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Capital IconMinnesota Legislature
Office of the Revisor of Statutes

SF 1291

2nd Engrossment - 90th Legislature (2017 - 2018) Posted on 02/22/2018 02:58pm

KEY: stricken = removed, old language.
underscored = added, new language.
Version List Authors and Status
Pdf Rtf

Current Version - 2nd Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33
2.1 2.2
2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17
2.18
2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 4.1 4.2
4.3
4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10
5.11
5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21
5.22
5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25
6.26
6.27 6.28 6.29 6.30 6.31 6.32 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8
7.9
7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24
7.25
7.26 7.27 7.28 7.29 7.30 7.31 8.1 8.2
8.3
8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27
9.28
9.29 9.30 9.31 9.32 9.33 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17
10.18
10.19 10.20 10.21 10.22 10.23 10.24 10.25
10.26
10.27 10.28 10.29 10.30 10.31 11.1 11.2 11.3 11.4 11.5
11.6
11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30
11.31
12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10
12.11
12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24
12.25
12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33
13.1
13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9
13.10
13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28
14.29
14.30 14.31 14.32 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18
15.19
15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 16.1 16.2 16.3 16.4 16.5
16.6
16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27
16.28
16.29 16.30 16.31 16.32 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13
17.14
17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28
17.29
18.1 18.2 18.3 18.4 18.5 18.6
18.7
18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 19.1 19.2 19.3 19.4 19.5 19.6 19.7
19.8
19.9 19.10 19.11
19.12
19.13 19.14
19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 20.1 20.2 20.3
20.4
20.5 20.6 20.7 20.8
20.9
20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22
20.23
20.24 20.25 20.26 20.27 20.28 20.29 21.1 21.2 21.3 21.4 21.5 21.6
21.7
21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19
21.20
21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 22.1 22.2 22.3 22.4 22.5
22.6
22.7 22.8 22.9 22.10
22.11
22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28
23.1
23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11
23.12
23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 25.34 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33
26.34
27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14
27.15
27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 39.1 39.2 39.3 39.4 39.5
39.6
39.7 39.8 39.9 39.10 39.11
39.12
39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28
39.29
40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32
41.1
41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18
42.19
42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31
45.32
46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14
50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 53.1 53.2 53.3
53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 54.1 54.2
54.3
54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11
54.12
54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30
55.31
56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30
57.1
57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19
58.20
58.21 58.22 58.23 58.24 58.25
58.26
58.27 58.28 58.29 58.30 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20
59.21
59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 59.33 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 62.34 62.35
63.1
63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16
63.17
63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 64.1 64.2 64.3 64.4 64.5
64.6
64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 65.1 65.2 65.3 65.4 65.5 65.6
65.7
65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19
66.20
66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 67.35 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26
70.27
70.28 70.29 70.30 70.31 70.32 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15
71.16
71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17
73.18
73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31
74.32
75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21
75.22
75.23 75.24 75.25 75.26 75.27 75.28 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8
77.9
77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30
77.31
78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24
78.25
78.26 78.27 78.28 78.29 78.30 78.31 78.32 79.1 79.2
79.3
79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12
79.13
79.14 79.15 79.16
79.17
79.18 79.19
79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15
80.16
80.17 80.18 80.19 80.20 80.21 80.22
80.23
80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 82.1 82.2 82.3 82.4 82.5
82.6
82.7 82.8 82.9 82.10
82.11
82.12 82.13 82.14 82.15 82.16 82.17
82.18
82.19 82.20 82.21 82.22 82.23 82.24
82.25
82.26 82.27 82.28 82.29 82.30
83.1
83.2 83.3 83.4 83.5 83.6
83.7
83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17
83.18
83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30
84.1
84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17
84.18
84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 85.1 85.2 85.3 85.4 85.5 85.6
85.7
85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19
87.20
87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8
88.9
88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25
88.26
88.27 88.28 88.29 88.30 88.31 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13
91.14
91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24
93.25
93.26 93.27 93.28 93.29 93.30 93.31 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29
94.30
95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 95.34 95.35
96.1
96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 97.33 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26
98.27
98.28 98.29 98.30 98.31 98.32 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13
100.14
100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 101.1 101.2 101.3 101.4 101.5
101.6
101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 101.33 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 103.1 103.2
103.3
103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15
103.16
103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 104.1 104.2 104.3 104.4 104.5 104.6 104.7
104.8
104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10
105.11
105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 106.1 106.2 106.3 106.4
106.5
106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10
108.11
108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33
110.34
111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26
113.27
113.28 113.29 113.30 113.31 114.1 114.2 114.3 114.4 114.5
114.6
114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25
114.26
114.27 114.28 114.29 114.30 114.31 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17
115.18
115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31
115.32
116.1 116.2
116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 117.1 117.2 117.3
117.4
117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25
119.26
119.27 119.28 119.29 119.30 119.31 119.32 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10
120.11
120.12 120.13
120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23
121.24
121.25 121.26 121.27 121.28 121.29 121.30 121.31 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16
122.17
122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 123.34 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 124.34 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24
125.25
125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8
126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20
126.21
126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20
128.21
128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11
130.12
130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17
132.18
132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 135.1 135.2
135.3
135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11
135.12
135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22
136.23
136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 137.1 137.2
137.3
137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 138.1 138.2 138.3 138.4
138.5
138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17
139.18
139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 141.33 141.34 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18
142.19
142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32
144.1
144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 144.34 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10
147.11
147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30
148.31
149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11
150.12
150.13 150.14 150.15 150.16
150.17
150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16
151.17
151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 156.1 156.2
156.3
156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12
157.13
157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 158.1 158.2 158.3 158.4 158.5
158.6
158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26
158.27
158.28 158.29
158.30
159.1 159.2
159.3 159.4 159.5 159.6 159.7
159.8
159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30
162.31
163.1 163.2 163.3 163.4 163.5 163.6
163.7
163.8 163.9 163.10 163.11
163.12
163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 164.34 164.35 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 165.33 166.1 166.2 166.3 166.4 166.5 166.6
166.7
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A bill for an act
 relating to human services; modifying provisions governing children and families
services, chemical and mental health services, operations, health care, and
community supports; making various technical corrections; amending Minnesota
Statutes 2016, sections 144D.04, subdivision 2, by adding a subdivision; 245.095;
245.462, subdivisions 6, 11; 245.464, subdivision 2; 245.466, subdivision 2;
245.470, subdivision 2; 245.4871, subdivisions 9a, 14, by adding a subdivision;
245.4875, subdivision 2; 245.488, subdivision 2; 245.735, subdivision 3; 245.8261,
subdivision 1; 245A.02, subdivisions 5a, 8, 9, 12, by adding subdivisions; 245A.03,
subdivisions 1, 7; 245A.04, subdivisions 2, 4, 6, 7, 10, 14, by adding a subdivision;
245A.05; 245A.11, by adding subdivisions; 245D.02, subdivision 20; 245D.03,
subdivision 1; 245D.04, subdivision 3; 245D.071, subdivisions 1, 3; 245D.09,
subdivision 5a; 245D.11, subdivision 4; 245D.24, subdivision 3; 253B.02,
subdivision 9; 254B.15, subdivisions 4, 5; 256.01, subdivision 29; 256.045,
subdivision 3; 256B.02, subdivision 7; 256B.04, subdivision 21; 256B.055,
subdivision 12; 256B.0615; 256B.0616; 256B.0622, subdivisions 2, 2b, 3a, 4, 7a,
7b; 256B.0623, subdivision 2; 256B.0624, subdivisions 1, 2, 3, 4; 256B.0625,
subdivisions 35a, 43, 60a; 256B.064, subdivision 1b; 256B.0651, subdivision 17;
256B.0659, subdivisions 3, 12, 14, 21, 23, 24; 256B.0911, subdivision 3a;
256B.092, subdivisions 1a, 14; 256B.0943, subdivisions 1, 2, 4, 7, 8, 9; 256B.0946,
subdivisions 1, 1a, 4, 6; 256B.0947, subdivisions 3a, 7; 256B.49, subdivisions 13,
25; 256B.4912, by adding a subdivision; 256B.4913, by adding a subdivision;
256B.4914, subdivisions 3, 5, 8, 16; 256B.84; 256B.85, subdivision 12b; 256D.051,
subdivisions 1, 1a, 2, 3, 3a, 3b, 6b, 8, 18; 256G.01, subdivision 4; 256G.02,
subdivision 4; 256G.09, subdivision 2; 256G.10; 256J.751, subdivisions 2, 5, by
adding subdivisions; 256N.02, subdivisions 10, 16, 17, 18; 256N.22, subdivision
1; 256N.23, subdivision 6; 256N.24, subdivisions 1, 8, 11, 12, 14; 256P.02,
subdivisions 1, 1a; 256P.08, subdivision 4; 626.5572, subdivision 21; proposing
coding for new law in Minnesota Statutes, chapters 245; 245A; repealing Minnesota
Statutes 2016, sections 119B.125, subdivision 8; 245.469; 245.4879; 256B.0624,
subdivisions 4a, 5, 6, 7, 8, 9, 10, 11; 256B.0944; Minnesota Rules, parts 9555.6255;
9555.7100; 9555.7200; 9555.7300; 9555.7600.

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

ARTICLE 1

CHILDREN AND FAMILIES SERVICES

Section 1.

Minnesota Statutes 2016, section 256D.051, subdivision 1, is amended to read:


Subdivision 1.

Food stamp employment and training program.

The commissioner
shall implement a food stamp employment and training program in order to meet the food
stamp employment and training participation requirements of the United States Department
of Agriculture. deleted text begin Unless exempt under subdivision 3a, each adult recipient in the unit must
participate in the food stamp employment and training program each month that the person
is eligible for food stamps. The person's participation in food stamp employment and training
services must begin no later than the first day of the calendar month following the
determination of eligibility for food stamps. With the county agency's consent, anddeleted text end To the
extent of available resources, deleted text begin the persondeleted text end new text begin a recipientnew text end may deleted text begin voluntarily continuedeleted text end new text begin volunteernew text end to
participate in food stamp employment and training services deleted text begin for up to three additional
consecutive months immediately following termination of food stamp benefits in order to
complete the provisions of the person's employability development plandeleted text end .new text begin A recipient who
volunteers for employment and training services is subject to the work requirements in Code
of Federal Regulations, title 7, section 273.7.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 2.

Minnesota Statutes 2016, section 256D.051, subdivision 1a, is amended to read:


Subd. 1a.

Notices deleted text begin and sanctionsdeleted text end .

(a) At the time the county agency notifies the household
that it is eligible for food stamps, the county agency must inform deleted text begin all mandatory employment
and training services participants as identified in subdivision 1 in the household that they
must comply with all food stamp employment and training program requirements each
month, including the requirement to attend an initial orientation to the food stamp
employment and training program and that food stamp eligibility will end unless the
participants comply with the requirements specified in the noticedeleted text end new text begin an adult of the opportunity
to volunteer for and participate in SNAP employment and training activities, provide plain
language material that explains the benefits of voluntary participation, and provide the name
and address of the county's designated employment and training service providernew text end .

(b) deleted text begin A participant who fails without good cause to comply with food stamp employment
and training program requirements of this section, including attendance at orientation, will
lose food stamp eligibility for the following periods:deleted text end new text begin The county must inform each recipient
who is an able-bodied adult without dependents that the recipient's SNAP benefits are limited
to three months in a 36-month period from the first full month of application unless the
recipient meets the work requirements in Code of Federal Regulations, title 7, section 273.7.
new text end

deleted text begin (1) for the first occurrence, for one month or until the person complies with the
requirements not previously complied with, whichever is longer;
 deleted text end

deleted text begin (2) for the second occurrence, for three months or until the person complies with the
requirements not previously complied with, whichever is longer; or
 deleted text end

deleted text begin (3) for the third and any subsequent occurrence, for six months or until the person
complies with the requirements not previously complied with, whichever is longer.
 deleted text end

deleted text begin If the participant is not the food stamp head of household, the person shall be considered
an ineligible household member for food stamp purposes. If the participant is the food stamp
head of household, the entire household is ineligible for food stamps as provided in Code
of Federal Regulations, title 7, section 273.7(g). "Good cause" means circumstances beyond
the control of the participant, such as illness or injury, illness or injury of another household
member requiring the participant's presence, a household emergency, or the inability to
obtain child care for children between the ages of six and 12 or to obtain transportation
needed in order for the participant to meet the food stamp employment and training program
participation requirements.
 deleted text end

deleted text begin (c) The county agency shall mail or hand deliver a notice to the participant not later than
five days after determining that the participant has failed without good cause to comply
with food stamp employment and training program requirements which specifies the
requirements that were not complied with, the factual basis for the determination of
noncompliance, and the right to reinstate eligibility upon a showing of good cause for failure
to meet the requirements. The notice must ask the reason for the noncompliance and identify
the participant's appeal rights. The notice must request that the participant inform the county
agency if the participant believes that good cause existed for the failure to comply and must
state that the county agency intends to terminate eligibility for food stamp benefits due to
failure to comply with food stamp employment and training program requirements.
 deleted text end

deleted text begin (d) If the county agency determines that the participant did not comply during the month
with all food stamp employment and training program requirements that were in effect, and
if the county agency determines that good cause was not present, the county must provide
a ten-day notice of termination of food stamp benefits. The amount of food stamps that are
withheld from the household and determination of the impact of the sanction on other
household members is governed by Code of Federal Regulations, title 7, section 273.7.
 deleted text end

deleted text begin (e) The participant may appeal the termination of food stamp benefits under the provisions
of section 256.045.
 deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 3.

Minnesota Statutes 2016, section 256D.051, subdivision 2, is amended to read:


Subd. 2.

County agency duties.

(a) The county agency shall provide to food stamp
recipients a food stamp employment and training program. The program must include:

(1) orientation to the food stamp employment and training program;

(2) an individualized employability assessment and an individualized employability
development plan that includes assessment of literacy, ability to communicate in the English
language, educational and employment history, and that estimates the length of time it will
take the participant to obtain employment. The employability assessment and development
plan must be completed in consultation with the participant, must assess the participant's
assets, barriers, and strengths, and must identify steps necessary to overcome barriers to
employment. A copy of the employability development plan must be provided to the
registrant;

(3) referral to available accredited remedial or skills trainingnew text begin or career pathwaysnew text end programs
designed to address participant's barriers to employment;

(4) referral to available programs that provide subsidized or unsubsidized employment
as necessary;

(5) a job search program, including job seeking skills training; and

(6) other activities, to the extent of available resources designed by the county agency
to prepare the participant for permanent employment.

deleted text begin In order to allow time for job search, the county agency may not require an individual
to participate in the food stamp employment and training program for more than 32 hours
a week. The county agency shall require an individual to spend at least eight hours a week
in job search or other food stamp employment and training program activities.
 deleted text end

(b) The county agency shall prepare an annual plan for the operation of its food stamp
employment and training program. The plan must be submitted to and approved by the
commissioner of employment and economic development. The plan must include:

(1) a description of the services to be offered by the county agency;

(2) a plan to coordinate the activities of all public new text begin entities and private nonprofit new text end entities
providing employment-related services in order to avoid duplication of effort and to providenew text begin
a wide range of allowable activities andnew text end services more efficiently;

(3) a description of the factors that will be taken into account when determining a client's
employability development plan; and

(4) provisions to ensure that deleted text begin thedeleted text end new text begin anew text end county agency's employment and training service
provider provides each recipient with an orientation, employability assessment, and
employability development plan as specified in paragraph (a), clauses (1) and (2), within
30 days of the recipient's deleted text begin eligibility for assistancedeleted text end new text begin request to participate in employment and
trainingnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 4.

Minnesota Statutes 2016, section 256D.051, subdivision 3, is amended to read:


Subd. 3.

Participant duties.

In order to receive food stamp deleted text begin assistancedeleted text end new text begin employment and
training servicesnew text end , a deleted text begin registrantdeleted text end new text begin participant who volunteersnew text end shall: (1) cooperate with the county
agency in all aspects of the food stamp employment and training program; new text begin and new text end (2) deleted text begin accept
any suitable employment, including employment offered through the Job Training Partnership
Act, and other employment and training options; and (3)deleted text end participate in food stamp
employment and training activities assigned by the county agency. The county agency may
terminate new text begin employment and training new text end assistance to a deleted text begin registrantdeleted text end new text begin voluntary participantnew text end who fails
to cooperate in the food stamp employment and training program, deleted text begin as provided in subdivision
1adeleted text end new text begin unless good cause is providednew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 5.

Minnesota Statutes 2016, section 256D.051, subdivision 3a, is amended to read:


Subd. 3a.

Requirement to register work.

deleted text begin (a)deleted text end To the extent required under Code of
Federal Regulations, title 7, section 273.7(a), each applicant for and recipient of food stamps
is required to register for work as a condition of eligibility for food stamp benefits. Applicants
and recipients are registered by signing an application or annual reapplication for food
stamps, and must be informed that they are registering for work by signing the form.

deleted text begin (b) The commissioner shall determine, within federal requirements, persons required to
participate in the food stamp employment and training (FSET) program.
 deleted text end

deleted text begin (c) The following food stamp recipients are exempt from mandatory participation in
food stamp employment and training services:
 deleted text end

deleted text begin (1) recipients of benefits under the Minnesota family investment program, Minnesota
supplemental aid program, or the general assistance program;
 deleted text end

deleted text begin (2) a child;
 deleted text end

deleted text begin (3) a recipient over age 55;
 deleted text end

deleted text begin (4) a recipient who has a mental or physical illness, injury, or incapacity which is expected
to continue for at least 30 days and which impairs the recipient's ability to obtain or retain
employment as evidenced by professional certification or the receipt of temporary or
permanent disability benefits issued by a private or government source;
 deleted text end

deleted text begin (5) a parent or other household member responsible for the care of either a dependent
child in the household who is under age six or a person in the household who is professionally
certified as having a physical or mental illness, injury, or incapacity. Only one parent or
other household member may claim exemption under this provision;
 deleted text end

deleted text begin (6) a recipient receiving unemployment insurance or who has applied for unemployment
insurance and has been required to register for work with the Department of Employment
and Economic Development as part of the unemployment insurance application process;
 deleted text end

deleted text begin (7) a recipient participating each week in a drug addiction or alcohol abuse treatment
and rehabilitation program, provided the operators of the treatment and rehabilitation
program, in consultation with the county agency, recommend that the recipient not participate
in the food stamp employment and training program;
 deleted text end

deleted text begin (8) a recipient employed or self-employed for 30 or more hours per week at employment
paying at least minimum wage, or who earns wages from employment equal to or exceeding
30 hours multiplied by the federal minimum wage; or
 deleted text end

deleted text begin (9) a student enrolled at least half time in any school, training program, or institution of
higher education. When determining if a student meets this criteria, the school's, program's
or institution's criteria for being enrolled half time shall be used.
 deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 6.

Minnesota Statutes 2016, section 256D.051, subdivision 3b, is amended to read:


Subd. 3b.

Orientation.

The county agency or its employment and training service
deleted text begin providerdeleted text end new text begin providersnew text end must provide an orientation to food stamp employment and training
services to each deleted text begin nonexempt food stampdeleted text end recipient within 30 days of the date deleted text begin that food stamp
eligibility is determineddeleted text end new text begin the recipient agreed to volunteernew text end . The orientation must inform the
participant of the deleted text begin requirement to participatedeleted text end new text begin benefits of participatingnew text end in services, the date,
time, and address to report to for services, the name and telephone number of the food stamp
employment and training service provider, the consequences for failure without good cause
to comply, the services and support services available through food stamp employment and
training services and other providers of similar services, and must encourage the participant
to view the food stamp program as a temporary means of supplementing the family's food
needs until the family achieves self-sufficiency through employment. The orientation may
be provided through audio-visual methods, but the participant must have the opportunity
for face-to-face interaction with county agency staff.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 7.

Minnesota Statutes 2016, section 256D.051, subdivision 6b, is amended to read:


Subd. 6b.

Federal reimbursement.

(a) Federal financial participation from the United
States Department of Agriculture for food stamp employment and training expenditures
that are eligible for reimbursement through the food stamp employment and training program
are dedicated funds and are annually appropriated to the commissioner of human services
for the operation of the food stamp employment and training program.

(b) The appropriation must be used for skill attainment through employment, training,
and support services for food stamp participants. By February 15, 2017, the commissioner
shall report to the chairs and ranking minority members of the legislative committees having
jurisdiction over the food stamp employment and training program on the progress of
securing additional federal reimbursement dollars under this program.

(c) Federal financial participation for the nonstate portion of food stamp employment
and training costs must be paid to the county agency or service provider that incurred the
costsnew text begin at a rate to be determined by the Departments of Human Services and Employment
and Economic Developmentnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 8.

Minnesota Statutes 2016, section 256D.051, subdivision 8, is amended to read:


Subd. 8.

Voluntary quit.

A person who is required to participate in food stamp
employment and training services is not eligible for food stamps if, without good cause, the
person refuses a legitimate offer of, or quits, suitable employment within deleted text begin 60deleted text end new text begin 30new text end days before
the date of application. A person who is required to participate in food stamp employment
and training services and, without good cause, voluntarily quits suitable employment or
refuses a legitimate offer of suitable employment while receiving food stamps shall be
terminated from the food stamp program deleted text begin as specified in subdivision 1adeleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 9.

Minnesota Statutes 2016, section 256D.051, subdivision 18, is amended to read:


Subd. 18.

Work experience placements.

(a) To the extent of available resources, each
county agency deleted text begin mustdeleted text end new text begin maynew text end establish and operate a work experience component in the food
stamp employment and training program for recipients who are subject to a federal limit of
three months of food stamp eligibility in any 36-month period. The purpose of the work
experience component is to enhance the participant's employability, self-sufficiency, and
to provide meaningful, productive work activities.

(b) The commissioner shall assist counties in the design and implementation of these
components. The commissioner must ensure that job placements under a work experience
component comply with section 256J.72. Written or oral concurrence with job duties of
persons placed under the community work experience program shall be obtained from the
appropriate exclusive bargaining representative.

(c) Worksites developed under this section are limited to projects that serve a useful
public service such as health, social service, environmental protection, education, urban
and rural development and redevelopment, welfare, recreation, public facilities, public
safety, community service, services to aged or disabled citizens, and child care. To the
extent possible, the prior training, skills, and experience of a recipient must be used in
making appropriate work experience assignments.

(d) Structured, supervised deleted text begin volunteerdeleted text end new text begin uncompensatednew text end work with an agency or organization
that is monitored by the county service provider may, with the approval of the county agency,
be used as a work experience placement.

(e) As a condition of placing a person receiving food stamps in a program under this
subdivision, the county agency shall first provide the recipient the opportunity:

(1) for placement in suitable subsidized or unsubsidized employment through participation
in job search under section 256D.051; deleted text begin or
deleted text end

(2) for placement in suitable employment through participation in deleted text begin on-the-job trainingdeleted text end new text begin a
paid work experiencenew text end , if such employment is availabledeleted text begin .deleted text end new text begin ; or
new text end

new text begin (3) for placement in an educational program designed to increase job skills and
employability.
 new text end

(f) The county agency shall limit the maximum monthly number of hours that any
participant may work in a work experience placement to a number equal to the amount of
the family's monthly food stamp allotment divided by the greater of the federal minimum
wage or the applicable state minimum wage.

After a participant has been assigned to a position for nine months, the participant may
not continue in that assignment unless the maximum number of hours a participant works
is no greater than the amount of the food stamp benefit divided by the rate of pay for
individuals employed in the same or similar occupations by the same employer at the same
site.

(g) The participant's employability development plan must include the length of time
needed in the work experience program, the need to continue job seeking activities while
participating in work experience, and the participant's employment goals.

(h) After each six months of a recipient's participation in a work experience job placement,
and at the conclusion of each work experience assignment under this section, the county
agency shall reassess and revise, as appropriate, the participant's employability development
plan.

(i) A participant has good cause for failure to cooperate with a work experience job
placement if, in the judgment of the employment and training service provider, the reason
for failure is reasonable and justified. deleted text begin Good cause for purposes of this section is defined in
subdivision 1a, paragraph (b).
deleted text end

(j) A recipient who has failed without good cause to participate in or comply with the
work experience job placement shall be terminated from participation in work experience
job activities. deleted text begin If the recipient is not exempt from mandatory food stamp employment and
training program participation under subdivision 3a, the recipient will be assigned to other
mandatory program activities. If the recipient is exempt from mandatory participation but
is participating as a volunteer, the person shall be terminated from the food stamp
employment and training program.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2017.
 new text end

Sec. 10.

Minnesota Statutes 2016, section 256J.751, subdivision 2, is amended to read:


Subd. 2.

deleted text begin Quarterly comparison reportdeleted text end new text begin TANF work participation ratesnew text end .

deleted text begin (a) The
commissioner shall report quarterly to all counties on each county's performance on the
following measures:
 deleted text end

deleted text begin (1) percent of MFIP caseload working in paid employment;
 deleted text end

deleted text begin (2) percent of MFIP caseload receiving only the food portion of assistance;
 deleted text end

deleted text begin (3) number of MFIP cases that have left assistance;
 deleted text end

deleted text begin (4) median placement wage rate;
 deleted text end

deleted text begin (5) caseload by months of TANF assistance;
 deleted text end

deleted text begin (6) percent of MFIP and diversionary work program (DWP) cases off cash assistance
or working 30 or more hours per week at one-year, two-year, and three-year follow-up
points from a baseline quarter. This measure is called the self-support index. The
commissioner shall report quarterly an expected range of performance for each county,
county grouping, and tribe on the self-support index. The expected range shall be derived
by a statistical methodology developed by the commissioner in consultation with the counties
and tribes. The statistical methodology shall control differences across counties in economic
conditions and demographics of the MFIP and DWP case load; and
 deleted text end

deleted text begin (7) the TANF work participation rate, defined as the participation requirements specified
under Public Law 109-171, the Deficit Reduction Act of 2005.
 deleted text end

deleted text begin (b)deleted text end The commissioner shall not apply the limits on vocational educational training and
education activities under Code of Federal Regulations, title 45, section 261.33(c), when
determining TANF work participation rates for individual counties under this subdivision.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2016, section 256J.751, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Comparison reports. new text end

new text begin The commissioner, in cooperation with counties, tribes,
and employment services agencies, shall develop and provide monthly and quarterly reports
to all counties, tribes, and employment service agencies on each county's and tribe's
performance, including work participation rate and racial and geographic data that measures
disparities within MFIP.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Minnesota Statutes 2016, section 256J.751, is amended by adding a subdivision
to read:


new text begin Subd. 4a. new text end

new text begin Self-support index. new text end

new text begin The self-support index is the percentage of MFIP and
diversionary work program (DWP) cases off cash assistance or working 30 hours or more
per week at one-, two-, and three-year follow-up points from a baseline quarter. The
commissioner shall report quarterly an expected range of performance for each county,
county grouping, and tribe on the self-support index. The expected range shall be based on
a statistical methodology developed by the commissioner in consultation with the counties
and tribes. The statistical methodology shall control differences across counties in economic
conditions and demographics of the MFIP and DWP caseload.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2016, section 256J.751, subdivision 5, is amended to read:


Subd. 5.

Failure to meet federal performance standards.

(a) If sanctions occur for
failure to meet the performance standards specified in title 1 of Public Law 104-193 of the
Personal Responsibility and Work Opportunity Act of 1996, and under Public Law 109-171,
the Deficit Reduction Act of 2005, the state shall pay 88 percent of the sanction. The
remaining 12 percent of the sanction will be paid by the counties. The county portion of the
sanction will be distributed across all counties in proportion to each county's percentage of
the MFIP average monthly caseload during the period for which the sanction was applied.

(b) If a county fails to meet the performance standards specified in title 1 of Public Law
104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and Public Law
109-171, the Deficit Reduction Act of 2005, for any year, the commissioner shall work with
counties to organize a joint state-county technical assistance team to work with the county.
The commissioner shall coordinate any technical assistance with other departments and
agencies including the Departments of Employment and Economic Development and
Education as necessary to achieve the purpose of this paragraph.

(c) For state performance measures, a low-performing county is one that:

(1) performs below the bottom of their expected range for the measure in subdivision
deleted text begin 2, clause (6),deleted text end new text begin 5new text end in an annualized measurement reported in October of each year; or

(2) performs below 40 percent for the deleted text begin measure in subdivision 2, clause (7)deleted text end new text begin TANF work
participation ratenew text end , as averaged across the four quarterly measurements for the year, or the
ten counties with the lowest rates if more than ten are below 40 percent.

(d) Low-performing counties under paragraph (c) must engage in corrective action
planning as defined by the commissioner. The commissioner may coordinate technical
assistance as specified in paragraph (b) for low-performing counties under paragraph (c).

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2016, section 256N.02, subdivision 10, is amended to read:


Subd. 10.

Financially responsible agency.

"Financially responsible agency" means the
agency that is financially responsible for a child. These agencies include both local social
service agencies under section 393.07 and tribal social service agencies authorized in section
256.01, subdivision 14b, as part of the American Indian Child Welfare Initiative, and
Minnesota tribes who assume financial responsibility of children from other states. Under
Northstar Care for Children, the agency that is financially responsible at the time of placement
for foster care continues to be responsible under section 256N.27 for the local share of any
maintenance payments, even after finalization of the adoption deleted text begin ofdeleted text end new text begin or new text end transfer of permanent
legal and physical custody of a child.

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2016, section 256N.02, subdivision 16, is amended to read:


Subd. 16.

Permanent legal and physical custody.

"Permanent legal and physical
custody" means new text begin (1) new text end a new text begin full new text end transfer of permanent legal and physical custody new text begin ordered by a
Minnesota juvenile court under section 260C.515, subdivision 4, new text end to a relative deleted text begin ordered by a
Minnesota juvenile court under section 260C.515, subdivision 4deleted text end new text begin who is not a parent as
defined in section 260C.007, subdivision 25new text end , or new text begin (2) new text end for a child under jurisdiction of a tribal
court, a judicial determination under a similar provision in tribal code which means that a
relative will assume the duty and authority to provide care, control, and protection of a child
who is residing in foster care, and to make decisions regarding the child's education, health
care, and general welfare until adulthood.new text begin For purposes of establishing eligibility for Northstar
kinship assistance, permanent legal and physical custody shall not include joint legal custody,
joint physical custody, or joint legal and physical custody between a child's parent and
relative custodian.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2016, section 256N.02, subdivision 17, is amended to read:


Subd. 17.

Reassessment.

"Reassessment" means an update of a previous assessment
through the process under section 256N.24 for a child who has been continuously eligible
for Northstar Care for Children, or when a child identified as an at-risk child (Level A)
under deleted text begin guardianship ordeleted text end adoption assistance has manifested the disability upon which eligibility
for the agreement was based according to section 256N.25, subdivision 3, paragraph (b).
A reassessment may be used to update an initial assessment, a special assessment, or a
previous reassessment.

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2016, section 256N.02, subdivision 18, is amended to read:


Subd. 18.

Relative.

"Relative," as described in section 260C.007, subdivision 27, means
a person related to the child by blood, marriage, or adoptiondeleted text begin ,deleted text end new text begin ; the legal parent, guardian, or
custodian of the child's sibling;new text end or an individual who is an important friend with whom the
child has resided or had significant contact. For an Indian child, relative, as described in
section 260C.007, subdivision 26b, means a person who is a member of the Indian child's
family as defined in the Indian Child Welfare Act of 1978, United States Code, title 25,
section 1903, paragraphs (2), (6), and (9).

new text begin EFFECTIVE DATE. new text end

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

Sec. 18.

Minnesota Statutes 2016, section 256N.22, subdivision 1, is amended to read:


Subdivision 1.

General eligibility requirements.

(a) To be eligible for Northstar kinship
assistance under this section, there must be a judicial determination under section 260C.515,
subdivision 4, that a transfer of permanent legal and physical custody to a relative new text begin who is
not a parent new text end is in the child's best interest. For a child under jurisdiction of a tribal court, a
judicial determination under a similar provision in tribal code indicating that a relative will
assume the duty and authority to provide care, control, and protection of a child who is
residing in foster care, and to make decisions regarding the child's education, health care,
and general welfare until adulthood, and that this is in the child's best interest is considered
equivalent. new text begin A child whose parent shares legal, physical, or legal and physical custody with
a relative custodian is not eligible for Northstar kinship assistance. new text end Additionally, a child
must:

(1) have been removed from the child's home pursuant to a voluntary placement
agreement or court order;

(2)(i) have resided with the prospective relative custodian who has been a licensed child
foster parent for at least six consecutive months; or

(ii) have received from the commissioner an exemption from the requirement in item
(i) that the prospective relative custodian has been a licensed child foster parent for at least
six consecutive months, based on a determination that:

(A) an expedited move to permanency is in the child's best interest;

(B) expedited permanency cannot be completed without provision of Northstar kinship
assistance;

(C) the prospective relative custodian is uniquely qualified to meet the child's needs, as
defined in section 260C.212, subdivision 2, on a permanent basis;

(D) the child and prospective relative custodian meet the eligibility requirements of this
section; and

(E) efforts were made by the legally responsible agency to place the child with the
prospective relative custodian as a licensed child foster parent for six consecutive months
before permanency, or an explanation why these efforts were not in the child's best interests;

(3) meet the agency determinations regarding permanency requirements in subdivision
2;

(4) meet the applicable citizenship and immigration requirements in subdivision 3;

(5) have been consulted regarding the proposed transfer of permanent legal and physical
custody to a relative, if the child is at least 14 years of age or is expected to attain 14 years
of age prior to the transfer of permanent legal and physical custody; and

(6) have a written, binding agreement under section 256N.25 among the caregiver or
caregivers, the financially responsible agency, and the commissioner established prior to
transfer of permanent legal and physical custody.

(b) In addition to the requirements in paragraph (a), the child's prospective relative
custodian or custodians must meet the applicable background study requirements in
subdivision 4.

(c) To be eligible for title IV-E Northstar kinship assistance, a child must also meet any
additional criteria in section 473(d) of the Social Security Act. The sibling of a child who
meets the criteria for title IV-E Northstar kinship assistance in section 473(d) of the Social
Security Act is eligible for title IV-E Northstar kinship assistance if the child and sibling
are placed with the same prospective relative custodian or custodians, and the legally
responsible agency, relatives, and commissioner agree on the appropriateness of the
arrangement for the sibling. A child who meets all eligibility criteria except those specific
to title IV-E Northstar kinship assistance is entitled to Northstar kinship assistance paid
through funds other than title IV-E.

new text begin EFFECTIVE DATE. new text end

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

Sec. 19.

Minnesota Statutes 2016, section 256N.23, subdivision 6, is amended to read:


Subd. 6.

Exclusions.

The commissioner must not enter into an adoption assistance
agreement with the following individuals:

(1) a child's biological parent or stepparent;

(2) a child's relative under section 260C.007, subdivision 26b or 27, with whom the
child resided immediately prior to child welfare involvement unless:

(i) the child was in the custody of a Minnesota county or tribal agency pursuant to an
order under chapter 260C or equivalent provisions of tribal code and the agency had
placement and care responsibility for permanency planning for the child; and

(ii) the child is under guardianship of the commissioner of human services according to
the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota tribal
court after termination of parental rights, suspension of parental rights, or a finding by the
tribal court that the child cannot safely return to the care of the parent;

(3) an individual adopting a child who is the subject of a direct adoptive placement under
section 259.47 or the equivalent in tribal code;

(4) a child's legal custodian or guardian who is now adopting the childnew text begin , except for a
relative custodian as defined in section 256N.02, subdivision 19, who is currently receiving
Northstar kinship assistance benefitsnew text end ; or

(5) an individual who is adopting a child who is not a citizen or resident of the United
States and was either adopted in another country or brought to the United States for the
purposes of adoption.

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

Minnesota Statutes 2016, section 256N.24, subdivision 1, is amended to read:


Subdivision 1.

Assessment.

(a) Each child eligible under sections 256N.21, 256N.22,
and 256N.23, must be assessed to determine the benefits the child may receive under section
256N.26, in accordance with the assessment tool, process, and requirements specified in
subdivision 2.

(b) If an agency applies the emergency foster care rate for initial placement under section
256N.26, the agency may wait up to 30 days to complete the initial assessment.

(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic
level, level B, or one of ten supplemental difficulty of care levels, levels C to L.

(d) An assessment must not be completed for:

(1) a child eligible for Northstar deleted text begin kinship assistance under section 256N.22 ordeleted text end adoption
assistance under section 256N.23 who is determined to be an at-risk child. A child under
this clause must be assigned level A under section 256N.26, subdivision 1; and

(2) a child transitioning into Northstar Care for Children under section 256N.28,
subdivision 7, unless the commissioner determines an assessment is appropriate.

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2016, section 256N.24, subdivision 8, is amended to read:


Subd. 8.

Completing the special assessment.

(a) The special assessment must be
completed in consultation with the child's caregiver. Face-to-face contact with the caregiver
is not required to complete the special assessment.

(b) If a new special assessment is required prior to the effective date of the Northstar
kinship assistance agreement, it must be completed by the financially responsible agency,
in consultation with the legally responsible agency if different. If the prospective relative
custodian is unable or unwilling to cooperate with the special assessment process, the child
shall be assigned the basic level, level B under section 256N.26, subdivision 3deleted text begin , unless the
child is known to be an at-risk child, in which case, the child shall be assigned level A under
section 256N.26, subdivision 1deleted text end .

(c) If a special assessment is required prior to the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency, in consultation with
the legally responsible agency if different. If there is no financially responsible agency, the
special assessment must be completed by the agency designated by the commissioner. If
the prospective adoptive parent is unable or unwilling to cooperate with the special
assessment process, the child must be assigned the basic level, level B under section 256N.26,
subdivision 3, unless the child is known to be an at-risk child, in which case, the child shall
be assigned level A under section 256N.26, subdivision 1.

(d) Notice to the prospective relative custodians or prospective adoptive parents must
be provided as specified in subdivision 13.

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

Minnesota Statutes 2016, section 256N.24, subdivision 11, is amended to read:


Subd. 11.

Completion of reassessment.

(a) The reassessment must be completed in
consultation with the child's caregiver. Face-to-face contact with the caregiver is not required
to complete the reassessment.

(b) For foster children eligible under section 256N.21, reassessments must be completed
by the financially responsible agency, in consultation with the legally responsible agency
if different.

(c) If reassessment is required after the effective date of the Northstar kinship assistance
agreement, the reassessment must be completed by the financially responsible agency.

(d) If a reassessment is required after the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency or, if there is no
financially responsible agency, the agency designated by the commissioner.

(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment, the
child must be assessed at level B under section 256N.26, subdivision 3, unless the child has
deleted text begin andeleted text end new text begin a Northstarnew text end adoption assistance deleted text begin or Northstar kinship assistancedeleted text end agreement in place and
is known to be an at-risk child, in which case the child must be assessed at level A under
section 256N.26, subdivision 1.

new text begin EFFECTIVE DATE. new text end

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

Sec. 23.

Minnesota Statutes 2016, section 256N.24, subdivision 12, is amended to read:


Subd. 12.

Approval of initial assessments, special assessments, and reassessments.

(a) Any agency completing initial assessments, special assessments, or reassessments must
designate one or more supervisors or other staff to examine and approve assessments
completed by others in the agency under subdivision 2. The person approving an assessment
must not be the case manager or staff member completing that assessment.

