federal poverty guideline plus the earned income disregards
14.11and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
14.12by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
14.13Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
14.14pregnant women and infants less than one year of age.
14.15    (c) Dependent care and child support paid under court order shall be deducted from
14.16the countable income of pregnant women.
14.17    (d) (b) An infant born to a woman who was eligible for and receiving medical
14.18assistance on the date of the child's birth shall continue to be eligible for medical assistance
14.19without redetermination until the child's first birthday.
14.20EFFECTIVE DATE.This section is effective January 1, 2014.

14.21    Sec. 20. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
14.22    Subd. 10. Certain persons needing treatment for breast or cervical cancer. (a)
14.23Medical assistance may be paid for a person who:
14.24(1) has been screened for breast or cervical cancer by the Minnesota breast and
14.25cervical cancer control program, and program funds have been used to pay for the person's
14.26screening;
14.27(2) according to the person's treating health professional, needs treatment, including
14.28diagnostic services necessary to determine the extent and proper course of treatment, for
14.29breast or cervical cancer, including precancerous conditions and early stage cancer;
14.30(3) meets the income eligibility guidelines for the Minnesota breast and cervical
14.31cancer control program;
14.32(4) is under age 65;
14.33(5) is not otherwise eligible for medical assistance under United States Code, title
14.3442, section 1396a(a)(10)(A)(i); and
15.1(6) is not otherwise covered under creditable coverage, as defined under United
15.2States Code, title 42, section 1396a(aa).
15.3(b) Medical assistance provided for an eligible person under this subdivision shall
15.4be limited to services provided during the period that the person receives treatment for
15.5breast or cervical cancer.
15.6(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
15.7without meeting the eligibility criteria relating to income and assets in section 256B.056,
15.8subdivisions 1a to 5b 5a.
15.9EFFECTIVE DATE.This section is effective January 1, 2014.

15.10    Sec. 21. Minnesota Statutes 2012, section 256B.057, is amended by adding a
15.11subdivision to read:
15.12    Subd. 12. Presumptive eligibility determinations made by qualified hospitals.
15.13The commissioner shall establish a process to qualify hospitals that are participating
15.14providers under the medical assistance program to determine presumptive eligibility for
15.15medical assistance for applicants who may have a basis of eligibility using the modified
15.16adjusted gross income methodology as defined in section 256B.056, subdivision 1a,
15.17paragraph (b), clause (1).
15.18EFFECTIVE DATE.This section is effective January 1, 2014.

15.19    Sec. 22. Minnesota Statutes 2012, section 256B.059, subdivision 1, is amended to read:
15.20    Subdivision 1. Definitions. (a) For purposes of this section and sections 256B.058
15.21and 256B.0595, the terms defined in this subdivision have the meanings given them.
15.22    (b) "Community spouse" means the spouse of an institutionalized spouse.
15.23    (c) "Spousal share" means one-half of the total value of all assets, to the extent that
15.24either the institutionalized spouse or the community spouse had an ownership interest at
15.25the time of the first continuous period of institutionalization.
15.26    (d) "Assets otherwise available to the community spouse" means assets individually
15.27or jointly owned by the community spouse, other than assets excluded by subdivision 5,
15.28paragraph (c).
15.29    (e) "Community spouse asset allowance" is the value of assets that can be transferred
15.30under subdivision 3.
15.31    (f) "Institutionalized spouse" means a person who is:
15.32    (1) in a hospital, nursing facility, or intermediate care facility for persons with
15.33developmental disabilities, or receiving home and community-based services under section
16.1256B.0915 , 256B.092, or 256B.49 and is expected to remain in the facility or institution
16.2or receive the home and community-based services for at least 30 consecutive days; and
16.3    (2) married to a person who is not in a hospital, nursing facility, or intermediate
16.4care facility for persons with developmental disabilities, and is not receiving home and
16.5community-based services under section 256B.0915, 256B.092, or 256B.49.
16.6    (g) "For the sole benefit of" means no other individual or entity can benefit in any
16.7way from the assets or income at the time of a transfer or at any time in the future.
16.8    (h) "Continuous period of institutionalization" means a 30-consecutive-day period
16.9of time in which a person is expected to stay in a medical or long-term care facility, or
16.10receive home and community-based services that would qualify for coverage under the
16.11elderly waiver (EW) or alternative care (AC) programs section 256B.0913, 256B.0915,
16.12256B.092, or 256B.49. For a stay in a facility, the 30-consecutive-day period begins
16.13on the date of entry into a medical or long-term care facility. For receipt of home and
16.14community-based services, the 30-consecutive-day period begins on the date that the
16.15following conditions are met:
16.16    (1) the person is receiving services that meet the nursing facility level of care
16.17determined by a long-term care consultation;
16.18    (2) the person has received the long-term care consultation within the past 60 days;
16.19    (3) the services are paid by the EW program under section 256B.0915 or the AC
16.20program under section 256B.0913, 256B.0915, 256B.092, or 256B.49 or would qualify
16.21for payment under the EW or AC programs those sections if the person were otherwise
16.22eligible for either program, and but for the receipt of such services the person would have
16.23resided in a nursing facility; and
16.24    (4) the services are provided by a licensed provider qualified to provide home and
16.25community-based services.
16.26EFFECTIVE DATE.This section is effective January 1, 2014.

16.27    Sec. 23. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
16.28    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
16.29to citizens of the United States, qualified noncitizens as defined in this subdivision, and
16.30other persons residing lawfully in the United States. Citizens or nationals of the United
16.31States must cooperate in obtaining satisfactory documentary evidence of citizenship or
16.32nationality according to the requirements of the federal Deficit Reduction Act of 2005,
16.33Public Law 109-171.
16.34(b) "Qualified noncitizen" means a person who meets one of the following
16.35immigration criteria:
17.1(1) admitted for lawful permanent residence according to United States Code, title 8;
17.2(2) admitted to the United States as a refugee according to United States Code,
17.3title 8, section 1157;
17.4(3) granted asylum according to United States Code, title 8, section 1158;
17.5(4) granted withholding of deportation according to United States Code, title 8,
17.6section 1253(h);
17.7(5) paroled for a period of at least one year according to United States Code, title 8,
17.8section 1182(d)(5);
17.9(6) granted conditional entrant status according to United States Code, title 8,
17.10section 1153(a)(7);
17.11(7) determined to be a battered noncitizen by the United States Attorney General
17.12according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
17.13title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
17.14(8) is a child of a noncitizen determined to be a battered noncitizen by the United
17.15States Attorney General according to the Illegal Immigration Reform and Immigrant
17.16Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
17.17Public Law 104-200; or
17.18(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
17.19Law 96-422, the Refugee Education Assistance Act of 1980.
17.20(c) All qualified noncitizens who were residing in the United States before August
17.2122, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
17.22medical assistance with federal financial participation.
17.23(d) Beginning December 1, 1996, qualified noncitizens who entered the United
17.24States on or after August 22, 1996, and who otherwise meet the eligibility requirements
17.25of this chapter are eligible for medical assistance with federal participation for five years
17.26if they meet one of the following criteria:
17.27(1) refugees admitted to the United States according to United States Code, title 8,
17.28section 1157;
17.29(2) persons granted asylum according to United States Code, title 8, section 1158;
17.30(3) persons granted withholding of deportation according to United States Code,
17.31title 8, section 1253(h);
17.32(4) veterans of the United States armed forces with an honorable discharge for
17.33a reason other than noncitizen status, their spouses and unmarried minor dependent
17.34children; or
17.35(5) persons on active duty in the United States armed forces, other than for training,
17.36their spouses and unmarried minor dependent children.
18.1 Beginning July 1, 2010, children and pregnant women who are noncitizens
18.2described in paragraph (b) or who are lawfully present in the United States as defined
18.3in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
18.4eligibility requirements of this chapter, are eligible for medical assistance with federal
18.5financial participation as provided by the federal Children's Health Insurance Program
18.6Reauthorization Act of 2009, Public Law 111-3.
18.7(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
18.8are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
18.9subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
18.10Code, title 8, section 1101(a)(15).
18.11(f) Payment shall also be made for care and services that are furnished to noncitizens,
18.12regardless of immigration status, who otherwise meet the eligibility requirements of
18.13this chapter, if such care and services are necessary for the treatment of an emergency
18.14medical condition.
18.15(g) For purposes of this subdivision, the term "emergency medical condition" means
18.16a medical condition that meets the requirements of United States Code, title 42, section
18.171396b(v).
18.18(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
18.19of an emergency medical condition are limited to the following:
18.20(i) services delivered in an emergency room or by an ambulance service licensed
18.21under chapter 144E that are directly related to the treatment of an emergency medical
18.22condition;
18.23(ii) services delivered in an inpatient hospital setting following admission from an
18.24emergency room or clinic for an acute emergency condition; and
18.25(iii) follow-up services that are directly related to the original service provided
18.26to treat the emergency medical condition and are covered by the global payment made
18.27to the provider.
18.28    (2) Services for the treatment of emergency medical conditions do not include:
18.29(i) services delivered in an emergency room or inpatient setting to treat a
18.30nonemergency condition;
18.31(ii) organ transplants, stem cell transplants, and related care;
18.32(iii) services for routine prenatal care;
18.33(iv) continuing care, including long-term care, nursing facility services, home health
18.34care, adult day care, day training, or supportive living services;
18.35(v) elective surgery;
19.1(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
19.2part of an emergency room visit;
19.3(vii) preventative health care and family planning services;
19.4(viii) dialysis;
19.5(ix) chemotherapy or therapeutic radiation services;
19.6(x) rehabilitation services;
19.7(xi) physical, occupational, or speech therapy;
19.8(xii) transportation services;
19.9(xiii) case management;
19.10(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
19.11(xv) dental services;
19.12(xvi) hospice care;
19.13(xvii) audiology services and hearing aids;
19.14(xviii) podiatry services;
19.15(xix) chiropractic services;
19.16(xx) immunizations;
19.17(xxi) vision services and eyeglasses;
19.18(xxii) waiver services;
19.19(xxiii) individualized education programs; or
19.20(xxiv) chemical dependency treatment.
19.21(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented,
19.22nonimmigrants, or lawfully present in the United States as defined in Code of Federal
19.23Regulations, title 8, section 103.12, ineligible for federally funded medical assistance
19.24because of immigration status are not covered by a group health plan or health insurance
19.25coverage according to Code of Federal Regulations, title 42, section 457.310, and who
19.26otherwise meet the eligibility requirements of this chapter, are eligible for medical
19.27assistance through the period of pregnancy, including labor and delivery, and 60 days
19.28postpartum, to the extent federal funds are available under title XXI of the Social Security
19.29Act, and the state children's health insurance program.
19.30(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
19.31services from a nonprofit center established to serve victims of torture and are otherwise
19.32ineligible for medical assistance under this chapter are eligible for medical assistance
19.33without federal financial participation. These individuals are eligible only for the period
19.34during which they are receiving services from the center. Individuals eligible under this
19.35paragraph shall not be required to participate in prepaid medical assistance.
19.36EFFECTIVE DATE.This section is effective January 1, 2014.

20.1    Sec. 24. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
20.2    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
20.3for the quality of care based on standards established under subdivision 1, paragraph (b),
20.4clause (10), and the cost of care or utilization of services provided to its enrollees under
20.5subdivision 1, paragraph (b), clause (1).
20.6(b) A health care delivery system may contract and coordinate with providers and
20.7clinics for the delivery of services and shall contract with community health clinics,
20.8federally qualified health centers, community mental health centers or programs, county
20.9agencies, and rural clinics to the extent practicable.
20.10(c) A health care delivery system must demonstrate how its services will be
20.11coordinated with other services affecting its attributed patients' health, quality of care, and
20.12cost of care that are provided by other providers and county agencies in the local service
20.13area. The health care delivery system must document how other providers and counties,
20.14including county-based purchasing plans, will provide services to attributed patients of
20.15the health care delivery system, and how it will address applicable local needs, priorities,
20.16and public health goals. As part of this documentation, the health care delivery system
20.17must describe the involvement of local providers and counties, including county-based
20.18purchasing plans, in developing the application to participate in the demonstration project.
20.19EFFECTIVE DATE.This section is effective July 1, 2013, and applies to health
20.20care delivery system contracts entered into on or after that date.

20.21    Sec. 25. Minnesota Statutes 2012, section 256B.694, is amended to read:
20.22256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
20.23CONTRACT.
20.24    (a) MS 2010 [Expired, 2008 c 364 s 10]
20.25    (b) The commissioner shall consider, and may approve, contracting on a
20.26single-health plan basis with other county-based purchasing plans, or with other qualified
20.27health plans that have coordination arrangements with counties, to serve persons with a
20.28disability who voluntarily enroll enrolled in state public health care programs, in order
20.29to promote better coordination or integration of health care services, social services and
20.30other community-based services, provided that all requirements applicable to health plan
20.31purchasing, including those in section 256B.69, subdivision 23, are satisfied. Nothing in
20.32this paragraph supersedes or modifies the requirements in paragraph (a).

21.1    Sec. 26. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
21.2to read:
21.3    Subd. 1b. Affordable Care Act. "Affordable Care Act" means Public Law 111-148,
21.4as amended by the federal Health Care and Education Reconciliation Act of 2010, Public
21.5Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.

21.6    Sec. 27. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
21.7    Subd. 3a. Family with children. (a) "Family with children" means:
21.8(1) parents and their children residing in the same household; or
21.9(2) grandparents, foster parents, relative caretakers as defined in the medical
21.10assistance program, or legal guardians; and their wards who are children residing in the
21.11same household. "Family" has the meaning given for family and family size as defined
21.12in Code of Federal Regulations, title 26, section 1.36B-1.
21.13(b) The term includes children who are temporarily absent from the household in
21.14settings such as schools, camps, or parenting time with noncustodial parents.
21.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.16approval, whichever is later. The commissioner of human services shall notify the revisor
21.17of statutes when federal approval is obtained.

21.18    Sec. 28. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
21.19    Subd. 5. Income. (a) "Income" has the meaning given for earned and unearned
21.20income for families and children in the medical assistance program, according to the
21.21state's aid to families with dependent children plan in effect as of July 16, 1996. The
21.22definition does not include medical assistance income methodologies and deeming
21.23requirements. The earned income of full-time and part-time students under age 19 is
21.24not counted as income. Public assistance payments and supplemental security income
21.25are not excluded income modified adjusted gross income, as defined in Code of Federal
21.26Regulations, title 26, section 1.36B-1.
21.27(b) For purposes of this subdivision, and unless otherwise specified in this section,
21.28the commissioner shall use reasonable methods to calculate gross earned and unearned
21.29income including, but not limited to, projecting income based on income received within
21.30the past 30 days, the last 90 days, or the last 12 months.
21.31EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.32approval, whichever is later. The commissioner of human services shall notify the revisor
21.33of statutes when federal approval is obtained.

22.1    Sec. 29. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.2to read:
22.3    Subd. 6. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
22.4means the Minnesota Insurance Marketplace as defined in section 62V.02.

22.5    Sec. 30. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.6to read:
22.7    Subd. 7. Participating entity. "Participating entity" means a health carrier as
22.8defined in section 62A.01, subdivision 2; a county-based purchasing plan established
22.9under section 256B.692; an accountable care organization or other entity operating a
22.10health care delivery systems demonstration project authorized under section 256B.0755;
22.11an entity operating a county integrated health care delivery network pilot project
22.12authorized under section 256B.0756; or a network of health care providers established to
22.13offer services under MinnesotaCare.
22.14EFFECTIVE DATE.This section is effective January 1, 2015.

22.15    Sec. 31. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
22.16    Subd. 2. Commissioner's duties. (a) The commissioner shall establish an office
22.17for the state administration of this plan. The plan shall be used to provide covered health
22.18services for eligible persons. Payment for these services shall be made to all eligible
22.19providers participating entities under contract with the commissioner. The commissioner
22.20shall adopt rules to administer the MinnesotaCare program. The commissioner shall
22.21establish marketing efforts to encourage potentially eligible persons to receive information
22.22about the program and about other medical care programs administered or supervised by
22.23the Department of Human Services.
22.24(b) A toll-free telephone number and Web site must be used to provide information
22.25about medical programs and to promote access to the covered services.
22.26EFFECTIVE DATE.Paragraph (a) is effective January 1, 2015. Paragraph (b) is
22.27effective January 1, 2014.

22.28    Sec. 32. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
22.29to read:
22.30    Subd. 6. Federal approval. (a) The commissioner of human services shall seek
22.31federal approval to implement the MinnesotaCare program under this chapter as a basic
22.32health program. In any agreement with the Centers for Medicare and Medicaid Services
23.1to operate MinnesotaCare as a basic health program, the commissioner shall seek to
23.2include procedures to ensure that federal funding is predictable, stable, and sufficient
23.3to sustain ongoing operation of MinnesotaCare. These procedures must address issues
23.4related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
23.5and minimization of state financial risk. The commissioner shall consult with the
23.6commissioner of management and budget, when developing the proposal for establishing
23.7MinnesotaCare as a basic health program to be submitted to the Centers for Medicare
23.8and Medicaid Services.
23.9(b) The commissioner of human services, in consultation with the commissioner
23.10of management and budget, shall work with the Centers for Medicare and Medicaid
23.11Services to establish a process for reconciliation and adjustment of federal payments that
23.12balances state and federal liability over time. The commissioner of human services shall
23.13request that the United States secretary of health and human services hold the state, and
23.14enrollees, harmless in the reconciliation process for the first three years, to allow the state
23.15to develop a statistically valid methodology for predicting enrollment trends and their
23.16net effect on federal payments.
23.17(c) The commissioner of human services, through December 31, 2015, may modify
23.18the MinnesotaCare program as specified in this chapter, if it is necessary to enhance
23.19health benefits, expand provider access, or reduce cost-sharing and premiums in order
23.20to comply with the terms and conditions of federal approval as a basic health program.
23.21The commissioner may not reduce benefits, impose greater limits on access to providers,
23.22or increase cost-sharing and premiums by enrollees under the authority granted by this
23.23paragraph. If the commissioner modifies the terms and requirements for MinnesotaCare
23.24under this paragraph, the commissioner shall provide the legislature with notice of
23.25implementation of the modifications at least ten working days before notifying enrollees
23.26and participating entities. The costs of any changes to the program necessary to comply
23.27with federal approval shall not become part of the program's base funding for purposes of
23.28future budget forecasts.
23.29EFFECTIVE DATE.This section is effective the day following final enactment.

23.30    Sec. 33. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
23.31to read:
23.32    Subd. 7. Coordination with Minnesota Insurance Marketplace. MinnesotaCare
23.33shall be considered a public health care program for purposes of chapter 62V.
23.34EFFECTIVE DATE.This section is effective January 1, 2014.

24.1    Sec. 34. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
24.2    Subdivision 1. Covered health services. (a) "Covered health services" means the
24.3health services reimbursed under chapter 256B, with the exception of inpatient hospital
24.4services, special education services, private duty nursing services, adult dental care
24.5services other than services covered under section 256B.0625, subdivision 9, orthodontic
24.6services, nonemergency medical transportation services, personal care assistance and case
24.7management services, and nursing home or intermediate care facilities services, inpatient
24.8mental health services, and chemical dependency services.
24.9    (b) No public funds shall be used for coverage of abortion under MinnesotaCare
24.10except where the life of the female would be endangered or substantial and irreversible
24.11impairment of a major bodily function would result if the fetus were carried to term; or
24.12where the pregnancy is the result of rape or incest.
24.13    (c) Covered health services shall be expanded as provided in this section.
24.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.15approval, whichever is later. The commissioner of human services shall notify the revisor
24.16of statutes when federal approval is obtained.

24.17    Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
24.18    Subd. 1a. Pregnant women and Children; MinnesotaCare health care reform
24.19waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage
24.20of all services that are eligible for reimbursement under the medical assistance program
24.21according to chapter 256B, except that abortion services under MinnesotaCare shall be
24.22limited as provided under subdivision 1. Pregnant women and Children are exempt from
24.23the provisions of subdivision 5, regarding co-payments. Pregnant women and Children
24.24who are lawfully residing in the United States but who are not "qualified noncitizens" under
24.25title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
24.26Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
24.27of all services provided under the medical assistance program according to chapter 256B.
24.28EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.29approval, whichever is later. The commissioner of human services shall notify the revisor
24.30of statutes when federal approval is obtained.

24.31    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
24.32    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
24.33inpatient hospital services, including inpatient hospital mental health services and inpatient
25.1hospital and residential chemical dependency treatment, subject to those limitations
25.2necessary to coordinate the provision of these services with eligibility under the medical
25.3assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
25.4section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
25.52
, with family gross income that exceeds 200 percent of the federal poverty guidelines or
25.6215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
25.7pregnant, is subject to an annual limit of $10,000.
25.8    (b) Admissions for inpatient hospital services paid for under section 256L.11,
25.9subdivision 3
, must be certified as medically necessary in accordance with Minnesota
25.10Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
25.11    (1) all admissions must be certified, except those authorized under rules established
25.12under section 254A.03, subdivision 3, or approved under Medicare; and
25.13    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
25.14for admissions for which certification is requested more than 30 days after the day of
25.15admission. The hospital may not seek payment from the enrollee for the amount of the
25.16payment reduction under this clause.
25.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
25.18approval, whichever is later. The commissioner of human services shall notify the revisor
25.19of statutes when federal approval is obtained.

25.20    Sec. 37. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
25.21to read:
25.22    Subd. 4a. Loss ratio. Health coverage provided through the MinnesotaCare
25.23program must have a medical loss ratio of at least 85 percent, as defined using the loss
25.24ratio methodology described in section 1001 of the Affordable Care Act.
25.25EFFECTIVE DATE.This section is effective January 1, 2015.

25.26    Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
25.27    Subd. 5. Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
25.28 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
25.29requirements for all enrollees:
25.30    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
25.31subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
25.32    (2) (1) $3 per prescription for adult enrollees;
25.33    (3) (2) $25 for eyeglasses for adult enrollees;
26.1    (4) (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means
26.2an episode of service which is required because of a recipient's symptoms, diagnosis, or
26.3established illness, and which is delivered in an ambulatory setting by a physician or
26.4physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
26.5audiologist, optician, or optometrist;
26.6    (5) (4) $6 for nonemergency visits to a hospital-based emergency room for services
26.7provided through December 31, 2010, and $3.50 effective January 1, 2011; and
26.8(6) (5) a family deductible equal to the maximum amount allowed under Code of
26.9Federal Regulations, title 42, part 447.54.
26.10    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
26.11children under the age of 21.
26.12    (c) (b) Paragraph (a) does not apply to pregnant women and children under the
26.13age of 21.
26.14    (d) (c) Paragraph (a), clause (4) (3), does not apply to mental health services.
26.15    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
26.16poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
26.17and who are not pregnant shall be financially responsible for the coinsurance amount, if
26.18applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
26.19    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
26.20or changes from one prepaid health plan to another during a calendar year, any charges
26.21submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
26.22expenses incurred by the enrollee for inpatient services, that were submitted or incurred
26.23prior to enrollment, or prior to the change in health plans, shall be disregarded.
26.24(g) (d) MinnesotaCare reimbursements to fee-for-service providers and payments to
26.25managed care plans or county-based purchasing plans shall not be increased as a result of
26.26the reduction of the co-payments in paragraph (a), clause (5) (4), effective January 1, 2011.
26.27(h) (e) The commissioner, through the contracting process under section 256L.12,
26.28may allow managed care plans and county-based purchasing plans to waive the family
26.29deductible under paragraph (a), clause (6) (5). The value of the family deductible shall not
26.30be included in the capitation payment to managed care plans and county-based purchasing
26.31plans. Managed care plans and county-based purchasing plans shall certify annually to the
26.32commissioner the dollar value of the family deductible.
26.33EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
26.34approval, whichever is later. The commissioner of human services shall notify the revisor
26.35of statutes when federal approval is obtained.

27.1    Sec. 39. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
27.2    Subd. 6. Lien. When the state agency provides, pays for, or becomes liable for
27.3covered health services, the agency shall have a lien for the cost of the covered health
27.4services upon any and all causes of action accruing to the enrollee, or to the enrollee's
27.5legal representatives, as a result of the occurrence that necessitated the payment for the
27.6covered health services. All liens under this section shall be subject to the provisions
27.7of section 256.015. For purposes of this subdivision, "state agency" includes prepaid
27.8health plans participating entities, under contract with the commissioner according to
27.9sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
27.10purchasing entities under section 256B.692 section 256L.121.
27.11EFFECTIVE DATE.This section is effective January 1, 2015.

27.12    Sec. 40. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
27.13    Subdivision 1. Families with children. (a) Families with children with family
27.14income above 133 percent of the federal poverty guidelines and equal to or less than
27.15275 200 percent of the federal poverty guidelines for the applicable family size shall be
27.16eligible for MinnesotaCare according to this section. All other provisions of sections
27.17256L.01 to 256L.18, including the insurance-related barriers to enrollment under section
27.18256L.07, shall apply unless otherwise specified.
27.19    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
27.20if the children are eligible. Children may be enrolled separately without enrollment by
27.21parents. However, if one parent in the household enrolls, both parents must enroll, unless
27.22other insurance is available. If one child from a family is enrolled, all children must
27.23be enrolled, unless other insurance is available. If one spouse in a household enrolls,
27.24the other spouse in the household must also enroll, unless other insurance is available.
27.25Families cannot choose to enroll only certain uninsured members.
27.26    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
27.27to the MinnesotaCare program. These persons are no longer counted in the parental
27.28household and may apply as a separate household.
27.29    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
27.30(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
27.318
, are exempt from the eligibility requirements of this subdivision.
27.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.33approval, whichever is later. The commissioner of human services shall notify the revisor
27.34of statutes when federal approval is obtained.

28.1    Sec. 41. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
28.2to read:
28.3    Subd. 1c. General requirements. To be eligible for coverage under MinnesotaCare,
28.4a person must meet the eligibility requirements of this section. A person eligible for
28.5MinnesotaCare shall not be considered a qualified individual under section 1312 of the
28.6Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
28.7through the Minnesota Insurance Marketplace under chapter 62V.
28.8EFFECTIVE DATE.This section is effective January 1, 2014.

28.9    Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
28.10    Subd. 7. Single adults and households with no children. (a) The definition of
28.11eligible persons includes all individuals and households families with no children who
28.12have gross family incomes that are above 133 percent and equal to or less than 200 percent
28.13of the federal poverty guidelines for the applicable family size.
28.14    (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
28.15and households with no children who have gross family incomes that are equal to or less
28.16than 250 percent of the federal poverty guidelines.
28.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
28.18approval, whichever is later. The commissioner of human services shall notify the revisor
28.19of statutes when federal approval is obtained.

28.20    Sec. 43. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
28.21    Subd. 8. Applicants potentially eligible for medical assistance. (a) Individuals
28.22who receive supplemental security income or retirement, survivors, or disability benefits
28.23due to a disability, or other disability-based pension, who qualify under subdivision 7, but
28.24who are potentially eligible for medical assistance without a spenddown shall be allowed
28.25to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
28.26conditions of eligibility. The commissioner shall identify and refer the applications of
28.27such individuals to their county social service agency. The county and the commissioner
28.28shall cooperate to ensure that the individuals obtain medical assistance coverage for any
28.29months for which they are eligible.
28.30(b) The enrollee must cooperate with the county social service agency in determining
28.31medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
28.32cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
28.33from the plan within one calendar month. Persons disenrolled for nonapplication for
29.1medical assistance may not reenroll until they have obtained a medical assistance
29.2eligibility determination. Persons disenrolled for noncooperation with medical assistance
29.3may not reenroll until they have cooperated with the county agency and have obtained a
29.4medical assistance eligibility determination.
29.5(c) Beginning January 1, 2000, Counties that choose to become MinnesotaCare
29.6enrollment sites shall consider MinnesotaCare applications to also be applications for
29.7medical assistance. Applicants who are potentially eligible for medical assistance, except
29.8for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
29.9medical assistance.
29.10(d) The commissioner shall redetermine provider payments made under
29.11MinnesotaCare to the appropriate medical assistance payments for those enrollees who
29.12subsequently become eligible for medical assistance.
29.13EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.14approval, whichever is later. The commissioner of human services shall notify the revisor
29.15of statutes when federal approval is obtained.

29.16    Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
29.17    Subd. 10. Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to
29.18citizens or nationals of the United States, qualified noncitizens, and other persons residing
29.19 lawfully in the United States present noncitizens as defined in Code of Federal Regulations,
29.20title 8, section 103.12. Undocumented noncitizens and nonimmigrants are ineligible for
29.21MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in one
29.22or more of the classes listed in United States Code, title 8, section 1101(a)(15), and an
29.23undocumented noncitizen is an individual who resides in the United States without the
29.24approval or acquiescence of the United States Citizenship and Immigration Services.
29.25Families with children who are citizens or nationals of the United States must cooperate in
29.26obtaining satisfactory documentary evidence of citizenship or nationality according to the
29.27requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.
29.28(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and
29.29individuals who are lawfully present and ineligible for medical assistance by reason of
29.30immigration status and who have incomes equal to or less than 200 percent of federal
29.31poverty guidelines.
29.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.33approval, whichever is later. The commissioner of human services shall notify the revisor
29.34of statutes when federal approval is obtained.

30.1    Sec. 45. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:
30.2    Subd. 12. Persons in detention. Beginning January 1, 1999, An applicant or
30.3enrollee residing in a correctional or detention facility is not eligible for MinnesotaCare,
30.4unless the applicant or enrollee is awaiting disposition of charges. An enrollee residing in
30.5a correctional or detention facility is not eligible at renewal of eligibility under section
30.6256L.05, subdivision 3a.
30.7EFFECTIVE DATE.This section is effective January 1, 2014.

30.8    Sec. 46. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
30.9to read:
30.10    Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
30.11medical assistance under chapter 256B are not eligible for MinnesotaCare under this
30.12section.
30.13(b) The commissioner shall coordinate eligibility and coverage to ensure that
30.14individuals transitioning between medical assistance and MinnesotaCare have seamless
30.15eligibility and access to health care services.
30.16EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
30.17approval, whichever is later. The commissioner of human services shall notify the revisor
30.18of statutes when federal approval is obtained.

30.19    Sec. 47. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
30.20    Subdivision 1. Application assistance and information availability. (a) Applicants
30.21may submit applications online, in person, by mail, or by phone in accordance with the
30.22Affordable Care Act, and by any other means by which medical assistance applications
30.23may be submitted. Applicants may submit applications through the Minnesota Insurance
30.24Marketplace or through the MinnesotaCare program. Applications and application
30.25assistance must be made available at provider offices, local human services agencies,
30.26school districts, public and private elementary schools in which 25 percent or more of
30.27the students receive free or reduced price lunches, community health offices, Women,
30.28Infants and Children (WIC) program sites, Head Start program sites, public housing
30.29councils, crisis nurseries, child care centers, early childhood education and preschool
30.30program sites, legal aid offices, and libraries, and at any other locations at which medical
30.31assistance applications must be made available. These sites may accept applications and
30.32forward the forms to the commissioner or local county human services agencies that
31.1choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
31.2commissioner or to participating local county human services agencies.
31.3(b) Application assistance must be available for applicants choosing to file an online
31.4application through the Minnesota Insurance Marketplace.
31.5EFFECTIVE DATE.This section is effective January 1, 2014.

31.6    Sec. 48. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
31.7    Subd. 2. Commissioner's duties. The commissioner or county agency shall use
31.8electronic verification through the Minnesota Insurance Marketplace as the primary
31.9method of income verification. If there is a discrepancy between reported income
31.10and electronically verified income, an individual may be required to submit additional
31.11verification to the extent permitted under the Affordable Care Act. In addition, the
31.12commissioner shall perform random audits to verify reported income and eligibility. The
31.13commissioner may execute data sharing arrangements with the Department of Revenue
31.14and any other governmental agency in order to perform income verification related to
31.15eligibility and premium payment under the MinnesotaCare program.
31.16EFFECTIVE DATE.This section is effective January 1, 2014.

31.17    Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
31.18    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
31.19first day of the month following the month in which eligibility is approved and the first
31.20premium payment has been received. As provided in section 256B.057, coverage for
31.21newborns is automatic from the date of birth and must be coordinated with other health
31.22coverage. The effective date of coverage for eligible newly adoptive children added to a
31.23family receiving covered health services is the month of placement. The effective date
31.24of coverage for other new members added to the family is the first day of the month
31.25following the month in which the change is reported. All eligibility criteria must be met
31.26by the family at the time the new family member is added. The income of the new family
31.27member is included with the family's modified adjusted gross income and the adjusted
31.28premium begins in the month the new family member is added.
31.29(b) The initial premium must be received by the last working day of the month for
31.30coverage to begin the first day of the following month.
31.31(c) Benefits are not available until the day following discharge if an enrollee is
31.32hospitalized on the first day of coverage.
32.1(d) (c) Notwithstanding any other law to the contrary, benefits under sections
32.2256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
32.3an eligible person may have coverage and the commissioner shall use cost avoidance
32.4techniques to ensure coordination of any other health coverage for eligible persons. The
32.5commissioner shall identify eligible persons who may have coverage or benefits under
32.6other plans of insurance or who become eligible for medical assistance.
32.7(e) (d) The effective date of coverage for individuals or families who are exempt
32.8from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first
32.9day of the month following the month in which verification of American Indian status
32.10is received or eligibility is approved, whichever is later.
32.11(f) (e) The effective date of coverage for children eligible under section 256L.07,
32.12subdivision 8, is the first day of the month following the date of termination from foster
32.13care or release from a juvenile residential correctional facility.
32.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
32.15approval, whichever is later. The commissioner of human services shall notify the revisor
32.16of statutes when federal approval is obtained.

32.17    Sec. 50. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:
32.18    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective
32.19date of coverage shall be the first day of the month following termination from medical
32.20assistance for families and individuals who are eligible for MinnesotaCare and who
32.21submitted a written request for retroactive MinnesotaCare coverage with a completed
32.22application within 30 days of the mailing of notification of termination from medical
32.23assistance. The applicant must provide all required verifications within 30 days of the
32.24written request for verification. For retroactive coverage, premiums must be paid in full
32.25for any retroactive month, current month, and next month within 30 days of the premium
32.26billing. General assistance medical care recipients may qualify for retroactive coverage
32.27under this subdivision at six-month renewal.
32.28EFFECTIVE DATE.This section is effective January 1, 2014.

32.29    Sec. 51. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
32.30    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
32.31commissioner for MinnesotaCare.
32.32    (b) The commissioner shall develop and implement procedures to: (1) require
32.33enrollees to report changes in income; (2) adjust sliding scale premium payments, based
33.1upon both increases and decreases in enrollee income, at the time the change in income
33.2is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
33.3premiums. Failure to pay includes payment with a dishonored check, a returned automatic
33.4bank withdrawal, or a refused credit card or debit card payment. The commissioner may
33.5demand a guaranteed form of payment, including a cashier's check or a money order, as
33.6the only means to replace a dishonored, returned, or refused payment.
33.7    (c) Premiums are calculated on a calendar month basis and may be paid on a
33.8monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
33.9commissioner of the premium amount required. The commissioner shall inform applicants
33.10and enrollees of these premium payment options. Premium payment is required before
33.11enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
33.12received before noon are credited the same day. Premium payments received after noon
33.13are credited on the next working day.
33.14    (d) Nonpayment of the premium will result in disenrollment from the plan effective
33.15for the calendar month for which the premium was due. Persons disenrolled for
33.16nonpayment or who voluntarily terminate coverage from the program may not reenroll
33.17until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
33.18all past due premiums as well as current premiums due, including premiums due for the
33.19period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
33.20to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
33.21terminate coverage from the program may not reenroll for four calendar months unless
33.22the person demonstrates good cause for nonpayment. Good cause does not exist if a
33.23person chooses to pay other family expenses instead of the premium. The commissioner
33.24shall define good cause in rule.
33.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.26approval, whichever is later. The commissioner of human services shall notify the revisor
33.27of statutes when federal approval is obtained.

33.28    Sec. 52. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
33.29    Subdivision 1. General requirements. (a) Children enrolled in the original
33.30children's health plan as of September 30, 1992, children who enrolled in the
33.31MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
33.32article 4, section 17, and children who have family gross incomes that are equal to or
33.33less than 200 percent of the federal poverty guidelines are eligible without meeting the
33.34requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
33.35they maintain continuous coverage in the MinnesotaCare program or medical assistance.
34.1    Parents Families and individuals enrolled in MinnesotaCare under section 256L.04,
34.2subdivision 1
, whose income increases above 275 200 percent of the federal poverty
34.3guidelines, are no longer eligible for the program and shall be disenrolled by the
34.4commissioner. Beginning January 1, 2008, Individuals enrolled in MinnesotaCare under
34.5section 256L.04, subdivision 7, whose income increases above 200 percent of the federal
34.6poverty guidelines or 250 percent of the federal poverty guidelines on or after July 1,
34.72009, are no longer eligible for the program and shall be disenrolled by the commissioner.
34.8 For persons disenrolled under this subdivision, MinnesotaCare coverage terminates the
34.9last day of the calendar month following the month in which the commissioner determines
34.10that the income of a family or individual exceeds program income limits.
34.11    (b) Children may remain enrolled in MinnesotaCare if their gross family income as
34.12defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty
34.13guidelines. The premium for children remaining eligible under this paragraph shall be the
34.14maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
34.15    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
34.16gross household income exceeds $57,500 for the 12-month period of eligibility.
34.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.18approval, whichever is later. The commissioner of human services shall notify the revisor
34.19of statutes when federal approval is obtained.

34.20    Sec. 53. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
34.21    Subd. 2. Must not have access to employer-subsidized minimum essential
34.22 coverage. (a) To be eligible, a family or individual must not have access to subsidized
34.23health coverage through an employer and must not have had access to employer-subsidized
34.24coverage through a current employer for 18 months prior to application or reapplication.
34.25A family or individual whose employer-subsidized coverage is lost due to an employer
34.26terminating health care coverage as an employee benefit during the previous 18 months is
34.27not eligible that is affordable and provides minimum value as defined in Code of Federal
34.28Regulations, title 26, section 1.36B-2.
34.29(b) This subdivision does not apply to a family or individual who was enrolled
34.30in MinnesotaCare within six months or less of reapplication and who no longer has
34.31employer-subsidized coverage due to the employer terminating health care coverage as an
34.32employee benefit. This subdivision does not apply to children with family gross incomes
34.33that are equal to or less than 200 percent of federal poverty guidelines.
34.34(c) For purposes of this requirement, subsidized health coverage means health
34.35coverage for which the employer pays at least 50 percent of the cost of coverage for
35.1the employee or dependent, or a higher percentage as specified by the commissioner.
35.2Children are eligible for employer-subsidized coverage through either parent, including
35.3the noncustodial parent. The commissioner must treat employer contributions to Internal
35.4Revenue Code Section 125 plans and any other employer benefits intended to pay
35.5health care costs as qualified employer subsidies toward the cost of health coverage for
35.6employees for purposes of this subdivision.
35.7EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
35.8approval, whichever is later. The commissioner of human services shall notify the revisor
35.9of statutes when federal approval is obtained.

35.10    Sec. 54. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
35.11    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
35.12MinnesotaCare program must have no To be eligible, a family or individual must not have
35.13minimum essential health coverage while enrolled, as defined by section 5000A of the
35.14Internal Revenue Code. Children with family gross incomes equal to or greater than 200
35.15percent of federal poverty guidelines, and adults, must have had no health coverage for
35.16at least four months prior to application and renewal. Children enrolled in the original
35.17children's health plan and children in families with income equal to or less than 200
35.18percent of the federal poverty guidelines, who have other health insurance, are eligible if
35.19the coverage:
35.20(1) lacks two or more of the following:
35.21(i) basic hospital insurance;
35.22(ii) medical-surgical insurance;
35.23(iii) prescription drug coverage;
35.24(iv) dental coverage; or
35.25(v) vision coverage;
35.26(2) requires a deductible of $100 or more per person per year; or
35.27(3) lacks coverage because the child has exceeded the maximum coverage for a
35.28particular diagnosis or the policy excludes a particular diagnosis.
35.29The commissioner may change this eligibility criterion for sliding scale premiums
35.30in order to remain within the limits of available appropriations. The requirement of no
35.31health coverage does not apply to newborns.
35.32(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
35.33assistance, and the Civilian Health and Medical Program of the Uniformed Service,
35.34CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
36.1part II, chapter 55, are not considered insurance or health coverage for purposes of the
36.2four-month requirement described in this subdivision.
36.3(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
36.4Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
36.5Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
36.6to have minimum essential health coverage. An applicant or enrollee who is entitled to
36.7premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
36.8to establish eligibility for MinnesotaCare.
36.9(d) Applicants who were recipients of medical assistance within one month of
36.10application must meet the provisions of this subdivision and subdivision 2.
36.11(e) Cost-effective health insurance that was paid for by medical assistance is not
36.12considered health coverage for purposes of the four-month requirement under this
36.13section, except if the insurance continued after medical assistance no longer considered it
36.14cost-effective or after medical assistance closed.
36.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.16approval, whichever is later. The commissioner of human services shall notify the revisor
36.17of statutes when federal approval is obtained.

36.18    Sec. 55. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
36.19    Subd. 2. Residency requirement. To be eligible for health coverage under the
36.20MinnesotaCare program, pregnant women, individuals, and families with children must
36.21meet the residency requirements as provided by Code of Federal Regulations, title 42,
36.22section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply
36.23upon receipt of federal approval.
36.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.25approval, whichever is later. The commissioner of human services shall notify the revisor
36.26of statutes when federal approval is obtained.

36.27    Sec. 56. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:
36.28    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers
36.29under sections 256L.01 to 256L.11 this chapter shall be at the same rates and conditions
36.30established for medical assistance, except as provided in subdivisions 2 to 6 this section.
36.31(b) Effective for services provided on or after July 1, 2009, total payments for basic
36.32care services shall be reduced by three percent, in accordance with section 256B.766.
37.1Payments made to managed care and county-based purchasing plans shall be reduced for
37.2services provided on or after October 1, 2009, to reflect this reduction.
37.3(c) Effective for services provided on or after July 1, 2009, payment rates for
37.4physician and professional services shall be reduced as described under section 256B.76,
37.5subdivision 1, paragraph (c). Payments made to managed care and county-based
37.6purchasing plans shall be reduced for services provided on or after October 1, 2009,
37.7to reflect this reduction.
37.8EFFECTIVE DATE.This section is effective January 1, 2014.

37.9    Sec. 57. Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:
37.10    Subd. 3. Inpatient hospital services. Inpatient hospital services provided under
37.11section 256L.03, subdivision 3, shall be paid for as provided in subdivisions 4 to 6 at the
37.12medical assistance rate.
37.13EFFECTIVE DATE.This section is effective January 1, 2014.

37.14    Sec. 58. [256L.121] SERVICE DELIVERY.
37.15    Subdivision 1. Competitive process. The commissioner of human services shall
37.16establish a competitive process for entering into contracts with participating entities for
37.17the offering of standard health plans through MinnesotaCare. Coverage through standard
37.18health plans must be available to enrollees beginning January 1, 2015. Each standard health
37.19plan must cover the health services listed in, and meet the requirements of, section 256L.03.
37.20The competitive process must meet the requirements of section 1331 of the Affordable
37.21Care Act and be designed to ensure enrollee access to high-quality health care coverage
37.22options. The commissioner, to the extent feasible, shall seek to ensure that enrollees have
37.23a choice of coverage from more than one participating entity within a geographic area.
37.24    Subd. 2. Other requirements for participating entities. The commissioner shall
37.25require participating entities, as a condition of contract, to document to the commissioner:
37.26(1) the provision of culturally and linguistically appropriate services, including
37.27marketing materials, to MinnesotaCare enrollees; and
37.28(2) the inclusion in provider networks of providers designated as essential
37.29community providers under section 62Q.19.
37.30    Subd. 3. Coordination with state-administered health programs. The
37.31commissioner shall coordinate the administration of the MinnesotaCare program with
37.32medical assistance to maximize efficiency and improve the continuity of care. This
37.33includes, but is not limited to:
38.1(1) establishing geographic areas for MinnesotaCare that are consistent with the
38.2geographic areas of the medical assistance program, within which participating entities
38.3may offer health plans;
38.4(2) requiring, as a condition of participation in MinnesotaCare, participating entities
38.5to also participate in the medical assistance program;
38.6    (3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and
38.7256B.694 when contracting with MinnesotaCare participating entities;
38.8(4) providing MinnesotaCare enrollees, to the extent possible, with the option to
38.9remain in the same health plan and provider network, if they later become eligible for
38.10medical assistance or coverage through the Minnesota Insurance Marketplace and if, in
38.11the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health
38.12plan is also a medical assistance health plan in the enrollee's county of residence; and
38.13(5) establishing requirements and criteria for selection that ensure that covered
38.14health care services will be coordinated with local public health, social services, long-term
38.15care services, mental health services, and other local services affecting enrollees' health,
38.16access, and quality of care.
38.17EFFECTIVE DATE.This section is effective the day following final enactment.

38.18    Sec. 59. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
38.19    Subdivision 1. Premium determination. (a) Families with children and individuals
38.20shall pay a premium determined according to subdivision 2.
38.21    (b) Pregnant women and children under age two are exempt from the provisions
38.22of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
38.23for failure to pay premiums. For pregnant women, this exemption continues until the
38.24first day of the month following the 60th day postpartum. Women who remain enrolled
38.25during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
38.26disenrolled on the first of the month following the 60th day postpartum for the penalty
38.27period that otherwise applies under section 256L.06, unless they begin paying premiums.
38.28    (c) (b) Members of the military and their families who meet the eligibility criteria
38.29for MinnesotaCare upon eligibility approval made within 24 months following the end
38.30of the member's tour of active duty shall have their premiums paid by the commissioner.
38.31The effective date of coverage for an individual or family who meets the criteria of this
38.32paragraph shall be the first day of the month following the month in which eligibility is
38.33approved. This exemption applies for 12 months.
38.34(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
38.35their families shall have their premiums waived by the commissioner in accordance with
39.1section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
39.2An individual must document status as an American Indian, as defined under Code of
39.3Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
39.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
39.5approval, whichever is later. The commissioner of human services shall notify the revisor
39.6of statutes when federal approval is obtained.

39.7    Sec. 60. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
39.8    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
39.9commissioner shall establish a sliding fee scale to determine the percentage of monthly
39.10 gross individual or family income that households at different income levels must pay to
39.11obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
39.12on the enrollee's monthly gross individual or family income. The sliding fee scale must
39.13contain separate tables based on enrollment of one, two, or three or more persons. Until
39.14June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
39.15individual or family income for individuals or families with incomes below the limits for
39.16the medical assistance program for families and children in effect on January 1, 1999, and
39.17proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
39.188.8 percent. These percentages are matched to evenly spaced income steps ranging from
39.19the medical assistance income limit for families and children in effect on January 1, 1999,
39.20to 275 200 percent of the federal poverty guidelines for the applicable family size, up to a
39.21family size of five. The sliding fee scale for a family of five must be used for families of
39.22more than five. The sliding fee scale and percentages are not subject to the provisions of
39.23chapter 14. If a family or individual reports increased income after enrollment, premiums
39.24shall be adjusted at the time the change in income is reported.
39.25    (b) Children in families whose gross income is above 275 percent of the federal
39.26poverty guidelines shall pay the maximum premium. The maximum premium is defined
39.27as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
39.28cases paid the maximum premium, the total revenue would equal the total cost of
39.29MinnesotaCare medical coverage and administration. In this calculation, administrative
39.30costs shall be assumed to equal ten percent of the total. The costs of medical coverage
39.31for pregnant women and children under age two and the enrollees in these groups shall
39.32be excluded from the total. The maximum premium for two enrollees shall be twice the
39.33maximum premium for one, and the maximum premium for three or more enrollees shall
39.34be three times the maximum premium for one.
40.1    (c) Beginning July 1, 2009, (b) MinnesotaCare enrollees shall pay premiums
40.2according to the premium scale specified in paragraph (d) (c), with the exception that
40.3children in families with income at or below 200 percent of the federal poverty guidelines
40.4shall pay no premiums. For purposes of paragraph (d) (c), "minimum" means a monthly
40.5premium of $4.
40.6    (d) the following premium scale is established for individuals and families with
40.7gross family incomes of 275 percent of the federal poverty guidelines or less:
40.8
Federal Poverty Guideline Range
Percent of Average Gross Monthly Income
40.9
0-45%
minimum
40.10
40.11
46-54%
$4 or 1.1% of family income, whichever is
greater
40.12
55-81%
1.6%
40.13
82-109%
2.2%
40.14
110-136%
2.9%
40.15
137-164%
3.6%
40.16
165-191%
4.6%
40.17
192-219%
5.6%
40.18
220-248%
6.5%
40.19
249-275%
7.2%
40.20(c) Effective January 1, 2014, the following premium scale is established for
40.21individuals and families with incomes of 200 percent of federal poverty guidelines or less:
40.22
Federal Poverty Guideline Range
Percent of Average Income
40.23
0-45%
minimum
40.24
40.25
46-54%
$4 or .25% of family income, whichever is
greater
40.26
55-81%
.5%
40.27
82-109%
1.0%
40.28
110-136%
1.5%
40.29
137-164%
2.0%
40.30
165-191%
2.5%
40.31
192-200%
3.0%
40.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
40.33approval, whichever is later. The commissioner of human services shall notify the revisor
40.34of statutes when federal approval is obtained.

40.35    Sec. 61. Laws 2013, chapter 1, section 1, the effective date, is amended to read:
40.36EFFECTIVE DATE.This section is effective January 1, 2014 July 1, 2013.

41.1    Sec. 62. DETERMINATION OF FUNDING ADEQUACY FOR
41.2MINNESOTACARE.
41.3The commissioners of revenue and management and budget, in consultation with
41.4the commissioner of human services, shall conduct an assessment of health care taxes,
41.5including the gross premiums tax, the provider tax, and Medicaid surcharges, and their
41.6relationship to the long-term solvency of the health care access fund, as part of the state
41.7revenue and expenditure forecast in November 2013. The commissioners shall determine
41.8the amount of state funding that will be required after December 31, 2019, in addition
41.9to the federal payments made available under section 1331 of the Affordable Care Act,
41.10for the MinnesotaCare program. The commissioners shall evaluate the stability and
41.11likelihood of long-term federal funding for the MinnesotaCare program under section
41.121331. The commissioners shall report the results of this assessment to the chairs and
41.13ranking minority members of the legislative committees with jurisdiction over human
41.14services, finances, and taxes by January 15, 2014, along with recommendations for
41.15changes to state revenue for the health care access fund, if state funding continues to
41.16be required beyond December 31, 2019.

41.17    Sec. 63. REVISOR'S INSTRUCTION.
41.18The revisor shall remove cross-references to the sections repealed in this act
41.19wherever they appear in Minnesota Statutes and Minnesota Rules and make changes
41.20necessary to correct the punctuation, grammar, or structure of the remaining text and
41.21preserve its meaning.

41.22    Sec. 64. REPEALER.
41.23(a) Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.02, subdivision
41.243; 256L.031; 256L.04, subdivisions 1b, 7a, and 9; and 256L.11, subdivisions 2a, 5, and
41.256, are repealed, effective January 1, 2014.
41.26(b) Minnesota Statutes 2012, sections 256L.01, subdivision 3; 256L.03, subdivision
41.274; 256L.04, subdivision 2a; 256L.07, subdivisions 1, 4, 5, 8, and 9; 256L.09, subdivisions
41.281, 4, 5, 6, and 7; 256L.12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9a, and 9b; and 256L.17,
41.29subdivisions 1, 2, 3, 4, and 5, are repealed effective January 1, 2015.
41.30(c) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b;
41.31256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed.

42.1ARTICLE 2
42.2CONTINGENT REFORM 2020; REDESIGNING HOME AND
42.3COMMUNITY-BASED SERVICES

42.4    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
42.5    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
42.6electronically submit to the commissioner of health case mix assessments that conform
42.7with the assessment schedule defined by Code of Federal Regulations, title 42, section
42.8483.20, and published by the United States Department of Health and Human Services,
42.9Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
42.10Instrument User's Manual, version 3.0, and subsequent updates when issued by the
42.11Centers for Medicare and Medicaid Services. The commissioner of health may substitute
42.12successor manuals or question and answer documents published by the United States
42.13Department of Health and Human Services, Centers for Medicare and Medicaid Services,
42.14to replace or supplement the current version of the manual or document.
42.15(b) The assessments used to determine a case mix classification for reimbursement
42.16include the following:
42.17(1) a new admission assessment must be completed by day 14 following admission;
42.18(2) an annual assessment which must have an assessment reference date (ARD)
42.19within 366 days of the ARD of the last comprehensive assessment;
42.20(3) a significant change assessment must be completed within 14 days of the
42.21identification of a significant change; and
42.22(4) all quarterly assessments must have an assessment reference date (ARD) within
42.2392 days of the ARD of the previous assessment.
42.24(c) In addition to the assessments listed in paragraph (b), the assessments used to
42.25determine nursing facility level of care include the following:
42.26(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a
42.27county, tribe, or managed care organization under contract with the Department of Human
42.28Services 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line
42.29or other organization under contract with the Minnesota Board on Aging; and
42.30(2) a nursing facility level of care determination as provided for under section
42.31256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
42.32completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
42.33managed care organization under contract with the Department of Human Services.

43.1    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
43.2144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
43.3REPORT AND STUDY REQUIRED.
43.4    Subdivision 1. Report requirements. The commissioners of health and human
43.5services, with the cooperation of counties and in consultation with stakeholders, including
43.6persons who need or are using long-term care services and supports, lead agencies,
43.7regional entities, senior, disability, and mental health organization representatives, service
43.8providers, and community members shall prepare a report to the legislature by August 15,
43.92013, and biennially thereafter, regarding the status of the full range of long-term care
43.10services and supports for the elderly and children and adults with disabilities and mental
43.11illnesses in Minnesota. The report shall address:
43.12    (1) demographics and need for long-term care services and supports in Minnesota;
43.13    (2) summary of county and regional reports on long-term care gaps, surpluses,
43.14imbalances, and corrective action plans;
43.15    (3) status of long-term care services and related mental health services, housing
43.16options, and supports by county and region including:
43.17    (i) changes in availability of the range of long-term care services and housing options;
43.18    (ii) access problems, including access to the least restrictive and most integrated
43.19services and settings, regarding long-term care services; and
43.20    (iii) comparative measures of long-term care services availability, including serving
43.21people in their home areas near family, and changes over time; and
43.22    (4) recommendations regarding goals for the future of long-term care services and
43.23supports, policy and fiscal changes, and resource development and transition needs.
43.24    Subd. 2. Critical access study. The commissioner shall conduct a onetime study to
43.25assess local capacity and availability of home and community-based services for older
43.26adults, people with disabilities, and people with mental illnesses. The study must assess
43.27critical access at the community level and identify potential strategies to build home and
43.28community-based service capacity in critical access areas. The report shall be submitted
43.29to the legislature no later than August 15, 2015.

43.30    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
43.31    Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
43.32licensure of city, county, and state agency social workers is voluntary, except an individual
43.33who is newly employed by a city or state agency after July 1, 2016, must be licensed
43.34if the individual who provides social work services, as those services are defined in
44.1section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title
44.2incorporating the words "social work" or "social worker."
44.3(b) City, county, and state agencies employing social workers and staff who are
44.4designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
44.5256.01, subdivision 24, are not required to employ licensed social workers.

44.6    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
44.7    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
44.82
, the commissioner of human services shall carry out the specific duties in paragraphs (a)
44.9through (cc) (dd):
44.10    (a) Administer and supervise all forms of public assistance provided for by state law
44.11and other welfare activities or services as are vested in the commissioner. Administration
44.12and supervision of human services activities or services includes, but is not limited to,
44.13assuring timely and accurate distribution of benefits, completeness of service, and quality
44.14program management. In addition to administering and supervising human services
44.15activities vested by law in the department, the commissioner shall have the authority to:
44.16    (1) require county agency participation in training and technical assistance programs
44.17to promote compliance with statutes, rules, federal laws, regulations, and policies
44.18governing human services;
44.19    (2) monitor, on an ongoing basis, the performance of county agencies in the
44.20operation and administration of human services, enforce compliance with statutes, rules,
44.21federal laws, regulations, and policies governing welfare services and promote excellence
44.22of administration and program operation;
44.23    (3) develop a quality control program or other monitoring program to review county
44.24performance and accuracy of benefit determinations;
44.25    (4) require county agencies to make an adjustment to the public assistance benefits
44.26issued to any individual consistent with federal law and regulation and state law and rule
44.27and to issue or recover benefits as appropriate;
44.28    (5) delay or deny payment of all or part of the state and federal share of benefits and
44.29administrative reimbursement according to the procedures set forth in section 256.017;
44.30    (6) make contracts with and grants to public and private agencies and organizations,
44.31both profit and nonprofit, and individuals, using appropriated funds; and
44.32    (7) enter into contractual agreements with federally recognized Indian tribes with
44.33a reservation in Minnesota to the extent necessary for the tribe to operate a federally
44.34approved family assistance program or any other program under the supervision of the
44.35commissioner. The commissioner shall consult with the affected county or counties in
45.1the contractual agreement negotiations, if the county or counties wish to be included,
45.2in order to avoid the duplication of county and tribal assistance program services. The
45.3commissioner may establish necessary accounts for the purposes of receiving and
45.4disbursing funds as necessary for the operation of the programs.
45.5    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
45.6regulation, and policy necessary to county agency administration of the programs.
45.7    (c) Administer and supervise all child welfare activities; promote the enforcement of
45.8laws protecting disabled, dependent, neglected and delinquent children, and children born
45.9to mothers who were not married to the children's fathers at the times of the conception
45.10nor at the births of the children; license and supervise child-caring and child-placing
45.11agencies and institutions; supervise the care of children in boarding and foster homes or
45.12in private institutions; and generally perform all functions relating to the field of child
45.13welfare now vested in the State Board of Control.
45.14    (d) Administer and supervise all noninstitutional service to disabled persons,
45.15including those who are visually impaired, hearing impaired, or physically impaired
45.16or otherwise disabled. The commissioner may provide and contract for the care and
45.17treatment of qualified indigent children in facilities other than those located and available
45.18at state hospitals when it is not feasible to provide the service in state hospitals.
45.19    (e) Assist and actively cooperate with other departments, agencies and institutions,
45.20local, state, and federal, by performing services in conformity with the purposes of Laws
45.211939, chapter 431.
45.22    (f) Act as the agent of and cooperate with the federal government in matters of
45.23mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
45.24431, including the administration of any federal funds granted to the state to aid in the
45.25performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
45.26and including the promulgation of rules making uniformly available medical care benefits
45.27to all recipients of public assistance, at such times as the federal government increases its
45.28participation in assistance expenditures for medical care to recipients of public assistance,
45.29the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
45.30    (g) Establish and maintain any administrative units reasonably necessary for the
45.31performance of administrative functions common to all divisions of the department.
45.32    (h) Act as designated guardian of both the estate and the person of all the wards of
45.33the state of Minnesota, whether by operation of law or by an order of court, without any
45.34further act or proceeding whatever, except as to persons committed as developmentally
45.35disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
45.36recognized by the Secretary of the Interior whose interests would be best served by
46.1adoptive placement, the commissioner may contract with a licensed child-placing agency
46.2or a Minnesota tribal social services agency to provide adoption services. A contract
46.3with a licensed child-placing agency must be designed to supplement existing county
46.4efforts and may not replace existing county programs or tribal social services, unless the
46.5replacement is agreed to by the county board and the appropriate exclusive bargaining
46.6representative, tribal governing body, or the commissioner has evidence that child
46.7placements of the county continue to be substantially below that of other counties. Funds
46.8encumbered and obligated under an agreement for a specific child shall remain available
46.9until the terms of the agreement are fulfilled or the agreement is terminated.
46.10    (i) Act as coordinating referral and informational center on requests for service for
46.11newly arrived immigrants coming to Minnesota.
46.12    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
46.13way be construed to be a limitation upon the general transfer of powers herein contained.
46.14    (k) Establish county, regional, or statewide schedules of maximum fees and charges
46.15which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
46.16nursing home care and medicine and medical supplies under all programs of medical
46.17care provided by the state and for congregate living care under the income maintenance
46.18programs.
46.19    (l) Have the authority to conduct and administer experimental projects to test methods
46.20and procedures of administering assistance and services to recipients or potential recipients
46.21of public welfare. To carry out such experimental projects, it is further provided that the
46.22commissioner of human services is authorized to waive the enforcement of existing specific
46.23statutory program requirements, rules, and standards in one or more counties. The order
46.24establishing the waiver shall provide alternative methods and procedures of administration,
46.25shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
46.26in no event shall the duration of a project exceed four years. It is further provided that no
46.27order establishing an experimental project as authorized by the provisions of this section
46.28shall become effective until the following conditions have been met:
46.29    (1) the secretary of health and human services of the United States has agreed, for
46.30the same project, to waive state plan requirements relative to statewide uniformity; and
46.31    (2) a comprehensive plan, including estimated project costs, shall be approved by
46.32the Legislative Advisory Commission and filed with the commissioner of administration.
46.33    (m) According to federal requirements, establish procedures to be followed by
46.34local welfare boards in creating citizen advisory committees, including procedures for
46.35selection of committee members.
47.1    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
47.2control error rates for the aid to families with dependent children program formerly
47.3codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
47.4following manner:
47.5    (1) one-half of the total amount of the disallowance shall be borne by the county
47.6boards responsible for administering the programs. For the medical assistance and the
47.7AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
47.8shared by each county board in the same proportion as that county's expenditures for the
47.9sanctioned program are to the total of all counties' expenditures for the AFDC program
47.10formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
47.11food stamp program, sanctions shall be shared by each county board, with 50 percent of
47.12the sanction being distributed to each county in the same proportion as that county's
47.13administrative costs for food stamps are to the total of all food stamp administrative costs
47.14for all counties, and 50 percent of the sanctions being distributed to each county in the
47.15same proportion as that county's value of food stamp benefits issued are to the total of
47.16all benefits issued for all counties. Each county shall pay its share of the disallowance
47.17to the state of Minnesota. When a county fails to pay the amount due hereunder, the
47.18commissioner may deduct the amount from reimbursement otherwise due the county, or
47.19the attorney general, upon the request of the commissioner, may institute civil action
47.20to recover the amount due; and
47.21    (2) notwithstanding the provisions of clause (1), if the disallowance results from
47.22knowing noncompliance by one or more counties with a specific program instruction, and
47.23that knowing noncompliance is a matter of official county board record, the commissioner
47.24may require payment or recover from the county or counties, in the manner prescribed in
47.25clause (1), an amount equal to the portion of the total disallowance which resulted from the
47.26noncompliance, and may distribute the balance of the disallowance according to clause (1).
47.27    (o) Develop and implement special projects that maximize reimbursements and
47.28result in the recovery of money to the state. For the purpose of recovering state money,
47.29the commissioner may enter into contracts with third parties. Any recoveries that result
47.30from projects or contracts entered into under this paragraph shall be deposited in the
47.31state treasury and credited to a special account until the balance in the account reaches
47.32$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
47.33transferred and credited to the general fund. All money in the account is appropriated to
47.34the commissioner for the purposes of this paragraph.
47.35    (p) Have the authority to make direct payments to facilities providing shelter
47.36to women and their children according to section 256D.05, subdivision 3. Upon
48.1the written request of a shelter facility that has been denied payments under section
48.2256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
48.3a determination within 30 days of the request for review regarding issuance of direct
48.4payments to the shelter facility. Failure to act within 30 days shall be considered a
48.5determination not to issue direct payments.
48.6    (q) Have the authority to establish and enforce the following county reporting
48.7requirements:
48.8    (1) the commissioner shall establish fiscal and statistical reporting requirements
48.9necessary to account for the expenditure of funds allocated to counties for human
48.10services programs. When establishing financial and statistical reporting requirements, the
48.11commissioner shall evaluate all reports, in consultation with the counties, to determine if
48.12the reports can be simplified or the number of reports can be reduced;
48.13    (2) the county board shall submit monthly or quarterly reports to the department
48.14as required by the commissioner. Monthly reports are due no later than 15 working days
48.15after the end of the month. Quarterly reports are due no later than 30 calendar days after
48.16the end of the quarter, unless the commissioner determines that the deadline must be
48.17shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
48.18or risking a loss of federal funding. Only reports that are complete, legible, and in the
48.19required format shall be accepted by the commissioner;
48.20    (3) if the required reports are not received by the deadlines established in clause (2),
48.21the commissioner may delay payments and withhold funds from the county board until
48.22the next reporting period. When the report is needed to account for the use of federal
48.23funds and the late report results in a reduction in federal funding, the commissioner shall
48.24withhold from the county boards with late reports an amount equal to the reduction in
48.25federal funding until full federal funding is received;
48.26    (4) a county board that submits reports that are late, illegible, incomplete, or not
48.27in the required format for two out of three consecutive reporting periods is considered
48.28noncompliant. When a county board is found to be noncompliant, the commissioner
48.29shall notify the county board of the reason the county board is considered noncompliant
48.30and request that the county board develop a corrective action plan stating how the
48.31county board plans to correct the problem. The corrective action plan must be submitted
48.32to the commissioner within 45 days after the date the county board received notice
48.33of noncompliance;
48.34    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
48.35after the date the report was originally due. If the commissioner does not receive a report
48.36by the final deadline, the county board forfeits the funding associated with the report for
49.1that reporting period and the county board must repay any funds associated with the
49.2report received for that reporting period;
49.3    (6) the commissioner may not delay payments, withhold funds, or require repayment
49.4under clause (3) or (5) if the county demonstrates that the commissioner failed to
49.5provide appropriate forms, guidelines, and technical assistance to enable the county to
49.6comply with the requirements. If the county board disagrees with an action taken by the
49.7commissioner under clause (3) or (5), the county board may appeal the action according
49.8to sections 14.57 to 14.69; and
49.9    (7) counties subject to withholding of funds under clause (3) or forfeiture or
49.10repayment of funds under clause (5) shall not reduce or withhold benefits or services to
49.11clients to cover costs incurred due to actions taken by the commissioner under clause
49.12(3) or (5).
49.13    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
49.14federal fiscal disallowances or sanctions are based on a statewide random sample in direct
49.15proportion to each county's claim for that period.
49.16    (s) Be responsible for ensuring the detection, prevention, investigation, and
49.17resolution of fraudulent activities or behavior by applicants, recipients, and other
49.18participants in the human services programs administered by the department.
49.19    (t) Require county agencies to identify overpayments, establish claims, and utilize
49.20all available and cost-beneficial methodologies to collect and recover these overpayments
49.21in the human services programs administered by the department.
49.22    (u) Have the authority to administer a drug rebate program for drugs purchased
49.23pursuant to the prescription drug program established under section 256.955 after the
49.24beneficiary's satisfaction of any deductible established in the program. The commissioner
49.25shall require a rebate agreement from all manufacturers of covered drugs as defined in
49.26section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
49.27or after July 1, 2002, must include rebates for individuals covered under the prescription
49.28drug program who are under 65 years of age. For each drug, the amount of the rebate shall
49.29be equal to the rebate as defined for purposes of the federal rebate program in United
49.30States Code, title 42, section 1396r-8. The manufacturers must provide full payment
49.31within 30 days of receipt of the state invoice for the rebate within the terms and conditions
49.32used for the federal rebate program established pursuant to section 1927 of title XIX of
49.33the Social Security Act. The manufacturers must provide the commissioner with any
49.34information necessary to verify the rebate determined per drug. The rebate program shall
49.35utilize the terms and conditions used for the federal rebate program established pursuant to
49.36section 1927 of title XIX of the Social Security Act.
50.1    (v) Have the authority to administer the federal drug rebate program for drugs
50.2purchased under the medical assistance program as allowed by section 1927 of title XIX
50.3of the Social Security Act and according to the terms and conditions of section 1927.
50.4Rebates shall be collected for all drugs that have been dispensed or administered in an
50.5outpatient setting and that are from manufacturers who have signed a rebate agreement
50.6with the United States Department of Health and Human Services.
50.7    (w) Have the authority to administer a supplemental drug rebate program for drugs
50.8purchased under the medical assistance program. The commissioner may enter into
50.9supplemental rebate contracts with pharmaceutical manufacturers and may require prior
50.10authorization for drugs that are from manufacturers that have not signed a supplemental
50.11rebate contract. Prior authorization of drugs shall be subject to the provisions of section
50.12256B.0625, subdivision 13 .
50.13    (x) Operate the department's communication systems account established in Laws
50.141993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
50.15communication costs necessary for the operation of the programs the commissioner
50.16supervises. A communications account may also be established for each regional
50.17treatment center which operates communications systems. Each account must be used
50.18to manage shared communication costs necessary for the operations of the programs the
50.19commissioner supervises. The commissioner may distribute the costs of operating and
50.20maintaining communication systems to participants in a manner that reflects actual usage.
50.21Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
50.22other costs as determined by the commissioner. Nonprofit organizations and state, county,
50.23and local government agencies involved in the operation of programs the commissioner
50.24supervises may participate in the use of the department's communications technology and
50.25share in the cost of operation. The commissioner may accept on behalf of the state any
50.26gift, bequest, devise or personal property of any kind, or money tendered to the state for
50.27any lawful purpose pertaining to the communication activities of the department. Any
50.28money received for this purpose must be deposited in the department's communication
50.29systems accounts. Money collected by the commissioner for the use of communication
50.30systems must be deposited in the state communication systems account and is appropriated
50.31to the commissioner for purposes of this section.
50.32    (y) Receive any federal matching money that is made available through the medical
50.33assistance program for the consumer satisfaction survey. Any federal money received for
50.34the survey is appropriated to the commissioner for this purpose. The commissioner may
50.35expend the federal money received for the consumer satisfaction survey in either year of
50.36the biennium.
51.1    (z) Designate community information and referral call centers and incorporate
51.2cost reimbursement claims from the designated community information and referral
51.3call centers into the federal cost reimbursement claiming processes of the department
51.4according to federal law, rule, and regulations. Existing information and referral centers
51.5provided by Greater Twin Cities United Way or existing call centers for which Greater
51.6Twin Cities United Way has legal authority to represent, shall be included in these
51.7designations upon review by the commissioner and assurance that these services are
51.8accredited and in compliance with national standards. Any reimbursement is appropriated
51.9to the commissioner and all designated information and referral centers shall receive
51.10payments according to normal department schedules established by the commissioner
51.11upon final approval of allocation methodologies from the United States Department of
51.12Health and Human Services Division of Cost Allocation or other appropriate authorities.
51.13    (aa) Develop recommended standards for foster care homes that address the
51.14components of specialized therapeutic services to be provided by foster care homes with
51.15those services.
51.16    (bb) Authorize the method of payment to or from the department as part of the
51.17human services programs administered by the department. This authorization includes the
51.18receipt or disbursement of funds held by the department in a fiduciary capacity as part of
51.19the human services programs administered by the department.
51.20    (cc) Have the authority to administer a drug rebate program for drugs purchased for
51.21persons eligible for general assistance medical care under section 256D.03, subdivision 3.
51.22For manufacturers that agree to participate in the general assistance medical care rebate
51.23program, the commissioner shall enter into a rebate agreement for covered drugs as
51.24defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
51.25rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
51.26United States Code, title 42, section 1396r-8. The manufacturers must provide payment
51.27within the terms and conditions used for the federal rebate program established under
51.28section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
51.29the terms and conditions used for the federal rebate program established under section
51.301927 of title XIX of the Social Security Act.
51.31    Effective January 1, 2006, drug coverage under general assistance medical care shall
51.32be limited to those prescription drugs that:
51.33    (1) are covered under the medical assistance program as described in section
51.34256B.0625, subdivisions 13 and 13d ; and
51.35    (2) are provided by manufacturers that have fully executed general assistance
51.36medical care rebate agreements with the commissioner and comply with such agreements.
52.1Prescription drug coverage under general assistance medical care shall conform to
52.2coverage under the medical assistance program according to section 256B.0625,
52.3subdivisions 13 to 13g
.
52.4    The rebate revenues collected under the drug rebate program are deposited in the
52.5general fund.
52.6(dd) Designate the agencies that operate the Senior LinkAge Line under section
52.7256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
52.8of Minnesota Aging and the Disability Resource Centers under United States Code, title
52.942, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost
52.10reimbursement claims from the designated centers into the federal cost reimbursement
52.11claiming processes of the department according to federal law, rule, and regulations. Any
52.12reimbursement must be appropriated to the commissioner and all Aging and Disability
52.13Resource Center designated agencies shall receive payments of grant funding that supports
52.14the activity and generates the federal financial participation according to Board on Aging
52.15administrative granting mechanisms.

52.16    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
52.17    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
52.18Linkage Line, to which shall serve people with disabilities as the designated Aging and
52.19Disability Resource Center under United States Code, title 42, section 3001, the Older
52.20Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and
52.21shall serve as Minnesota's neutral access point for statewide disability information and
52.22assistance and must be available during business hours through a statewide toll-free
52.23number and the Internet. The Disability Linkage Line shall:
52.24(1) deliver information and assistance based on national and state standards;
52.25    (2) provide information about state and federal eligibility requirements, benefits,
52.26and service options;
52.27(3) provide benefits and options counseling;
52.28    (4) make referrals to appropriate support entities;
52.29    (5) educate people on their options so they can make well-informed choices and link
52.30them to quality profiles;
52.31    (6) help support the timely resolution of service access and benefit issues;
52.32(7) inform people of their long-term community services and supports;
52.33(8) provide necessary resources and supports that can lead to employment and
52.34increased economic stability of people with disabilities; and
53.1(9) serve as the technical assistance and help center for the Web-based tool,
53.2Minnesota's Disability Benefits 101.org.; and
53.3(10) provide preadmission screening for individuals under 60 years of age using
53.4the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911,
53.5subdivision 4d.

53.6    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
53.7    Subd. 7. Consumer information and assistance and long-term care options
53.8counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
53.9statewide service to aid older Minnesotans and their families in making informed choices
53.10about long-term care options and health care benefits. Language services to persons
53.11with limited English language skills may be made available. The service, known as
53.12Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
53.13Resource Center under United States Code, title 42, section 3001, the Older Americans
53.14Act Amendments of 2006, in partnership with the Disability LinkAge Line under section
53.15256.01, subdivision 24, and must be available during business hours through a statewide
53.16toll-free number and must also be available through the Internet. The Minnesota Board
53.17on Aging shall consult with, and when appropriate work through, the area agencies on
53.18aging to provide and maintain the telephone infrastructure and related support for the
53.19Aging and Disability Resource Center partners that agree by memorandum to access the
53.20infrastructure, including the designated providers of the Senior LinkAge Line and the
53.21Disability Linkage Line.
53.22    (b) The service must provide long-term care options counseling by assisting older
53.23adults, caregivers, and providers in accessing information and options counseling about
53.24choices in long-term care services that are purchased through private providers or available
53.25through public options. The service must:
53.26    (1) develop a comprehensive database that includes detailed listings in both
53.27consumer- and provider-oriented formats;
53.28    (2) make the database accessible on the Internet and through other telecommunication
53.29and media-related tools;
53.30    (3) link callers to interactive long-term care screening tools and make these tools
53.31available through the Internet by integrating the tools with the database;
53.32    (4) develop community education materials with a focus on planning for long-term
53.33care and evaluating independent living, housing, and service options;
53.34    (5) conduct an outreach campaign to assist older adults and their caregivers in
53.35finding information on the Internet and through other means of communication;
54.1    (6) implement a messaging system for overflow callers and respond to these callers
54.2by the next business day;
54.3    (7) link callers with county human services and other providers to receive more
54.4in-depth assistance and consultation related to long-term care options;
54.5    (8) link callers with quality profiles for nursing facilities and other home and
54.6community-based services providers developed by the commissioner commissioners of
54.7health and human services;
54.8    (9) incorporate information about the availability of housing options, as well as
54.9registered housing with services and consumer rights within the MinnesotaHelp.info
54.10network long-term care database to facilitate consumer comparison of services and costs
54.11among housing with services establishments and with other in-home services and to
54.12support financial self-sufficiency as long as possible. Housing with services establishments
54.13and their arranged home care providers shall provide information that will facilitate price
54.14comparisons, including delineation of charges for rent and for services available. The
54.15commissioners of health and human services shall align the data elements required by
54.16section 144G.06, the Uniform Consumer Information Guide, and this section to provide
54.17consumers standardized information and ease of comparison of long-term care options.
54.18The commissioner of human services shall provide the data to the Minnesota Board on
54.19Aging for inclusion in the MinnesotaHelp.info network long-term care database;
54.20(10) provide long-term care options counseling. Long-term care options counselors
54.21shall:
54.22(i) for individuals not eligible for case management under a public program or public
54.23funding source, provide interactive decision support under which consumers, family
54.24members, or other helpers are supported in their deliberations to determine appropriate
54.25long-term care choices in the context of the consumer's needs, preferences, values, and
54.26individual circumstances, including implementing a community support plan;
54.27(ii) provide Web-based educational information and collateral written materials to
54.28familiarize consumers, family members, or other helpers with the long-term care basics,
54.29issues to be considered, and the range of options available in the community;
54.30(iii) provide long-term care futures planning, which means providing assistance to
54.31individuals who anticipate having long-term care needs to develop a plan for the more
54.32distant future; and
54.33(iv) provide expertise in benefits and financing options for long-term care, including
54.34Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
54.35private pay options, and ways to access low or no-cost services or benefits through
54.36volunteer-based or charitable programs;
55.1(11) using risk management and support planning protocols, provide long-term care
55.2options counseling to current residents of nursing homes deemed appropriate for discharge
55.3by the commissioner and older adults who request service after consultation with the
55.4Senior LinkAge Line under clause (12). In order to meet this requirement, The Senior
55.5LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The
55.6Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge
55.7by developing targeting criteria in consultation with the commissioner who shall provide
55.8designated Senior LinkAge Line contact centers with a list of nursing home residents that
55.9meet the criteria as being appropriate for discharge planning via a secure Web portal.
55.10Senior LinkAge Line shall provide these residents, if they indicate a preference to
55.11receive long-term care options counseling, with initial assessment, review of risk factors,
55.12independent living support consultation, or and, if appropriate, a referral to:
55.13(i) long-term care consultation services under section 256B.0911;
55.14(ii) designated care coordinators of contracted entities under section 256B.035 for
55.15persons who are enrolled in a managed care plan; or
55.16(iii) the long-term care consultation team for those who are appropriate eligible
55.17 for relocation service coordination due to high-risk factors or psychological or physical
55.18disability; and
55.19(12) develop referral protocols and processes that will assist certified health care
55.20homes and hospitals to identify at-risk older adults and determine when to refer these
55.21individuals to the Senior LinkAge Line for long-term care options counseling under this
55.22section. The commissioner is directed to work with the commissioner of health to develop
55.23protocols that would comply with the health care home designation criteria and protocols
55.24available at the time of hospital discharge. The commissioner shall keep a record of the
55.25number of people who choose long-term care options counseling as a result of this section.

55.26    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
55.27to read:
55.28    Subd. 7a. Preadmission screening activities related to nursing facility
55.29admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
55.30including certified boarding care facilities, must be screened prior to admission regardless
55.31of income, assets, or funding sources for nursing facility care, except as described in
55.32subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
55.33need for nursing facility level of care as described in section 256B.0911, subdivision
55.344e, and to complete activities required under federal law related to mental illness and
55.35developmental disability as outlined in paragraph (b).
56.1(b) A person who has a diagnosis or possible diagnosis of mental illness or
56.2developmental disability must receive a preadmission screening before admission
56.3regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
56.4the need for further evaluation and specialized services, unless the admission prior to
56.5screening is authorized by the local mental health authority or the local developmental
56.6disabilities case manager, or unless authorized by the county agency according to Public
56.7Law 101-508.
56.8(c) The following criteria apply to the preadmission screening:
56.9(1) requests for preadmission screenings must be submitted via an online form
56.10developed by the commissioner;
56.11(2) the Senior LinkAge Line must use forms and criteria developed by the
56.12commissioner to identify persons who require referral for further evaluation and
56.13determination of the need for specialized services; and
56.14(3) the evaluation and determination of the need for specialized services must be
56.15done by:
56.16(i) a qualified independent mental health professional, for persons with a primary or
56.17secondary diagnosis of a serious mental illness; or
56.18(ii) a qualified developmental disability professional, for persons with a primary or
56.19secondary diagnosis of developmental disability. For purposes of this requirement, a
56.20qualified developmental disability professional must meet the standards for a qualified
56.21developmental disability professional under Code of Federal Regulations, title 42, section
56.22483.430.
56.23(d) The local county mental health authority or the state developmental disability
56.24authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
56.25nursing facility if the individual does not meet the nursing facility level of care criteria or
56.26needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
56.27purposes of this section, "specialized services" for a person with developmental disability
56.28means active treatment as that term is defined under Code of Federal Regulations, title
56.2942, section 483.440(a)(1).
56.30(e) In assessing a person's needs, the screener shall:
56.31(1) use an automated system designated by the commissioner;
56.32(2) consult with care transitions coordinators or physician; and
56.33(3) consider the assessment of the individual's physician.
56.34Other personnel may be included in the level of care determination as deemed
56.35necessary by the screener.
56.36EFFECTIVE DATE.This section is effective October 1, 2013.

57.1    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
57.2to read:
57.3    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
57.4screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
57.5(1) a person who, having entered an acute care facility from a certified nursing
57.6facility, is returning to a certified nursing facility; or
57.7(2) a person transferring from one certified nursing facility in Minnesota to another
57.8certified nursing facility in Minnesota.
57.9(b) Persons who are exempt from preadmission screening for purposes of level of
57.10care determination include:
57.11(1) persons described in paragraph (a);
57.12(2) an individual who has a contractual right to have nursing facility care paid for
57.13indefinitely by the Veterans' Administration;
57.14(3) an individual enrolled in a demonstration project under section 256B.69,
57.15subdivision 8, at the time of application to a nursing facility; and
57.16(4) an individual currently being served under the alternative care program or under
57.17a home and community-based services waiver authorized under section 1915(c) of the
57.18federal Social Security Act.
57.19(c) Persons admitted to a Medicaid-certified nursing facility from the community
57.20on an emergency basis as described in paragraph (d) or from an acute care facility on a
57.21nonworking day must be screened the first working day after admission.
57.22(d) Emergency admission to a nursing facility prior to screening is permitted when
57.23all of the following conditions are met:
57.24(1) a person is admitted from the community to a certified nursing or certified
57.25boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and
57.26older and Disability Linkage Line nonworking hours for under age 60;
57.27(2) a physician has determined that delaying admission until preadmission screening
57.28is completed would adversely affect the person's health and safety;
57.29(3) there is a recent precipitating event that precludes the client from living safely in
57.30the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
57.31inability to continue to provide care;
57.32(4) the attending physician has authorized the emergency placement and has
57.33documented the reason that the emergency placement is recommended; and
57.34(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first
57.35working day following the emergency admission.
58.1Transfer of a patient from an acute care hospital to a nursing facility is not considered
58.2an emergency except for a person who has received hospital services in the following
58.3situations: hospital admission for observation, care in an emergency room without hospital
58.4admission, or following hospital 24-hour bed care and from whom admission is being
58.5sought on a nonworking day.
58.6(e) A nursing facility must provide written information to all persons admitted
58.7regarding the person's right to request and receive long-term care consultation services as
58.8defined in section 256B.0911, subdivision 1a. The information must be provided prior to
58.9the person's discharge from the facility and in a format specified by the commissioner.
58.10EFFECTIVE DATE.This section is effective October 1, 2013.

58.11    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
58.12to read:
58.13    Subd. 7c. Screening requirements. (a) A person may be screened for nursing
58.14facility admission by telephone or in a face-to-face screening interview. The Senior
58.15LinkAge Line shall identify each individual's needs using the following categories:
58.16(1) the person needs no face-to-face long-term care consultation assessment
58.17completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
58.18managed care organization under contract with the Department of Human Services to
58.19determine the need for nursing facility level of care based on information obtained from
58.20other health care professionals;
58.21(2) the person needs an immediate face-to-face long-term care consultation
58.22assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
58.23tribe, or managed care organization under contract with the Department of Human
58.24Services to determine the need for nursing facility level of care and complete activities
58.25required under subdivision 7a; or
58.26(3) the person may be exempt from screening requirements as outlined in subdivision
58.277b, but will need transitional assistance after admission or in-person follow-along after
58.28a return home.
58.29(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities
58.30with only a telephone screening must receive a face-to-face assessment from the long-term
58.31care consultation team member of the county in which the facility is located or from the
58.32recipient's county case manager within 40 calendar days of admission as described in
58.33section 256B.0911, subdivision 4d, paragraph (c).
58.34(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
58.35facility must be screened prior to admission.
59.1(d) Screenings provided by the Senior LinkAge Line must include processes
59.2to identify persons who may require transition assistance described in subdivision 7,
59.3paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
59.4EFFECTIVE DATE.This section is effective October 1, 2013.

59.5    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
59.6to read:
59.7    Subd. 7d. Payment for preadmission screening. Funding for preadmission
59.8screening shall be provided to the Minnesota Board on Aging for the population 60
59.9years of age and older by the Department of Human Services to cover screener salaries
59.10and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota
59.11Board on Aging shall employ, or contract with other agencies to employ, within the limits
59.12of available funding, sufficient personnel to provide preadmission screening and level of
59.13care determination services and shall seek to maximize federal funding for the service as
59.14provided under section 256.01, subdivision 2, paragraph (dd).
59.15EFFECTIVE DATE.This section is effective October 1, 2013.

59.16    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
59.17subdivision to read:
59.18    Subd. 3a. Priority for other grants. The commissioner of health shall give
59.19priority to a grantee selected under subdivision 3 when awarding technology-related
59.20grants, if the grantee is using technology as a part of a proposal, unless that priority
59.21conflicts with existing state or federal guidance related to grant awards by the Department
59.22of Health. The commissioner of transportation shall give priority to a grantee selected
59.23under subdivision 3 when distributing transportation-related funds to create transportation
59.24options for older adults.

59.25    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
59.26subdivision to read:
59.27    Subd. 3b. State waivers. The commissioner of health may waive applicable state
59.28laws and rules on a time-limited basis if the commissioner of health determines that a
59.29participating grantee requires a waiver in order to achieve demonstration project goals.

59.30    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
60.1    Subd. 5. Grant preference. The commissioner of human services shall give
60.2preference when awarding grants under this section to areas where nursing facility
60.3closures have occurred or are occurring or areas with service needs identified by section
60.4144A.351. The commissioner may award grants to the extent grant funds are available
60.5and to the extent applications are approved by the commissioner. Denial of approval of an
60.6application in one year does not preclude submission of an application in a subsequent
60.7year. The maximum grant amount is limited to $750,000.

60.8    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.9subdivision to read:
60.10    Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
60.11subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
60.12(1) an impact assessment focusing on program outcomes, especially those
60.13experienced directly by the person receiving services;
60.14(2) study samples drawn from the population of interest for each project; and
60.15(3) a time series analysis to examine aggregate trends in average monthly
60.16utilization, expenditures, and other outcomes in the targeted populations before and after
60.17implementation of the initiatives.

60.18    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.19subdivision to read:
60.20    Subd. 6. Work, empower, and encourage independence. As provided under
60.21subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
60.22demonstration project to provide navigation, employment supports, and benefits planning
60.23services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
60.24This demonstration shall promote economic stability, increase independence, and reduce
60.25applications for disability benefits while providing a positive impact on the health and
60.26future of participants.

60.27    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.28subdivision to read:
60.29    Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
60.30upon federal approval, the commissioner shall establish a demonstration project to provide
60.31service coordination, outreach, in-reach, tenancy support, and community living assistance
60.32to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
61.1demonstration shall promote housing stability, reduce costly medical interventions, and
61.2increase opportunities for independent community living.

61.3    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
61.4    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
61.5services is to assist persons with long-term or chronic care needs in making care
61.6decisions and selecting support and service options that meet their needs and reflect
61.7their preferences. The availability of, and access to, information and other types of
61.8assistance, including assessment and support planning, is also intended to prevent or delay
61.9institutional placements and to provide access to transition assistance after admission.
61.10Further, the goal of these services is to contain costs associated with unnecessary
61.11institutional admissions. Long-term consultation services must be available to any person
61.12regardless of public program eligibility. The commissioner of human services shall seek
61.13to maximize use of available federal and state funds and establish the broadest program
61.14possible within the funding available.
61.15(b) These services must be coordinated with long-term care options counseling
61.16provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and
61.17section 256.01, subdivision 24. The lead agency providing long-term care consultation
61.18services shall encourage the use of volunteers from families, religious organizations, social
61.19clubs, and similar civic and service organizations to provide community-based services.

61.20    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
61.21read:
61.22    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
61.23    (a) Until additional requirements apply under paragraph (b), "long-term care
61.24consultation services" means:
61.25    (1) intake for and access to assistance in identifying services needed to maintain an
61.26individual in the most inclusive environment;
61.27    (2) providing recommendations for and referrals to cost-effective community
61.28services that are available to the individual;
61.29    (3) development of an individual's person-centered community support plan;
61.30    (4) providing information regarding eligibility for Minnesota health care programs;
61.31    (5) face-to-face long-term care consultation assessments, which may be completed
61.32in a hospital, nursing facility, intermediate care facility for persons with developmental
61.33disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
61.34residence;
62.1    (6) federally mandated preadmission screening activities described under
62.2subdivisions 4a and 4b;
62.3    (7) (6) determination of home and community-based waiver and other service
62.4eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level
62.5of care determination for individuals who need an institutional level of care as determined
62.6under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and
62.7community support plan development, appropriate referrals to obtain necessary diagnostic
62.8information, and including an eligibility determination for consumer-directed community
62.9supports;
62.10    (8) (7) providing recommendations for institutional placement when there are no
62.11cost-effective community services available;
62.12    (9) (8) providing access to assistance to transition people back to community settings
62.13after institutional admission; and
62.14(10) (9) providing information about competitive employment, with or without
62.15supports, for school-age youth and working-age adults and referrals to the Disability
62.16Linkage Line and Disability Benefits 101 to ensure that an informed choice about
62.17competitive employment can be made. For the purposes of this subdivision, "competitive
62.18employment" means work in the competitive labor market that is performed on a full-time
62.19or part-time basis in an integrated setting, and for which an individual is compensated at or
62.20above the minimum wage, but not less than the customary wage and level of benefits paid
62.21by the employer for the same or similar work performed by individuals without disabilities.
62.22(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
62.232c, and 3a, "long-term care consultation services" also means:
62.24(1) service eligibility determination for state plan home care services identified in:
62.25(i) section 256B.0625, subdivisions 7, 19a, and 19c;
62.26(ii) section 256B.0657; or
62.27(iii) consumer support grants under section 256.476;
62.28(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
62.29determination of eligibility for case management services available under sections
62.30256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part
62.319525.0016;
62.32(3) determination of institutional level of care, home and community-based service
62.33waiver, and other service eligibility as required under section 256B.092, determination
62.34of eligibility for family support grants under section 252.32, semi-independent living
62.35services under section 252.275, and day training and habilitation services under section
62.36256B.092 ; and
63.1(4) obtaining necessary diagnostic information to determine eligibility under clauses
63.2(2) and (3).
63.3    (c) "Long-term care options counseling" means the services provided by the linkage
63.4lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and
63.5also includes telephone assistance and follow up once a long-term care consultation
63.6assessment has been completed.
63.7    (d) "Minnesota health care programs" means the medical assistance program under
63.8chapter 256B and the alternative care program under section 256B.0913.
63.9    (e) "Lead agencies" means counties administering or tribes and health plans under
63.10contract with the commissioner to administer long-term care consultation assessment and
63.11support planning services.