(b) In cases where a special assessment or reassessment for deleted text begin guardiandeleted text end new text begin Northstar kinshipnew text end
assistance and adoption assistance is required under subdivision 8 or 11, the commissioner
shall review and approve the assessment as part of the eligibility determination process
outlined in section 256N.22, subdivision 7, for Northstar kinship assistance, or section
256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum
for the negotiated agreement amount under section 256N.25.

(c) The new rate is effective the calendar month that the assessment is approved, or the
effective date of the agreement, whichever is later.

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

Minnesota Statutes 2016, section 256N.24, subdivision 14, is amended to read:


Subd. 14.

Assessment tool determines rate of benefits.

The assessment tool established
by the commissioner in subdivision 2 determines the monthly benefit level for children in
foster care. The monthly payment for deleted text begin guardiandeleted text end new text begin Northstar kinshipnew text end assistance or adoption
assistance may be negotiated up to the monthly benefit level under foster care for those
children eligible for a payment under section 256N.26, subdivision 1.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2016, section 256P.02, subdivision 1, is amended to read:


Subdivision 1.

Property ownership.

(a) The agency must apply paragraphs (b) to (e)
to determine the value of personal property. The agency must use the equity value of legally
available personal property to determine whether an applicant or participant is eligible for
assistance.

(b) When personal property is jointly owned by two or more persons, the agency shall
assume that each person owns an equal share, except that either person owns the entire sum
of a joint personal checking or savings account. When an applicant or participant documents
greater or lesser ownership, the agency must use that greater or lesser share to determine
the equity value held by the applicant or participant. Other types of ownership must be
evaluated according to law.

(c) Personal property owned by the applicant or participant must be presumed legally
available to the applicant or participant unless the applicant or participant documents that
the property is not legally available to the applicant or participant. When personal property
is not legally available, its equity value must not be applied against the limits of subdivision
2.

(d) An applicant must disclose whether the applicant has transferred personal property
valued in excess of the property limits in subdivision 2 for which reasonable compensation
was not received within one year prior to application. A participant must disclose all transfers
of property valued in excess of these limits, according to the reporting requirements in
section 256J.30, subdivision 9. When a transfer of personal property without reasonable
compensation has occurred:

(1) the person who transferred the property must provide the property's description,
information needed to determine the property's equity value, the names of the persons who
received the property, and the circumstances of and reasons for the transfer; and

(2) when the transferred property can be reasonably reacquired, or when reasonable
compensation can be secured, the property is presumed legally available to the applicant or
participant.

(e) A participant may build the equity value of personal property to the limits in
subdivision 2.

new text begin (f) Any lump sum payment that remains in the third month after the month of receipt is
counted in the asset limit.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2016, section 256P.02, subdivision 1a, is amended to read:


Subd. 1a.

Exemption.

Participants who qualify for child care assistance programs under
chapter 119B new text begin and funds under chapter 256Q new text end are exempt from this section.

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 2

CHEMICAL AND MENTAL HEALTH SERVICES

Section 1.

Minnesota Statutes 2016, section 245.462, subdivision 6, is amended to read:


Subd. 6.

Community support services program.

"Community support services program"
means services, other than inpatient or residential treatment services, provided or coordinated
by an identified program and staff under the clinical supervision of a mental health
professional designed to help adults with serious and persistent mental illness to function
and remain in the community. A community support services program includes:

(1) client outreachdeleted text begin ,deleted text end new text begin ;
new text end

(2) medication monitoringdeleted text begin ,deleted text end new text begin ;
new text end

(3) assistance in independent living skillsdeleted text begin ,deleted text end new text begin ;
new text end

(4) development of employability and work-related opportunitiesdeleted text begin ,deleted text end new text begin ;
new text end

(5) crisis deleted text begin assistance,deleted text end new text begin planning to develop a written plan identifying warning signs of a
crisis, available resources, and actions to mitigate the crisis;
new text end

(6) psychosocial rehabilitationdeleted text begin ,deleted text end new text begin ;
new text end

(7) help in applying for government benefitsdeleted text begin ,deleted text end new text begin ;new text end and

(8) housing support services.

The community support services program must be coordinated with the case management
services specified in section 245.4711.new text begin Crisis planning shall be coordinated with crisis
services under section 245.991.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 2.

Minnesota Statutes 2016, section 245.462, subdivision 11, is amended to read:


Subd. 11.

Emergency services.

"Emergency services" means an immediate response
service available on a 24-hour, seven-day-a-week basis for persons having a psychiatric
crisis, a mental health crisis, or emergencynew text begin as defined in section 245.991new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 3.

Minnesota Statutes 2016, section 245.464, subdivision 2, is amended to read:


Subd. 2.

Priorities.

By January 1, 1990, the commissioner shall require that each of the
treatment services and management activities described in sections deleted text begin 245.469 to 245.477deleted text end new text begin
245.470 to 245.477 and 245.991new text end are developed for adults with mental illness within available
resources based on the following ranked priorities:

(1) the provision of locally available deleted text begin emergencydeleted text end new text begin crisisnew text end services;

(2) the provision of locally available services to all adults with serious and persistent
mental illness and all adults with acute mental illness;

(3) the provision of specialized services regionally available to meet the special needs
of all adults with serious and persistent mental illness and all adults with acute mental illness;

(4) the provision of locally available services to adults with other mental illness; and

(5) the provision of education and preventive mental health services targeted at high-risk
populations.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 4.

Minnesota Statutes 2016, section 245.466, subdivision 2, is amended to read:


Subd. 2.

Adult mental health services.

The adult mental health service system developed
by each county board must include the following services:

(1) education and prevention services in accordance with section 245.468;

(2) deleted text begin emergencydeleted text end new text begin crisisnew text end services in accordance with section deleted text begin 245.469deleted text end new text begin 245.991new text end ;

(3) outpatient services in accordance with section 245.470;

(4) community support program services in accordance with section 245.4711;

(5) residential treatment services in accordance with section 245.472;

(6) acute care hospital inpatient treatment services in accordance with section 245.473;

(7) regional treatment center inpatient services in accordance with section 245.474;

(8) screening in accordance with section 245.476; and

(9) case management in accordance with sections 245.462, subdivision 3; and 245.4711.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 5.

Minnesota Statutes 2016, section 245.470, subdivision 2, is amended to read:


Subd. 2.

Specific requirements.

The county board shall require that all service providers
of outpatient services:

(1) meet the professional qualifications contained in sections 245.461 to 245.486;

(2) use a multidisciplinary mental health professional staff including at a minimum,
arrangements for psychiatric consultation, licensed psychologist consultation, and other
necessary multidisciplinary mental health professionals;

(3) develop individual treatment plans;

(4) provide initial appointments within three weeks, except in emergencies where there
must be immediate access as described in section deleted text begin 245.469deleted text end new text begin 245.991new text end ; and

(5) establish fee schedules approved by the county board that are based on a client's
ability to pay.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 6.

Minnesota Statutes 2016, section 245.4871, subdivision 9a, is amended to read:


Subd. 9a.

Crisis deleted text begin assistancedeleted text end new text begin planningnew text end .

"Crisis deleted text begin assistancedeleted text end new text begin planningnew text end " means deleted text begin assistance to
the child, the child's family, and all providers of services to the child to: recognize factors
precipitating a mental health crisis, identify behaviors related to the crisis, and be informed
of available resources to resolve the crisis. Crisis assistance requires the development of a
plan which addresses prevention and intervention strategies to be used in a potential crisis.
Other interventions include: (1) arranging for admission to acute care hospital inpatient
treatment; (2) crisis placement; (3) community resources for follow-up; and (4) emotional
support to the family during crisis. Crisis assistance does not include services designed to
secure the safety of a child who is at risk of abuse or neglect or necessary emergency services.deleted text end new text begin
the development of a written plan to assist a child's family to contend with a potential crisis
and is distinct from the immediate provision of intervention services as defined in section
245.991, subdivision 2, paragraph (g). The plan must address prevention and intervention
strategies to be used in a crisis. The plan identity factors that might precipitate a crisis and
behaviors related to the emergence of a crisis, and the resources available to resolve a crisis.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 7.

Minnesota Statutes 2016, section 245.4871, subdivision 14, is amended to read:


Subd. 14.

Emergency services.

"Emergency services" means an immediate response
service available on a 24-hour, seven-day-a-week basis for each child having a psychiatric
crisis, a mental health crisis, or a mental health emergencynew text begin as defined in section 245.991new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 8.

Minnesota Statutes 2016, section 245.4875, subdivision 2, is amended to read:


Subd. 2.

Children's mental health services.

The children's mental health service system
developed by each county board must include the following services:

(1) education and prevention services according to section 245.4877;

(2) mental health identification and intervention services according to section 245.4878;

(3) emergency services according to section deleted text begin 245.4879deleted text end new text begin 245.991new text end ;

(4) outpatient services according to section 245.488;

(5) family community support services according to section 245.4881;

(6) day treatment services according to section 245.4884, subdivision 2;

(7) residential treatment services according to section 245.4882;

(8) acute care hospital inpatient treatment services according to section 245.4883;

(9) screening according to section 245.4885;

(10) case management according to section 245.4881;

(11) therapeutic support of foster care according to section 245.4884, subdivision 4;

(12) professional home-based family treatment according to section 245.4884, subdivision
4; and

(13) mental health crisis services according to section 245.488, subdivision 3.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 9.

Minnesota Statutes 2016, section 245.488, subdivision 2, is amended to read:


Subd. 2.

Specific requirements.

The county board shall require that a service provider
of outpatient services to children:

(1) meets the professional qualifications contained in sections 245.487 to 245.4889;

(2) uses a multidisciplinary mental health professional staff including, at a minimum,
arrangements for psychiatric consultation, licensed psychologist consultation, and other
necessary multidisciplinary mental health professionals;

(3) develops individual treatment plans; and

(4) provides initial appointments within three weeks, except in emergencies where there
must be immediate access as described in section deleted text begin 245.4879deleted text end new text begin 245.991new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 10.

Minnesota Statutes 2016, section 245.735, subdivision 3, is amended to read:


Subd. 3.

Certified community behavioral health clinics.

(a) The commissioner shall
establish a state certification process for certified community behavioral health clinics
(CCBHCs) to be eligible for the prospective payment system in paragraph (f). Entities that
choose to be CCBHCs must:

(1) comply with the CCBHC criteria published by the United States Department of
Health and Human Services;

(2) employ or contract for clinic staff who have backgrounds in diverse disciplines,
including licensed mental health professionals, and staff who are culturally and linguistically
trained to serve the needs of the clinic's patient population;

(3) ensure that clinic services are available and accessible to patients of all ages and
genders and that crisis management services are available 24 hours per day;

(4) establish fees for clinic services for nonmedical assistance patients using a sliding
fee scale that ensures that services to patients are not denied or limited due to a patient's
inability to pay for services;

(5) comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data;

(6) provide crisis mental health services, withdrawal management services, emergency
crisis intervention services, and stabilization services; screening, assessment, and diagnosis
services, including risk assessments and level of care determinations; patient-centered
treatment planning; outpatient mental health and substance use services; targeted case
management; psychiatric rehabilitation services; peer support and counselor services and
family support services; and intensive community-based mental health services, including
mental health services for members of the armed forces and veterans;

(7) provide coordination of care across settings and providers to ensure seamless
transitions for patients across the full spectrum of health services, including acute, chronic,
and behavioral needs. Care coordination may be accomplished through partnerships or
formal contracts with:

(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified
health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or
community-based mental health providers; and

(ii) other community services, supports, and providers, including schools, child welfare
agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally
licensed health care and mental health facilities, urban Indian health clinics, Department of
Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals,
and hospital outpatient clinics;

(8) be certified as mental health clinics under section 245.69, subdivision 2;

(9) be certified to provide integrated treatment for co-occurring mental illness and
substance use disorders in adults or children under Minnesota Rules, chapter 9533, effective
July 1, 2017;

(10) comply with standards relating to mental health services in Minnesota Rules, parts
9505.0370 to 9505.0372;

(11) be licensed to provide chemical dependency treatment under Minnesota Rules, parts
9530.6405 to 9530.6505;

(12) be certified to provide children's therapeutic services and supports under section
256B.0943;

(13) be certified to provide adult rehabilitative mental health services under section
256B.0623;

(14) be enrolled to provide mental health crisis response services under section deleted text begin 256B.0624deleted text end new text begin
245.991new text end ;

(15) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;

(16) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926; and

(17) provide services that comply with the evidence-based practices described in
paragraph (e).

(b) If an entity is unable to provide one or more of the services listed in paragraph (a),
clauses (6) to (17), the commissioner may certify the entity as a CCBHC, if the entity has
a current contract with another entity that has the required authority to provide that service
and that meets federal CCBHC criteria as a designated collaborating organization, or, to
the extent allowed by the federal CCBHC criteria, the commissioner may approve a referral
arrangement. The CCBHC must meet federal requirements regarding the type and scope of
services to be provided directly by the CCBHC.

(c) Notwithstanding any other law that requires a county contract or other form of county
approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets
CCBHC requirements may receive the prospective payment under paragraph (f) for those
services without a county contract or county approval. There is no county share when
medical assistance pays the CCBHC prospective payment. As part of the certification process
in paragraph (a), the commissioner shall require a letter of support from the CCBHC's host
county confirming that the CCBHC and the county or counties it serves have an ongoing
relationship to facilitate access and continuity of care, especially for individuals who are
uninsured or who may go on and off medical assistance.

(d) When the standards listed in paragraph (a) or other applicable standards conflict or
address similar issues in duplicative or incompatible ways, the commissioner may grant
variances to state requirements if the variances do not conflict with federal requirements.
If standards overlap, the commissioner may substitute all or a part of a licensure or
certification that is substantially the same as another licensure or certification. The
commissioner shall consult with stakeholders, as described in subdivision 4, before granting
variances under this provision.

(e) The commissioner shall issue a list of required evidence-based practices to be
delivered by CCBHCs, and may also provide a list of recommended evidence-based practices.
The commissioner may update the list to reflect advances in outcomes research and medical
services for persons living with mental illnesses or substance use disorders. The commissioner
shall take into consideration the adequacy of evidence to support the efficacy of the practice,
the quality of workforce available, and the current availability of the practice in the state.
At least 30 days before issuing the initial list and any revisions, the commissioner shall
provide stakeholders with an opportunity to comment.

(f) The commissioner shall establish standards and methodologies for a prospective
payment system for medical assistance payments for services delivered by certified
community behavioral health clinics, in accordance with guidance issued by the Centers
for Medicare and Medicaid Services. During the operation of the demonstration project,
payments shall comply with federal requirements for an enhanced federal medical assistance
percentage. The commissioner may include quality bonus payment in the prospective
payment system based on federal criteria and on a clinic's provision of the evidence-based
practices in paragraph (e). The prospective payment system does not apply to MinnesotaCare.
Implementation of the prospective payment system is effective July 1, 2017, or upon federal
approval, whichever is later.

(g) The commissioner shall seek federal approval to continue federal financial
participation in payment for CCBHC services after the federal demonstration period ends
for clinics that were certified as CCBHCs during the demonstration period and that continue
to meet the CCBHC certification standards in paragraph (a). Payment for CCBHC services
shall cease effective July 1, 2019, if continued federal financial participation for the payment
of CCBHC services cannot be obtained.

(h) The commissioner may certify at least one CCBHC located in an urban area and at
least one CCBHC located in a rural area, as defined by federal criteria. To the extent allowed
by federal law, the commissioner may limit the number of certified clinics so that the
projected claims for certified clinics will not exceed the funds budgeted for this purpose.
The commissioner shall give preference to clinics that:

(1) provide a comprehensive range of services and evidence-based practices for all age
groups, with services being fully coordinated and integrated; and

(2) enhance the state's ability to meet the federal priorities to be selected as a CCBHC
demonstration state.

(i) The commissioner shall recertify CCBHCs at least every three years. The
commissioner shall establish a process for decertification and shall require corrective action,
medical assistance repayment, or decertification of a CCBHC that no longer meets the
requirements in this section or that fails to meet the standards provided by the commissioner
in the application and certification process.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 11.

Minnesota Statutes 2016, section 245.8261, subdivision 1, is amended to read:


Subdivision 1.

Scope.

(a) This section applies to providers of the following mental health
services for children:

(1) emergency services as defined in sections 245.4871, subdivision 14, and deleted text begin 245.4879deleted text end new text begin
245.991new text end ;

(2) family community support services as defined in section 245.4871, subdivision 17;

(3) day treatment services as defined in section 245.4871, subdivision 10;

(4) therapeutic support of foster care as defined in section 245.4871, subdivision 34;

(5) professional home-based family treatment as defined in sections 245.4871, subdivision
31, and 245.4884, subdivision 3; and

(6) mental health crisis services as defined in sections 245.4871, subdivision 24a, and
245.488, subdivision 3.

(b) Providers of mental health services for children under paragraph (a) must meet the
requirements of this section before using a restrictive procedure with a child.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 12.

new text begin [245.991] MENTAL HEALTH CRISIS SERVICES.
 new text end

new text begin Subdivision 1. new text end

new text begin Availability of crisis services. new text end

new text begin (a) By August 1, 2017, a county board
must provide or contract for crisis services within the county to meet the needs of children
and adults in the county experiencing a crisis 24 hours a day, seven days a week. The
provider entity shall seek reimbursement under available health insurance for the recipient.
If the recipient lacks insurance that covers this service, or cannot afford the cost-sharing, a
provider entity may require a recipient to pay a fee according to section 245.481. A provider
entity shall not delay the timely provision of crisis services because of delays in determining
this fee or because of the unwillingness or inability of the recipient to pay the fee. Crisis
services must include screening, assessment, intervention services, and appropriate case
disposition, including stabilization services. A tribal authority that accepts crisis grant
funding has the same responsibilities within the tribal authority's designated service area.
 new text end

new text begin (b) Crisis services must:
 new text end

new text begin (1) promote the safety and emotional stability of a recipient;
 new text end

new text begin (2) minimize further deterioration of a recipient;
 new text end

new text begin (3) help a recipient to obtain ongoing care and treatment;
 new text end

new text begin (4) prevent a recipient's placement in a setting that is more intensive, costly, or restrictive
than necessary and appropriate to meet a recipient's needs when clinically appropriate; and
 new text end

new text begin (5) provide support, psychoeducation, and referrals to third parties, including family
members, friends, or service providers, for a recipient in need of crisis services.
 new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin For purposes of this section, the following terms have the meanings
given them.
 new text end

new text begin (a) "Adult" means a recipient 18 years of age or older.
 new text end

new text begin (b) "Assessment" means an immediate face-to-face assessment by a mental health
practitioner under the clinical supervision of a mental health professional, a physician, or
a mental health professional.
 new text end

new text begin (c) "Certified family peer specialist" is an individual qualified to provide services under
section 256B.0616 and who is under the supervision of a mental health professional.
 new text end

new text begin (d) "Certified peer specialist" is an individual qualified to provide services under section
256B.0615 and who is under the supervision of a mental health professional.
 new text end

new text begin (e) "Commissioner" means the commissioner of human services.
 new text end

new text begin (f) "Crisis" is a behavioral, emotional, or psychiatric situation that without the provision
of crisis response services, would likely result in significantly reduced levels of functioning
in primary activities of daily living, or in an emergency situation, or in the placement of the
recipient in a more restrictive setting, including, but not limited to, inpatient hospitalization.
Crisis includes a behavioral, emotional, or psychiatric situation that causes an immediate
need for mental health services consistent with section 62Q.55. A crisis is not limited to the
standards for emergency admission or transportation in section 253B.05.
 new text end

new text begin (g) "Intervention services" means face-to-face, short-term intensive mental health services
initiated during a crisis to help the recipient cope with immediate stressors, identify and
utilize available resources and strengths, engage in voluntary treatment, and begin to return
to the recipient's baseline level of functioning.
 new text end

new text begin (h) "Mental health practitioner" is a crisis team member defined by section 245.462,
subdivision 17, or 245.4871, subdivision 26, and is under the clinical supervision of a mental
health professional on the team.
 new text end

new text begin (i) "Mental health professional" has the meaning given in section 245.462, subdivision
18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6).
 new text end

new text begin (j) "Screening" is the process by which a provider entity gathers information, determines
if a potential crisis exists, identifies parties involved, and determines an appropriate response.
 new text end

new text begin (k) "Stabilization services" means individualized mental health services provided to a
recipient following intervention services that are designed to restore the recipient to the
recipient's prior functional level. Stabilization services does not include inpatient, partial
hospitalization, or day treatment. Stabilization services include family psychoeducation.
 new text end

new text begin (l) "Warm handoff" means a referral or transfer of a recipient to other services, facilitated
by outreach performed by the crisis team. A warm handoff includes follow-up with the
target provider entity or recipient.
 new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) Crisis services are available to recipients of all ages.
 new text end

new text begin (b) For the purposes of an assessment, an eligible recipient is an individual who is
screened as potentially experiencing a crisis.
 new text end

new text begin (c) For the purpose of intervention services, an eligible recipient is an individual who
is assessed as experiencing a crisis and for whom intervention services are necessary.
 new text end

new text begin (d) For the purpose of stabilization services, an eligible recipient is an individual who
is assessed as experiencing a crisis and for whom stabilization services are necessary.
 new text end

new text begin (e) For the purpose of residential stabilization services, an eligible recipient is an adult
who is assessed as experiencing a crisis and for whom residential stabilization services are
necessary.
 new text end

new text begin Subd. 4. new text end

new text begin Provider entity standards. new text end

new text begin (a) The commissioner shall establish a certification
process and recertification process to determine whether a provider entity meets the
requirements in this section. A certification may be valid for up to three years, or a shorter
period as determined by the commissioner.
 new text end

new text begin (b) The commissioner shall establish a process for decertification of a provider entity
and shall require corrective action, medical assistance repayment, or decertification of a
provider entity that no longer meets the requirements in this section or that fails to meet the
clinical quality standards or administrative standards provided by the commissioner in the
application and certification process.
 new text end

new text begin (c) A provider entity is an entity that is:
 new text end

new text begin (1) operated by a county board;
 new text end

new text begin (2) under a provider contract with the county board in the county where the potential
crisis occurs. To provide services under this clause, the provider entity must directly provide
the service or, if the service is subcontracted, maintain responsibility for the service and
billing; or
 new text end

new text begin (3) an Indian health service facility or facility owned and operated by a tribe or tribal
organization operating under United States Code, title 25, section 450f.
 new text end

new text begin (d) The commissioner must certify that a provider entity has the ability to:
 new text end

new text begin (1) recruit, hire, manage, and train mental health professionals, mental health practitioners,
certified peer specialists, and rehabilitation workers;
 new text end

new text begin (2) provide adequate administrative ability to ensure availability of services;
 new text end

new text begin (3) ensure adequate preservice and in-service training;
 new text end

new text begin (4) ensure that staff are skilled in delivering crisis services to any recipient, regardless
of the recipient's age, a recipient's needs within a family system, and in engaging a recipient's
legal guardian or family as applicable;
 new text end

new text begin (5) ensure that staff are capable of implementing culturally responsive treatment identified
in the treatment plan that is meaningful and appropriate as determined by the recipient's
culture, beliefs, values, and language;
 new text end

new text begin (6) ensure coordination with live interpreter and written translation services to provide
care and treatment plans that are accessible to the recipient;
 new text end

new text begin (7) ensure a flexible response to the recipient's changing intervention and care needs as
identified by the recipient;
 new text end

new text begin (8) ensure that a mental health practitioner and a mental health professional have
communication tools to promptly communicate and consult about assessment and intervention
services as services occur;
 new text end

new text begin (9) coordinate with and recommend the use of crisis services by other responders,
including 911 dispatch, community hospitals, ambulance services, transportation services,
social services, law enforcement, and schools through regularly scheduled interagency
meetings;
 new text end

new text begin (10) ensure that screening, assessment, and intervention services are available in the
designated service area 24 hours a day, seven days a week;
 new text end

new text begin (11) coordinate services with detoxification or withdrawal management services to
ensure a recipient receives care that is responsive to chemical and mental health needs;
 new text end

new text begin (12) ensure that services are coordinated with other mental health service providers,
county mental health authorities, or federally recognized American Indian authorities and
others as necessary, with the consent of the adult. Services must also be coordinated with
the recipient's case manager if the adult is receiving case management services;
 new text end

new text begin (13) ensure that services are provided consistent with sections 245.461 to 245.486 and
245.487 to 245.4887;
 new text end

new text begin (14) submit information as required by the state;
 new text end

new text begin (15) maintain staff training and personnel files, including documentation of staff
completion of required training modules;
 new text end

new text begin (16) establish and maintain a quality assurance and evaluation plan to evaluate the
outcomes of services and recipient satisfaction, including notifying recipients of the process
by which the county accepts and responds to concerns;
 new text end

new text begin (17) maintain records as required by applicable laws;
 new text end

new text begin (18) comply with all applicable laws and statutes;
 new text end

new text begin (19) demonstrate that the provider entity is enrolled as a medical assistance provider;
 new text end

new text begin (20) develop and maintain written policies and procedures regarding service provision
and administration of the provider entity, including safety of staff and recipients in a high-risk
situation;
 new text end

new text begin (21) directly provide or connect a recipient through a warm handoff to stabilization
services or other ongoing supports as indicated in a recipient's treatment plan;
 new text end

new text begin (22) respond to a call for crisis services in a designated service area, or according to a
written agreement with the local mental health authority for an adjacent area;
 new text end

new text begin (23) document protocol used when delivering services by telemedicine, as provided by
sections 62A.67 to 62A.672, including responsibilities of the originating site, means to
promote recipient safety, timelines for connection and response, and steps to be taken in
the event of lost connection; and
 new text end

new text begin (24) develop and publicly post a written policy containing criteria for providing services,
and the response to a call for a person who is ineligible for service.
 new text end

new text begin (e) A crisis provider that is certified to provide crisis services before August 1, 2017,
may continue to operate according to standards in Minnesota Statutes 2016, sections 245.469,
245.4879, 256B.0624, and 256B.0944, until certified by the commissioner under this section
or January 1, 2019, whichever comes first. This paragraph expires January 1, 2019.
 new text end

new text begin Subd. 5. new text end

new text begin Crisis team. new text end

new text begin (a) A crisis team is comprised of at least two members, one of
whom must be qualified as a mental health professional. A second member must be qualified
as a mental health professional or mental health practitioner. Additional staff should be
added to reflect the needs of the area served.
 new text end

new text begin (b) Staff for a crisis team must be qualified to provide services in the following ways:
 new text end

new text begin (1) mental health professional;
 new text end

new text begin (2) mental health practitioner;
 new text end

new text begin (3) certified peer specialist; or
 new text end

new text begin (4) certified family peer specialist.
 new text end

new text begin (c) Assessment and intervention services must be led by a mental health professional,
or a mental health practitioner under the supervision of a mental health professional as
described in subdivision 11.
 new text end

new text begin (d) At least one member of the crisis team must provide assessment and intervention
services when needed. Crisis team members must have experience in assessments, crisis
intervention techniques, treatment engagement strategies, working with families, and clinical
decision making under emergency conditions, and have knowledge of local services and
resources.
 new text end

new text begin Subd. 6. new text end

new text begin Screening standards. new text end

new text begin (a) A crisis team shall conduct a screening for a recipient
to determine the need for further services. A screening must be available by telephone and
may be performed by alternate means as clinically appropriate.
 new text end

new text begin (b) In conducting a screening, a provider entity shall:
 new text end

new text begin (1) employ evidence-based practices as identified by the commissioner to reduce the
risk of the recipient's suicide and self-injurious behavior;
 new text end

new text begin (2) work with the recipient to establish a plan and time frame for responding to the crisis,
including immediate needs for support by telephone or text message until a face-to-face
response can arrive;
 new text end

new text begin (3) coordinate response with other emergency responders as appropriate;
 new text end

new text begin (4) consider other available services to determine which intervention service would best
address the recipient's needs and circumstances;
 new text end

new text begin (5) document significant factors related to the determination of a crisis, including prior
calls to the crisis team, recent presentation at an emergency department, known calls to 911
or law enforcement, or the presence of third parties with knowledge of a potential recipient's
history or current needs;
 new text end

new text begin (6) screen for the needs of a third-party caller, including a recipient who primarily
identifies as a family member or a caregiver but also presents signs of a crisis; and
 new text end

new text begin (7) provide psychoeducation to third-party callers, including education on the available
means for reducing self-harm.
 new text end

new text begin (c) A provider entity shall consider the following to indicate a positive screening unless
the provider entity documents specific evidence to show why crisis response was clinically
inappropriate:
 new text end

new text begin (1) the recipient presented in an emergency department or urgent care setting, and the
health care team at that location requested crisis services; or
 new text end

new text begin (2) a peace officer requested crisis services for a recipient who may be subject to
transportation under section 253B.05 for a mental health crisis.
 new text end

new text begin (d) Direct contact with the recipient is not required before initiating an assessment or
intervention service. A crisis team may gather relevant information from a third party at the
scene to establish the need for services and potential safety factors.
 new text end

new text begin (e) A crisis team that receives a call for services outside of the team's coverage area shall
offer to connect the recipient with a crisis team serving the recipient's location.
 new text end

new text begin (f) A crisis team shall consider input from a recipient, the recipient's guardian, or the
recipient's family whenever possible in determining if a potential crisis exists and face-to-face
assessment is necessary.
 new text end

new text begin Subd. 7. new text end

new text begin Assessment. new text end

new text begin (a) If screening indicates a potential crisis, an assessment must
be completed. An assessment evaluates any immediate needs for services and, as time
permits, the recipient's current life situation, sources of stress, mental health problems and
symptoms, strengths, cultural considerations, support network, vulnerabilities, current
functioning, and the recipient's preferences as communicated directly by the recipient, or
as communicated in a health care directive as described in chapters 145C and 253B, the
treatment plan described under subdivision 8, paragraph (b); a crisis prevention plan; or
wellness recovery action plan. An assessment includes, when feasible, assessing whether
the recipient is willing to voluntarily accept treatment, determining whether the recipient
has an advance directive, and obtaining information and history from an involved family
member or caregiver.
 new text end

new text begin (b) An assessment is provided face-to-face by a crisis team outside of an inpatient hospital
setting. A service must be provided promptly and respond to the recipient's location whenever
possible, including community or clinical settings. As clinically appropriate, a crisis team
must coordinate a response with other health care providers if a recipient requires
detoxification, withdrawal management, or medical stabilization services in addition to
crisis services.
 new text end

new text begin (c) A crisis team shall consider input from a recipient, the recipient's guardian, or the
recipient's family whenever possible in determining if a crisis exists.
 new text end

new text begin (d) If after an assessment, a crisis provider entity refers a recipient to an acute setting,
including an emergency department, in-patient hospitalization, or crisis residential treatment,
a crisis team member who performed or conferred on the assessment must contact the
provider entity and consult with the triage nurse or other staff responsible for intake. The
crisis team member must convey key findings or concerns that led to the referral. This
consultation shall occur with the recipient's consent, the recipient's legal guardian's consent,
or as allowed by section 144.293, subdivision 5.
 new text end

new text begin Subd. 8. new text end

new text begin Intervention. new text end

new text begin (a) If the assessment determines intervention services are needed,
the intervention services must be provided promptly. At least one crisis team member must
provide the intervention services face-to-face with a recipient. If a mental health practitioner
is providing in-person services, the mental health practitioner must seek clinical supervision
as required under subdivision 11, including obtaining approval before acting as a health
officer as defined in section 253B.02.
 new text end

new text begin (b) The crisis team must develop a crisis intervention treatment plan as soon as appropriate
but no later than 24 hours after the initial face-to-face intervention. The crisis intervention
treatment plan must:
 new text end

new text begin (1) address the recipient's needs and problems noted in the assessment;
 new text end

new text begin (2) include measurable short-term goals;
 new text end

new text begin (3) address cultural considerations;
 new text end

new text begin (4) specify the frequency and type of services to be provided to achieve the recipient's
goals and reduce or eliminate the crisis; and
 new text end

new text begin (5) be updated as needed to reflect current goals and services.
 new text end

new text begin (c) If the crisis team refers a recipient to an acute setting, as described in subdivision 7,
paragraph (d), a crisis team member must send a copy of the crisis intervention treatment
plan by secure electronic transmission to the provider entity to which the recipient was
referred. This release shall occur with the recipient's consent, the recipient's legal guardian's
consent, or as allowed by section 144.293, subdivision 5.
 new text end

new text begin (d) The crisis team must document when short-term goals are met and when no further
crisis services are required.
 new text end

new text begin (e) If the recipient's crisis is stabilized, but the recipient needs a referral to another service,
the crisis team must provide a warm handoff to those services. If the recipient has a case
manager, planning for other services must be coordinated with the case manager.
 new text end

new text begin (f) If the recipient's crisis is stabilized and the recipient does not have an advance
directive, the case manager or crisis team shall offer to work with the recipient to develop
one.
 new text end

new text begin Subd. 9. new text end

new text begin Stabilization service. new text end

new text begin (a) Stabilization services must be provided by qualified
staff. Stabilization services may be provided in the recipient's home, the home of a family
member or friend of the recipient, another community setting, or a short-term supervised,
licensed residential program. Stabilization services include family psychoeducation and
must meet the following requirements:
 new text end

new text begin (1) include a stabilization treatment plan that meets the criteria in subdivision 13;
 new text end

new text begin (2) staff must be qualified as defined in subdivision 10; and
 new text end

new text begin (3) service must be delivered according to the treatment plan and include face-to-face
contact with the recipient by qualified staff for further assessment, help with referrals,
updating of the stabilization treatment plan, supportive counseling, skills training, and
collaboration with other service providers in the community.
 new text end

new text begin (b) If stabilization services are provided to an adult in a supervised, licensed residential
setting, the adult must have daily face-to-face contact with a qualified mental health
practitioner or professional. The program must have 24-hour-a-day residential staffing that
may include staff who do not meet the qualifications in subdivision 10. The residential staff
must have 24-hour-a-day immediate direct or telephone access to a qualified mental health
professional or practitioner.
 new text end

new text begin (c) If stabilization services are provided to an adult in a supervised, licensed residential
setting that serves no more than four adult residents, and one or more adults are present at
the setting to receive stabilization services, the residential staff must include, for at least
eight hours per day, at least one staff member who meets the qualifications in subdivision
10.
 new text end

new text begin (d) If stabilization services are provided to an adult in a supervised, licensed residential
setting that serves more than four adult residents, and one or more are adults receiving
stabilization services, the residential staff must include, for 24 hours a day, at least one staff
member who meets the qualifications in subdivision 10. During the first 48 hours that an
adult is in the residential program, the residential program must have at least two staff
members working 24 hours a day. After the first 48 hours that an adult is in the residential
program, staff levels may be adjusted according to the needs of the adult as specified in the
stabilization treatment plan.
 new text end

new text begin Subd. 10. new text end

new text begin Stabilization staff qualifications. new text end

new text begin (a) Stabilization services must be provided
by a qualified individual staff member. A qualified individual staff member includes:
 new text end

new text begin (1) a mental health professional;
 new text end

new text begin (2) a mental health practitioner;
 new text end

new text begin (3) a certified peer specialist;
 new text end

new text begin (4) a certified family peer specialist; or
 new text end

new text begin (5) a mental health rehabilitation worker who meets the criteria in section 256B.0623,
subdivision 5, clause (4), and works under the clinical supervision of a mental health
professional or under the direction of a mental health practitioner.
 new text end

new text begin (b) Except for a mental health professional, a stabilization staff member must have
completed at least 30 hours of training in intervention and stabilization services during the
past two years.
 new text end

new text begin Subd. 11. new text end

new text begin Supervision. new text end

new text begin A mental health practitioner may provide assessment and
intervention services if the following clinical supervision requirements are met:
 new text end

new text begin (1) the qualified provider entity accepts full responsibility for any service provided;
 new text end

new text begin (2) the mental health professional who is an employee or under contract with the qualified
provider, must be immediately available in person or by telephone for clinical supervision;
 new text end

new text begin (3) the mental health professional is consulted, in person or by telephone, during the
first three hours when a mental health practitioner provides on-site service;
 new text end

new text begin (4) the mental health professional must:
 new text end

new text begin (i) review and approve the assessment and crisis intervention treatment plan;
 new text end

new text begin (ii) document the consultation; and
 new text end

new text begin (iii) sign the assessment and crisis intervention treatment plan within the next business
day;
 new text end

new text begin (5) if the intervention services continue into a second calendar day, a mental health
professional must contact the recipient face-to-face on the second day to provide service
and update the crisis intervention treatment plan;
 new text end

new text begin (6) the on-site observation must be documented in the recipient's record and signed by
the mental health professional; and
 new text end

new text begin (7) specific consultation and approval must be obtained from the mental health
professional before a mental health practitioner acts as a health officer as defined in section
253B.02, subdivision 9.
 new text end

new text begin Subd. 12. new text end

new text begin Recipient file. new text end

new text begin (a) A provider entity must maintain for each assessment,
intervention, or stabilization recipient a file that complies with the requirements established
by the commissioner. The file must contain the following information:
 new text end

new text begin (1) the crisis intervention treatment plan signed by the recipient or the recipient's legal
guardian, mental health professional, and mental health practitioner who developed the
crisis treatment plan, or if the recipient or the recipient's legal guardian refused to sign the
plan, the date, and the reason as to why the recipient or the recipient's legal guardian would
not sign the plan, as stated by the recipient or the recipient's legal guardian;
 new text end

new text begin (2) signed release forms;
 new text end

new text begin (3) recipient's health information and current medications;
 new text end

new text begin (4) emergency contacts for the recipient;
 new text end

new text begin (5) case records that document the date of service, place of service delivery, signature
of the provider entity of the service, and the nature, extent, and units of service;
 new text end

new text begin (6) documentation of in-person and telephone contact with the recipient's family or other
supporters;
 new text end

new text begin (7) documentation of required clinical supervision by a mental health professional;
 new text end

new text begin (8) a summary of consultation between crisis team members;
 new text end

new text begin (9) any written information by the recipient or the recipient's legal guardian that the
recipient or the recipient's legal guardian wants in the file; and
 new text end

new text begin (10) the recipient's advance directive if available.
 new text end

new text begin (b) For a recipient of crisis stabilization services, a provider entity must also maintain
a copy of the stabilization treatment plan as defined in subdivision 13. If a recipient was
referred to crisis stabilization from a different provider entity, an assessment or referral may
be substituted for the crisis intervention treatment plan in clause (1).
 new text end

new text begin Subd. 13. new text end

new text begin Stabilization treatment plan. new text end

new text begin (a) A written stabilization treatment plan must
be completed within 24 hours of beginning services for the recipient. A stabilization treatment
plan must be developed by a mental health professional or mental health practitioner under
the clinical supervision of a mental health professional. The stabilization treatment plan
must include, at a minimum:
 new text end

new text begin (1) problems identified in the assessment;
 new text end

new text begin (2) the recipient's strengths and resources;
 new text end

new text begin (3) concrete, measurable short-term goals to be achieved, including time frames for
achievement;
 new text end

new text begin (4) specific objectives directed toward achieving each goal;
 new text end

new text begin (5) planned frequency and type of service initiated;
 new text end

new text begin (6) a crisis response action plan;
 new text end

new text begin (7) progress notes on the outcome of goals;
 new text end

new text begin (8) each specific provider, when applicable; and
 new text end

new text begin (9) a documentation of the participants involved in the service planning. The recipient,
if possible, must be a participant.
 new text end

new text begin (b) The recipient or the recipient's legal guardian must sign the stabilization treatment
plan or if the recipient or the recipient's legal guardian refused to sign the plan, the date and
the reason why the recipient or the recipient's legal guardian would not sign the plan, as
stated by the recipient or the recipient's legal guardian. A copy of the plan must be given
to the recipient and the recipient's legal guardian. The mental health professional must
approve and sign any treatment plan. If a treatment plan completed by a referring entity,
such as an in-patient hospital, meets the criteria in this subdivision, it may be adopted by
the crisis team for the purpose of stabilization services.
 new text end

new text begin Subd. 14. new text end

new text begin Crisis service infrastructure. new text end

new text begin The commissioner must:
 new text end

new text begin (1) develop a central phone number to route calls to the appropriate crisis service;
 new text end

new text begin (2) provide telephone consultation 24 hours a day to a crisis team that is serving a person
with a traumatic brain injury or an intellectual disability and who is experiencing a crisis;
 new text end

new text begin (3) expand crisis services across the state, including rural areas of the state;
 new text end

new text begin (4) examine access to crisis service by population; and
 new text end

new text begin (5) establish and implement state standards for crisis services.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 13.