63.12    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
63.13read:
63.14    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
63.15services planning, or other assistance intended to support community-based living,
63.16including persons who need assessment in order to determine waiver or alternative care
63.17program eligibility, must be visited by a long-term care consultation team within 20
63.18calendar days after the date on which an assessment was requested or recommended.
63.19Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
63.20applies to an assessment of a person requesting personal care assistance services and
63.21private duty nursing. The commissioner shall provide at least a 90-day notice to lead
63.22agencies prior to the effective date of this requirement. Face-to-face assessments must be
63.23conducted according to paragraphs (b) to (i).
63.24    (b) The lead agency may utilize a team of either the social worker or public health
63.25nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
63.26use certified assessors to conduct the assessment. The consultation team members must
63.27confer regarding the most appropriate care for each individual screened or assessed. For
63.28a person with complex health care needs, a public health or registered nurse from the
63.29team must be consulted.
63.30    (c) The assessment must be comprehensive and include a person-centered assessment
63.31of the health, psychological, functional, environmental, and social needs of referred
63.32individuals and provide information necessary to develop a community support plan that
63.33meets the consumers needs, using an assessment form provided by the commissioner.
63.34    (d) The assessment must be conducted in a face-to-face interview with the person
63.35being assessed and the person's legal representative, and other individuals as requested by
64.1the person, who can provide information on the needs, strengths, and preferences of the
64.2person necessary to develop a community support plan that ensures the person's health and
64.3safety, but who is not a provider of service or has any financial interest in the provision
64.4of services. For persons who are to be assessed for elderly waiver customized living
64.5services under section 256B.0915, with the permission of the person being assessed or
64.6the person's designated or legal representative, the client's current or proposed provider
64.7of services may submit a copy of the provider's nursing assessment or written report
64.8outlining its recommendations regarding the client's care needs. The person conducting
64.9the assessment will notify the provider of the date by which this information is to be
64.10submitted. This information shall be provided to the person conducting the assessment
64.11prior to the assessment.
64.12    (e) If the person chooses to use community-based services, the person or the person's
64.13legal representative must be provided with a written community support plan within 40
64.14calendar days of the assessment visit, regardless of whether the individual is eligible for
64.15Minnesota health care programs. The written community support plan must include:
64.16(1) a summary of assessed needs as defined in paragraphs (c) and (d);
64.17(2) the individual's options and choices to meet identified needs, including all
64.18available options for case management services and providers;
64.19(3) identification of health and safety risks and how those risks will be addressed,
64.20including personal risk management strategies;
64.21(4) referral information; and
64.22(5) informal caregiver supports, if applicable.
64.23For a person determined eligible for state plan home care under subdivision 1a,
64.24paragraph (b), clause (1), the person or person's representative must also receive a copy of
64.25the home care service plan developed by the certified assessor.
64.26(f) A person may request assistance in identifying community supports without
64.27participating in a complete assessment. Upon a request for assistance identifying
64.28community support, the person must be transferred or referred to long-term care options
64.29counseling services available under sections 256.975, subdivision 7, and 256.01,
64.30subdivision 24, for telephone assistance and follow up.
64.31    (g) The person has the right to make the final decision between institutional
64.32placement and community placement after the recommendations have been provided,
64.33except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
64.34    (h) The lead agency must give the person receiving assessment or support planning,
64.35or the person's legal representative, materials, and forms supplied by the commissioner
64.36containing the following information:
65.1    (1) written recommendations for community-based services and consumer-directed
65.2options;
65.3(2) documentation that the most cost-effective alternatives available were offered to
65.4the individual. For purposes of this clause, "cost-effective" means community services and
65.5living arrangements that cost the same as or less than institutional care. For an individual
65.6found to meet eligibility criteria for home and community-based service programs under
65.7section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
65.8approved waiver plan for each program;
65.9(3) the need for and purpose of preadmission screening conducted by long-term care
65.10options counselors according to sections 256.975, subdivisions 7a to 7c, and 256.01,
65.11subdivision 24, if the person selects nursing facility placement. If the individual selects
65.12nursing facility placement, the lead agency shall forward information needed to complete
65.13the level of care determinations and screening for developmental disability and mental
65.14illness collected during the assessment to the long-term care options counselor using forms
65.15provided by the commissioner;
65.16    (4) the role of long-term care consultation assessment and support planning in
65.17eligibility determination for waiver and alternative care programs, and state plan home
65.18care, case management, and other services as defined in subdivision 1a, paragraphs (a),
65.19clause (7), and (b);
65.20    (5) information about Minnesota health care programs;
65.21    (6) the person's freedom to accept or reject the recommendations of the team;
65.22    (7) the person's right to confidentiality under the Minnesota Government Data
65.23Practices Act, chapter 13;
65.24    (8) the certified assessor's decision regarding the person's need for institutional level
65.25of care as determined under criteria established in section 256B.0911, subdivision 4a,
65.26paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services
65.27and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
65.28    (9) the person's right to appeal the certified assessor's decision regarding eligibility
65.29for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
65.30(b), and incorporating the decision regarding the need for institutional level of care or the
65.31lead agency's final decisions regarding public programs eligibility according to section
65.32256.045, subdivision 3 .
65.33    (i) Face-to-face assessment completed as part of eligibility determination for
65.34the alternative care, elderly waiver, community alternatives for disabled individuals,
65.35community alternative care, and brain injury waiver programs under sections 256B.0913,
66.1256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60
66.2calendar days after the date of assessment.
66.3(j) The effective eligibility start date for programs in paragraph (i) can never be
66.4prior to the date of assessment. If an assessment was completed more than 60 days
66.5before the effective waiver or alternative care program eligibility start date, assessment
66.6and support plan information must be updated in a face-to-face visit and documented in
66.7the department's Medicaid Management Information System (MMIS). Notwithstanding
66.8retroactive medical assistance coverage of state plan services, the effective date of
66.9eligibility for programs included in paragraph (i) cannot be prior to the date the most
66.10recent updated assessment is completed.

66.11    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
66.12read:
66.13    Subd. 4d. Preadmission screening of individuals under 65 60 years of age. (a)
66.14It is the policy of the state of Minnesota to ensure that individuals with disabilities or
66.15chronic illness are served in the most integrated setting appropriate to their needs and have
66.16the necessary information to make informed choices about home and community-based
66.17service options.
66.18    (b) Individuals under 65 60 years of age who are admitted to a Medicaid-certified
66.19 nursing facility from a hospital must be screened prior to admission as outlined in
66.20subdivisions 4a through 4c according to the requirements outlined in section 256.975,
66.21subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required
66.22under section 256.01, subdivision 24.
66.23    (c) Individuals under 65 years of age who are admitted to nursing facilities with
66.24only a telephone screening must receive a face-to-face assessment from the long-term
66.25care consultation team member of the county in which the facility is located or from the
66.26recipient's county case manager within 40 calendar days of admission.
66.27    (d) Individuals under 65 years of age who are admitted to a nursing facility
66.28without preadmission screening according to the exemption described in subdivision 4b,
66.29paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
66.30a face-to-face assessment within 40 days of admission.
66.31    (e) (d) At the face-to-face assessment, the long-term care consultation team member
66.32or county case manager must perform the activities required under subdivision 3b.
66.33    (f) (e) For individuals under 21 years of age, a screening interview which
66.34recommends nursing facility admission must be face-to-face and approved by the
66.35commissioner before the individual is admitted to the nursing facility.
67.1    (g) (f) In the event that an individual under 65 60 years of age is admitted to a
67.2nursing facility on an emergency basis, the county Disability Linkage Line must be
67.3notified of the admission on the next working day, and a face-to-face assessment as
67.4described in paragraph (c) must be conducted within 40 calendar days of admission.
67.5    (h) (g) At the face-to-face assessment, the long-term care consultation team member
67.6or the case manager must present information about home and community-based options,
67.7including consumer-directed options, so the individual can make informed choices. If the
67.8individual chooses home and community-based services, the long-term care consultation
67.9team member or case manager must complete a written relocation plan within 20 working
67.10days of the visit. The plan shall describe the services needed to move out of the facility
67.11and a time line for the move which is designed to ensure a smooth transition to the
67.12individual's home and community.
67.13    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive
67.14a face-to-face assessment at least every 12 months to review the person's service choices
67.15and available alternatives unless the individual indicates, in writing, that annual visits are
67.16not desired. In this case, the individual must receive a face-to-face assessment at least
67.17once every 36 months for the same purposes.
67.18    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay
67.19county agencies directly for face-to-face assessments for individuals under 65 years of age
67.20who are being considered for placement or residing in a nursing facility.
67.21(j) Funding for preadmission screening shall be provided to the Disability Linkage
67.22Line for the under 60 population by the Department of Human Services to cover screener
67.23salaries and expenses to provide the services described in subdivisions 7a to 7c. The
67.24Disability Linkage Line shall employ, or contract with other agencies to employ, within
67.25the limits of available funding, sufficient personnel to provide preadmission screening and
67.26level of care determination services and shall seek to maximize federal funding for the
67.27service as provided under section 256.01, subdivision 2, paragraph (dd).
67.28EFFECTIVE DATE.This section is effective October 1, 2013.

67.29    Sec. 21. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
67.30read:
67.31    Subd. 4d. Preadmission screening of individuals under 65 years of age. (a)
67.32It is the policy of the state of Minnesota to ensure that individuals with disabilities or
67.33chronic illness are served in the most integrated setting appropriate to their needs and have
67.34the necessary information to make informed choices about home and community-based
67.35service options.
68.1    (b) Individuals under 65 years of age who are admitted to a nursing facility from a
68.2hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.
68.3    (c) Individuals under 65 years of age who are admitted to nursing facilities with
68.4only a telephone screening must receive a face-to-face assessment from the long-term
68.5care consultation team member of the county in which the facility is located or from the
68.6recipient's county case manager within 40 calendar days of admission.
68.7    (d) Individuals under 65 years of age who are admitted to a nursing facility
68.8without preadmission screening according to the exemption described in subdivision 4b,
68.9paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
68.10a face-to-face assessment within 40 days of admission.
68.11    (e) At the face-to-face assessment, the long-term care consultation team member or
68.12county case manager must perform the activities required under subdivision 3b.
68.13    (f) For individuals under 21 years of age, a screening interview which recommends
68.14nursing facility admission must be face-to-face and approved by the commissioner before
68.15the individual is admitted to the nursing facility.
68.16    (g) In the event that an individual under 65 years of age is admitted to a nursing
68.17facility on an emergency basis, the county must be notified of the admission on the
68.18next working day, and a face-to-face assessment as described in paragraph (c) must be
68.19conducted within 40 calendar days of admission.
68.20    (h) At the face-to-face assessment, the long-term care consultation team member or
68.21the case manager must present information about home and community-based options,
68.22including consumer-directed options, so the individual can make informed choices. If the
68.23individual chooses home and community-based services, the long-term care consultation
68.24team member or case manager must complete a written relocation plan within 20 working
68.25days of the visit. The plan shall describe the services needed to move out of the facility
68.26and a time line for the move which is designed to ensure a smooth transition to the
68.27individual's home and community.
68.28    (i) An individual under 65 years of age residing in a nursing facility shall receive a
68.29face-to-face assessment at least every 12 months to review the person's service choices
68.30and available alternatives unless the individual indicates, in writing, that annual visits are
68.31not desired. In this case, the individual must receive a face-to-face assessment at least
68.32once every 36 months for the same purposes.
68.33    (j) Notwithstanding the provisions of subdivision 6, the commissioner may pay
68.34county agencies directly for face-to-face assessments for individuals under 65 years of age
68.35who are being considered for placement or residing in a nursing facility. Until September
69.130, 2013, payments for individuals under 65 years of age shall be made as described
69.2in this subdivision.

69.3    Sec. 22. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
69.4subdivision to read:
69.5    Subd. 4e. Determination of institutional level of care. The determination of the
69.6need for nursing facility, hospital, and intermediate care facility levels of care must be
69.7made according to criteria developed by the commissioner, and in section 256B.092,
69.8using forms developed by the commissioner. Effective January 1, 2014, for individuals
69.9age 21 and older, the determination of need for nursing facility level of care shall be
69.10based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
69.11determination of the need for nursing facility level of care must be made according to
69.12criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
69.13becomes effective on or after October 1, 2019.

69.14    Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
69.15    Subd. 6. Payment for long-term care consultation services. (a) Until September
69.1630, 2013, payment for long-term care consultation face-to-face assessment shall be made
69.17as described in this subdivision.
69.18    (b) The total payment for each county must be paid monthly by certified nursing
69.19facilities in the county. The monthly amount to be paid by each nursing facility for each
69.20fiscal year must be determined by dividing the county's annual allocation for long-term
69.21care consultation services by 12 to determine the monthly payment and allocating the
69.22monthly payment to each nursing facility based on the number of licensed beds in the
69.23nursing facility. Payments to counties in which there is no certified nursing facility must be
69.24made by increasing the payment rate of the two facilities located nearest to the county seat.
69.25    (b) (c) The commissioner shall include the total annual payment determined under
69.26paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434,
69.27or 256B.441.
69.28    (c) (d) In the event of the layaway, delicensure and decertification, or removal
69.29from layaway of 25 percent or more of the beds in a facility, the commissioner may
69.30adjust the per diem payment amount in paragraph (b) (c) and may adjust the monthly
69.31payment amount in paragraph (a) (b). The effective date of an adjustment made under this
69.32paragraph shall be on or after the first day of the month following the effective date of the
69.33layaway, delicensure and decertification, or removal from layaway.
70.1    (d) (e) Payments for long-term care consultation services are available to the county
70.2or counties to cover staff salaries and expenses to provide the services described in
70.3subdivision 1a. The county shall employ, or contract with other agencies to employ,
70.4within the limits of available funding, sufficient personnel to provide long-term care
70.5consultation services while meeting the state's long-term care outcomes and objectives as
70.6defined in subdivision 1. The county shall be accountable for meeting local objectives
70.7as approved by the commissioner in the biennial home and community-based services
70.8quality assurance plan on a form provided by the commissioner.
70.9    (e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment
70.10of the screening costs under the medical assistance program may not be recovered from
70.11a facility.
70.12    (f) (g) The commissioner of human services shall amend the Minnesota medical
70.13assistance plan to include reimbursement for the local consultation teams.
70.14    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented,
70.15the county may bill, as case management services, assessments, support planning, and
70.16follow-along provided to persons determined to be eligible for case management under
70.17Minnesota health care programs. No individual or family member shall be charged for an
70.18initial assessment or initial support plan development provided under subdivision 3a or 3b.
70.19(h) (i) The commissioner shall develop an alternative payment methodology,
70.20effective on October 1, 2013, for long-term care consultation services that includes
70.21the funding available under this subdivision, and for assessments authorized under
70.22sections 256B.092 and 256B.0659. In developing the new payment methodology, the
70.23commissioner shall consider the maximization of other funding sources, including federal
70.24administrative reimbursement through federal financial participation funding, for all
70.25long-term care consultation and preadmission screening activity. The alternative payment
70.26methodology shall include the use of the appropriate time studies and the state financing
70.27of nonfederal share as part of the state's medical assistance program.

70.28    Sec. 24. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
70.29    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
70.30reimbursement for nursing facilities shall be authorized for a medical assistance recipient
70.31only if a preadmission screening has been conducted prior to admission or the county has
70.32authorized an exemption. Medical assistance reimbursement for nursing facilities shall
70.33not be provided for any recipient who the local screener has determined does not meet the
70.34level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
70.35if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
71.1Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
71.2mental illness is approved by the local mental health authority or an admission for a
71.3recipient with developmental disability is approved by the state developmental disability
71.4authority.
71.5    (b) The nursing facility must not bill a person who is not a medical assistance
71.6recipient for resident days that preceded the date of completion of screening activities
71.7as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing
71.8facility must include unreimbursed resident days in the nursing facility resident day totals
71.9reported to the commissioner.

71.10    Sec. 25. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
71.11    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
71.12    (a) Funding for services under the alternative care program is available to persons who
71.13meet the following criteria:
71.14    (1) the person has been determined by a community assessment under section
71.15256B.0911 to be a person who would require the level of care provided in a nursing
71.16facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for
71.17the provision of services under the alternative care program;
71.18    (2) the person is age 65 or older;
71.19    (3) the person would be eligible for medical assistance within 135 days of admission
71.20to a nursing facility;
71.21    (4) the person is not ineligible for the payment of long-term care services by the
71.22medical assistance program due to an asset transfer penalty under section 256B.0595 or
71.23equity interest in the home exceeding $500,000 as stated in section 256B.056;
71.24    (5) the person needs long-term care services that are not funded through other
71.25state or federal funding, or other health insurance or other third-party insurance such as
71.26long-term care insurance;
71.27    (6) except for individuals described in clause (7), the monthly cost of the alternative
71.28care services funded by the program for this person does not exceed 75 percent of the
71.29monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
71.30does not prohibit the alternative care client from payment for additional services, but in no
71.31case may the cost of additional services purchased under this section exceed the difference
71.32between the client's monthly service limit defined under section 256B.0915, subdivision
71.333
, and the alternative care program monthly service limit defined in this paragraph. If
71.34care-related supplies and equipment or environmental modifications and adaptations are or
71.35will be purchased for an alternative care services recipient, the costs may be prorated on a
72.1monthly basis for up to 12 consecutive months beginning with the month of purchase.
72.2If the monthly cost of a recipient's other alternative care services exceeds the monthly
72.3limit established in this paragraph, the annual cost of the alternative care services shall be
72.4determined. In this event, the annual cost of alternative care services shall not exceed 12
72.5times the monthly limit described in this paragraph;
72.6    (7) for individuals assigned a case mix classification A as described under section
72.7256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
72.8living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
72.9when the dependency score in eating is three or greater as determined by an assessment
72.10performed under section 256B.0911, the monthly cost of alternative care services funded
72.11by the program cannot exceed $593 per month for all new participants enrolled in
72.12the program on or after July 1, 2011. This monthly limit shall be applied to all other
72.13participants who meet this criteria at reassessment. This monthly limit shall be increased
72.14annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly
72.15limit does not prohibit the alternative care client from payment for additional services, but
72.16in no case may the cost of additional services purchased exceed the difference between the
72.17client's monthly service limit defined in this clause and the limit described in clause (6)
72.18for case mix classification A; and
72.19(8) the person is making timely payments of the assessed monthly fee.
72.20A person is ineligible if payment of the fee is over 60 days past due, unless the person
72.21agrees to:
72.22    (i) the appointment of a representative payee;
72.23    (ii) automatic payment from a financial account;
72.24    (iii) the establishment of greater family involvement in the financial management of
72.25payments; or
72.26    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
72.27    The lead agency may extend the client's eligibility as necessary while making
72.28arrangements to facilitate payment of past-due amounts and future premium payments.
72.29Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
72.30reinstated for a period of 30 days.
72.31    (b) Alternative care funding under this subdivision is not available for a person who
72.32is a medical assistance recipient or who would be eligible for medical assistance without a
72.33spenddown or waiver obligation. A person whose initial application for medical assistance
72.34and the elderly waiver program is being processed may be served under the alternative care
72.35program for a period up to 60 days. If the individual is found to be eligible for medical
72.36assistance, medical assistance must be billed for services payable under the federally
73.1approved elderly waiver plan and delivered from the date the individual was found eligible
73.2for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
73.3care funds may not be used to pay for any service the cost of which: (i) is payable by
73.4medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
73.5pay a medical assistance income spenddown for a person who is eligible to participate in the
73.6federally approved elderly waiver program under the special income standard provision.
73.7    (c) Alternative care funding is not available for a person who resides in a licensed
73.8nursing home, certified boarding care home, hospital, or intermediate care facility, except
73.9for case management services which are provided in support of the discharge planning
73.10process for a nursing home resident or certified boarding care home resident to assist with
73.11a relocation process to a community-based setting.
73.12    (d) Alternative care funding is not available for a person whose income is greater
73.13than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
73.14to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
73.15year for which alternative care eligibility is determined, who would be eligible for the
73.16elderly waiver with a waiver obligation.

73.17    Sec. 26. Minnesota Statutes 2012, section 256B.0913, is amended by adding a
73.18subdivision to read:
73.19    Subd. 17. Essential community supports grants. (a) Notwithstanding subdivisions
73.201 to 14, the purpose of the essential community supports grant program is to provide
73.21targeted services to persons age 65 and older who need essential community support, but
73.22whose needs do not meet the level of care required for nursing facility placement under
73.23section 144.0724, subdivision 11.
73.24(b) Essential community supports grants are available not to exceed $400 per person
73.25per month. Essential community supports service grants may be used as authorized within
73.26an authorization period not to exceed 12 months. Grants must be available to a person who:
73.27(1) is age 65 or older;
73.28(2) is not eligible for medical assistance;
73.29(3) would otherwise be financially eligible for the alternative care program under
73.30subdivision 4;
73.31(4) has received a community assessment under section 256B.0911, subdivision 3a
73.32or 3b, and does not require the level of care provided in a nursing facility;
73.33(5) has a community support plan; and
73.34(6) has been determined by a community assessment under section 256B.0911,
73.35subdivision 3a or 3b, to be a person who would require provision of at least one of the
74.1following services, as defined in the approved elderly waiver plan, in order to maintain
74.2their community residence:
74.3(i) caregiver support;
74.4(ii) homemaker support;
74.5(iii) chores; or
74.6(iv) a personal emergency response device or system.
74.7(c) The person receiving any of the essential community supports in this subdivision
74.8must also receive service coordination, not to exceed $600 in a 12-month authorization
74.9period, as part of their community support plan.
74.10(d) A person who has been determined to be eligible for an essential community
74.11supports grant must be reassessed at least annually and continue to meet the criteria in
74.12paragraph (b) to remain eligible for an essential community supports grant.
74.13(e) The commissioner is authorized to use federal matching funds for essential
74.14community supports as necessary and to meet demand for essential community supports
74.15grants as outlined in paragraphs (f) and (g), and that amount of federal funds is
74.16appropriated to the commissioner for this purpose.
74.17(f) Upon federal approval and following a reasonable implementation period
74.18determined by the commissioner, essential community supports are available to an
74.19individual who:
74.20(1) is receiving nursing facility services or home and community-based long-term
74.21services and supports under section 256B.0915 or 256B.49 on the effective date of
74.22implementation of the revised nursing facility level of care under section 144.0724,
74.23subdivision 11;
74.24(2) meets one of the following criteria:
74.25(i) due to the implementation of the revised nursing facility level of care, loses
74.26eligibility for continuing medical assistance payment of nursing facility services at the
74.27first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or
74.28after the effective date of the revised nursing facility level of care criteria under section
74.29144.0724, subdivision 11; or
74.30(ii) due to the implementation of the revised nursing facility level of care, loses
74.31eligibility for continuing medical assistance payment of home and community-based
74.32long-term services and supports under section 256B.0915 or 256B.49 at the first
74.33reassessment required under those sections that occurs on or after the effective date of
74.34implementation of the revised nursing facility level of care under section 144.0724,
74.35subdivision 11;
74.36(3) is not eligible for personal care attendant services; and
75.1(4) has an assessed need for one or more of the supportive services offered under
75.2essential community supports.
75.3Individuals eligible under this paragraph includes individuals who continue to be
75.4eligible for medical assistance state plan benefits and those who are not or are no longer
75.5financially eligible for medical assistance.
75.6(g) Upon federal approval and following a reasonable implementation period
75.7determined by the commissioner, the services available through essential community
75.8supports include the services and grants provided in paragraphs (b) and (c), home-delivered
75.9meals, and community living assistance as defined by the commissioner. These services
75.10are available to all eligible recipients including those outlined in paragraphs (b) and (f).
75.11Recipients are eligible if they have a need for any of these services and meet all other
75.12eligibility criteria.

75.13    Sec. 27. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
75.14    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
75.15shall receive an initial assessment of strengths, informal supports, and need for services
75.16in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
75.17client served under the elderly waiver must be conducted at least every 12 months and at
75.18other times when the case manager determines that there has been significant change in
75.19the client's functioning. This may include instances where the client is discharged from
75.20the hospital. There must be a determination that the client requires nursing facility level
75.21of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and
75.22subsequent assessments to initiate and maintain participation in the waiver program.
75.23(b) Regardless of other assessments identified in section 144.0724, subdivision
75.244, as appropriate to determine nursing facility level of care for purposes of medical
75.25assistance payment for nursing facility services, only face-to-face assessments conducted
75.26according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
75.27level of care determination will be accepted for purposes of initial and ongoing access to
75.28waiver service payment.

75.29    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
75.30subdivision to read:
75.31    Subd. 1a. Home and community-based services for older adults. (a) The purpose
75.32of projects selected by the commissioner of human services under this section is to
75.33make strategic changes in the long-term services and supports system for older adults
75.34including statewide capacity for local service development and technical assistance, and
76.1statewide availability of home and community-based services for older adult services,
76.2caregiver support and respite care services, and other supports in the state of Minnesota.
76.3These projects are intended to create incentives for new and expanded home and
76.4community-based services in Minnesota in order to:
76.5(1) reach older adults early in the progression of their need for long-term services
76.6and supports, providing them with low-cost, high-impact services that will prevent or
76.7delay the use of more costly services;
76.8(2) support older adults to live in the most integrated, least restrictive community
76.9setting;
76.10(3) support the informal caregivers of older adults;
76.11(4) develop and implement strategies to integrate long-term services and supports
76.12with health care services, in order to improve the quality of care and enhance the quality
76.13of life of older adults and their informal caregivers;
76.14(5) ensure cost-effective use of financial and human resources;
76.15(6) build community-based approaches and community commitment to delivering
76.16long-term services and supports for older adults in their own homes;
76.17(7) achieve a broad awareness and use of lower-cost in-home services as an
76.18alternative to nursing homes and other residential services;
76.19(8) strengthen and develop additional home and community-based services and
76.20alternatives to nursing homes and other residential services; and
76.21(9) strengthen programs that use volunteers.
76.22(b) The services provided by these projects are available to older adults who are
76.23eligible for medical assistance and the elderly waiver under section 256B.0915, the
76.24alternative care program under section 256B.0913, or essential community supports grant
76.25under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
76.26services.

76.27    Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
76.28subdivision to read:
76.29    Subd. 1b. Definitions. (a) For purposes of this section, the following terms have
76.30the meanings given.
76.31(b) "Community" means a town; township; city; or targeted neighborhood within a
76.32city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
76.33(c) "Core home and community-based services provider" means a Faith in Action,
76.34Living at Home Block Nurse, Congregational Nurse, or similar community-based
76.35program governed by a board, the majority of whose members reside within the program's
77.1service area, that organizes and uses volunteers and paid staff to deliver nonmedical
77.2services intended to assist older adults to identify and manage risks and to maintain their
77.3community living and integration in the community.
77.4(d) "Eldercare development partnership" means a team of representatives of county
77.5social service and public health agencies, the area agency on aging, local nursing home
77.6providers, local home care providers, and other appropriate home and community-based
77.7providers in the area agency's planning and service area.
77.8(e) "Long-term services and supports" means any service available under the
77.9elderly waiver program or alternative care grant programs, nursing facility services,
77.10transportation services, caregiver support and respite care services, and other home and
77.11community-based services identified as necessary either to maintain lifestyle choices for
77.12older adults or to support them to remain in their own home.
77.13(f) "Older adult" refers to an individual who is 65 years of age or older.

77.14    Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
77.15subdivision to read:
77.16    Subd. 1c. Eldercare development partnerships. The commissioner of human
77.17services shall select and contract with eldercare development partnerships sufficient to
77.18provide statewide availability of service development and technical assistance using a
77.19request for proposals process. Eldercare development partnerships shall:
77.20(1) develop a local long-term services and supports strategy consistent with state
77.21goals and objectives;
77.22(2) identify and use existing local skills, knowledge, and relationships, and build
77.23on these assets;
77.24(3) coordinate planning for funds to provide services to older adults, including funds
77.25received under Title III of the Older Americans Act, Title XX of the Social Security Act,
77.26and the Local Public Health Act;
77.27(4) target service development and technical assistance where nursing facility
77.28closures have occurred or are occurring or in areas where service needs have been
77.29identified through activities under section 144A.351;
77.30(5) provide sufficient staff for development and technical support in its designated
77.31area; and
77.32(6) designate a single public or nonprofit member of the eldercare development
77.33partnerships to apply grant funding and manage the project.

77.34    Sec. 31. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
78.1    Subd. 6. Caregiver support and respite care projects. (a) The commissioner
78.2shall establish up to 36 projects to expand the respite care network in the state and to
78.3support caregivers in their responsibilities for care. The purpose of each project shall
78.4be to availability of caregiver support and respite care services for family and other
78.5caregivers. The commissioner shall use a request for proposals to select nonprofit entities
78.6to administer the projects. Projects shall:
78.7(1) establish a local coordinated network of volunteer and paid respite workers;
78.8(2) coordinate assignment of respite workers care services to clients and care
78.9receivers and assure the health and safety of the client; and caregivers of older adults;
78.10(3) provide training for caregivers and ensure that support groups are available
78.11in the community.
78.12(b) The caregiver support and respite care funds shall be available to the four to six
78.13local long-term care strategy projects designated in subdivisions 1 to 5.
78.14(c) The commissioner shall publish a notice in the State Register to solicit proposals
78.15from public or private nonprofit agencies for the projects not included in the four to six
78.16local long-term care strategy projects defined in subdivision 2. A county agency may,
78.17alone or in combination with other county agencies, apply for caregiver support and
78.18respite care project funds. A public or nonprofit agency within a designated SAIL project
78.19area may apply for project funds if the agency has a letter of agreement with the county
78.20or counties in which services will be developed, stating the intention of the county or
78.21counties to coordinate their activities with the agency requesting a grant.
78.22(d) The commissioner shall select grantees based on the following criteria:
78.23(1) the ability of the proposal to demonstrate need in the area served, as evidenced
78.24by a community needs assessment or other demographic data;
78.25(2) the ability of the proposal to clearly describe how the project
78.26(3) assure the health and safety of the older adults;
78.27(4) identify at-risk caregivers;
78.28(5) provide information, education, and training for caregivers in the designated
78.29community; and
78.30(6) demonstrate the need in the proposed service area particularly where nursing
78.31facility closures have occurred or are occurring or areas with service needs identified
78.32by section 144A.351. Preference must be given for projects that reach underserved
78.33populations.
78.34(b) Projects must clearly describe:
78.35(1) how they will achieve the their purpose defined in paragraph (b);
78.36(3) the ability of the proposal to reach underserved populations;
79.1(4) the ability of the proposal to demonstrate community commitment to the project,
79.2as evidenced by letters of support and cooperation as well as formation of a community
79.3task force;
79.4(5) the ability of the proposal to clearly describe (2) the process for recruiting,
79.5training, and retraining volunteers; and
79.6(6) the inclusion in the proposal of the (3) a plan to promote the project in the
79.7designated community, including outreach to persons needing the services.
79.8(e) (c) Funds for all projects under this subdivision may be used to:
79.9(1) hire a coordinator to develop a coordinated network of volunteer and paid respite
79.10care services and assign workers to clients;
79.11(2) recruit and train volunteer providers;
79.12(3) train provide information, training, and education to caregivers;
79.13(4) ensure the development of support groups for caregivers;
79.14(5) (4) advertise the availability of the caregiver support and respite care project; and
79.15(6) (5) purchase equipment to maintain a system of assigning workers to clients.
79.16(f) (d) Project funds may not be used to supplant existing funding sources.

79.17    Sec. 32. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
79.18subdivision to read:
79.19    Subd. 7a. Core home and community-based services. The commissioner shall
79.20select and contract with core home and community-based services providers for projects
79.21to provide services and supports to older adults both with and without family and other
79.22informal caregivers using a request for proposals process. Projects must:
79.23(1) have a credible, public, or private nonprofit sponsor providing ongoing financial
79.24support;
79.25(2) have a specific, clearly defined geographic service area;
79.26(3) use a practice framework designed to identify high-risk older adults and help them
79.27take action to better manage their chronic conditions and maintain their community living;
79.28(4) have a team approach to coordination and care, ensuring that the older adult
79.29participants, their families, and the formal and informal providers are all part of planning
79.30and providing services;
79.31(5) provide information, support services, homemaking services, counseling, and
79.32training for the older adults and family caregivers;
79.33(6) encourage service area or neighborhood residents and local organizations to
79.34collaborate in meeting the needs of older adults in their geographic service areas;
80.1(7) recruit, train, and direct the use of volunteers to provide informal services and
80.2other appropriate support to older adults and their caregivers; and
80.3(8) provide coordination and management of formal and informal services to older
80.4adults and their families using less expensive alternatives.

80.5    Sec. 33. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to
80.6read:
80.7    Subd. 13. Community service grants. The commissioner shall award contracts
80.8for grants to public and private nonprofit agencies to establish services that strengthen
80.9a community's ability to provide a system of home and community-based services
80.10for elderly persons. The commissioner shall use a request for proposal process. The
80.11commissioner shall give preference when awarding grants under this section to areas
80.12where nursing facility closures have occurred or are occurring or to areas with service
80.13needs identified under section 144A.351. The commissioner shall consider grants for:
80.14(1) caregiver support and respite care projects under subdivision 6;
80.15(2) the living-at-home/block nurse grant under subdivisions 7 to 10; and
80.16(3) services identified as needed for community transition.

80.17    Sec. 34. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
80.18    Subdivision 1. Development and implementation of quality profiles. (a) The
80.19commissioner of human services, in cooperation with the commissioner of health,
80.20shall develop and implement a quality profile system profiles for nursing facilities and,
80.21beginning not later than July 1, 2004 2014, other providers of long-term care services,
80.22except when the quality profile system would duplicate requirements under section
80.23256B.5011 , 256B.5012, or 256B.5013. The system quality profiles must be developed
80.24and implemented to the extent possible without the collection of significant amounts of
80.25new data. To the extent possible, the system using existing data sets maintained by the
80.26commissioners of health and human services to the extent possible. The profiles must
80.27incorporate or be coordinated with information on quality maintained by area agencies on
80.28aging, long-term care trade associations, the ombudsman offices, counties, tribes, health
80.29plans, and other entities and the long-term care database maintained under section 256.975,
80.30subdivision 7. The system profiles must be designed to provide information on quality to:
80.31(1) consumers and their families to facilitate informed choices of service providers;
80.32(2) providers to enable them to measure the results of their quality improvement
80.33efforts and compare quality achievements with other service providers; and
81.1(3) public and private purchasers of long-term care services to enable them to
81.2purchase high-quality care.
81.3(b) The system profiles must be developed in consultation with the long-term care
81.4task force, area agencies on aging, and representatives of consumers, providers, and labor
81.5unions. Within the limits of available appropriations, the commissioners may employ
81.6consultants to assist with this project.

81.7    Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
81.8    Subd. 2. Quality measurement tools. The commissioners shall identify and apply
81.9existing quality measurement tools to:
81.10(1) emphasize quality of care and its relationship to quality of life; and
81.11(2) address the needs of various users of long-term care services, including, but not
81.12limited to, short-stay residents, persons with behavioral problems, persons with dementia,
81.13and persons who are members of minority groups.
81.14    The tools must be identified and applied, to the extent possible, without requiring
81.15providers to supply information beyond current state and federal requirements.

81.16    Sec. 36. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
81.17    Subd. 3. Consumer surveys of nursing facilities residents. Following
81.18identification of the quality measurement tool, the commissioners shall conduct surveys
81.19of long-term care service consumers of nursing facilities to develop quality profiles
81.20of providers. To the extent possible, surveys must be conducted face-to-face by state
81.21employees or contractors. At the discretion of the commissioners, surveys may be
81.22conducted by telephone or by provider staff. Surveys must be conducted periodically to
81.23update quality profiles of individual service nursing facilities providers.

81.24    Sec. 37. Minnesota Statutes 2012, section 256B.439, is amended by adding a
81.25subdivision to read:
81.26    Subd. 3a. Home and community-based services report card in cooperation with
81.27the commissioner of health. The profiles developed for home and community-based
81.28services providers under this section shall be incorporated into a report card and
81.29maintained by the Minnesota Board on Aging pursuant to section 256.975, subdivision
81.307, paragraph (b), clause (2), as data becomes available. The commissioner, in
81.31cooperation with the commissioner of health, shall use consumer choice, quality of life,
81.32care approaches, and cost or flexible purchasing categories to organize the consumer
81.33information in the profiles. The final categories used shall include consumer input and
82.1survey data to the extent that it is available through the state agencies. The commissioner
82.2shall develop and disseminate the qualify profiles for a limited number of provider types
82.3initially, and develop quality profiles for additional provider types as measurement tools
82.4are developed and data becomes available. This includes providers of services to older
82.5adults and people with disabilities, regardless of payor source.

82.6    Sec. 38. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
82.7    Subd. 4. Dissemination of quality profiles. By July 1, 2003 2014, the
82.8commissioners shall implement a system public awareness effort to disseminate the quality
82.9profiles developed from consumer surveys using the quality measurement tool. Profiles
82.10may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and
82.11to consumers, providers, and purchasers of long-term care services through all feasible
82.12printed and electronic outlets. The commissioners may conduct a public awareness
82.13campaign to inform potential users regarding profile contents and potential uses.

82.14    Sec. 39. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
82.15    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
82.16nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
82.17section 144.122; until September 30, 2013, long-term care consultation fees under
82.18section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
82.19scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
82.20under section 256B.437; or single bed room incentives under section 256B.431,
82.21subdivision 42
; property taxes and property insurance; and PERA.

82.22    Sec. 40. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
82.23    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
82.24shall calculate a payment rate for external fixed costs.
82.25    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
82.26shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
82.27home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
82.28result of its number of nursing home beds divided by its total number of licensed beds.
82.29    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
82.30shall be the amount of the fee divided by actual resident days.
82.31    (c) The portion related to scholarships shall be determined under section 256B.431,
82.32subdivision 36.
83.1    (d) Until September 30, 2013, the portion related to long-term care consultation shall
83.2be determined according to section 256B.0911, subdivision 6.
83.3    (e) The portion related to development and education of resident and family advisory
83.4councils under section 144A.33 shall be $5 divided by 365.
83.5    (f) The portion related to planned closure rate adjustments shall be as determined
83.6under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
83.7Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
83.8be included in the payment rate for external fixed costs beginning October 1, 2016.
83.9Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
83.10longer be included in the payment rate for external fixed costs beginning on October 1 of
83.11the first year not less than two years after their effective date.
83.12    (g) The portions related to property insurance, real estate taxes, special assessments,
83.13and payments made in lieu of real estate taxes directly identified or allocated to the nursing
83.14facility shall be the actual amounts divided by actual resident days.
83.15    (h) The portion related to the Public Employees Retirement Association shall be
83.16actual costs divided by resident days.
83.17    (i) The single bed room incentives shall be as determined under section 256B.431,
83.18subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
83.19no longer be included in the payment rate for external fixed costs beginning October 1,
83.202016. Single bed room incentives that take effect on or after October 1, 2014, shall no
83.21longer be included in the payment rate for external fixed costs beginning on October 1 of
83.22the first year not less than two years after their effective date.
83.23    (j) The payment rate for external fixed costs shall be the sum of the amounts in
83.24paragraphs (a) to (i).

83.25    Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
83.26    Subd. 12. Informed choice. Persons who are determined likely to require the level
83.27of care provided in a nursing facility as determined under section 256B.0911, subdivision
83.284e, or a hospital shall be informed of the home and community-based support alternatives
83.29to the provision of inpatient hospital services or nursing facility services. Each person
83.30must be given the choice of either institutional or home and community-based services
83.31using the provisions described in section 256B.77, subdivision 2, paragraph (p).

83.32    Sec. 42. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
83.33    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
83.34shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
84.1With the permission of the recipient or the recipient's designated legal representative,
84.2the recipient's current provider of services may submit a written report outlining their
84.3recommendations regarding the recipient's care needs prepared by a direct service
84.4employee with at least 20 hours of service to that client. The person conducting the
84.5assessment or reassessment must notify the provider of the date by which this information
84.6is to be submitted. This information shall be provided to the person conducting the
84.7assessment and the person or the person's legal representative and must be considered
84.8prior to the finalization of the assessment or reassessment.
84.9(b) There must be a determination that the client requires a hospital level of care or a
84.10nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
84.11(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the
84.12waiver program.
84.13(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
84.14appropriate to determine nursing facility level of care for purposes of medical assistance
84.15payment for nursing facility services, only face-to-face assessments conducted according
84.16to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
84.17determination or a nursing facility level of care determination must be accepted for
84.18purposes of initial and ongoing access to waiver services payment.
84.19(d) Recipients who are found eligible for home and community-based services under
84.20this section before their 65th birthday may remain eligible for these services after their
84.2165th birthday if they continue to meet all other eligibility factors.
84.22(e) The commissioner shall develop criteria to identify recipients whose level of
84.23functioning is reasonably expected to improve and reassess these recipients to establish
84.24a baseline assessment. Recipients who meet these criteria must have a comprehensive
84.25transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
84.26reassessed every six months until there has been no significant change in the recipient's
84.27functioning for at least 12 months. After there has been no significant change in the
84.28recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
84.29informal support systems, and need for services shall be conducted at least every 12
84.30months and at other times when there has been a significant change in the recipient's
84.31functioning. Counties, case managers, and service providers are responsible for
84.32conducting these reassessments and shall complete the reassessments out of existing funds.

84.33    Sec. 43. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
84.34    Subdivision 1. Basis and scope. (a) Upon federal approval, the commissioner
84.35shall establish a medical assistance state plan option for the provision of home and
85.1community-based personal assistance service and supports called "community first
85.2services and supports (CFSS)."
85.3(b) CFSS is a participant-controlled method of selecting and providing services
85.4and supports that allows the participant maximum control of the services and supports.
85.5Participants may choose the degree to which they direct and manage their supports by
85.6choosing to have a significant and meaningful role in the management of services and
85.7supports including by directly employing support workers with the necessary supports
85.8to perform that function.
85.9(c) CFSS is available statewide to eligible individuals to assist with accomplishing
85.10activities of daily living (ADLs), instrumental activities of daily living (IADLs), and
85.11health-related procedures and tasks through hands-on assistance to accomplish the task
85.12or constant supervision and cueing to accomplish the task; and to assist with acquiring,
85.13maintaining, and enhancing the skills necessary to accomplish ADLs, IADLs, and
85.14health-related procedures and tasks. CFSS allows payment for certain supports and goods
85.15such as environmental modifications and technology that are intended to replace or
85.16decrease the need for human assistance.
85.17(d) Upon federal approval, CFSS will replace the personal care assistance program
85.18under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
85.19    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
85.20this subdivision have the meanings given.
85.21(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming,
85.22dressing, bathing, mobility, positioning, and transferring.
85.23(c) "Agency-provider model" means a method of CFSS under which a qualified
85.24agency provides services and supports through the agency's own employees and policies.
85.25The agency must allow the participant to have a significant role in the selection and
85.26dismissal of support workers of their choice for the delivery of their specific services
85.27and supports.
85.28(d) "Behavior" means a description of a need for services and supports used to
85.29determine the home care rating and additional service units. The presence of Level I
85.30behavior is used to determine the home care rating. "Level I behavior" means physical
85.31aggression towards self or others or destruction of property that requires the immediate
85.32response of another person. If qualified for a home care rating as described in subdivision
85.338, additional service units can be added as described in subdivision 8, paragraph (f), for
85.34the following behaviors:
85.35(1) Level I behavior;
86.1(2) increased vulnerability due to cognitive deficits or socially inappropriate
86.2behavior; or
86.3(3) increased need for assistance for recipients who are verbally aggressive or
86.4resistive to care so that time needed to perform activities of daily living is increased.
86.5(e) "Complex health-related needs" means an intervention listed in clauses (1) to
86.6(8) that has been ordered by a physician, and is specified in a community support plan,
86.7including:
86.8(1) tube feedings requiring:
86.9(i) a gastrojejunostomy tube; or
86.10(ii) continuous tube feeding lasting longer than 12 hours per day;
86.11(2) wounds described as:
86.12(i) stage III or stage IV;
86.13(ii) multiple wounds;
86.14(iii) requiring sterile or clean dressing changes or a wound vac; or
86.15(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require
86.16specialized care;
86.17(3) parenteral therapy described as:
86.18(i) IV therapy more than two times per week lasting longer than four hours for
86.19each treatment; or
86.20(ii) total parenteral nutrition (TPN) daily;
86.21(4) respiratory interventions, including:
86.22(i) oxygen required more than eight hours per day;
86.23(ii) respiratory vest more than one time per day;
86.24(iii) bronchial drainage treatments more than two times per day;
86.25(iv) sterile or clean suctioning more than six times per day;
86.26(v) dependence on another to apply respiratory ventilation augmentation devices
86.27such as BiPAP and CPAP; and
86.28(vi) ventilator dependence under section 256B.0652;
86.29(5) insertion and maintenance of catheter, including:
86.30(i) sterile catheter changes more than one time per month;
86.31(ii) clean intermittent catheterization, and including self-catheterization more than
86.32six times per day; or
86.33(iii) bladder irrigations;
86.34(6) bowel program more than two times per week requiring more than 30 minutes to
86.35perform each time;
86.36(7) neurological intervention, including:
87.1(i) seizures more than two times per week and requiring significant physical
87.2assistance to maintain safety; or
87.3(ii) swallowing disorders diagnosed by a physician and requiring specialized
87.4assistance from another on a daily basis; and
87.5(8) other congenital or acquired diseases creating a need for significantly increased
87.6direct hands-on assistance and interventions in six to eight activities of daily living.
87.7(f) "Community first services and supports" or "CFSS" means the assistance and
87.8supports program under this section needed for accomplishing activities of daily living,
87.9instrumental activities of daily living, and health-related tasks through hands-on assistance
87.10to complete the task or supervision and cueing to complete the task, or the purchase of
87.11goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for
87.12human assistance.
87.13(g) "Community first services and supports service delivery plan" or "service delivery
87.14plan" means a written summary of the services and supports, that is based on the community
87.15support plan identified in section 256B.0911 and coordinated services and support plan
87.16and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined
87.17by the participant to meet the assessed needs, using a person-centered planning process.
87.18(h) "Critical activities of daily living" means transferring, mobility, eating, and
87.19toileting.
87.20(i) "Dependency" in activities of daily living means a person requires hands-on
87.21assistance or constant supervision and cueing to accomplish one or more of the activities
87.22of daily living every day or on the days during the week that the activity is performed;
87.23however, a child may not be found to be dependent in an activity of daily living if,
87.24because of the child's age, an adult would either perform the activity for the child or assist
87.25the child with the activity. Assistance needed is the assistance appropriate for a typical
87.26child of the same age.
87.27(j) "Extended CFSS" means CFSS services and supports under the agency–provider
87.28model included in a service plan through one of the home and community-based services
87.29waivers authorized under sections 256B.0915; 256B.092, subdivision 5; and 256B.49,
87.30which exceed the amount, duration, and frequency of the state plan CFSS services for
87.31participants.
87.32(k) "Financial management services contractor or vendor" means a qualified
87.33organization having a written contract with the department to provide services necessary to
87.34use the budget model under subdivision 13, that include but are not limited to: participant
87.35education and technical assistance; CFSS service delivery planning and budgeting; billing,
87.36making payments, and monitoring of spending; and assisting the participant in fulfilling
88.1employer-related requirements in accordance with Section 3504 of the IRS code and
88.2the IRS Revenue Procedure 70-6.
88.3(l) "Budget model" means a service delivery method of CFSS that uses an
88.4individualized CFSS service delivery plan and service budget and assistance from the
88.5financial management services contractor to facilitate participant employment of support
88.6workers and the acquisition of supports and goods.
88.7(m) "Health-related procedures and tasks" means procedures and tasks related to
88.8the specific needs of an individual that can be delegated or assigned by a state-licensed
88.9healthcare or behavioral health professional and performed by a support worker.
88.10(n) "Instrumental activities of daily living" means activities related to living
88.11independently in the community, including but not limited to: meal planning, preparation,
88.12and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning;
88.13assistance with medications; managing money; communicating needs, preferences, and
88.14activities; arranging supports; and assistance with traveling around and participating
88.15in the community.
88.16(o) "Legal representative" means parent of a minor, a court-appointed guardian, or
88.17another representative with legal authority to make decisions about services and supports
88.18for the participant. Other representatives with legal authority to make decisions include
88.19but are not limited to a health care agent or an attorney-in-fact authorized through a health
88.20care directive or power of attorney.
88.21(p) "Medication assistance" means providing verbal or visual reminders to take
88.22regularly scheduled medication, and includes any of the following supports listed in clauses
88.23(1) to (3) and other types of assistance, except that a support worker may not determine
88.24medication dose or time for medication or inject medications into veins, muscles, or skin:
88.25(1) under the direction of the participant or the participant's representative, bringing
88.26medications to the participant including medications given through a nebulizer, opening a
88.27container of previously set-up medications, emptying the container into the participant's
88.28hand, opening and giving the medication in the original container to the participant, or
88.29bringing to the participant liquids or food to accompany the medication;
88.30(2) organizing medications as directed by the participant or the participant's
88.31representative; and
88.32(3) providing verbal or visual reminders to perform regularly scheduled medications.
88.33(q) "Participant's representative" means a parent, family member, advocate, or
88.34other adult authorized by the participant to serve as a representative in connection with
88.35the provision of CFSS. This authorization must be in writing or by another method
88.36that clearly indicates the participant's free choice. The participant's representative must
89.1have no financial interest in the provision of any services included in the participant's
89.2service delivery plan and must be capable of providing the support necessary to assist
89.3the participant in the use of CFSS. If through the assessment process described in
89.4subdivision 5 a participant is determined to be in need of a participant's representative, one
89.5must be selected. If the participant is unable to assist in the selection of a participant's
89.6representative, the legal representative shall appoint one. Two persons may be designated
89.7as a participant's representative for reasons such as divided households and court-ordered
89.8custodies. Duties of a participant's representatives may include:
89.9(1) being available while care is provided in a method agreed upon by the participant
89.10or the participant's legal representative and documented in the participant's CFSS service
89.11delivery plan;
89.12(2) monitoring CFSS services to ensure the participant's CFSS service delivery
89.13plan is being followed; and
89.14(3) reviewing and signing CFSS time sheets after services are provided to provide
89.15verification of the CFSS services.
89.16(r) "Person-centered planning process" means a process that is driven by the
89.17participant for discovering and planning services and supports that ensures the participant
89.18makes informed choices and decisions. The person-centered planning process must:
89.19(1) include people chosen by the participant;
89.20(2) provide necessary information and support to ensure that the participant directs
89.21the process to the maximum extent possible, and is enabled to make informed choices
89.22and decisions;
89.23(3) be timely and occur at time and locations of convenience to the participant;
89.24(4) reflect cultural considerations of the participant;
89.25(5) include strategies for solving conflict or disagreement within the process,
89.26including clear conflict-of-interest guidelines for all planning;
89.27(6) offer choices to the participant regarding the services and supports they receive
89.28and from whom;
89.29(7) include a method for the participant to request updates to the plan; and
89.30(8) record the alternative home and community-based settings that were considered
89.31by the participant.
89.32(s) "Shared services" means the provision of CFSS services by the same CFSS
89.33support worker to two or three participants who voluntarily enter into an agreement to
89.34receive services at the same time and in the same setting by the same provider.
89.35(t) "Support specialist" means a professional with the skills and ability to assist the
89.36participant using either the agency provider model under subdivision 11 or the flexible
90.1spending model under subdivision 13, in services including but not limited to assistance
90.2regarding:
90.3(1) the development, implementation, and evaluation of the CFSS service delivery
90.4plan under subdivision 6;
90.5(2) recruitment, training, or supervision, including supervision of health-related
90.6tasks or behavioral supports appropriately delegated by a health care professional, and
90.7evaluation of support workers; and
90.8(3) facilitating the use of informal and community supports, goods, or resources.
90.9(u) "Support worker" means an employee of the agency provider or of the participant
90.10who has direct contact with the participant and provides services as specified within the
90.11participant's service delivery plan.
90.12(v) "Wages and benefits" means the hourly wages and salaries, the employer's
90.13share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
90.14compensation, mileage reimbursement, health and dental insurance, life insurance,
90.15disability insurance, long-term care insurance, uniform allowance, contributions to
90.16employee retirement accounts, or other forms of employee compensation and benefits.
90.17    Subd. 3. Eligibility. (a) CFSS is available to a person who meets one of the
90.18following:
90.19(1) is a recipient of medical assistance as determined under section 256B.055,
90.20256B.056, or 256B.057, subdivisions 5 and 9;
90.21(2) is a recipient of the alternative care program under section 256B.0913;
90.22(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093,
90.23or 256B.49; or
90.24(4) has medical services identified in a participant's individualized education
90.25program and is eligible for services as determined in section 256B.0625, subdivision 26.
90.26(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
90.27meet all of the following:
90.28(1) require assistance and be determined dependent in one activity of daily living or
90.29Level I behavior based on assessment under section 256B.0911;
90.30(2) is not a recipient under the family support grant under section 252.32;
90.31(3) lives in the person's own apartment or home including a family foster care setting
90.32licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a
90.33noncertified boarding care or boarding and lodging establishments under chapter 157.
90.34    Subd. 4. Eligibility for other services. Selection of CFSS by a participant must not
90.35restrict access to other medically necessary care and services furnished under the state
90.36plan medical assistance benefit or other services available through alternative care.
91.1    Subd. 5. Assessment requirements. (a) The assessment of functional need must:
91.2(1) be conducted by a certified assessor according to the criteria established in
91.3section 256B.0911, subdivision 3a;
91.4(2) be conducted face-to-face, initially and at least annually thereafter, or when there
91.5is a significant change in the participant's condition or a change in the need for services
91.6and supports; and
91.7(3) be completed using the format established by the commissioner.
91.8(b) A participant who is residing in a facility may be assessed and choose CFSS for
91.9the purpose of using CFSS to return to the community as described in subdivisions 3
91.10and 7, paragraph (a), clause (5).
91.11(c) The results of the assessment and any recommendations and authorizations for
91.12CFSS must be determined and communicated in writing by the lead agency's certified
91.13assessor as defined in section 256B.0911 to the participant and the agency-provider or
91.14financial management services provider chosen by the participant within 40 calendar days
91.15and must include the participant's right to appeal under section 256.045, subdivision 3.
91.16(d) The lead agency assessor may request a temporary authorization for CFSS
91.17services. Authorization for a temporary level of CFSS services is limited to the time
91.18specified by the commissioner, but shall not exceed 45 days. The level of services
91.19authorized under this provision shall have no bearing on a future authorization.
91.20    Subd. 6. Community first services and support service delivery plan. (a) The
91.21CFSS service delivery plan must be developed, implemented, and evaluated through a
91.22person-centered planning process by the participant, or the participant's representative
91.23or legal representative who may be assisted by a support specialist. The CFSS service
91.24delivery plan must reflect the services and supports that are important to the participant
91.25and for the participant to meet the needs assessed by the certified assessor and identified
91.26in the community support plan under section 256B.0911 or the coordinated services and
91.27support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS
91.28service delivery plan must be reviewed by the participant and the agency-provider or
91.29financial management services contractor at least annually upon reassessment, or when
91.30there is a significant change in the participant's condition, or a change in the need for
91.31services and supports.
91.32(b) The commissioner shall establish the format and criteria for the CFSS service
91.33delivery plan.
91.34(c) The CFSS service delivery plan must be person-centered and:
91.35(1) specify the agency-provider or financial management services contractor selected
91.36by the participant;
92.1(2) reflect the setting in which the participant resides that is chosen by the participant;
92.2(3) reflect the participant's strengths and preferences;
92.3(4) include the means to address the clinical and support needs as identified through
92.4an assessment of functional needs;
92.5(5) include individually identified goals and desired outcomes;
92.6(6) reflect the services and supports, paid and unpaid, that will assist the participant
92.7to achieve identified goals, and the providers of those services and supports, including
92.8natural supports;
92.9(7) identify the amount and frequency of face-to-face supports and amount and
92.10frequency of remote supports and technology that will be used;
92.11(8) identify risk factors and measures in place to minimize them, including
92.12individualized backup plans;
92.13(9) be understandable to the participant and the individuals providing support;
92.14(10) identify the individual or entity responsible for monitoring the plan;
92.15(11) be finalized and agreed to in writing by the participant and signed by all
92.16individuals and providers responsible for its implementation;
92.17(12) be distributed to the participant and other people involved in the plan; and
92.18(13) prevent the provision of unnecessary or inappropriate care.
92.19(d) The total units of agency-provider services or the budget allocation amount for
92.20the budget model include both annual totals and a monthly average amount that cover
92.21the number of months of the service authorization. The amount used each month may
92.22vary, but additional funds must not be provided above the annual service authorization
92.23amount unless a change in condition is assessed and authorized by the certified assessor
92.24and documented in the community support plan, coordinated services and supports plan,
92.25and service delivery plan.
92.26    Subd. 7. Community first services and supports; covered services. Services
92.27and supports covered under CFSS include:
92.28(1) assistance to accomplish activities of daily living (ADLs), instrumental activities
92.29of daily living (IADLs), and health-related procedures and tasks through hands-on
92.30assistance to complete the task or supervision and cueing to complete the task;
92.31(2) assistance to acquire, maintain, or enhance the skills necessary for the participant
92.32to accomplish activities of daily living, instrumental activities of daily living, or
92.33health-related tasks;
92.34(3) expenditures for items, services, supports, environmental modifications, or
92.35goods, including assistive technology. These expenditures must:
92.36(i) relate to a need identified in a participant's CFSS service delivery plan;
93.1(ii) increase independence or substitute for human assistance to the extent that
93.2expenditures would otherwise be made for human assistance for the participant's assessed
93.3needs;
93.4(4) observation and redirection for behavior or symptoms where there is a need for
93.5assistance. A recipient qualifies as having a need for assistance due to behaviors if the
93.6recipient's behavior requires assistance at least four times per week and shows one or
93.7more of the following behaviors:
93.8(i) physical aggression towards self or others, or destruction of property that requires
93.9the immediate response of another person;
93.10(ii) increased vulnerability due to cognitive deficits or socially inappropriate
93.11behavior; or
93.12(iii) increased need for assistance for recipients who are verbally aggressive or
93.13resistive to care so that time needed to perform activities of daily living is increased;
93.14(5) back-up systems or mechanisms, such as the use of pagers or other electronic
93.15devices, to ensure continuity of the participant's services and supports;
93.16(6) transition costs, including:
93.17(i) deposits for rent and utilities;
93.18(ii) first month's rent and utilities;
93.19(iii) bedding;
93.20(iv) basic kitchen supplies;
93.21(v) other necessities, to the extent that these necessities are not otherwise covered
93.22under any other funding that the participant is eligible to receive; and
93.23(vi) other required necessities for an individual to make the transition from a nursing
93.24facility, institution for mental diseases, or intermediate care facility for persons with
93.25developmental disabilities to a community-based home setting where the participant
93.26resides; and
93.27(7) services by a support specialist defined under subdivision 2 that are chosen
93.28by the participant.
93.29    Subd. 8. Determination of CFSS service methodology. (a) All community first
93.30services and supports must be authorized by the commissioner or the commissioner's
93.31designee before services begin, except for the assessments established in section
93.32256B.0911. The authorization for CFSS must be completed as soon as possible following
93.33an assessment but no later than 40 calendar days from the date of the assessment.
93.34(b) The amount of CFSS authorized must be based on the recipient's home care
93.35rating described in subdivision 8, paragraphs (d) and (e), and any additional service units
93.36for which the person qualifies as described in subdivision 8, paragraph (f).
94.1(c) The home care rating shall be determined by the commissioner or the
94.2commissioner's designee based on information submitted to the commissioner identifying
94.3the following for a recipient:
94.4(1) the total number of dependencies of activities of daily living as defined in
94.5subdivision 2, paragraph (b);
94.6(2) the presence of complex health-related needs as defined in subdivision 2,
94.7paragraph (e); and
94.8(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d),
94.9clause (1).
94.10(d) The methodology to determine the total service units for CFSS for each home
94.11care rating is based on the median paid units per day for each home care rating from
94.12fiscal year 2007 data for the PCA program.
94.13(e) Each home care rating is designated by the letters P through Z and EN and has
94.14the following base number of service units assigned:
94.15(i) P home care rating requires Level 1 behavior or one to three dependencies in
94.16ADLs and qualifies one for five service units;
94.17(ii) Q home care rating requires Level 1 behavior and one to three dependencies in
94.18ADLs and qualifies one for six service units;
94.19(iii) R home care rating requires complex health-related needs and one to three
94.20dependencies in ADLs and qualifies one for seven service units;
94.21(iv) S home care rating requires four to six dependencies in ADLs and qualifies
94.22one for ten service units;
94.23(v) T home care rating requires four to six dependencies in ADLs and Level 1
94.24behavior and qualifies one for 11 service units;
94.25(vi) U home care rating requires four to six dependencies in ADLs and a complex
94.26health need and qualifies one for 14 service units;
94.27(vii) V home care rating requires seven to eight dependencies in ADLs and qualifies
94.28one for 17 service units;
94.29(viii) W home care rating requires seven to eight dependencies in ADLs and Level 1
94.30behavior and qualifies one for 20 service units;
94.31(ix) Z home care rating requires seven to eight dependencies in ADLs and a complex
94.32health related need and qualifies one for 30 service units; and
94.33(x) EN home care rating includes ventilator dependency as defined in section
94.34256B.0651, subdivision 1, paragraph (g). Recipients who meet the definition of
94.35ventilator-dependent and the EN home care rating and utilize a combination of CFSS
94.36and other home care services are limited to a total of 96 service units per day for those
95.1services in combination. Additional units may be authorized when a recipient's assessment
95.2indicates a need for two staff to perform activities. Additional time is limited to 16 service
95.3units per day.
95.4(f) Additional service units are provided through the assessment and identification of
95.5the following:
95.6(1) 30 additional minutes per day for a dependency in each critical activity of daily
95.7living as defined in subdivision 2, paragraph (h);
95.8(2) 30 additional minutes per day for each complex health-related function as
95.9defined in subdivision 2, paragraph (e); and
95.10(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2,
95.11paragraph (d).
95.12    Subd. 9. Noncovered services. (a) Services or supports that are not eligible for
95.13payment under this section include those that:
95.14(1) are not authorized by the certified assessor or included in the written service
95.15delivery plan;
95.16(2) are provided prior to the authorization of services and the approval of the written
95.17CFSS service delivery plan;
95.18(3) are duplicative of other paid services in the written service delivery plan;
95.19(4) supplant natural unpaid supports that appropriately meet a need in the service
95.20plan, are provided voluntarily to the participant and are selected by the participant in lieu
95.21of other services and supports;
95.22(5) are not effective means to meet the participant's needs; and
95.23(6) are available through other funding sources, including, but not limited to, funding
95.24through Title IV-E of the Social Security Act.
95.25(b) Additional services, goods, or supports that are not covered include:
95.26(1) those that are not for the direct benefit of the participant, except that services for
95.27caregivers such as training to improve the ability to provide CFSS are considered to directly
95.28benefit the participant if chosen by the participant and approved in the support plan;
95.29(2) any fees incurred by the participant, such as Minnesota health care programs fees
95.30and co-pays, legal fees, or costs related to advocate agencies;
95.31(3) insurance, except for insurance costs related to employee coverage;
95.32(4) room and board costs for the participant with the exception of allowable
95.33transition costs in subdivision 7, clause (6);
95.34(5) services, supports, or goods that are not related to the assessed needs;
96.1(6) special education and related services provided under the Individuals with
96.2Disabilities Education Act and vocational rehabilitation services provided under the
96.3Rehabilitation Act of 1973;
96.4(7) assistive technology devices and assistive technology services other than those
96.5for back-up systems or mechanisms to ensure continuity of service and supports listed in
96.6subdivision 7;
96.7(8) medical supplies and equipment;
96.8(9) environmental modifications, except as specified in subdivision 7;
96.9(10) expenses for travel, lodging, or meals related to training the participant, the
96.10participant's representative, legal representative, or paid or unpaid caregivers that exceed
96.11$500 in a 12-month period;
96.12(11) experimental treatments;
96.13(12) any service or good covered by other medical assistance state plan services,
96.14including prescription and over-the-counter medications, compounds, and solutions and
96.15related fees, including premiums and co-payments;
96.16(13) membership dues or costs, except when the service is necessary and appropriate
96.17to treat a physical condition or to improve or maintain the participant's physical condition.
96.18The condition must be identified in the participant's CFSS plan and monitored by a
96.19physician enrolled in a Minnesota health care program;
96.20(14) vacation expenses other than the cost of direct services;
96.21(15) vehicle maintenance or modifications not related to the disability, health
96.22condition, or physical need; and
96.23(16) tickets and related costs to attend sporting or other recreational or entertainment
96.24events.
96.25    Subd. 10. Provider qualifications and general requirements. (a)
96.26Agency-providers delivering services under the agency-provider model under subdivision
96.2711 or financial management service (FMS) contractors under subdivision 13 shall:
96.28(1) enroll as a medical assistance Minnesota health care programs provider and meet
96.29all applicable provider standards;
96.30(2) comply with medical assistance provider enrollment requirements;
96.31(3) demonstrate compliance with law and policies of CFSS as determined by the
96.32commissioner;
96.33(4) comply with background study requirements under chapter 245C;
96.34(5) verify and maintain records of all services and expenditures by the participant,
96.35including hours worked by support workers and support specialists;
97.1(6) not engage in any agency-initiated direct contact or marketing in person, by
97.2telephone, or other electronic means to potential participants, guardians, family member,
97.3or participants' representatives;
97.4(7) pay support workers and support specialists based upon actual hours of services
97.5provided;
97.6(8) withhold and pay all applicable federal and state payroll taxes;
97.7(9) make arrangements and pay unemployment insurance, taxes, workers'
97.8compensation, liability insurance, and other benefits, if any;
97.9(10) enter into a written agreement with the participant, participant's representative,
97.10or legal representative that assigns roles and responsibilities to be performed before
97.11services, supports, or goods are provided using a format established by the commissioner;
97.12(11) report maltreatment as required under sections 626.556 and 626.557; and
97.13(12) provide the participant with a copy of the service-related rights under
97.14subdivision 19 at the start of services and supports.
97.15(b) The commissioner shall develop policies and procedures designed to ensure
97.16program integrity and fiscal accountability for goods and services provided in this section
97.17in consultation with the implementation council described in subdivision 21.
97.18    Subd. 11. Agency-provider model. (a) The agency-provider model is limited to
97.19the services provided by support workers and support specialists who are employed by
97.20an agency-provider that is licensed according to chapter 245A or meets other criteria
97.21established by the commissioner, including required training.
97.22(b) The agency-provider shall allow the participant to have a significant role in the
97.23selection and dismissal of the support workers for the delivery of the services and supports
97.24specified in the participant's service delivery plan.
97.25(c) A participant may use authorized units of CFSS services as needed within a
97.26service authorization that is not greater than 12 months. Using authorized units in a
97.27flexible manner in either the agency-provider model or the budget model does not increase
97.28the total amount of services and supports authorized for a participant or included in the
97.29participant's service delivery plan.
97.30(d) A participant may share CFSS services. Two or three CFSS participants may
97.31share services at the same time provided by the same support worker.
97.32(e) The agency-provider must use a minimum of 72.5 percent of the revenue
97.33generated by the medical assistance payment for CFSS for support worker wages and
97.34benefits. The agency-provider must document how this requirement is being met. The
97.35revenue generated by the support specialist and the reasonable costs associated with the
97.36support specialist must not be used in making this calculation.
98.1(f) The agency-provider model must be used by individuals who have been restricted
98.2by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160
98.3to 9505.2245.
98.4    Subd. 12. Requirements for initial enrollment of CFSS provider agencies. (a)
98.5All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider
98.6agency in a format determined by the commissioner, information and documentation that
98.7includes, but is not limited to, the following:
98.8(1) the CFSS provider agency's current contact information including address,
98.9telephone number, and e-mail address;
98.10(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
98.11provider's payments from Medicaid in the previous year, whichever is less;
98.12(3) proof of fidelity bond coverage in the amount of $20,000;
98.13(4) proof of workers' compensation insurance coverage;
98.14(5) proof of liability insurance;
98.15(6) a description of the CFSS provider agency's organization identifying the names
98.16or all owners, managing employees, staff, board of directors, and the affiliations of the
98.17directors, owners, or staff to other service providers;
98.18(7) a copy of the CFSS provider agency's written policies and procedures including:
98.19hiring of employees; training requirements; service delivery; and employee and consumer
98.20safety including process for notification and resolution of consumer grievances,
98.21identification and prevention of communicable diseases, and employee misconduct;
98.22(8) copies of all other forms the CFSS provider agency uses in the course of daily
98.23business including, but not limited to:
98.24(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from
98.25the standard time sheet for CFSS services approved by the commissioner, and a letter
98.26requesting approval of the CFSS provider agency's nonstandard time sheet;
98.27(ii) the CFSS provider agency's template for the CFSS care plan; and
98.28(iii) the CFSS provider agency's template for the written agreement in subdivision
98.2921 for recipients using the CFSS choice option, if applicable;
98.30(9) a list of all training and classes that the CFSS provider agency requires of its
98.31staff providing CFSS services;
98.32(10) documentation that the CFSS provider agency and staff have successfully
98.33completed all the training required by this section;
98.34(11) documentation of the agency's marketing practices;
98.35(12) disclosure of ownership, leasing, or management of all residential properties
98.36that is used or could be used for providing home care services;
99.1(13) documentation that the agency will use the following percentages of revenue
99.2generated from the medical assistance rate paid for CFSS services for employee personal
99.3care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The
99.4revenue generated by the support specialist and the reasonable costs associated with the
99.5support specialist shall not be used in making this calculation; and
99.6(14) documentation that the agency does not burden recipients' free exercise of their
99.7right to choose service providers by requiring personal care assistants to sign an agreement
99.8not to work with any particular CFSS recipient or for another CFSS provider agency after
99.9leaving the agency and that the agency is not taking action on any such agreements or
99.10requirements regardless of the date signed.
99.11(b) CFSS provider agencies shall provide to the commissioner the information
99.12specified in paragraph (a).
99.13(c) All CFSS provider agencies shall require all employees in management and
99.14supervisory positions and owners of the agency who are active in the day-to-day
99.15management and operations of the agency to complete mandatory training as determined
99.16by the commissioner. Employees in management and supervisory positions and owners
99.17who are active in the day-to-day operations of an agency who have completed the required
99.18training as an employee with a CFSS provider agency do not need to repeat the required
99.19training if they are hired by another agency, if they have completed the training within
99.20the past three years. CFSS provider agency billing staff shall complete training about
99.21CFSS program financial management. Any new owners or employees in management
99.22and supervisory positions involved in the day-to-day operations are required to complete
99.23mandatory training as a requisite of working for the agency. CFSS provider agencies
99.24certified for participation in Medicare as home health agencies are exempt from the
99.25training required in this subdivision.
99.26    Subd. 13. Budget model. (a) Under the budget model participants can exercise
99.27more responsibility and control over the services and supports described and budgeted
99.28within the CFSS service delivery plan. Under this model, participants may use their
99.29budget allocation to:
99.30(1) directly employ support workers;
99.31(2) obtain supports and goods as defined in subdivision 7; and
99.32(3) choose a range of support assistance services from the financial management
99.33services (FMS) contractor related to:
99.34(i) assistance in managing the budget to meet the service delivery plan needs,
99.35consistent with federal and state laws and regulations;
100.1(ii) the employment, training, supervision, and evaluation of workers by the
100.2participant;
100.3(iii) acquisition and payment for supports and goods; and
100.4(iv) evaluation of individual service outcomes as needed for the scope of the
100.5participant's degree of control and responsibility.
100.6(b) Participants who are unable to fulfill any of the functions listed in paragraph (a)
100.7may authorize a legal representative or participant's representative to do so on their behalf.
100.8(c) The FMS contractor shall not provide CFSS services and supports under the
100.9agency-provider service model. The FMS contractor shall provide service functions as
100.10determined by the commissioner that include but are not limited to:
100.11(1) information and consultation about CFSS;
100.12(2) assistance with the development of the service delivery plan and budget model
100.13as requested by the participant;
100.14(3) billing and making payments for budget model expenditures;
100.15(4) assisting participants in fulfilling employer-related requirements according to
100.16Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,
100.17regulation 137036-08, which includes assistance with filing and paying payroll taxes, and
100.18obtaining worker compensation coverage;
100.19(5) data recording and reporting of participant spending; and
100.20(6) other duties established in the contract with the department.
100.21(d) A participant who requests to purchase goods and supports along with support
100.22worker services under the agency-provider model must use the budget model with
100.23a service delivery plan that specifies the amount of services to be authorized to the
100.24agency-provider and the expenditures to be paid by the FMS contractor.
100.25(e) The FMS contractor shall:
100.26(1) not limit or restrict the participant's choice of service or support providers or
100.27service delivery models consistent with any applicable state and federal requirements;
100.28(2) provide the participant and the targeted case manager, if applicable, with a
100.29monthly written summary of the spending for services and supports that were billed
100.30against the spending budget;
100.31(3) be knowledgeable of state and federal employment regulations under the Fair
100.32Labor Standards Act of 1938, and comply with the requirements under the Internal
100.33Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax
100.34Liability for vendor or fiscal employer agent, and any requirements necessary to process
100.35employer and employee deductions, provide appropriate and timely submission of
100.36employer tax liabilities, and maintain documentation to support medical assistance claims;
101.1(4) have current and adequate liability insurance and bonding and sufficient cash
101.2flow as determined by the commissioner and have on staff or under contract a certified
101.3public accountant or an individual with a baccalaureate degree in accounting;
101.4(5) assume fiscal accountability for state funds designated for the program; and
101.5(6) maintain documentation of receipts, invoices, and bills to track all services and
101.6supports expenditures for any goods purchased and maintain time records of support
101.7workers. The documentation and time records must be maintained for a minimum of
101.8five years from the claim date and be available for audit or review upon request by the
101.9commissioner. Claims submitted by the FMS contractor to the commissioner for payment
101.10must correspond with services, amounts, and time periods as authorized in the participant's
101.11spending budget and service plan.
101.12(f) The commissioner of human services shall:
101.13(1) establish rates and payment methodology for the FMS contractor;
101.14(2) identify a process to ensure quality and performance standards for the FMS
101.15contractor and ensure statewide access to FMS contractors; and
101.16(3) establish a uniform protocol for delivering and administering CFSS services
101.17to be used by eligible FMS contractors.
101.18(g) The commissioner of human services shall disenroll or exclude participants from
101.19the budget model and transfer them to the agency-provider model under the following
101.20circumstances that include but are not limited to:
101.21(1) when a participant has been restricted by the Minnesota restricted recipient
101.22program, the participant may be excluded for a specified time period under Minnesota
101.23Rules, parts 9505.2160 to 9505.2245;
101.24(2) when a participant exits the budget model during the participant's service plan
101.25year. Upon transfer, the participant shall not access the budget model for the remainder of
101.26that service plan year; or
101.27(3) when the department determines that the participant or participant's representative
101.28or legal representative cannot manage participant responsibilities under the budget model.
101.29The commissioner must develop policies for determining if a participant is unable to
101.30manage responsibilities under a budget model.
101.31(h) A participant may appeal under section 256.045, subdivision 3, in writing to the
101.32department to contest the department's decision under paragraph (c), clause (3), to remove
101.33or exclude the participant from the budget model.
101.34    Subd. 14. Participant's responsibilities under budget model. (a) A participant
101.35using the budget model must use an FMS contractor or vendor that is under contract with
101.36the department. Upon a determination of eligibility and completion of the assessment and
102.1community support plan, the participant shall choose a FMS contractor from a list of
102.2eligible vendors maintained by the department.
102.3(b) When the participant, participant's representative, or legal representative chooses
102.4to be the employer of the support worker, they are responsible for the hiring and supervision
102.5of the support worker, including, but not limited to, recruiting, interviewing, training, and
102.6discharging the support worker consistent with federal and state laws and regulations.
102.7(c) In addition to the employer responsibilities in paragraph (b), the participant,
102.8participant's representative, or legal representative is responsible for:
102.9(1) tracking the services provided and all expenditures for goods or other supports;
102.10(2) preparing and submitting time sheets, signed by both the participant and support
102.11worker, to the FMS contractor on a regular basis and in a timely manner according to
102.12the FMS contractor's procedures;
102.13(3) notifying the FMS contractor within ten days of any changes in circumstances
102.14affecting the CFSS service plan or in the participant's place of residence including, but
102.15not limited to, any hospitalization of the participant or change in the participant's address,
102.16telephone number, or employment;
102.17(4) notifying the FMS contractor of any changes in the employment status of each
102.18participant support worker; and
102.19(5) reporting any problems resulting from the quality of services rendered by the
102.20support worker to the FMS contractor. If the participant is unable to resolve any problems
102.21resulting from the quality of service rendered by the support worker with the assistance of
102.22the FMS contractor, the participant shall report the situation to the department.
102.23    Subd. 15. Documentation of support services provided. (a) Support services
102.24provided to a participant by a support worker employed by either an agency-provider
102.25or the participant acting as the employer must be documented daily by each support
102.26worker, on a time sheet form approved by the commissioner. All documentation may be
102.27Web-based, electronic, or paper documentation. The completed form must be submitted
102.28on a monthly basis to the provider or the participant and the FMS contractor selected by
102.29the participant to provide assistance with meeting the participant's employer obligations
102.30and kept in the recipient's health record.
102.31(b) The activity documentation must correspond to the written service delivery plan
102.32and be reviewed by the agency provider or the participant and the FMS contractor when
102.33the participant is acting as the employer of the support worker.
102.34(c) The time sheet must be on a form approved by the commissioner documenting
102.35time the support worker provides services in the home. The following criteria must be
102.36included in the time sheet:
103.1(1) full name of the support worker and individual provider number;
103.2(2) provider name and telephone numbers, if an agency-provider is responsible for
103.3delivery services under the written service plan;
103.4(3) full name of the participant;
103.5(4) consecutive dates, including month, day, and year, and arrival and departure
103.6times with a.m. or p.m. notations;
103.7(5) signatures of the participant or the participant's representative;
103.8(6) personal signature of the support worker;
103.9(7) any shared care provided, if applicable;
103.10(8) a statement that it is a federal crime to provide false information on CFSS
103.11billings for medical assistance payments; and
103.12(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
103.13    Subd. 16. Support workers requirements. (a) Support workers shall:
103.14(1) enroll with the department as a support worker after a background study under
103.15chapter 245C has been completed and the support worker has received a notice from the
103.16commissioner that:
103.17(i) the support worker is not disqualified under section 245C.14; or
103.18(ii) is disqualified, but the support worker has received a set-aside of the
103.19disqualification under section 245C.22;
103.20(2) have the ability to effectively communicate with the participant or the
103.21participant's representative;
103.22(3) have the skills and ability to provide the services and supports according to the
103.23person's CFSS service delivery plan and respond appropriately to the participant's needs;
103.24(4) not be a participant of CFSS, unless the support services provided by the support
103.25worker differ from those provided to the support worker;
103.26(5) complete the basic standardized training as determined by the commissioner
103.27before completing enrollment. The training must be available in languages other than
103.28English and to those who need accommodations due to disabilities. Support worker
103.29training must include successful completion of the following training components: basic
103.30first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles
103.31and responsibilities of support workers including information about basic body mechanics,
103.32emergency preparedness, orientation to positive behavioral practices, orientation to
103.33responding to a mental health crisis, fraud issues, time cards and documentation, and an
103.34overview of person-centered planning and self-direction. Upon completion of the training
103.35components, the support worker must pass the certification test to provide assistance
103.36to participants;
104.1(6) complete training and orientation on the participant's individual needs; and
104.2(7) maintain the privacy and confidentiality of the participant, and not independently
104.3determine the medication dose or time for medications for the participant.
104.4(b) The commissioner may deny or terminate a support worker's provider enrollment
104.5and provider number if the support worker:
104.6(1) lacks the skills, knowledge, or ability to adequately or safely perform the
104.7required work;
104.8(2) fails to provide the authorized services required by the participant employer;
104.9(3) has been intoxicated by alcohol or drugs while providing authorized services to
104.10the participant or while in the participant's home;
104.11(4) has manufactured or distributed drugs while providing authorized services to the
104.12participant or while in the participant's home; or
104.13(5) has been excluded as a provider by the commissioner of human services, or the
104.14United States Department of Health and Human Services, Office of Inspector General,
104.15from participation in Medicaid, Medicare, or any other federal health care program.
104.16(c) A support worker may appeal in writing to the commissioner to contest the
104.17decision to terminate the support worker's provider enrollment and provider number.
104.18    Subd. 17. Support specialist requirements and payments. The commissioner
104.19shall develop qualifications, scope of functions, and payment rates and service limits for a
104.20support specialist that may provide additional or specialized assistance necessary to plan,
104.21implement, arrange, augment, or evaluate services and supports.
104.22    Subd. 18. Service unit and budget allocation requirements and limits. (a) For the
104.23agency-provider model, services will be authorized in units of service. The total service
104.24unit amount must be established based upon the assessed need for CFSS services, and must
104.25not exceed the maximum number of units available as determined under subdivision 8.
104.26(b) For the budget model, the budget allocation allowed for services and supports
104.27is established by multiplying the number of units authorized under subdivision 8 by the
104.28payment rate established by the commissioner.
104.29    Subd. 19. Support system. (a) The commissioner shall provide information,
104.30consultation, training, and assistance to ensure the participant is able to manage the
104.31services and supports and budgets, if applicable. This support shall include individual
104.32consultation on how to select and employ workers, manage responsibilities under CFSS,
104.33and evaluate personal outcomes.
104.34(b) The commissioner shall provide assistance with the development of risk
104.35management agreements.
105.1    Subd. 20. Service-related rights. (a) Participants must be provided with adequate
105.2information, counseling, training, and assistance, as needed, to ensure that the participant
105.3is able to choose and manage services, models, and budgets. This support shall include
105.4information regarding:
105.5(1) person-centered planning;
105.6(2) the range and scope of individual choices;
105.7(3) the process for changing plans, services and budgets;
105.8(4) the grievance process;
105.9(5) individual rights;
105.10(6) identifying and assessing appropriate services;
105.11(7) risks and responsibilities; and
105.12(8) risk management.
105.13(b) The commissioner must ensure that the participant has a copy of the most recent
105.14community support plan and service delivery plan.
105.15(c) A participant who appeals a reduction in previously authorized CFSS services
105.16may continue previously authorized services pending an appeal in accordance with section
105.17256.045.
105.18(d) If the units of service or budget allocation for CFSS are reduced, denied, or
105.19terminated, the commissioner must provide notice of the reasons for the reduction in the
105.20participant's notice of denial, termination, or reduction.
105.21(e) If all or part of a service delivery plan is denied approval, the commissioner must
105.22provide a notice that describes the basis of the denial.
105.23    Subd. 21. Development and Implementation Council. The commissioner
105.24shall establish a Development and Implementation Council of which the majority of
105.25members are individuals with disabilities, elderly individuals, and their representatives.
105.26The commissioner shall consult and collaborate with the council when developing and
105.27implementing this section for at least the first five years of operation. The commissioner,
105.28in consultation with the council, shall provide recommendations on how to improve the
105.29quality and integrity of CFSS, reduce the paper documentation required in subdivisions
105.3010, 12, and 15, make use of electronic means of documentation and online reporting in
105.31order to reduce administrative costs and improve training to the legislative chairs of the
105.32health and human services policy and finance committees by February 1, 2014.
105.33    Subd. 22. Quality assurance and risk management system. (a) The commissioner
105.34shall establish quality assurance and risk management measures for use in developing and
105.35implementing CFSS, including those that (1) recognize the roles and responsibilities of
105.36those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and
106.1budgets based upon a recipient's resources and capabilities. Risk management measures
106.2must include background studies, and backup and emergency plans, including disaster
106.3planning.
106.4(b) The commissioner shall provide ongoing technical assistance and resource and
106.5educational materials for CFSS participants.
106.6(c) Performance assessment measures, such as a participant's satisfaction with the
106.7services and supports, and ongoing monitoring of health and well-being shall be identified
106.8in consultation with the council established in subdivision 21.
106.9(d) Data reporting requirements will be developed in consultation with the council
106.10established in subdivision 21.
106.11    Subd. 23. Commissioner's access. When the commissioner is investigating a
106.12possible overpayment of Medicaid funds, the commissioner must be given immediate
106.13access without prior notice to the agency provider or FMS contractor's office during
106.14regular business hours and to documentation and records related to services provided and
106.15submission of claims for services provided. Denying the commissioner access to records
106.16is cause for immediate suspension of payment and terminating the agency provider's
106.17enrollment according to section 256B.064 or terminating the FMS contract.
106.18    Subd. 24. CFSS agency-providers; background studies. CFSS agency-providers
106.19enrolled to provide personal care assistance services under the medical assistance program
106.20shall comply with the following:
106.21(1) owners who have a five percent interest or more and all managing employees
106.22are subject to a background study as provided in chapter 245C. This applies to currently
106.23enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS
106.24agency-provider. "Managing employee" has the same meaning as Code of Federal
106.25Regulations, title 42, section 455. An organization is barred from enrollment if:
106.26(i) the organization has not initiated background studies on owners managing
106.27employees; or
106.28(ii) the organization has initiated background studies on owners and managing
106.29employees, but the commissioner has sent the organization a notice that an owner or
106.30managing employee of the organization has been disqualified under section 245C.14, and
106.31the owner or managing employee has not received a set-aside of the disqualification
106.32under section 245C.22;
106.33(2) a background study must be initiated and completed for all support specialists; and
106.34(3) a background study must be initiated and completed for all support workers.
106.35EFFECTIVE DATE.This section is effective upon federal approval but no earlier
106.36than January 1, 2014. The service will begin 90 days after federal approval or January 1,
107.12014, whichever is later. The commissioner of human services shall notify the revisor of
107.2statutes when this occurs.

107.3    Sec. 44. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
107.4to read:
107.5    Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
107.6negotiate a supplementary service rate under this section for any individual that has been
107.7determined to be eligible for Housing Stability Services as approved by the Centers
107.8for Medicare and Medicaid Services, and who resides in an establishment voluntarily
107.9registered under section 144D.025, as a supportive housing establishment or participates
107.10in the Minnesota supportive housing demonstration program under section 256I.04,
107.11subdivision 3, paragraph (a), clause (4).

107.12    Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
107.13    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
107.14shall immediately make an oral report to the common entry point. The common entry
107.15point may accept electronic reports submitted through a Web-based reporting system
107.16established by the commissioner. Use of a telecommunications device for the deaf or other
107.17similar device shall be considered an oral report. The common entry point may not require
107.18written reports. To the extent possible, the report must be of sufficient content to identify
107.19the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
107.20any evidence of previous maltreatment, the name and address of the reporter, the time,
107.21date, and location of the incident, and any other information that the reporter believes
107.22might be helpful in investigating the suspected maltreatment. A mandated reporter may
107.23disclose not public data, as defined in section 13.02, and medical records under sections
107.24144.291 to 144.298, to the extent necessary to comply with this subdivision.
107.25(b) A boarding care home that is licensed under sections 144.50 to 144.58 and
107.26certified under Title 19 of the Social Security Act, a nursing home that is licensed under
107.27section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a
107.28hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under
107.29Code of Federal Regulations, title 42, section 482.66, may submit a report electronically
107.30to the common entry point instead of submitting an oral report. The report may be a
107.31duplicate of the initial report the facility submits electronically to the commissioner of
107.32health to comply with the reporting requirements under Code of Federal Regulations, title
107.3342, section 483.13. The commissioner of health may modify these reporting requirements
108.1to include items required under paragraph (a) that are not currently included in the
108.2electronic reporting form.
108.3EFFECTIVE DATE.This section is effective July 1, 2014.

108.4    Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
108.5    Subd. 9. Common entry point designation. (a) Each county board shall designate
108.6a common entry point for reports of suspected maltreatment. Two or more county boards
108.7may jointly designate a single The commissioner of human services shall establish a
108.8 common entry point effective July 1, 2014. The common entry point is the unit responsible
108.9for receiving the report of suspected maltreatment under this section.
108.10(b) The common entry point must be available 24 hours per day to take calls from
108.11reporters of suspected maltreatment. The common entry point shall use a standard intake
108.12form that includes:
108.13(1) the time and date of the report;
108.14(2) the name, address, and telephone number of the person reporting;
108.15(3) the time, date, and location of the incident;
108.16(4) the names of the persons involved, including but not limited to, perpetrators,
108.17alleged victims, and witnesses;
108.18(5) whether there was a risk of imminent danger to the alleged victim;
108.19(6) a description of the suspected maltreatment;
108.20(7) the disability, if any, of the alleged victim;
108.21(8) the relationship of the alleged perpetrator to the alleged victim;
108.22(9) whether a facility was involved and, if so, which agency licenses the facility;
108.23(10) any action taken by the common entry point;
108.24(11) whether law enforcement has been notified;
108.25(12) whether the reporter wishes to receive notification of the initial and final
108.26reports; and
108.27(13) if the report is from a facility with an internal reporting procedure, the name,
108.28mailing address, and telephone number of the person who initiated the report internally.
108.29(c) The common entry point is not required to complete each item on the form prior
108.30to dispatching the report to the appropriate lead investigative agency.
108.31(d) The common entry point shall immediately report to a law enforcement agency
108.32any incident in which there is reason to believe a crime has been committed.
108.33(e) If a report is initially made to a law enforcement agency or a lead investigative
108.34agency, those agencies shall take the report on the appropriate common entry point intake
108.35forms and immediately forward a copy to the common entry point.
109.1(f) The common entry point staff must receive training on how to screen and
109.2dispatch reports efficiently and in accordance with this section.
109.3(g) The commissioner of human services shall maintain a centralized database
109.4for the collection of common entry point data, lead investigative agency data including
109.5maltreatment report disposition, and appeals data. The common entry point shall
109.6have access to the centralized database and must log the reports into the database and
109.7immediately identify and locate prior reports of abuse, neglect, or exploitation.
109.8(h) When appropriate, the common entry point staff must refer calls that do not
109.9allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
109.10that might resolve the reporter's concerns.
109.11(i) a common entry point must be operated in a manner that enables the
109.12commissioner of human services to:
109.13(1) track critical steps in the reporting, evaluation, referral, response, disposition,
109.14and investigative process to ensure compliance with all requirements for all reports;
109.15(2) maintain data to facilitate the production of aggregate statistical reports for
109.16monitoring patterns of abuse, neglect, or exploitation;
109.17(3) serve as a resource for the evaluation, management, and planning of preventative
109.18and remedial services for vulnerable adults who have been subject to abuse, neglect,
109.19or exploitation;
109.20(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
109.21of the common entry point; and
109.22(5) track and manage consumer complaints related to the common entry point.
109.23(j) The commissioners of human services and health shall collaborate on the
109.24creation of a system for referring reports to the lead investigative agencies. This system
109.25shall enable the commissioner of human services to track critical steps in the reporting,
109.26evaluation, referral, response, disposition, investigation, notification, determination, and
109.27appeal processes.

109.28    Sec. 47. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
109.29    Subd. 9e. Education requirements. (a) The commissioners of health, human
109.30services, and public safety shall cooperate in the development of a joint program for
109.31education of lead investigative agency investigators in the appropriate techniques for
109.32investigation of complaints of maltreatment. This program must be developed by July
109.331, 1996. The program must include but need not be limited to the following areas: (1)
109.34information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
109.35conclusions based on evidence; (5) interviewing skills, including specialized training to
110.1interview people with unique needs; (6) report writing; (7) coordination and referral
110.2to other necessary agencies such as law enforcement and judicial agencies; (8) human
110.3relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
110.4systems and the appropriate methods for interviewing relatives in the course of the
110.5assessment or investigation; (10) the protective social services that are available to protect
110.6alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
110.7which lead investigative agency investigators and law enforcement workers cooperate in
110.8conducting assessments and investigations in order to avoid duplication of efforts; and
110.9(12) data practices laws and procedures, including provisions for sharing data.
110.10(b) The commissioner of human services shall conduct an outreach campaign to
110.11promote the common entry point for reporting vulnerable adult maltreatment. This
110.12campaign shall use the Internet and other means of communication.
110.13(b) (c) The commissioners of health, human services, and public safety shall offer at
110.14least annual education to others on the requirements of this section, on how this section is
110.15implemented, and investigation techniques.
110.16(c) (d) The commissioner of human services, in coordination with the commissioner
110.17of public safety shall provide training for the common entry point staff as required in this
110.18subdivision and the program courses described in this subdivision, at least four times
110.19per year. At a minimum, the training shall be held twice annually in the seven-county
110.20metropolitan area and twice annually outside the seven-county metropolitan area. The
110.21commissioners shall give priority in the program areas cited in paragraph (a) to persons
110.22currently performing assessments and investigations pursuant to this section.
110.23(d) (e) The commissioner of public safety shall notify in writing law enforcement
110.24personnel of any new requirements under this section. The commissioner of public
110.25safety shall conduct regional training for law enforcement personnel regarding their
110.26responsibility under this section.
110.27(e) (f) Each lead investigative agency investigator must complete the education
110.28program specified by this subdivision within the first 12 months of work as a lead
110.29investigative agency investigator.
110.30A lead investigative agency investigator employed when these requirements take
110.31effect must complete the program within the first year after training is available or as soon
110.32as training is available.
110.33All lead investigative agency investigators having responsibility for investigation
110.34duties under this section must receive a minimum of eight hours of continuing education
110.35or in-service training each year specific to their duties under this section.

111.1    Sec. 48. FEDERAL APPROVAL.
111.2This article is contingent on federal approval.

111.3    Sec. 49. REPEALER.
111.4(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
111.53, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
111.6(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
111.7repealed effective October 1, 2013.

111.8ARTICLE 3
111.9SAFE AND HEALTHY DEVELOPMENT OF CHILDREN,
111.10YOUTH, AND FAMILIES

111.11    Section 1. Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:
111.12    Subdivision 1. Eligible participants. Families eligible for child care assistance
111.13under the MFIP child care program are:
111.14    (1) MFIP participants who are employed or in job search and meet the requirements
111.15of section 119B.10;
111.16    (2) persons who are members of transition year families under section 119B.011,
111.17subdivision 20
, and meet the requirements of section 119B.10;
111.18    (3) families who are participating in employment orientation or job search, or
111.19other employment or training activities that are included in an approved employability
111.20development plan under section 256J.95;
111.21    (4) MFIP families who are participating in work job search, job support,
111.22employment, or training activities as required in their employment plan, or in appeals,
111.23hearings, assessments, or orientations according to chapter 256J;
111.24    (5) MFIP families who are participating in social services activities under chapter
111.25256J or mental health treatment as required in their employment plan approved according
111.26to chapter 256J;
111.27    (6) families who are participating in services or activities that are included in an
111.28approved family stabilization plan under section 256J.575;
111.29    (7) MFIP child-only cases under section 256J.88, for up to 20 hours of child care
111.30per child per week under the following conditions: (i) child care will be authorized if the
111.31child's primary caregiver is receiving SSI for a disability related to depression or other
111.32serious mental illness; and (ii) child care will only be authorized for children five years
111.33of age or younger. The child's authorized care under this clause is not conditional based
111.34on the primary caregiver participating in an authorized activity under section 119B.07 or
112.1119B.11. Medical appointments, treatment, or therapy are considered authorized activities
112.2for participants in this category;
112.3    (8) families who are participating in programs as required in tribal contracts under
112.4section 119B.02, subdivision 2, or 256.01, subdivision 2; and
112.5    (8) (9) families who are participating in the transition year extension under section
112.6119B.011, subdivision 20a .