Minnesota Statutes 2016, section 245D.02, subdivision 20, is amended to read:


Subd. 20.

Mental health crisis intervention team.

"Mental health crisis intervention
team" means a mental health crisis response provider as identified in section deleted text begin 256B.0624,
subdivision 2, paragraph (d), for adults, and in section 256B.0944, subdivision 1, paragraph
(d), for childrendeleted text end new text begin 245.991new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 14.

Minnesota Statutes 2016, section 253B.02, subdivision 9, is amended to read:


Subd. 9.

Health officer.

"Health officer" means:

(1) a licensed physician;

(2) a deleted text begin licensed psychologistdeleted text end new text begin mental health professional as defined in section 245.462,
subdivision 18, clauses (1) to (6)new text end ;

deleted text begin (3) a licensed social worker;
 deleted text end

deleted text begin (4)deleted text end new text begin (3)new text end a registered nurse working in an emergency room of a hospital;

deleted text begin (5)deleted text end new text begin (4)new text end a psychiatric or public health nurse as defined in section 145A.02, subdivision
18;

deleted text begin (6)deleted text end new text begin (5)new text end an advanced practice registered nurse (APRN) as defined in section 148.171,
subdivision 3;

deleted text begin (7)deleted text end new text begin (6) a mental health practitioner as defined in section 245.462, subdivision 17, with
the consultation and approval bynew text end a mental health professional providing deleted text begin mental health mobiledeleted text end
crisis deleted text begin interventiondeleted text end services as described under section deleted text begin 256B.0624deleted text end new text begin 245.991new text end ; or

deleted text begin (8)deleted text end new text begin (7)new text end a formally designated member of a prepetition screening unit established by
section 253B.07.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 15.

Minnesota Statutes 2016, section 256B.0615, is amended to read:


256B.0615 MENTAL HEALTH CERTIFIED PEER SPECIALIST.

Subdivision 1.

Scope.

Medical assistance covers mental health certified peer specialist
services, as established in subdivision 2, subject to federal approval, if provided to recipients
who are eligible for services under sections 256B.0622, 256B.0623, and 256B.0624 and
are provided by a certified peer specialist who has completed the training under subdivision
5.

Subd. 2.

Establishment.

The commissioner of human services shall establish a certified
peer specialist program model, which:

(1) provides nonclinical peer support deleted text begin counselingdeleted text end new text begin servicesnew text end by certified peer specialists;

(2) provides a part of a wraparound continuum of services in conjunction with other
community mental health services;

(3) is individualized to the consumer; and

(4) promotes socialization, recovery, self-sufficiency, self-advocacy, development of
natural supports, and maintenance of skills learned in other support services.

Subd. 3.

Eligibility.

Peer support services may be made available to consumers of (1)
intensive residential treatment services under section 256B.0622; (2) adult rehabilitative
mental health services under section 256B.0623; and (3) crisis stabilization and mental
health mobile crisis intervention services under section 256B.0624.

Subd. 4.

Peer support specialist deleted text begin programdeleted text end new text begin servicenew text end providers.

The commissioner shall
develop a process to certify peer support deleted text begin specialist programsdeleted text end new text begin specialistsnew text end , in accordance with
the federal guidelines, in order deleted text begin for the programdeleted text end to bill for reimbursable services. deleted text begin Peer support
programs may be freestanding or within existing mental health community provider centers.
deleted text end

Subd. 5.

Certified peer specialist training and certification.

The commissioner of
human services shall develop a training and certification process for certified peer specialists,
who must be at least 21 years of age and have a high school diploma or its equivalent. The
candidates must have had a primary diagnosis of mental illness, be a current or former
consumer of mental health services, and must demonstrate leadership and advocacy skills
and a strong dedication to recovery. The training curriculum must teach participating
consumers specific skills relevant to providing peer support to other consumers. In addition
to initial training and certification, the commissioner shall develop ongoing continuing
educational workshops on pertinent issues related to peer support deleted text begin counselingdeleted text end new text begin servicesnew text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2016, section 256B.0616, is amended to read:


256B.0616 MENTAL HEALTH CERTIFIED FAMILY PEER SPECIALIST.

Subdivision 1.

Scope.

Medical assistance covers mental health certified family peer
specialists services, as established in subdivision 2, subject to federal approval, if provided
to recipients who have an emotional disturbance or severe emotional disturbance under
chapter 245, and are provided by a certified family peer specialist who has completed the
training under subdivision 5. A family peer specialist cannot provide services to the peer
specialist's family.

Subd. 2.

Establishment.

The commissioner of human services shall establish a certified
family peer deleted text begin specialists program modeldeleted text end new text begin support specialist servicenew text end whichnew text begin increases the child's
ability to function within the child's home, school, and community bynew text end :

(1) deleted text begin providesdeleted text end new text begin providingnew text end nonclinical family peer support deleted text begin counselingdeleted text end , building on the
strengths of families deleted text begin and helpingdeleted text end new text begin to helpnew text end them achieve desired outcomes;

(2) deleted text begin collaboratesdeleted text end new text begin collaboratingnew text end with deleted text begin othersdeleted text end new text begin other services that arenew text end providing care or support
to the family;

(3) deleted text begin provides nonadversarial advocacydeleted text end new text begin teaching the family self-advocacy skillsnew text end ;

(4) deleted text begin promotesdeleted text end new text begin supportingnew text end the individual family culture in the treatment milieu;

(5) deleted text begin linksdeleted text end new text begin linkingnew text end parents to other parents in the community;

deleted text begin (6) offers support and encouragement;
 deleted text end

deleted text begin (7) assistsdeleted text end new text begin (6) assistingnew text end parents deleted text begin in developingdeleted text end new text begin to developnew text end coping mechanisms and
problem-solving skills;

deleted text begin (8) promotesdeleted text end new text begin (7) promotingnew text end resiliency, deleted text begin self-advocacy,deleted text end development of natural supports,
and maintenance of skills learned in other support services;

deleted text begin (9) establishesdeleted text end new text begin (8) establishingnew text end and deleted text begin providesdeleted text end new text begin providingnew text end peer-led parent support groups;
and

deleted text begin (10) increases the child's ability to function better within the child's home, school, and
community bydeleted text end new text begin (9)new text end educating parents on community resourcesdeleted text begin , assisting with problem solving,deleted text end
and deleted text begin educating parents ondeleted text end mental illnesses.

Subd. 3.

Eligibility.

Family peer support services may be deleted text begin locateddeleted text end new text begin provided to a childnew text end in
inpatient hospitalization, partial hospitalization, residential treatment, treatment foster care,
day treatment, children's therapeutic services and supports, deleted text begin ordeleted text end new text begin andnew text end crisis services.

Subd. 4.

Peer support specialist deleted text begin programdeleted text end providers.

The commissioner shall develop
a process to certify family peer support deleted text begin specialist programsdeleted text end new text begin specialistsnew text end , in accordance with
the federal guidelines, in order deleted text begin for the programdeleted text end to bill for reimbursable services. deleted text begin Family
peer support programs must operate within an existing mental health community provider
or center.
deleted text end

Subd. 5.

Certified family peer specialist training and certification.

The commissioner
shall develop a training and certification process for certified family peer specialists who
must be at least 21 years of age and have a high school diploma or its equivalent. The
candidates must have raised or be currently raising a child with a mental illness, have had
experience navigating the children's mental health system, and must demonstrate leadership
and advocacy skills and a strong dedication to family-driven and family-focused services.
The training curriculum must teach deleted text begin participating family peer specialistsdeleted text end specific skills
deleted text begin relevantdeleted text end to deleted text begin providingdeleted text end new text begin providenew text end peer support to other parents. In addition to initial training
and certification, the commissioner shall develop ongoing continuing educational workshops
on pertinent issues related to family peer support deleted text begin counselingdeleted text end new text begin servicesnew text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2016, section 256B.0622, subdivision 2, is amended to read:


Subd. 2.

Definitions.

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

(b) "ACT team" means the group of interdisciplinary mental health staff who work as
a team to provide assertive community treatment.

(c) "Assertive community treatment" means intensive nonresidential treatment and
rehabilitative mental health services provided according to the assertive community treatment
model. Assertive community treatment provides a single, fixed point of responsibility for
treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per
day, seven days per week, in a community-based setting.

(d) "Individual treatment plan" means the document that results from a person-centered
planning process of determining real-life outcomes with clients and developing strategies
to achieve those outcomes.

(e) "Assertive engagement" means the use of collaborative strategies to engage clients
to receive services.

(f) "Benefits and finance support" means assisting clients in capably managing financial
affairs. Services include, but are not limited to, assisting clients in applying for benefits;
assisting with redetermination of benefits; providing financial crisis management; teaching
and supporting budgeting skills and asset development; and coordinating with a client's
representative payee, if applicable.

(g) "Co-occurring disorder treatment" means the treatment of co-occurring mental illness
and substance use disorders and is characterized by assertive outreach, stage-wise
comprehensive treatment, treatment goal setting, and flexibility to work within each stage
of treatment. Services include, but are not limited to, assessing and tracking clients' stages
of change readiness and treatment; applying the appropriate treatment based on stages of
change, such as outreach and motivational interviewing techniques to work with clients in
earlier stages of change readiness and cognitive behavioral approaches and relapse prevention
to work with clients in later stages of change; and facilitating access to community supports.

(h) "Crisis assessment and intervention" means mental health crisis response services
as defined in section deleted text begin 256B.0624, subdivision 2, paragraphs (c) to (e)deleted text end new text begin 245.991, subdivisions
7 to 9new text end .

(i) "Employment services" means assisting clients to work at jobs of their choosing.
Services must follow the principles of the individual placement and support (IPS)
employment model, including focusing on competitive employment; emphasizing individual
client preferences and strengths; ensuring employment services are integrated with mental
health services; conducting rapid job searches and systematic job development according
to client preferences and choices; providing benefits counseling; and offering all services
in an individualized and time-unlimited manner. Services shall also include educating clients
about opportunities and benefits of work and school and assisting the client in learning job
skills, navigating the work place, and managing work relationships.

(j) "Family psychoeducation and support" means services provided to the client's family
and other natural supports to restore and strengthen the client's unique social and family
relationships. Services include, but are not limited to, individualized psychoeducation about
the client's illness and the role of the family and other significant people in the therapeutic
process; family intervention to restore contact, resolve conflict, and maintain relationships
with family and other significant people in the client's life; ongoing communication and
collaboration between the ACT team and the family; introduction and referral to family
self-help programs and advocacy organizations that promote recovery and family
engagement, individual supportive counseling, parenting training, and service coordination
to help clients fulfill parenting responsibilities; coordinating services for the child and
restoring relationships with children who are not in the client's custody; and coordinating
with child welfare and family agencies, if applicable. These services must be provided with
the client's agreement and consent.

(k) "Housing access support" means assisting clients to find, obtain, retain, and move
to safe and adequate housing of their choice. Housing access support includes, but is not
limited to, locating housing options with a focus on integrated independent settings; applying
for housing subsidies, programs, or resources; assisting the client in developing relationships
with local landlords; providing tenancy support and advocacy for the individual's tenancy
rights at the client's home; and assisting with relocation.

(l) "Individual treatment team" means a minimum of three members of the ACT team
who are responsible for consistently carrying out most of a client's assertive community
treatment services.

(m) "Intensive residential treatment services treatment team" means all staff who provide
intensive residential treatment services under this section to clients. At a minimum, this
includes the clinical supervisor; mental health professionals as defined in section 245.462,
subdivision 18, clauses (1) to (6); mental health practitioners as defined in section 245.462,
subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision
5, clause (4); and mental health certified peer specialists under section 256B.0615.

(n) "Intensive residential treatment services" means short-term, time-limited services
provided in a residential setting to clients who are in need of more restrictive settings and
are at risk of significant functional deterioration if they do not receive these services. Services
are designed to develop and enhance psychiatric stability, personal and emotional adjustment,
self-sufficiency, and skills to live in a more independent setting. Services must be directed
toward a targeted discharge date with specified client outcomes.

(o) "Medication assistance and support" means assisting clients in accessing medication,
developing the ability to take medications with greater independence, and providing
medication setup. This includes the prescription, administration, and order of medication
by appropriate medical staff.

(p) "Medication education" means educating clients on the role and effects of medications
in treating symptoms of mental illness and the side effects of medications.

(q) "Overnight staff" means a member of the intensive residential treatment services
team who is responsible during hours when clients are typically asleep.

(r) "Mental health certified peer specialist services" has the meaning given in section
256B.0615.

(s) "Physical health services" means any service or treatment to meet the physical health
needs of the client to support the client's mental health recovery. Services include, but are
not limited to, education on primary health issues, including wellness education; medication
administration and monitoring; providing and coordinating medical screening and follow-up;
scheduling routine and acute medical and dental care visits; tobacco cessation strategies;
assisting clients in attending appointments; communicating with other providers; and
integrating all physical and mental health treatment.

(t) "Primary team member" means the person who leads and coordinates the activities
of the individual treatment team and is the individual treatment team member who has
primary responsibility for establishing and maintaining a therapeutic relationship with the
client on a continuing basis.

(u) "Rehabilitative mental health services" means mental health services that are
rehabilitative and enable the client to develop and enhance psychiatric stability, social
competencies, personal and emotional adjustment, independent living, parenting skills, and
community skills, when these abilities are impaired by the symptoms of mental illness.

(v) "Symptom management" means supporting clients in identifying and targeting the
symptoms and occurrence patterns of their mental illness and developing strategies to reduce
the impact of those symptoms.

(w) "Therapeutic interventions" means empirically supported techniques to address
specific symptoms and behaviors such as anxiety, psychotic symptoms, emotional
dysregulation, and trauma symptoms. Interventions include empirically supported
psychotherapies including, but not limited to, cognitive behavioral therapy, exposure therapy,
acceptance and commitment therapy, interpersonal therapy, and motivational interviewing.

(x) "Wellness self-management and prevention" means a combination of approaches to
working with the client to build and apply skills related to recovery, and to support the client
in participating in leisure and recreational activities, civic participation, and meaningful
structure.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 18.

Minnesota Statutes 2016, section 256B.0622, subdivision 7a, is amended to read:


Subd. 7a.

Assertive community treatment team staff requirements and roles.

(a)
The required treatment staff qualifications and roles for an ACT team are:

(1) the team leader:

(i) shall be a licensed mental health professional who is qualified under Minnesota Rules,
part 9505.0371, subpart 5, item A. Individuals who are not licensed but who are eligible
for licensure and are otherwise qualified may also fulfill this role but must obtain full
licensure within 24 months of assuming the role of team leader;

(ii) must be an active member of the ACT team and provide some direct services to
clients;

(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the team, providing clinical
oversight of services in conjunction with the psychiatrist or psychiatric care provider, and
supervising team members to ensure delivery of best and ethical practices; and

(iv) must be available to provide overall clinical oversight to the ACT team after regular
business hours and on weekends and holidays. The team leader may delegate this duty to
another qualified member of the ACT team;

(2) the psychiatric care provider:

(i) must be a licensed psychiatrist certified by the American Board of Psychiatry and
Neurology or eligible for board certification or certified by the American Osteopathic Board
of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who
is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A. The psychiatric care
provider must have demonstrated clinical experience working with individuals with serious
and persistent mental illness;

(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide clinical
supervision to the team;

(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;

(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;

(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role;

(vi) may not provide specific roles and responsibilities by telemedicine unless approved
by the commissioner; and

(vii) shall provide psychiatric backup to the program after regular business hours and
on weekends and holidays. The psychiatric care provider may delegate this duty to another
qualified psychiatric provider;

new text begin (3) the lead mental health professional:
 new text end

new text begin (i) shall be a licensed mental health professional who is qualified under Minnesota Rules,
part 9505.0371, subpart 5, item A. An individual who is not licensed but who is eligible for
licensure and is otherwise qualified may also fulfill the mental health professional role but
must obtain full licensure within 24 months of assuming the role;
 new text end

new text begin (ii) is responsible for the provision of individual supportive therapy, symptom
management, and empirically supported psychotherapy as specified in a person's treatment
plan and must use empirically supported techniques to address a wide range of clinical and
behavioral needs for this population;
 new text end

new text begin (iii) conduct comprehensive assessment of psychiatric history including but not limited
to onset, course and effect of illness, past treatment and responses, and risk behaviors;
mental status; and diagnosis and educate the ACT team in identifying and choosing the
appropriate interventions for psychiatric needs; and
 new text end

new text begin (iv) provide direct clinical services including individual supportive therapy and
psychotherapy to clients on an individual, group, and family basis to teach behavioral
symptom-management techniques to alleviate and manage symptoms not reduced with
medication and promote personal growth and development by assisting clients to adapt and
cope with internal and external stresses;
 new text end

deleted text begin (3)deleted text end new text begin (4) new text end the nursing staff:

(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;

(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and

(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;

deleted text begin (4)deleted text end new text begin (5)new text end the co-occurring disorder specialist:

(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in Minnesota Rules, part 9530.6450, subpart 5. No more than two
co-occurring disorder specialists may occupy this role; and

(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;

deleted text begin (5)deleted text end new text begin (6)new text end the new text begin employment andnew text end vocational specialist:

(i) shall be a full-time new text begin employment andnew text end vocational specialist who has at least one-year
experience providing employment services or advanced education that involved field training
in new text begin employment andnew text end vocational services to individuals with mental illness. An individual
who does not meet these qualifications may also serve as the new text begin employment andnew text end vocational
specialist upon completing a training plan approved by the commissioner;

(ii) shall provide or facilitate the provision of new text begin employment andnew text end vocational services to
clients. The vocational specialist serves as a consultant and educator to fellow ACT team
members on these services; and

(iii) should not refer individuals to receive any type of new text begin employment or new text end vocational services
or linkage by providers outside of the ACT team;

deleted text begin (6)deleted text end new text begin (7)new text end the mental health certified peer specialist:

(i) shall be a full-time equivalent mental health certified peer specialist as defined in
section 256B.0615. No more than two individuals can share this position. The mental health
certified peer specialist is a fully integrated team member who provides highly individualized
services in the community and promotes the self-determination and shared decision-making
abilities of clients. This requirement may be waived due to workforce shortages upon
approval of the commissioner;

(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and

(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;

deleted text begin (7)deleted text end new text begin (8)new text end the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and

deleted text begin (8)deleted text end new text begin (9)new text end additional staff:

(i) shall be based on team size. Additional treatment team staff may include licensed
mental health professionals as defined in Minnesota Rules, part 9505.0371, subpart 5, item
A; mental health practitioners as defined in Minnesota Rules, part 9505.0370, subpart 17;
or mental health rehabilitation workers as defined in section 256B.0623, subdivision 5,
clause (4). These individuals shall have the knowledge, skills, and abilities required by the
population served to carry out rehabilitation and support functions; and

(ii) shall be selected based on specific program needs or the population served.

(b) Each ACT team must clearly document schedules for all ACT team members.

(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.

(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in their respective discipline and be able to work collaboratively
as a member of a multidisciplinary team to deliver the majority of the treatment,
rehabilitation, and support services clients require to fully benefit from receiving assertive
community treatment.

(e) Each ACT team member must fulfill training requirements established by the
commissioner.

Sec. 19.

Minnesota Statutes 2016, section 256B.0622, subdivision 7b, is amended to read:


Subd. 7b.

Assertive community treatment program size and opportunities.

(a) Each
ACT team shall maintain an annual average caseload that does not exceed 100 clients.
Staff-to-client ratios shall be based on team size as follows:

(1) a small ACT team must:

(i) employ at least six but no more than seven full-time treatment team staff, excluding
the program assistant and the psychiatric care provider;

(ii) serve an annual average maximum of no more than 50 clients;

(iii) ensure at least one full-time equivalent position for every eight clients served;

(iv) schedule ACT team staff for at least eight-hour shift coverage on weekdays and
on-call duty to provide crisis services and deliver services after hours when staff are not
working;

(v) provide crisis services during business hours if the small ACT team does not have
sufficient staff numbers to operate an after-hours on-call system. During all other hours,
the ACT team may arrange for coverage for crisis assessment and intervention services
through a reliable crisis-intervention provider as long as there is a mechanism by which the
ACT team communicates routinely with the crisis-intervention provider and the on-call
ACT team staff are available to see clients face-to-face when necessary or if requested by
the crisis-intervention services provider;

(vi) adjust schedules and provide staff to carry out the needed service activities in the
evenings or on weekend days or holidays, when necessary;

(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team's psychiatric
care provider during all hours is not feasible, alternative psychiatric prescriber backup must
be arranged and a mechanism of timely communication and coordination established in
writing;

(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each
week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time
equivalent nursing, one full-time substance abuse specialist, one full-time equivalent mental
health certified peer specialist, one full-time vocational specialist, one full-time program
assistant, and at least one additional full-time ACT team member who has mental health
professional deleted text begin or practitioner statusdeleted text end ; and

(2) a midsize ACT team shall:

(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry
time for 51 clients, with an additional two hours for every six clients added to the team, 1.5
to two full-time equivalent nursing staff, one full-time substance abuse specialist, one
full-time equivalent mental health certified peer specialist, one full-time vocational specialist,
one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT
members, with at least one dedicated full-time staff member with mental health professional
status. Remaining team members may have mental health professional or practitioner status;

(ii) employ seven or more treatment team full-time equivalents, excluding the program
assistant and the psychiatric care provider;

(iii) serve an annual average maximum caseload of 51 to 74 clients;

(iv) ensure at least one full-time equivalent position for every nine clients served;

(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays
and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum
specifications, staff are regularly scheduled to provide the necessary services on a
client-by-client basis in the evenings and on weekends and holidays;

(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working;

(vii) have the authority to arrange for coverage for crisis assessment and intervention
services through a reliable crisis-intervention provider as long as there is a mechanism by
which the ACT team communicates routinely with the crisis-intervention provider and the
on-call ACT team staff are available to see clients face-to-face when necessary or if requested
by the crisis-intervention services provider; and

(viii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the psychiatric care provider
during all hours is not feasible, alternative psychiatric prescriber backup must be arranged
and a mechanism of timely communication and coordination established in writing;

(3) a large ACT team must:

(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week
per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff,
one full-time substance abuse specialist, one full-time equivalent mental health certified
peer specialist, one full-time vocational specialist, one full-time program assistant, and at
least two additional full-time equivalent ACT team members, with at least one dedicated
full-time staff member with mental health professional status. Remaining team members
may have mental health professional or mental health practitioner status;

(ii) employ nine or more treatment team full-time equivalents, excluding the program
assistant and psychiatric care provider;

(iii) serve an annual average maximum caseload of 75 to 100 clients;

(iv) ensure at least one full-time equivalent position for every nine individuals served;

(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the
second shift providing services at least 12 hours per day weekdays. For weekends and
holidays, the team must operate and schedule ACT team staff to work one eight-hour shift,
with a minimum of two staff each weekend day and every holiday;

(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working; and

(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team psychiatric care
provider during all hours is not feasible, alternative psychiatric backup must be arranged
and a mechanism of timely communication and coordination established in writing.

(b) An ACT team of any size may have a staff-to-client ratio that is lower than the
requirements described in paragraph (a) upon approval by the commissioner, but may not
exceed a one-to-ten staff-to-client ratio.

Sec. 20.

Minnesota Statutes 2016, section 256B.0623, subdivision 2, is amended to read:


Subd. 2.

Definitions.

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

(a) "Adult rehabilitative mental health services" means mental health services which are
rehabilitative and enable the recipient to develop and enhance psychiatric stability, social
competencies, personal and emotional adjustment, independent living, parenting skills, and
community skills, when these abilities are impaired by the symptoms of mental illness.
Adult rehabilitative mental health services are also appropriate when provided to enable a
recipient to retain stability and functioning, if the recipient would be at risk of significant
functional decompensation or more restrictive service settings without these services.

(1) Adult rehabilitative mental health services instruct, assist, and support the recipient
in areas such as: interpersonal communication skills, community resource utilization and
integration skills, crisis deleted text begin assistancedeleted text end new text begin planning as defined in section 245.462, subdivision 6new text end ,
relapse prevention skills, health care directives, budgeting and shopping skills, healthy
lifestyle skills and practices, cooking and nutrition skills, transportation skills, medication
education and monitoring, mental illness symptom management skills, household
management skills, employment-related skills, parenting skills, and transition to community
living services.

(2) These services shall be provided to the recipient on a one-to-one basis in the recipient's
home or another community setting or in groups.

(b) "Medication education services" means services provided individually or in groups
which focus on educating the recipient about mental illness and symptoms; the role and
effects of medications in treating symptoms of mental illness; and the side effects of
medications. Medication education is coordinated with medication management services
and does not duplicate it. Medication education services are provided by physicians,
pharmacists, physician assistants, or registered nurses.

(c) "Transition to community living services" means services which maintain continuity
of contact between the rehabilitation services provider and the recipient and which facilitate
discharge from a hospital, residential treatment program under Minnesota Rules, chapter
9505, board and lodging facility, or nursing home. Transition to community living services
are not intended to provide other areas of adult rehabilitative mental health services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 21.

Minnesota Statutes 2016, section 256B.0624, subdivision 1, is amended to read:


Subdivision 1.

Scope.

Medical assistance covers deleted text begin adultdeleted text end mental health crisis response
services as defined in deleted text begin subdivision 2, paragraphs (c) to (e)deleted text end new text begin section 245.991new text end , subject to federal
approval, if provided to a recipient as defined in subdivision 3 and provided by a qualified
provider entity as defined in this section and by a qualified individual provider working
within the provider's scope of practice and deleted text begin as defined in this subdivision anddeleted text end identified in
the recipient's individual crisis treatment plan as defined in deleted text begin subdivision 11deleted text end new text begin section 245.991new text end
and if determined to be medically necessary.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 22.

Minnesota Statutes 2016, section 256B.0624, subdivision 2, is amended to read:


Subd. 2.

Definitions.

deleted text begin For purposes of this section,deleted text end The deleted text begin followingdeleted text end termsnew text begin used in this
sectionnew text end have the meanings given themnew text begin in section 245.991, subdivision 2new text end .

deleted text begin (a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation
which, but for the provision of crisis response services, would likely result in significantly
reduced levels of functioning in primary activities of daily living, or in an emergency
situation, or in the placement of the recipient in a more restrictive setting, including, but
not limited to, inpatient hospitalization.
 deleted text end

deleted text begin (b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric situation
which causes an immediate need for mental health services and is consistent with section
62Q.55.
 deleted text end

deleted text begin A mental health crisis or emergency is determined for medical assistance service
reimbursement by a physician, a mental health professional, or crisis mental health
practitioner with input from the recipient whenever possible.
 deleted text end

deleted text begin (c) "Mental health crisis assessment" means an immediate face-to-face assessment by
a physician, a mental health professional, or mental health practitioner under the clinical
supervision of a mental health professional, following a screening that suggests that the
adult may be experiencing a mental health crisis or mental health emergency situation. It
includes, when feasible, assessing whether the person might be willing to voluntarily accept
treatment, determining whether the person has an advance directive, and obtaining
information and history from involved family members or caretakers.
 deleted text end

deleted text begin (d) "Mental health mobile crisis intervention services" means face-to-face, short-term
intensive mental health services initiated during a mental health crisis or mental health
emergency to help the recipient cope with immediate stressors, identify and utilize available
resources and strengths, engage in voluntary treatment, and begin to return to the recipient's
baseline level of functioning. The services, including screening and treatment plan
recommendations, must be culturally and linguistically appropriate.
 deleted text end

deleted text begin (1) This service is provided on site by a mobile crisis intervention team outside of an
inpatient hospital setting. Mental health mobile crisis intervention services must be available
24 hours a day, seven days a week.
 deleted text end

deleted text begin (2) The initial screening must consider other available services to determine which
service intervention would best address the recipient's needs and circumstances.
 deleted text end

deleted text begin (3) The mobile crisis intervention team must be available to meet promptly face-to-face
with a person in mental health crisis or emergency in a community setting or hospital
emergency room.
 deleted text end

deleted text begin (4) The intervention must consist of a mental health crisis assessment and a crisis
treatment plan.
 deleted text end

deleted text begin (5) The team must be available to individuals who are experiencing a co-occurring
substance use disorder, who do not need the level of care provided in a detoxification facility.
 deleted text end

deleted text begin (6) The treatment plan must include recommendations for any needed crisis stabilization
services for the recipient, including engagement in treatment planning and family
psychoeducation.
 deleted text end

deleted text begin (e) "Mental health crisis stabilization services" means individualized mental health
services provided to a recipient following crisis intervention services which are designed
to restore the recipient to the recipient's prior functional level. Mental health crisis
stabilization services may be provided in the recipient's home, the home of a family member
or friend of the recipient, another community setting, or a short-term supervised, licensed
residential program. Mental health crisis stabilization does not include partial hospitalization
or day treatment. Mental health crisis stabilization services includes family psychoeducation.
 deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 23.

Minnesota Statutes 2016, section 256B.0624, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

deleted text begin An eligible recipient is an individual who:
 deleted text end

deleted text begin (1) is age 18 or older;
 deleted text end

deleted text begin (2) is screened as possibly experiencing a mental health crisis or emergency where a
mental health crisis assessment is needed; and
 deleted text end

deleted text begin (3) is assessed as experiencing a mental health crisis or emergency, and mental health
crisis intervention or crisis intervention and stabilization services are determined to be
medically necessary.
 deleted text end

new text begin (a) An eligible adult recipient is an individual who:
 new text end

new text begin (1) is eligible for medical assistance;
 new text end

new text begin (2) is 18 years of age or older;
 new text end

new text begin (3) for the purposes of an assessment, is screened as potentially experiencing a crisis;
 new text end

new text begin (4) for the purposes of intervention services, is assessed as experiencing a crisis and for
whom intervention services are necessary;
 new text end

new text begin (5) for the purposes of stabilization services, is assessed as experiencing a crisis and for
whom stabilization services are necessary; and
 new text end

new text begin (6) for the purposes of residential stabilization services, is assessed as experiencing a
crisis and for whom residential stabilization services are necessary.
 new text end

new text begin (b) An eligible child recipient is an individual who:
 new text end

new text begin (1) is eligible for medical assistance;
 new text end

new text begin (2) is younger than 18 years of age;
 new text end

new text begin (3) for the purposes of an assessment, is screened as potentially experiencing a crisis;
 new text end

new text begin (4) for the purposes of intervention services, is assessed as experiencing a crisis and for
whom intervention services are necessary; and
 new text end

new text begin (5) for the purposes of stabilization services, is assessed as experiencing a crisis and for
whom stabilization services are necessary.
 new text end

new text begin (c) A crisis is determined for medical assistance service reimbursement by a physician,
a mental health professional, or a mental health practitioner who is a member of the crisis
team with input from the recipient, the recipient's guardian, or the recipient's family whenever
possible.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 24.

Minnesota Statutes 2016, section 256B.0624, subdivision 4, is amended to read:


Subd. 4.

Provider entity standards.

deleted text begin (a)deleted text end A provider entity is an entity that meets the
standards listed in deleted text begin paragraph (b) and:deleted text end new text begin section 245.991, subdivision 4, and is a currently
enrolled medical assistance provider.
new text end

deleted text begin (1) is a county board operated entity; or
 deleted text end

deleted text begin (2) is a provider entity that is under contract with the county board in the county where
the potential crisis or emergency is occurring. To provide services under this section, the
provider entity must directly provide the services; or if services are subcontracted, the
provider entity must maintain responsibility for services and billing.
 deleted text end

deleted text begin (b) The adult mental health crisis response services provider entity must have the capacity
to meet and carry out the following standards:
 deleted text end

deleted text begin (1) has the capacity to recruit, hire, and manage and train mental health professionals,
practitioners, and rehabilitation workers;
 deleted text end

deleted text begin (2) has adequate administrative ability to ensure availability of services;
 deleted text end

deleted text begin (3) is able to ensure adequate preservice and in-service training;
 deleted text end

deleted text begin (4) is able to ensure that staff providing these services are skilled in the delivery of
mental health crisis response services to recipients;
 deleted text end

deleted text begin (5) is able to ensure that staff are capable of implementing culturally specific treatment
identified in the individual treatment plan that is meaningful and appropriate as determined
by the recipient's culture, beliefs, values, and language;
 deleted text end

deleted text begin (6) is able to ensure enough flexibility to respond to the changing intervention and care
needs of a recipient as identified by the recipient during the service partnership between
the recipient and providers;
 deleted text end

deleted text begin (7) is able to ensure that mental health professionals and mental health practitioners have
the communication tools and procedures to communicate and consult promptly about crisis
assessment and interventions as services occur;
 deleted text end

deleted text begin (8) is able to coordinate these services with county emergency services, community
hospitals, ambulance, transportation services, social services, law enforcement, and mental
health crisis services through regularly scheduled interagency meetings;
 deleted text end

deleted text begin (9) is able to ensure that mental health crisis assessment and mobile crisis intervention
services are available 24 hours a day, seven days a week;
 deleted text end

deleted text begin (10) is able to ensure that services are coordinated with other mental health service
providers, county mental health authorities, or federally recognized American Indian
authorities and others as necessary, with the consent of the adult. Services must also be
coordinated with the recipient's case manager if the adult is receiving case management
services;
 deleted text end

deleted text begin (11) is able to ensure that crisis intervention services are provided in a manner consistent
with sections 245.461 to 245.486;
 deleted text end

deleted text begin (12) is able to submit information as required by the state;
 deleted text end

deleted text begin (13) maintains staff training and personnel files;
 deleted text end

deleted text begin (14) is able to establish and maintain a quality assurance and evaluation plan to evaluate
the outcomes of services and recipient satisfaction;
 deleted text end

deleted text begin (15) is able to keep records as required by applicable laws;
 deleted text end

deleted text begin (16) is able to comply with all applicable laws and statutes;
 deleted text end

deleted text begin (17) is an enrolled medical assistance provider; and
 deleted text end

deleted text begin (18) develops and maintains written policies and procedures regarding service provision
and administration of the provider entity, including safety of staff and recipients in high-risk
situations.
 deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 25.

Minnesota Statutes 2016, section 256B.0625, subdivision 35a, is amended to
read:


Subd. 35a.

Children's mental health crisis response services.

Medical assistance
covers children's mental health crisis response services according to section deleted text begin 256B.0944deleted text end new text begin
256B.0624new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 26.

Minnesota Statutes 2016, section 256B.092, subdivision 14, is amended to read:


Subd. 14.

Reduce avoidable behavioral crisis emergency room admissions,
psychiatric inpatient hospitalizations, and commitments to institutions.

(a) Persons
receiving home and community-based services authorized under this section who have had
two or more admissions within a calendar year to an emergency room, psychiatric unit, or
institution must receive consultation from a mental health professional as defined in section
245.462, subdivision 18, or a behavioral professional as defined in the home and
community-based services state plan within 30 days of discharge. The mental health
professional or behavioral professional must:

(1) conduct a functional assessment of the crisis incident as defined in section 245D.02,
subdivision 11, which led to the hospitalization with the goal of developing proactive
strategies as well as necessary reactive strategies to reduce the likelihood of future avoidable
hospitalizations due to a behavioral crisis;

(2) use the results of the functional assessment to amend the coordinated service and
support plan set forth in section 245D.02, subdivision 4b, to address the potential need for
additional staff training, increased staffing, deleted text begin access to crisis mobility services,deleted text end mental health
services, use of technology, and crisis deleted text begin stabilizationdeleted text end services in section deleted text begin 256B.0624, subdivision
7deleted text end new text begin 245.991new text end ; and

(3) identify the need for additional consultation, testing, deleted text begin and mental health crisis
intervention team services as defined in section 245D.02, subdivision 20,deleted text end psychotropic
medication use and monitoring under section 245D.051, and the frequency and duration of
ongoing consultation.

(b) For the purposes of this subdivision, "institution" includes, but is not limited to, the
Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 27.

Minnesota Statutes 2016, section 256B.0943, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

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

(a) "Children's therapeutic services and supports" means the flexible package of mental
health services for children who require varying therapeutic and rehabilitative levels of
intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision
20. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified
in the individual treatment plan.

(b) "Clinical supervision" means the overall responsibility of the mental health
professional for the control and direction of individualized treatment planning, service
delivery, and treatment review for each client. A mental health professional who is an
enrolled Minnesota health care program provider accepts full professional responsibility
for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
and oversees or directs the supervisee's work.

(c) "Clinical trainee" means a mental health practitioner who meets the qualifications
specified in Minnesota Rules, part 9505.0371, subpart 5, item C.

new text begin (d) "Crisis planning" means the development of a written plan to assist a child's family
to contend with a potential crisis and is distinct from the immediate provision of crisis
intervention services. The plan addresses prevention and intervention strategies to be used
in a crisis. It identifies factors that might precipitate a mental health crisis, identify behaviors
related to the emergence of a crisis, and resources available to resolve a crisis.
 new text end

deleted text begin (d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a. Crisis
assistance entails the development of a written plan to assist a child's family to contend with
a potential crisis and is distinct from the immediate provision of crisis intervention services.
 deleted text end

(e) "Culturally competent provider" means a provider who understands and can utilize
to a client's benefit the client's culture when providing services to the client. A provider
may be culturally competent because the provider is of the same cultural or ethnic group
as the client or the provider has developed the knowledge and skills through training and
experience to provide services to culturally diverse clients.

(f) "Day treatment program" for children means a site-based structured mental health
program consisting of psychotherapy for three or more individuals and individual or group
skills training provided by a multidisciplinary team, under the clinical supervision of a
mental health professional.

(g) "Diagnostic assessment" has the meaning given in Minnesota Rules, part 9505.0372,
subpart 1.

(h) "Direct service time" means the time that a mental health professional, clinical trainee,
mental health practitioner, or mental health behavioral aide spends face-to-face with a client
and the client's family or providing covered telemedicine services. Direct service time
includes time in which the provider obtains a client's history, develops a client's treatment
plan, records individual treatment outcomes, or provides service components of children's
therapeutic services and supports. Direct service time does not include time doing work
before and after providing direct services, including scheduling or maintaining clinical
records.

(i) "Direction of mental health behavioral aide" means the activities of a mental health
professional or mental health practitioner in guiding the mental health behavioral aide in
providing services to a client. The direction of a mental health behavioral aide must be based
on the client's individualized treatment plan and meet the requirements in subdivision 6,
paragraph (b), clause (5).

(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.