112.7    Sec. 2. Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:
112.8    Subdivision 1. Subsidy restrictions. (a) Beginning October 31, 2011 July 1, 2014,
112.9the maximum rate paid for child care assistance in any county or multicounty region under
112.10the child care fund shall be the rate for like-care arrangements in the county effective July
112.111, 2006 2012, decreased increased by 2.5 two percent.
112.12    (b) Biennially, beginning in 2012, the commissioner shall survey rates charged
112.13by child care providers in Minnesota to determine the 75th percentile for like-care
112.14arrangements in counties. When the commissioner determines that, using the
112.15commissioner's established protocol, the number of providers responding to the survey is
112.16too small to determine the 75th percentile rate for like-care arrangements in a county or
112.17multicounty region, the commissioner may establish the 75th percentile maximum rate
112.18based on like-care arrangements in a county, region, or category that the commissioner
112.19deems to be similar.
112.20    (c) A rate which includes a special needs rate paid under subdivision 3 or under a
112.21school readiness service agreement paid under section 119B.231, may be in excess of the
112.22maximum rate allowed under this subdivision.
112.23    (d) The department shall monitor the effect of this paragraph on provider rates. The
112.24county shall pay the provider's full charges for every child in care up to the maximum
112.25established. The commissioner shall determine the maximum rate for each type of care
112.26on an hourly, full-day, and weekly basis, including special needs and disability care. The
112.27maximum payment to a provider for one day of care must not exceed the daily rate. The
112.28maximum payment to a provider for one week of care must not exceed the weekly rate.
112.29(e) Child care providers receiving reimbursement under this chapter must not be
112.30paid activity fees or an additional amount above the maximum rates for care provided
112.31during nonstandard hours for families receiving assistance.
112.32    (f) When the provider charge is greater than the maximum provider rate allowed,
112.33the parent is responsible for payment of the difference in the rates in addition to any
112.34family co-payment fee.
113.1    (g) All maximum provider rates changes shall be implemented on the Monday
113.2following the effective date of the maximum provider rate.

113.3    Sec. 3. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
113.4    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
113.5must not be reimbursed for more than ten 25 full-day absent days per child, excluding
113.6holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal
113.7nonlicensed family child care providers must not be reimbursed for absent days. If a child
113.8attends for part of the time authorized to be in care in a day, but is absent for part of the
113.9time authorized to be in care in that same day, the absent time must be reimbursed but the
113.10time must not count toward the ten 25 absent day days limit. Child care providers must
113.11only be reimbursed for absent days if the provider has a written policy for child absences
113.12and charges all other families in care for similar absences.
113.13(b) Notwithstanding paragraph (a), children in families may exceed the ten 25 absent
113.14days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school
113.15or general equivalency diploma; and (3) is a student in a school district or another similar
113.16program that provides or arranges for child care, parenting support, social services, career
113.17and employment supports, and academic support to achieve high school graduation, upon
113.18request of the program and approval of the county. If a child attends part of an authorized
113.19day, payment to the provider must be for the full amount of care authorized for that day.
113.20    (c) Child care providers must be reimbursed for up to ten federal or state holidays or
113.21designated holidays per year when the provider charges all families for these days and the
113.22holiday or designated holiday falls on a day when the child is authorized to be in attendance.
113.23Parents may substitute other cultural or religious holidays for the ten recognized state and
113.24federal holidays. Holidays do not count toward the ten 25 absent day days limit.
113.25    (d) A family or child care provider must not be assessed an overpayment for an
113.26absent day payment unless (1) there was an error in the amount of care authorized for the
113.27family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
113.28the family or provider did not timely report a change as required under law.
113.29    (e) The provider and family shall receive notification of the number of absent days
113.30used upon initial provider authorization for a family and ongoing notification of the
113.31number of absent days used as of the date of the notification.

113.32    Sec. 4. Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:
113.33    Subd. 2a. Immediate suspension expedited hearing. (a) Within five working days
113.34of receipt of the license holder's timely appeal, the commissioner shall request assignment
114.1of an administrative law judge. The request must include a proposed date, time, and place
114.2of a hearing. A hearing must be conducted by an administrative law judge within 30
114.3calendar days of the request for assignment, unless an extension is requested by either
114.4party and granted by the administrative law judge for good cause. The commissioner shall
114.5issue a notice of hearing by certified mail or personal service at least ten working days
114.6before the hearing. The scope of the hearing shall be limited solely to the issue of whether
114.7the temporary immediate suspension should remain in effect pending the commissioner's
114.8final order under section 245A.08, regarding a licensing sanction issued under subdivision
114.93 following the immediate suspension. The burden of proof in expedited hearings under
114.10this subdivision shall be limited to the commissioner's demonstration that reasonable
114.11cause exists to believe that the license holder's actions or failure to comply with applicable
114.12law or rule poses, or if the actions of other individuals or conditions in the program
114.13poses an imminent risk of harm to the health, safety, or rights of persons served by the
114.14program. "Reasonable cause" means there exist specific articulable facts or circumstances
114.15which provide the commissioner with a reasonable suspicion that there is an imminent
114.16risk of harm to the health, safety, or rights of persons served by the program. When the
114.17commissioner has determined there is reasonable cause to order the temporary immediate
114.18suspension of a license based on a violation of safe sleep requirements, as defined in
114.19section 245A.1435, the commissioner is not required to demonstrate that an infant died or
114.20was injured as a result of the safe sleep violations.
114.21    (b) The administrative law judge shall issue findings of fact, conclusions, and a
114.22recommendation within ten working days from the date of hearing. The parties shall have
114.23ten calendar days to submit exceptions to the administrative law judge's report. The
114.24record shall close at the end of the ten-day period for submission of exceptions. The
114.25commissioner's final order shall be issued within ten working days from the close of the
114.26record. Within 90 calendar days after a final order affirming an immediate suspension, the
114.27commissioner shall make a determination regarding whether a final licensing sanction
114.28shall be issued under subdivision 3. The license holder shall continue to be prohibited
114.29from operation of the program during this 90-day period.
114.30    (c) When the final order under paragraph (b) affirms an immediate suspension, and a
114.31final licensing sanction is issued under subdivision 3 and the license holder appeals that
114.32sanction, the license holder continues to be prohibited from operation of the program
114.33pending a final commissioner's order under section 245A.08, subdivision 5, regarding the
114.34final licensing sanction.

115.1    Sec. 5. Minnesota Statutes 2012, section 245A.1435, is amended to read:
115.2245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT
115.3DEATH SYNDROME IN LICENSED PROGRAMS.
115.4    (a) When a license holder is placing an infant to sleep, the license holder must
115.5place the infant on the infant's back, unless the license holder has documentation from
115.6the infant's parent physician directing an alternative sleeping position for the infant. The
115.7parent physician directive must be on a form approved by the commissioner and must
115.8include a statement that the parent or legal guardian has read the information provided by
115.9the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance
115.10of placing an infant or child on its back to sleep to reduce the risk of SIDS. remain on file
115.11at the licensed location. An infant who independently rolls onto its stomach after being
115.12placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant
115.13is at least six months of age or the license holder has a signed statement from the parent
115.14indicating that the infant regularly rolls over at home.
115.15(b) The license holder must place the infant in a crib directly on a firm mattress with
115.16a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be
115.17dislodged by pulling on the corner of the sheet. The license holder must not place pillows,
115.18quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib
115.19with the infant The license holder must place the infant in a crib directly on a firm mattress
115.20with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress,
115.21and overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner
115.22of the sheet with reasonable effort. The license holder must not place anything in the crib
115.23with the infant except for the infant's pacifier. The requirements of this section apply to
115.24license holders serving infants up to and including 12 months younger than one year of age.
115.25Licensed child care providers must meet the crib requirements under section 245A.146.
115.26(c) If an infant falls asleep before being placed in a crib, the license holder must
115.27move the infant to a crib as soon as practicable, and must keep the infant within sight of
115.28the license holder until the infant is placed in a crib. When an infant falls asleep while
115.29being held, the license holder must consider the supervision needs of other children in
115.30care when determining how long to hold the infant before placing the infant in a crib to
115.31sleep. The sleeping infant must not be in a position where the airway may be blocked or
115.32with anything covering the infant's face.
115.33(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended
115.34for an infant of any age and is prohibited for any infant who has begun to roll over
115.35independently. However, with the written consent of a parent or guardian according to this
115.36paragraph, a license holder may place the infant who has not yet begun to roll over on its
116.1own down to sleep in a one-piece sleeper equipped with an attached system that fastens
116.2securely only across the upper torso, with no constriction of the hips or legs, to create a
116.3swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter,
116.4the license holder must obtain informed written consent for the use of swaddling from the
116.5parent or guardian of the infant on a form provided by the commissioner and prepared in
116.6partnership with the Minnesota Sudden Infant Death Center.

116.7    Sec. 6. Minnesota Statutes 2012, section 245A.144, is amended to read:
116.8245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
116.9DEATH AND SHAKEN BABY SYNDROME ABUSIVE HEAD TRAUMA FOR
116.10CHILD FOSTER CARE PROVIDERS.
116.11    (a) Licensed child foster care providers that care for infants or children through five
116.12years of age must document that before staff persons and caregivers assist in the care
116.13of infants or children through five years of age, they are instructed on the standards in
116.14section 245A.1435 and receive training on reducing the risk of sudden unexpected infant
116.15death syndrome and shaken baby syndrome for abusive head trauma from shaking infants
116.16and young children. This section does not apply to emergency relative placement under
116.17section 245A.035. The training on reducing the risk of sudden unexpected infant death
116.18syndrome and shaken baby syndrome abusive head trauma may be provided as:
116.19    (1) orientation training to child foster care providers, who care for infants or children
116.20through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
116.21    (2) in-service training to child foster care providers, who care for infants or children
116.22through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
116.23    (b) Training required under this section must be at least one hour in length and must
116.24be completed at least once every five years. At a minimum, the training must address
116.25the risk factors related to sudden unexpected infant death syndrome and shaken baby
116.26syndrome abusive head trauma, means of reducing the risk of sudden unexpected infant
116.27death syndrome and shaken baby syndrome abusive head trauma, and license holder
116.28communication with parents regarding reducing the risk of sudden unexpected infant
116.29death syndrome and shaken baby syndrome abusive head trauma.
116.30    (c) Training for child foster care providers must be approved by the county or
116.31private licensing agency that is responsible for monitoring the child foster care provider
116.32under section 245A.16. The approved training fulfills, in part, training required under
116.33Minnesota Rules, part 2960.3070.

117.1    Sec. 7. Minnesota Statutes 2012, section 245A.1444, is amended to read:
117.2245A.1444 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
117.3DEATH SYNDROME AND SHAKEN BABY SYNDROME ABUSIVE HEAD
117.4TRAUMA BY OTHER PROGRAMS.
117.5    A licensed chemical dependency treatment program that serves clients with infants
117.6or children through five years of age, who sleep at the program and a licensed children's
117.7residential facility that serves infants or children through five years of age, must document
117.8that before program staff persons or volunteers assist in the care of infants or children
117.9through five years of age, they are instructed on the standards in section 245A.1435 and
117.10receive training on reducing the risk of sudden unexpected infant death syndrome and
117.11shaken baby syndrome abusive head trauma from shaking infants and young children. The
117.12training conducted under this section may be used to fulfill training requirements under
117.13Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.
117.14    This section does not apply to child care centers or family child care programs
117.15governed by sections 245A.40 and 245A.50.

117.16    Sec. 8. [245A.1446] FAMILY CHILD CARE DIAPERING AREA
117.17DISINFECTION.
117.18Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may
117.19disinfect the diaper changing surface with either a solution of at least two teaspoons
117.20of chlorine bleach to one quart of water or with a surface disinfectant that meets the
117.21following criteria:
117.22(1) the manufacturer's label or instructions state that the product is registered with
117.23the United States Environmental Protection Agency;
117.24(2) the manufacturer's label or instructions state that the disinfectant is effective
117.25against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa;
117.26(3) the manufacturer's label or instructions state that the disinfectant is effective with
117.27a ten minute or less contact time;
117.28(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing
117.29and use;
117.30(5) the disinfectant is used only in accordance with the manufacturer's directions; and
117.31(6) the product does not include triclosan or derivatives of triclosan.

117.32    Sec. 9. [245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION
117.33REQUIREMENTS.
118.1    Subdivision 1. In-person checks on infants. (a) License holders that serve infants
118.2are encouraged to monitor sleeping infants by conducting in-person checks on each infant
118.3in their care every 30 minutes.
118.4(b) Upon enrollment of an infant in a family child care program, the license holder is
118.5encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during
118.6the first four months of care.
118.7(c) When an infant has an upper respiratory infection, the license holder is
118.8encouraged to conduct in-person checks on the sleeping infant every 15 minutes
118.9throughout the hours of sleep.
118.10    Subd. 2. Use of audio or visual monitoring devices. In addition to conducting
118.11the in-person checks encouraged under subdivision 1, license holders serving infants are
118.12encouraged to use and maintain an audio or visual monitoring device to monitor each
118.13sleeping infant in care during all hours of sleep.

118.14    Sec. 10. [245A.152] CHILD CARE LICENSE HOLDER INSURANCE.
118.15(a) A license holder must provide a written notice to all parents or guardians of all
118.16children to be accepted for care prior to admission stating whether the license holder has
118.17liability insurance. This notice may be incorporated into and provided on the admission
118.18form used by the license holder.
118.19(b) If the license holder has liability insurance:
118.20(1) the license holder shall inform parents in writing that a current certificate of
118.21coverage for insurance is available for inspection to all parents or guardians of children
118.22receiving services and to all parents seeking services from the family child care program;
118.23(2) the notice must provide the parent or guardian with the date of expiration or
118.24next renewal of the policy; and
118.25(3) upon the expiration date of the policy, the license holder must provide a new
118.26written notice indicating whether the insurance policy has lapsed or whether the license
118.27holder has renewed the policy.
118.28If the policy was renewed, the license holder must provide the new expiration date of the
118.29policy in writing to the parents or guardians.
118.30(c) If the license holder does not have liability insurance, the license holder must
118.31provide an annual notice on a form developed and made available by the commissioner,
118.32to the parents or guardians of children in care indicating that the license holder does not
118.33carry liability insurance.
118.34(d) The license holder must notify all parents and guardians in writing immediately
118.35of any change in insurance status.
119.1(e) The license holder must make available upon request the certificate of liability
119.2insurance to the parents of children in care, to the commissioner, and to county licensing
119.3agents.
119.4(f) The license holder must document, with the signature of the parent or guardian,
119.5that the parent or guardian received the notices required by this section.

119.6    Sec. 11. Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:
119.7    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
119.8 abusive head trauma training. (a) License holders must document that before staff
119.9persons and volunteers care for infants, they are instructed on the standards in section
119.10245A.1435 and receive training on reducing the risk of sudden unexpected infant death
119.11syndrome. In addition, license holders must document that before staff persons care for
119.12infants or children under school age, they receive training on the risk of shaken baby
119.13syndrome abusive head trauma from shaking infants and young children. The training
119.14in this subdivision may be provided as orientation training under subdivision 1 and
119.15in-service training under subdivision 7.
119.16    (b) Sudden unexpected infant death syndrome reduction training required under
119.17this subdivision must be at least one-half hour in length and must be completed at least
119.18once every five years year. At a minimum, the training must address the risk factors
119.19related to sudden unexpected infant death syndrome, means of reducing the risk of sudden
119.20unexpected infant death syndrome in child care, and license holder communication with
119.21parents regarding reducing the risk of sudden unexpected infant death syndrome.
119.22    (c) Shaken baby syndrome Abusive head trauma training under this subdivision
119.23must be at least one-half hour in length and must be completed at least once every five
119.24years year. At a minimum, the training must address the risk factors related to shaken
119.25baby syndrome for shaking infants and young children, means to reduce the risk of shaken
119.26baby syndrome abusive head trauma in child care, and license holder communication with
119.27parents regarding reducing the risk of shaken baby syndrome abusive head trauma.
119.28(d) The commissioner shall make available for viewing a video presentation on the
119.29dangers associated with shaking infants and young children. The video presentation must
119.30be part of the orientation and annual in-service training of licensed child care center
119.31staff persons caring for children under school age. The commissioner shall provide to
119.32child care providers and interested individuals, at cost, copies of a video approved by the
119.33commissioner of health under section 144.574 on the dangers associated with shaking
119.34infants and young children.

120.1    Sec. 12. Minnesota Statutes 2012, section 245A.50, is amended to read:
120.2245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.
120.3    Subdivision 1. Initial training. (a) License holders, caregivers, and substitutes must
120.4comply with the training requirements in this section.
120.5    (b) Helpers who assist with care on a regular basis must complete six hours of
120.6training within one year after the date of initial employment.
120.7    Subd. 2. Child growth and development and behavior guidance training. (a) For
120.8purposes of family and group family child care, the license holder and each adult caregiver
120.9who provides care in the licensed setting for more than 30 days in any 12-month period
120.10shall complete and document at least two four hours of child growth and development
120.11and behavior guidance training within the first year of prior to initial licensure, and before
120.12caring for children. For purposes of this subdivision, "child growth and development
120.13training" means training in understanding how children acquire language and develop
120.14physically, cognitively, emotionally, and socially. "Behavior guidance training" means
120.15training in the understanding of the functions of child behavior and strategies for managing
120.16challenging situations. Child growth and development and behavior guidance training
120.17must be repeated annually. Training curriculum shall be developed or approved by the
120.18commissioner of human services by January 1, 2014.
120.19    (b) Notwithstanding paragraph (a), individuals are exempt from this requirement if
120.20they:
120.21    (1) have taken a three-credit course on early childhood development within the
120.22past five years;
120.23    (2) have received a baccalaureate or master's degree in early childhood education or
120.24school-age child care within the past five years;
120.25    (3) are licensed in Minnesota as a prekindergarten teacher, an early childhood
120.26educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early
120.27childhood special education teacher, or an elementary teacher with a kindergarten
120.28endorsement; or
120.29    (4) have received a baccalaureate degree with a Montessori certificate within the
120.30past five years.
120.31    Subd. 3. First aid. (a) When children are present in a family child care home
120.32governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person
120.33must be present in the home who has been trained in first aid. The first aid training must
120.34have been provided by an individual approved to provide first aid instruction. First aid
120.35training may be less than eight hours and persons qualified to provide first aid training
121.1include individuals approved as first aid instructors. First aid training must be repeated
121.2every two years.
121.3    (b) A family child care provider is exempt from the first aid training requirements
121.4under this subdivision related to any substitute caregiver who provides less than 30 hours
121.5of care during any 12-month period.
121.6    (c) Video training reviewed and approved by the county licensing agency satisfies
121.7the training requirement of this subdivision.
121.8    Subd. 4. Cardiopulmonary resuscitation. (a) When children are present in a family
121.9child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least
121.10one staff person must be present in the home who has been trained in cardiopulmonary
121.11resuscitation (CPR) and in the treatment of obstructed airways that includes CPR
121.12techniques for infants and children. The CPR training must have been provided by an
121.13individual approved to provide CPR instruction, must be repeated at least once every three
121.14 two years, and must be documented in the staff person's records.
121.15    (b) A family child care provider is exempt from the CPR training requirement in
121.16this subdivision related to any substitute caregiver who provides less than 30 hours of
121.17care during any 12-month period.
121.18    (c) Video training reviewed and approved by the county licensing agency satisfies
121.19the training requirement of this subdivision. Persons providing CPR training must use
121.20CPR training that has been developed:
121.21    (1) by the American Heart Association or the American Red Cross and incorporates
121.22psychomotor skills to support the instruction; or
121.23    (2) using nationally recognized, evidence-based guidelines for CPR training and
121.24incorporates psychomotor skills to support the instruction.
121.25    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
121.26 abusive head trauma training. (a) License holders must document that before staff
121.27persons, caregivers, and helpers assist in the care of infants, they are instructed on the
121.28standards in section 245A.1435 and receive training on reducing the risk of sudden
121.29unexpected infant death syndrome. In addition, license holders must document that before
121.30staff persons, caregivers, and helpers assist in the care of infants and children under
121.31school age, they receive training on reducing the risk of shaken baby syndrome abusive
121.32head trauma from shaking infants and young children. The training in this subdivision
121.33may be provided as initial training under subdivision 1 or ongoing annual training under
121.34subdivision 7.
121.35    (b) Sudden unexpected infant death syndrome reduction training required under this
121.36subdivision must be at least one-half hour in length and must be completed in person
122.1 at least once every five years two years. On the years when the license holder is not
122.2receiving the in-person training on sudden unexpected infant death reduction, the license
122.3holder must receive sudden unexpected infant death reduction training through a video
122.4of no more than one hour in length developed or approved by the commissioner. At a
122.5minimum, the training must address the risk factors related to sudden unexpected infant
122.6death syndrome, means of reducing the risk of sudden unexpected infant death syndrome
122.7 in child care, and license holder communication with parents regarding reducing the risk
122.8of sudden unexpected infant death syndrome.
122.9    (c) Shaken baby syndrome Abusive head trauma training required under this
122.10subdivision must be at least one-half hour in length and must be completed at least once
122.11every five years year. At a minimum, the training must address the risk factors related
122.12to shaken baby syndrome shaking infants and young children, means of reducing the
122.13risk of shaken baby syndrome abusive head trauma in child care, and license holder
122.14communication with parents regarding reducing the risk of shaken baby syndrome abusive
122.15head trauma.
122.16(d) Training for family and group family child care providers must be developed
122.17by the commissioner in conjunction with the Minnesota Sudden Infant Death Center
122.18and approved by the county licensing agency by the Minnesota Center for Professional
122.19Development.
122.20    (e) The commissioner shall make available for viewing by all licensed child care
122.21providers a video presentation on the dangers associated with shaking infants and young
122.22children. The video presentation shall be part of the initial and ongoing annual training of
122.23licensed child care providers, caregivers, and helpers caring for children under school age.
122.24The commissioner shall provide to child care providers and interested individuals, at cost,
122.25copies of a video approved by the commissioner of health under section 144.574 on the
122.26dangers associated with shaking infants and young children.
122.27    Subd. 6. Child passenger restraint systems; training requirement. (a) A license
122.28holder must comply with all seat belt and child passenger restraint system requirements
122.29under section 169.685.
122.30    (b) Family and group family child care programs licensed by the Department of
122.31Human Services that serve a child or children under nine years of age must document
122.32training that fulfills the requirements in this subdivision.
122.33    (1) Before a license holder, staff person, caregiver, or helper transports a child or
122.34children under age nine in a motor vehicle, the person placing the child or children in a
122.35passenger restraint must satisfactorily complete training on the proper use and installation
123.1of child restraint systems in motor vehicles. Training completed under this subdivision may
123.2be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.
123.3    (2) Training required under this subdivision must be at least one hour in length,
123.4completed at initial training, and repeated at least once every five years. At a minimum,
123.5the training must address the proper use of child restraint systems based on the child's
123.6size, weight, and age, and the proper installation of a car seat or booster seat in the motor
123.7vehicle used by the license holder to transport the child or children.
123.8    (3) Training under this subdivision must be provided by individuals who are certified
123.9and approved by the Department of Public Safety, Office of Traffic Safety. License holders
123.10may obtain a list of certified and approved trainers through the Department of Public
123.11Safety Web site or by contacting the agency.
123.12    (c) Child care providers that only transport school-age children as defined in section
123.13245A.02, subdivision 19 , paragraph (f), in child care buses as defined in section 169.448,
123.14subdivision 1, paragraph (e), are exempt from this subdivision.
123.15    Subd. 7. Training requirements for family and group family child care. For
123.16purposes of family and group family child care, the license holder and each primary
123.17caregiver must complete eight 16 hours of ongoing training each year. For purposes
123.18of this subdivision, a primary caregiver is an adult caregiver who provides services in
123.19the licensed setting for more than 30 days in any 12-month period. Repeat of topical
123.20training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training
123.21requirement. Additional ongoing training subjects to meet the annual 16-hour training
123.22requirement must be selected from the following areas:
123.23    (1) "child growth and development training" has the meaning given in under
123.24 subdivision 2, paragraph (a);
123.25    (2) "learning environment and curriculum" includes, including training in
123.26establishing an environment and providing activities that provide learning experiences to
123.27meet each child's needs, capabilities, and interests;
123.28    (3) "assessment and planning for individual needs" includes, including training in
123.29observing and assessing what children know and can do in order to provide curriculum
123.30and instruction that addresses their developmental and learning needs, including children
123.31with special needs and bilingual children or children for whom English is not their
123.32primary language;
123.33    (4) "interactions with children" includes, including training in establishing
123.34supportive relationships with children, guiding them as individuals and as part of a group;
124.1    (5) "families and communities" includes, including training in working
124.2collaboratively with families and agencies or organizations to meet children's needs and to
124.3encourage the community's involvement;
124.4    (6) "health, safety, and nutrition" includes, including training in establishing and
124.5maintaining an environment that ensures children's health, safety, and nourishment,
124.6including child abuse, maltreatment, prevention, and reporting; home and fire safety; child
124.7injury prevention; communicable disease prevention and control; first aid; and CPR; and
124.8    (7) "program planning and evaluation" includes, including training in establishing,
124.9implementing, evaluating, and enhancing program operations.; and
124.10(8) behavior guidance, including training in the understanding of the functions of
124.11child behavior and strategies for managing behavior.
124.12    Subd. 8. Other required training requirements. (a) The training required of
124.13family and group family child care providers and staff must include training in the cultural
124.14dynamics of early childhood development and child care. The cultural dynamics and
124.15disabilities training and skills development of child care providers must be designed to
124.16achieve outcomes for providers of child care that include, but are not limited to:
124.17    (1) an understanding and support of the importance of culture and differences in
124.18ability in children's identity development;
124.19    (2) understanding the importance of awareness of cultural differences and
124.20similarities in working with children and their families;
124.21    (3) understanding and support of the needs of families and children with differences
124.22in ability;
124.23    (4) developing skills to help children develop unbiased attitudes about cultural
124.24differences and differences in ability;
124.25    (5) developing skills in culturally appropriate caregiving; and
124.26    (6) developing skills in appropriate caregiving for children of different abilities.
124.27    The commissioner shall approve the curriculum for cultural dynamics and disability
124.28training.
124.29    (b) The provider must meet the training requirement in section 245A.14, subdivision
124.3011
, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child
124.31care or group family child care home to use the swimming pool located at the home.
124.32    Subd. 9. Supervising for safety; training requirement. Effective July 1, 2014,
124.33all family child care license holders and each adult caregiver who provides care in the
124.34licensed family child care home for more than 30 days in any 12-month period shall
124.35complete and document at least six hours approved training on supervising for safety
124.36prior to initial licensure, and before caring for children. At least two hours of training
125.1on supervising for safety must be repeated annually. For purposes of this subdivision,
125.2"supervising for safety" includes supervision basics, supervision outdoors, equipment and
125.3materials, illness, injuries, and disaster preparedness. The commissioner shall develop
125.4the supervising for safety curriculum by January 1, 2014.
125.5    Subd. 10. Approved training. (a) County licensing staff must accept training
125.6approved by the Minnesota Center for Professional Development, including:
125.7(1) face-to-face or classroom training;
125.8(2) online training; and
125.9(3) relationship-based professional development, such as mentoring, coaching,
125.10and consulting.
125.11(b) New and increased training requirements under this section must not be imposed
125.12on providers until the commissioner establishes statewide accessibility to the required
125.13provider training.

125.14    Sec. 13. Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:
125.15    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
125.16child, including a child determined eligible for medical assistance without consideration of
125.17parental income, must contribute to the cost of services used by making monthly payments
125.18on a sliding scale based on income, unless the child is married or has been married, parental
125.19rights have been terminated, or the child's adoption is subsidized according to section
125.20259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial
125.21or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
125.22mitigating, rehabilitation, maintenance, and personal care services as defined in United
125.23States Code, title 26, section 213, needed by the child with a chronic illness or disability.
125.24    (b) For households with adjusted gross income equal to or greater than 100 percent
125.25of federal poverty guidelines, the parental contribution shall be computed by applying the
125.26following schedule of rates to the adjusted gross income of the natural or adoptive parents:
125.27    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
125.28poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
125.29contribution is $4 per month;
125.30    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
125.31poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
125.32the parental contribution shall be determined using a sliding fee scale established by the
125.33commissioner of human services which begins at one percent of adjusted gross income
125.34at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
126.1gross income for those with adjusted gross income up to 545 percent of federal poverty
126.2guidelines;
126.3    (3) if the adjusted gross income is greater than 545 percent of federal poverty
126.4guidelines and less than 675 percent of federal poverty guidelines, the parental
126.5contribution shall be 7.5 percent of adjusted gross income;
126.6    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
126.7poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
126.8contribution shall be determined using a sliding fee scale established by the commissioner
126.9of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
126.10federal poverty guidelines and increases to ten percent of adjusted gross income for those
126.11with adjusted gross income up to 975 percent of federal poverty guidelines; and
126.12    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
126.13poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.
126.14    If the child lives with the parent, the annual adjusted gross income is reduced by
126.15$2,400 prior to calculating the parental contribution. If the child resides in an institution
126.16specified in section 256B.35, the parent is responsible for the personal needs allowance
126.17specified under that section in addition to the parental contribution determined under this
126.18section. The parental contribution is reduced by any amount required to be paid directly to
126.19the child pursuant to a court order, but only if actually paid.
126.20    (c) The household size to be used in determining the amount of contribution under
126.21paragraph (b) includes natural and adoptive parents and their dependents, including the
126.22child receiving services. Adjustments in the contribution amount due to annual changes
126.23in the federal poverty guidelines shall be implemented on the first day of July following
126.24publication of the changes.
126.25    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
126.26natural or adoptive parents determined according to the previous year's federal tax form,
126.27except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
126.28have been used to purchase a home shall not be counted as income.
126.29    (e) The contribution shall be explained in writing to the parents at the time eligibility
126.30for services is being determined. The contribution shall be made on a monthly basis
126.31effective with the first month in which the child receives services. Annually upon
126.32redetermination or at termination of eligibility, if the contribution exceeded the cost of
126.33services provided, the local agency or the state shall reimburse that excess amount to
126.34the parents, either by direct reimbursement if the parent is no longer required to pay a
126.35contribution, or by a reduction in or waiver of parental fees until the excess amount is
126.36exhausted. All reimbursements must include a notice that the amount reimbursed may be
127.1taxable income if the parent paid for the parent's fees through an employer's health care
127.2flexible spending account under the Internal Revenue Code, section 125, and that the
127.3parent is responsible for paying the taxes owed on the amount reimbursed.
127.4    (f) The monthly contribution amount must be reviewed at least every 12 months;
127.5when there is a change in household size; and when there is a loss of or gain in income
127.6from one month to another in excess of ten percent. The local agency shall mail a written
127.7notice 30 days in advance of the effective date of a change in the contribution amount.
127.8A decrease in the contribution amount is effective in the month that the parent verifies a
127.9reduction in income or change in household size.
127.10    (g) Parents of a minor child who do not live with each other shall each pay the
127.11contribution required under paragraph (a). An amount equal to the annual court-ordered
127.12child support payment actually paid on behalf of the child receiving services shall be
127.13deducted from the adjusted gross income of the parent making the payment prior to
127.14calculating the parental contribution under paragraph (b).
127.15    (h) The contribution under paragraph (b) shall be increased by an additional five
127.16percent if the local agency determines that insurance coverage is available but not
127.17obtained for the child. For purposes of this section, "available" means the insurance is a
127.18benefit of employment for a family member at an annual cost of no more than five percent
127.19of the family's annual income. For purposes of this section, "insurance" means health
127.20and accident insurance coverage, enrollment in a nonprofit health service plan, health
127.21maintenance organization, self-insured plan, or preferred provider organization.
127.22    Parents who have more than one child receiving services shall not be required
127.23to pay more than the amount for the child with the highest expenditures. There shall
127.24be no resource contribution from the parents. The parent shall not be required to pay
127.25a contribution in excess of the cost of the services provided to the child, not counting
127.26payments made to school districts for education-related services. Notice of an increase in
127.27fee payment must be given at least 30 days before the increased fee is due.
127.28    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
127.29in the 12 months prior to July 1:
127.30    (1) the parent applied for insurance for the child;
127.31    (2) the insurer denied insurance;
127.32    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
127.33a complaint or appeal, in writing, to the commissioner of health or the commissioner of
127.34commerce, or litigated the complaint or appeal; and
127.35    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
127.36    For purposes of this section, "insurance" has the meaning given in paragraph (h).
128.1    A parent who has requested a reduction in the contribution amount under this
128.2paragraph shall submit proof in the form and manner prescribed by the commissioner or
128.3county agency, including, but not limited to, the insurer's denial of insurance, the written
128.4letter or complaint of the parents, court documents, and the written response of the insurer
128.5approving insurance. The determinations of the commissioner or county agency under this
128.6paragraph are not rules subject to chapter 14.
128.7(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
128.82015, the parental contribution shall be computed by applying the following contribution
128.9schedule to the adjusted gross income of the natural or adoptive parents:
128.10(1) if the adjusted gross income is equal to or greater than 100 percent of federal
128.11poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
128.12contribution is $4 per month;
128.13(2) if the adjusted gross income is equal to or greater than 175 percent of federal
128.14poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
128.15the parental contribution shall be determined using a sliding fee scale established by the
128.16commissioner of human services which begins at one percent of adjusted gross income
128.17at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
128.18gross income for those with adjusted gross income up to 525 percent of federal poverty
128.19guidelines;
128.20(3) if the adjusted gross income is greater than 525 percent of federal poverty
128.21guidelines and less than 675 percent of federal poverty guidelines, the parental
128.22contribution shall be 9.5 percent of adjusted gross income;
128.23(4) if the adjusted gross income is equal to or greater than 675 percent of federal
128.24poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
128.25contribution shall be determined using a sliding fee scale established by the commissioner
128.26of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
128.27federal poverty guidelines and increases to 12 percent of adjusted gross income for those
128.28with adjusted gross income up to 900 percent of federal poverty guidelines; and
128.29(5) if the adjusted gross income is equal to or greater than 900 percent of federal
128.30poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
128.31income. If the child lives with the parent, the annual adjusted gross income is reduced by
128.32$2,400 prior to calculating the parental contribution. If the child resides in an institution
128.33specified in section 256B.35, the parent is responsible for the personal needs allowance
128.34specified under that section in addition to the parental contribution determined under this
128.35section. The parental contribution is reduced by any amount required to be paid directly to
128.36the child pursuant to a court order, but only if actually paid.

129.1    Sec. 14. Minnesota Statutes 2012, section 256.82, subdivision 3, is amended to read:
129.2    Subd. 3. Setting foster care standard rates. The commissioner shall annually
129.3establish minimum standard maintenance rates for foster care maintenance and difficulty
129.4of care payments for all children in foster care. Any increase in rates shall in no case
129.5exceed three percent per annum. The foster care rates in effect on January 1, 2013, shall
129.6remain in effect until December 13, 2015.

129.7    Sec. 15. Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:
129.8    Subd. 24. Disregard. "Disregard" means earned income that is not counted when
129.9determining initial eligibility in the initial income test in section 256J.21, subdivision 3,
129.10 or income that is not counted when determining ongoing eligibility and calculating the
129.11amount of the assistance payment for participants. The commissioner shall determine
129.12the amount of the disregard according to section 256J.24, subdivision 10 for ongoing
129.13eligibility shall be 50 percent of gross earned income.
129.14EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
129.15from the United States Department of Agriculture, whichever is later.

129.16    Sec. 16. Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:
129.17    Subd. 3. Initial income test. The county agency shall determine initial eligibility
129.18by considering all earned and unearned income that is not excluded under subdivision 2.
129.19To be eligible for MFIP, the assistance unit's countable income minus the disregards in
129.20paragraphs (a) and (b) must be below the transitional standard of assistance family wage
129.21level according to section 256J.24 for that size assistance unit.
129.22(a) The initial eligibility determination must disregard the following items:
129.23(1) the employment disregard is 18 percent of the gross earned income whether or
129.24not the member is working full time or part time;
129.25(2) dependent care costs must be deducted from gross earned income for the actual
129.26amount paid for dependent care up to a maximum of $200 per month for each child less
129.27than two years of age, and $175 per month for each child two years of age and older under
129.28this chapter and chapter 119B;
129.29(3) all payments made according to a court order for spousal support or the support
129.30of children not living in the assistance unit's household shall be disregarded from the
129.31income of the person with the legal obligation to pay support, provided that, if there has
129.32been a change in the financial circumstances of the person with the legal obligation to pay
129.33support since the support order was entered, the person with the legal obligation to pay
129.34support has petitioned for a modification of the support order; and
130.1(4) an allocation for the unmet need of an ineligible spouse or an ineligible child
130.2under the age of 21 for whom the caregiver is financially responsible and who lives with
130.3the caregiver according to section 256J.36.
130.4(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant
130.5units when at least one member has received MFIP in this state within four months of
130.6the most recent application for MFIP, apply the disregard as defined in section 256J.08,
130.7subdivision 24
, for all unit members.
130.8After initial eligibility is established, the assistance payment calculation is based on
130.9the monthly income test.
130.10EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
130.11from the United States Department of Agriculture, whichever is later.

130.12    Sec. 17. Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:
130.13    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
130.14on the number of persons in the assistance unit eligible for both food and cash assistance
130.15unless the restrictions in subdivision 6 on the birth of a child apply. The amount of the
130.16transitional standard is published annually by the Department of Human Services.
130.17EFFECTIVE DATE.This section is effective July 1, 2014.

130.18    Sec. 18. Minnesota Statutes 2012, section 256J.24, subdivision 5a, is amended to read:
130.19    Subd. 5a. Food portion of Adjustments to the MFIP transitional standard. (a)
130.20Effective October 1, 2015, the commissioner shall adjust the MFIP transitional standard as
130.21needed to reflect a onetime increase in the cash portion of 16 percent.
130.22(b) When any adjustments are made in the Supplemental Nutrition Assistance
130.23Program, the commissioner shall adjust the food portion of the MFIP transitional standard
130.24as needed to reflect adjustments to the Supplemental Nutrition Assistance Program. The
130.25commissioner shall publish the transitional standard including a breakdown of the cash
130.26and food portions for an assistance unit of sizes one to ten in the State Register whenever
130.27an adjustment is made.

130.28    Sec. 19. Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:
130.29    Subd. 7. Family wage level. The family wage level is 110 percent of the transitional
130.30standard under subdivision 5 or 6, when applicable, and is the standard used when there is
130.31earned income in the assistance unit. As specified in section 256J.21. If there is earned
130.32income in the assistance unit, earned income is subtracted from the family wage level to
131.1determine the amount of the assistance payment, as specified in section 256J.21. The
131.2assistance payment may not exceed the transitional standard under subdivision 5 or 6,
131.3or the shared household standard under subdivision 9, whichever is applicable, for the
131.4assistance unit.
131.5EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
131.6from the United States Department of Agriculture, whichever is later.

131.7    Sec. 20. Minnesota Statutes 2012, section 256J.621, is amended to read:
131.8256J.621 WORK PARTICIPATION CASH BENEFITS.
131.9    Subdivision 1. Program characteristics. (a) Effective October 1, 2009, upon
131.10exiting the diversionary work program (DWP) or upon terminating the Minnesota family
131.11investment program with earnings, a participant who is employed may be eligible for work
131.12participation cash benefits of $25 per month to assist in meeting the family's basic needs
131.13as the participant continues to move toward self-sufficiency.
131.14    (b) To be eligible for work participation cash benefits, the participant shall not
131.15receive MFIP or diversionary work program assistance during the month and the
131.16participant or participants must meet the following work requirements:
131.17    (1) if the participant is a single caregiver and has a child under six years of age, the
131.18participant must be employed at least 87 hours per month;
131.19    (2) if the participant is a single caregiver and does not have a child under six years of
131.20age, the participant must be employed at least 130 hours per month; or
131.21    (3) if the household is a two-parent family, at least one of the parents must be
131.22employed 130 hours per month.
131.23    Whenever a participant exits the diversionary work program or is terminated from
131.24MFIP and meets the other criteria in this section, work participation cash benefits are
131.25available for up to 24 consecutive months.
131.26    (c) Expenditures on the program are maintenance of effort state funds under
131.27a separate state program for participants under paragraph (b), clauses (1) and (2).
131.28Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
131.29funds. Months in which a participant receives work participation cash benefits under this
131.30section do not count toward the participant's MFIP 60-month time limit.
131.31    Subd. 2. Program suspension. (a) Effective December 1, 2013, the work
131.32participation cash benefits program shall be suspended.
131.33(b) The commissioner of human services may reinstate the work participation cash
131.34benefits program if the United States Department of Human Services determines that the
132.1state of Minnesota did not meet the federal TANF work participation rate and sends a
132.2notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I
132.3of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation
132.4Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005.
132.5(c) The commissioner shall notify the chairs and ranking minority members of the
132.6legislative committees with jurisdiction over human services policy and finance of the
132.7potential penalty and the commissioner's plans to reinstate the work participation cash
132.8benefit program within 30 days of the date the commissioner receives notification that
132.9the state failed to meet the federal work participation rate.

132.10    Sec. 21. Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:
132.11    Subd. 7. Performance base funds. (a) For the purpose of this section, the following
132.12terms have the meanings given.
132.13(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
132.14TANF and separate state program caseload has fallen relative to federal fiscal year 2005
132.15based on caseload data from October 1 to September 30.
132.16(2) "TANF participation rate target" means a 50 percent participation rate reduced by
132.17the CRC for the previous year.
132.18(b) (a) For calendar year 2010 2016 and yearly thereafter, each county and tribe will
132.19 must be allocated 95 percent of their initial calendar year allocation. Allocations for
132.20counties and tribes will must be allocated additional funds adjusted based on performance
132.21as follows:
132.22    (1) a county or tribe that achieves the TANF participation rate target or a five
132.23percentage point improvement over the previous year's TANF participation rate under
132.24section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for
132.25the most recent year for which the measurements are available, will receive an additional
132.26allocation equal to 2.5 percent of its initial allocation;
132.27    (2) (1) a county or tribe that performs within or above its range of expected
132.28performance on the annualized three-year self-support index under section 256J.751,
132.29subdivision 2
, clause (6), will must receive an additional allocation equal to 2.5 five
132.30percent of its initial allocation; and
132.31    (3) a county or tribe that does not achieve the TANF participation rate target or
132.32a five percentage point improvement over the previous year's TANF participation rate
132.33under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive
132.34months for the most recent year for which the measurements are available, will not
133.1receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
133.2improvement plan with the commissioner; or
133.3    (4) (2) a county or tribe that does not perform within or above performs below its
133.4range of expected performance on the annualized three-year self-support index under
133.5section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal
133.6to 2.5 percent of its initial allocation until after negotiating for a single year, may receive
133.7an additional allocation of up to five percent of its initial allocation. A county or tribe that
133.8continues to perform below its range of expected performance for two consecutive years
133.9must negotiate a multiyear improvement plan with the commissioner. If no improvement
133.10is shown by the end of the multiyear plan, the commissioner may decrease the county's or
133.11tribe's performance-based funds by up to five percent. The decrease must remain in effect
133.12until the county or tribe performs within or above its range of expected performance.
133.13    (c) (b) For calendar year 2009 2016 and yearly thereafter, performance-based funds
133.14for a federally approved tribal TANF program in which the state and tribe have in place a
133.15contract under section 256.01, addressing consolidated funding, will must be allocated
133.16as follows:
133.17    (1) a tribe that achieves the participation rate approved in its federal TANF plan
133.18using the average of 12 consecutive months for the most recent year for which the
133.19measurements are available, will receive an additional allocation equal to 2.5 percent of
133.20its initial allocation; and
133.21    (2) (1) a tribe that performs within or above its range of expected performance on the
133.22annualized three-year self-support index under section 256J.751, subdivision 2, clause (6),
133.23will must receive an additional allocation equal to 2.5 percent of its initial allocation; or
133.24    (3) a tribe that does not achieve the participation rate approved in its federal TANF
133.25plan using the average of 12 consecutive months for the most recent year for which the
133.26measurements are available, will not receive an additional allocation equal to 2.5 percent
133.27of its initial allocation until after negotiating a multiyear improvement plan with the
133.28commissioner; or
133.29    (4) (2) a tribe that does not perform within or above performs below its range of
133.30expected performance on the annualized three-year self-support index under section
133.31256J.751, subdivision 2 , clause (6), will not receive an additional allocation equal to 2.5
133.32percent until after negotiating for a single year may receive an additional allocation of up
133.33to five percent of its initial allocation. A county or tribe that continues to perform below
133.34its range of expected performance for two consecutive years must negotiate a multiyear
133.35improvement plan with the commissioner. If no improvement is shown by the end of the
133.36multiyear plan, the commissioner may decrease the tribe's performance-based funds by
134.1up to five percent. The decrease must remain in effect until the tribe performs within or
134.2above its range of expected performance.
134.3    (d) (c) Funds remaining unallocated after the performance-based allocations in
134.4paragraph paragraphs (a) and (b) are available to the commissioner for innovation projects
134.5under subdivision 5.
134.6     (1) (d) If available funds are insufficient to meet county and tribal allocations under
134.7paragraph paragraphs (a) and (b), the commissioner may make available for allocation
134.8funds that are unobligated and available from the innovation projects through the end of
134.9the current biennium shall proportionally prorate funds to counties and tribes that qualify
134.10for an additional allocation under paragraphs (a), clause (1), and (b), clause (1).
134.11    (2) If after the application of clause (1) funds remain insufficient to meet county and
134.12tribal allocations under paragraph (b), the commissioner must proportionally reduce the
134.13allocation of each county and tribe with respect to their maximum allocation available
134.14under paragraph (b).

134.15    Sec. 22. [256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM
134.16FEDERAL RULES AND REGULATIONS.
134.17    Subdivision 1. Duties of the commissioner. The commissioner of human services
134.18may pursue TANF demonstration projects or waivers of TANF requirements from the
134.19United States Department of Health and Human Services as needed to allow the state to
134.20build a more results-oriented Minnesota Family Investment Program to better meet the
134.21needs of Minnesota families.
134.22    Subd. 2. Purpose. The purpose of the TANF demonstration projects or waivers is to:
134.23(1) replace the federal TANF process measure and its complex administrative
134.24requirements with state-developed outcomes measures that track adult employment and
134.25exits from MFIP cash assistance;
134.26(2) simplify programmatic and administrative requirements; and
134.27(3) make other policy or programmatic changes that improve the performance of the
134.28program and the outcomes for participants.
134.29    Subd. 3. Report to legislature. The commissioner shall report to the members of
134.30the legislative committees having jurisdiction over human services issues by March 1,
134.312014, regarding the progress of this waiver or demonstration project.
134.32EFFECTIVE DATE.This section is effective the day following final enactment.

135.1    Sec. 23. Minnesota Statutes 2012, section 256K.45, is amended to read:
135.2256K.45 RUNAWAY AND HOMELESS YOUTH ACT.
135.3    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this
135.4section.
135.5(b) "Commissioner" means the commissioner of human services.
135.6(c) "Homeless youth" means a person 21 years of age or younger who is
135.7unaccompanied by a parent or guardian and is without shelter where appropriate care and
135.8supervision are available, whose parent or legal guardian is unable or unwilling to provide
135.9shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
135.10following are not fixed, regular, or adequate nighttime residences:
135.11(1) a supervised publicly or privately operated shelter designed to provide temporary
135.12living accommodations;
135.13(2) an institution or a publicly or privately operated shelter designed to provide
135.14temporary living accommodations;
135.15(3) transitional housing;
135.16(4) a temporary placement with a peer, friend, or family member that has not offered
135.17permanent residence, a residential lease, or temporary lodging for more than 30 days; or
135.18(5) a public or private place not designed for, nor ordinarily used as, a regular
135.19sleeping accommodation for human beings.
135.20Homeless youth does not include persons incarcerated or otherwise detained under
135.21federal or state law.
135.22(d) "Youth at risk of homelessness" means a person 21 years of age or younger
135.23whose status or circumstances indicate a significant danger of experiencing homelessness
135.24in the near future. Status or circumstances that indicate a significant danger may include:
135.25(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
135.26youth whose parents or primary caregivers are or were previously homeless; (4) youth
135.27who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
135.28with parents due to chemical or alcohol dependency, mental health disabilities, or other
135.29disabilities; and (6) runaways.
135.30(e) "Runaway" means an unmarried child under the age of 18 years who is absent
135.31from the home of a parent or guardian or other lawful placement without the consent of
135.32the parent, guardian, or lawful custodian.
135.33    Subd. 2. Homeless and runaway youth report. The commissioner shall develop a
135.34 report for homeless youth, youth at risk of homelessness, and runaways. The report shall
135.35include coordination of services as defined under subdivisions 3 to 5 prepare a biennial
135.36report, beginning in February 2015, which provides meaningful information to the
136.1legislative committees having jurisdiction over the issue of homeless youth, that includes,
136.2but is not limited to: (1) a list of the areas of the state with the greatest need for services
136.3and housing for homeless youth, and the level and nature of the needs identified; (2) details
136.4about grants made; (3) the distribution of funds throughout the state based on population
136.5need; (4) follow-up information, if available, on the status of homeless youth and whether
136.6they have stable housing two years after services are provided; and (5) any other outcomes
136.7for populations served to determine the effectiveness of the programs and use of funding.
136.8    Subd. 3. Street and community outreach and drop-in program. Youth drop-in
136.9centers must provide walk-in access to crisis intervention and ongoing supportive services
136.10including one-to-one case management services on a self-referral basis. Street and
136.11community outreach programs must locate, contact, and provide information, referrals,
136.12and services to homeless youth, youth at risk of homelessness, and runaways. Information,
136.13referrals, and services provided may include, but are not limited to:
136.14(1) family reunification services;
136.15(2) conflict resolution or mediation counseling;
136.16(3) assistance in obtaining temporary emergency shelter;
136.17(4) assistance in obtaining food, clothing, medical care, or mental health counseling;
136.18(5) counseling regarding violence, prostitution, substance abuse, sexually transmitted
136.19diseases, and pregnancy;
136.20(6) referrals to other agencies that provide support services to homeless youth,
136.21youth at risk of homelessness, and runaways;
136.22(7) assistance with education, employment, and independent living skills;
136.23(8) aftercare services;
136.24(9) specialized services for highly vulnerable runaways and homeless youth,
136.25including teen parents, emotionally disturbed and mentally ill youth, and sexually
136.26exploited youth; and
136.27(10) homelessness prevention.
136.28    Subd. 4. Emergency shelter program. (a) Emergency shelter programs must
136.29provide homeless youth and runaways with referral and walk-in access to emergency,
136.30short-term residential care. The program shall provide homeless youth and runaways with
136.31safe, dignified shelter, including private shower facilities, beds, and at least one meal each
136.32day; and shall assist a runaway and homeless youth with reunification with the family or
136.33legal guardian when required or appropriate.
136.34(b) The services provided at emergency shelters may include, but are not limited to:
136.35(1) family reunification services;
136.36(2) individual, family, and group counseling;
137.1(3) assistance obtaining clothing;
137.2(4) access to medical and dental care and mental health counseling;
137.3(5) education and employment services;
137.4(6) recreational activities;
137.5(7) advocacy and referral services;
137.6(8) independent living skills training;
137.7(9) aftercare and follow-up services;
137.8(10) transportation; and
137.9(11) homelessness prevention.
137.10    Subd. 5. Supportive housing and transitional living programs. Transitional
137.11living programs must help homeless youth and youth at risk of homelessness to find and
137.12maintain safe, dignified housing. The program may also provide rental assistance and
137.13related supportive services, or refer youth to other organizations or agencies that provide
137.14such services. Services provided may include, but are not limited to:
137.15(1) educational assessment and referrals to educational programs;
137.16(2) career planning, employment, work skill training, and independent living skills
137.17training;
137.18(3) job placement;
137.19(4) budgeting and money management;
137.20(5) assistance in securing housing appropriate to needs and income;
137.21(6) counseling regarding violence, prostitution, substance abuse, sexually transmitted
137.22diseases, and pregnancy;
137.23(7) referral for medical services or chemical dependency treatment;
137.24(8) parenting skills;
137.25(9) self-sufficiency support services or life skill training;
137.26(10) aftercare and follow-up services; and
137.27(11) homelessness prevention.
137.28    Subd. 6. Funding. Any Funds appropriated for this section may be expended on
137.29programs described under subdivisions 3 to 5, technical assistance, and capacity building.
137.30Up to four percent of funds appropriated may be used for the purpose of monitoring and
137.31evaluating runaway and homeless youth programs receiving funding under this section.
137.32Funding shall be directed to meet the greatest need, with a significant share of the funding
137.33focused on homeless youth providers in greater Minnesota to meet the greatest need
137.34on a statewide basis.

137.35    Sec. 24. Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:
138.1    Subdivision 1. Formula. The commissioner shall allocate state funds appropriated
138.2under this chapter to each county board on a calendar year basis in an amount determined
138.3according to the formula in paragraphs (a) to (e).
138.4(a) For calendar years 2011 and 2012, the commissioner shall allocate available
138.5funds to each county in proportion to that county's share in calendar year 2010.
138.6(b) For calendar year 2013 and each calendar year thereafter, the commissioner shall
138.7allocate available funds to each county as follows:
138.8(1) 75 percent must be distributed on the basis of the county share in calendar year
138.92012;
138.10(2) five percent must be distributed on the basis of the number of persons residing in
138.11the county as determined by the most recent data of the state demographer;
138.12(3) ten percent must be distributed on the basis of the number of vulnerable children
138.13that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in
138.14the county as determined by the most recent data of the commissioner; and
138.15(4) ten percent must be distributed on the basis of the number of vulnerable adults
138.16that are subjects of reports under section 626.557 in the county as determined by the most
138.17recent data of the commissioner.
138.18(c) For calendar year 2014, the commissioner shall allocate available funds to each
138.19county as follows:
138.20(1) 50 percent must be distributed on the basis of the county share in calendar year
138.212012;
138.22(2) Ten percent must be distributed on the basis of the number of persons residing in
138.23the county as determined by the most recent data of the state demographer;
138.24(3) 20 percent must be distributed on the basis of the number of vulnerable children
138.25that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
138.26county as determined by the most recent data of the commissioner; and
138.27(4) 20 percent must be distributed on the basis of the number of vulnerable adults
138.28that are subjects of reports under section 626.557 in the county as determined by the
138.29most recent data of the commissioner The commissioner is precluded from changing the
138.30formula under this subdivision or recommending a change to the legislature without
138.31public review and input.
138.32(d) For calendar year 2015, the commissioner shall allocate available funds to each
138.33county as follows:
138.34(1) 25 percent must be distributed on the basis of the county share in calendar year
138.352012;
139.1(2) 15 percent must be distributed on the basis of the number of persons residing in
139.2the county as determined by the most recent data of the state demographer;
139.3(3) 30 percent must be distributed on the basis of the number of vulnerable children
139.4that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
139.5county as determined by the most recent data of the commissioner; and
139.6(4) 30 percent must be distributed on the basis of the number of vulnerable adults
139.7that are subjects of reports under section 626.557 in the county as determined by the most
139.8recent data of the commissioner.
139.9(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall
139.10allocate available funds to each county as follows:
139.11(1) 20 percent must be distributed on the basis of the number of persons residing in
139.12the county as determined by the most recent data of the state demographer;
139.13(2) 40 percent must be distributed on the basis of the number of vulnerable children
139.14that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
139.15county as determined by the most recent data of the commissioner; and
139.16(3) 40 percent must be distributed on the basis of the number of vulnerable adults
139.17that are subjects of reports under section 626.557 in the county as determined by the most
139.18recent data of the commissioner.

139.19    Sec. 25. Minnesota Statutes 2012, section 257.85, subdivision 11, is amended to read:
139.20    Subd. 11. Financial considerations. (a) Payment of relative custody assistance
139.21under a relative custody assistance agreement is subject to the availability of state funds
139.22and payments may be reduced or suspended on order of the commissioner if insufficient
139.23funds are available Beginning July 1, 2013, relative custody assistance shall be a forecasted
139.24program, and the commissioner, with the approval of the commissioner of management
139.25and budget, may transfer unencumbered appropriation balances within fiscal years of
139.26each biennium to other forecasted programs of the Department of Human Services. The
139.27commissioner shall inform the chairs and ranking minority members of the senate Health
139.28and Human Services Finance Division and the house of representatives Health and Human
139.29Services Finance Committee quarterly about transfers made under this provision.
139.30(b) Upon receipt from a local agency of a claim for reimbursement, the commissioner
139.31shall reimburse the local agency in an amount equal to 100 percent of the relative custody
139.32assistance payments provided to relative custodians. The local agency may not seek and
139.33the commissioner shall not provide reimbursement for the administrative costs associated
139.34with performing the duties described in subdivision 4.
140.1(c) For the purposes of determining eligibility or payment amounts under MFIP,
140.2relative custody assistance payments shall be excluded in determining the family's
140.3available income.

140.4    Sec. 26. Minnesota Statutes 2012, section 259A.05, subdivision 5, is amended to read:
140.5    Subd. 5. Transfer of funds. The commissioner of human services may transfer
140.6funds into the adoption assistance account when a deficit in the adoption assistance
140.7program occurs Beginning July 1, 2013, adoption assistance shall be a forecasted program
140.8and the commissioner, with the approval of the commissioner of management and budget,
140.9may transfer unencumbered appropriation balances within fiscal years of each biennium to
140.10other forecasted programs of the Department of Human Services. The commissioner shall
140.11inform the chairs and ranking minority members of the senate Health and Human Services
140.12Finance Division and the house of representatives Health and Human Services Finance
140.13Committee quarterly about transfers made under this provision.

140.14    Sec. 27. Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:
140.15    Subd. 4. Reimbursement for special nonmedical expenses. (a) Reimbursement
140.16for special nonmedical expenses is available to children, except those eligible for adoption
140.17assistance based on being an at-risk child.
140.18(b) Reimbursements under this paragraph shall be made only after the adoptive
140.19parent documents that the requested service was denied by the local social service agency,
140.20community agencies, the local school district, the local public health department, the
140.21parent's insurance provider, or the child's program. The denial must be for an eligible
140.22service or qualified item under the program requirements of the applicable agency or
140.23organization.
140.24(c) Reimbursements must be previously authorized, adhere to the requirements and
140.25procedures prescribed by the commissioner, and be limited to:
140.26(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a
140.27documented disability that requires special instruction for and services by the child care
140.28provider. Child care reimbursements may be made if all available adult caregivers are
140.29employed, unemployed due to a disability as defined in section 259A.01, subdivision 14,
140.30 or attending educational or vocational training programs. Documentation from a qualified
140.31expert that is dated within the last 12 months must be provided to verify the disability. If a
140.32parent is attending an educational or vocational training program, child care reimbursement
140.33is limited to no more than the time necessary to complete the credit requirements for an
140.34associate or baccalaureate degree as determined by the educational institution. Child
141.1care reimbursement is not limited for an adoptive parent completing basic or remedial
141.2education programs needed to prepare for postsecondary education or employment;
141.3(2) respite care provided for the relief of the child's parent up to 504 hours of respite
141.4care annually;
141.5(3) camping up to 14 days per state fiscal year for a child to attend a special needs
141.6camp. The camp must be accredited by the American Camp Association as a special needs
141.7camp in order to be eligible for camp reimbursement;
141.8(4) postadoption counseling to promote the child's integration into the adoptive
141.9family that is provided by the placing agency during the first year following the date of the
141.10adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;
141.11(5) family counseling that is required to meet the child's special needs.
141.12Reimbursement is limited to the prorated portion of the counseling fees allotted to the
141.13family when the adoptive parent's health insurance or Medicaid pays for the child's
141.14counseling but does not cover counseling for the rest of the family members;
141.15(6) home modifications to accommodate the child's special needs upon which
141.16eligibility for adoption assistance was approved. Reimbursement is limited to once every
141.17five years per child;
141.18(7) vehicle modifications to accommodate the child's special needs upon which
141.19eligibility for adoption assistance was approved. Reimbursement is limited to once every
141.20five years per family; and
141.21(8) burial expenses up to $1,000, if the special needs, upon which eligibility for
141.22adoption assistance was approved, resulted in the death of the child.
141.23(d) The adoptive parent shall submit statements for expenses incurred between July
141.241 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days
141.25after the end of the fiscal year in order for reimbursement to occur.

141.26    Sec. 28. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:
141.27    Subd. 6. Delinquent child. (a) Except as otherwise provided in paragraphs (b)
141.28and (c), "delinquent child" means a child:
141.29(1) who has violated any state or local law, except as provided in section 260B.225,
141.30subdivision 1
, and except for juvenile offenders as described in subdivisions 16 to 18;
141.31(2) who has violated a federal law or a law of another state and whose case has been
141.32referred to the juvenile court if the violation would be an act of delinquency if committed
141.33in this state or a crime or offense if committed by an adult;
141.34(3) who has escaped from confinement to a state juvenile correctional facility after
141.35being committed to the custody of the commissioner of corrections; or
142.1(4) who has escaped from confinement to a local juvenile correctional facility after
142.2being committed to the facility by the court.
142.3(b) The term delinquent child does not include a child alleged to have committed
142.4murder in the first degree after becoming 16 years of age, but the term delinquent child
142.5does include a child alleged to have committed attempted murder in the first degree.
142.6(c) The term delinquent child does not include a child under the age of 16 years
142.7 alleged to have engaged in conduct which would, if committed by an adult, violate any
142.8federal, state, or local law relating to being hired, offering to be hired, or agreeing to be
142.9hired by another individual to engage in sexual penetration or sexual conduct.
142.10EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
142.11offenses committed on or after that date.

142.12    Sec. 29. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:
142.13    Subd. 16. Juvenile petty offender; juvenile petty offense. (a) "Juvenile petty
142.14offense" includes a juvenile alcohol offense, a juvenile controlled substance offense,
142.15a violation of section 609.685, or a violation of a local ordinance, which by its terms
142.16prohibits conduct by a child under the age of 18 years which would be lawful conduct if
142.17committed by an adult.
142.18(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also
142.19includes an offense that would be a misdemeanor if committed by an adult.
142.20(c) "Juvenile petty offense" does not include any of the following:
142.21(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242,
142.22609.324 , subdivision 2 or 3, 609.5632, 609.576, 609.66, 609.746, 609.748, 609.79,
142.23or 617.23;
142.24(2) a major traffic offense or an adult court traffic offense, as described in section
142.25260B.225 ;
142.26(3) a misdemeanor-level offense committed by a child whom the juvenile court
142.27previously has found to have committed a misdemeanor, gross misdemeanor, or felony
142.28offense; or
142.29(4) a misdemeanor-level offense committed by a child whom the juvenile court
142.30has found to have committed a misdemeanor-level juvenile petty offense on two or
142.31more prior occasions, unless the county attorney designates the child on the petition
142.32as a juvenile petty offender notwithstanding this prior record. As used in this clause,
142.33"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that
142.34would have been a juvenile petty offense if it had been committed on or after July 1, 1995.
143.1(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The
143.2term juvenile petty offender does not include a child under the age of 16 years alleged
143.3to have violated any law relating to being hired, offering to be hired, or agreeing to be
143.4hired by another individual to engage in sexual penetration or sexual conduct which, if
143.5committed by an adult, would be a misdemeanor.
143.6EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
143.7offenses committed on or after that date.

143.8    Sec. 30. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:
143.9    Subd. 6. Child in need of protection or services. "Child in need of protection or
143.10services" means a child who is in need of protection or services because the child:
143.11    (1) is abandoned or without parent, guardian, or custodian;
143.12    (2)(i) has been a victim of physical or sexual abuse as defined in section 626.556,
143.13subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in
143.14subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
143.15would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or
143.16child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment
143.17as defined in subdivision 15;
143.18    (3) is without necessary food, clothing, shelter, education, or other required care
143.19for the child's physical or mental health or morals because the child's parent, guardian,
143.20or custodian is unable or unwilling to provide that care;
143.21    (4) is without the special care made necessary by a physical, mental, or emotional
143.22condition because the child's parent, guardian, or custodian is unable or unwilling to
143.23provide that care;
143.24    (5) is medically neglected, which includes, but is not limited to, the withholding of
143.25medically indicated treatment from a disabled infant with a life-threatening condition. The
143.26term "withholding of medically indicated treatment" means the failure to respond to the
143.27infant's life-threatening conditions by providing treatment, including appropriate nutrition,
143.28hydration, and medication which, in the treating physician's or physicians' reasonable
143.29medical judgment, will be most likely to be effective in ameliorating or correcting all
143.30conditions, except that the term does not include the failure to provide treatment other
143.31than appropriate nutrition, hydration, or medication to an infant when, in the treating
143.32physician's or physicians' reasonable medical judgment:
143.33    (i) the infant is chronically and irreversibly comatose;
144.1    (ii) the provision of the treatment would merely prolong dying, not be effective in
144.2ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
144.3futile in terms of the survival of the infant; or
144.4    (iii) the provision of the treatment would be virtually futile in terms of the survival
144.5of the infant and the treatment itself under the circumstances would be inhumane;
144.6    (6) is one whose parent, guardian, or other custodian for good cause desires to be
144.7relieved of the child's care and custody, including a child who entered foster care under a
144.8voluntary placement agreement between the parent and the responsible social services
144.9agency under section 260C.227;
144.10    (7) has been placed for adoption or care in violation of law;
144.11    (8) is without proper parental care because of the emotional, mental, or physical
144.12disability, or state of immaturity of the child's parent, guardian, or other custodian;
144.13    (9) is one whose behavior, condition, or environment is such as to be injurious or
144.14dangerous to the child or others. An injurious or dangerous environment may include, but
144.15is not limited to, the exposure of a child to criminal activity in the child's home;
144.16    (10) is experiencing growth delays, which may be referred to as failure to thrive, that
144.17have been diagnosed by a physician and are due to parental neglect;
144.18    (11) has engaged in prostitution as defined in section 609.321, subdivision 9 is a
144.19sexually exploited youth;
144.20    (12) has committed a delinquent act or a juvenile petty offense before becoming
144.21ten years old;
144.22    (13) is a runaway;
144.23    (14) is a habitual truant;
144.24    (15) has been found incompetent to proceed or has been found not guilty by reason
144.25of mental illness or mental deficiency in connection with a delinquency proceeding, a
144.26certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
144.27proceeding involving a juvenile petty offense; or
144.28(16) has a parent whose parental rights to one or more other children were
144.29involuntarily terminated or whose custodial rights to another child have been involuntarily
144.30transferred to a relative and there is a case plan prepared by the responsible social services
144.31agency documenting a compelling reason why filing the termination of parental rights
144.32petition under section 260C.301, subdivision 3, is not in the best interests of the child; or.
144.33(17) is a sexually exploited youth.
144.34EFFECTIVE DATE.This section is effective August 1, 2014.

144.35    Sec. 31. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:
145.1    Subd. 31. Sexually exploited youth. "Sexually exploited youth" means an
145.2individual who:
145.3(1) is alleged to have engaged in conduct which would, if committed by an adult,
145.4violate any federal, state, or local law relating to being hired, offering to be hired, or
145.5agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;
145.6(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
145.7609.3451 , 609.3453, 609.352, 617.246, or 617.247;
145.8(3) is a victim of a crime described in United States Code, title 18, section 2260;
145.92421; 2422; 2423; 2425; 2425A; or 2256; or
145.10(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.
145.11EFFECTIVE DATE.This section is effective the day following final enactment.

145.12    Sec. 32. Minnesota Statutes 2012, section 518A.60, is amended to read:
145.13518A.60 COLLECTION; ARREARS ONLY.
145.14(a) Remedies available for the collection and enforcement of support in this chapter
145.15and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
145.16for whom support is owed are emancipated and the obligor owes past support or has an
145.17accumulated arrearage as of the date of the youngest child's emancipation. Child support
145.18arrearages under this section include arrearages for child support, medical support, child
145.19care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
145.20section 518A.41, subdivision 1, paragraph (h).
145.21(b) This section applies retroactively to any support arrearage that accrued on or
145.22before June 3, 1997, and to all arrearages accruing after June 3, 1997.
145.23(c) Past support or pregnancy and confinement expenses ordered for which the
145.24obligor has specific court ordered terms for repayment may not be enforced using
145.25drivers' and occupational or professional license suspension, credit bureau reporting, and
145.26additional income withholding under section 518A.53, subdivision 10, paragraph (a),
145.27unless the obligor fails to comply with the terms of the court order for repayment.
145.28(d) If an arrearage exists at the time a support order would otherwise terminate
145.29and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
145.30arrearage shall be repaid in an amount equal to the current support order until all arrears
145.31have been paid in full, absent a court order to the contrary.
145.32(e) If an arrearage exists according to a support order which fails to establish a
145.33monthly support obligation in a specific dollar amount, the public authority, if it provides
145.34child support services, or the obligee, may establish a payment agreement which shall
146.1equal what the obligor would pay for current support after application of section 518A.34,
146.2plus an additional 20 percent of the current support obligation, until all arrears have been
146.3paid in full. If the obligor fails to enter into or comply with a payment agreement, the
146.4public authority, if it provides child support services, or the obligee, may move the district
146.5court or child support magistrate, if section 484.702 applies, for an order establishing
146.6repayment terms.
146.7(f) If there is no longer a current support order because all of the children of the
146.8order are emancipated, the public authority may discontinue child support services and
146.9close its case under title IV-D of the Social Security Act if:
146.10(1) the arrearage is under $500; or
146.11(2) the arrearage is considered unenforceable by the public authority because there
146.12have been no collections for three years, and all administrative and legal remedies have
146.13been attempted or are determined by the public authority to be ineffective because the
146.14obligor is unable to pay, the obligor has no known income or assets, and there is no
146.15reasonable prospect that the obligor will be able to pay in the foreseeable future.
146.16    (g) At least 60 calendar days before the discontinuation of services under paragraph
146.17(f), the public authority must mail a written notice to the obligee and obligor at the
146.18obligee's and obligor's last known addresses that the public authority intends to close the
146.19child support enforcement case and explaining each party's rights. Seven calendar days
146.20after the first notice is mailed, the public authority must mail a second notice under this
146.21paragraph to the obligee.
146.22    (h) The case must be kept open if the obligee responds before case closure and
146.23provides information that could reasonably lead to collection of arrears. If the case is
146.24closed, the obligee may later request that the case be reopened by completing a new
146.25application for services, if there is a change in circumstances that could reasonably lead to
146.26the collection of arrears.

146.27    Sec. 33. Laws 1998, chapter 407, article 6, section 116, is amended to read:
146.28    Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
146.29    The commissioner of human services shall request and receive approval from the
146.30legislature before adjusting the payment to discontinue the state subsidy to retailers for
146.31electronic benefit transfer transaction costs Supplemental Nutrition Assistance Program
146.32transactions when the federal government discontinues the federal subsidy to the same.

146.33    Sec. 34. DIRECTION TO COMMISSIONERS; INCOME AND ASSET
146.34EXCLUSION.
147.1(a) The commissioner of human services shall not count conditional cash transfers
147.2made to families participating in a family independence demonstration as income or
147.3assets for purposes of determining or redetermining eligibility for child care assistance
147.4programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota
147.5Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I;
147.6the Minnesota family investment program, work benefit program, or diversionary work
147.7program under Minnesota Statutes, chapter 256J, during the duration of the demonstration.
147.8(b) The commissioner of human services shall not count conditional cash transfers
147.9made to families participating in a family independence demonstration as income or assets
147.10for purposes of determining or redetermining eligibility for medical assistance under
147.11Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter
147.12256L, except that for enrollees subject to a modified adjusted gross income calculation to
147.13determine eligibility, the conditional cash transfer payments shall be counted as income if
147.14they are included on the enrollee's federal tax return as income, or if the payments can be
147.15taken into account in the month of receipt as a lump sum payment.
147.16(c) The commissioner of the Minnesota Housing Finance Agency shall not count
147.17conditional cash transfers made to families participating in a family independence
147.18demonstration as income or assets for purposes of determining or redetermining eligibility
147.19for housing assistance programs under Minnesota Statutes, section 462A.201, during
147.20the duration of the demonstration.
147.21(d) For the purposes of this section:
147.22(1) "conditional cash transfer" means a payment made to a participant in a family
147.23independence demonstration by a sponsoring organization to incent, support, or facilitate
147.24participation; and
147.25(2) "family independence demonstration" means an initiative sponsored or
147.26cosponsored by a governmental or nongovernmental organization, the goal of which is
147.27to facilitate individualized goal-setting and peer support for cohorts of no more than 12
147.28families each toward the development of financial and nonfinancial assets that enable the
147.29participating families to achieve financial independence.
147.30(e) The citizens league shall provide a report to the legislative committees having
147.31jurisdiction over human services issues by July 1, 2016, informing the legislature on the
147.32progress and outcomes of the demonstration under this section.

147.33    Sec. 35. UNIFORM BENEFITS FOR CHILDREN IN FOSTER CARE,
147.34PERMANENT RELATIVE CARE, AND ADOPTION ASSISTANCE.
148.1Using available resources, the commissioner of human services, in consultation with
148.2representatives of the judicial branch, county human services, and tribes participating in
148.3the American Indian child welfare initiative under Minnesota Statutes, section 256.01,
148.4subdivision 14b, together with other appropriate stakeholders, which might include
148.5communities of color; youth in foster care or those who have aged out of care; kinship
148.6caregivers, foster parents, adoptive parents, foster and adoptive agencies; guardians ad
148.7litem; and experts in permanency, adoption, child development, and the effects of trauma,
148.8and the use of medical assistance home and community-based waivers for persons with
148.9disabilities, shall analyze benefits and services available to children in family foster care
148.10under Minnesota Rules, parts 9560.0650 to 9560.0656, relative custody assistance under
148.11Minnesota Statutes, section 257.85, and adoption assistance under Minnesota Statutes,
148.12chapter 259A. The goal of the analysis is to establish a uniform set of benefits available
148.13to children in foster care, permanent relative care, and adoption so that the benefits
148.14can follow the child rather than being tied to the child's legal status. Included in the
148.15analysis is possible accessing of federal title IV-E through guardianship assistance. The
148.16commissioner shall report findings and conclusions to the chairs and ranking minority
148.17members of the legislative committees and divisions with jurisdiction over health and
148.18human services policy and finance by January 15, 2014, and include draft legislation
148.19establishing uniform benefits.

148.20    Sec. 36. REPEALER.
148.21(a) Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed effective
148.22July 1, 2014.
148.23(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following
148.24final enactment.

148.25ARTICLE 4
148.26STRENGTHENING CHEMICAL AND MENTAL HEALTH SERVICES

148.27    Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:
148.28    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the brain
148.29or a clinically significant disorder of thought, mood, perception, orientation, memory, or
148.30behavior that is detailed in a diagnostic codes list published by the commissioner, and that
148.31seriously limits a person's capacity to function in primary aspects of daily living such as
148.32personal relations, living arrangements, work, and recreation.
148.33    (b) An "adult with acute mental illness" means an adult who has a mental illness that
148.34is serious enough to require prompt intervention.
149.1    (c) For purposes of case management and community support services, a "person
149.2with serious and persistent mental illness" means an adult who has a mental illness and
149.3meets at least one of the following criteria:
149.4    (1) the adult has undergone two or more episodes of inpatient care for a mental
149.5illness within the preceding 24 months;
149.6    (2) the adult has experienced a continuous psychiatric hospitalization or residential
149.7treatment exceeding six months' duration within the preceding 12 months;
149.8    (3) the adult has been treated by a crisis team two or more times within the preceding
149.924 months;
149.10    (4) the adult:
149.11    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression,
149.12schizoaffective disorder, or borderline personality disorder;
149.13    (ii) indicates a significant impairment in functioning; and
149.14    (iii) has a written opinion from a mental health professional, in the last three years,
149.15stating that the adult is reasonably likely to have future episodes requiring inpatient or
149.16residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
149.17management or community support services are provided;
149.18    (5) the adult has, in the last three years, been committed by a court as a person who is
149.19mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or
149.20    (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period
149.21has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and
149.22(ii) has a written opinion from a mental health professional, in the last three years, stating
149.23that the adult is reasonably likely to have future episodes requiring inpatient or residential
149.24treatment, of a frequency described in clause (1) or (2), unless ongoing case management
149.25or community support services are provided; or
149.26    (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is
149.27age 21 or younger.

149.28    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
149.29    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
149.30the exception of the placement of a Minnesota specialty treatment facility as defined in
149.31paragraph (c), must be developed under the direction of the county board, or multiple
149.32county boards acting jointly, as the local mental health authority. The planning process
149.33for each pilot shall include, but not be limited to, mental health consumers, families,
149.34advocates, local mental health advisory councils, local and state providers, representatives
149.35of state and local public employee bargaining units, and the department of human services.
150.1As part of the planning process, the county board or boards shall designate a managing
150.2entity responsible for receipt of funds and management of the pilot project.
150.3(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
150.4request for proposal for regions in which a need has been identified for services.
150.5(c) For purposes of this section, Minnesota specialty treatment facility is defined as
150.6an intensive rehabilitative mental health service under section 256B.0622, subdivision 2,
150.7paragraph (b).

150.8    Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
150.9    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
150.10commissioner shall facilitate integration of funds or other resources as needed and
150.11requested by each project. These resources may include:
150.12(1) residential services funds administered under Minnesota Rules, parts 9535.2000
150.13to 9535.3000, in an amount to be determined by mutual agreement between the project's
150.14managing entity and the commissioner of human services after an examination of the
150.15county's historical utilization of facilities located both within and outside of the county
150.16and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
150.17(2) community support services funds administered under Minnesota Rules, parts
150.189535.1700 to 9535.1760;
150.19(3) other mental health special project funds;
150.20(4) medical assistance, general assistance medical care, MinnesotaCare and group
150.21residential housing if requested by the project's managing entity, and if the commissioner
150.22determines this would be consistent with the state's overall health care reform efforts; and
150.23(5) regional treatment center resources consistent with section 246.0136, subdivision
150.241
.; and
150.25(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
150.26participate in mental health specialty treatment services, awarded to providers through
150.27a request for proposal process.
150.28(b) The commissioner shall consider the following criteria in awarding start-up and
150.29implementation grants for the pilot projects:
150.30(1) the ability of the proposed projects to accomplish the objectives described in
150.31subdivision 2;
150.32(2) the size of the target population to be served; and
150.33(3) geographical distribution.
151.1(c) The commissioner shall review overall status of the projects initiatives at least
151.2every two years and recommend any legislative changes needed by January 15 of each
151.3odd-numbered year.
151.4(d) The commissioner may waive administrative rule requirements which are
151.5incompatible with the implementation of the pilot project.
151.6(e) The commissioner may exempt the participating counties from fiscal sanctions
151.7for noncompliance with requirements in laws and rules which are incompatible with the
151.8implementation of the pilot project.
151.9(f) The commissioner may award grants to an entity designated by a county board or
151.10group of county boards to pay for start-up and implementation costs of the pilot project.

151.11    Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
151.12    Subd. 2. General provisions. (a) In the design and implementation of reforms to
151.13the mental health system, the commissioner shall:
151.14    (1) consult with consumers, families, counties, tribes, advocates, providers, and
151.15other stakeholders;
151.16    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
151.17January 15, 2008, recommendations for legislation to update the role of counties and to
151.18clarify the case management roles, functions, and decision-making authority of health
151.19plans and counties, and to clarify county retention of the responsibility for the delivery of
151.20social services as required under subdivision 3, paragraph (a);
151.21    (3) withhold implementation of any recommended changes in case management
151.22roles, functions, and decision-making authority until after the release of the report due
151.23January 15, 2008;
151.24    (4) ensure continuity of care for persons affected by these reforms including
151.25ensuring client choice of provider by requiring broad provider networks and developing
151.26mechanisms to facilitate a smooth transition of service responsibilities;
151.27    (5) provide accountability for the efficient and effective use of public and private
151.28resources in achieving positive outcomes for consumers;
151.29    (6) ensure client access to applicable protections and appeals; and
151.30    (7) make budget transfers necessary to implement the reallocation of services and
151.31client responsibilities between counties and health care programs that do not increase the
151.32state and county costs and efficiently allocate state funds.
151.33    (b) When making transfers under paragraph (a) necessary to implement movement
151.34of responsibility for clients and services between counties and health care programs,
151.35the commissioner, in consultation with counties, shall ensure that any transfer of state
152.1grants to health care programs, including the value of case management transfer grants
152.2under section 256B.0625, subdivision 20, does not exceed the value of the services being
152.3transferred for the latest 12-month period for which data is available. The commissioner
152.4may make quarterly adjustments based on the availability of additional data during the
152.5first four quarters after the transfers first occur. If case management transfer grants under
152.6section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
152.7to repeal, exceeds the value of the services being transferred, the difference becomes an
152.8ongoing part of each county's adult and children's mental health grants under sections
152.9245.4661 , 245.4889, and 256E.12.
152.10    (c) This appropriation is not authorized to be expended after December 31, 2010,
152.11unless approved by the legislature.

152.12    Sec. 5. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:
152.13    Subd. 8. Transition services. The county board may continue to provide mental
152.14health services as defined in sections 245.487 to 245.4889 to persons over 18 years of
152.15age, but under 21 years of age, if the person was receiving case management or family
152.16community support services prior to age 18, and if one of the following conditions is met:
152.17(1) the person is receiving special education services through the local school
152.18district; or
152.19(2) it is in the best interest of the person to continue services defined in sections
152.20245.487 to 245.4889; or
152.21(3) the person is requesting services and the services are medically necessary.

152.22    Sec. 6. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:
152.23    Subdivision 1. Availability of case management services. (a) The county board
152.24shall provide case management services for each child with severe emotional disturbance
152.25who is a resident of the county and the child's family who request or consent to the services.
152.26Case management services may be continued must be offered to be provided for a child with
152.27a serious emotional disturbance who is over the age of 18 consistent with section 245.4875,
152.28subdivision 8
, or the child's legal representative, provided the child's service needs can be
152.29met within the children's service system. Before discontinuing case management services
152.30under this subdivision for children between the ages of 17 and 21, a transition plan
152.31must be developed. The transition plan must be developed with the child and, with the
152.32consent of a child age 18 or over, the child's parent, guardian, or legal representative. The
152.33transition plan should include plans for health insurance, housing, education, employment,
153.1and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case
153.2manager must meet the requirements in section 245.4871, subdivision 4.
153.3(b) Except as permitted by law and the commissioner under demonstration projects,
153.4case management services provided to children with severe emotional disturbance eligible
153.5for medical assistance must be billed to the medical assistance program under sections
153.6256B.02, subdivision 8 , and 256B.0625.
153.7(c) Case management services are eligible for reimbursement under the medical
153.8assistance program. Costs of mentoring, supervision, and continuing education may be
153.9included in the reimbursement rate methodology used for case management services under
153.10the medical assistance program.

153.11    Sec. 7. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
153.12    Subd. 8. State-operated services account. (a) The state-operated services account is
153.13established in the special revenue fund. Revenue generated by new state-operated services
153.14listed under this section established after July 1, 2010, that are not enterprise activities must
153.15be deposited into the state-operated services account, unless otherwise specified in law:
153.16(1) intensive residential treatment services;
153.17(2) foster care services; and
153.18(3) psychiatric extensive recovery treatment services.
153.19(b) Funds deposited in the state-operated services account are available to the
153.20commissioner of human services for the purposes of:
153.21(1) providing services needed to transition individuals from institutional settings
153.22within state-operated services to the community when those services have no other
153.23adequate funding source;
153.24(2) grants to providers participating in mental health specialty treatment services
153.25under section 245.4661; and
153.26(3) to fund the operation of the Intensive Residential Treatment Service program in
153.27Willmar.

153.28    Sec. 8. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
153.29to read:
153.30    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
153.31to the account in subdivision 8 for noncovered allowable costs of a provider certified and
153.32licensed under section 256B.0622 and operating under section 246.014.

153.33    Sec. 9. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:
154.1    Subdivision 1. Administrative requirements. (a) When a person is committed,
154.2the court shall issue a warrant or an order committing the patient to the custody of the
154.3head of the treatment facility. The warrant or order shall state that the patient meets the
154.4statutory criteria for civil commitment.
154.5(b) The commissioner shall prioritize patients being admitted from jail or a
154.6correctional institution who are:
154.7(1) ordered confined in a state hospital for an examination under Minnesota Rules of
154.8Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
154.9(2) under civil commitment for competency treatment and continuing supervision
154.10under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
154.11(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
154.12Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
154.13detained in a state hospital or other facility pending completion of the civil commitment
154.14proceedings; or
154.15(4) committed under this chapter to the commissioner after dismissal of the patient's
154.16criminal charges.
154.17Patients described in this paragraph must be admitted to a service operated by the
154.18commissioner within 48 hours. The commitment must be ordered by the court as provided
154.19in section 253B.09, subdivision 1, paragraph (c).
154.20(c) Upon the arrival of a patient at the designated treatment facility, the head of the
154.21facility shall retain the duplicate of the warrant and endorse receipt upon the original
154.22warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment
154.23must be filed in the court of commitment. After arrival, the patient shall be under the
154.24control and custody of the head of the treatment facility.
154.25(d) Copies of the petition for commitment, the court's findings of fact and
154.26conclusions of law, the court order committing the patient, the report of the examiners,
154.27and the prepetition report shall be provided promptly to the treatment facility.

154.28    Sec. 10. Minnesota Statutes 2012, section 254B.13, is amended to read:
154.29254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
154.30    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
154.31approve and implement navigator pilot projects developed under the planning process
154.32required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
154.33enhance coordination of the delivery of chemical health services required under section
154.34254B.03 .
155.1    Subd. 2. Program design and implementation. (a) The commissioner and
155.2counties participating in the navigator pilot projects shall continue to work in partnership
155.3to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
155.479, article 7, section 26.
155.5(b) The commissioner and counties participating in the navigator pilot projects shall
155.6complete the planning phase by June 30, 2010, and, if approved by the commissioner for
155.7implementation, enter into agreements governing the operation of the navigator pilot
155.8projects with implementation scheduled no earlier than July 1, 2010.
155.9    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
155.10participation in a navigator pilot program, an individual must:
155.11(1) be a resident of a county with an approved navigator program;
155.12(2) be eligible for consolidated chemical dependency treatment fund services;
155.13(3) be a voluntary participant in the navigator program;
155.14(4) satisfy one of the following items:
155.15(i) have at least one severity rating of three or above in dimension four, five, or six in
155.16a comprehensive assessment under Minnesota Rules, part 9530.6422; or
155.17(ii) have at least one severity rating of two or above in dimension four, five, or six in
155.18a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
155.19participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
155.209530.6505, or be within 60 days following discharge after participation in a Rule 31
155.21treatment program; and
155.22(5) have had at least two treatment episodes in the past two years, not limited
155.23to episodes reimbursed by the consolidated chemical dependency treatment funds. An
155.24admission to an emergency room, a detoxification program, or a hospital may be substituted
155.25for one treatment episode if it resulted from the individual's substance use disorder.
155.26(b) New eligibility criteria may be added as mutually agreed upon by the
155.27commissioner and participating navigator programs.
155.28    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
155.29projects under this section and report the results of the evaluation to the chairs and
155.30ranking minority members of the legislative committees with jurisdiction over chemical
155.31health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
155.32based on outcome evaluation criteria negotiated with the navigator pilot projects prior
155.33to implementation.
155.34    Subd. 4. Notice of navigator pilot project discontinuation. Each county's
155.35participation in the navigator pilot project may be discontinued for any reason by the county
155.36or the commissioner of human services after 30 days' written notice to the other party.
156.1Any unspent funds held for the exiting county's pro rata share in the special revenue fund
156.2under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
156.3chemical dependency treatment fund following discontinuation of the pilot project.
156.4    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
156.5this chapter, the commissioner may authorize navigator pilot projects to use chemical
156.6dependency treatment funds to pay for nontreatment navigator pilot services:
156.7(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
156.8(a); and
156.9(2) by vendors in addition to those authorized under section 254B.05 when not
156.10providing chemical dependency treatment services.
156.11(b) For purposes of this section, "nontreatment navigator pilot services" include
156.12navigator services, peer support, family engagement and support, housing support, rent
156.13subsidies, supported employment, and independent living skills.
156.14(c) State expenditures for chemical dependency services and nontreatment navigator
156.15pilot services provided by or through the navigator pilot projects must not be greater than
156.16the chemical dependency treatment fund expected share of forecasted expenditures in the
156.17absence of the navigator pilot projects. The commissioner may restructure the schedule of
156.18payments between the state and participating counties under the local agency share and
156.19division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
156.20facilitate the operation of the navigator pilot projects.
156.21(d) To the extent that state fiscal year expenditures within a pilot project are less
156.22than the expected share of forecasted expenditures in the absence of the pilot projects,
156.23the commissioner shall deposit the unexpended funds in a separate account within the
156.24consolidated chemical dependency treatment fund, and make these funds available for
156.25expenditure by the pilot projects the following year. To the extent that treatment and
156.26nontreatment pilot services expenditures within the pilot project exceed the amount
156.27expected in the absence of the pilot projects, the pilot project county or counties are
156.28responsible for the portion of nontreatment pilot services expenditures in excess of the
156.29otherwise expected share of forecasted expenditures.
156.30(e) (d) The commissioner may waive administrative rule requirements that are
156.31incompatible with the implementation of the navigator pilot project, except that any
156.32chemical dependency treatment funded under this section must continue to be provided
156.33by a licensed treatment provider.
156.34(f) (e) The commissioner shall not approve or enter into any agreement related to
156.35navigator pilot projects authorized under this section that puts current or future federal
156.36funding at risk.
157.1(f) The commissioner shall provide participating navigator pilot projects with
157.2transactional data, reports, provider data, and other data generated by county activity to
157.3assess and measure outcomes. This information must be transmitted or made available in
157.4an acceptable form to participating navigator pilot projects at least once every six months
157.5or within a reasonable time following the commissioner's receipt of information from the
157.6counties needed to comply with this paragraph.
157.7    Subd. 6. Duties of county board. The county board, or other county entity that
157.8is approved to administer a navigator pilot project, shall:
157.9(1) administer the navigator pilot project in a manner consistent with the objectives
157.10described in subdivision 2 and the planning process in subdivision 5;
157.11(2) ensure that no one is denied chemical dependency treatment services for which
157.12they would otherwise be eligible under section 254A.03, subdivision 3; and
157.13(3) provide the commissioner with timely and pertinent information as negotiated in
157.14agreements governing operation of the navigator pilot projects.
157.15    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
157.16program under subdivision 2a is excluded from mandatory enrollment in managed care
157.17until these services are included in the health plan's benefit set.
157.18    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
157.19projects implemented pursuant to subdivision 1 are authorized to continue operation after
157.20July 1, 2013, under existing agreements governing operation of the pilot projects.
157.21EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
157.22August 1, 2013. Subdivision 7 is effective July 1, 2013.

157.23    Sec. 11. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL
157.24HEALTH CARE.
157.25    Subdivision 1. Authorization for continuum of care pilot projects. The
157.26commissioner shall establish chemical dependency continuum of care pilot projects to
157.27begin implementing the measures developed with stakeholder input and identified in the
157.28report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot
157.29projects are intended to improve the effectiveness and efficiency of the service continuum
157.30for chemically dependent individuals in Minnesota while reducing duplication of efforts
157.31and promoting scientifically supported practices.
157.32    Subd. 2. Program implementation. (a) The commissioner, in coordination with
157.33representatives of the Minnesota Association of County Social Service Administrators
157.34and the Minnesota Inter-County Association, shall develop a process for identifying and
157.35selecting interested counties and providers for participation in the continuum of care pilot
158.1projects. There will be three pilot projects; one representing the northern region, one for
158.2the metro region, and one for the southern region. The selection process of counties and
158.3providers must include consideration of population size, geographic distribution, cultural
158.4and racial demographics, and provider accessibility. The commissioner shall identify
158.5counties and providers that are selected for participation in the continuum of care pilot
158.6projects no later than September 30, 2013.
158.7(b) The commissioner and entities participating in the continuum of care pilot
158.8projects shall enter into agreements governing the operation of the continuum of care pilot
158.9projects. The agreements shall identify pilot project outcomes and include timelines for
158.10implementation and beginning operation of the pilot projects.
158.11(c) Entities that are currently participating in the navigator pilot project are
158.12eligible to participate in the continuum of care pilot project subsequent to or instead of
158.13participating in the navigator pilot project.
158.14(d) The commissioner may waive administrative rule requirements that are
158.15incompatible with implementation of the continuum of care pilot projects.
158.16(e) Notwithstanding section 254A.19, the commissioner may designate noncounty
158.17entities to complete chemical use assessments and placement authorizations required
158.18under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section
158.19254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the
158.20discretion of the commissioner.
158.21    Subd. 3. Program design. (a) The operation of the pilot projects shall include:
158.22(1) new services that are responsive to the chronic nature of substance use disorder;
158.23(2) telehealth services, when appropriate to address barriers to services;
158.24(3) services that assure integration with the mental health delivery system when
158.25appropriate;
158.26(4) services that address the needs of diverse populations; and
158.27(5) an assessment and access process that permits clients to present directly to a
158.28service provider for a substance use disorder assessment and authorization of services.
158.29(b) Prior to implementation of the continuum of care pilot projects, a utilization
158.30review process must be developed and agreed to by the commissioner, participating
158.31counties, and providers. The utilization review process shall be described in the
158.32agreements governing operation of the continuum of care pilot projects.
158.33    Subd. 4. Notice of project discontinuation. Each entity's participation in the
158.34continuum of care pilot project may be discontinued for any reason by the county or the
158.35commissioner after 30 days' written notice to the entity.
159.1    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
159.2chapter, the commissioner may authorize chemical dependency treatment funds to pay for
159.3nontreatment services arranged by continuum of care pilot projects. Individuals who are
159.4currently accessing Rule 31 treatment services are eligible for concurrent participation in
159.5the continuum of care pilot projects.
159.6(b) County expenditures for continuum of care pilot project services shall not
159.7be greater than their expected share of forecasted expenditures in the absence of the
159.8continuum of care pilot projects.
159.9EFFECTIVE DATE.This section is effective August 1, 2013.