(k) "Individual behavioral plan" means a plan of intervention, treatment, and services
for a child written by a mental health professional or mental health practitioner, under the
clinical supervision of a mental health professional, to guide the work of the mental health
behavioral aide. The individual behavioral plan may be incorporated into the child's individual
treatment plan so long as the behavioral plan is separately communicable to the mental
health behavioral aide.

(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part 9505.0371,
subpart 7.

(m) "Mental health behavioral aide services" means medically necessary one-on-one
activities performed by a trained paraprofessional qualified as provided in subdivision 7,
paragraph (b), clause (3), to assist a child retain or generalize psychosocial skills as previously
trained by a mental health professional or mental health practitioner and as described in the
child's individual treatment plan and individual behavior plan. Activities involve working
directly with the child or child's family as provided in subdivision 9, paragraph (b), clause
(4).

(n) "Mental health practitioner" means an individual as defined in Minnesota Rules, part
9505.0370, subpart 17.

(o) "Mental health professional" means an individual as defined in Minnesota Rules,
part 9505.0370, subpart 18.

(p) "Mental health service plan development" includes:

(1) the development, review, and revision of a child's individual treatment plan, as
provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of the client
or client's parents, primary caregiver, or other person authorized to consent to mental health
services for the client, and including arrangement of treatment and support activities specified
in the individual treatment plan; and

(2) administering standardized outcome measurement instruments, determined and
updated by the commissioner, as periodically needed to evaluate the effectiveness of
treatment for children receiving clinical services and reporting outcome measures, as required
by the commissioner.

(q) "Mental illness," for persons at least age 18 but under age 21, has the meaning given
in section 245.462, subdivision 20, paragraph (a).

(r) "Psychotherapy" means the treatment of mental or emotional disorders or
maladjustment by psychological means. Psychotherapy may be provided in many modalities
in accordance with Minnesota Rules, part 9505.0372, subpart 6, including patient and/or
family psychotherapy; family psychotherapy; psychotherapy for crisis; group psychotherapy;
or multiple-family psychotherapy. Beginning with the American Medical Association's
Current Procedural Terminology, standard edition, 2014, the procedure "individual
psychotherapy" is replaced with "patient and/or family psychotherapy," a substantive change
that permits the therapist to work with the client's family without the client present to obtain
information about the client or to explain the client's treatment plan to the family.
Psychotherapy is appropriate for crisis response when a child has become dysregulated or
experienced new trauma since the diagnostic assessment was completed and needs
psychotherapy to address issues not currently included in the child's individual treatment
plan.

(s) "Rehabilitative services" or "psychiatric rehabilitation services" means a series or
multidisciplinary combination of psychiatric and psychosocial interventions to: (1) restore
a child or adolescent to an age-appropriate developmental trajectory that had been disrupted
by a psychiatric illness; or (2) enable the child to self-monitor, compensate for, cope with,
counteract, or replace psychosocial skills deficits or maladaptive skills acquired over the
course of a psychiatric illness. Psychiatric rehabilitation services for children combine
psychotherapy to address internal psychological, emotional, and intellectual processing
deficits, and skills training to restore personal and social functioning. Psychiatric
rehabilitation services establish a progressive series of goals with each achievement building
upon a prior achievement. Continuing progress toward goals is expected, and rehabilitative
potential ceases when successive improvement is not observable over a period of time.

(t) "Skills training" means individual, family, or group training, delivered by or under
the supervision of a mental health professional, designed to facilitate the acquisition of
psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
to the service delivery requirements under subdivision 9, paragraph (b), clause (2).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 28.

Minnesota Statutes 2016, section 256B.0943, subdivision 2, is amended to read:


Subd. 2.

Covered service components of children's therapeutic services and supports.

(a) Subject to federal approval, medical assistance covers medically necessary children's
therapeutic services and supports as defined in this section that an eligible provider entity
certified under subdivision 4 provides to a client eligible under subdivision 3.

(b) The service components of children's therapeutic services and supports are:

(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis,
and group psychotherapy;

(2) individual, family, or group skills training provided by a mental health professional
or mental health practitioner;

(3) crisis deleted text begin assistancedeleted text end new text begin planningnew text end ;

(4) mental health behavioral aide services;

(5) direction of a mental health behavioral aide;

(6) mental health service plan development; and

(7) children's day treatment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 29.

Minnesota Statutes 2016, section 256B.0943, subdivision 4, is amended to read:


Subd. 4.

Provider entity certification.

(a) The commissioner shall establish an initial
provider entity application and certification process and recertification process to determine
whether a provider entity has an administrative and clinical infrastructure that meets the
requirements in subdivisions 5 and 6. A provider entity must be certified for the three core
rehabilitation services of psychotherapy, skills training, and crisis deleted text begin assistancedeleted text end new text begin planningnew text end . The
commissioner shall recertify a provider entity at least every three years. The commissioner
shall establish a process for decertification of a provider entity and shall require corrective
action, medical assistance repayment, or decertification of a provider entity that no longer
meets the requirements in this section or that fails to meet the clinical quality standards or
administrative standards provided by the commissioner in the application and certification
process.

(b) For purposes of this section, a provider entity must be:

(1) an Indian health services facility or a facility owned and operated by a tribe or tribal
organization operating as a 638 facility under deleted text begin Public Law 93-638deleted text end new text begin United States Code, title
25, section 450f, new text end certified by the state;

(2) a county-operated entity certified by the state; or

(3) a noncounty entity certified by the state.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 30.

Minnesota Statutes 2016, section 256B.0943, subdivision 7, is amended to read:


Subd. 7.

Qualifications of individual and team providers.

(a) An individual or team
provider working within the scope of the provider's practice or qualifications may provide
service components of children's therapeutic services and supports that are identified as
medically necessary in a client's individual treatment plan.

(b) An individual provider must be qualified as:

(1) a mental health professional as defined in subdivision 1, paragraph (o); or

(2) a mental health practitioner or clinical trainee. The mental health practitioner or
clinical trainee must work under the clinical supervision of a mental health professional; or

(3) a mental health behavioral aide working under the clinical supervision of a mental
health professional to implement the rehabilitative mental health services previously
introduced by a mental health professional or practitioner and identified in the client's
individual treatment plan and individual behavior plan.

(A) A level I mental health behavioral aide must:

(i) be at least 18 years old;

(ii) have a high school diploma or general equivalency diploma (GED) or two years of
experience as a deleted text begin primarydeleted text end caregiver to a child with severe emotional disturbance within the
previous ten years; and

(iii) meet deleted text begin preservicedeleted text end new text begin trainingnew text end and continuing education requirements under subdivision
8.

(B) A level II mental health behavioral aide must:

(i) be at least 18 years old;

(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
deleted text begin clinicaldeleted text end services in the treatment of mental illness concerning children or adolescents or
complete a certificate program established under subdivision 8a; and

(iii) meet deleted text begin preservicedeleted text end new text begin trainingnew text end and continuing education requirements in subdivision 8.

(c) A day treatment multidisciplinary team must include at least one mental health
professional or clinical trainee and one mental health practitioner.

new text begin EFFECTIVE DATE. new text end

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

Sec. 31.

Minnesota Statutes 2016, section 256B.0943, subdivision 8, is amended to read:


Subd. 8.

Required deleted text begin preservicedeleted text end new text begin trainingnew text end and continuing education.

(a) A provider entity
shall establish a deleted text begin plandeleted text end new text begin training programnew text end to provide deleted text begin preservicedeleted text end new text begin trainingnew text end and continuing education
for staff. The deleted text begin plandeleted text end new text begin training programnew text end must deleted text begin clearlydeleted text end describe the deleted text begin type ofdeleted text end trainingnew text begin provided by
the entitynew text end necessary tonew text begin obtain new skills andnew text end maintain current skills deleted text begin and obtain new skills
and that relates to the provider entity's goals and objectives for services offereddeleted text end new text begin to provide
appropriate servicesnew text end .

(b) A provider new text begin entity new text end that employs a mental health behavioral aide under this section
must require the mental health behavioral aide to complete 30 hours of deleted text begin preservicedeleted text end training.
deleted text begin The preservice training must include parent team training. The preservice training must
include 15 hours of in-person training of a mental health behavioral aide in mental health
services delivery and eight hours of parent team training.deleted text end new text begin Before providing services to a
client, the aide must complete 24 hours of training, including training on the role and
limitations of a behavioral aide, boundaries, ethics, confidentiality, the federal Health
Insurance Portability and Accountability Act of 1996 (HIPAA), child development,
documentation, crisis de-escalation skills, and common medications, their side effects and
impact on symptoms. A provider entity's policies are not considered part of the 24 hours of
required training.
new text end

new text begin Within 60 days of employment, the aide must complete six hours of Department of
Human Services approved or delivered parent team training.new text end Curricula for parent team
training must be approved in advance by the commissioner. Components of parent team
training include:

(1) deleted text begin partnering withdeleted text end parentsnew text begin as partnersnew text end ;

(2) deleted text begin fundamentals of family supportdeleted text end new text begin understanding and supporting familiesnew text end ;

(3) deleted text begin fundamentals of policy and decision makingdeleted text end new text begin impact on siblingsnew text end ;

(4) deleted text begin defining equal partnershipdeleted text end new text begin the role of culture in family structuresnew text end ;new text begin and
new text end

deleted text begin (5) complexities of the parent and service provider partnership in multiple service delivery
systems due to system strengths and weaknesses;
 deleted text end

deleted text begin (6) sibling impacts;
 deleted text end

deleted text begin (7)deleted text end new text begin (5) community resources andnew text end support networksdeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (8) community resources.
 deleted text end

(c) A provider entity that employs a mental health practitioner and a mental health
behavioral aide to provide children's therapeutic services and supports under this section
must require the mental health practitioner and mental health behavioral aide to complete
20 hours of continuing education every two calendar years. The continuing education must
be related to serving the needs of a child with emotional disturbance deleted text begin in the child's home
environment and the child's familydeleted text end .

(d) The provider entity must document the mental health practitioner's or mental health
behavioral aide's annual completion of the required continuing education. The documentation
must include the date, subject, deleted text begin anddeleted text end number of hours of the continuing education, and
attendance records, as verified by the staff member's signature, job title, and the instructor's
name. The provider entity must keep documentation for each employee, including records
of attendance at professional workshops and conferences, at a central location and in the
employee's personnel file.

new text begin EFFECTIVE DATE. new text end

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

Sec. 32.

Minnesota Statutes 2016, section 256B.0943, subdivision 9, is amended to read:


Subd. 9.

Service delivery criteria.

(a) In delivering services under this section, a certified
provider entity must ensure that:

(1) each individual provider's caseload size permits the provider to deliver services to
both clients with severe, complex needs and clients with less intensive needs. The provider's
caseload size should reasonably enable the provider to play an active role in service planning,
monitoring, and delivering services to meet the client's and client's family's needs, as specified
in each client's individual treatment plan;

(2) site-based programs, including day treatment programs, provide staffing and facilities
to ensure the client's health, safety, and protection of rights, and that the programs are able
to implement each client's individual treatment plan; and

(3) a day treatment program is provided to a group of clients by a multidisciplinary team
under the clinical supervision of a mental health professional. The day treatment program
must be provided in and by: (i) an outpatient hospital accredited by the Joint Commission
on Accreditation of Health Organizations and licensed under sections 144.50 to 144.55; (ii)
a community mental health center under section 245.62; or (iii) an entity that is certified
under subdivision 4 to operate a program that meets the requirements of section 245.4884,
subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment
program must stabilize the client's mental health status while developing and improving the
client's independent living and socialization skills. The goal of the day treatment program
must be to reduce or relieve the effects of mental illness and provide training to enable the
client to live in the community. The program must be available year-round at least three to
five days per week, two or three hours per day, unless the normal five-day school week is
shortened by a holiday, weather-related cancellation, or other districtwide reduction in a
school week. A child transitioning into or out of day treatment must receive a minimum
treatment of one day a week for a two-hour time block. The two-hour time block must
include at least one hour of patient and/or family or group psychotherapy. The remainder
of the structured treatment program may include patient and/or family or group
psychotherapy, and individual or group skills training, if included in the client's individual
treatment plan. Day treatment programs are not part of inpatient or residential treatment
services. When a day treatment group that meets the minimum group size requirement
temporarily falls below the minimum group size because of a member's temporary absence,
medical assistance covers a group session conducted for the group members in attendance.
A day treatment program may provide fewer than the minimally required hours for a
particular child during a billing period in which the child is transitioning into, or out of, the
program.

(b) To be eligible for medical assistance payment, a provider entity must deliver the
service components of children's therapeutic services and supports in compliance with the
following requirements:

(1) patient and/or family, family, and group psychotherapy must be delivered as specified
in Minnesota Rules, part 9505.0372, subpart 6. Psychotherapy to address the child's
underlying mental health disorder must be documented as part of the child's ongoing
treatment. A provider must deliver, or arrange for, medically necessary psychotherapy,
unless the child's parent or caregiver chooses not to receive it. When a provider delivering
other services to a child under this section deems it not medically necessary to provide
psychotherapy to the child for a period of 90 days or longer, the provider entity must
document the medical reasons why psychotherapy is not necessary. When a provider
determines that a child needs psychotherapy but psychotherapy cannot be delivered due to
a shortage of licensed mental health professionals in the child's community, the provider
must document the lack of access in the child's medical record;

(2) individual, family, or group skills training must be provided by a mental health
professional or a mental health practitioner who is delivering services that fall within the
scope of the provider's practice and is supervised by a mental health professional who
accepts full professional responsibility for the training. Skills training is subject to the
following requirements:

(i) a mental health professional, clinical trainee, or mental health practitioner shall provide
skills training;

(ii) skills training delivered to a child or the child's family must be targeted to the specific
deficits or maladaptations of the child's mental health disorder and must be prescribed in
the child's individual treatment plan;

(iii) the mental health professional delivering or supervising the delivery of skills training
must document any underlying psychiatric condition and must document how skills training
is being used in conjunction with psychotherapy to address the underlying condition;

(iv) skills training delivered to the child's family must teach skills needed by parents to
enhance the child's skill development, to help the child utilize daily life skills taught by a
mental health professional, clinical trainee, or mental health practitioner, and to develop or
maintain a home environment that supports the child's progressive use of skills;

(v) group skills training may be provided to multiple recipients who, because of the
nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
interaction in a group setting, which must be staffed as follows:

(A) one mental health professional or one clinical trainee or mental health practitioner
under supervision of a licensed mental health professional must work with a group of three
to eight clients; or

(B) two mental health professionals, two clinical trainees or mental health practitioners
under supervision of a licensed mental health professional, or one mental health professional
or clinical trainee and one mental health practitioner must work with a group of nine to 12
clients;

(vi) a mental health professional, clinical trainee, or mental health practitioner must have
taught the psychosocial skill before a mental health behavioral aide may practice that skill
with the client; and

(vii) for group skills training, when a skills group that meets the minimum group size
requirement temporarily falls below the minimum group size because of a group member's
temporary absence, the provider may conduct the session for the group members in
attendance;

(3) crisis deleted text begin assistancedeleted text end new text begin planningnew text end to a child and family must include development of a written
plan that anticipates the particular factors specific to the child that may precipitate a
psychiatric crisis for the child in the near future. The written plan must document actions
that the family should be prepared to take to resolve or stabilize a crisis, such as advance
arrangements for direct intervention and support services to the child and the child's family.
Crisis deleted text begin assistancedeleted text end new text begin planningnew text end must include preparing resources designed to address abrupt or
substantial changes in the functioning of the child or the child's family when sudden change
in behavior or a loss of usual coping mechanisms is observed, or the child begins to present
a danger to self or others;

(4) mental health behavioral aide services must be medically necessary treatment services,
identified in the child's individual treatment plan and individual behavior plan, which are
performed minimally by a paraprofessional qualified according to subdivision 7, paragraph
(b), clause (3), and which are designed to improve the functioning of the child in the
progressive use of developmentally appropriate psychosocial skills. Activities involve
working directly with the child, child-peer groupings, or child-family groupings to practice,
repeat, reintroduce, and master the skills defined in subdivision 1, paragraph (t), as previously
taught by a mental health professional, clinical trainee, or mental health practitioner including:

(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions
so that the child progressively recognizes and responds to the cues independently;

(ii) performing as a practice partner or role-play partner;

(iii) reinforcing the child's accomplishments;

(iv) generalizing skill-building activities in the child's multiple natural settings;

(v) assigning further practice activities; and

(vi) intervening as necessary to redirect the child's target behavior and to de-escalate
behavior that puts the child or other person at risk of injury.

To be eligible for medical assistance payment, mental health behavioral aide services must
be delivered to a child who has been diagnosed with an emotional disturbance or a mental
illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must
implement treatment strategies in the individual treatment plan and the individual behavior
plan as developed by the mental health professional, clinical trainee, or mental health
practitioner providing direction for the mental health behavioral aide. The mental health
behavioral aide must document the delivery of services in written progress notes. Progress
notes must reflect implementation of the treatment strategies, as performed by the mental
health behavioral aide and the child's responses to the treatment strategies;

(5) direction of a mental health behavioral aide must include the following:

(i) ongoing face-to-face observation of the mental health behavioral aide delivering
services to a child by a mental health professional or mental health practitioner for at least
a total of one hour during every 40 hours of service provided to a child; and

(ii) immediate accessibility of the mental health professional, clinical trainee, or mental
health practitioner to the mental health behavioral aide during service provision;

(6) mental health service plan development must be performed in consultation with the
child's family and, when appropriate, with other key participants in the child's life by the
child's treating mental health professional or clinical trainee or by a mental health practitioner
and approved by the treating mental health professional. Treatment plan drafting consists
of development, review, and revision by face-to-face or electronic communication. The
provider must document events, including the time spent with the family and other key
participants in the child's life to review, revise, and sign the individual treatment plan; and

(7) to be eligible for payment, a diagnostic assessment must be complete with regard to
all required components, including multiple assessment appointments required for an
extended diagnostic assessment and the written report. Dates of the multiple assessment
appointments must be noted in the client's clinical record.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 33.

Minnesota Statutes 2016, section 256B.0946, subdivision 1, is amended to read:


Subdivision 1.

Required covered service components.

(a) Effective May 23, 2013,
and subject to federal approval, medical assistance covers medically necessary intensive
treatment services described under paragraph (b) that are provided by a provider entity
eligible under subdivision 3 to a client eligible under subdivision 2 who is placed in a foster
home licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or placed in a foster
home licensed under the regulations established by a federally recognized Minnesota tribe.

(b) Intensive treatment services to children with mental illness residing in foster family
settings that comprise specific required service components provided in clauses (1) to (5)
are reimbursed by medical assistance when they meet the following standards:

(1) psychotherapy provided by a mental health professional as defined in Minnesota
Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
Rules, part 9505.0371, subpart 5, item C;

(2) crisis deleted text begin assistancedeleted text end new text begin planningnew text end provided according to standards for children's therapeutic
services and supports in section 256B.0943;

(3) individual, family, and group psychoeducation services, defined in subdivision 1a,
paragraph (q), provided by a mental health professional or a clinical trainee;

(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
health professional or a clinical trainee; and

(5) service delivery payment requirements as provided under subdivision 4.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 34.

Minnesota Statutes 2016, section 256B.0946, subdivision 1a, is amended to read:


Subd. 1a.

Definitions.

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

(a) "Clinical care consultation" means communication from a treating clinician to other
providers working with the same client to inform, inquire, and instruct regarding the client's
symptoms, strategies for effective engagement, care and intervention needs, and treatment
expectations across service settings, including but not limited to the client's school, social
services, day care, probation, home, primary care, medication prescribers, disabilities
services, and other mental health providers and to direct and coordinate clinical service
components provided to the client and family.

(b) "Clinical supervision" means the documented time a clinical supervisor and supervisee
spend together to discuss the supervisee's work, to review individual client cases, and for
the supervisee's professional development. It includes the documented oversight and
supervision responsibility for planning, implementation, and evaluation of services for a
client's mental health treatment.

(c) "Clinical supervisor" means the mental health professional who is responsible for
clinical supervision.

(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371, subpart
5, item C;

(e) "Crisis deleted text begin assistancedeleted text end new text begin planningnew text end " has the meaning given in section 245.4871, subdivision
9a, including the development of a plan that addresses prevention and intervention strategies
to be used in a potential crisis, but does not include actual crisis intervention.

(f) "Culturally appropriate" means providing mental health services in a manner that
incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
strengths and resources to promote overall wellness.

(g) "Culture" means the distinct ways of living and understanding the world that are
used by a group of people and are transmitted from one generation to another or adopted
by an individual.

(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part 9505.0370,
subpart 11.

(i) "Family" means a person who is identified by the client or the client's parent or
guardian as being important to the client's mental health treatment. Family may include,
but is not limited to, parents, foster parents, children, spouse, committed partners, former
spouses, persons related by blood or adoption, persons who are a part of the client's
permanency plan, or persons who are presently residing together as a family unit.

(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.

(k) "Foster family setting" means the foster home in which the license holder resides.

(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part 9505.0370,
subpart 15.

(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
9505.0370, subpart 17.

(n) "Mental health professional" has the meaning given in Minnesota Rules, part
9505.0370, subpart 18.

(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370, subpart
20.

(p) "Parent" has the meaning given in section 260C.007, subdivision 25.

(q) "Psychoeducation services" means information or demonstration provided to an
individual, family, or group to explain, educate, and support the individual, family, or group
in understanding a child's symptoms of mental illness, the impact on the child's development,
and needed components of treatment and skill development so that the individual, family,
or group can help the child to prevent relapse, prevent the acquisition of comorbid disorders,
and achieve optimal mental health and long-term resilience.

(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370, subpart
27.

(s) "Team consultation and treatment planning" means the coordination of treatment
plans and consultation among providers in a group concerning the treatment needs of the
child, including disseminating the child's treatment service schedule to all members of the
service team. Team members must include all mental health professionals working with the
child, a parent, the child unless the team lead or parent deem it clinically inappropriate, and
at least two of the following: an individualized education program case manager; probation
agent; children's mental health case manager; child welfare worker, including adoption or
guardianship worker; primary care provider; foster parent; and any other member of the
child's service team.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 35.

Minnesota Statutes 2016, section 256B.0946, subdivision 4, is amended to read:


Subd. 4.

Service delivery payment requirements.

(a) To be eligible for payment under
this section, a provider must develop and practice written policies and procedures for
intensive treatment in foster care, consistent with subdivision 1, paragraph (b), and comply
with the following requirements in paragraphs (b) to (n).

(b) A qualified clinical supervisor, as defined in and performing in compliance with
Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
provision of services described in this section.

(c) Each client receiving treatment services must receive an extended diagnostic
assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within 30
days of enrollment in this service unless the client has a previous extended diagnostic
assessment that the client, parent, and mental health professional agree still accurately
describes the client's current mental health functioning.

(d) Each previous and current mental health, school, and physical health treatment
provider must be contacted to request documentation of treatment and assessments that the
eligible client has received. This information must be reviewed and incorporated into the
diagnostic assessment and team consultation and treatment planning review process.

(e) Each client receiving treatment must be assessed for a trauma history, and the client's
treatment plan must document how the results of the assessment will be incorporated into
treatment.

(f) Each client receiving treatment services must have an individual treatment plan that
is reviewed, evaluated, and signed every 90 days using the team consultation and treatment
planning process, as defined in subdivision 1a, paragraph (s).

(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided in
accordance with the client's individual treatment plan.

(h) Each client must have a crisis deleted text begin assistancedeleted text end plan within ten days of initiating services
and must have access to clinical phone support 24 hours per day, seven days per week,
during the course of treatment. The crisis plan must demonstrate coordination with the local
or regional deleted text begin mobiledeleted text end crisis deleted text begin intervention teamdeleted text end new text begin provider entity as defined in section 245.991,
subdivision 4new text end .

(i) Services must be delivered and documented at least three days per week, equaling at
least six hours of treatment per week, unless reduced units of service are specified on the
treatment plan as part of transition or on a discharge plan to another service or level of care.
Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.

(j) Location of service delivery must be in the client's home, day care setting, school, or
other community-based setting that is specified on the client's individualized treatment plan.

(k) Treatment must be developmentally and culturally appropriate for the client.

(l) Services must be delivered in continual collaboration and consultation with the client's
medical providers and, in particular, with prescribers of psychotropic medications, including
those prescribed on an off-label basis. Members of the service team must be aware of the
medication regimen and potential side effects.

(m) Parents, siblings, foster parents, and members of the child's permanency plan must
be involved in treatment and service delivery unless otherwise noted in the treatment plan.

(n) Transition planning for the child must be conducted starting with the first treatment
plan and must be addressed throughout treatment to support the child's permanency plan
and postdischarge mental health service needs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 36.

Minnesota Statutes 2016, section 256B.0946, subdivision 6, is amended to read:


Subd. 6.

Excluded services.

(a) Services in clauses (1) to (7) are not covered under this
section and are not eligible for medical assistance payment as components of intensive
treatment in foster care services, but may be billed separately:

(1) inpatient psychiatric hospital treatment;

(2) mental health targeted case management;

(3) partial hospitalization;

(4) medication management;

(5) children's mental health day treatment services;

(6) crisis response services under section deleted text begin 256B.0944deleted text end new text begin 256B.0624new text end ; and

(7) transportation.

(b) Children receiving intensive treatment in foster care services are not eligible for
medical assistance reimbursement for the following services while receiving intensive
treatment in foster care:

(1) psychotherapy and skills training components of children's therapeutic services and
supports under section 256B.0625, subdivision 35b;

(2) mental health behavioral aide services as defined in section 256B.0943, subdivision
1, paragraph (m);

(3) home and community-based waiver services;

(4) mental health residential treatment; and

(5) room and board costs as defined in section 256I.03, subdivision 6.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 37.

Minnesota Statutes 2016, section 256B.0947, subdivision 3a, is amended to read:


Subd. 3a.

Required service components.

(a) Subject to federal approval, medical
assistance covers all medically necessary intensive nonresidential rehabilitative mental
health services and supports, as defined in this section, under a single daily rate per client.
Services and supports must be delivered by an eligible provider under subdivision 5 to an
eligible client under subdivision 3.

(b) Intensive nonresidential rehabilitative mental health services, supports, and ancillary
activities covered by the single daily rate per client must include the following, as needed
by the individual client:

(1) individual, family, and group psychotherapy;

(2) individual, family, and group skills training, as defined in section 256B.0943,
subdivision 1, paragraph (t);

(3) crisis deleted text begin assistancedeleted text end new text begin planningnew text end as defined in section 245.4871, subdivision 9a, which
includes recognition of factors precipitating a mental health crisis, identification of behaviors
related to the crisis, and the development of a plan to address prevention, intervention, and
follow-up strategies to be used in the lead-up to or onset of, and conclusion of, a mental
health crisis; crisis deleted text begin assistancedeleted text end new text begin planningnew text end does not mean crisis response services or deleted text begin crisisdeleted text end
intervention services provided in section deleted text begin 256B.0944deleted text end new text begin 245.991new text end ;

(4) medication management provided by a physician or an advanced practice registered
nurse with certification in psychiatric and mental health care;

(5) mental health case management as provided in section 256B.0625, subdivision 20;

(6) medication education services as defined in this section;

(7) care coordination by a client-specific lead worker assigned by and responsible to the
treatment team;

(8) psychoeducation of and consultation and coordination with the client's biological,
adoptive, or foster family and, in the case of a youth living independently, the client's
immediate nonfamilial support network;

(9) clinical consultation to a client's employer or school or to other service agencies or
to the courts to assist in managing the mental illness or co-occurring disorder and to develop
client support systems;

(10) coordination with, or performance of, deleted text begin crisisdeleted text end intervention and stabilization services
as defined in section deleted text begin 256B.0944deleted text end new text begin 245.991, subdivision 2new text end ;

(11) assessment of a client's treatment progress and effectiveness of services using
standardized outcome measures published by the commissioner;

(12) transition services as defined in this section;

(13) integrated dual disorders treatment as defined in this section; and

(14) housing access support.

(c) The provider shall ensure and document the following by means of performing the
required function or by contracting with a qualified person or entity:

(1) client access to crisis intervention services, as defined in section deleted text begin 256B.0944deleted text end new text begin 245.991new text end ,
and available 24 hours per day and seven days per week;

(2) completion of an extended diagnostic assessment, as defined in Minnesota Rules,
part 9505.0372, subpart 1, item C; and

(3) determination of the client's needed level of care using an instrument approved and
periodically updated by the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 38.

Minnesota Statutes 2016, section 256B.0947, subdivision 7, is amended to read:


Subd. 7.

Medical assistance payment and rate setting.

(a) Payment for services in this
section must be based on one daily encounter rate per provider inclusive of the following
services received by an eligible client in a given calendar day: all rehabilitative services,
supports, and ancillary activities under this section, staff travel time to provide rehabilitative
services under this section, and crisis response services under section deleted text begin 256B.0944deleted text end new text begin 256B.0624new text end .

(b) Payment must not be made to more than one entity for each client for services
provided under this section on a given day. If services under this section are provided by a
team that includes staff from more than one entity, the team shall determine how to distribute
the payment among the members.

(c) The commissioner shall establish regional cost-based rates for entities that will bill
medical assistance for nonresidential intensive rehabilitative mental health services. In
developing these rates, the commissioner shall consider:

(1) the cost for similar services in the health care trade area;

(2) actual costs incurred by entities providing the services;

(3) the intensity and frequency of services to be provided to each client;

(4) the degree to which clients will receive services other than services under this section;
and

(5) the costs of other services that will be separately reimbursed.

(d) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 39.

Minnesota Statutes 2016, section 256B.49, subdivision 25, is amended to read:


Subd. 25.

Reduce avoidable behavioral crisis emergency room admissions,
psychiatric inpatient hospitalizations, and commitments to institutions.

(a) Persons
receiving home and community-based services authorized under this section who have two
or more admissions within a calendar year to an emergency room, psychiatric unit, or
institution must receive consultation from a mental health professional as defined in section
245.462, subdivision 18, or a behavioral professional as defined in the home and
community-based services state plan within 30 days of discharge. The mental health
professional or behavioral professional must:

(1) conduct a functional assessment of the crisis incident as defined in section 245D.02,
subdivision 11, which led to the hospitalization with the goal of developing proactive
strategies as well as necessary reactive strategies to reduce the likelihood of future avoidable
hospitalizations due to a behavioral crisis;

(2) use the results of the functional assessment to amend the coordinated service and
support plan in section 245D.02, subdivision 4b, to address the potential need for additional
staff training, increased staffing, deleted text begin access to crisis mobility services,deleted text end mental health services,
use of technology, and crisis deleted text begin stabilizationdeleted text end services in section deleted text begin 256B.0624, subdivision 7deleted text end new text begin
245.991new text end ; and

(3) identify the need for additional consultation, testing, deleted text begin mental health crisis intervention
team services as defined in section 245D.02, subdivision 20,deleted text end psychotropic medication use
and monitoring under section 245D.051, and the frequency and duration of ongoing
consultation.

(b) For the purposes of this subdivision, "institution" includes, but is not limited to, the
Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 40.

Minnesota Statutes 2016, section 256B.84, is amended to read:


256B.84 AMERICAN INDIAN CONTRACTING PROVISIONS.

Notwithstanding other state laws or rules, Indian health services and agencies operated
by Indian tribes are not required to have a county contract or county certification to enroll
as providers of adult rehabilitative mental health services under section 256B.0623; and
adult mental health crisis response services under section deleted text begin 256B.0624deleted text end new text begin 245.991new text end . In order to
enroll as providers of these services, Indian health services and agencies operated by Indian
tribes must meet the vendor of medical care requirements in section 256B.02, subdivision
7.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 41. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin The revisor shall make necessary cross-reference changes and remove statutory
cross-references in Minnesota Statutes and Minnesota Rules to conform with the
recodification and repealer in this article. The revisor may make technical and other necessary
changes to sentence structure to preserve the meaning of the text. The revisor may alter the
statutory coding in this article to incorporate statutory changes made by other laws during
the 2017 regular legislative session. If a provision repealed by this article is also amended
by other law during the 2017 regular legislative session, the revisor shall merge the
amendment into the recodification, notwithstanding Minnesota Statutes, section 645.30.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 42. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2016, sections 245.469; 245.4879; 256B.0624, subdivisions 4a, 5,
6, 7, 8, 9, 10, and 11; and 256B.0944, new text end new text begin are repealed.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

ARTICLE 3

OPERATIONS

Section 1.

Minnesota Statutes 2016, section 245.095, is amended to read:


245.095 LIMITS ON RECEIVING PUBLIC FUNDS.

Subdivision 1.

Prohibition.

new text begin (a) new text end If a provider, vendor, or individual enrolled, licensed,
deleted text begin ordeleted text end receiving funds under a grant contractnew text begin , or registerednew text end in any program administered by the
commissionernew text begin , including under the commissioner's powers and authorities in section 256.01,new text end
is excluded from deleted text begin anydeleted text end new text begin thatnew text end program deleted text begin administered by the commissioner, including under the
commissioner's powers and authorities in section 256.01deleted text end , the commissioner shallnew text begin :
new text end

new text begin (1)new text end prohibit the excluded provider, vendor, or individual from enrolling deleted text begin ordeleted text end new text begin ,new text end becoming
licensednew text begin , receiving grant funds, or registeringnew text end in any other program administered by the
commissionerdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider,
vendor, or individual in any other program administered by the commissioner.
 new text end

new text begin (b) new text end The duration of this prohibitionnew text begin , disenrollment, revocation, suspension,
disqualification, or debarmentnew text end must last for the longest applicable sanction or disqualifying
period in effect for the provider, vendor, or individual permitted by state or federal law.

Subd. 2.

Definitions.

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

(b) "Excluded" means disenrolled,deleted text begin subject to license revocation or suspension, deleted text end
new text begin disqualified, has a license that has been revoked or suspended under chapter 245A, or has
been debarred or suspendednew text end deleted text begin disqualified, or subject to vendor debarment deleted text end under Minnesota
Rules, part 1230.1150new text begin , or excluded pursuant to section 256B.064, subdivision 3new text end .

(c) "Individual" means a natural person providing products or services as a provider or
vendor.

(d) "Provider" means an owner, controlling individual, license holder, director, or
managerial official.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 3b. new text end

new text begin Authorized agent. new text end

new text begin "Authorized agent" means the controlling individual
designated by the license holder to be responsible for communicating with the commissioner
of human services on all matters provided for in this chapter and on whom service of all
notices and orders must be made, pursuant to section 245A.04, subdivision 1.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 3.

Minnesota Statutes 2016, section 245A.02, subdivision 5a, is amended to read:


Subd. 5a.

Controlling individual.

new text begin (a) new text end "Controlling individual" means deleted text begin a public body,
governmental agency, business entity, officer, owner, or managerial official whose
responsibilities include the direction of the management or policies of a program. For
purposes of this subdivision, owner means an individual who has direct or indirect ownership
interest in a corporation, partnership, or other business association issued a license under
this chapter.deleted text end new text begin the owner of a program or service licensed under this chapter and the following
individuals, if applicable:
new text end

new text begin (1) each officer of the organization, including the chief executive officer and chief
financial officer;
 new text end

new text begin (2) the individual designated as the authorized agent pursuant to section 245A.04,
subdivision 1;
 new text end

new text begin (3) the individual designated as the compliance officer pursuant to section 256B.04,
subdivision 21; and
 new text end

new text begin (4) each managerial official whose responsibilities include the direction of the
management or policies of a program.
 new text end

deleted text begin For purposes of this subdivision, managerial official means those individuals who have
the decision-making authority related to the operation of the program, and the responsibility
for the ongoing management of or direction of the policies, services, or employees of the
program. A site director who has no ownership interest in the program is not considered to
be a managerial official for purposes of this definition.
 deleted text end

new text begin (b)new text end Controlling individual does not include:

(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;

(2) an individual who is a state or federal official, or state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more programs, unless the individual is also an officer,
owner, or managerial official of the program, receives remuneration from the program, or
owns any of the beneficial interests not excluded in this subdivision;

(3) an individual who owns less than five percent of the outstanding common shares of
a corporation:

(i) whose securities are exempt under section 80A.45, clause (6); or

(ii) whose transactions are exempt under section 80A.46, clause (2); or

(4) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the program
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation.

new text begin (c) For purposes of this subdivision, "managerial official" means those individuals who
have the decision-making authority related to the operation of the program, and the
responsibility for the ongoing management of or direction of the policies, services, or
employees of the program. A site director who has no ownership interest in the program is
not considered to be a managerial official for purposes of this definition.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 4.

Minnesota Statutes 2016, section 245A.02, subdivision 8, is amended to read:


Subd. 8.

License.

"License" means a certificate issued by the commissioner new text begin under section
245A.04 new text end authorizing the license holder to provide a specified program for a specified period
of time and in accordance with the terms of the license and the rules of the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 5.

Minnesota Statutes 2016, section 245A.02, subdivision 9, is amended to read:


Subd. 9.

License holder.

"License holder" means deleted text begin an individual, corporation, partnership,
voluntary association, or otherdeleted text end new text begin an individual,new text end organizationnew text begin , or government entitynew text end that is
legally responsible for the operation of the programnew text begin or servicenew text end , new text begin and new text end has been granted a
license by the commissioner under this chapter deleted text begin or chapter 245Ddeleted text end and the rules of the
commissionerdeleted text begin , and is a controlling individualdeleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 6.

Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 10b. new text end

new text begin Organization. new text end

new text begin "Organization" means a domestic or foreign corporation,
nonprofit corporation, limited liability company, partnership, limited partnership, limited
liability partnership, association, voluntary association, and any other legal or commercial
entity. For purposes of this chapter, organization does not include a government entity.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 7.

Minnesota Statutes 2016, section 245A.02, subdivision 12, is amended to read:


Subd. 12.

Private agency.

"Private agency" means deleted text begin an individual, corporation, partnership,
voluntary associationdeleted text end new text begin an individualnew text end or deleted text begin otherdeleted text end organizationdeleted text begin , other than a county agency, or a
court with jurisdiction,deleted text end that places persons who cannot remain in their own homes in
residential programs, foster care, or adoptive homes.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 8.

Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 12a. new text end

new text begin Provisional license. new text end

new text begin "Provisional license" means a license of limited duration
not to exceed 15 months issued under section 245A.04, subdivision 7, paragraph (g), or
245A.045.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 9.

Minnesota Statutes 2016, section 245A.03, subdivision 1, is amended to read:


Subdivision 1.

License required.

Unless licensed by the commissionernew text begin under this chapternew text end ,
an individual, deleted text begin corporation, partnership, voluntary association, otherdeleted text end organization, or
deleted text begin controlling individualdeleted text end new text begin government entitynew text end must not:

(1) operate a residential or a nonresidential program;

(2) receive a child or adult for care, supervision, or placement in foster care or adoption;

(3) help plan the placement of a child or adult in foster care or adoption or engage in
placement activities as defined in section 259.21, subdivision 9, in this state, whether or not
the adoption occurs in this state; or

(4) advertise a residential or nonresidential program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 10.

Minnesota Statutes 2016, section 245A.04, subdivision 2, is amended to read:


Subd. 2.

Notification of affected municipality.

The commissioner must not issue a
license new text begin under this chapter new text end without giving 30 calendar days' written notice to the affected
municipality or other political subdivision unless the program is considered a permitted
single-family residential use under sections 245A.11 and 245A.14. new text begin The commissioner may
provide the notice through electronic communication. new text end The notification must be given before
the first issuance of a license new text begin under this chapter new text end and annually after that time if annual
notification is requested in writing by the affected municipality or other political subdivision.
State funds must not be made available to or be spent by an agency or department of state,
county, or municipal government for payment to a residential or nonresidential program
licensed under this chapter until the provisions of this subdivision have been complied with
in full. The provisions of this subdivision shall not apply to programs located in hospitals.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 11.

Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:


Subd. 4.

Inspections; waiver.

(a) Before issuing deleted text begin an initialdeleted text end new text begin anew text end licensenew text begin under this chapternew text end ,
the commissioner shall conduct an inspection of the program. The inspection must include
but is not limited to:

(1) an inspection of the physical plant;

(2) an inspection of records and documents;

(3) an evaluation of the program by consumers of the program; and

(4) observation of the program in operation.

For the purposes of this subdivision, "consumer" means a person who receives the
services of a deleted text begin licenseddeleted text end programnew text begin licensed under this chapternew text end , the person's legal guardian, or
the parent or individual having legal custody of a child who receives the services of a deleted text begin licenseddeleted text end
programnew text begin licensed under this chapternew text end .

(b) The evaluation required in paragraph (a), clause (3) or the observation in paragraph
(a), clause (4) is not required prior to issuing deleted text begin an initialdeleted text end new text begin anew text end license under subdivision 7. If the
commissioner issues deleted text begin an initialdeleted text end new text begin anew text end license under deleted text begin subdivision 7deleted text end new text begin this chapternew text end , these requirements
must be completed within one year after the issuance of deleted text begin an initialdeleted text end new text begin thenew text end license.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 12.

Minnesota Statutes 2016, section 245A.04, subdivision 6, is amended to read:


Subd. 6.

Commissioner's evaluation.

new text begin (a) new text end Before issuing, denying, suspending, revoking,
or making conditional a license, the commissioner shall evaluate information gathered under
this section. The commissioner's evaluation shall considernew text begin the requirements of statutes and
rules applicable to the program or services for which the applicant is seeking to be licensed,
including the disqualification standards set forth in chapter 245C, and shall evaluatenew text end facts,
conditions, or circumstances concerningnew text begin :
new text end

new text begin (1)new text end the program's operationdeleted text begin ,deleted text end new text begin ;
new text end

new text begin (2)new text end the well-being of persons served by the programdeleted text begin ,deleted text end new text begin ;
new text end

new text begin (3)new text end available consumer evaluations of the programdeleted text begin , anddeleted text end new text begin ;
new text end

new text begin (4)new text end information about the qualifications of the personnel employed by the applicant or
license holderdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (5) the applicant's ability to demonstrate competent knowledge of the applicable laws
and rules including but not limited to this chapter and chapters 119B and 245C.
 new text end

new text begin (b) new text end The commissioner shall new text begin also new text end evaluate the results of the study required in subdivision
3 and determine whether a risk of harm to the persons served by the program exists. In
conducting this evaluation, the commissioner shall apply the disqualification standards set
forth in chapter 245C.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 13.

Minnesota Statutes 2016, section 245A.04, subdivision 7, is amended to read:


Subd. 7.

Grant of license; license extension.

(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
licensenew text begin consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043, or a provisional license under section 245A.045new text end . At minimum, the
license shall state:

(1) the name of the license holder;

(2) the address of the program;

(3) the effective date and expiration date of the license;

(4) the type of license;

(5) the maximum number and ages of persons that may receive services from the program;
and

(6) any special conditions of licensure.

(b) The commissioner may issue deleted text begin an initialdeleted text end new text begin anew text end license for a period not to exceed two years
if:

(1) the commissioner is unable to conduct the evaluation or observation required by
subdivision 4, paragraph (a), clauses (3) and (4), because the program is not yet operational;

(2) certain records and documents are not available because persons are not yet receiving
services from the program; and

(3) the applicant complies with applicable laws and rules in all other respects.

(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program. deleted text begin A license shall not be
transferable to another individual, corporation, partnership, voluntary association, other
organization, or controlling individual or to another location.
deleted text end

deleted text begin (d) A license holder must notify the commissioner and obtain the commissioner's approval
before making any changes that would alter the license information listed under paragraph
(a).
 deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end Except as provided in paragraphs deleted text begin (g)deleted text end new text begin (f)new text end and deleted text begin (h)deleted text end new text begin (g)new text end , the commissioner shall not
issue or reissue a license if the applicant, license holder, or controlling individual has:

(1) been disqualified and the disqualification was not set aside and no variance has been
granted;

(2) been denied a license new text begin under this chapter, including a license following the expiration
of a provisional license under section 245A.045, new text end within the past two years;

(3) had a license new text begin issued under this chapter new text end revoked within the past five years;

(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement
for which payment is delinquent; or

(5) failed to submit the information required of an applicant under subdivision 1,
paragraph (f) or (g), after being requested by the commissioner.

When a license new text begin issued under this chapter new text end is revoked under clause (1) or (3), the license
holder and controlling individual may not hold any license under chapter 245A or 245D for
five years following the revocation, and other licenses held by the applicant, license holder,
or controlling individual shall also be revoked.

deleted text begin (f)deleted text end new text begin (e)new text end The commissioner shall not issue or reissue a license new text begin under this chapter new text end if an
individual living in the household where the deleted text begin licenseddeleted text end services will be provided as specified
under section 245C.03, subdivision 1, has been disqualified and the disqualification has not
been set aside and no variance has been granted.

deleted text begin (g)deleted text end new text begin (f)new text end Pursuant to section 245A.07, subdivision 1, paragraph (b), new text begin and section 245A.045,
subdivision 2, new text end when a license new text begin issued under this chapter new text end has been suspended or revoked and
the suspension or revocation is under appeal, the program may continue to operate pending
a final order from the commissioner. If the license under suspension or revocation will
expire before a final order is issued, a temporary provisional license may be issued provided
any applicable license fee is paid before the temporary provisional license is issued.

deleted text begin (h)deleted text end new text begin (g)new text end Notwithstanding paragraph deleted text begin (g)deleted text end new text begin (f)new text end , when a revocation is based on the
disqualification of a controlling individual or license holder, and the controlling individual
or license holder is ordered under section 245C.17 to be immediately removed from direct
contact with persons receiving services or is ordered to be under continuous, direct
supervision when providing direct contact services, the program may continue to operate
only if the program complies with the order and submits documentation demonstrating
compliance with the order. If the disqualified individual fails to submit a timely request for
reconsideration, or if the disqualification is not set aside and no variance is granted, the
order to immediately remove the individual from direct contact or to be under continuous,
direct supervision remains in effect pending the outcome of a hearing and final order from
the commissioner.

deleted text begin (i)deleted text end new text begin (h)new text end For purposes of reimbursement for meals only, under the Child and Adult Care
Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A,
part 226, relocation within the same county by a licensed family day care provider, shall
be considered an extension of the license for a period of no more than 30 calendar days or
until the new license is issued, whichever occurs first, provided the county agency has
determined the family day care provider meets licensure requirements at the new location.

deleted text begin (j)deleted text end new text begin (i)new text end Unless otherwise specified by statute, all licenses new text begin issued under this chapter new text end expire
at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
apply for and be granted a new license to operate the program or the program must not be
operated after the expiration date.

deleted text begin (k)deleted text end new text begin (j)new text end The commissioner shall not issue or reissue a license new text begin under this chapter new text end if it has
been determined that a tribal licensing authority has established jurisdiction to license the
program or service.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 14.

Minnesota Statutes 2016, section 245A.04, is amended by adding a subdivision
to read:


new text begin Subd. 7a. new text end

new text begin Notification required. new text end

new text begin (a) A license holder must notify the commissioner and
obtain the commissioner's approval before making any change that would alter the license
information listed under subdivision 7, paragraph (a).
 new text end

new text begin (b) At least 30 days before the effective date of a change, the license holder must notify
the commissioner in writing of any:
 new text end

new text begin (1) change to the license holder's authorized agent as defined in section 245A.02,
subdivision 3b;
 new text end

new text begin (2) change to the license holder's controlling individual as defined in section 245A.02,
subdivision 5a;
 new text end

new text begin (3) change to license holder information on file with the secretary of state;
 new text end

new text begin (4) change to a program's business structure;
 new text end

new text begin (5) change in the location of the program or service licensed under this chapter; and
 new text end

new text begin (6) change in the federal or state tax identification number associated with the license
holder.
 new text end

new text begin (c) When a license holder notifies the commissioner of a change to the business structure
governing the licensed program or services but is not selling the business, the license holder
must provide amended articles of incorporation and other documentation of the change and
any other information requested by the commissioner.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 15.

Minnesota Statutes 2016, section 245A.04, subdivision 10, is amended to read:


Subd. 10.

Adoption agency; additional requirements.

In addition to the other
requirements of this section, an individualdeleted text begin , corporation, partnership, voluntary association,
otherdeleted text end new text begin ornew text end organizationdeleted text begin , or controlling individualdeleted text end applying for a license to place children for
adoption must:

(1) incorporate as a nonprofit corporation under chapter 317A;

(2) file with the application for licensure a copy of the disclosure form required under
section 259.37, subdivision 2;

(3) provide evidence that a bond has been obtained and will be continuously maintained
throughout the entire operating period of the agency, to cover the cost of transfer of records
to and storage of records by the agency which has agreed, according to rule established by
the commissioner, to receive the applicant agency's records if the applicant agency voluntarily
or involuntarily ceases operation and fails to provide for proper transfer of the records. The
bond must be made in favor of the agency which has agreed to receive the records; and

(4) submit a certified audit to the commissioner each year the license is renewed as
required under section 245A.03, subdivision 1.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 16.

new text begin [245A.043] LICENSE APPLICATION AFTER A CHANGE OF
OWNERSHIP.
 new text end

new text begin Subdivision 1. new text end

new text begin Transfer prohibited. new text end

new text begin A license issued under this chapter is only valid
for a premises and individual, organization, or government entity identified by the
commissioner on the license. A license is not transferable or assignable.
 new text end

new text begin Subd. 2. new text end

new text begin Change of ownership. new text end

new text begin If the commissioner determines that there will be a
change in ownership, the commissioner shall require submission of a new license application.
A change in ownership occurs when:
 new text end

new text begin (1) the license holder sells or transfers 100 percent of the property, stock, or assets;
 new text end

new text begin (2) the license holder merges with another organization;
 new text end

new text begin (3) the license holder consolidates with two or more organizations, resulting in the
creation of a new organization;
 new text end

new text begin (4) there is a change in the federal tax identification number associated with the license
holder; or
 new text end

new text begin (5) there is a turnover of each controlling individual associated with the license within
a 12-month period. A change to the license holder's controlling individuals, including a
change due to a transfer of stock, is not a change in ownership if at least one controlling
individual who was listed on the license for at least 12 consecutive months continues to be
a controlling individual after the reported change.
 new text end

new text begin Subd. 3. new text end

new text begin Change of ownership requirements. new text end

new text begin (a) A license holder who intends to
change the ownership of the program or service as defined in subdivision 2 to a party that
intends to assume operation without an interruption in service longer than 60 days after
acquiring the program or service must provide the commissioner with written notice of the
proposed sale or change on a form provided by the commissioner, at least 60 days before
the anticipated date of the change in program owner. For purposes of this subdivision and
subdivision 4, "party" means the party that intends to operate the service or program.
 new text end

new text begin (b) The party must submit a license application under this chapter on the form and in
the manner prescribed by the commissioner at least 30 days before the change of program
ownership is complete, and must include documentation to support the upcoming change.
The party must comply with background study requirements under chapter 245C and shall
pay the application fee required in section 245A.10. A party that intends to assume operation
without an interruption in service longer than 60 days after acquiring the program or service
is exempt from the requirements of Minnesota Rules, part 9530.6800.
 new text end

new text begin (c) The commissioner may develop streamlined application procedures for when the
party is an existing license holder under this chapter and is acquiring a program licensed
under this chapter or service in the same service class as one or more licensed programs or
services it operates and those licenses are in substantial compliance according to the licensing
standards in this chapter and applicable rules. For purposes of this subdivision, "substantial
compliance" means the commissioner did not issue, within the past 12 months, a sanction
under section 245A.045 or 245A.07 against a license held by the party or made a license
held by the party conditional according to section 245A.06 within the past 12 months.
 new text end

new text begin (d) Except when a temporary change of ownership license is issued pursuant to
subdivision 5, the existing license holder is solely responsible for operating the program
according to applicable rules and statutes until a license under this chapter is issued to the
party.
 new text end

new text begin (e) If a licensing inspection of the program or service was conducted within the previous
12 months and the existing license holder's license record demonstrates substantial
compliance with the applicable licensing requirements, the commissioner may waive the
party's inspection required by section 245A.04, subdivision 4. The party must submit to the
commissioner proof that the premises was inspected by a fire marshal or that the fire marshal
deemed that an inspection was not warranted and proof that the premises was inspected for
compliance with the building code or that no inspection was deemed warranted.
 new text end

new text begin (f) If the party is seeking a license for a program or service that has an outstanding
correction order, the party must submit a letter with the license application identifying how
and within what length of time the party will resolve the outstanding correction order and
come into full compliance with the licensing requirements.
 new text end

new text begin (g) Any action taken under section 245A.06 or 245A.07 against the existing license
holder's license at the time the party is applying for a license, including when the existing
license holder is operating under a conditional license or is subject to a revocation, shall
remain in effect until the commissioner determines that the grounds for the action are
corrected or no longer exist.
 new text end

new text begin (h) The commissioner shall evaluate the application of the party according to section
245A.04, subdivision 6. Pursuant to section 245A.04, subdivision 7, if the commissioner
determines that the party complies with applicable laws and rules, the commissioner may
issue a license or a temporary change of ownership license.
 new text end

new text begin (i) The commissioner may deny an application as provided in section 245A.05. An
applicant whose application was denied by the commissioner may appeal the denial according
to section 245A.05.
 new text end

new text begin (j) This subdivision does not apply to a licensed program or service located in a home
where the license holder resides.
 new text end

new text begin Subd. 4. new text end

new text begin Temporary change of ownership license. new text end

new text begin (a) After receiving the party's
application and upon the written request of the existing license holder and the party, the
commissioner may issue a temporary change of ownership license to the party while the
commissioner evaluates the party's application. Until a decision is made to grant or deny a
license under this chapter, the existing license holder and the party shall both be responsible
for operating the program or service according to applicable laws and rules, and the sale or
transfer of the license holder's ownership interest in the licensed program or service does
not terminate the existing license.
 new text end

new text begin (b) The commissioner may establish criteria to issue a temporary change of ownership
license when a license holder's death, divorce, or other event affecting the ownership of the
program when an applicant seeks to assume operation of the program or service to ensure
continuity of the program or service while a license application is evaluated. This subdivision
applies to any program or service licensed under this chapter.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 17.

new text begin [245A.045] PROVISIONAL LICENSE.
 new text end

new text begin Subdivision 1. new text end

new text begin When a provisional license shall be required. new text end

new text begin (a) Before issuing a
license under section 245A.04, subdivision 7, the commissioner shall issue a provisional
license for a period of up to 15 months if the applicant or license holder:
 new text end

new text begin (1) is licensed but does not hold a license in the same service class for which a license
application was submitted;
 new text end

new text begin (2) was licensed in the same service class for less than 12 months at the time the
application was submitted;
 new text end

new text begin (3) was in substantial, but not complete, compliance with applicable requirements for
licensure under section 245A.04 but demonstrates the potential to comply with all applicable
laws and rules by the end of the provisional license term, if the commissioner determines
that the deficiencies identified do not adversely affect the health, welfare, or safety of a
client; or
 new text end

new text begin (4) is identified as the buyer of a program that (i) was licensed under this chapter for
less than 12 months, (ii) has an outstanding correction order violation, (iii) is operating
under a conditional license, (iv) was issued a revocation order, or (v) is buying a program
that is currently operating under a provisional license.
 new text end

new text begin (b) The commissioner may place terms and conditions on the provisional license as the
commissioner determines necessary until the applicant achieves full compliance with
applicable statutes and rules before the expiration of the provisional license. The decision
to issue a provisional license under this section instead of a license under section 245A.04,
subdivision 7, is not appealable.
 new text end

new text begin (c) Before the expiration of the provisional license, the commissioner shall conduct at
least one unannounced inspection of the program. At least 60 days before the expiration of
the provisional license, the license holder of a provisional license must apply for a license
under section 245A.04, subdivision 7, in a manner prescribed by the commissioner. The
commissioner may grant or deny the application to convert a provisional license according
to section 245A.05. An applicant whose application is denied by the commissioner may
appeal the denial according to section 245A.05.
 new text end

new text begin Subd. 2. new text end

new text begin Sanctions for provisional license. new text end

new text begin (a) The commissioner may issue the
following sanctions against a program or service of a license holder who does not comply
with an applicable law or rule:
 new text end

new text begin (1) a fine or temporary immediate suspension under section 245A.07; or
 new text end

new text begin (2) a revocation under this subdivision.
 new text end

new text begin (b) The commissioner may revoke a provisional license if the commissioner identifies
any of the following:
 new text end

new text begin (1) a license holder failed to fully comply with applicable laws or rules including chapters
119B, 245A, and 245C;
 new text end

new text begin (2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
a disqualification that was not set aside under section 245C.22;
 new text end

new text begin (3) a license holder knowingly withheld relevant information from or gave false or
misleading information to the commissioner in connection with an application for a license
or the background study status of an individual, during an investigation, or regarding
compliance with applicable laws or rules;
 new text end

new text begin (4) a license holder or controlling individual is prohibited from becoming licensed
pursuant to section 245.095;
 new text end

new text begin (5) a license holder adds or removes a controlling individual identified in the license
application within the first 12 months of operation; or
 new text end

new text begin (6) a license holder fails to demonstrate competency in licensing statutes and rules.
 new text end

new text begin (c) When revoking a provisional license under this section, the commissioner shall
consider facts, conditions, or circumstances concerning the program's operation, the
well-being of persons served by the program, available consumer evaluations of the program,
information about the qualifications of the personnel employed by the license holder, and
the program's overall development of competency in demonstrating compliance with
applicable statutes and rules.
 new text end

new text begin (d) The commissioner must notify by certified mail or personal service a license holder
when the license holder's provisional license is revoked. If mailed, the notice must be mailed
to the address shown on the application or the last known address of the license holder. The
notice must state the reason for revocation.
 new text end

new text begin (e) If a provisional license is revoked, the notice must inform the license holder of the
right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505
to 1400.8612. The license holder may appeal a revocation order. The appeal of a revocation
order must be made in writing by certified mail or personal service. If mailed, the appeal
must be postmarked and sent to the commissioner within ten calendar days after the license
holder receives notice. If a request is made by personal service, it must be received by the
commissioner within ten calendar days after the license holder received notice. Except as
provided in subdivision 2, paragraph (c), if a license holder submits a timely appeal of a
revocation order, the license holder may continue to operate the program as provided in
section 245A.04, subdivision 7, paragraphs (f) and (g), until the commissioner issues a final
order on the revocation. The hearing must be conducted according to section 245A.08.
 new text end

new text begin Subd. 3. new text end

new text begin Exclusions. new text end

new text begin This section does not apply to the following programs or services:
family child care, child foster care, adult day services, adult foster care, and community
residential settings.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 18.

Minnesota Statutes 2016, section 245A.05, is amended to read:


245A.05 DENIAL OF APPLICATION.

(a) The commissioner may deny a license if an applicant or controlling individual:

(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;

(2) fails to comply with applicable laws or rules;

(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;

(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;

(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;

(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted; deleted text begin or
deleted text end

(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g)deleted text begin .deleted text end new text begin ;
new text end

new text begin (8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;
 new text end

new text begin (9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules including but not limited to this chapter and chapters 199B and
245C; or
 new text end

new text begin (10) is prohibited from holding a license according to section 245.095.
 new text end

(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial. Notice must be given by certified mail or personal service. The notice
must state the reasons the application was denied and must inform the applicant of the right
to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
1400.8612. The applicant may appeal the denial by notifying the commissioner in writing
by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
the commissioner within 20 calendar days after the applicant received the notice of denial.
If an appeal request is made by personal service, it must be received by the commissioner
within 20 calendar days after the applicant received the notice of denial. Section 245A.08
applies to hearings held to appeal the commissioner's denial of an application.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 19.

Minnesota Statutes 2016, section 256B.02, subdivision 7, is amended to read:


Subd. 7.

Vendor of medical care.

(a) "Vendor of medical care" means any person or
persons furnishing, within the scope of the vendor's respective license, any or all of the
following goods or services: medical, surgical, hospital, ambulatory surgical center services,
optical, visual, dental and nursing services; drugs and medical supplies; appliances;
laboratory, diagnostic, and therapeutic services; nursing home and convalescent care;
screening and health assessment services provided by public health nurses as defined in
section 145A.02, subdivision 18; health care services provided at the residence of the patient
if the services are performed by a public health nurse and the nurse indicates in a statement
submitted under oath that the services were actually provided; and such other medical
services or supplies provided or prescribed by persons authorized by state law to give such
services and suppliesnew text begin , including services under section 256B.4912new text end .new text begin For purposes of this
chapter, the term includes a person or entity that furnishes a good or service eligible for
medical assistance or federally approved waiver plan payments under this chapter.new text end The term
includes, but is not limited to, directors and officers of corporations or members of
partnerships who, either individually or jointly with another or others, have the legal control,
supervision, or responsibility of submitting claims for reimbursement to the medical
assistance program. The term only includes directors and officers of corporations who
personally receive a portion of the distributed assets upon liquidation or dissolution, and
their liability is limited to the portion of the claim that bears the same proportion to the total
claim as their share of the distributed assets bears to the total distributed assets.

(b) "Vendor of medical care" also includes any person who is credentialed as a health
professional under standards set by the governing body of a federally recognized Indian
tribe authorized under an agreement with the federal government according to United States
Code, title 25, section 450f, to provide health services to its members, and who through a
tribal facility provides covered services to American Indian people within a contract health
service delivery area of a Minnesota reservation, as defined under Code of Federal
Regulations, title 42, section 36.22.

(c) A federally recognized Indian tribe that intends to implement standards for
credentialing health professionals must submit the standards to the commissioner of human
services, along with evidence of meeting, exceeding, or being exempt from corresponding
state standards. The commissioner shall maintain a copy of the standards and supporting
evidence, and shall use those standards to enroll tribal-approved health professionals as
medical assistance providers. For purposes of this section, "Indian" and "Indian tribe" mean
persons or entities that meet the definition in United States Code, title 25, section 450b.

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

Minnesota Statutes 2016, section 256B.04, subdivision 21, is amended to read:


Subd. 21.

Provider enrollment.

(a) If the commissioner or the Centers for Medicare
and Medicaid Services determines that a provider is designated "high-risk," the commissioner
may withhold payment from providers within that category upon initial enrollment for a
90-day period. The withholding for each provider must begin on the date of the first
submission of a claim.

(b) An enrolled provider that is also licensed by the commissioner under chapter 245A,
or is licensed as a home care provider by the Department of Health under chapter 144A and
has a home and community-based services designation on the home care license under
section 144A.484, must designate an individual as the entity's compliance officer. The
compliance officer must:

(1) develop policies and procedures to assure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;

(2) train the employees of the provider entity, and any agents or subcontractors of the
provider entity including billers, on the policies and procedures under clause (1);

(3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services, and implement action to remediate any resulting problems;

(4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;

(5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and

(6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.

The commissioner may require, as a condition of enrollment in medical assistance, that a
provider within a particular industry sector or category establish a compliance program that
contains the core elements established by the Centers for Medicare and Medicaid Services.

(c) The commissioner may revoke the enrollment of an ordering or rendering provider
for a period of not more than one year, if the provider fails to maintain and, upon request
from the commissioner, provide access to documentation relating to written orders or requests
for payment for durable medical equipment, certifications for home health services, or
referrals for other items or services written or ordered by such provider, when the
commissioner has identified a pattern of a lack of documentation. A pattern means a failure
to maintain documentation or provide access to documentation on more than one occasion.
Nothing in this paragraph limits the authority of the commissioner to sanction a provider
under the provisions of section 256B.064.

(d) The commissioner shall terminate or deny the enrollment of any individual or entity
if the individual or entity has been terminated from participation in Medicare or under the
Medicaid program or Children's Health Insurance Program of any other state.

(e) As a condition of enrollment in medical assistance, the commissioner shall require
that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
Services, its agents, or its designated contractors and the state agency, its agents, or its
designated contractors to conduct unannounced on-site inspections of any provider location.
The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
and standards used to designate Medicare providers in Code of Federal Regulations, title
42, section 424.518. The list and criteria are not subject to the requirements of chapter 14.
The commissioner's designations are not subject to administrative appeal.

(f) As a condition of enrollment in medical assistance, the commissioner shall require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
high-risk for fraud, waste, or abuse.

(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable
medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
meeting the durable medical equipment provider and supplier definition in clause (3),
operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
annually renewed and designates the Minnesota Department of Human Services as the
obligee, and must be submitted in a form approved by the commissioner. For purposes of
this clause, the following medical suppliers are not required to obtain a surety bond: a
federally qualified health center, a home health agency, the Indian Health Service, a
pharmacy, and a rural health clinic.

(2) At the time of initial enrollment or reenrollment, durable medical equipment providers
and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. deleted text begin The surety bond must allow for recovery of costs and
fees in pursuing a claim on the bond.deleted text end new text begin The surety bond must be in a form approved by the
commissioner, renewed annually, and allow for recovery of the entire value of the bond for
up to five years from the date of submission of a claim for medical assistance payment if
the enrolled provider violates this chapter or Minnesota Rules, chapter 9505, regardless of
the actual loss.
new text end

(3) "Durable medical equipment provider or supplier" means a medical supplier that can
purchase medical equipment or supplies for sale or rental to the general public and is able
to perform or arrange for necessary repairs to and maintenance of equipment offered for
sale or rental.

(h) The Department of Human Services may require a provider to purchase a surety
bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
if: (1) the provider fails to demonstrate financial viability, (2) the department determines
there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
provider or category of providers is designated high-risk pursuant to paragraph (a) and as
per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an
amount of $100,000 or ten percent of the provider's payments from Medicaid during the
immediately preceding 12 months, whichever is greater. The surety bond must name the
Department of Human Services as an obligee and must allow for recovery of costs and fees
in pursuing a claim on the bond. This paragraph does not apply if the provider currently
maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2016, section 256B.0622, subdivision 3a, is amended to read:


Subd. 3a.

Provider certification and contract requirements for assertive community
treatment.

(a) The assertive community treatment provider new text begin entity new text end mustdeleted text begin :
deleted text end

deleted text begin (1) have a contract with the host county to provide assertive community treatment
services; and
 deleted text end

deleted text begin (2)deleted text end have each ACT team be certified by the state following the certification process and
procedures developed by the commissioner. The certification process determines whether
the ACT team meets the standards for assertive community treatment under this section as
well as minimum program fidelity standards as measured by a nationally recognized fidelity
tool approved by the commissioner. Recertification must occur at least every three years.

(b) An ACT team certified under this subdivision must meet the following standards:

(1) have capacity to recruit, hire, manage, and train required ACT team members;

(2) have adequate administrative ability to ensure availability of services;

(3) ensure adequate preservice and ongoing training for staff;

(4) ensure that staff is capable of implementing culturally specific services that are
culturally responsive and appropriate as determined by the client's culture, beliefs, values,
and language as identified in the individual treatment plan;

(5) ensure flexibility in service delivery to respond to the changing and intermittent care
needs of a client as identified by the client and the individual treatment plan;

(6) develop and maintain client files, individual treatment plans, and contact charting;

(7) develop and maintain staff training and personnel files;

(8) submit information as required by the state;

(9) keep all necessary records required by law;

(10) comply with all applicable laws;

(11) be an enrolled Medicaid provider;

(12) establish and maintain a quality assurance plan to determine specific service
outcomes and the client's satisfaction with services; and

(13) develop and maintain written policies and procedures regarding service provision
and administration of the provider entity.

(c) The commissioner may intervene at any time and decertify an ACT team with cause.
The commissioner shall establish a process for decertification of an ACT team and shall
require corrective action, medical assistance repayment, or decertification of an ACT team
that no longer meets the requirements in this section or that fails to meet the clinical quality
standards or administrative standards provided by the commissioner in the application and
certification process. The decertification is subject to appeal to the state.

new text begin (d) A provider entity must specify in the provider entity's application what geographic
area and populations will be served by the proposed program. A provider entity must
document that the capacity or program specialties of existing programs are not sufficient
to meet the service needs of the target population. A provider entity must submit evidence
of ongoing relationships with other providers and levels of care to facilitate referrals to and
from the proposed program.
 new text end

new text begin (e) A provider entity must submit documentation that the provider entity requested a
statement of need from each county board and tribal authority that serves as a local mental
health authority in the proposed service area. The statement of need must specify if the local
mental health authority supports or does not support the need for the proposed program and
the basis for this determination. If a local mental health authority does not respond within
60 days of the receipt of the request, the commissioner shall determine the need for the
program based on the documentation submitted by the provider entity.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

Minnesota Statutes 2016, section 256B.0622, subdivision 4, is amended to read:


Subd. 4.

Provider new text begin entity new text end licensure and contract requirements for intensive residential
treatment services.

(a) The intensive residential treatment services provider new text begin entity new text end must:

(1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;

(2) not exceed 16 beds per site;new text begin and
new text end

(3) comply with the additional standards in this sectiondeleted text begin ; and
deleted text end

deleted text begin (4) have a contract with the host county to provide these servicesdeleted text end .

(b) The commissioner shall develop procedures for counties and providers to submit
deleted text begin contracts and otherdeleted text end documentation as needed to allow the commissioner to determine whether
the standards in this section are met.

new text begin (c) A provider entity must specify in the provider entity's application what geographic
area and populations will be served by the proposed program. A provider entity must
document that the capacity or program specialties of existing programs are not sufficient
to meet the service needs of the target population. A provider entity must submit evidence
of ongoing relationships with other providers and levels of care to facilitate referrals to and
from the proposed program.
 new text end

new text begin (d) A provider entity must submit documentation that the provider entity requested a
statement of need from each county board and tribal authority that serves as a local mental
health authority in the proposed service area. The statement of need must specify if the local
mental health authority supports or does not support the need for the proposed program and
the basis for this determination. If a local mental health authority does not respond within
60 days of the receipt of the request, the commissioner shall determine the need for the
program based on the documentation submitted by the provider entity.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 23.

Minnesota Statutes 2016, section 256B.0625, subdivision 43, is amended to read:


Subd. 43.

Mental health provider travel time.

new text begin (a) new text end Medical assistance covers provider
travel time if a deleted text begin recipient's individual treatment plandeleted text end new text begin recipientnew text end requires the provision of mental
health services outside of the provider's deleted text begin normaldeleted text end new text begin usualnew text end place of business. deleted text begin This does not include
any travel time which is included in other billable services, and is only covered when the
mental health service being provided to a recipient is covered under medical assistance.
deleted text end

new text begin (b) Mental health provider travel time under this subdivision covers the time the provider
is in transit to deliver a mental health service to a recipient at a location that is not the
provider's usual place of business or to the next location for delivery of a covered mental
health service, and the time a provider is in transit returning from the location of the last
recipient who received services on that day to the provider's usual place of business. A
provider must travel the most direct route available. Mental health provider travel time does
not include time for scheduled or unscheduled stops, meal breaks, or vehicle maintenance
or repair, including refueling or vehicle emergencies. Recipient transport is not covered
under this subdivision.
 new text end

new text begin (c) Mental health provider travel time under this subdivision is only covered when the
mental health service being provided is covered under medical assistance and only when
the covered service is delivered and billed. Mental health provider travel time is not covered
when the mental health service being provided otherwise includes provider travel time or
when the service is site based.
 new text end

new text begin (d) If the first occurrence of mental health provider travel time in a day begins at a
location other than the provider's usual place of business, the provider shall bill for the lesser
of the travel time between the location and the recipient and the travel time between the
provider's usual place of business and the recipient. This provision does not apply to mental
health crisis services provided under section 256B.0624 outside of normal business hours
if on-call staff are being dispatched directly from a location other than the provider's usual
place of business.
 new text end

new text begin (e) Mental health provider travel time may be billed for not more than one round trip
per recipient per day.
 new text end

new text begin (f) As a condition of payment, a provider must document each occurrence of mental
health provider travel time according to this subdivision. Program funds paid for mental
health provider travel time that is not documented according to this subdivision shall be
recovered by the department. The documentation may be collected and maintained
electronically or in paper form but must be made available and produced upon request. A
provider must compile records that meet the following requirements for each occurrence:
 new text end

new text begin (1) the record must be in English and must be legible according to the standard of a
reasonable person;
 new text end

new text begin (2) the recipient's name and date of birth or individual identification number must be on
each page of the record;
 new text end

new text begin (3) the reason the provider must travel to provide services, if not otherwise documented
in the recipient's individual treatment plan; and
 new text end

new text begin (4) each entry in the record must document:
 new text end

new text begin (i) the date on which the entry is made;
 new text end

new text begin (ii) the date the travel occurred;
 new text end

new text begin (iii) the printed last name, first name, and middle initial of the provider and the provider's
identification number, if the provider has one;
 new text end

new text begin (iv) the signature of the traveling provider stating that the provider understands that it
is a federal crime to provide false information on service billings for medical assistance
payments;
 new text end

new text begin (v) the location of the provider's usual place of business;
 new text end

new text begin (vi) the address, or the description if the address is not available, of both the origination
site and destination site and the travel time for the most direct route from the origination
site to the destination site;
 new text end

new text begin (vii) any unusual travel conditions that may cause a need to bill for additional time over
and above what an electronic source document shows the mileage and time necessary to
travel from the origination site to destination site;
 new text end

new text begin (viii) the time the provider left the origination site and the time the provider arrived at
the destination site, with a.m. and p.m. designations; and
 new text end

new text begin (ix) the electronic source documentation used to calculate the most direct route detailing
driving directions, mileage, and time.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

Minnesota Statutes 2016, section 256B.064, subdivision 1b, is amended to read:


Subd. 1b.

Sanctions available.

The commissioner may impose the following sanctions
for the conduct described in subdivision 1a: suspension or withholding of payments to a
vendor and suspending or terminating participation in the program, or imposition of a fine
under subdivision 2, paragraph (f). When imposing sanctions under this section, the
commissioner shall consider the nature, chronicity, or severity of the conduct and the effect
of the conduct on the health and safety of persons served by the vendor.new text begin The commissioner
shall suspend a vendor's participation in the program for a minimum of five years if the
vendor is convicted of a crime, received a stay of adjudication, or entered a court-ordered
diversion program for an offense related to provision of a health service under medical
assistance or health care fraud.new text end Regardless of imposition of sanctions, the commissioner
may make a referral to the appropriate state licensing board.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2016, section 256B.0651, subdivision 17, is amended to read:


Subd. 17.

Recipient protection.

(a) Providers of home care services must provide each
recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days
prior to terminating services to a recipient, if the termination results from provider sanctions
under section 256B.064, such as a payment withhold, a suspension of participation, or a
termination of participation. If a home care provider determines it is unable to continue
providing services to a recipient, the provider must notify the recipient, the recipient's
responsible party, and the commissioner 30 days prior to terminating services to the recipient
because of an action under section 256B.064, and must assist the commissioner and lead
agency in supporting the recipient in transitioning to another home care provider of the
recipient's choice.

(b) In the event of a payment withhold from a home care provider, a suspension of
participation, or a termination of participation of a home care provider under section
256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care
and the lead agencies for all recipients with active service agreements with the provider. At
the commissioner's request, the lead agencies must contact recipients to ensure that the
recipients are continuing to receive needed care, and that the recipients have been given
free choice of provider if they transfer to another home care provider. In addition, the
commissioner or the commissioner's delegate may directly notify recipients who receive
care from the provider that payments have been new text begin or will be new text end withheld or that the provider's
participation in medical assistance has been new text begin or will be new text end suspended or terminated, if the
commissioner determines that notification is necessary to protect the welfare of the recipients.
For purposes of this subdivision, "lead agencies" means counties, tribes, and managed care
organizations.

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

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


Subd. 3.

deleted text begin Noncovereddeleted text end Personal care assistance servicesnew text begin not coverednew text end .

(a) Personal care
assistance services are not eligible for medical assistance payment under this section when
provided:

(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal guardian,
licensed foster provider, except as allowed under section 256B.0652, subdivision 10, or
responsible party;

(2) in order to meet staffing or license requirements in a residential or child care setting;

(3) solely as a child care or babysitting service; deleted text begin or
deleted text end

(4) without authorization by the commissioner or the commissioner's designeedeleted text begin .deleted text end new text begin ; or
new text end

new text begin (5) on dates not within the frequency requirements of subdivision 14, paragraph (c), and
subdivision 19, paragraph (a).
 new text end

(b) The following personal care services are not eligible for medical assistance payment
under this section when provided in residential settings:

(1) when the provider of home care services who is not related by blood, marriage, or
adoption owns or otherwise controls the living arrangement, including licensed or unlicensed
services; or

(2) when personal care assistance services are the responsibility of a residential or
program license holder under the terms of a service agreement and administrative rules.

(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible for
medical assistance reimbursement for personal care assistance services under this section
include:

(1) sterile procedures;

(2) injections of fluids and medications into veins, muscles, or skin;

(3) home maintenance or chore services;

(4) homemaker services not an integral part of assessed personal care assistance services
needed by a recipient;

(5) application of restraints or implementation of procedures under section 245.825;

(6) instrumental activities of daily living for children under the age of 18, except when
immediate attention is needed for health or hygiene reasons integral to the personal care
services and the need is listed in the service plan by the assessor; and

(7) assessments for personal care assistance services by personal care assistance provider
agencies or by independently enrolled registered nurses.

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2016, section 256B.0659, subdivision 12, is amended to read:


Subd. 12.

Documentation of personal care assistance services provided.

(a) Personal
care assistance services for a recipient must be documented daily by each personal care
assistant, on a time sheet form approved by the commissioner. All documentation may be
Web-based, electronic, or paper documentation. The completed form must be submitted on
a monthly basis to the provider and kept in the recipient's health record.

(b) The activity documentation must correspond to the personal care assistance care plan
and be reviewed by the qualified professional.

(c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:

(1) full name of personal care assistant and individual provider number;

(2) provider name and telephone numbers;

(3) full name of recipientnew text begin and either the recipient's medical assistance identification
number or date of birthnew text end ;

(4) consecutive dates, including month, day, and year, and arrival and departure times
with a.m. or p.m. notations;

(5) signatures of recipient or the responsible party;

(6) personal signature of the personal care assistant;

(7) any shared care provided, if applicable;

(8) a statement that it is a federal crime to provide false information on personal care
service billings for medical assistance payments; and

(9) dates and location of recipient stays in a hospital, care facility, or incarceration.

new text begin EFFECTIVE DATE. new text end

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

Sec. 28.

Minnesota Statutes 2016, section 256B.0659, subdivision 14, is amended to read:


Subd. 14.

Qualified professional; duties.

(a) Effective January 1, 2010, all personal
care assistants must be supervised by a qualified professional.

(b) Through direct training, observation, return demonstrations, and consultation with
the staff and the recipient, the qualified professional must ensure and document that the
personal care assistant is:

(1) capable of providing the required personal care assistance services;

(2) knowledgeable about the plan of personal care assistance services before services
are performed; and

(3) able to identify conditions that should be immediately brought to the attention of the
qualified professional.