159.10    Sec. 12. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER
159.11SPECIALIST.
159.12    Subdivision 1. Scope. Medical assistance covers mental health certified family peer
159.13specialists services, as established in subdivision 2, subject to federal approval, if provided
159.14to recipients who have an emotional disturbance or severe emotional disturbance under
159.15chapter 245, and are provided by a certified family peer specialist who has completed the
159.16training under subdivision 5. A family peer specialist cannot provide services to the
159.17peer specialist's family.
159.18    Subd. 2. Establishment. The commissioner of human services shall establish a
159.19certified family peer specialists program model which:
159.20(1) provides nonclinical family peer support counseling, building on the strengths
159.21of families and helping them achieve desired outcomes;
159.22(2) collaborates with others providing care or support to the family;
159.23(3) provides nonadversarial advocacy;
159.24(4) promotes the individual family culture in the treatment milieu;
159.25(5) links parents to other parents in the community;
159.26(6) offers support and encouragement;
159.27(7) assists parents in developing coping mechanisms and problem-solving skills;
159.28(8) promotes resiliency, self-advocacy, development of natural supports, and
159.29maintenance of skills learned in other support services;
159.30(9) establishes and provides peer led parent support groups; and
159.31(10) increases the child's ability to function better within the child's home, school,
159.32and community by educating parents on community resources, assisting with problem
159.33solving, and educating parents on mental illnesses.
160.1    Subd. 3. Eligibility. Family peer support services may be located in inpatient
160.2hospitalization, partial hospitalization, residential treatment, treatment foster care, day
160.3treatment, children's therapeutic services and supports, or crisis services.
160.4    Subd. 4. Peer support specialist program providers. The commissioner shall
160.5develop a process to certify family peer support specialist programs, in accordance with
160.6the federal guidelines, in order for the program to bill for reimbursable services. Family
160.7peer support programs must operate within an existing mental health community provider
160.8or center.
160.9    Subd. 5. Certified family peer specialist training and certification. The
160.10commissioner shall develop a training and certification process for certified family peer
160.11specialists who must be at least 21 years of age and have a high school diploma or its
160.12equivalent. The candidates must have raised or are currently raising a child with a mental
160.13illness, have had experience navigating the children's mental health system, and must
160.14demonstrate leadership and advocacy skills and a strong dedication to family-driven and
160.15family-focused services. The training curriculum must teach participating family peer
160.16specialists specific skills relevant to providing peer support to other parents. In addition
160.17to initial training and certification, the commissioner shall develop ongoing continuing
160.18educational workshops on pertinent issues related to family peer support counseling.

160.19    Sec. 13. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
160.20    Subd. 2. Definitions. For purposes of this section, the following terms have the
160.21meanings given them.
160.22(a) "Adult rehabilitative mental health services" means mental health services
160.23which are rehabilitative and enable the recipient to develop and enhance psychiatric
160.24stability, social competencies, personal and emotional adjustment, and independent living,
160.25parenting skills, and community skills, when these abilities are impaired by the symptoms
160.26of mental illness. Adult rehabilitative mental health services are also appropriate when
160.27provided to enable a recipient to retain stability and functioning, if the recipient would
160.28be at risk of significant functional decompensation or more restrictive service settings
160.29without these services.
160.30(1) Adult rehabilitative mental health services instruct, assist, and support the
160.31recipient in areas such as: interpersonal communication skills, community resource
160.32utilization and integration skills, crisis assistance, relapse prevention skills, health care
160.33directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
160.34and nutrition skills, transportation skills, medication education and monitoring, mental
161.1illness symptom management skills, household management skills, employment-related
161.2skills, parenting skills, and transition to community living services.
161.3(2) These services shall be provided to the recipient on a one-to-one basis in the
161.4recipient's home or another community setting or in groups.
161.5(b) "Medication education services" means services provided individually or in
161.6groups which focus on educating the recipient about mental illness and symptoms; the role
161.7and effects of medications in treating symptoms of mental illness; and the side effects of
161.8medications. Medication education is coordinated with medication management services
161.9and does not duplicate it. Medication education services are provided by physicians,
161.10pharmacists, physician's assistants, or registered nurses.
161.11(c) "Transition to community living services" means services which maintain
161.12continuity of contact between the rehabilitation services provider and the recipient and
161.13which facilitate discharge from a hospital, residential treatment program under Minnesota
161.14Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
161.15living services are not intended to provide other areas of adult rehabilitative mental health
161.16services.

161.17    Sec. 14. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to
161.18read:
161.19    Subd. 48. Psychiatric consultation to primary care practitioners. Effective
161.20January 1, 2006, Medical assistance covers consultation provided by a psychiatrist,
161.21psychologist, or an advanced practice registered nurse certified in psychiatric mental
161.22health via telephone, e-mail, facsimile, or other means of communication to primary care
161.23practitioners, including pediatricians. The need for consultation and the receipt of the
161.24consultation must be documented in the patient record maintained by the primary care
161.25practitioner. If the patient consents, and subject to federal limitations and data privacy
161.26provisions, the consultation may be provided without the patient present.

161.27    Sec. 15. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to
161.28read:
161.29    Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
161.30community-based service coordination that is performed through a hospital emergency
161.31department as an eligible procedure under a state healthcare program for a frequent user.
161.32A frequent user is defined as an individual who has frequented the hospital emergency
161.33department for services three or more times in the previous four consecutive months.
161.34In-reach community-based service coordination includes navigating services to address a
162.1client's mental health, chemical health, social, economic, and housing needs, or any other
162.2activity targeted at reducing the incidence of emergency room and other nonmedically
162.3necessary health care utilization.
162.4(2) Medical assistance covers in-reach community-based service coordination that
162.5is performed through a hospital emergency department or inpatient psychiatric unit
162.6for a child or young adult up to age 21 with a serious emotional disturbance who has
162.7frequented the hospital emergency room two or more times in the previous consecutive
162.8three months or been admitted to an inpatient psychiatric unit two or more times in the
162.9previous consecutive four months, or is being discharged to a shelter.
162.10    (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
162.11days posthospital discharge based upon the specific identified emergency department visit
162.12or inpatient admitting event. In-reach community-based service coordination shall seek to
162.13connect frequent users with existing covered services available to them, including, but not
162.14limited to, targeted case management, waiver case management, or care coordination in a
162.15health care home. For children and young adults with a serious emotional disturbance,
162.16in-reach community-based service coordination includes navigating and arranging for
162.17community-based services prior to discharge to address a client's mental health, chemical
162.18health, social, educational, family support and housing needs, or any other activity targeted
162.19at reducing multiple incidents of emergency room use, inpatient readmissions, and other
162.20nonmedically necessary health care utilization. In-reach services shall seek to connect
162.21them with existing covered services, including targeted case management, waiver case
162.22management, care coordination in a health care home, children's therapeutic services and
162.23supports, crisis services, and respite care. Eligible in-reach service coordinators must hold
162.24a minimum of a bachelor's degree in social work, public health, corrections, or a related
162.25field. The commissioner shall submit any necessary application for waivers to the Centers
162.26for Medicare and Medicaid Services to implement this subdivision.
162.27    (c)(1) For the purposes of this subdivision, "in-reach community-based service
162.28coordination" means the practice of a community-based worker with training, knowledge,
162.29skills, and ability to access a continuum of services, including housing, transportation,
162.30chemical and mental health treatment, employment, education, and peer support services,
162.31by working with an organization's staff to transition an individual back into the individual's
162.32living environment. In-reach community-based service coordination includes working
162.33with the individual during their discharge and for up to a defined amount of time in the
162.34individual's living environment, reducing the individual's need for readmittance.
162.35    (2) Hospitals utilizing in-reach service coordinators shall report annually to the
162.36commissioner on the number of adults, children, and adolescents served; the postdischarge
163.1services which they accessed; and emergency department/psychiatric hospitalization
163.2readmissions. The commissioner shall ensure that services and payments provided under
163.3in-reach care coordination do not duplicate services or payments provided under section
163.4256B.0753, 256B.0755, or 256B.0625, subdivision 20.

163.5    Sec. 16. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
163.6subdivision to read:
163.7    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
163.8federal approval, whichever is later, medical assistance covers family psychoeducation
163.9services provided to a child up to age 21 with a diagnosed mental health condition when
163.10identified in the child's individual treatment plan and provided by a licensed mental health
163.11professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
163.12clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
163.13has determined it medically necessary to involve family members in the child's care. For
163.14the purposes of this subdivision, "family psychoeducation services" means information
163.15or demonstration provided to an individual or family as part of an individual, family,
163.16multifamily group, or peer group session to explain, educate, and support the child and
163.17family in understanding a child's symptoms of mental illness, the impact on the child's
163.18development, and needed components of treatment and skill development so that the
163.19individual, family, or group can help the child to prevent relapse, prevent the acquisition
163.20of comorbid disorders, and to achieve optimal mental health and long-term resilience.

163.21    Sec. 17. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
163.22subdivision to read:
163.23    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
163.24federal approval, whichever is later, medical assistance covers clinical care consultation
163.25for a person up to age 21 who is diagnosed with a complex mental health condition or a
163.26mental health condition that co-occurs with other complex and chronic conditions, when
163.27described in the person's individual treatment plan and provided by a licensed mental
163.28health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
163.29clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the
163.30purposes of this subdivision, "clinical care consultation" means communication from a
163.31treating mental health professional to other providers or educators not under the clinical
163.32supervision of the treating mental health professional who are working with the same client
163.33to inform, inquire, and instruct regarding the client's symptoms; strategies for effective
164.1engagement, care, and intervention needs; treatment expectations across service settings;
164.2and to direct and coordinate clinical service components provided to the client and family.

164.3    Sec. 18. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
164.4    Subdivision 1. Definitions. For purposes of this section, the following terms have
164.5the meanings given them.
164.6(a) "Children's therapeutic services and supports" means the flexible package of
164.7mental health services for children who require varying therapeutic and rehabilitative
164.8levels of intervention. The services are time-limited interventions that are delivered using
164.9various treatment modalities and combinations of services designed to reach treatment
164.10outcomes identified in the individual treatment plan.
164.11(b) "Clinical supervision" means the overall responsibility of the mental health
164.12professional for the control and direction of individualized treatment planning, service
164.13delivery, and treatment review for each client. A mental health professional who is an
164.14enrolled Minnesota health care program provider accepts full professional responsibility
164.15for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
164.16and oversees or directs the supervisee's work.
164.17(c) "County board" means the county board of commissioners or board established
164.18under sections 402.01 to 402.10 or 471.59.
164.19(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
164.20(e) "Culturally competent provider" means a provider who understands and can
164.21utilize to a client's benefit the client's culture when providing services to the client. A
164.22provider may be culturally competent because the provider is of the same cultural or
164.23ethnic group as the client or the provider has developed the knowledge and skills through
164.24training and experience to provide services to culturally diverse clients.
164.25(f) "Day treatment program" for children means a site-based structured program
164.26consisting of group psychotherapy for more than three individuals and other intensive
164.27therapeutic services provided by a multidisciplinary team, under the clinical supervision
164.28of a mental health professional.
164.29(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
164.3011
.
164.31(h) "Direct service time" means the time that a mental health professional, mental
164.32health practitioner, or mental health behavioral aide spends face-to-face with a client
164.33and the client's family. Direct service time includes time in which the provider obtains
164.34a client's history or provides service components of children's therapeutic services and
164.35supports. Direct service time does not include time doing work before and after providing
165.1direct services, including scheduling, maintaining clinical records, consulting with others
165.2about the client's mental health status, preparing reports, receiving clinical supervision,
165.3and revising the client's individual treatment plan.
165.4(i) "Direction of mental health behavioral aide" means the activities of a mental
165.5health professional or mental health practitioner in guiding the mental health behavioral
165.6aide in providing services to a client. The direction of a mental health behavioral aide
165.7must be based on the client's individualized treatment plan and meet the requirements in
165.8subdivision 6, paragraph (b), clause (5).
165.9(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
165.1015
. For persons at least age 18 but under age 21, mental illness has the meaning given in
165.11section 245.462, subdivision 20, paragraph (a).
165.12(k) "Individual behavioral plan" means a plan of intervention, treatment, and
165.13services for a child written by a mental health professional or mental health practitioner,
165.14under the clinical supervision of a mental health professional, to guide the work of the
165.15mental health behavioral aide.
165.16(l) "Individual treatment plan" has the meaning given in section 245.4871,
165.17subdivision 21
.
165.18(m) "Mental health behavioral aide services" means medically necessary one-on-one
165.19activities performed by a trained paraprofessional to assist a child retain or generalize
165.20psychosocial skills as taught by a mental health professional or mental health practitioner
165.21and as described in the child's individual treatment plan and individual behavior plan.
165.22Activities involve working directly with the child or child's family as provided in
165.23subdivision 9, paragraph (b), clause (4).
165.24(n) "Mental health professional" means an individual as defined in section 245.4871,
165.25subdivision 27
, clauses (1) to (6), or tribal vendor as defined in section 256B.02,
165.26subdivision 7
, paragraph (b).
165.27    (o) "Mental health service plan development" includes:
165.28    (1) the development, review, and revision of a child's individual treatment plan,
165.29as provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of
165.30the client or client's parents, primary caregiver, or other person authorized to consent to
165.31mental health services for the client, and including arrangement of treatment and support
165.32activities specified in the individual treatment plan; and
165.33    (2) administering standardized outcome measurement instruments, determined
165.34and updated by the commissioner, as periodically needed to evaluate the effectiveness
165.35of treatment for children receiving clinical services and reporting outcome measures,
165.36as required by the commissioner.
166.1(o) (p) "Preschool program" means a day program licensed under Minnesota Rules,
166.2parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
166.3supports provider to provide a structured treatment program to a child who is at least 33
166.4months old but who has not yet attended the first day of kindergarten.
166.5(p) (q) "Skills training" means individual, family, or group training, delivered
166.6by or under the direction of a mental health professional, designed to facilitate the
166.7acquisition of psychosocial skills that are medically necessary to rehabilitate the child
166.8to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
166.9illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
166.10or maladaptive skills acquired over the course of a psychiatric illness. Skills training
166.11is subject to the following requirements:
166.12(1) a mental health professional or a mental health practitioner must provide skills
166.13training;
166.14(2) the child must always be present during skills training; however, a brief absence
166.15of the child for no more than ten percent of the session unit may be allowed to redirect or
166.16instruct family members;
166.17(3) skills training delivered to children or their families must be targeted to the
166.18specific deficits or maladaptations of the child's mental health disorder and must be
166.19prescribed in the child's individual treatment plan;
166.20(4) skills training delivered to the child's family must teach skills needed by parents
166.21to enhance the child's skill development and to help the child use in daily life the skills
166.22previously taught by a mental health professional or mental health practitioner and to
166.23develop or maintain a home environment that supports the child's progressive use skills;
166.24(5) group skills training may be provided to multiple recipients who, because of the
166.25nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
166.26interaction in a group setting, which must be staffed as follows:
166.27(i) one mental health professional or one mental health practitioner under supervision
166.28of a licensed mental health professional must work with a group of four to eight clients; or
166.29(ii) two mental health professionals or two mental health practitioners under
166.30supervision of a licensed mental health professional, or one professional plus one
166.31practitioner must work with a group of nine to 12 clients.

166.32    Sec. 19. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
166.33    Subd. 2. Covered service components of children's therapeutic services and
166.34supports. (a) Subject to federal approval, medical assistance covers medically necessary
166.35children's therapeutic services and supports as defined in this section that an eligible
167.1provider entity certified under subdivision 4 provides to a client eligible under subdivision
167.23.
167.3(b) The service components of children's therapeutic services and supports are:
167.4(1) individual, family, and group psychotherapy;
167.5(2) individual, family, or group skills training provided by a mental health
167.6professional or mental health practitioner;
167.7(3) crisis assistance;
167.8(4) mental health behavioral aide services; and
167.9(5) direction of a mental health behavioral aide.;
167.10(6) mental health service plan development;
167.11(7) clinical care consultation provided by a mental health professional under section
167.12256B.0625, subdivision 62;
167.13(8) family psychoeducation under section 256B.0625, subdivision 61; and
167.14(9) services provided by a family peer specialist under section 256B.0616.
167.15(c) Service components in paragraph (b) may be combined to constitute therapeutic
167.16programs, including day treatment programs and therapeutic preschool programs.

167.17    Sec. 20. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:
167.18    Subd. 7. Qualifications of individual and team providers. (a) An individual
167.19or team provider working within the scope of the provider's practice or qualifications
167.20may provide service components of children's therapeutic services and supports that are
167.21identified as medically necessary in a client's individual treatment plan.
167.22(b) An individual provider must be qualified as:
167.23(1) a mental health professional as defined in subdivision 1, paragraph (n); or
167.24(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The
167.25mental health practitioner must work under the clinical supervision of a mental health
167.26professional; or
167.27(3) a mental health behavioral aide working under the clinical supervision of a
167.28mental health professional to implement the rehabilitative mental health services identified
167.29in the client's individual treatment plan and individual behavior plan.
167.30(A) A level I mental health behavioral aide must:
167.31(i) be at least 18 years old;
167.32(ii) have a high school diploma or general equivalency diploma (GED) or two years
167.33of experience as a primary caregiver to a child with severe emotional disturbance within
167.34the previous ten years; and
167.35(iii) meet preservice and continuing education requirements under subdivision 8.
168.1(B) A level II mental health behavioral aide must:
168.2(i) be at least 18 years old;
168.3(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
168.4clinical services in the treatment of mental illness concerning children or adolescents or
168.5complete a certificate program established under subdivision 8a; and
168.6(iii) meet preservice and continuing education requirements in subdivision 8.
168.7(c) A preschool program multidisciplinary team must include at least one mental
168.8health professional and one or more of the following individuals under the clinical
168.9supervision of a mental health professional:
168.10(i) a mental health practitioner; or
168.11(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
168.12qualifications and training standards of a level I mental health behavioral aide.
168.13(d) A day treatment multidisciplinary team must include at least one mental health
168.14professional and one mental health practitioner.

168.15    Sec. 21. Minnesota Statutes 2012, section 256B.0943, is amended by adding a
168.16subdivision to read:
168.17    Subd. 8a. Level II mental health behavioral aide. The commissioner of human
168.18services, in collaboration with the Board of Trustees of the Minnesota State Colleges and
168.19Universities, shall develop a certificate program of not fewer than 11 credits for level II
168.20mental health behavioral aides. The program shall include classroom and field-based
168.21learning. The program components must include, but not be limited to, mental illnesses
168.22in children, parent and family perspectives, skill training, documentation and reporting,
168.23communication skills, and cultural competence.

168.24    Sec. 22. Minnesota Statutes 2012, section 256B.0946, is amended to read:
168.25256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
168.26    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
168.27 upon enactment and subject to federal approval, medical assistance covers medically
168.28necessary intensive treatment services described under paragraph (b) that are provided
168.29by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
168.30who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
168.31to 2960.3340.
168.32(b) Intensive treatment services to children with severe emotional disturbance mental
168.33illness residing in treatment foster care family settings must meet the relevant standards
168.34for mental health services under sections 245.487 to 245.4889. In addition, that comprise
169.1 specific required service components provided in clauses (1) to (5), are reimbursed by
169.2medical assistance must when they meet the following standards:
169.3(1) case management service component must meet the standards in Minnesota
169.4Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
169.5(1) psychotherapy provided by a mental health professional as defined in Minnesota
169.6Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
169.7Rules, part 9505.0371, subpart 5, item C;
169.8(2) psychotherapy, crisis assistance, and skills training components must meet the
169.9 provided according to standards for children's therapeutic services and supports in section
169.10256B.0943 ; and
169.11(3) individual family, and group psychoeducation services under supervision of,
169.12defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
169.13clinical trainee;
169.14(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
169.15health professional or a clinical trainee; and
169.16(5) service delivery payment requirements as provided under subdivision 4.
169.17    Subd. 1a. Definitions. For the purposes of this section, the following terms have
169.18the meanings given them.
169.19(a) "Clinical care consultation" means communication from a treating clinician to
169.20other providers working with the same client to inform, inquire, and instruct regarding
169.21the client's symptoms, strategies for effective engagement, care and intervention needs,
169.22and treatment expectations across service settings, including but not limited to the client's
169.23school, social services, day care, probation, home, primary care, medication prescribers,
169.24disabilities services, and other mental health providers and to direct and coordinate clinical
169.25service components provided to the client and family.
169.26(b) "Clinical supervision" means the documented time a clinical supervisor and
169.27supervisee spend together to discuss the supervisee's work, to review individual client
169.28cases, and for the supervisee's professional development. It includes the documented
169.29oversight and supervision responsibility for planning, implementation, and evaluation of
169.30services for a client's mental health treatment.
169.31(c) "Clinical supervisor" means the mental health professional who is responsible
169.32for clinical supervision.
169.33(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
169.34subpart 5, item C;
170.1(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
170.2including the development of a plan that addresses prevention and intervention strategies
170.3to be used in a potential crisis, but does not include actual crisis intervention.
170.4(f) "Culturally appropriate" means providing mental health services in a manner that
170.5incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
170.6subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
170.7strengths and resources to promote overall wellness.
170.8(g) "Culture" means the distinct ways of living and understanding the world that
170.9are used by a group of people and are transmitted from one generation to another or
170.10adopted by an individual.
170.11(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
170.129505.0370, subpart 11.
170.13(i) "Family" means a person who is identified by the client or the client's parent or
170.14guardian as being important to the client's mental health treatment. Family may include,
170.15but is not limited to, parents, foster parents, children, spouse, committed partners, former
170.16spouses, persons related by blood or adoption, persons who are a part of the client's
170.17permanency plan, or persons who are presently residing together as a family unit.
170.18(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
170.19(k) "Foster family setting" means the foster home in which the license holder resides.
170.20(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
170.219505.0370, subpart 15.
170.22(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
170.239505.0370, subpart 17.
170.24(n) "Mental health professional" has the meaning given in Minnesota Rules, part
170.259505.0370, subpart 18.
170.26(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
170.27subpart 20.
170.28(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
170.29(q) "Psychoeducation services" means information or demonstration provided to
170.30an individual, family, or group to explain, educate, and support the individual, family, or
170.31group in understanding a child's symptoms of mental illness, the impact on the child's
170.32development, and needed components of treatment and skill development so that the
170.33individual, family, or group can help the child to prevent relapse, prevent the acquisition
170.34of comorbid disorders, and to achieve optimal mental health and long-term resilience.
170.35(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
170.36subpart 27.
171.1(s) "Team consultation and treatment planning" means the coordination of treatment
171.2plans and consultation among providers in a group concerning the treatment needs of the
171.3child, including disseminating the child's treatment service schedule to all members of the
171.4service team. Team members must include all mental health professionals working with
171.5the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
171.6and at least two of the following: an individualized education program case manager;
171.7probation agent; children's mental health case manager; child welfare worker, including
171.8adoption or guardianship worker; primary care provider; foster parent; and any other
171.9member of the child's service team.
171.10    Subd. 2. Determination of client eligibility. A client's eligibility to receive
171.11treatment foster care under this section shall be determined by An eligible recipient is an
171.12individual, from birth through age 20, who is currently placed in a foster home licensed
171.13under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
171.14assessment, and an evaluation of level of care needed, and development of an individual
171.15treatment plan, as defined in paragraphs (a) to (c) and (b).
171.16(a) The diagnostic assessment must:
171.17(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
171.18conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
171.19worker that is mental health professional or a clinical trainee;
171.20(2) determine whether or not a child meets the criteria for mental illness, as defined
171.21in Minnesota Rules, part 9505.0370, subpart 20;
171.22(3) document that intensive treatment services are medically necessary within a
171.23foster family setting to ameliorate identified symptoms and functional impairments;
171.24(4) be performed within 180 days prior to before the start of service; and
171.25(2) include current diagnoses on all five axes of the client's current mental health
171.26status;
171.27(3) determine whether or not a child meets the criteria for severe emotional
171.28disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
171.29in section 245.462, subdivision 20; and
171.30(4) be completed annually until age 18. For individuals between age 18 and 21,
171.31unless a client's mental health condition has changed markedly since the client's most
171.32recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
171.33"updating" means a written summary, including current diagnoses on all five axes, by a
171.34mental health professional of the client's current mental status and service needs.
171.35(5) be completed as either a standard or extended diagnostic assessment annually to
171.36determine continued eligibility for the service.
172.1(b) The evaluation of level of care must be conducted by the placing county with
172.2an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
172.3described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
172.4 approved by the commissioner of human services and not subject to the rulemaking
172.5process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
172.6evaluation demonstrates that the child requires intensive intervention without 24-hour
172.7medical monitoring. The commissioner shall update the list of approved level of care
172.8instruments tools annually and publish on the department's Web site.
172.9(c) The individual treatment plan must be:
172.10(1) based on the information in the client's diagnostic assessment;
172.11(2) developed through a child-centered, family driven planning process that identifies
172.12service needs and individualized, planned, and culturally appropriate interventions that
172.13contain specific measurable treatment goals and objectives for the client and treatment
172.14strategies for the client's family and foster family;
172.15(3) reviewed at least once every 90 days and revised; and
172.16(4) signed by the client or, if appropriate, by the client's parent or other person
172.17authorized by statute to consent to mental health services for the client.
172.18    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
172.19intensive children's mental health services in a foster family setting must be certified
172.20by the state and have a service provision contract with a county board or a reservation
172.21tribal council and must be able to demonstrate the ability to provide all of the services
172.22required in this section.
172.23(b) For purposes of this section, a provider agency must have an individual
172.24placement agreement for each recipient and must be a licensed child placing agency, under
172.25Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
172.26(1) a county county-operated entity certified by the state;
172.27(2) an Indian Health Services facility operated by a tribe or tribal organization under
172.28funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
172.29Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
172.30(3) a noncounty entity under contract with a county board.
172.31(c) Certified providers that do not meet the service delivery standards required in
172.32this section shall be subject to a decertification process.
172.33(d) For the purposes of this section, all services delivered to a client must be
172.34provided by a mental health professional or a clinical trainee.
172.35    Subd. 4. Eligible provider responsibilities Service delivery payment
172.36requirements. (a) To be an eligible provider for payment under this section, a provider
173.1must develop and practice written policies and procedures for treatment foster care services
173.2 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
173.3(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
173.4(b) In delivering services under this section, a treatment foster care provider must
173.5ensure that staff caseload size reasonably enables the provider to play an active role in
173.6service planning, monitoring, delivering, and reviewing for discharge planning to meet
173.7the needs of the client, the client's foster family, and the birth family, as specified in each
173.8client's individual treatment plan.
173.9(b) A qualified clinical supervisor, as defined in and performing in compliance with
173.10Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
173.11provision of services described in this section.
173.12(c) Each client receiving treatment services must receive an extended diagnostic
173.13assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
173.1430 days of enrollment in this service unless the client has a previous extended diagnostic
173.15assessment that the client, parent, and mental health professional agree still accurately
173.16describes the client's current mental health functioning.
173.17(d) Each previous and current mental health, school, and physical health treatment
173.18provider must be contacted to request documentation of treatment and assessments that the
173.19eligible client has received and this information must be reviewed and incorporated into
173.20the diagnostic assessment and team consultation and treatment planning review process.
173.21(e) Each client receiving treatment must be assessed for a trauma history and
173.22the client's treatment plan must document how the results of the assessment will be
173.23incorporated into treatment.
173.24(f) Each client receiving treatment services must have an individual treatment plan
173.25that is reviewed, evaluated, and signed every 90 days using the team consultation and
173.26treatment planning process, as defined in subdivision 1a, paragraph (s).
173.27(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
173.28in accordance with the client's individual treatment plan.
173.29(h) Each client must have a crisis assistance plan within ten days of initiating
173.30services and must have access to clinical phone support 24 hours per day, seven days per
173.31week, during the course of treatment, and the crisis plan must demonstrate coordination
173.32with the local or regional mobile crisis intervention team.
173.33(i) Services must be delivered and documented at least three days per week, equaling
173.34at least six hours of treatment per week, unless reduced units of service are specified on
173.35the treatment plan as part of transition or on a discharge plan to another service or level of
173.36care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
174.1(j) Location of service delivery must be in the client's home, day care setting,
174.2school, or other community-based setting that is specified on the client's individualized
174.3treatment plan.
174.4(k) Treatment must be developmentally and culturally appropriate for the client.
174.5(l) Services must be delivered in continual collaboration and consultation with the
174.6client's medical providers and, in particular, with prescribers of psychotropic medications,
174.7including those prescribed on an off-label basis, and members of the service team must be
174.8aware of the medication regimen and potential side effects.
174.9(m) Parents, siblings, foster parents, and members of the child's permanency plan
174.10must be involved in treatment and service delivery unless otherwise noted in the treatment
174.11plan.
174.12(n) Transition planning for the child must be conducted starting with the first
174.13treatment plan and must be addressed throughout treatment to support the child's
174.14permanency plan and postdischarge mental health service needs.
174.15    Subd. 5. Service authorization. The commissioner will administer authorizations
174.16for services under this section in compliance with section 256B.0625, subdivision 25.
174.17    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
174.18under this section and are not eligible for medical assistance payment as components of
174.19intensive treatment in foster care services, but may be billed separately:
174.20(1) treatment foster care services provided in violation of medical assistance policy
174.21in Minnesota Rules, part 9505.0220;
174.22(2) service components of children's therapeutic services and supports
174.23simultaneously provided by more than one treatment foster care provider;
174.24(3) home and community-based waiver services; and
174.25(4) treatment foster care services provided to a child without a level of care
174.26determination according to section 245.4885, subdivision 1.
174.27(1) inpatient psychiatric hospital treatment;
174.28(2) mental health targeted case management;
174.29(3) partial hospitalization;
174.30(4) medication management;
174.31(5) children's mental health day treatment services;
174.32(6) crisis response services under section 256B.0944; and
174.33(7) transportation.
174.34(b) Children receiving intensive treatment in foster care services are not eligible for
174.35medical assistance reimbursement for the following services while receiving intensive
174.36treatment in foster care:
175.1(1) mental health case management services under section 256B.0625, subdivision
175.220
; and
175.3(2) (1) psychotherapy and skill skills training components of children's therapeutic
175.4services and supports under section 256B.0625, subdivision 35b.;
175.5(2) mental health behavioral aide services as defined in section 256B.0943,
175.6subdivision 1, paragraph (m);
175.7(3) home and community-based waiver services;
175.8(4) mental health residential treatment; and
175.9(5) room and board costs as defined in section 256I.03, subdivision 6.
175.10    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
175.11establish a single daily per-client encounter rate for intensive treatment in foster care
175.12services. The rate must be constructed to cover only eligible services delivered to an
175.13eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

175.14    Sec. 23. Minnesota Statutes 2012, section 256B.761, is amended to read:
175.15256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
175.16(a) Effective for services rendered on or after July 1, 2001, payment for medication
175.17management provided to psychiatric patients, outpatient mental health services, day
175.18treatment services, home-based mental health services, and family community support
175.19services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
175.2050th percentile of 1999 charges.
175.21(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
175.22services provided by an entity that operates: (1) a Medicare-certified comprehensive
175.23outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
175.241993, with at least 33 percent of the clients receiving rehabilitation services in the most
175.25recent calendar year who are medical assistance recipients, will be increased by 38 percent,
175.26when those services are provided within the comprehensive outpatient rehabilitation
175.27facility and provided to residents of nursing facilities owned by the entity.
175.28(c) The commissioner shall establish three levels of payment for mental health
175.29diagnostic assessment, based on three levels of complexity. The aggregate payment under
175.30the tiered rates must not exceed the projected aggregate payments for mental health
175.31diagnostic assessment under the previous single rate. The new rate structure is effective
175.32January 1, 2011, or upon federal approval, whichever is later.
175.33(d) In addition to rate increases otherwise provided, the commissioner may
175.34restructure coverage policy and rates to improve access to adult rehabilitative mental
175.35health services under section 256B.0623 and related mental health support services under
176.1section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
176.22016, the projected state share of increased costs due to this paragraph is transferred
176.3from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
176.4fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
176.5made to managed care plans and county-based purchasing plans under sections 256B.69,
176.6256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

176.7    Sec. 24. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:
176.8    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
176.9provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
176.10negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
176.11exceed $700 per month, including any legislatively authorized inflationary adjustments,
176.12for a group residential housing provider that:
176.13(1) is located in Hennepin County and has had a group residential housing contract
176.14with the county since June 1996;
176.15(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
176.1626-bed facility; and
176.17(3) serves a chemically dependent clientele, providing 24 hours per day supervision
176.18and limiting a resident's maximum length of stay to 13 months out of a consecutive
176.1924-month period.
176.20(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
176.21supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
176.22per month, including any legislatively authorized inflationary adjustments, of a group
176.23residential provider that:
176.24(1) is located in St. Louis County and has had a group residential housing contract
176.25with the county since 2006;
176.26(2) operates a 62-bed facility; and
176.27(3) serves a chemically dependent adult male clientele, providing 24 hours per
176.28day supervision and limiting a resident's maximum length of stay to 13 months out of
176.29a consecutive 24-month period.
176.30(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
176.31shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
176.32to exceed $700 per month, including any legislatively authorized inflationary adjustments,
176.33for the group residential provider described under paragraphs (a) and (b), not to exceed
176.34an additional 115 beds.

177.1    Sec. 25. CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.
177.2The commissioner of human services shall, in consultation with children's mental
177.3health community providers, hospitals providing care to children, children's mental health
177.4advocates, and other interested parties, develop recommendations and legislation, if
177.5necessary, for the state-operated child and adolescent behavioral health services facility
177.6to ensure that:
177.7(1) the facility and the services provided meet the needs of children with serious
177.8emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD,
177.9serious emotional disturbance co-occurring with a developmental disability, borderline
177.10personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries,
177.11violent tendencies, and complex medical issues;
177.12(2) qualified personnel and staff can be recruited who have specific expertise and
177.13training to treat the children in the facility; and
177.14(3) the treatment provided at the facility is high-quality, effective treatment.

177.15    Sec. 26. PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND
177.16CHILDREN'S MENTAL HEALTH SERVICES.
177.17(a) To assess the efficiency and other operational issues in the management of the
177.18health care delivery system, the commissioner of human services shall initiate a provider
177.19survey. The pilot survey shall consist of an electronic survey of providers of pediatric
177.20home health care services and children's mental health services to identify and measure
177.21issues that arise in dealing with the management of medical assistance. To the maximum
177.22degree possible, existing technology shall be used and interns sought to analyze the results.
177.23(b) The survey questions must focus on seven key business functions provided
177.24by medical assistance contractors: provider inquiries; provider outreach and education;
177.25claims processing; appeals; provider enrollment; medical review; and provider audit and
177.26reimbursement. The commissioner must consider the results of the survey in evaluating
177.27and renewing managed care and fee-for-service management contracts.
177.28(c) The commissioner shall report by January 15, 2014, the results of the survey to
177.29the chairs of the health and human services policy and finance committees and shall
177.30make recommendations on the value of implementing an annual survey with a rotating
177.31list of provider groups as a component of the continuous quality improvement system for
177.32medical assistance.

177.33    Sec. 27. MENTALLY ILL AND DANGEROUS COMMITMENTS
177.34STAKEHOLDERS GROUP.
178.1(a) The commissioner of human services, in consultation with the state court
178.2administrator, shall convene a stakeholder group to develop recommendations for the
178.3legislature that address issues raised in the February 2013 Office of the Legislative
178.4Auditor report on State-Operated Services for persons committed to the commissioner as
178.5mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must
178.6include representatives from the Department of Human Services, county human services,
178.7county attorneys, commitment defense attorneys, the ombudsman for mental health and
178.8developmental disabilities, the federal protection and advocacy system, and consumers
178.9and advocates for persons with mental illnesses.
178.10(b) The stakeholder group shall provide recommendations in the following areas:
178.11(1) the role of the special review board, including the scope of authority of the
178.12special review board and the authority of the commissioner to accept or reject special
178.13review board recommendations;
178.14(2) review of special review board decisions by the district court;
178.15(3) annual district court review of commitment, scope of court authority, and
178.16appropriate review criteria;
178.17(4) options, including annual court hearing and review, as alternatives to
178.18indeterminate commitment under Minnesota Statutes, section 253B.18; and
178.19(5) extension of the right to petition the court under Minnesota Statutes,
178.20section 253B.17, to those committed under Minnesota Statutes, section 253B.18.
178.21The commissioner of human services and the state court administrator shall provide
178.22relevant data for the group's consideration in developing these recommendations,
178.23including numbers of proceedings in each category and costs associated with court and
178.24administrative proceedings under Minnesota Statutes, section 253B.18.
178.25(c) By January 15, 2014, the commissioner of human services shall submit the
178.26recommendations of the stakeholder group to the chairs and ranking minority members
178.27of the committees of the legislature with jurisdiction over civil commitment and human
178.28services issues.

178.29ARTICLE 5
178.30DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY AND
178.31OFFICE OF INSPECTOR GENERAL

178.32    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
178.33subdivision to read:
179.1    Subd. 7b. Child care provider and recipient fraud investigations. Data related
179.2to child care fraud and recipient fraud investigations are governed by section 245E.01,
179.3subdivision 15.

179.4    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
179.5    Subd. 7. Use of data. (a) Except as otherwise provided in subdivision 7a or sections
179.6244.052 and 299C.093, the data provided under this section is private data on individuals
179.7under section 13.02, subdivision 12.
179.8(b) The data may be used only for by law enforcement and corrections agencies for
179.9 law enforcement and corrections purposes.
179.10(c) The commissioner of human services is authorized to have access to the data for:
179.11(1) state-operated services, as defined in section 246.014, are also authorized to
179.12have access to the data for the purposes described in section 246.13, subdivision 2,
179.13paragraph (b); and
179.14(2) purposes of completing background studies under chapter 245C.

179.15    Sec. 3. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision
179.16to read:
179.17    Subd. 4a. Agency background studies. (a) The commissioner shall develop and
179.18implement an electronic process for the regular transfer of new criminal case information
179.19that is added to the Minnesota court information system. The commissioner's system
179.20must include for review only information that relates to individuals who have been the
179.21subject of a background study under this chapter that remain affiliated with the agency
179.22that initiated the background study. For purposes of this paragraph, an individual remains
179.23affiliated with an agency that initiated the background study until the agency informs the
179.24commissioner that the individual is no longer affiliated. When any individual no longer
179.25affiliated according to this paragraph returns to a position requiring a background study
179.26under this chapter, the agency with whom the individual is again affiliated shall initiate
179.27a new background study regardless of the length of time the individual was no longer
179.28affiliated with the agency.
179.29(b) The commissioner shall develop and implement an online system for agencies that
179.30initiate background studies under this chapter to access and maintain records of background
179.31studies initiated by that agency. The system must show all active background study subjects
179.32affiliated with that agency and the status of each individual's background study. Each
179.33agency that initiates background studies must use this system to notify the commissioner
179.34of discontinued affiliation for purposes of the processes required under paragraph (a).

180.1    Sec. 4. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
180.2    Subdivision 1. Background studies conducted by Department of Human
180.3Services. (a) For a background study conducted by the Department of Human Services,
180.4the commissioner shall review:
180.5    (1) information related to names of substantiated perpetrators of maltreatment of
180.6vulnerable adults that has been received by the commissioner as required under section
180.7626.557, subdivision 9c , paragraph (j);
180.8    (2) the commissioner's records relating to the maltreatment of minors in licensed
180.9programs, and from findings of maltreatment of minors as indicated through the social
180.10service information system;
180.11    (3) information from juvenile courts as required in subdivision 4 for individuals
180.12listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
180.13    (4) information from the Bureau of Criminal Apprehension, including information
180.14regarding a background study subject's registration in Minnesota as a predatory offender
180.15under section 243.166;
180.16    (5) except as provided in clause (6), information from the national crime information
180.17system when the commissioner has reasonable cause as defined under section 245C.05,
180.18subdivision 5; and
180.19    (6) for a background study related to a child foster care application for licensure or
180.20adoptions, the commissioner shall also review:
180.21    (i) information from the child abuse and neglect registry for any state in which the
180.22background study subject has resided for the past five years; and
180.23    (ii) information from national crime information databases, when the background
180.24study subject is 18 years of age or older.
180.25    (b) Notwithstanding expungement by a court, the commissioner may consider
180.26information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
180.27received notice of the petition for expungement and the court order for expungement is
180.28directed specifically to the commissioner.
180.29    (c) The commissioner shall also review criminal case information received according
180.30to section 245C.04, subdivision 4a, from the Minnesota court information system that
180.31relates to individuals who have already been studied under this chapter and who remain
180.32affiliated with the agency that initiated the background study.

180.33    Sec. 5. Minnesota Statutes 2012, section 245C.32, subdivision 2, is amended to read:
180.34    Subd. 2. Use. (a) The commissioner may also use these systems and records to
180.35obtain and provide criminal history data from the Bureau of Criminal Apprehension,
181.1criminal history data held by the commissioner, and data about substantiated maltreatment
181.2under section 626.556 or 626.557, for other purposes, provided that:
181.3(1) the background study is specifically authorized in statute; or
181.4(2) the request is made with the informed consent of the subject of the study as
181.5provided in section 13.05, subdivision 4.
181.6(b) An individual making a request under paragraph (a), clause (2), must agree in
181.7writing not to disclose the data to any other individual without the consent of the subject
181.8of the data.
181.9(c) The commissioner may recover the cost of obtaining and providing background
181.10study data by charging the individual or entity requesting the study a fee of no more
181.11than $20 per study. The fees collected under this paragraph are appropriated to the
181.12commissioner for the purpose of conducting background studies.
181.13(d) The commissioner shall recover the cost of obtaining background study data
181.14required under section 524.5-118 through a fee of $100 per study for an individual who
181.15has not lived outside Minnesota for the past ten years, and a fee of $115 for an individual
181.16who has resided outside of Minnesota for any period during the ten years preceding the
181.17background study. The commissioner shall recover, from the individual, any additional
181.18fees charged by other states' licensing agencies that are associated with these data requests.
181.19Fees under subdivision 3 also apply when criminal history data from the National Criminal
181.20Records Repository is required.