(c) The qualified professional shall evaluate the personal care assistant within the first
14 days of starting to provide regularly scheduled services for a recipient, or sooner as
determined by the qualified professional, except for the personal care assistance choice
option under subdivision 19, paragraph (a), clause (4). For the initial evaluation, the qualified
professional shall evaluate the personal care assistance services for a recipient through direct
observation of a personal care assistant's work. The qualified professional may conduct
additional training and evaluation visits, based upon the needs of the recipient and the
personal care assistant's ability to meet those needs. Subsequent visits to evaluate the personal
care assistance services provided to a recipient do not require direct observation of each
personal care assistant's work and shall occur:

(1) at least every 90 days thereafter for the first year of a recipient's services;

(2) every 120 days after the first year of a recipient's service or whenever needed for
response to a recipient's request for increased supervision of the personal care assistance
staff; and

(3) after the first 180 days of a recipient's service, supervisory visits may alternate
between unscheduled phone or Internet technology and in-person visits, unless the in-person
visits are needed according to the care plan.

(d) Communication with the recipient is a part of the evaluation process of the personal
care assistance staff.

(e) At each supervisory visit, the qualified professional shall evaluate personal care
assistance services including the following information:

(1) satisfaction level of the recipient with personal care assistance services;

(2) review of the month-to-month plan for use of personal care assistance services;

(3) review of documentation of personal care assistance services provided;

(4) whether the personal care assistance services are meeting the goals of the service as
stated in the personal care assistance care plan and service plan;

(5) a written record of the results of the evaluation and actions taken to correct any
deficiencies in the work of a personal care assistant; and

(6) revision of the personal care assistance care plan as necessary in consultation with
the recipient or responsible party, to meet the needs of the recipient.

(f) The qualified professional shall complete the required documentation in the agency
recipient and employee files and the recipient's home, including the following documentation:

(1) the personal care assistance care plan based on the service plan and individualized
needs of the recipient;

(2) a month-to-month plan for use of personal care assistance services;

(3) changes in need of the recipient requiring a change to the level of service and the
personal care assistance care plan;

(4) evaluation results of supervision visits and identified issues with personal care
assistance staff with actions taken;

(5) all communication with the recipient and personal care assistance staff; deleted text begin and
deleted text end

(6) hands-on training or individualized training for the care of the recipientdeleted text begin .deleted text end new text begin ;
new text end

new text begin (7) the month, day, and year, and arrival and departure times with a.m. or p.m.
designations of each visit or call to the recipient when services are provided; and
 new text end

new text begin (8) the total amount of time of each service visit with the recipient.
 new text end

(g) The documentation in paragraph (f) must be done on agency templates.

(h) The services that are not eligible for payment as qualified professional services
include:

(1) direct professional nursing tasks that could be assessed and authorized as skilled
nursing tasks;

new text begin (2) the time spent documenting services;
 new text end

deleted text begin (2)deleted text end new text begin (3)new text end agency administrative activities;

deleted text begin (3)deleted text end new text begin (4)new text end training other than the individualized training required to provide care for a
recipient; and

deleted text begin (4)deleted text end new text begin (5)new text end any other activity that is not described in this section.

new text begin EFFECTIVE DATE. new text end

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

Sec. 29.

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


Subd. 21.

Requirements for provider enrollment of personal care assistance provider
agencies.

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

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

(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid
revenue in the previous calendar year is up to and including $300,000, the provider agency
must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is
over $300,000, the provider agency must purchase a surety bond of $100,000. The surety
bond must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of deleted text begin costs and fees in pursuing a claim on the bonddeleted text end new text begin the entire value of the
bond for up to five years from the date of submission of a claim for medical assistance
payment if the enrolled provider violates this chapter or Minnesota Rules, chapter 9505,
regardless of the actual lossnew text end ;

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

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 30.

Minnesota Statutes 2016, section 256B.4912, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Service documentation and billing requirements. new text end

new text begin (a) Only a service provided
as specified in a federally approved waiver plan, as authorized under sections 256B.0913,
256B.0915, 256B.092, and 256B.49, is eligible for payment. As a condition of payment, a
home and community-based waiver provider must document each time a service was
provided to a recipient. Payment for a service not documented according to this subdivision
or not specified in a federally approved waiver plan shall be recovered by the department
under section 256B.064. For payment of a service, documentation must meet the standards
in paragraphs (b) to (j).
 new text end

new text begin (b) The service delivered to a recipient must be documented in the provider's record of
service delivery.
 new text end

new text begin (c) The recipient's name and recipient identification number must be entered on each
document.
 new text end

new text begin (d) The provider's record of service delivery must be in English and must be legible
according to the standard of a reasonable person.
 new text end

new text begin (e) The provider's record of service delivery must contain a statement that it is a federal
crime to provide false information on service billings for medical assistance or services
under a federally approved waiver plan, as authorized under sections 256B.0913, 256B.0915,
256B.092, and 256B.49.
 new text end

new text begin (f) If an entry is a time-based service, each entry in the provider's record of service
delivery must contain:
 new text end

new text begin (1) the date that the entry was made;
 new text end

new text begin (2) the day, month, and year when the service was provided;
 new text end

new text begin (3) the service name or description of the service provided;
 new text end

new text begin (4) the start and stop times with a.m. and p.m. designations, except for case management
services as defined under sections 256B.0913, subdivision 7, 256B.0915, subdivision 1a,
256B.092, subdivision 1a, and 256B.49, subdivision 13;
 new text end

new text begin (5) the name, signature, and title, if any, of the provider of service. If the service is
provided by multiple staff members, the provider may designate a staff member responsible
for verifying services and completing the documentation required by this paragraph.
 new text end

new text begin (g) For all other services each record must contain:
 new text end

new text begin (1) the date the entry of service delivery was made;
 new text end

new text begin (2) the day, month, and year when the service was provided;
 new text end

new text begin (3) a service name or description of the service provided;
 new text end

new text begin (4) the name, signature, and title, if any, of the person providing the service. If the service
is provided by multiple staff, the provider may designate a staff person responsible for
verifying services and completing the documentation required by this paragraph; and
 new text end

new text begin (5) for services under section 245D.03, subdivision 1, paragraph (c), clause (3), entries
into the record under this subdivision shall occur at least monthly.
 new text end

new text begin (h) If the service billed is transportation, each entry must contain the information from
paragraphs (b) to (e) and (g). A provider must:
 new text end

new text begin (1) maintain odometer and other records pursuant to section 256B.0625, subdivision
17b, clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver
for a transportation service that is billed by mileage, except if the provider is a common
carrier as defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or publicly operated
transit systems. This documentation may be collected and maintained electronically or in
paper form, but must be made available and produced upon request;
 new text end

new text begin (2) maintain documentation demonstrating that a vehicle and a driver meets the standards
determined by the Department of Human Services on vehicle and driver qualifications;
 new text end

new text begin (3) only bill a waivered transportation service if the transportation is not to or from a
health care service available through the Medicaid state plan; and
 new text end

new text begin (4) only bill a waivered transportation service when the rate for waiver service does not
include transportation.
 new text end

new text begin (i) If the service provided is equipment or supplies, the documentation must contain the
information from paragraphs (b) to (e) and:
 new text end

new text begin (1) the recipient's assessed need for the equipment or supplies and the reason the
equipment or supplies are not covered by the Medicaid state plan;
 new text end

new text begin (2) the type and brand name of equipment or supplies delivered to or purchased by the
recipient, including whether the equipment or supplies were rented or purchased;
 new text end

new text begin (3) the quantity of supplies delivered or purchased;
 new text end

new text begin (4) the shipping invoice or a delivery service tracking log or other documentation showing
the date of delivery that proves the equipment or supplies were delivered to the recipient
or a receipt if the equipment or supplies were purchased by the recipient; and
 new text end

new text begin (5) the cost of equipment or supplies if the amount paid for the service depends on the
cost.
 new text end

new text begin (j) A service defined as "adult day care" under section 245A.02, subdivision 2a, must
meet the documentation standards specified in paragraphs (b) to (f) and must comply with
the following:
 new text end

new text begin (1) individual recipient's service records must contain the following:
 new text end

new text begin (i) the recipient's needs assessment and current plan of care according to section
245A.143, subdivisions 4 to 7, or Minnesota Rules, part 9555.9700, if applicable; and
 new text end

new text begin (ii) the day, month, and year the service was provided, including arrival and departure
times with a.m. and p.m. designations and the first and last name of the individual making
the entry;
 new text end

new text begin (2) entity records must contain the following:
 new text end

new text begin (i) the monthly and quarterly program requirements in Minnesota Rules, part 9555.9710,
subparts 1, items E and H, and 3, 4, and 6, if applicable;
 new text end

new text begin (ii) the names and qualifications of the registered physical therapists, registered nurses,
and registered dietitian who provide services to the adult day care or nonresidential program;
 new text end

new text begin (iii) the location where the service was provided and, if the location is an alternate
location than the primary place of service, the record must contain the address, or the
description if the address is not available, of both the origin and destination location, the
length of time at the alternate location with a.m. and p.m. designations, and a list of
participants who went to the alternate location; and
 new text end

new text begin (iv) documentation that the program is maintaining the appropriate staffing levels
according to licensing standards and the federally approved waiver plan.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2017.
 new text end

Sec. 31.

Minnesota Statutes 2016, section 256G.01, subdivision 4, is amended to read:


Subd. 4.

Additional coverage.

The provisions in sections 256G.02, subdivision 4,
paragraphs (a) to (d); 256G.02, subdivisions 5 to 8; 256G.03; 256G.04; 256G.05; and
256G.07, subdivisions 1 to 3, apply to the followingnew text begin financial assistancenew text end programs: the aid
to families with dependent children program formerly codified in sections 256.72 to 256.87,
Minnesota family investment program; medical assistance; general assistance; the family
general assistance program formerly codified in sections 256D.01 to 256D.23; general
assistance medical care formerly codified in chapter 256D; and Minnesota supplemental
aid.

new text begin EFFECTIVE DATE. new text end

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

Sec. 32.

Minnesota Statutes 2016, section 256G.02, subdivision 4, is amended to read:


Subd. 4.

County of financial responsibility.

(a) "County of financial responsibility"
has the meanings in paragraphs (b) to (f).

(b) For an applicant who resides in the state and is not in a facility described in
subdivision 6, it means the county in which the applicant resides at the time of application.

(c) For an applicant who resides in a facility described in subdivision 6, it means the
county in which the applicant last resided in nonexcluded status immediately before entering
the facility.

(d) For an applicant who has not resided in this state for any time other than the excluded
time, and subject to the limitations in section 256G.03, subdivision 2, it means the county
in which the applicant resides at the time of making application.

(e) For an individual already having a social service case open in one county, financial
responsibility for any additional social services attaches to the case that has the earliest date
of application and has been open without interruption.new text begin This provision does not apply to
financial assistance programs listed in section 256G.01, subdivision 4.
new text end

(f) Notwithstanding paragraphs (b) to (e), the county of financial responsibility for
semi-independent living services provided under section 252.275, and chapter 245D, is the
county of residence in nonexcluded status immediately before the placement into or request
for those services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 33.

Minnesota Statutes 2016, section 256G.09, subdivision 2, is amended to read:


Subd. 2.

Financial disputes.

(a) If the county receiving the transmittal does not believe
it is financially responsible, it deleted text begin should providedeleted text end new text begin shall submitnew text end to the department andnew text begin provide
tonew text end the initially responsible county a new text begin request for department resolution of financial
responsibility dispute form, with a new text end statement of all facts and documents necessary for the
department to make the requested determination of financial responsibility. The submission
must clearly state the program area in disputenew text begin , the application date or commitment date for
the program in dispute,new text end and deleted text begin must statedeleted text end the specific basis upon which the submitting county
is denying financial responsibility.new text begin If the receiving county fails to submit the dispute
resolution form to the department, the initially responsible county may submit the form to
the department and provide a copy to the receiving county.
new text end

(b) The deleted text begin initially responsibledeleted text end county new text begin responding to the dispute resolution request new text end then
has deleted text begin 15deleted text end new text begin 30new text end calendar days to submit its position and any supporting evidence to the department.
The absence of a submission by the initially responsible county new text begin or the responding county
new text end does not limit the right of the department to issue a binding opinion based on the evidence
actually submitted.

(c)new text begin The department shall not issue an advisory opinion.new text end Anew text begin county may not submit anew text end case
deleted text begin must not be submitteddeleted text end new text begin to the department under the dispute resolution processnew text end until the local
agency taking the application or making the commitment has made an initial determination
about eligibility and financial responsibility, and services have been initiated. This paragraph
does not prohibit the submission of closed cases that otherwise meet the applicable statute
of limitations.

new text begin EFFECTIVE DATE. new text end

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

Sec. 34.

Minnesota Statutes 2016, section 256G.10, is amended to read:


256G.10 DERIVATIVE SETTLEMENT.

The residence of the parent of a minor childdeleted text begin , with whom that child last lived in a
nonexcluded time setting,deleted text end or guardian of a ward shall determine the residence of the child
or ward for all social services governed by this chapter.new text begin If the child lived with each parent
separately, then the residence of the parent with whom the child lived most recently shall
determine the residence of the child for all social services governed by this chapter.
new text end

For purposes of this chapter, a minor child is defined as being under 18 years of age
unless otherwise specified in a program administered by the commissioner.

Physical or legal custody has no bearing on residence determinations. This section does
not, however, apply to situations involving another state, limit the application of an interstate
compact, or apply to situations involving state wards where the commissioner is defined
by law as the guardian.

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 4

HEALTH CARE

Section 1.

Minnesota Statutes 2016, section 256.01, subdivision 29, is amended to read:


Subd. 29.

State medical review team.

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 7, paragraph (b),new text begin and 12;new text end 256B.057, subdivision 9, deleted text begin and
256B.055, subdivision 12,deleted text end the commissioner shall review all medical evidence deleted text begin submitted
by county agencies with a referraldeleted text end and seek deleted text begin additionaldeleted text end information from providers, applicants,
and enrollees to support the determination of disability where necessary. Disability shall
be determined according to the rules of title XVI and title XIX of the Social Security Act
and pertinent rules and policies of the Social Security Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.

(c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:

(1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;

(2) the average length of time from receipt of the application to a decision;

(3) the number of appeals, appeal results, and the length of time taken from the date the
person involved requested an appeal for a written decision to be made on each appeal;

(4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and

(5) specific information on the medical certification, licensure, or other credentials of
the person or persons performing the medical review determinations and length of time in
that position.

(d) Any appeal made under section 256.045, subdivision 3, of a disability determination
made by the state medical review team must be decided according to the timelines under
section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within
the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be
immediately reviewed by the chief human services judge.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

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


Subd. 21.

Requirements for provider enrollment of personal care assistance provider
agencies.

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

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

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

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

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

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

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

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

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

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

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

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

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

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

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

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

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

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

(c) All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before new text begin submitting an application for new text end enrollment of the
agency as a provider. new text begin All personal care provider agencies shall also require qualified
professionals to complete the training required by subdivision 13 before submitting an
application for enrollment of the agency as a provider. new text end Employees in management and
supervisory positions and owners who are active in the day-to-day operations of an agency
who have completed the required training as an employee with a personal care assistance
provider agency do not need to repeat the required training if they are hired by another
agency, if they have completed the training within the past three years. By September 1,
2010, the required training must be available with meaningful access according to title VI
of the Civil Rights Act and federal regulations adopted under that law or any guidance from
the United States Health and Human Services Department. The required training must be
available online or by electronic remote connection. The required training must provide for
competency testing. Personal care assistance provider agency billing staff shall complete
training about personal care assistance program financial management. This training is
effective July 1, 2009. Any personal care assistance provider agency enrolled before that
date shall, if it has not already, complete the provider training within 18 months of July 1,
2009. Any new owners or employees in management and supervisory positions involved
in the day-to-day operations are required to complete mandatory training as a requisite of
working for the agency. Personal care assistance provider agencies certified for participation
in Medicare as home health agencies are exempt from the training required in this
subdivision. When available, Medicare-certified home health agency owners, supervisors,
or managers must successfully complete the competency test.

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2016, section 256B.0659, subdivision 23, is amended to read:


Subd. 23.

Enrollment requirements following termination.

(a) A terminated personal
care assistance provider agency, including all named individuals on the current enrollment
disclosure form and known or discovered affiliates of the personal care assistance provider
agency, is not eligible to enroll as a personal care assistance provider agency for two years
following the termination.

(b) After the two-year period in paragraph (a), if the provider seeks to reenroll as a
personal care assistance provider agency, the personal care assistance provider agency must
be placed on a one-year probation period, beginning after completion of the following:

(1) the department's provider trainings under this section; and

(2) initial enrollment requirements under subdivision 21.

(c) During the probationary period the commissioner shall complete site visits and request
submission of documentation to review compliance with program policy.

new text begin (d) This subdivision does not apply to a personal care assistance provider agency
terminated solely for failure to timely and completely comply with the requirements of
revalidation required by section 256B.04, subdivision 22.
 new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 5

COMMUNITY SUPPORTS

Section 1.

Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:


Subd. 2.

Contents of contract.

A housing with services contract, which need not be
entitled as such to comply with this section, shall include at least the following elements in
itself or through supporting documents or attachments:

(1) the name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners is not a natural person, identification of the type of business entity of
the owner or owners;

(3) the name and mailing address of the managing agent, through management agreement
or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept service
of process on behalf of the owner or owners and managing agent;

(5) a statement describing the registration and licensure status of the establishment and
any provider providing health-related or supportive services under an arrangement with the
establishment;

(6) the term of the contract;

(7) a description of the services to be provided to the resident in the base rate to be paid
by resident, including a delineation of the portion of the base rate that constitutes rent and
a delineation of charges for each service included in the base rate;

(8) a description of any additional services, including home care services, available for
an additional fee from the establishment directly or through arrangements with the
establishment, and a schedule of fees charged for these services;

(9) a description of the process through which the contract may be modified, amended,
or terminated, including whether a move to a different room or sharing a room would be
required in the event that the tenant can no longer pay the current rent;

(10) a description of the establishment's complaint resolution process available to residents
including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;

(11) the resident's designated representative, if any;

(12) the establishment's referral procedures if the contract is terminated;

(13) requirements of residency used by the establishment to determine who may reside
or continue to reside in the housing with services establishment;

(14) billing and payment procedures and requirements;

(15) a statement regarding the ability of deleted text begin residentsdeleted text end new text begin a residentnew text end to receive services from
service providers with whom the establishment does not have an arrangement;

(16) a statement regarding the availability of public funds for payment for residence or
services in the establishment; and

(17) a statement regarding the availability of and contact information for long-term care
consultation services under section 256B.0911 in the county in which the establishment is
located.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2016, section 144D.04, is amended by adding a subdivision to
read:


new text begin Subd. 2a. new text end

new text begin Additional contract requirements. new text end

new text begin (a) For a resident receiving one or more
health-related services from the establishment's arranged home care provider, as defined in
section 144D.01, subdivision 6, the contract must include the requirements in paragraph
(b), clauses (1) to (5). A restriction of a resident's rights under this subdivision is allowed
only if determined necessary for health and safety reasons identified by the home care
provider's registered nurse in an initial assessment or reassessment, as defined under section
144A.4791, subdivision 8, and documented in the written service plan under section
144A.4791, subdivision 9. Any restrictions of those rights for people served under sections
256B.0915 and 256B.49 must be documented in the resident's coordinated service and
support plan (CSSP), as defined under sections 256B.49, subdivision 15, and 256B.0915,
subdivision 6.
 new text end

new text begin (b) The contract must include a statement:
 new text end

new text begin (1) regarding the ability of a resident to furnish and decorate the resident's unit within
the terms of the lease;
 new text end

new text begin (2) regarding the resident's right to access food at any time;
 new text end

new text begin (3) regarding a resident's right to choose the resident's visitors and times of visits;
 new text end

new text begin (4) regarding the resident's right to choose a roommate if sharing a unit; and
 new text end

new text begin (5) notifying the resident of the resident's right to have and use a lockable door to the
resident's unit. The landlord shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:


Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a license is issued during this moratorium, and the license
holder changes the license holder's primary residence away from the physical location of
the foster care license, the commissioner shall revoke the license according to section
245A.07. The commissioner shall not issue an initial license for a community residential
setting licensed under chapter 245D. Exceptions to the moratorium include:

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

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

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

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

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

new text begin When approving an exception under this paragraph, the commissioner shall consider the
resource need determination process in paragraph (d), the availability of foster care licensed
beds in the geographic area in which the licensee seeks to operate, and the recommendation
of the local county board. The determination by the commissioner is final and not subject
to appeal.
 new text end

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. deleted text begin The department shall decrease
the statewide licensed capacity for adult foster care settings where the physical location is
not the primary residence of the license holder, or for adult community residential settings,
if the voluntary changes described in paragraph (e) are not sufficient to meet the savings
required by reductions in licensed bed capacity under Laws 2011, First Special Session
chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term care
residential services capacity within budgetary limits. Implementation of the statewide
licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense
up to 128 beds by June 30, 2014, using the needs determination process. Prior to any
involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies
and license holders to determine which adult foster care settings, where the physical location
is not the primary residence of the license holder, or community residential settings, are
licensed for up to five beds, but have operated at less than full capacity for 12 or more
months as of March 1, 2014. The settings that meet these criteria must be the first to be
considered for an involuntary decrease in statewide licensed capacity, up to a maximum of
35 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall
prioritize the selection of those beds to be closed based on the length of time the beds have
been vacant. The longer a bed has been vacant, the higher priority it must be given for
closure.deleted text end Under this paragraph, the commissioner has the authority to reduce unused licensed
capacity of a current foster care program, or the community residential settings, to accomplish
the consolidation or closure of settings. Under this paragraph, the commissioner has the
authority to manage statewide capacity, including adjusting the capacity available to each
county and adjusting statewide available capacity, to meet the statewide needs identified
through the new text begin resource need determination new text end process in paragraph deleted text begin (e)deleted text end new text begin (d)new text end . deleted text begin A decreased licensed
capacity according to this paragraph is not subject to appeal under this chapter.
deleted text end

deleted text begin (d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.
 deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end A resource need determination process, managed at the state level, using the
available reports required by section 144A.351, and other data and information shall be
used to determine where the reduced capacity required under paragraph (c) will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet long-term
care service needs within budgetary limits, including seeking proposals from service providers
or lead agencies to change service type, capacity, or location to improve services, increase
the independence of residents, and better meet needs identified by the long-term care services
reports and statewide data and information. By February 1, 2013, and August 1, 2014, and
each following year, the commissioner shall provide information and data on the overall
capacity of licensed long-term care services, actions taken under this subdivision to manage
statewide long-term care services and supports resources, and any recommendations for
change to the legislative committees with jurisdiction over health and human services budget.

new text begin (e) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
 new text end

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services
licensing division that the license holder provides or intends to provide these waiver-funded
services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2016, section 245A.04, subdivision 14, is amended to read:


Subd. 14.

Policies and procedures for program administration required and
enforceable.

(a) The license holder shall develop program policies and procedures necessary
to maintain compliance with licensing requirements under Minnesota Statutes and Minnesota
Rules.

(b) The license holder shall:

(1) provide training to program staff related to their duties in implementing the program's
policies and procedures developed under paragraph (a);

(2) document the provision of this training; and

(3) monitor implementation of policies and procedures by program staff.

(c) The license holder shall keep program policies and procedures readily accessible to
staff and index the policies and procedures with a table of contents or another method
approved by the commissioner.

new text begin (d) An adult foster care license holder that provides foster care services to a resident
under section 256B.0915 must annually provide a copy of the resident termination policy
under section 245A.11, subdivision 11, to a resident covered by the policy.
 new text end

Sec. 5.

Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
read:


new text begin Subd. 9. new text end

new text begin Adult foster care bedrooms. new text end

new text begin (a) A resident receiving services must have a
choice of roommate. Each roommate must consent in writing to sharing a bedroom with
one another. The license holder is responsible for notifying a resident of the resident's right
to request a change of roommate.
 new text end

new text begin (b) The license holder must provide a lock for each resident's bedroom door, unless
otherwise indicated for the resident's health, safety, or well-being. A restriction on the use
of the lock must be documented and justified in the resident's individual abuse prevention
plan required by sections 626.557, subdivision 14, and 245A.65, subdivision 2, paragraph
(b). For a resident served under section 256B.0915, the case manager must be part of the
interdisciplinary team under section 245A.65, subdivision 2, paragraph (b).
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
read:


new text begin Subd. 10. new text end

new text begin Adult foster care resident rights. new text end

new text begin (a) The license holder shall ensure that a
resident and a resident's legal representative are given, at admission:
 new text end

new text begin (1) an explanation and copy of the resident's rights specified in paragraph (b);
 new text end

new text begin (2) a written summary of the Vulnerable Adults Protection Act prepared by the
department; and
 new text end

new text begin (3) the name, address, and telephone number of the local agency to which a resident or
a resident's legal representative may submit an oral or written complaint.
 new text end

new text begin (b) Adult foster care resident rights include the right to:
 new text end

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

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

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

new text begin (4) have privacy for visits with the resident's spouse, next of kin, legal counsel, religious
adviser, or others, according to section 363A.09 of the Human Rights Act, including privacy
in the resident's bedroom;
 new text end

new text begin (5) keep, use, and access the resident's personal clothing and possessions as space permits,
unless this right infringes on the health, safety, or rights of another resident or household
member, including the right to access the resident's personal possessions at any time;
 new text end

new text begin (6) choose the resident's visitors and time of visits and participate in activities of
commercial, religious, political, and community groups without interference if the activities
do not infringe on the rights of another resident or household member;
 new text end

new text begin (7) if married, privacy for visits by the resident's spouse, and, if both spouses are residents
of the adult foster home, the residents have the right to share a bedroom and bed;
 new text end

new text begin (8) privacy, including use of the lock on the resident's bedroom door or unit door. A
resident's privacy must be respected by license holders, caregivers, household members,
and volunteers by knocking on the door of a resident's bedroom or bathroom and seeking
consent before entering, except in an emergency;
 new text end

new text begin (9) furnish and decorate the resident's bedroom or living unit;
 new text end

new text begin (10) engage in chosen activities and have an individual schedule supported by the license
holder that meets the resident's preferences;
 new text end

new text begin (11) freedom and support to access food at any time;
 new text end

new text begin (12) have personal, financial, service, health, and medical information kept private, and
be advised of disclosure of this information by the license holder;
 new text end

new text begin (13) access records and recorded information about the resident according to applicable
state and federal law, regulation, or rule;
 new text end

new text begin (14) be free from maltreatment;
 new text end

new text begin (15) be treated with courtesy and respect and receive respectful treatment of the resident's
property;
 new text end

new text begin (16) reasonable observance of cultural and ethnic practice and religion;
 new text end

new text begin (17) be free from bias and harassment regarding race, gender, age, disability, spirituality,
and sexual orientation;
 new text end

new text begin (18) be informed of and use the license holder's grievance policy and procedures,
including how to contact the highest level of authority in the program;
 new text end

new text begin (19) assert the resident's rights personally, or have the rights asserted by the resident's
family, authorized representative, or legal representative, without retaliation; and
 new text end

new text begin (20) give or withhold written informed consent to participate in any research or
experimental treatment.
 new text end

new text begin (c) A restriction of a resident's rights under paragraph (b), clauses (1) to (4), (6), (8),
(10), and (11), is allowed only if determined necessary to ensure the health, safety, and
well-being of the resident. Any restriction of a resident's right must be documented and
justified in the resident's individual abuse prevention plan required by sections 626.557,
subdivision 14, and 245A.65, subdivision 2, paragraph (b). For a resident served under
section 256B.0915, the case manager must be part of the interdisciplinary team under section
245A.65, subdivision 2, paragraph (b). The restriction must be implemented in the least
restrictive manner necessary to protect the resident and provide support to reduce or eliminate
the need for the restriction.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
read:


new text begin Subd. 11. new text end

new text begin Adult foster care service termination for elderly waiver participants. new text end

new text begin (a)
This subdivision applies to foster care services for a resident served under section 256B.0915.
 new text end

new text begin (b) The foster care license holder must establish policies and procedures for service
termination that promote continuity of care and service coordination with the resident and
the case manager and with another licensed caregiver, if any, who also provides support to
the resident. The policy must include the requirements specified in paragraphs (c) to (h).
 new text end

new text begin (c) The license holder must allow a resident to remain in the program and cannot terminate
services unless:
 new text end

new text begin (1) the termination is necessary for the resident's health, safety, and well-being and the
resident's needs cannot be met in the facility;
 new text end

new text begin (2) the safety of the resident or another resident in the program is endangered and positive
support strategies were attempted and have not achieved and effectively maintained safety
for the resident or another resident in the program;
 new text end

new text begin (3) the health, safety, and well-being of the resident or another resident in the program
would otherwise be endangered;
 new text end

new text begin (4) the program was not paid for services;
 new text end

new text begin (5) the program ceases to operate; or
 new text end

new text begin (6) the resident was terminated by the lead agency from waiver eligibility.
 new text end

new text begin (d) Before giving notice of service termination, the license holder must document the
action taken to minimize or eliminate the need for termination. The action taken by the
license holder must include, at a minimum:
 new text end

new text begin (1) consultation with the resident's interdisciplinary team to identify and resolve issues
leading to a notice of service termination; and
 new text end

new text begin (2) a request to the case manager or other professional consultation or intervention
services to support the resident in the program. This requirement does not apply to a notice
of service termination issued under paragraph (c), clause (4) or (5).
 new text end

new text begin (e) If, based on the best interests of the resident, the circumstances at the time of notice
were such that the license holder was unable to take the action specified in paragraph (d),
the license holder must document the specific circumstances and the reason the license
holder was unable to take the action.
 new text end

new text begin (f) The license holder must notify the resident or the resident's legal representative and
the case manager in writing of the intended service termination. The notice must include:
 new text end

new text begin (1) the reason for the action;
 new text end

new text begin (2) except for service termination under paragraph (c), clause (4) or (5), a summary of
the action taken to minimize or eliminate the need for termination and the reason the action
failed to prevent the termination;
 new text end

new text begin (3) the resident's right to appeal the service termination under section 256.045, subdivision
3, paragraph (a); and
 new text end

new text begin (4) the resident's right to seek a temporary order staying the service termination according
to the procedures in section 256.045, subdivision 4a, or subdivision 6, paragraph (c).
 new text end

new text begin (g) Notice of the proposed service termination must be given at least 30 days before
terminating a resident's service.
 new text end

new text begin (h) After the resident receives the notice of service termination and before the services
are terminated, the license holder must:
 new text end

new text begin (1) work with the support team or expanded support team to develop reasonable
alternatives to support continuity of care and to protect the resident;
 new text end

new text begin (2) provide information requested by the resident or case manager; and
 new text end

new text begin (3) maintain information about the service termination, including the written notice of
service termination, in the resident's record.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

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

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

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

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

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

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

(5) night supervision services as defined under the brain injury waiver plan; and

(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental disability, and elderly waiver plans,
excluding providers licensed by the Department of Health under chapter 144A and those
providers providing cleaning services only.

(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:

(1) intervention services, including:

(i) behavioral support services as defined under the brain injury and community access
for disability inclusion waiver plans;

(ii) in-home or out-of-home crisis respite services as defined under the developmental
disability waiver plan; and

(iii) specialist services as defined under the current developmental disability waiver
plan;

(2) in-home support services, including:

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

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

(iii) semi-independent living services;new text begin and
new text end

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

(3) residential supports and services, including:

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

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

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

(4) day services, including:

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

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

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

(5) supported employment as defined under the brain injury, developmental disability,
and community access for disability inclusion waiver plans.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2016, section 245D.04, subdivision 3, is amended to read:


Subd. 3.

Protection-related rights.

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

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

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

(3) be free from maltreatment;

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

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

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

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

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

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

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

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

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

(13) associate with other persons of the person's choice;

(14) personal privacynew text begin , including the right to use the lock on the person's bedroom or unit
doornew text end ; deleted text begin and
deleted text end

(15) engage in chosen activitiesnew text begin ; and
new text end

new text begin (16) access to the person's personal possessions at any time, including financial resourcesnew text end .

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

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

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

(3) have use of and free access to common areas in the residencenew text begin and the freedom to
come and go from the residence at willnew text end ; deleted text begin and
deleted text end

(4)new text begin choose the person's visitors and time of visits and havenew text end privacy for visits with the
person's spouse, next of kin, legal counsel, religious deleted text begin advisordeleted text end new text begin advisernew text end , or others, in accordance
with section 363A.09 of the Human Rights Act, including privacy in the person's bedroomdeleted text begin .deleted text end new text begin ;
new text end

new text begin (5) the freedom and support to access food at any time;
 new text end

new text begin (6) the freedom to furnish and decorate the person's bedroom or living unit;
 new text end

new text begin (7) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling
paint, mold, vermin, and insects;
 new text end

new text begin (8) a setting that is free from hazards that threaten the person's health or safety;
 new text end

new text begin (9) a setting that meets state and local building and zoning definitions of a dwelling unit
in a residential occupancy; and
 new text end

new text begin (10) have access to potable water and three nutritionally balanced meals and nutritious
snacks between meals each day.
 new text end

(c) Restriction of a person's rights under paragraph (a), clauses (13) to deleted text begin (15)deleted text end new text begin (16)new text end , or
paragraph (b) is allowed only if determined necessary to ensure the health, safety, and
well-being of the person. Any restriction of those rights must be documented in the person's
coordinated service and support plan or coordinated service and support plan addendum.
The restriction must be implemented in the least restrictive alternative manner necessary
to protect the person and provide support to reduce or eliminate the need for the restriction
in the most integrated setting and inclusive manner. The documentation must include the
following information:

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Minnesota Statutes 2016, section 245D.071, subdivision 1, is amended to read:


Subdivision 1.

Requirements for intensive support services.

Except for services
identified in section 245D.03, subdivision 1, paragraph (c), deleted text begin clausesdeleted text end new text begin clausenew text end (1) deleted text begin and (2)deleted text end , a
license holder providing intensive support services identified in section 245D.03, subdivision
1, paragraph (c), must comply with the requirements in this section and section 245D.07,
subdivisions 1new text begin , 1a,new text end and 3. Services identified in section 245D.03, subdivision 1, paragraph
(c), deleted text begin clausesdeleted text end new text begin clausenew text end (1) deleted text begin and (2)deleted text end , must comply with the requirements in section 245D.07,
subdivision 2.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2016, section 245D.071, subdivision 3, is amended to read:


Subd. 3.

Assessment and initial service planning.

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

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

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

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

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

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

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

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

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

(3) the person's preferences for how services and supports are providednew text begin , including how
the provider will support the person to have control of the person's schedulenew text end ;

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

(5) how services must be coordinated across other providers licensed under this chapter
serving the person and members of the support team or expanded support team to ensure
continuity of care and coordination of services for the person.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Minnesota Statutes 2016, section 245D.09, subdivision 5a, is amended to read:


Subd. 5a.

Alternative sources of training.

new text begin The commissioner may approve online
training and competency-based assessments in place of a specific number of hours of training
in the topics covered in subdivision 4.
 new text end

Orientation or training received by the staff person from sources other than the license
holder in the same subjects as identified in subdivision 4 may count toward the orientation
and annual training requirements if received in the 12-month period before the staff person's
date of hire. The license holder must maintain documentation of the training received from
other sources and of each staff person's competency in the required area according to the
requirements in subdivision 3.

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2016, section 245D.11, subdivision 4, is amended to read:


Subd. 4.

Admission criteria.

The license holder must establish policies and procedures
that promote continuity of care by ensuring that admission or service initiation criteria:

(1) is consistent with the service-related rights identified in section 245D.04, subdivisions
2, clauses (4) to (7), and 3, clause (8);

(2) identifies the criteria to be applied in determining whether the license holder can
develop services to meet the needs specified in the person's coordinated service and support
plan;

(3) requires a license holder providing services in a health care facility to comply with
the requirements in section 243.166, subdivision 4b, to provide notification to residents
when a registered predatory offender is admitted into the program or to a potential admission
when the facility was already serving a registered predatory offender. For purposes of this
clause, "health care facility" means a facility licensed by the commissioner as a residential
facility under chapter 245A to provide adult foster care or residential services to persons
with disabilities; deleted text begin and
deleted text end

(4) requires that when a person or the person's legal representative requests services
from the license holder, a refusal to admit the person must be based on an evaluation of the
person's assessed needs and the license holder's lack of capacity to meet the needs of the
person. The license holder must not refuse to admit a person based solely on the type of
residential services the person is receiving, or solely on the person's severity of disability,
orthopedic or neurological handicaps, sight or hearing impairments, lack of communication
skills, physical disabilities, toilet habits, behavioral disorders, or past failure to make progress.
Documentation of the basis for refusal must be provided to the person or the person's legal
representative and case manager upon requestdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (5) requires the person or the person's legal representative and license holder to sign and
date the residency agreement when the license holder provides foster care or supported
living services under section 245D.03, subdivision 1, paragraph (c), clause (3), item (i) or
(ii), to a person living in a community residential setting defined in section 245D.02,
subdivision 4a; an adult foster home defined in Minnesota Rules, part 9555.5105, subpart
5; or a foster family home defined in Minnesota Rules, part 9560.0521, subpart 12. The
residency agreement must include service termination requirements specified in section
245D.10, subdivision 3a, paragraphs (b) to (f). The residency agreement must be reviewed
annually, dated, and signed by the person or the person's legal representative and license
holder.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2016, section 245D.24, subdivision 3, is amended to read:


Subd. 3.

Bedrooms.

(a) deleted text begin Peopledeleted text end new text begin Each personnew text end receiving servicesnew text begin must have a choice of
roommate andnew text end must mutually consent, in writing, to sharing a bedroom with one another.
No more than two people receiving services may share one bedroom.

(b) A single occupancy bedroom must have at least 80 square feet of floor space with a
7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor
space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and other
habitable rooms by floor-to-ceiling walls containing no openings except doorways and must
not serve as a corridor to another room used in daily living.

(c) A person's personal possessions and items for the person's own use are the only items
permitted to be stored in a person's bedroom.

(d) Unless otherwise documented through assessment as a safety concern for the person,
each person must be provided with the following furnishings:

(1) a separate bed of proper size and height for the convenience and comfort of the
person, with a clean mattress in good repair;

(2) clean bedding appropriate for the season for each person;

(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal
possessions and clothing; and

(4) a mirror for grooming.

(e) When possible, a person must be allowed to have items of furniture that the person
personally owns in the bedroom, unless doing so would interfere with safety precautions,
violate a building or fire code, or interfere with another person's use of the bedroom. A
person may choose not to have a cabinet, dresser, shelves, or a mirror in the bedroom, as
otherwise required under paragraph (d), clause (3) or (4). A person may choose to use a
mattress other than an innerspring mattress and may choose not to have the mattress on a
mattress frame or support. If a person chooses not to have a piece of required furniture, the
license holder must document this choice and is not required to provide the item. If a person
chooses to use a mattress other than an innerspring mattress or chooses not to have a mattress
frame or support, the license holder must document this choice and allow the alternative
desired by the person.