181.21    Sec. 6. [245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD
181.22INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM.
181.23    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in this
181.24subdivision have the meanings given them.
181.25(b) "Applicant" has the meaning given in section 119B.011, subdivision 2.
181.26(c) "Child care assistance program" means any of the assistance programs under
181.27chapter 119B.
181.28(d) "Commissioner" means the commissioner of human services.
181.29(e) "Controlling individual" has the meaning given in section 245A.02, subdivision
181.305a.
181.31(f) "County" means a local county child care assistance program staff or
181.32subcontracted staff, or a county investigator acting on behalf of the commissioner.
181.33(g) "Department" means the Department of Human Services.
181.34(h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or
181.35omissions that result in fraud and abuse or error against the Department of Human Services.
182.1(i) "Identify" means to furnish the full name, current or last known address, phone
182.2number, and e-mail address of the individual or business entity.
182.3(j) "License holder" has the meaning given in section 245A.02, subdivision 9.
182.4(k) "Mail" means the use of any mail service with proof of delivery and receipt.
182.5(l) "Provider" means either a provider as defined in section 119B.011, subdivision
182.619, or a legal unlicensed provider as defined in section 119B.011, subdivision 16.
182.7(m) "Recipient" means a family receiving assistance as defined under section
182.8119B.011, subdivision 13.
182.9(n) "Terminate" means revocation of participation in the child care assistance
182.10program.
182.11    Subd. 2. Investigating provider or recipient financial misconduct. The
182.12department shall investigate alleged or suspected financial misconduct by providers and
182.13errors related to payments issued by the child care assistance program under this chapter.
182.14Recipients, employees, and staff may be investigated when the evidence shows that their
182.15conduct is related to the financial misconduct of a provider, license holder, or controlling
182.16individual.
182.17    Subd. 3. Scope of investigations. (a) The department may contact any person,
182.18agency, organization, or other entity that is necessary to an investigation.
182.19(b) The department may examine or interview any individual, document, or piece of
182.20evidence that may lead to information that is relevant to child care assistance program
182.21benefits, payments, and child care provider authorizations. This includes, but is not
182.22limited to:
182.23(1) child care assistance program payments;
182.24(2) services provided by the program or related to child care assistance program
182.25recipients;
182.26(3) services provided to a provider;
182.27(4) provider financial records of any type;
182.28(5) daily attendance records of the children receiving services from the provider;
182.29(6) billings; and
182.30(7) verification of the credentials of a license holder, controlling individual,
182.31employee, staff person, contractor, subcontractor, and entities under contract with the
182.32provider to provide services or maintain service and the provider's financial records
182.33related to those services.
182.34    Subd. 4. Determination of investigation. After completing its investigation, the
182.35department shall issue one of the following determinations:
182.36(1) no violation of child care assistance requirements occurred;
183.1(2) there is insufficient evidence to show that a violation of child care assistance
183.2requirements occurred;
183.3(3) a preponderance of evidence shows a violation of child care assistance program
183.4law, rule, or policy; or
183.5(4) there exists a credible allegation of fraud.
183.6    Subd. 5. Actions or administrative sanctions. (a) In addition to section 256.98,
183.7after completing the determination under subdivision 4, the department may take one or
183.8more of the actions or sanctions specified in this subdivision.
183.9(b) The department may take the following actions:
183.10(1) refer the investigation to law enforcement or a county attorney for possible
183.11criminal prosecution;
183.12(2) refer relevant information to the department's licensing division, the child care
183.13assistance program, the Department of Education, the federal child and adult care food
183.14program, or appropriate child or adult protection agency;
183.15(3) enter into a settlement agreement with a provider, license holder, controlling
183.16individual, or recipient; or
183.17(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction
183.18for possible civil action under the Minnesota False Claims Act, chapter 15C.
183.19(c) The department may impose sanctions by:
183.20(1) pursuing administrative disqualification through hearings or waivers;
183.21(2) establishing and seeking monetary recovery or recoupment; or
183.22(3) issuing an order of corrective action that states the practices that are violations of
183.23child care assistance program policies, laws, or regulations, and that they must be corrected.
183.24    Subd. 6. Duty to provide access. (a) A provider, license holder, controlling
183.25individual, employee, staff person, or recipient has an affirmative duty to provide access
183.26upon request to information specified under subdivision 8 or the program facility.
183.27(b) Failure to provide access may result in denial or termination of authorizations for
183.28or payments to a recipient, provider, license holder, or controlling individual in the child
183.29care assistance program.
183.30(c) When a provider fails to provide access, a 15-day notice of denial or termination
183.31must be issued to the provider, which prohibits the provider from participating in the child
183.32care assistance program. Notice must be sent to recipients whose children are under the
183.33provider's care pursuant to Minnesota Rules, part 3400.0185.
183.34(d) If the provider continues to fail to provide access at the expiration of the 15-day
183.35notice period, child care assistance program payments to the provider must be denied
183.36beginning the 16th day following notice of the initial failure or refusal to provide access.
184.1The department may rescind the denial based upon good cause if the provider submits in
184.2writing a good cause basis for having failed or refused to provide access. The writing must
184.3be postmarked no later than the 15th day following the provider's notice of initial failure
184.4to provide access. Additionally, the provider, license holder, or controlling individual
184.5must immediately provide complete, ongoing access to the department. Repeated failures
184.6to provide access must, after the initial failure or for any subsequent failure, result in
184.7termination from participation in the child care assistance program.
184.8(e) The department, at its own expense, may photocopy or otherwise duplicate
184.9records referenced in subdivision 8. Photocopying must be done on the provider's
184.10premises on the day of the request or other mutually agreeable time, unless removal of
184.11records is specifically permitted by the provider. If requested, a provider, license holder,
184.12or controlling individual, or a designee, must assist the investigator in duplicating any
184.13record, including a hard copy or electronically stored data, on the day of the request.
184.14(f) A provider, license holder, controlling individual, employee, or staff person must
184.15grant the department access during the department's normal business hours, and any hours
184.16that the program is operated, to examine the provider's program or the records listed in
184.17subdivision 8. A provider shall make records available at the provider's place of business
184.18on the day for which access is requested, unless the provider and the department both agree
184.19otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday
184.20through Friday, excluding state holidays as defined in section 645.44, subdivision 5.
184.21    Subd. 7. Honest and truthful statements. It shall be unlawful for a provider,
184.22license holder, controlling individual, or recipient to:
184.23(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact;
184.24(2) make any materially false, fictitious, or fraudulent statement or representation; or
184.25(3) make or use any false writing or document knowing the same to contain any
184.26materially false, fictitious, or fraudulent statement or entry related to any child care
184.27assistance program services that the provider, license holder, or controlling individual
184.28supplies or in relation to any child care assistance payments received by a provider, license
184.29holder, or controlling individual or to any fraud investigator or law enforcement officer
184.30conducting a financial misconduct investigation.
184.31    Subd. 8. Record retention. (a) The following records must be maintained,
184.32controlled, and made immediately accessible to license holders, providers, and controlling
184.33individuals. The records must be organized and labeled to correspond to categories that
184.34make them easy to identify so that they can be made available immediately upon request
184.35to an investigator acting on behalf of the commissioner at the provider's place of business:
185.1(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting
185.2records;
185.3(2) daily attendance records required by and that comply with section 119B.125,
185.4subdivision 6;
185.5(3) billing transmittal forms requesting payments from the child care assistance
185.6program and billing adjustments related to child care assistance program payments;
185.7(4) records identifying all persons, corporations, partnerships, and entities with an
185.8ownership or controlling interest in the provider's child care business;
185.9(5) employee records identifying those persons currently employed by the provider's
185.10child care business or who have been employed by the business at any time within the
185.11previous five years. The records must include each employee's name, hourly and annual
185.12salary, qualifications, position description, job title, and dates of employment. In addition,
185.13employee records that must be made available include the employee's time sheets, current
185.14home address of the employee or last known address of any former employee, and
185.15documentation of background studies required under chapter 119B or 245C;
185.16(6) records related to transportation of children in care, including but not limited to:
185.17(i) the dates and times that transportation is provided to children for transportation to
185.18and from the provider's business location for any purpose. For transportation related to
185.19field trips or locations away from the provider's business location, the names and addresses
185.20of those field trips and locations must also be provided;
185.21(ii) the name, business address, phone number, and Web site address, if any, of the
185.22transportation service utilized; and
185.23(iii) all billing or transportation records related to the transportation.
185.24(b) A provider, license holder, or controlling individual must retain all records
185.25in paragraph (a) for at least six years after the date the record is created. Microfilm or
185.26electronically stored records satisfy the record keeping requirements of this subdivision.
185.27(c) A provider, license holder, or controlling individual who withdraws or is
185.28terminated from the child care assistance program must retain the records required under
185.29this subdivision and make them available to the department on demand.
185.30(d) If the ownership of a provider changes, the transferor, unless otherwise provided
185.31by law or by written agreement with the transferee, is responsible for maintaining,
185.32preserving, and upon request from the department, making available the records related to
185.33the provider that were generated before the date of the transfer. Any written agreement
185.34affecting this provision must be held in the possession of the transferor and transferee.
185.35The written agreement must be provided to the department or county immediately upon
186.1request, and the written agreement must be retained by the transferor and transferee for six
186.2years after the agreement is fully executed.
186.3(e) In the event of an appealed case, the provider must retain all records required in
186.4this subdivision for the duration of the appeal or six years, whichever is longer.
186.5(f) A provider's use of electronic record keeping or electronic signatures is governed
186.6by chapter 325L.
186.7    Subd. 9. Factors regarding imposition of administrative sanctions. (a) The
186.8department shall consider the following factors in determining the administrative sanctions
186.9to be imposed:
186.10(1) nature and extent of financial misconduct;
186.11(2) history of financial misconduct;
186.12(3) actions taken or recommended by other state agencies, other divisions of the
186.13department, and court and administrative decisions;
186.14(4) prior imposition of sanctions;
186.15(5) size and type of provider;
186.16(6) information obtained through an investigation from any source;
186.17(7) convictions or pending criminal charges; and
186.18(8) any other information relevant to the acts or omissions related to the financial
186.19misconduct.
186.20(b) Any single factor under paragraph (a) may be determinative of the department's
186.21decision of whether and what sanctions are imposed.
186.22    Subd. 10. Written notice of department sanction. (a) The department shall give
186.23notice in writing to a person of an administrative sanction that is to be imposed. The notice
186.24shall be sent by mail as defined in subdivision 1, paragraph (k).
186.25(b) The notice shall state:
186.26(1) the factual basis for the department's determination;
186.27(2) the sanction the department intends to take;
186.28(3) the dollar amount of the monetary recovery or recoupment, if any;
186.29(4) how the dollar amount was computed;
186.30(5) the right to dispute the department's determination and to provide evidence;
186.31(6) the right to appeal the department's proposed sanction; and
186.32(7) the option to meet informally with department staff, and to bring additional
186.33documentation or information, to resolve the issues.
186.34(c) In cases of determinations resulting in denial or termination of payments, in
186.35addition to the requirements of paragraph (b), the notice must state:
186.36(1) the length of the denial or termination;
187.1(2) the requirements and procedures for reinstatement; and
187.2(3) the provider's right to submit documents and written arguments against the
187.3denial or termination of payments for review by the department before the effective date
187.4of denial or termination.
187.5(d) The submission of documents and written argument for review by the department
187.6under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the
187.7deadline for filing an appeal.
187.8(e) Unless timely appealed, the effective date of the proposed sanction shall be 30
187.9days after the license holder's, provider's, controlling individual's, or recipient's receipt of
187.10the notice. If a timely appeal is made, the proposed sanction shall be delayed pending
187.11the final outcome of the appeal. Implementation of a proposed sanction following the
187.12resolution of a timely appeal may be postponed if, in the opinion of the department, the
187.13delay of sanction is necessary to protect the health or safety of children in care. The
187.14department may consider the economic hardship of a person in implementing the proposed
187.15sanction, but economic hardship shall not be a determinative factor in implementing the
187.16proposed sanction.
187.17(f) Requests for an informal meeting to attempt to resolve issues and requests
187.18for appeals must be sent or delivered to the department's Office of Inspector General,
187.19Financial Fraud and Abuse Division.
187.20    Subd. 11. Appeal of department sanction under this section. (a) If the department
187.21does not pursue a criminal action against a provider, license holder, controlling individual,
187.22or recipient for financial misconduct, but the department imposes an administrative
187.23sanction, any individual or entity against whom the sanction was imposed may appeal the
187.24department's administrative sanction under this section pursuant to section 119B.16 or
187.25256.045 with the additional requirements in clauses (1) to (4). An appeal must specify:
187.26(1) each disputed item, the reason for the dispute, and an estimate of the dollar
187.27amount involved for each disputed item, if appropriate;
187.28(2) the computation that is believed to be correct, if appropriate;
187.29(3) the authority in the statute or rule relied upon for each disputed item; and
187.30(4) the name, address, and phone number of the person at the provider's place of
187.31business with whom contact may be made regarding the appeal.
187.32(b) An appeal is considered timely only if postmarked or received by the
187.33department's Office of Inspector General, Financial Fraud and Abuse Division within 30
187.34days after receiving a notice of department sanction.
188.1(c) Before the appeal hearing, the department may deny or terminate authorizations
188.2or payment to the entity or individual if the department determines that the action is
188.3necessary to protect the public welfare or the interests of the child care assistance program.
188.4    Subd. 12. Consolidated hearings with licensing sanction. If a financial
188.5misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing
188.6sanction exists for which there is an appeal hearing right and the sanction is timely
188.7appealed, and the overpayment recovery action and licensing sanction involve the same
188.8set of facts, the overpayment recovery action and licensing sanction must be consolidated
188.9in the contested case hearing related to the licensing sanction.
188.10    Subd. 13. Grounds for and methods of monetary recovery. (a) The department
188.11may obtain monetary recovery from a provider who has been improperly paid by the
188.12child care assistance program, regardless of whether the error was intentional or county
188.13error. The department does not need to establish a pattern as a precondition of monetary
188.14recovery of erroneous or false billing claims, duplicate billing claims, or billing claims
188.15based on false statements or financial misconduct.
188.16(b) The department shall obtain monetary recovery from providers by the following
188.17means:
188.18(1) permitting voluntary repayment of money, either in lump-sum payment or
188.19installment payments;
188.20(2) using any legal collection process;
188.21(3) deducting or withholding program payments; or
188.22(4) utilizing the means set forth in chapter 16D.
188.23    Subd. 14. Reporting of suspected fraudulent activity. (a) A person who, in
188.24good faith, makes a report of or testifies in any action or proceeding in which financial
188.25misconduct is alleged, and who is not involved in, has not participated in, or has not aided
188.26and abetted, conspired, or colluded in the financial misconduct, shall have immunity from
188.27any liability, civil or criminal, that results by reason of the person's report or testimony.
188.28For the purpose of any proceeding, the good faith of any person reporting or testifying
188.29under this provision shall be presumed.
188.30(b) If a person that is or has been involved in, participated in, aided and abetted,
188.31conspired, or colluded in the financial misconduct reports the financial misconduct,
188.32the department may consider that person's report and assistance in investigating the
188.33misconduct as a mitigating factor in the department's pursuit of civil, criminal, or
188.34administrative remedies.
189.1    Subd. 15. Data privacy. Data of any kind obtained or created in relation to a provider
189.2or recipient investigation under this section is defined, classified, and protected the same as
189.3all other data under section 13.46, and this data has the same classification as licensing data.
189.4    Subd. 16. Monetary recovery; random sample extrapolation. The department is
189.5authorized to calculate the amount of monetary recovery from a provider, license holder, or
189.6controlling individual based upon extrapolation from a statistical random sample of claims
189.7submitted by the provider, license holder, or controlling individual and paid by the child
189.8care assistance program. The department's random sample extrapolation shall constitute a
189.9rebuttable presumption of the accuracy of the calculation of monetary recovery. If the
189.10presumption is not rebutted by the provider, license holder, or controlling individual in the
189.11appeal process, the department shall use the extrapolation as the monetary recovery figure.
189.12The department may use sampling and extrapolation to calculate the amount of monetary
189.13recovery if the claims to be reviewed represent services to 50 or more children in care.
189.14    Subd. 17. Effect of department's monetary penalty determination. Unless
189.15a timely and proper appeal is received by the department's Office of Inspector General,
189.16Financial Fraud and Abuse Division, the department's administrative determination or
189.17sanction shall be considered a final department determination.
189.18    Subd. 18. Office of Inspector General recoveries. Overpayment recoveries
189.19resulting from child care provider fraud investigations initiated by the department's Office
189.20of Inspector General's fraud investigations staff are excluded from the county recovery
189.21provision in section 119B.11, subdivision 3.

189.22    Sec. 7. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
189.23    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
189.24Medicare and Medicaid Services determines that a provider is designated "high-risk," the
189.25commissioner may withhold payment from providers within that category upon initial
189.26enrollment for a 90-day period. The withholding for each provider must begin on the date
189.27of the first submission of a claim.
189.28(b) An enrolled provider that is also licensed by the commissioner under chapter
189.29245A must designate an individual as the entity's compliance officer. The compliance
189.30officer must:
189.31(1) develop policies and procedures to assure adherence to medical assistance laws
189.32and regulations and to prevent inappropriate claims submissions;
189.33(2) train the employees of the provider entity, and any agents or subcontractors of
189.34the provider entity including billers, on the policies and procedures under clause (1);
190.1(3) respond to allegations of improper conduct related to the provision or billing of
190.2medical assistance services, and implement action to remediate any resulting problems;
190.3(4) use evaluation techniques to monitor compliance with medical assistance laws
190.4and regulations;
190.5(5) promptly report to the commissioner any identified violations of medical
190.6assistance laws or regulations; and
190.7    (6) within 60 days of discovery by the provider of a medical assistance
190.8reimbursement overpayment, report the overpayment to the commissioner and make
190.9arrangements with the commissioner for the commissioner's recovery of the overpayment.
190.10The commissioner may require, as a condition of enrollment in medical assistance, that a
190.11provider within a particular industry sector or category establish a compliance program that
190.12contains the core elements established by the Centers for Medicare and Medicaid Services.
190.13(c) The commissioner may revoke the enrollment of an ordering or rendering
190.14provider for a period of not more than one year, if the provider fails to maintain and, upon
190.15request from the commissioner, provide access to documentation relating to written orders
190.16or requests for payment for durable medical equipment, certifications for home health
190.17services, or referrals for other items or services written or ordered by such provider, when
190.18the commissioner has identified a pattern of a lack of documentation. A pattern means a
190.19failure to maintain documentation or provide access to documentation on more than one
190.20occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a
190.21provider under the provisions of section 256B.064.
190.22(d) The commissioner shall terminate or deny the enrollment of any individual or
190.23entity if the individual or entity has been terminated from participation in Medicare or
190.24under the Medicaid program or Children's Health Insurance Program of any other state.
190.25(e) As a condition of enrollment in medical assistance, the commissioner shall
190.26require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
190.27and Medicaid Services or the Minnesota Department of Human Services commissioner
190.28 permit the Centers for Medicare and Medicaid Services, its agents, or its designated
190.29contractors and the state agency, its agents, or its designated contractors to conduct
190.30unannounced on-site inspections of any provider location. The commissioner shall publish
190.31in the Minnesota Health Care Program Provider Manual a list of provider types designated
190.32"limited," "moderate," or "high-risk," based on the criteria and standards used to designate
190.33Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and
190.34criteria are not subject to the requirements of chapter 14. The commissioner's designations
190.35are not subject to administrative appeal.
191.1(f) As a condition of enrollment in medical assistance, the commissioner shall
191.2require that a high-risk provider, or a person with a direct or indirect ownership interest in
191.3the provider of five percent or higher, consent to criminal background checks, including
191.4fingerprinting, when required to do so under state law or by a determination by the
191.5commissioner or the Centers for Medicare and Medicaid Services that a provider is
191.6designated high-risk for fraud, waste, or abuse.
191.7(g) As a condition of enrollment, all durable medical equipment, prosthetics,
191.8orthotics, and supplies (DMEPOS) suppliers operating in Minnesota are required to name
191.9the Department of Human Services, in addition to the Centers for Medicare and Medicaid
191.10Services, as an obligee on all surety performance bonds required pursuant to section
191.114312(a) of the Balanced Budget Act of 1997, Public Law 105-33, amending Social
191.12Security Act, section 1834(a). The performance bond must also allow for recovery of
191.13costs and fees in pursuing a claim on the bond.
191.14(h) The Department of Human Services may require a provider to purchase a
191.15performance surety bond as a condition of initial enrollment, reenrollment, reinstatement,
191.16or continued enrollment if: (1) the provider fails to demonstrate financial viability; (2) the
191.17department determines there is significant evidence of or potential for fraud and abuse
191.18by the provider; or (3) the provider or category of providers is designated high-risk
191.19pursuant to paragraph (a) and Code of Federal Regulations, title 42, section 455.450, or
191.20the department otherwise finds it is in the best interest of the Medicaid program to do so.
191.21The performance bond must be in an amount of $100,000 or ten percent of the provider's
191.22payments from Medicaid during the immediately preceding 12 months, whichever is
191.23greater. The performance bond must name the Department of Human Services as an
191.24obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.
191.25EFFECTIVE DATE.This section is effective the day following final enactment.

191.26    Sec. 8. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
191.27to read:
191.28    Subd. 22. Application fee. (a) The commissioner must collect and retain federally
191.29required nonrefundable application fees to pay for provider screening activities in
191.30accordance with Code of Federal Regulations, title 42, section 455, subpart E. The
191.31enrollment application must be made under the procedures specified by the commissioner,
191.32in the form specified by the commissioner, and accompanied by an application fee
191.33described in paragraph (b), or a request for a hardship exception as described in the
191.34specified procedures. Application fees must be deposited in the provider screening account
191.35in the special revenue fund. Amounts in the provider screening account are appropriated
192.1to the commissioner for costs associated with the provider screening activities required
192.2in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner
192.3shall conduct screening activities as required by Code of Federal Regulations, title 42,
192.4section 455, subpart E, and as otherwise provided by law, to include database checks,
192.5unannounced pre- and postenrollment site visits, fingerprinting, and criminal background
192.6studies. The commissioner must revalidate all providers under this subdivision at least
192.7once every five years.
192.8(b) The application fee under this subdivision is $532 for the calendar year 2013.
192.9For calendar year 2014 and subsequent years, the fee:
192.10(1) is adjusted by the percentage change to the consumer price index for all urban
192.11consumers, United States city average, for the 12-month period ending with June of the
192.12previous year. The resulting fee must be announced in the Federal Register;
192.13(2) is effective from January 1 to December 31 of a calendar year;
192.14(3) is required on the submission of an initial application, an application to establish
192.15a new practice location, an application for reenrollment when the provider is not enrolled
192.16at the time of application of reenrollment, or at revalidation when required by federal
192.17regulation; and
192.18(4) must be in the amount in effect for the calendar year during which the application
192.19for enrollment, new practice location, or reenrollment is being submitted.
192.20(c) The application fee under this subdivision cannot be charged to:
192.21(1) providers who are enrolled in Medicare or who provide documentation of
192.22payment of the fee to, and enrollment with, another state;
192.23(2) providers who are enrolled but are required to submit new applications for
192.24purposes of reenrollment; or
192.25(3) a provider who enrolls as an individual.
192.26EFFECTIVE DATE.This section is effective the day following final enactment.

192.27    Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
192.28    Subd. 1a. Grounds for sanctions against vendors. The commissioner may
192.29impose sanctions against a vendor of medical care for any of the following: (1) fraud,
192.30theft, or abuse in connection with the provision of medical care to recipients of public
192.31assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
192.32not medically necessary; (3) a pattern of making false statements of material facts for
192.33the purpose of obtaining greater compensation than that to which the vendor is legally
192.34entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
192.35agency access during regular business hours to examine all records necessary to disclose
193.1the extent of services provided to program recipients and appropriateness of claims for
193.2payment; (6) failure to repay an overpayment or a fine finally established under this
193.3section; and (7) failure to correct errors in the maintenance of health service or financial
193.4records for which a fine was imposed or after issuance of a warning by the commissioner;
193.5and (8) any reason for which a vendor could be excluded from participation in the
193.6Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
193.7The determination of services not medically necessary may be made by the commissioner
193.8in consultation with a peer advisory task force appointed by the commissioner on the
193.9recommendation of appropriate professional organizations. The task force expires as
193.10provided in section 15.059, subdivision 5.

193.11    Sec. 10. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
193.12    Subd. 1b. Sanctions available. The commissioner may impose the following
193.13sanctions for the conduct described in subdivision 1a: suspension or withholding of
193.14payments to a vendor and suspending or terminating participation in the program, or
193.15imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
193.16this section, the commissioner shall consider the nature, chronicity, or severity of the
193.17conduct and the effect of the conduct on the health and safety of persons served by the
193.18vendor. Regardless of imposition of sanctions, the commissioner may make a referral
193.19to the appropriate state licensing board.

193.20    Sec. 11. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
193.21    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
193.22shall determine any monetary amounts to be recovered and sanctions to be imposed upon
193.23a vendor of medical care under this section. Except as provided in paragraphs (b) and
193.24(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
193.25without prior notice and an opportunity for a hearing, according to chapter 14, on the
193.26commissioner's proposed action, provided that the commissioner may suspend or reduce
193.27payment to a vendor of medical care, except a nursing home or convalescent care facility,
193.28after notice and prior to the hearing if in the commissioner's opinion that action is
193.29necessary to protect the public welfare and the interests of the program.
193.30(b) Except when the commissioner finds good cause not to suspend payments under
193.31Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
193.32withhold or reduce payments to a vendor of medical care without providing advance
193.33notice of such withholding or reduction if either of the following occurs:
194.1(1) the vendor is convicted of a crime involving the conduct described in subdivision
194.21a; or
194.3(2) the commissioner determines there is a credible allegation of fraud for which an
194.4investigation is pending under the program. A credible allegation of fraud is an allegation
194.5which has been verified by the state, from any source, including but not limited to:
194.6(i) fraud hotline complaints;
194.7(ii) claims data mining; and
194.8(iii) patterns identified through provider audits, civil false claims cases, and law
194.9enforcement investigations.
194.10Allegations are considered to be credible when they have an indicia of reliability
194.11and the state agency has reviewed all allegations, facts, and evidence carefully and acts
194.12judiciously on a case-by-case basis.
194.13(c) The commissioner must send notice of the withholding or reduction of payments
194.14under paragraph (b) within five days of taking such action unless requested in writing by a
194.15law enforcement agency to temporarily withhold the notice. The notice must:
194.16(1) state that payments are being withheld according to paragraph (b);
194.17(2) set forth the general allegations as to the nature of the withholding action, but
194.18need not disclose any specific information concerning an ongoing investigation;
194.19(3) except in the case of a conviction for conduct described in subdivision 1a, state
194.20that the withholding is for a temporary period and cite the circumstances under which
194.21withholding will be terminated;
194.22(4) identify the types of claims to which the withholding applies; and
194.23(5) inform the vendor of the right to submit written evidence for consideration by
194.24the commissioner.
194.25The withholding or reduction of payments will not continue after the commissioner
194.26determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
194.27relating to the alleged fraud are completed, unless the commissioner has sent notice of
194.28intention to impose monetary recovery or sanctions under paragraph (a).
194.29(d) The commissioner shall suspend or terminate a vendor's participation in the
194.30program without providing advance notice and an opportunity for a hearing when the
194.31suspension or termination is required because of the vendor's exclusion from participation
194.32in Medicare. Within five days of taking such action, the commissioner must send notice of
194.33the suspension or termination. The notice must:
194.34(1) state that suspension or termination is the result of the vendor's exclusion from
194.35Medicare;
194.36(2) identify the effective date of the suspension or termination; and
195.1(3) inform the vendor of the need to be reinstated to Medicare before reapplying
195.2for participation in the program.
195.3(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
195.4sanction is to be imposed, a vendor may request a contested case, as defined in section
195.514.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
195.6appeal request must be received by the commissioner no later than 30 days after the date
195.7the notification of monetary recovery or sanction was mailed to the vendor. The appeal
195.8request must specify:
195.9(1) each disputed item, the reason for the dispute, and an estimate of the dollar
195.10amount involved for each disputed item;
195.11(2) the computation that the vendor believes is correct;
195.12(3) the authority in statute or rule upon which the vendor relies for each disputed item;
195.13(4) the name and address of the person or entity with whom contacts may be made
195.14regarding the appeal; and
195.15(5) other information required by the commissioner.
195.16(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
195.17services according to standards in this chapter and Minnesota Rules, chapter 9505. The
195.18commissioner may assess fines if specific required components of documentation are
195.19missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
195.20on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less.
195.21(g) The vendor shall pay the fine assessed on or before the payment date specified. If
195.22the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
195.23recover the amount of the fine. A timely appeal shall stay payment of the fine until the
195.24commissioner issues a final order.

195.25    Sec. 12. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to
195.26read:
195.27    Subd. 21. Requirements for initial enrollment of personal care assistance
195.28provider agencies. (a) All personal care assistance provider agencies must provide, at the
195.29time of enrollment as a personal care assistance provider agency in a format determined
195.30by the commissioner, information and documentation that includes, but is not limited to,
195.31the following:
195.32    (1) the personal care assistance provider agency's current contact information
195.33including address, telephone number, and e-mail address;
195.34    (2) proof of surety bond coverage in the amount of $50,000 $100,000 or ten percent
195.35of the provider's payments from Medicaid in the previous year, whichever is less more.
196.1The performance bond must be in a form approved by the commissioner, must be renewed
196.2annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;
196.3    (3) proof of fidelity bond coverage in the amount of $20,000;
196.4    (4) proof of workers' compensation insurance coverage;
196.5    (5) proof of liability insurance;
196.6    (6) a description of the personal care assistance provider agency's organization
196.7identifying the names of all owners, managing employees, staff, board of directors, and
196.8the affiliations of the directors, owners, or staff to other service providers;
196.9    (7) a copy of the personal care assistance provider agency's written policies and
196.10procedures including: hiring of employees; training requirements; service delivery;
196.11and employee and consumer safety including process for notification and resolution
196.12of consumer grievances, identification and prevention of communicable diseases, and
196.13employee misconduct;
196.14    (8) copies of all other forms the personal care assistance provider agency uses in
196.15the course of daily business including, but not limited to:
196.16    (i) a copy of the personal care assistance provider agency's time sheet if the time
196.17sheet varies from the standard time sheet for personal care assistance services approved
196.18by the commissioner, and a letter requesting approval of the personal care assistance
196.19provider agency's nonstandard time sheet;
196.20    (ii) the personal care assistance provider agency's template for the personal care
196.21assistance care plan; and
196.22    (iii) the personal care assistance provider agency's template for the written
196.23agreement in subdivision 20 for recipients using the personal care assistance choice
196.24option, if applicable;
196.25    (9) a list of all training and classes that the personal care assistance provider agency
196.26requires of its staff providing personal care assistance services;
196.27    (10) documentation that the personal care assistance provider agency and staff have
196.28successfully completed all the training required by this section;
196.29    (11) documentation of the agency's marketing practices;
196.30    (12) disclosure of ownership, leasing, or management of all residential properties
196.31that is used or could be used for providing home care services;
196.32    (13) documentation that the agency will use the following percentages of revenue
196.33generated from the medical assistance rate paid for personal care assistance services
196.34for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
196.35personal care assistance choice option and 72.5 percent of revenue from other personal
196.36care assistance providers. The revenue generated by the qualified professional and the
197.1reasonable costs associated with the qualified professional shall not be used in making
197.2this calculation; and
197.3    (14) effective May 15, 2010, documentation that the agency does not burden
197.4recipients' free exercise of their right to choose service providers by requiring personal
197.5care assistants to sign an agreement not to work with any particular personal care
197.6assistance recipient or for another personal care assistance provider agency after leaving
197.7the agency and that the agency is not taking action on any such agreements or requirements
197.8regardless of the date signed.
197.9    (b) Personal care assistance provider agencies shall provide the information specified
197.10in paragraph (a) to the commissioner at the time the personal care assistance provider
197.11agency enrolls as a vendor or upon request from the commissioner. The commissioner
197.12shall collect the information specified in paragraph (a) from all personal care assistance
197.13providers beginning July 1, 2009.
197.14    (c) All personal care assistance provider agencies shall require all employees in
197.15management and supervisory positions and owners of the agency who are active in the
197.16day-to-day management and operations of the agency to complete mandatory training
197.17as determined by the commissioner before enrollment of the agency as a provider.
197.18Employees in management and supervisory positions and owners who are active in
197.19the day-to-day operations of an agency who have completed the required training as
197.20an employee with a personal care assistance provider agency do not need to repeat
197.21the required training if they are hired by another agency, if they have completed the
197.22training within the past three years. By September 1, 2010, the required training must
197.23be available with meaningful access according to title VI of the Civil Rights Act and
197.24federal regulations adopted under that law or any guidance from the United States Health
197.25and Human Services Department. The required training must be available online or by
197.26electronic remote connection. The required training must provide for competency testing.
197.27Personal care assistance provider agency billing staff shall complete training about
197.28personal care assistance program financial management. This training is effective July 1,
197.292009. Any personal care assistance provider agency enrolled before that date shall, if it
197.30has not already, complete the provider training within 18 months of July 1, 2009. Any new
197.31owners or employees in management and supervisory positions involved in the day-to-day
197.32operations are required to complete mandatory training as a requisite of working for the
197.33agency. Personal care assistance provider agencies certified for participation in Medicare
197.34as home health agencies are exempt from the training required in this subdivision. When
197.35available, Medicare-certified home health agency owners, supervisors, or managers must
197.36successfully complete the competency test.
198.1EFFECTIVE DATE.This section is effective the day following final enactment.

198.2    Sec. 13. Minnesota Statutes 2012, section 299C.093, is amended to read:
198.3299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.
198.4The superintendent of the Bureau of Criminal Apprehension shall maintain a
198.5computerized data system relating to individuals required to register as predatory offenders
198.6under section 243.166. To the degree feasible, the system must include the data required
198.7to be provided under section 243.166, subdivisions 4 and 4a, and indicate the time period
198.8that the person is required to register. The superintendent shall maintain this data in a
198.9manner that ensures that it is readily available to law enforcement agencies. This data is
198.10private data on individuals under section 13.02, subdivision 12, but may be used for law
198.11enforcement and corrections purposes. The commissioner of human services has access
198.12to the data for state-operated services, as defined in section 246.014, are also authorized
198.13to have access to the data for the purposes described in section 246.13, subdivision 2,
198.14paragraph (b), and for purposes of conducting background studies under chapter 245C.

198.15    Sec. 14. Minnesota Statutes 2012, section 524.5-118, subdivision 1, is amended to read:
198.16    Subdivision 1. When required; exception. (a) The court shall require a background
198.17study under this section:
198.18(1) before the appointment of a guardian or conservator, unless a background study
198.19has been done on the person under this section within the previous five two years; and
198.20(2) once every five two years after the appointment, if the person continues to serve
198.21as a guardian or conservator.
198.22(b) The background study must include:
198.23(1) criminal history data from the Bureau of Criminal Apprehension, other criminal
198.24history data held by the commissioner of human services, and data regarding whether the
198.25person has been a perpetrator of substantiated maltreatment of a vulnerable adult and a
198.26 or minor.;
198.27(c) The court shall request a search of the (2) criminal history data from the National
198.28Criminal Records Repository if the proposed guardian or conservator has not resided in
198.29Minnesota for the previous five ten years or if the Bureau of Criminal Apprehension
198.30information received from the commissioner of human services under subdivision 2,
198.31paragraph (b), indicates that the subject is a multistate offender or that the individual's
198.32multistate offender status is undetermined.; and
198.33(3) state licensing agency data if the proposed guardian or conservator has ever been
198.34denied a professional license in the state of Minnesota or elsewhere that is directly related
199.1to the responsibilities of a professional fiduciary, or has ever held a professional license
199.2directly related to the responsibilities of a professional fiduciary that was conditioned,
199.3suspended, revoked, or canceled.
199.4(d) (c) If the guardian or conservator is not an individual, the background study must
199.5be done on all individuals currently employed by the proposed guardian or conservator
199.6who will be responsible for exercising powers and duties under the guardianship or
199.7conservatorship.
199.8(e) (d) If the court determines that it would be in the best interests of the ward or
199.9protected person to appoint a guardian or conservator before the background study can
199.10be completed, the court may make the appointment pending the results of the study,
199.11however, the background study must then be completed as soon as reasonably possible
199.12after appointment, no later than 30 days after appointment.
199.13(f) (e) The fee for conducting a background study for appointment of a professional
199.14guardian or conservator must be paid by the guardian or conservator. In other cases,
199.15the fee must be paid as follows:
199.16(1) if the matter is proceeding in forma pauperis, the fee is an expense for purposes
199.17of section 524.5-502, paragraph (a);
199.18(2) if there is an estate of the ward or protected person, the fee must be paid from
199.19the estate; or
199.20(3) in the case of a guardianship or conservatorship of the person that is not
199.21proceeding in forma pauperis, the court may order that the fee be paid by the guardian or
199.22conservator or by the court.
199.23(g) (f) The requirements of this subdivision do not apply if the guardian or
199.24conservator is:
199.25(1) a state agency or county;
199.26(2) a parent or guardian of a proposed ward or protected person who has a
199.27developmental disability, if the parent or guardian has raised the proposed ward or
199.28protected person in the family home until the time the petition is filed, unless counsel
199.29appointed for the proposed ward or protected person under section 524.5-205, paragraph
199.30(d)
; 524.5-304, paragraph (b); 524.5-405, paragraph (a); or 524.5-406, paragraph (b),
199.31recommends a background study; or
199.32(3) a bank with trust powers, bank and trust company, or trust company, organized
199.33under the laws of any state or of the United States and which is regulated by the
199.34commissioner of commerce or a federal regulator.

200.1    Sec. 15. Minnesota Statutes 2012, section 524.5-118, is amended by adding a
200.2subdivision to read:
200.3    Subd. 2a. Procedure; state licensing agency data. The court shall request
200.4the commissioner of human services to provide the court within 25 working days of
200.5receipt of the request with licensing agency data from Minnesota licensing agencies
200.6that the commissioner determines issue professional licenses directly related to the
200.7responsibilities of a professional fiduciary. The commissioner shall enter into agreements
200.8with these agencies to provide for electronic access to the relevant licensing data by the
200.9commissioner. The data provided by the commissioner to the court shall include, as
200.10applicable, license number and status; original date of issue; last renewal date; expiration
200.11date; date of the denial, condition, suspension, revocation, or cancellation; the name of the
200.12licensing agency that denied, conditioned, suspended, revoked, or canceled the license;
200.13and the basis for denial, condition, suspension, revocation, or cancellation of the license.
200.14If the proposed guardian or conservator has resided in a state other than Minnesota in the
200.15previous ten years, licensing agency data shall also include the licensing agency data
200.16from any other state where the proposed guardian or conservator resided. If the proposed
200.17guardian or conservator has or has had a professional license in another state that is
200.18directly related to the responsibilities of a professional fiduciary, state licensing agency
200.19data shall also include data from the relevant licensing agency of that state.

200.20    Sec. 16. Minnesota Statutes 2012, section 524.5-303, is amended to read:
200.21524.5-303 JUDICIAL APPOINTMENT OF GUARDIAN: PETITION.
200.22(a) An individual or a person interested in the individual's welfare may petition for
200.23a determination of incapacity, in whole or in part, and for the appointment of a limited
200.24or unlimited guardian for the individual.
200.25(b) The petition must set forth the petitioner's name, residence, current address if
200.26different, relationship to the respondent, and interest in the appointment and, to the extent
200.27known, state or contain the following with respect to the respondent and the relief requested:
200.28(1) the respondent's name, age, principal residence, current street address, and, if
200.29different, the address of the dwelling in which it is proposed that the respondent will
200.30reside if the appointment is made;
200.31(2) the name and address of the respondent's:
200.32(i) spouse, or if the respondent has none, an adult with whom the respondent has
200.33resided for more than six months before the filing of the petition; and
201.1(ii) adult children or, if the respondent has none, the respondent's parents and adult
201.2brothers and sisters, or if the respondent has none, at least one of the adults nearest in
201.3kinship to the respondent who can be found;
201.4(3) the name of the administrative head and address of the institution where the
201.5respondent is a patient, resident, or client of any hospital, nursing home, home care
201.6agency, or other institution;
201.7(4) the name and address of any legal representative for the respondent;
201.8(5) the name, address, and telephone number of any person nominated as guardian
201.9by the respondent in any manner permitted by law, including a health care agent nominated
201.10in a health care directive;
201.11(6) the name, address, and telephone number of any proposed guardian and the
201.12reason why the proposed guardian should be selected;
201.13(7) the name and address of any health care agent or proxy appointed pursuant to
201.14a health care directive as defined in section 145C.01, a living will under chapter 145B,
201.15or other similar document executed in another state and enforceable under the laws of
201.16this state;
201.17(8) the reason why guardianship is necessary, including a brief description of the
201.18nature and extent of the respondent's alleged incapacity;
201.19(9) if an unlimited guardianship is requested, the reason why limited guardianship
201.20is inappropriate and, if a limited guardianship is requested, the powers to be granted to
201.21the limited guardian; and
201.22(10) a general statement of the respondent's property with an estimate of its value,
201.23including any insurance or pension, and the source and amount of any other anticipated
201.24income or receipts.
201.25(c) The petition must also set forth the following information regarding the proposed
201.26guardian or any employee of the guardian responsible for exercising powers and duties
201.27under the guardianship:
201.28(1) whether the proposed guardian has ever been removed for cause from serving as
201.29a guardian or conservator and, if so, the case number and court location; and
201.30(2) if the proposed guardian is a professional guardian or conservator, a summary of
201.31the proposed guardian's educational background and relevant work and other experience.;
201.32(3) whether the proposed guardian has ever applied for or held, at any time, any
201.33professional license, and if so, the name of the licensing agency, and as applicable, the
201.34license number and status; whether the license is active or has been denied, conditioned,
201.35suspended, revoked, or canceled; and the basis for the denial, condition, suspension,
201.36revocation, or cancellation of the license;
202.1(4) whether the proposed guardian has ever been found civilly liable in an action
202.2that involved fraud, misrepresentation, material omission, misappropriation, theft, or
202.3conversion, and if so, the case number and court location;
202.4(5) whether the proposed guardian has ever filed for or received protection under the
202.5bankruptcy laws, and if so, the case number and court location;
202.6(6) whether the proposed guardian has any outstanding civil monetary judgments
202.7against the proposed guardian, and if so, the case number, court location, and outstanding
202.8amount owed;
202.9(7) whether an order for protection or harassment restraining order has ever been
202.10issued against the proposed guardian, and if so, the case number and court location; and
202.11(8) whether the proposed guardian has ever been convicted of a crime other than a
202.12petty misdemeanor or traffic offense, and if so, the case number and the crime of which
202.13the guardian was convicted.

202.14    Sec. 17. Minnesota Statutes 2012, section 524.5-316, is amended to read:
202.15524.5-316 REPORTS; MONITORING OF GUARDIANSHIP; COURT
202.16ORDERS.
202.17(a) A guardian shall report to the court in writing on the condition of the ward at least
202.18annually and whenever ordered by the court. A copy of the report must be provided to the
202.19ward and to interested persons of record with the court. A report must state or contain:
202.20(1) the current mental, physical, and social condition of the ward;
202.21(2) the living arrangements for all addresses of the ward during the reporting period;
202.22(3) any restrictions placed on the ward's right to communication and visitation with
202.23persons of the ward's choice and the factual bases for those restrictions;
202.24(4) the medical, educational, vocational, and other services provided to the ward and
202.25the guardian's opinion as to the adequacy of the ward's care;
202.26(5) a recommendation as to the need for continued guardianship and any
202.27recommended changes in the scope of the guardianship;
202.28(6) an address and telephone number where the guardian can be contacted; and
202.29(7) whether the guardian has ever been removed for cause from serving as a guardian
202.30or conservator and, if so, the case number and court location;
202.31(8) any changes occurring that would affect the accuracy of information contained
202.32in the most recent criminal background study of the guardian conducted under section
202.33524.5-118; and
203.1(9) (7) if applicable, the amount of reimbursement for services rendered to the ward
203.2that the guardian received during the previous year that were not reimbursed by county
203.3contract.
203.4(b) A guardian shall report to the court in writing within 30 days of the occurrence of
203.5any of the events listed in this paragraph. The guardian must report any of the occurrences
203.6in this paragraph and follow the same reporting requirements in this paragraph for
203.7any employee of the guardian responsible for exercising powers and duties under the
203.8guardianship. A copy of the report must be provided to the ward and to interested persons
203.9of record with the court. A guardian shall report when:
203.10(1) the guardian is removed for cause from serving as a guardian or conservator, and
203.11if so, the case number and court location;
203.12(2) the guardian has a professional license denied, conditioned, suspended, revoked,
203.13or canceled, and if so, the licensing agency and license number, and the basis for denial,
203.14condition, suspension, revocation, or cancellation of the license;
203.15(3) the guardian is found civilly liable in an action that involves fraud,
203.16misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the
203.17case number and court location;
203.18(4) the guardian files for or receives protection under the bankruptcy laws, and
203.19if so, the case number and court location;
203.20(5) a civil monetary judgment is entered against the guardian, and if so, the case
203.21number, court location, and outstanding amount owed;
203.22(6) the guardian is convicted of a crime other than a petty misdemeanor or traffic
203.23offense, and if so, the case number and court location; or
203.24(7) an order for protection or harassment restraining order is issued against the
203.25guardian, and if so, the case number and court location.
203.26(b) (c) A ward or interested person of record with the court may submit to the court a
203.27written statement disputing statements or conclusions regarding the condition of the ward
203.28or addressing any disciplinary or legal action that are is contained in the report guardian's
203.29reports and may petition the court for an order that is in the best interests of the ward or
203.30for other appropriate relief.
203.31(c) (d) An interested person may notify the court in writing that the interested person
203.32does not wish to receive copies of reports required under this section.
203.33(d) (e) The court may appoint a visitor to review a report, interview the ward or
203.34guardian, and make any other investigation the court directs.
204.1(e) (f) The court shall establish a system for monitoring guardianships, including the
204.2filing and review of annual reports. If an annual report is not filed within 60 days of the
204.3required date, the court shall issue an order to show cause.
204.4(g) If a guardian fails to comply with this section, the court may decline to appoint that
204.5person as a guardian or conservator, or may remove a person as guardian or conservator.

204.6    Sec. 18. Minnesota Statutes 2012, section 524.5-403, is amended to read:
204.7524.5-403 ORIGINAL PETITION FOR APPOINTMENT OR PROTECTIVE
204.8ORDER.
204.9(a) The following may petition for the appointment of a conservator or for any
204.10other appropriate protective order:
204.11(1) the person to be protected;
204.12(2) an individual interested in the estate, affairs, or welfare of the person to be
204.13protected; or
204.14(3) a person who would be adversely affected by lack of effective management of
204.15the property and business affairs of the person to be protected.
204.16(b) The petition must set forth the petitioner's name, residence, current address
204.17if different, relationship to the respondent, and interest in the appointment or other
204.18protective order, and, to the extent known, state or contain the following with respect to
204.19the respondent and the relief requested:
204.20(1) the respondent's name, age, principal residence, current street address, and, if
204.21different, the address of the dwelling where it is proposed that the respondent will reside if
204.22the appointment is made;
204.23(2) if the petition alleges impairment in the respondent's ability to receive and
204.24evaluate information, a brief description of the nature and extent of the respondent's
204.25alleged impairment;
204.26(3) if the petition alleges that the respondent is missing, detained, or unable to
204.27return to the United States, a statement of the relevant circumstances, including the time
204.28and nature of the disappearance or detention and a description of any search or inquiry
204.29concerning the respondent's whereabouts;
204.30(4) the name and address of the respondent's:
204.31(i) spouse, or if the respondent has none, an adult with whom the respondent has
204.32resided for more than six months before the filing of the petition; and
204.33(ii) adult children or, if the respondent has none, the respondent's parents and adult
204.34brothers and sisters or, if the respondent has none, at least one of the adults nearest in
204.35kinship to the respondent who can be found;
205.1(5) the name of the administrative head and address of the institution where the
205.2respondent is a patient, resident, or client of any hospital, nursing home, home care
205.3agency, or other institution;
205.4(6) the name and address of any legal representative for the respondent;
205.5(7) the name and address of any health care agent or proxy appointed pursuant to
205.6a health care directive as defined in section 145C.01, a living will under chapter 145B,
205.7or other similar document executed in another state and enforceable under the laws of
205.8this state;
205.9(8) a general statement of the respondent's property with an estimate of its value,
205.10including any insurance or pension, and the source and amount of other anticipated
205.11income or receipts; and
205.12(9) the reason why a conservatorship or other protective order is in the best interest
205.13of the respondent.
205.14(c) If a conservatorship is requested, the petition must also set forth to the extent
205.15known:
205.16(1) the name, address, and telephone number of any proposed conservator and the
205.17reason why the proposed conservator should be selected;
205.18(2) the name, address, and telephone number of any person nominated as conservator
205.19by the respondent if the respondent has attained 14 years of age; and
205.20(3) the type of conservatorship requested and, if an unlimited conservatorship,
205.21the reason why limited conservatorship is inappropriate or, if a limited conservatorship,
205.22the property to be placed under the conservator's control and any limitation on the
205.23conservator's powers and duties.
205.24(d) The petition must also set forth the following information regarding the proposed
205.25conservator or any employee of the conservator responsible for exercising powers and
205.26duties under the conservatorship:
205.27(1) whether the proposed conservator has ever been removed for cause from serving
205.28as a guardian or conservator and, if so, the case number and court location; and
205.29(2) if the proposed conservator is a professional guardian or conservator, a summary
205.30of the proposed conservator's educational background and relevant work and other
205.31experience.;
205.32(3) whether the proposed conservator has ever applied for or held, at any time, any
205.33professional license, and if so, the name of the licensing agency, and as applicable, the
205.34license number and status; whether the license is active or has been denied, conditioned,
205.35suspended, revoked, or canceled; and the basis for the denial, condition, suspension,
205.36revocation, or cancellation of the license;
206.1(4) whether the proposed conservator has ever been found civilly liable in an action
206.2that involved fraud, misrepresentation, material omission, misappropriation, theft, or
206.3conversion, and if so, the case number and court location;
206.4(5) whether the proposed conservator has ever filed for or received protection under
206.5the bankruptcy laws, and if so, the case number and court location;
206.6(6) whether the proposed conservator has any outstanding civil monetary judgments
206.7against the proposed conservator, and if so, the case number, court location, and
206.8outstanding amount owed;
206.9(7) whether an order for protection or harassment restraining order has ever been
206.10issued against the proposed conservator, and if so, the case number and court location; and
206.11(8) whether the proposed conservator has ever been convicted of a crime other than
206.12a petty misdemeanor or traffic offense, and if so, the case number and the crime of which
206.13the conservator was convicted.

206.14    Sec. 19. Minnesota Statutes 2012, section 524.5-420, is amended to read:
206.15524.5-420 REPORTS; APPOINTMENT OF VISITOR; MONITORING;
206.16COURT ORDERS.
206.17(a) A conservator shall report to the court for administration of the estate annually
206.18unless the court otherwise directs, upon resignation or removal, upon termination of the
206.19conservatorship, and at other times as the court directs. An order, after notice and hearing,
206.20allowing an intermediate report of a conservator adjudicates liabilities concerning the
206.21matters adequately disclosed in the accounting. An order, after notice and hearing, allowing
206.22a final report adjudicates all previously unsettled liabilities relating to the conservatorship.
206.23(b) A report must state or contain a listing of the assets of the estate under the
206.24conservator's control and a listing of the receipts, disbursements, and distributions during
206.25the reporting period.
206.26(c) The report must also state:
206.27(1) an address and telephone number where the conservator can be contacted;.
206.28(2) whether the conservator has ever been removed for cause from serving as a