(f) A person must be allowed to bring personal possessions into the bedroom and other
designated storage space, if such space is available, in the residence. The person must be
allowed to accumulate possessions to the extent the residence is able to accommodate them,
unless doing so is contraindicated for the person's physical or mental health, would interfere
with safety precautions or another person's use of the bedroom, or would violate a building
or fire code. The license holder must allow for locked storage of personal items. Any
restriction on the possession or locked storage of personal items, including requiring a
person to use a lock provided by the license holder, must comply with section 245D.04,
subdivision 3, paragraph (c), and allow the person to be present if and when the license
holder opens the lock.

new text begin (g) A person must be allowed to lock the person's bedroom door. The license holder
must document and assess the physical plant and the environment, and the population served,
and identify the risk factors that require using locked doors, and the specific action taken
to minimize the safety risk to a person receiving services at the site.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2016, section 256.045, subdivision 3, is amended to read:


Subd. 3.

State agency hearings.

(a) State agency hearings are available for the following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food Stamp Act whose application for assistance is denied, not acted upon with
reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed
to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section 626.556 is denied or not
acted upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under section 626.556, after the individual or facility has exercised the
right to administrative reconsideration under section 626.556;

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;

(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, from residential supports and services as defined in section 245D.03, subdivision 1,
paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a; deleted text begin or
deleted text end

(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914deleted text begin .deleted text end new text begin ; or
new text end

new text begin (14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4a.
 new text end

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.

(e) The scope of hearings under paragraph (a), deleted text begin clausedeleted text end new text begin clausesnew text end (12)new text begin and (14)new text end , shall be
limited to whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a, paragraph (b),new text begin or 245A.11, subdivision 11,new text end and whether the requirements
of section 245D.10, subdivision 3a, deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (c)new text begin to (e), or 245A.11, subdivision
2a, paragraphs (d) to (f)new text end , were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.

(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.

(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.

(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.

(i) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

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


Subd. 24.

Personal care assistance provider agency; general duties.

A personal care
assistance provider agency shall:

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

(2) comply with general medical assistance coverage requirements;

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

(4) comply with background study requirements;

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

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

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

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

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

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

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

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

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

(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissionerdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (15) provide written notice to a recipient at least 30 calendar days before the service
termination becomes effective except when:
 new text end

new text begin (i) the recipient engages in conduct that significantly alters the terms of the recipient's
personal care assistance care plan with the agency;
 new text end

new text begin (ii) the recipient or another person present at the setting where services are provided
engage in conduct that creates an imminent risk of harm to the personal care assistant or
other agency staff;
 new text end

new text begin (iii) the agency cannot safely meet the recipient's needs because an emergency or a
significant change in the recipient's condition occurred within a 24-hour period causing the
recipient's service needs to exceed the recipient's identified needs in the personal care
assistance care plan; or
 new text end

new text begin (iv) a recipient initiates a request to terminate personal care assistance services, the
agency must give the recipient a written acknowledgment of the recipient's service
termination request that includes the date the request was received by the agency and the
requested date of termination.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:


Subd. 3a.

Assessment and support planning.

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

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

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

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

(e) The person or the person's legal representative must be provided with a written
community support plan within 40 calendar days of the assessment visit, regardless of
whether the individual is eligible for Minnesota health care programs. The written community
support plan must include:

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

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

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

(4) referral information; and

(5) informal caregiver supports, if applicable.

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

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

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

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

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

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

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

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

(5) information about Minnesota health care programs;

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

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

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

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

(i) Face-to-face assessment completed as part of eligibility determination for the
alternative care, elderly waiver, community access for disability inclusion, community
alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915,
and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after
the date of assessment.

(j) The effective eligibility start date for programs in paragraph (i) can never be prior to
the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (i)
cannot be prior to the date the most recent updated assessment is completed.

new text begin EFFECTIVE DATE. new text end

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

Sec. 18.

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


Subd. 1a.

Case management services.

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

(b) Case management service activities provided to or arranged for a person include:

(1) development of the coordinated service and support plan under subdivision 1b;

(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options;

(3) consulting with relevant medical experts or service providers;

(4) assisting the person in the identification of potential providersnew text begin , including services
provided in a non-disability-specific settingnew text end ;

(5) assisting the person to access services and assisting in appeals under section 256.045;

(6) coordination of services, if coordination is not provided by another service provider;

(7) evaluation and monitoring of the services identified in the coordinated service and
support plan, which must incorporate at least one annual face-to-face visit by the case
manager with each person; and

(8) reviewing coordinated service and support plans and providing the lead agency with
recommendations for service authorization based upon the individual's needs identified in
the coordinated service and support plan.

(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.
Case management services must be provided by a public or private agency that is enrolled
as a medical assistance provider determined by the commissioner to meet all of the
requirements in the approved federal waiver plans. Case management services must not be
provided to a recipient by a private agency that has a financial interest in the provision of
any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision 1a, paragraph (e).

(d) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
coordinated service and support plan and habilitation plan.

(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than ten hours of case management
education and disability-related training each year.

new text begin EFFECTIVE DATE. new text end

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

Sec. 19.

Minnesota Statutes 2016, section 256B.49, subdivision 13, is amended to read:


Subd. 13.

Case management.

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

(1) finalizing the written coordinated service and support plan within ten working days
after the case manager receives the plan from the certified assessor;

(2) informing the recipient or the recipient's legal guardian or conservator of service
options;

(3) assisting the recipient in the identification of potential service providers and available
options for case management service and providersnew text begin , including services provided in
non-disability-specific settingnew text end ;

(4) assisting the recipient to access services and assisting with appeals under section
256.045; and

(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:

(1) finalizing the coordinated service and support plan;

(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved coordinated service and support plan; and

(3) adjustments to the coordinated service and support plan.

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision 1a, paragraph (e).

(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin New services. new text end

new text begin A service added to section 256B.4914 after January 1, 2014, is
not subject to rate stabilization adjustment in this section.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:


Subd. 3.

Applicable services.

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

(1) 24-hour customized living;

(2) adult day care;

(3) adult day care bath;

(4) behavioral programming;

(5) companion services;

(6) customized living;

(7) day training and habilitation;

(8) housing access coordination;

(9) independent living skills;

(10) in-home family support;

(11) night supervision;

(12) personal support;

(13) prevocational services;

(14) residential care services;

(15) residential support services;

(16) respite services;

(17) structured day services;

(18) supported employment services;

(19) supported living services;

(20) transportation services; deleted text begin and
deleted text end

(21)new text begin individualized home supports; and
new text end

new text begin (22)new text end other services as approved by the federal government in the state home and
community-based services plan.

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:


Subd. 5.

Base wage index and standard component values.

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

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

(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home
health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide (SOC
code 31-1012); and 20 percent of the median wage for social and human services aide (SOC
code 21-1093); and

(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012);
20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20
percent of the median wage for social and human services aide (SOC code 21-1093);

(2) for day services, 20 percent of the median wage for nursing aide (SOC code 31-1012);
20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 60
percent of the median wage for social and human services aide (SOC code 21-1093);

(3) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in a
family foster care setting, the wage is $2.80 per hour;

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

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

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

(7) for supportive living services staff, 20 percent of the median wage for nursing aide
(SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code
21-1093);

(8) for housing access coordination staff, 50 percent of the median wage for community
and social services specialist (SOC code 21-1099); and 50 percent of the median wage for
social and human services aide (SOC code 21-1093);

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

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

new text begin (11) for individualized home supports services staff, 40 percent of the median wage for
community social service specialist (SOC code 21-1099); 50 percent of the median wage
for social and human services aide (SOC code 21-1093); and ten percent of the median
wage for psychiatric technician (SOC code 29-2053).
 new text end

deleted text begin (11)deleted text end new text begin (12)new text end for supported employment staff, 20 percent of the median wage for nursing
aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
code 29-2053); and 60 percent of the median wage for social and human services aide (SOC
code 21-1093);

deleted text begin (12)deleted text end new text begin (13)new text end for adult companion staff, 50 percent of the median wage for personal and
home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
orderlies, and attendants (SOC code 31-1012);

deleted text begin (13)deleted text end new text begin (14)new text end for night supervision staff, 20 percent of the median wage for home health
aide (SOC code 31-1011); 20 percent of the median wage for personal and home health
aide (SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code
31-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 20 percent of the median wage for social and human services aide (SOC code 21-1093);

deleted text begin (14)deleted text end new text begin (15)new text end for respite staff, 50 percent of the median wage for personal and home care
aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies,
and attendants (SOC code 31-1012);

deleted text begin (15)deleted text end new text begin (16)new text end for personal support staff, 50 percent of the median wage for personal and
home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
orderlies, and attendants (SOC code 31-1012);

deleted text begin (16)deleted text end new text begin (17)new text end for supervisory staff, the basic wage is $17.43 per hour with exception of the
supervisor of behavior analyst and behavior specialists, which must be $30.75 per hour;

deleted text begin (17)deleted text end new text begin (18)new text end for registered nurse, the basic wage is $30.82 per hour; and

deleted text begin (18)deleted text end new text begin (19)new text end for licensed practical nurse, the basic wage is $18.64 per hour.

(b) Component values for residential support services are:

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

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

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

(4) general administrative support ratio: 13.25 percent;

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

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

(c) Component values for family foster care are:

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

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

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

(4) general administrative support ratio: 3.3 percent;

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

(6) absence factor: 1.7 percent.

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

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

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

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

(4) program plan support ratio: 5.6 percent;

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

(6) general administrative support ratio: 13.25 percent;

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

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

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

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

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

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

(4) program plan supports ratio: 3.1 percent;

(5) client programming and supports ratio: 8.6 percent;

(6) general administrative support ratio: 13.25 percent;

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

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

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

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

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

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

(4) program plan support ratio: 3.1 percent;

(5) client programming and support ratio: 8.6 percent;

(6) general administrative support ratio: 13.25 percent;

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

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

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

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

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

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

(4) general administrative support ratio: 13.25 percent;

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

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

(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor
Statistics available on December 31, 2016. The commissioner shall publish these updated
values and load them into the rate management system. This adjustment occurs every five
years. For adjustments in 2021 and beyond, the commissioner shall use the data available
on December 31 of the calendar year five years prior.

(i) On July 1, 2017, the commissioner shall update the framework components in
paragraphs (b) to (g); subdivision 6, clauses (8) and (9); and subdivision 7, clauses (16) and
(17), for changes in the Consumer Price Index. The commissioner will adjust these values
higher or lower by the percentage change in the Consumer Price Index-All Items, United
States city average (CPI-U) from January 1, 2014, to January 1, 2017. The commissioner
shall publish these updated values and load them into the rate management system. This
adjustment occurs every five years. For adjustments in 2021 and beyond, the commissioner
shall use the data available on January 1 of the calendar year four years prior and January
1 of the current calendar year.

new text begin EFFECTIVE DATE. new text end

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

Sec. 23.

Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:


Subd. 8.

Payments for unit-based services with programming.

Payments for unit-based
services with programming, including behavior programming, housing access coordination,
in-home family support, independent living skills training,new text begin individualized home supports,new text end
hourly supported living services, and supported employment provided to an individual
outside of any day or residential service plan must be calculated as follows, unless the
services are authorized separately under subdivision 6 or 7:

(1) determine the number of units of service to meet a recipient's needs;

(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
5;

(3) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (2). This is defined as the customized direct-care rate;

(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision
5, paragraph (a), or the customized direct-care rate;

(5) multiply the number of direct staff hours by the product of the supervision span of
control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (16);

(6) combine the results of clauses (4) and (5), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause
(2). This is defined as the direct staffing rate;

(7) for program plan support, multiply the result of clause (6) by one plus the program
plan supports ratio in subdivision 5, paragraph (e), clause (4);

(8) for employee-related expenses, multiply the result of clause (7) by one plus the
employee-related cost ratio in subdivision 5, paragraph (e), clause (3);

(9) for client programming and supports, multiply the result of clause (8) by one plus
the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);

(10) this is the subtotal rate;

(11) sum the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization factor ratio;

(12) divide the result of clause (10) by one minus the result of clause (11). This is the
total payment amount;

(13) for supported employment provided in a shared manner, divide the total payment
amount in clause (12) by the number of service recipients, not to exceed three. For
independent living skills trainingnew text begin and individualized home supportsnew text end provided in a shared
manner, divide the total payment amount in clause (12) by the number of service recipients,
not to exceed two; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

Minnesota Statutes 2016, section 256B.4914, subdivision 16, is amended to read:


Subd. 16.

Budget neutrality adjustments.

(a) The commissioner shall use the following
adjustments to the rate generated by the framework to assure budget neutrality until the rate
information is available to implement paragraph (b). The rate generated by the framework
shall be multiplied by the appropriate factor, as designated below:

(1) for residential services: 1.003;

(2) for day services: 1.000;

(3) for unit-based services with programming: 0.941; and

(4) for unit-based services without programming: 0.796.

(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated
spending for all home and community-based waiver services under the new payment rates
defined in subdivisions 6 to 9 with estimated spending for the same recipients and services
under the rates in effect on July 1, 2013. This comparison must distinguish spending under
each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and
services for one or more service months after the new rates have gone into effect. The
commissioner shall consult with the commissioner of management and budget on this
analysis to ensure budget neutrality. If estimated spending under the new rates for services
under one or more subdivisions differs in this comparison by 0.3 percent or more, the
commissioner shall assure aggregate budget neutrality across all service areas by adjusting
the budget neutrality factor in paragraph (a) in each subdivision so that total estimated
spending for each subdivision under the new rates matches estimated spending under the
rates in effect on July 1, 2013.

new text begin (c) A service rate developed using values in subdivision 5, paragraph (a), clause (11),
is not subject to budget neutrality adjustments.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2016, section 256B.85, subdivision 12b, is amended to read:


Subd. 12b.

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

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 26. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 9555.6255, new text end new text begin is repealed.
 new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 6

TECHNICAL CORRECTIONS

Section 1.

Minnesota Statutes 2016, section 245.4871, is amended by adding a subdivision
to read:


new text begin Subd. 11a. new text end

new text begin Diagnostic assessment. new text end

new text begin "Diagnostic assessment" has the meaning given in
Minnesota Rules, part 9505.0370, subpart 11, and is delivered according to part 9505.0372,
subpart 1.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2016, section 245.735, subdivision 3, is amended to read:


Subd. 3.

Certified community behavioral health clinics.

(a) The commissioner shall
establish a state certification process for new text begin a new text end certified community behavioral health deleted text begin clinics
(CCBHCs)deleted text end new text begin clinic (CCBHC)new text end to be eligible for the prospective payment system in paragraph
(f). Entities that choose to be deleted text begin CCBHCsdeleted text end new text begin a CCBHCnew text end must:

(1) comply with the CCBHC criteria published by the United States Department of
Health and Human Services;

(2) employ or contract for clinic staff who have backgrounds in diverse disciplines,
including licensed mental health professionals, and staff who are culturally and linguistically
trained to serve the needs of the clinic's patient population;

(3) ensure that clinic services are available and accessible to patients of all ages and
genders and that crisis management services are available 24 hours per day;

(4) establish fees for clinic services for nonmedical assistance patients using a sliding
fee scale that ensures that services to patients are not denied or limited due to a patient's
inability to pay for services;

(5) comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data;

(6) provide crisis mental health services, withdrawal management services, emergency
crisis intervention services, and stabilization services; screening, assessment, and diagnosis
services, including risk assessments and level of care determinations; patient-centered
treatment planning; outpatient mental health and substance use services; targeted case
management; psychiatric rehabilitation services; peer support and counselor services and
family support services; and intensive community-based mental health services, including
mental health services for members of the armed forces and veterans;

(7) provide coordination of care across settings and providers to ensure seamless
transitions for patients across the full spectrum of health services, including acute, chronic,
and behavioral needs. Care coordination may be accomplished through partnerships or
formal contracts with:

(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified
health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or
community-based mental health providers; and

(ii) other community services, supports, and providers, including schools, child welfare
agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally
licensed health care and mental health facilities, urban Indian health clinics, Department of
Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals,
and hospital outpatient clinics;

(8) be certified as mental health clinics under section 245.69, subdivision 2;

(9) be certified to provide integrated treatment for co-occurring mental illness and
substance use disorders in adults or children under Minnesota Rules, chapter 9533, effective
July 1, 2017;

(10) comply with standards relating to mental health services in Minnesota Rules, parts
9505.0370 to 9505.0372;

(11) be licensed to provide chemical dependency treatment under Minnesota Rules, parts
9530.6405 to 9530.6505;

(12) be certified to provide children's therapeutic services and supports under section
256B.0943;

(13) be certified to provide adult rehabilitative mental health services under section
256B.0623;

(14) be enrolled to provide mental health crisis response services under section
256B.0624;

(15) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;

(16) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926; and

(17) provide services that comply with the evidence-based practices described in
paragraph (e).

(b) If an entity is unable to provide one or more of the services listed in paragraph (a),
clauses (6) to (17), the commissioner may certify the entity as a CCBHC, if the entity has
a current contract with another entity that has the required authority to provide that service
and that meets federal CCBHC criteria as a designated collaborating organization, or, to
the extent allowed by the federal CCBHC criteria, the commissioner may approve a referral
arrangement. The CCBHC must meet federal requirements regarding the type and scope of
services to be provided directly by the CCBHC.

(c) Notwithstanding any other law that requires a county contract or other form of county
approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets
CCBHC requirements may receive the prospective payment under paragraph (f) for those
services without a county contract or county approval. There is no county share when
medical assistance pays the CCBHC prospective payment. As part of the certification process
in paragraph (a), the commissioner shall require a letter of support from the CCBHC's host
county confirming that the CCBHC and the county or counties it serves have an ongoing
relationship to facilitate access and continuity of care, especially for individuals who are
uninsured or who may go on and off medical assistance.

(d) When the standards listed in paragraph (a) or other applicable standards conflict or
address similar issues in duplicative or incompatible ways, the commissioner may grant
variances to state requirements if the variances do not conflict with federal requirements.
If standards overlap, the commissioner may substitute all or a part of a licensure or
certification that is substantially the same as another licensure or certification. The
commissioner shall consult with stakeholders, as described in subdivision 4, before granting
variances under this provision.

(e) The commissioner shall issue a list of required evidence-based practices to be
delivered by deleted text begin CCBHCsdeleted text end new text begin a CCBHCnew text end , and may also provide a list of recommended
evidence-based practices. The commissioner may update the list to reflect advances in
outcomes research and medical services for persons living with mental illnesses or substance
use disorders. The commissioner shall take into consideration the adequacy of evidence to
support the efficacy of the practice, the quality of workforce available, and the current
availability of the practice in the state. At least 30 days before issuing the initial list and
any revisions, the commissioner shall provide stakeholders with an opportunity to comment.

(f) The commissioner shall establish standards and methodologies for a prospective
payment system for medical assistance payments for services delivered by deleted text begin certified
community behavioral health clinicsdeleted text end new text begin a CCBHCnew text end , in accordance with guidance issued by the
Centers for Medicare and Medicaid Services. During the operation of the demonstration
project, payments shall comply with federal requirements for an enhanced federal medical
assistance percentage. The commissioner may include quality bonus payment in the
prospective payment system based on federal criteria and on a clinic's provision of the
evidence-based practices in paragraph (e). The prospective payment system does not apply
to MinnesotaCare. Implementation of the prospective payment system is effective July 1,
2017, or upon federal approval, whichever is later.

(g) The commissioner shall seek federal approval to continue federal financial
participation in payment for CCBHC services after the federal demonstration period ends
for clinics that were certified as deleted text begin CCBHCsdeleted text end new text begin a CCBHCnew text end during the demonstration period and
that continue to meet the CCBHC certification standards in paragraph (a). Payment for
CCBHC services shall cease effective July 1, 2019, if continued federal financial participation
for the payment of CCBHC services cannot be obtained.

(h) The commissioner may certify at least one CCBHC located in an urban area and at
least one CCBHC located in a rural area, as defined by federal criteria. To the extent allowed
by federal law, the commissioner may limit the number of certified clinics so that the
projected claims for certified clinics will not exceed the funds budgeted for this purpose.
The commissioner shall give preference to clinics that:

(1) provide a comprehensive range of services and evidence-based practices for all age
groups, with services being fully coordinated and integrated; and

(2) enhance the state's ability to meet the federal priorities to be selected as a CCBHC
demonstration state.

(i) The commissioner shall recertify deleted text begin CCBHCsdeleted text end new text begin a CCBHCnew text end at least every three years. The
commissioner shall establish a process for decertification and shall require corrective action,
medical assistance repayment, or decertification of a CCBHC that no longer meets the
requirements in this section or that fails to meet the standards provided by the commissioner
in the application and certification process.

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2016, section 254B.15, subdivision 4, is amended to read:


Subd. 4.

Legislative update.

No later than February 1, 2017, the commissioner shall
present an update on the progress of the proposal to members of the legislative committees
in the house of representatives and senate with jurisdiction over health and human services
policy and finance deleted text begin on the progress of the proposaldeleted text end and shall make recommendations on any
legislative changes and state appropriations necessary to implement the proposal.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2016, section 254B.15, subdivision 5, is amended to read:


Subd. 5.

Stakeholder input.

In developing the proposal, the commissioner shall consult
with consumers, providers, counties, tribes, deleted text begin health plansdeleted text end new text begin managed care organizationsnew text end , and
other stakeholders.

new text begin EFFECTIVE DATE. new text end

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

Sec. 5.

Minnesota Statutes 2016, section 256B.055, subdivision 12, is amended to read:


Subd. 12.

Disabled children.

(a) A person is eligible for medical assistance if the person
is under age 19 and qualifies as a disabled individual under United States Code, title 42,
section 1382c(a), and would be eligible for medical assistance under the state plan if residing
in a medical institution, and the child requires a level of care provided in a hospital, nursing
facility, or intermediate care facility for persons with developmental disabilities, for whom
home care is appropriate, provided that the cost to medical assistance under this section is
not more than the amount that medical assistance would pay for if the child resides in an
institution. After the child is determined to be eligible under this section, the commissioner
shall review the child's disability under United States Code, title 42, section 1382c(a) and
level of care defined under this section no more often than annually and may elect, based
on the recommendation of health care professionals under contract with the state medical
review team, to extend the review of disability and level of care up to a maximum of four
years. The commissioner's decision on the frequency of continuing review of disability and
level of care is not subject to administrative appeal under section 256.045. The county
agency shall send a notice of disability review to the enrollee six months prior to the date
the recertification of disability is due. Nothing in this subdivision shall be construed as
affecting other redeterminations of medical assistance eligibility under this chapter and
annual cost-effective reviews under this section.

(b) For purposes of this subdivision, "hospital" means an institution as defined in section
144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 4640.3600, and
licensed pursuant to sections 144.50 to 144.58. For purposes of this subdivision, a child
requires a level of care provided in a hospital if the child is determined by the commissioner
to need an extensive array of health services, including mental health services, for an
undetermined period of time, whose health condition requires frequent monitoring and
treatment by a health care professional or by a person supervised by a health care
professional, who would reside in a hospital or require frequent hospitalization if these
services were not provided, and the daily care needs are more complex than a nursing facility
level of care.

A child with serious emotional disturbance requires a level of care provided in a hospital
if the commissioner determines that the individual requires 24-hour supervision because
the person exhibits recurrent or frequent suicidal or homicidal ideation or behavior, recurrent
or frequent psychosomatic disorders or somatopsychic disorders that may become life
threatening, recurrent or frequent severe socially unacceptable behavior associated with
psychiatric disorder, ongoing and chronic psychosis or severe, ongoing and chronic
developmental problems requiring continuous skilled observation, or severe disabling
symptoms for which office-centered outpatient treatment is not adequate, and which overall
severely impact the individual's ability to function.

(c) For purposes of this subdivision, "nursing facility" means a facility which provides
nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to sections
144A.02 to 144A.10, which is appropriate if a person is in active restorative treatment; is
in need of special treatments provided or supervised by a licensed nurse; or has unpredictable
episodes of active disease processes requiring immediate judgment by a licensed nurse. For
purposes of this subdivision, a child requires the level of care provided in a nursing facility
if the child is determined by the commissioner to meet the requirements of the preadmission
screening assessment document under section 256B.0911, adjusted to address age-appropriate
standards for children age 18 and under.

(d) For purposes of this subdivision, "intermediate care facility for persons with
developmental disabilities" or "ICF/DD" means a program licensed to provide services to
persons with developmental disabilities under section 252.28, and chapter 245A, and a
physical plant licensed as a supervised living facility under chapter 144, which together are
certified by the Minnesota Department of Health as meeting the standards in Code of Federal
Regulations, title 42, part 483, for an intermediate care facility which provides services for
persons with developmental disabilities who require 24-hour supervision and active treatment
for medical, behavioral, or habilitation needs. For purposes of this subdivision, a child
requires a level of care provided in an ICF/DD if the commissioner finds that the child has
a developmental disability in accordance with section 256B.092, is in need of a 24-hour
plan of care and active treatment similar to persons with developmental disabilities, and
there is a reasonable indication that the child will need ICF/DD services.

(e) For purposes of this subdivision, a person requires the level of care provided in a
nursing facility if the person requires 24-hour monitoring or supervision and a plan of mental
health treatment because of specific symptoms or functional impairments associated with
a serious mental illness or disorder diagnosis, which meet severity criteria for mental health
established by the commissioner and published in March 1997 as the Minnesota Mental
Health Level of Care for Children and Adolescents with Severe Emotional Disorders.

(f) The determination of the level of care needed by the child shall be made by the
commissioner based on information supplied to the commissioner by the parent or guardian,
the child's physician or physicians, and other professionals as requested by the commissioner.
The commissioner shall establish a screening team to conduct the level of care determinations
according to this subdivision.

(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
must assess the case to determine whether:

(1) the child qualifies as a disabled individual under United States Code, title 42, section
1382c(a), and would be eligible for medical assistance if residing in a medical institution;
and

(2) the cost of medical assistance services for the child, if eligible under this subdivision,
would not be more than the cost to medical assistance if the child resides in a medical
institution deleted text begin to be determined as follows:deleted text end new text begin . The commissioner shall presume that the cost of
medical assistance services for a child who meets the conditions in paragraph (b), (c), (d),
or (e) is not more than the cost to medical assistance if the child resides in a medical
institution.
new text end

deleted text begin (i) for a child who requires a level of care provided in an ICF/DD, the cost of care for
the child in an institution shall be determined using the average payment rate established
for the regional treatment centers that are certified as ICF's/DD;
 deleted text end

deleted text begin (ii) for a child who requires a level of care provided in an inpatient hospital setting
according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
Rules, part 9505.3520, items F and G; and
 deleted text end

deleted text begin (iii) for a child who requires a level of care provided in a nursing facility according to
paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota Rules,
part 9505.3040, except that the nursing facility average rate shall be adjusted to reflect rates
which would be paid for children under age 16. The commissioner may authorize an amount
up to the amount medical assistance would pay for a child referred to the commissioner by
the preadmission screening team under section 256B.0911.
 deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2016, section 256B.0622, subdivision 2, is amended to read:


Subd. 2.

Definitions.

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

(b) "ACT team" means the group of interdisciplinary mental health staff who work as
a team to provide assertive community treatment.

(c) "Assertive community treatment" means intensive nonresidential treatment and
rehabilitative mental health services provided according to the assertive community treatment
model. Assertive community treatment provides a single, fixed point of responsibility for
treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per
day, seven days per week, in a community-based setting.

(d) "Individual treatment plan" means the document that results from a person-centered
planning process of determining real-life outcomes with clients and developing strategies
to achieve those outcomes.

(e) "Assertive engagement" means the use of collaborative strategies to engage clients
to receive services.

(f) "Benefits and finance support" means assisting clients in capably managing financial
affairs. Services include, but are not limited to, assisting clients in applying for benefits;
assisting with redetermination of benefits; providing financial crisis management; teaching
and supporting budgeting skills and asset development; and coordinating with a client's
representative payee, if applicable.

(g) "Co-occurring disorder treatment" means the treatment of co-occurring mental illness
and substance use disorders and is characterized by assertive outreach, stage-wise
comprehensive treatment, treatment goal setting, and flexibility to work within each stage
of treatment. Services include, but are not limited to, assessing and tracking clients' stages
of change readiness and treatment; applying the appropriate treatment based on stages of
change, such as outreach and motivational interviewing techniques to work with clients in
earlier stages of change readiness and cognitive behavioral approaches and relapse prevention
to work with clients in later stages of change; and facilitating access to community supports.

(h) "Crisis assessment and intervention" means mental health crisis response services
as defined in section 256B.0624, subdivision 2, paragraphs (c) to (e).

(i) "Employment services" means assisting clients to work at jobs of their choosing.
Services must follow the principles of the individual placement and support (IPS)
employment model, including focusing on competitive employment; emphasizing individual
client preferences and strengths; ensuring employment services are integrated with mental
health services; conducting rapid job searches and systematic job development according
to client preferences and choices; providing benefits counseling; and offering all services
in an individualized and time-unlimited manner. Services shall also include educating clients
about opportunities and benefits of work and school and assisting the client in learning job
skills, navigating the work place, and managing work relationships.

(j) "Family psychoeducation and support" means services provided to the client's family
and other natural supports to restore and strengthen the client's unique social and family
relationships. Services include, but are not limited to, individualized psychoeducation about
the client's illness and the role of the family and other significant people in the therapeutic
process; family intervention to restore contact, resolve conflict, and maintain relationships
with family and other significant people in the client's life; ongoing communication and
collaboration between the ACT team and the family; introduction and referral to family
self-help programs and advocacy organizations that promote recovery and family
engagement, individual supportive counseling, parenting training, and service coordination
to help clients fulfill parenting responsibilities; coordinating services for the child and
restoring relationships with children who are not in the client's custody; and coordinating
with child welfare and family agencies, if applicable. These services must be provided with
the client's agreement and consent.

(k) "Housing access support" means assisting clients to find, obtain, retain, and move
to safe and adequate housing of deleted text begin theirdeleted text end new text begin the client'snew text end choice. Housing access support includes,
but is not limited to, locating housing options with a focus on integrated independent settings;
applying for housing subsidies, programs, or resources; assisting the client in developing
relationships with local landlords; providing tenancy support and advocacy for the individual's
tenancy rights at the client's home; and assisting with relocation.

(l) "Individual treatment team" means a minimum of three members of the ACT team
who are responsible for consistently carrying out most of a client's assertive community
treatment services.

(m) "Intensive residential treatment services treatment team" means all staff who provide
intensive residential treatment services under this section to clients. At a minimum, this
includes the clinical supervisor; mental health professionals as defined in section 245.462,
subdivision 18, clauses (1) to (6); mental health practitioners as defined in section 245.462,
subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision
5, clause (4); and mental health certified peer specialists under section 256B.0615.

(n) "Intensive residential treatment services" means short-term, time-limited services
provided in a residential setting to clients who are in need of more restrictive settings and
are at risk of significant functional deterioration if they do not receive these services. Services
are designed to develop and enhance psychiatric stability, personal and emotional adjustment,
self-sufficiency, and skills to live in a more independent setting. Services must be directed
toward a targeted discharge date with specified client outcomes.

(o) "Medication assistance and support" means assisting clients in accessing medication,
developing the ability to take medications with greater independence, and providing
medication setup. This includes the prescription, administration, and order of medication
by appropriate medical staff.

(p) "Medication education" means educating clients on the role and effects of medications
in treating symptoms of mental illness and the side effects of medications.

(q) "Overnight staff" means a member of the intensive residential treatment services
team who is responsible during hours when clients are typically asleep.

(r) "Mental health certified peer specialist services" has the meaning given in section
256B.0615.

(s) "Physical health services" means any service or treatment to meet the physical health
needs of the client to support the client's mental health recovery. Services include, but are
not limited to, education on primary health issues, including wellness education; medication
administration and monitoring; providing and coordinating medical screening and follow-up;
scheduling routine and acute medical and dental care visits; tobacco cessation strategies;
assisting clients in attending appointments; communicating with other providers; and
integrating all physical and mental health treatment.

(t) "Primary team member" means the person who leads and coordinates the activities
of the individual treatment team and is the individual treatment team member who has
primary responsibility for establishing and maintaining a therapeutic relationship with the
client on a continuing basis.

(u) "Rehabilitative mental health services" means mental health services that are
rehabilitative and enable the client to develop and enhance psychiatric stability, social
competencies, personal and emotional adjustment, independent living, parenting skills, and
community skills, when these abilities are impaired by the symptoms of mental illness.

(v) "Symptom management" means supporting clients in identifying and targeting the
symptoms and occurrence patterns of their mental illness and developing strategies to reduce
the impact of those symptoms.

(w) "Therapeutic interventions" means empirically supported techniques to address
specific symptoms and behaviors such as anxiety, psychotic symptoms, emotional
dysregulation, and trauma symptoms. Interventions include empirically supported
psychotherapies including, but not limited to, cognitive behavioral therapy, exposure therapy,
acceptance and commitment therapy, interpersonal therapy, and motivational interviewing.

(x) "Wellness self-management and prevention" means a combination of approaches to
working with the client to build and apply skills related to recovery, and to support the client
in participating in leisure and recreational activities, civic participation, and meaningful
structure.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2016, section 256B.0622, subdivision 2b, is amended to read:


Subd. 2b.

Continuing stay and discharge criteria for assertive community treatment.

(a) A client receiving assertive community treatment is eligible to continue receiving services
if:

(1) the client has not achieved the desired outcomes of deleted text begin theirdeleted text end new text begin the client'snew text end individual
treatment plan;

(2) the client's level of functioning has not been restored, improved, or sustained over
the time frame outlined in the individual treatment plan;

(3) the client continues to be at risk for relapse based on current clinical assessment,
history, or the tenuous nature of the functional gains; or

(4) the client is functioning effectively with this service and discharge would otherwise
be indicated but without continued services the client's functioning would decline; and

(5) one of the following must also apply:

(i) the client has achieved current individual treatment plan goals but additional goals
are indicated as evidenced by documented symptoms;

(ii) the client is making satisfactory progress toward meeting goals and there is
documentation that supports that continuation of this service shall be effective in addressing
the goals outlined in the individual treatment plan;

(iii) the client is making progress, but the specific interventions in the individual treatment
plan need to be modified so that greater gains, which are consistent with the client's potential
level of functioning, are possible; or

(iv) the client fails to make progress or demonstrates regression in meeting goals through
the interventions outlined in the individual treatment plan.

(b) Clients receiving assertive community treatment are eligible to be discharged if they
meet at least one of the following criteria:

(1) the client and the ACT team determine that assertive community treatment services
are no longer needed based on the attainment of goals as identified in the individual treatment
plan and a less intensive level of care would adequately address current goals;

(2) the client moves out of the ACT team's service area and the ACT team has facilitated
the referral to either a new ACT team or other appropriate mental health service and has
assisted the individual in the transition process;

(3) the client, or the client's legal guardian when applicable, chooses to withdraw from
assertive community treatment services and documented attempts by the ACT team to
re-engage the client with the service have not been successful;

(4) the client has a demonstrated need for a medical nursing home placement lasting
more than three months, as determined by a physician;

(5) the client is hospitalized, in residential treatment, or in jail for a period of greater
than three months. However, the ACT team must make provisions for the client to return
to the ACT team upon their discharge or release from the hospital or jail if the client still
meets eligibility criteria for assertive community treatment and the team is not at full capacity;

(6) the ACT team is unable to locate, contact, and engage the client for a period of greater
than three months after persistent efforts by the ACT team to locate the client; or

(7) the client requests a discharge, despite repeated and proactive efforts by the ACT
team to engage the client in service planning. The ACT team must develop a transition plan
to arrange for alternate treatment for clients in this situation who have a history of suicide
attempts, assault, or forensic involvement.

(c) For all clients who are discharged from assertive community treatment to another
service provider within the ACT team's service area there is a three-month transfer period,
from the date of discharge, during which a client who does not adjust well to the new service,
may voluntarily return to the ACT team. During this period, the ACT team must maintain
contact with the client's new service provider.

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2016, section 256B.0622, subdivision 7a, is amended to read:


Subd. 7a.

Assertive community treatment team staff requirements and roles.

(a)
The required treatment staff qualifications and roles for an ACT team are:

(1) the team leader:

(i) shall be a licensed mental health professional who is qualified under Minnesota Rules,
part 9505.0371, subpart 5, item A. Individuals who are not licensed but who are eligible
for licensure and are otherwise qualified may also fulfill this role but must obtain full
licensure within 24 months of assuming the role of team leader;

(ii) must be an active member of the ACT team and provide some direct services to
clients;

(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the team, providing clinical
oversight of services in conjunction with the psychiatrist or psychiatric care provider, and
supervising team members to ensure delivery of best and ethical practices; and

(iv) must be available to provide overall clinical oversight to the ACT team after regular
business hours and on weekends and holidays. The team leader may delegate this duty to
another qualified member of the ACT team;

(2) the psychiatric care provider:

(i) must be a licensed psychiatrist certified by the American Board of Psychiatry and
Neurology or eligible for board certification or certified by the American Osteopathic Board
of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who
is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A. The psychiatric care
provider must have demonstrated clinical experience working with individuals with serious
and persistent mental illness;

(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide clinical
supervision to the team;

(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;

(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;

(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role;

(vi) may not provide specific roles and responsibilities by telemedicine unless approved
by the commissioner; and

(vii) shall provide psychiatric backup to the program after regular business hours and
on weekends and holidays. The psychiatric care provider may delegate this duty to another
qualified psychiatric provider;

(3) the nursing staff:

(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;

(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and

(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;

(4) the co-occurring disorder specialist:

(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in Minnesota Rules, part 9530.6450, subpart 5. No more than two
co-occurring disorder specialists may occupy this role; and

(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;

(5) the vocational specialist:

(i) shall be a full-time vocational specialist who has at least one-year experience providing
employment services or advanced education that involved field training in vocational services
to individuals with mental illness. An individual who does not meet these qualifications
may also serve as the vocational specialist upon completing a training plan approved by the
commissioner;

(ii) shall provide or facilitate the provision of vocational services to clients. The vocational
specialist serves as a consultant and educator to fellow ACT team members on these services;
and

(iii) should not refer individuals to receive any type of vocational services or linkage by
providers outside of the ACT team;

(6) the mental health certified peer specialist:

(i) shall be a full-time equivalent mental health certified peer specialist as defined in
section 256B.0615. No more than two individuals can share this position. The mental health
certified peer specialist is a fully integrated team member who provides highly individualized
services in the community and promotes the self-determination and shared decision-making
abilities of clients. This requirement may be waived due to workforce shortages upon
approval of the commissioner;

(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and

(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;

(7) the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and

(8) additional staff:

(i) shall be based on team size. Additional treatment team staff may include licensed
mental health professionals as defined in Minnesota Rules, part 9505.0371, subpart 5, item
A; mental health practitioners as defined in Minnesota Rules, part 9505.0370, subpart 17;
or mental health rehabilitation workers as defined in section 256B.0623, subdivision 5,
clause (4). These individuals shall have the knowledge, skills, and abilities required by the
population served to carry out rehabilitation and support functions; and

(ii) shall be selected based on specific program needs or the population served.

(b) Each ACT team must clearly document schedules for all ACT team members.

(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.

(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in deleted text begin theirdeleted text end new text begin the staff member'snew text end respective discipline and be able to
work collaboratively as a member of a multidisciplinary team to deliver the majority of the
treatment, rehabilitation, and support services clients require to fully benefit from receiving
assertive community treatment.

(e) Each ACT team member must fulfill training requirements established by the
commissioner.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2016, section 256B.0625, subdivision 60a, is amended to read:


Subd. 60a.

Community emergency medical technician services.

(a) Medical assistance
covers services provided by a deleted text begin community emergency medical techniciandeleted text end new text begin community medical
response emergency medical techniciannew text end (CEMT) who is certified under section 144E.275,
subdivision 7, when the services are provided in accordance with this subdivision.

(b) A CEMT may provide a posthospital discharge visit when ordered by a treating
physician. The posthospital discharge visit includes:

(1) verbal or visual reminders of discharge orders;

(2) recording and reporting of vital signs to the patient's primary care provider;

(3) medication access confirmation;

(4) food access confirmation; and

(5) identification of home hazards.

(c) An individual who has repeat ambulance calls due to falls, has been discharged from
a nursing home, or has been identified by the individual's primary care provider as at risk
for nursing home placement, may receive a safety evaluation visit from a CEMT when
ordered by a primary care provider in accordance with the individual's care plan. A safety
evaluation visit includes:

(1) medication access confirmation;

(2) food access confirmation; and

(3) identification of home hazards.

(d) A CEMT shall be paid at $9.75 per 15-minute increment. A safety evaluation visit
may not be billed for the same day as a posthospital discharge visit for the same individual.

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Minnesota Statutes 2016, section 256P.08, subdivision 4, is amended to read:


Subd. 4.

Recovering general assistance and Minnesota supplemental aid
overpayments.

(a) If an amount of assistance is paid to an assistance unit in excess of the
payment due, it shall be recoverable by the agency. The agency shall give written notice to
the participant of its intention to recover the overpayment.

(b) If the individual is no longer receiving assistance, the agency may request voluntary
repayment or pursue civil recovery.

(c) If the individual is receiving assistance, except as provided for interim assistance in
section 256D.06, subdivision 5, when an overpayment occurs the agency shall recover the
overpayment by withholding an amount equal to:

(1) three percent of the assistance unit's standard of need for all Minnesota supplemental
aid assistance units, and nonfraud cases for general assistance; deleted text begin anddeleted text end new text begin or
new text end

(2) ten percent where fraud has occurred in general assistance cases; or

(3) the amount of the monthly general assistance or Minnesota supplemental aid payment,
whichever is less.

(d) In cases when there is both an overpayment and underpayment, the county agency
shall offset one against the other in correcting the payment.

(e) Overpayments may also be voluntarily repaid, in part or in full, by the individual, in
addition to the assistance reductions provided in this subdivision, to include further voluntary
reductions in the grant level agreed to in writing by the individual, until the total amount
of the overpayment is repaid.

(f) The county agency shall make reasonable efforts to recover overpayments to
individuals no longer on assistance. The agency need not attempt to recover overpayments
of less than $35 paid to an individual no longer on assistance if the individual does not
receive assistance again within three years, unless the individual has been convicted of
violating section 256.98.

(g) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to agency error and six years prior to the month of discovery due to client
error or an intentional program violation determined under section 256.046.

(h) Residents of licensed residential facilities shall not have overpayments recovered
from their personal needs allowance.

(i) Overpayments by another maintenance benefit program shall not be recovered from
the general assistance or Minnesota supplemental aid grant.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2016, section 626.5572, subdivision 21, is amended to read:


Subd. 21.

Vulnerable adult.

(a) "Vulnerable adult" means any person 18 years of age
or older who:

(1) is a resident or inpatient of a facility;

(2) receives services required to be licensed under chapter 245A, except that a person
receiving outpatient services for treatment of chemical dependency or mental illness, or one
who is served in the Minnesota sex offender program on a court-hold order for commitment,
or is committed as a sexual psychopathic personality or as a sexually dangerous person
under chapter 253B, is not considered a vulnerable adult unless the person meets the
requirements of clause (4);

(3) receives services from a home care provider required to be licensed under deleted text begin sections
144A.43 to 144A.482deleted text end new text begin section 144A.471new text end ; or from a person or organization that offers,
provides, or arranges for personal care assistance services under the medical assistance
program as authorized under section 256B.0625, subdivision 19a, 256B.0651, 256B.0653,
256B.0654, 256B.0659, or 256B.85; or

(4) regardless of residence or whether any type of service is received, possesses a physical
or mental infirmity or other physical, mental, or emotional dysfunction:

(i) that impairs the individual's ability to provide adequately for the individual's own
care without assistance, including the provision of food, shelter, clothing, health care, or
supervision; and

(ii) because of the dysfunction or infirmity and the need for care or services, the individual
has an impaired ability to protect the individual's self from maltreatment.

(b) For purposes of this subdivision, "care or services" means care or services for the
health, safety, welfare, or maintenance of an individual.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin In each section of Minnesota Statutes referred to in column A, the revisor of statutes
shall delete the reference in column B and insert the reference in column C. The revisor
shall make changes necessary to correct the punctuation, grammar, or structure of the
remaining text and preserve its meaning.
 new text end

new text begin Column A
 new text end 		new text begin Column B
 new text end 		new text begin Column C
 new text end
new text begin 144.651, subd. 20, 29
 new text end 		new text begin Older Americans Act, section
307(a)(12)
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, section
3027(a)(12) (2016)
 new text end
new text begin 256.01, subd. 2, 24
 new text end 		new text begin United States Code, title 42,
section 3001, the Older
Americans Act Amendments
of 2006
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, sections 3001
- 3058ff (2016)
 new text end
new text begin 256.974
 new text end 		new text begin Older Americans Act, as
amended, United States Code,
title 42, section 3027(a)(9) and
3058g(a)
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, sections
3027(a)(9) and 3058g(a)
(2016)
 new text end
new text begin 256.974
 new text end 		new text begin Code of Federal Regulations,
title 45, parts 1321 and 1327
 new text end 		new text begin Code of Federal Regulations,
title 45, parts 1321 (2015) and
1324 (Federal Register,
volume 81, page 35644
(2016))
 new text end
new text begin 256.9744, subd. 1
 new text end 		new text begin Older Americans Act, as
amended, United States Code,
title 42, section 3058g(d)
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, section
3058g(d) (2016)
 new text end
new text begin 256.975, subd. 2
 new text end 		new text begin Older Americans Act of 1965,
as amended
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, sections 3001
- 3058ff (2016)
 new text end
new text begin 256.975, subd. 7
 new text end 		new text begin United States Code, title 42,
section 3001, the Older
Americans Act Amendments
of 2006
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, sections 3001
- 3058ff (2016)
 new text end
new text begin 256.977, subd. 3
 new text end 		new text begin Older Americans Act
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, sections 3001
- 3058ff (2016)
 new text end
new text begin 256B.0917, subd. 1c
 new text end 		new text begin title III of the Older Americans
Act
 new text end 		new text begin Older Americans Act of 1965,
as amended, United States
Code, title 42, sections 3021
- 3030s-2 (2016)
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 13. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2016, section 119B.125, subdivision 8, new text end new text begin is repealed.
 new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 9555.7100; 9555.7200; 9555.7300; and 9555.7600, new text end new text begin are
repealed.
 new text end

new text begin EFFECTIVE DATE. new text end

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

APPENDIX

Repealed Minnesota Statutes: SF1291-2

119B.125 PROVIDER REQUIREMENTS.

Subd. 8.

Overpayment claim for failure to comply with access to records requirement.

(a) In establishing an overpayment claim under subdivision 6 for failure to provide access to attendance records, the county or commissioner is limited to the six years prior to the date the county or the commissioner requested the attendance records.

(b) When the commissioner or county establishes an overpayment claim against a current or former provider, the commissioner or county must provide notice of the claim to the provider. A notice of overpayment claim must specify the reason for the overpayment, the authority for making the overpayment claim, the time period in which the overpayment occurred, the amount of the overpayment, and the provider's right to appeal.

(c) The commissioner or county may seek to recover overpayments paid to a current or former provider. When a provider has been convicted of fraud under section 256.98, theft under section 609.52, or a federal crime relating to theft of state funds or fraudulent billing for a program administered by the commissioner or a county, recovery may be sought regardless of the amount of overpayment.

245.469 EMERGENCY SERVICES.

Subdivision 1.

Availability of emergency services.

By July 1, 1988, county boards must provide or contract for enough emergency services within the county to meet the needs of adults in the county who are experiencing an emotional crisis or mental illness. Clients may be required to pay a fee according to section 245.481. Emergency services must include assessment, crisis intervention, and appropriate case disposition. Emergency services must:

(1) promote the safety and emotional stability of adults with mental illness or emotional crises;

(2) minimize further deterioration of adults with mental illness or emotional crises;

(3) help adults with mental illness or emotional crises to obtain ongoing care and treatment; and

(4) prevent placement in settings that are more intensive, costly, or restrictive than necessary and appropriate to meet client needs.

Subd. 2.

Specific requirements.

(a) The county board shall require that all service providers of emergency services to adults with mental illness provide immediate direct access to a mental health professional during regular business hours. For evenings, weekends, and holidays, the service may be by direct toll-free telephone access to a mental health professional, a mental health practitioner, or until January 1, 1991, a designated person with training in human services who receives clinical supervision from a mental health professional.

(b) The commissioner may waive the requirement in paragraph (a) that the evening, weekend, and holiday service be provided by a mental health professional or mental health practitioner after January 1, 1991, if the county documents that:

(1) mental health professionals or mental health practitioners are unavailable to provide this service;

(2) services are provided by a designated person with training in human services who receives clinical supervision from a mental health professional; and

(3) the service provider is not also the provider of fire and public safety emergency services.

(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the evening, weekend, and holiday service not be provided by the provider of fire and public safety emergency services if:

(1) every person who will be providing the first telephone contact has received at least eight hours of training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner;

(2) every person who will be providing the first telephone contact will annually receive at least four hours of continued training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner;

(3) the local social service agency has provided public education about available emergency mental health services and can assure potential users of emergency services that their calls will be handled appropriately;

(4) the local social service agency agrees to provide the commissioner with accurate data on the number of emergency mental health service calls received;

(5) the local social service agency agrees to monitor the frequency and quality of emergency services; and

(6) the local social service agency describes how it will comply with paragraph (d).

(d) Whenever emergency service during nonbusiness hours is provided by anyone other than a mental health professional, a mental health professional must be available on call for an emergency assessment and crisis intervention services, and must be available for at least telephone consultation within 30 minutes.

Subd. 3.

Mental health crisis services.

The commissioner of human services shall increase access to mental health crisis services for children and adults. In order to increase access, the commissioner must:

(1) develop a central phone number where calls can be routed to the appropriate crisis services;

(2) provide telephone consultation 24 hours a day to mobile crisis teams who are serving people with traumatic brain injury or intellectual disabilities who are experiencing a mental health crisis;

(3) expand crisis services across the state, including rural areas of the state and examining access per population;

(4) establish and implement state standards for crisis services; and

(5) provide grants to adult mental health initiatives, counties, tribes, or community mental health providers to establish new mental health crisis residential service capacity.

Priority will be given to regions that do not have a mental health crisis residential services program, do not have an inpatient psychiatric unit within the region, do not have an inpatient psychiatric unit within 90 miles, or have a demonstrated need based on the number of crisis residential or intensive residential treatment beds available to meet the needs of the residents in the region. At least 50 percent of the funds must be distributed to programs in rural Minnesota. Grant funds may be used for start-up costs, including but not limited to renovations, furnishings, and staff training. Grant applications shall provide details on how the intended service will address identified needs and shall demonstrate collaboration with crisis teams, other mental health providers, hospitals, and police.

245.4879 EMERGENCY SERVICES.

Subdivision 1.

Availability of emergency services.

County boards must provide or contract for enough mental health emergency services within the county to meet the needs of children, and children's families when clinically appropriate, in the county who are experiencing an emotional crisis or emotional disturbance. The county board shall ensure that parents, providers, and county residents are informed about when and how to access emergency mental health services for children. A child or the child's parent may be required to pay a fee according to section 245.481. Emergency service providers shall not delay the timely provision of emergency service because of delays in determining this fee or because of the unwillingness or inability of the parent to pay the fee. Emergency services must include assessment, crisis intervention, and appropriate case disposition. Emergency services must:

(1) promote the safety and emotional stability of children with emotional disturbances or emotional crises;

(2) minimize further deterioration of the child with emotional disturbance or emotional crisis;

(3) help each child with an emotional disturbance or emotional crisis to obtain ongoing care and treatment; and

(4) prevent placement in settings that are more intensive, costly, or restrictive than necessary and appropriate to meet the child's needs.

Subd. 2.

Specific requirements.

(a) The county board shall require that all service providers of emergency services to the child with an emotional disturbance provide immediate direct access to a mental health professional during regular business hours. For evenings, weekends, and holidays, the service may be by direct toll-free telephone access to a mental health professional, a mental health practitioner, or until January 1, 1991, a designated person with training in human services who receives clinical supervision from a mental health professional.

(b) The commissioner may waive the requirement in paragraph (a) that the evening, weekend, and holiday service be provided by a mental health professional or mental health practitioner after January 1, 1991, if the county documents that:

(1) mental health professionals or mental health practitioners are unavailable to provide this service;

(2) services are provided by a designated person with training in human services who receives clinical supervision from a mental health professional; and

(3) the service provider is not also the provider of fire and public safety emergency services.

(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the evening, weekend, and holiday service not be provided by the provider of fire and public safety emergency services if:

(1) every person who will be providing the first telephone contact has received at least eight hours of training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner;

(2) every person who will be providing the first telephone contact will annually receive at least four hours of continued training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner;

(3) the local social service agency has provided public education about available emergency mental health services and can assure potential users of emergency services that their calls will be handled appropriately;

(4) the local social service agency agrees to provide the commissioner with accurate data on the number of emergency mental health service calls received;

(5) the local social service agency agrees to monitor the frequency and quality of emergency services; and

(6) the local social service agency describes how it will comply with paragraph (d).

(d) When emergency service during nonbusiness hours is provided by anyone other than a mental health professional, a mental health professional must be available on call for an emergency assessment and crisis intervention services, and must be available for at least telephone consultation within 30 minutes.

256B.0624 ADULT CRISIS RESPONSE SERVICES COVERED.

Subd. 4a.

Alternative provider standards.

If a county demonstrates that, due to geographic or other barriers, it is not feasible to provide mobile crisis intervention services according to the standards in subdivision 4, paragraph (b), clause (9), the commissioner may approve a crisis response provider based on an alternative plan proposed by a county or group of counties. The alternative plan must:

(1) result in increased access and a reduction in disparities in the availability of crisis services;

(2) provide mobile services outside of the usual nine-to-five office hours and on weekends and holidays; and

(3) comply with standards for emergency mental health services in section 245.469.

Subd. 5.

Mobile crisis intervention staff qualifications.

For provision of adult mental health mobile crisis intervention services, a mobile crisis intervention team is comprised of at least two mental health professionals as defined in section 245.462, subdivision 18, clauses (1) to (6), or a combination of at least one mental health professional and one mental health practitioner as defined in section 245.462, subdivision 17, with the required mental health crisis training and under the clinical supervision of a mental health professional on the team. The team must have at least two people with at least one member providing on-site crisis intervention services when needed. Team members must be experienced in mental health assessment, crisis intervention techniques, treatment engagement strategies, working with families, and clinical decision-making under emergency conditions and have knowledge of local services and resources. The team must recommend and coordinate the team's services with appropriate local resources such as the county social services agency, mental health services, and local law enforcement when necessary.

Subd. 6.

Crisis assessment and mobile intervention treatment planning.

(a) Prior to initiating mobile crisis intervention services, a screening of the potential crisis situation must be conducted. The screening may use the resources of crisis assistance and emergency services as defined in sections 245.462, subdivision 6, and 245.469, subdivisions 1 and 2. The screening must gather information, determine whether a crisis situation exists, identify parties involved, and determine an appropriate response.

(b) If a crisis exists, a crisis assessment must be completed. A crisis assessment evaluates any immediate needs for which emergency services are needed and, as time permits, the recipient's current life situation, sources of stress, mental health problems and symptoms, strengths, cultural considerations, support network, vulnerabilities, current functioning, and the recipient's preferences as communicated directly by the recipient, or as communicated in a health care directive as described in chapters 145C and 253B, the treatment plan described under paragraph (d), a crisis prevention plan, or a wellness recovery action plan.

(c) If the crisis assessment determines mobile crisis intervention services are needed, the intervention services must be provided promptly. As opportunity presents during the intervention, at least two members of the mobile crisis intervention team must confer directly or by telephone about the assessment, treatment plan, and actions taken and needed. At least one of the team members must be on site providing crisis intervention services. If providing on-site crisis intervention services, a mental health practitioner must seek clinical supervision as required in subdivision 9.

(d) The mobile crisis intervention team must develop an initial, brief crisis treatment plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention. The plan must address the needs and problems noted in the crisis assessment and include measurable short-term goals, cultural considerations, and frequency and type of services to be provided to achieve the goals and reduce or eliminate the crisis. The treatment plan must be updated as needed to reflect current goals and services.

(e) The team must document which short-term goals have been met and when no further crisis intervention services are required.

(f) If the recipient's crisis is stabilized, but the recipient needs a referral to other services, the team must provide referrals to these services. If the recipient has a case manager, planning for other services must be coordinated with the case manager. If the recipient is unable to follow up on the referral, the team must link the recipient to the service and follow up to ensure the recipient is receiving the service.

(g) If the recipient's crisis is stabilized and the recipient does not have an advance directive, the case manager or crisis team shall offer to work with the recipient to develop one.

Subd. 7.

Crisis stabilization services.

(a) Crisis stabilization services must be provided by qualified staff of a crisis stabilization services provider entity and must meet the following standards:

(1) a crisis stabilization treatment plan must be developed which meets the criteria in subdivision 11;

(2) staff must be qualified as defined in subdivision 8; and

(3) services must be delivered according to the treatment plan and include face-to-face contact with the recipient by qualified staff for further assessment, help with referrals, updating of the crisis stabilization treatment plan, supportive counseling, skills training, and collaboration with other service providers in the community.

(b) If crisis stabilization services are provided in a supervised, licensed residential setting, the recipient must be contacted face-to-face daily by a qualified mental health practitioner or mental health professional. The program must have 24-hour-a-day residential staffing which may include staff who do not meet the qualifications in subdivision 8. The residential staff must have 24-hour-a-day immediate direct or telephone access to a qualified mental health professional or practitioner.

(c) If crisis stabilization services are provided in a supervised, licensed residential setting that serves no more than four adult residents, and one or more individuals are present at the setting to receive residential crisis stabilization services, the residential staff must include, for at least eight hours per day, at least one individual who meets the qualifications in subdivision 8, paragraph (a), clause (1) or (2).

(d) If crisis stabilization services are provided in a supervised, licensed residential setting that serves more than four adult residents, and one or more are recipients of crisis stabilization services, the residential staff must include, for 24 hours a day, at least one individual who meets the qualifications in subdivision 8. During the first 48 hours that a recipient is in the residential program, the residential program must have at least two staff working 24 hours a day. Staffing levels may be adjusted thereafter according to the needs of the recipient as specified in the crisis stabilization treatment plan.

Subd. 8.

Adult crisis stabilization staff qualifications.

(a) Adult mental health crisis stabilization services must be provided by qualified individual staff of a qualified provider entity. Individual provider staff must have the following qualifications:

(1) be a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (6);

(2) be a mental health practitioner as defined in section 245.462, subdivision 17. The mental health practitioner must work under the clinical supervision of a mental health professional;

(3) be a certified peer specialist under section 256B.0615. The certified peer specialist must work under the clinical supervision of a mental health professional; or

(4) be a mental health rehabilitation worker who meets the criteria in section 256B.0623, subdivision 5, clause (4); works under the direction of a mental health practitioner as defined in section 245.462, subdivision 17, or under direction of a mental health professional; and works under the clinical supervision of a mental health professional.

(b) Mental health practitioners and mental health rehabilitation workers must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years.

Subd. 9.

Supervision.

Mental health practitioners may provide crisis assessment and mobile crisis intervention services if the following clinical supervision requirements are met:

(1) the mental health provider entity must accept full responsibility for the services provided;

(2) the mental health professional of the provider entity, who is an employee or under contract with the provider entity, must be immediately available by phone or in person for clinical supervision;

(3) the mental health professional is consulted, in person or by phone, during the first three hours when a mental health practitioner provides on-site service;

(4) the mental health professional must:

(i) review and approve of the tentative crisis assessment and crisis treatment plan;

(ii) document the consultation; and

(iii) sign the crisis assessment and treatment plan within the next business day;

(5) if the mobile crisis intervention services continue into a second calendar day, a mental health professional must contact the recipient face-to-face on the second day to provide services and update the crisis treatment plan; and

(6) the on-site observation must be documented in the recipient's record and signed by the mental health professional.

Subd. 10.

Recipient file.

Providers of mobile crisis intervention or crisis stabilization services must maintain a file for each recipient containing the following information:

(1) individual crisis treatment plans signed by the recipient, mental health professional, and mental health practitioner who developed the crisis treatment plan, or if the recipient refused to sign the plan, the date and reason stated by the recipient as to why the recipient would not sign the plan;

(2) signed release forms;

(3) recipient health information and current medications;

(4) emergency contacts for the recipient;

(5) case records which document the date of service, place of service delivery, signature of the person providing the service, and the nature, extent, and units of service. Direct or telephone contact with the recipient's family or others should be documented;

(6) required clinical supervision by mental health professionals;

(7) summary of the recipient's case reviews by staff;

(8) any written information by the recipient that the recipient wants in the file; and

(9) an advance directive, if there is one available.

Documentation in the file must comply with all requirements of the commissioner.

Subd. 11.

Treatment plan.

The individual crisis stabilization treatment plan must include, at a minimum:

(1) a list of problems identified in the assessment;

(2) a list of the recipient's strengths and resources;

(3) concrete, measurable short-term goals and tasks to be achieved, including time frames for achievement;

(4) specific objectives directed toward the achievement of each one of the goals;

(5) documentation of the participants involved in the service planning. The recipient, if possible, must be a participant. The recipient or the recipient's legal guardian must sign the service plan or documentation must be provided why this was not possible. A copy of the plan must be given to the recipient and the recipient's legal guardian. The plan should include services arranged, including specific providers where applicable;

(6) planned frequency and type of services initiated;

(7) a crisis response action plan if a crisis should occur;

(8) clear progress notes on outcome of goals;

(9) a written plan must be completed within 24 hours of beginning services with the recipient; and

(10) a treatment plan must be developed by a mental health professional or mental health practitioner under the clinical supervision of a mental health professional. The mental health professional must approve and sign all treatment plans.

256B.0944 CHILDREN'S MENTAL HEALTH CRISIS RESPONSE SERVICES.

Subdivision 1.

Definitions.

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

(a) "Mental health crisis" means a child's behavioral, emotional, or psychiatric situation that, but for the provision of crisis response services to the child, would likely result in significantly reduced levels of functioning in primary activities of daily living, an emergency situation, or the child's placement in a more restrictive setting, including, but not limited to, inpatient hospitalization.

(b) "Mental health emergency" means a child's behavioral, emotional, or psychiatric situation that causes an immediate need for mental health services and is consistent with section 62Q.55. A physician, mental health professional, or crisis mental health practitioner determines a mental health crisis or emergency for medical assistance reimbursement with input from the client and the client's family, if possible.

(c) "Mental health crisis assessment" means an immediate face-to-face assessment by a physician, mental health professional, or mental health practitioner under the clinical supervision of a mental health professional, following a screening that suggests the child may be experiencing a mental health crisis or mental health emergency situation.

(d) "Mental health mobile crisis intervention services" means face-to-face, short-term intensive mental health services initiated during a mental health crisis or mental health emergency. Mental health mobile crisis services must help the recipient cope with immediate stressors, identify and utilize available resources and strengths, and begin to return to the recipient's baseline level of functioning. Mental health mobile services must be provided on site by a mobile crisis intervention team outside of an emergency room, urgent care, or an inpatient hospital setting.

(e) "Mental health crisis stabilization services" means individualized mental health services provided to a recipient following crisis intervention services that are designed to restore the recipient to the recipient's prior functional level. The individual treatment plan recommending mental health crisis stabilization must be completed by the intervention team or by staff after an inpatient or urgent care visit. Mental health crisis stabilization services may be provided in the recipient's home, the home of a family member or friend of the recipient, schools, another community setting, or a short-term supervised, licensed residential program if the service is not included in the facility's cost pool or per diem. Mental health crisis stabilization is not reimbursable when provided as part of a partial hospitalization or day treatment program.

Subd. 2.

Medical assistance coverage.

Medical assistance covers medically necessary children's mental health crisis response services, subject to federal approval, if provided to an eligible recipient under subdivision 3, by a qualified provider entity under subdivision 4 or a qualified individual provider working within the provider's scope of practice, and identified in the recipient's individual crisis treatment plan under subdivision 8.

Subd. 3.

Eligibility.

An eligible recipient is an individual who:

(1) is eligible for medical assistance;

(2) is under age 18 or between the ages of 18 and 21;

(3) is screened as possibly experiencing a mental health crisis or mental health emergency where a mental health crisis assessment is needed;

(4) is assessed as experiencing a mental health crisis or mental health emergency, and mental health mobile crisis intervention or mental health crisis stabilization services are determined to be medically necessary; and

(5) meets the criteria for emotional disturbance or mental illness.

Subd. 4.

Provider entity standards.

(a) A crisis intervention and crisis stabilization provider entity must meet the administrative and clinical standards specified in section 256B.0943, subdivisions 5 and 6, meet the standards listed in paragraph (b), and be:

(1) an Indian health service facility or facility owned and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638 facility;

(2) a county board-operated entity; or

(3) a provider entity that is under contract with the county board in the county where the potential crisis or emergency is occurring.

(b) The children's mental health crisis response services provider entity must:

(1) ensure that mental health crisis assessment and mobile crisis intervention services are available 24 hours a day, seven days a week;

(2) directly provide the services or, if services are subcontracted, the provider entity must maintain clinical responsibility for services and billing;

(3) ensure that crisis intervention services are provided in a manner consistent with sections 245.487 to 245.4889; and

(4) develop and maintain written policies and procedures regarding service provision that include safety of staff and recipients in high-risk situations.

Subd. 4a.

Alternative provider standards.

If a provider entity demonstrates that, due to geographic or other barriers, it is not feasible to provide mobile crisis intervention services 24 hours a day, seven days a week, according to the standards in subdivision 4, paragraph (b), clause (1), the commissioner may approve a crisis response provider based on an alternative plan proposed by a provider entity. The alternative plan must:

(1) result in increased access and a reduction in disparities in the availability of crisis services; and

(2) provide mobile services outside of the usual nine-to-five office hours and on weekends and holidays.

Subd. 5.

Mobile crisis intervention staff qualifications.

(a) To provide children's mental health mobile crisis intervention services, a mobile crisis intervention team must include:

(1) at least two mental health professionals as defined in section 256B.0943, subdivision 1, paragraph (o); or

(2) a combination of at least one mental health professional and one mental health practitioner as defined in section 245.4871, subdivision 26, with the required mental health crisis training and under the clinical supervision of a mental health professional on the team.

(b) The team must have at least two people with at least one member providing on-site crisis intervention services when needed. Team members must be experienced in mental health assessment, crisis intervention techniques, and clinical decision making under emergency conditions and have knowledge of local services and resources. The team must recommend and coordinate the team's services with appropriate local resources, including the county social services agency, mental health service providers, and local law enforcement, if necessary.

Subd. 6.

Initial screening and crisis assessment planning.

(a) Before initiating mobile crisis intervention services, a screening of the potential crisis situation must be conducted. The screening may use the resources of crisis assistance and emergency services as defined in sections 245.4871, subdivision 14, and 245.4879, subdivisions 1 and 2. The screening must gather information, determine whether a crisis situation exists, identify the parties involved, and determine an appropriate response.

(b) If a crisis exists, a crisis assessment must be completed. A crisis assessment must evaluate any immediate needs for which emergency services are needed and, as time permits, the recipient's current life situation, sources of stress, mental health problems and symptoms, strengths, cultural considerations, support network, vulnerabilities, and current functioning.

(c) If the crisis assessment determines mobile crisis intervention services are needed, the intervention services must be provided promptly. As the opportunity presents itself during the intervention, at least two members of the mobile crisis intervention team must confer directly or by telephone about the assessment, treatment plan, and actions taken and needed. At least one of the team members must be on site providing crisis intervention services. If providing on-site crisis intervention services, a mental health practitioner must seek clinical supervision as required under subdivision 9.

(d) The mobile crisis intervention team must develop an initial, brief crisis treatment plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention. The plan must address the needs and problems noted in the crisis assessment and include measurable short-term goals, cultural considerations, and frequency and type of services to be provided to achieve the goals and reduce or eliminate the crisis. The crisis treatment plan must be updated as needed to reflect current goals and services. The team must involve the client and the client's family in developing and implementing the plan.

(e) The team must document in progress notes which short-term goals have been met and when no further crisis intervention services are required.

(f) If the client's crisis is stabilized, but the client needs a referral for mental health crisis stabilization services or to other services, the team must provide a referral to these services. If the recipient has a case manager, planning for other services must be coordinated with the case manager.

Subd. 7.

Crisis stabilization services.

Crisis stabilization services must be provided by a mental health professional or a mental health practitioner who works under the clinical supervision of a mental health professional and for a crisis stabilization services provider entity and must meet the following standards:

(1) a crisis stabilization treatment plan must be developed which meets the criteria in subdivision 8;

(2) services must be delivered according to the treatment plan and include face-to-face contact with the recipient by qualified staff for further assessment, help with referrals, updating the crisis stabilization treatment plan, supportive counseling, skills training, and collaboration with other service providers in the community; and

(3) mental health practitioners must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years.

Subd. 8.

Treatment plan.

(a) The individual crisis stabilization treatment plan must include, at a minimum:

(1) a list of problems identified in the assessment;

(2) a list of the recipient's strengths and resources;

(3) concrete, measurable short-term goals and tasks to be achieved, including time frames for achievement of the goals;

(4) specific objectives directed toward the achievement of each goal;

(5) documentation of the participants involved in the service planning;

(6) planned frequency and type of services initiated;

(7) a crisis response action plan if a crisis should occur; and

(8) clear progress notes on the outcome of goals.

(b) The client, if clinically appropriate, must be a participant in the development of the crisis stabilization treatment plan. The client or the client's legal guardian must sign the service plan or documentation must be provided why this was not possible. A copy of the plan must be given to the client and the client's legal guardian. The plan should include services arranged, including specific providers where applicable.

(c) A treatment plan must be developed by a mental health professional or mental health practitioner under the clinical supervision of a mental health professional. A written plan must be completed within 24 hours of beginning services with the client.

Subd. 9.

Supervision.

(a) A mental health practitioner may provide crisis assessment and mobile crisis intervention services if the following clinical supervision requirements are met:

(1) the mental health provider entity must accept full responsibility for the services provided;

(2) the mental health professional of the provider entity, who is an employee or under contract with the provider entity, must be immediately available by telephone or in person for clinical supervision;

(3) the mental health professional is consulted, in person or by telephone, during the first three hours when a mental health practitioner provides on-site service; and

(4) the mental health professional must review and approve the tentative crisis assessment and crisis treatment plan, document the consultation, and sign the crisis assessment and treatment plan within the next business day.

(b) If the mobile crisis intervention services continue into a second calendar day, a mental health professional must contact the client face-to-face on the second day to provide services and update the crisis treatment plan. The on-site observation must be documented in the client's record and signed by the mental health professional.

Subd. 10.

Client record.

The provider must maintain a file for each client that complies with the requirements under section 256B.0943, subdivision 11, and contains the following information:

(1) individual crisis treatment plans signed by the recipient, mental health professional, and mental health practitioner who developed the crisis treatment plan, or if the recipient refused to sign the plan, the date and reason stated by the recipient for not signing the plan;

(2) signed release of information forms;

(3) recipient health information and current medications;

(4) emergency contacts for the recipient;

(5) case records that document the date of service, place of service delivery, signature of the person providing the service, and the nature, extent, and units of service. Direct or telephone contact with the recipient's family or others should be documented;

(6) required clinical supervision by mental health professionals;

(7) summary of the recipient's case reviews by staff; and

(8) any written information by the recipient that the recipient wants in the file.

Subd. 11.

Excluded services.

The following services are excluded from reimbursement under this section:

(1) room and board services;

(2) services delivered to a recipient while admitted to an inpatient hospital;

(3) transportation services under children's mental health crisis response service;

(4) services provided and billed by a provider who is not enrolled under medical assistance to provide children's mental health crisis response services;

(5) crisis response services provided by a residential treatment center to clients in their facility;

(6) services performed by volunteers;

(7) direct billing of time spent "on call" when not delivering services to a recipient;

(8) provider service time included in case management reimbursement;

(9) outreach services to potential recipients; and

(10) a mental health service that is not medically necessary.

Repealed Minnesota Rule: SF1291-2

9555.6255 RESIDENT'S RIGHTS.

Subpart 1.

Information about rights.

The operator shall ensure that a resident and a resident's legal representative are given, at admission:

A.

an explanation and copy of the resident's rights specified in subparts 2 to 7;

B.

a written summary of the Vulnerable Adults Act prepared by the department; and

C.

the name, address, and telephone number of the local agency to which a resident or a resident's legal representative may submit an oral or written complaint.

Subp. 2.

Right to use telephone.

A resident has the right to daily, private access to and use of a non-coin operated telephone for local calls and long distance calls made collect or paid for by the resident.

Subp. 3.

Right to receive and send mail.

A resident has the right to receive and send uncensored, unopened mail.

Subp. 4.

Right to privacy.

A resident has the right to personal privacy and privacy for visits from others, and the respect of individuality and cultural identity. Privacy must be respected by operators, caregivers, household members, and volunteers by knocking on the door of a resident's bedroom and seeking consent before entering, except in an emergency, and during toileting, bathing, and other activities of personal hygiene, except as needed for resident safety or assistance as noted in the resident's individual record.

Subp. 5.

Right to use personal property.

A resident has the right to keep and use personal clothing and possessions as space permits, unless to do so would infringe on the health, safety, or rights of other residents or household members.

Subp. 6.

Right to associate.

A resident has the right to meet with or refuse to meet with visitors and participate in activities of commercial, religious, political, and community groups without interference if the activities do not infringe on the rights of other residents or household members.

Subp. 7.

Married residents.

Married residents have the right to privacy for visits by their spouses, and, if both spouses are residents of the adult foster home, they have the right to share a bedroom and bed.

9555.7100 SCOPE.

Parts 9555.7100 to 9555.7600 govern the investigation and reporting of maltreatment of vulnerable adults and some aspects of the emergency and continuing protective social services required to be furnished by local social services agencies under Minnesota Statutes, section 626.557.

9555.7200 DEFINITIONS.

Subpart 1.

Scope.

As used in parts 9555.7100 to 9555.7600, the following terms have the meanings given them.

Subp. 2.

Abuse.

"Abuse" means:

A.

any act which constitutes a violation of Minnesota Statutes, section 609.322related to prostitution;

B.

any act which constitutes a violation of Minnesota Statutes, sections 609.342to 609.345 related to criminal sexual conduct; or

C.

the intentional and nontherapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce mental or emotional distress.

Subp. 3.

Caretaker.

"Caretaker" means an individual or facility which has responsibility for the care of a vulnerable adult as a result of family relationship, or which has assumed responsibility for all or a portion of the care of the vulnerable adult voluntarily, by contract, or by agreement. A person who has assumed only financial responsibility for an adult is not a caretaker.

Subp. 4.

County of financial responsibility.

"County of financial responsibility" means the county designated as the county of financial responsibility.

Subp. 5.

Facility.

"Facility" means a hospital or other entity required to be licensed pursuant to Minnesota Statutes, sections 144.50 to 144.58; a nursing home required to be licensed pursuant to Minnesota Statutes, section 144A.02; an agency, residential or nonresidential program required to be licensed pursuant to Minnesota Statutes, chapter 245A; a mental health program receiving funds pursuant to Minnesota Statutes, section 245.61; and any entity required to be certified for participation in titles XVIII or XIX of the Social Security Act, United States Code, title 42, section 1395 et seq.

Subp. 6.

False.

"False" means disproved to the satisfaction of the investigating agency.

Subp. 7.

Host county.

"Host county" means the county in which a facility is located.

Subp. 8.

Impairment of mental or physical function or emotional status.

"Impairment of mental or physical function or emotional status" means a condition which includes being substantially unable to carry out one or more of the essential major activities of daily living, such as caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, or working; being unable to protect oneself from hazardous or abusive situations without assistance; a substantial disorder of thought or mood which significantly impairs judgment, behavior, capacity to recognize reality or ability to cope with the ordinary demands of life; substantial difficulty in engaging in the rational decision-making process, and inability to weigh the possible benefits and risks of seeking assistance; a condition in which an individual is so fearful, so ashamed, so confused, or so anxious about the consequences of reporting that that individual would be unable or unlikely to make a responsible decision regarding whether or not to report abuse or neglect.

Subp. 9.

Licensing agency.

"Licensing agency" means:

A.

the commissioner of health, for a facility which is required to be licensed or certified by the Department of Health;

B.

the commissioner of human services for programs required by Minnesota Statutes, chapter 245A, to be licensed;

C.

any licensing board which regulates persons pursuant to Minnesota Statutes, section 214.01; and

D.

the Minnesota Department of Health if the human services occupation of the alleged perpetrator is credentialed pursuant to Minnesota Statutes, section 149A.20or 214.13.

Subp. 10.

Local social services agency.

"Local social services agency" means the local agency under the authority of the human services board or board of county commissioners which is responsible for social services.

Subp. 11.

Neglect.

"Neglect" means failure by a caretaker to supply or to ensure the supply of necessary food, clothing, shelter, health care, or supervision for a vulnerable adult.

Subp. 12.

Report.

"Report" means any verbal or written report of abuse or neglect of a vulnerable adult received by the local social services agency, police department, county sheriff, or licensing agency.

Subp. 13.

State agency.

"State agency" means the Minnesota Department of Human Services.

Subp. 14.

Substantiated.

"Substantiated" means proved to the satisfaction of the investigating agency.

Subp. 15.

Vulnerable adult.

"Vulnerable adult" means any person 18 years of age or older:

A.

who is a resident or patient of a facility;

B.

who receives services at or from a program required to be licensed pursuant to Minnesota Statutes, chapter 245A; or

C.

who, regardless of residence, is unable or unlikely to report abuse or neglect without assistance because of impairment of mental or physical function or emotional status.

Subp. 16.

Inconclusive.

"Inconclusive" means a report which cannot be substantiated or disproved to the satisfaction of the investigating agency.

9555.7300 COMPLAINT INVESTIGATION BY LOCAL SOCIAL SERVICES AGENCIES.

Subpart 1.

Duty to accept and investigate complaints.

The local social services agency shall accept and investigate all complaints alleging that a vulnerable adult has been abused or neglected in that agency's county. The local social services agency shall notify each relevant licensing agency and the local police departments or county sheriffs and shall cooperate in coordinating its investigation with the investigations of the licensing agencies, police departments, and sheriffs. The local social services agency shall immediately send a report of its findings to all other agencies notified concerning the complaint in question.

Subp. 2.

Time limits to initiate investigations.

The local social services agency shall begin to investigate all complaints within the following time limits:

A.

The local social services agency shall conduct an immediate on-site investigation for complaints alleging or from which it can be inferred that a vulnerable adult is in need of immediate care or protection because the adult is life-threatened or likely to experience physical injury due to abuse or abandonment.

B.

The local social services agency shall begin its investigation within 24 hours for complaints alleging, or when there is substantial evidence, that a vulnerable adult is not in need of immediate care or protection but is allegedly abused.

C.

The local social services agency shall begin its investigation within 72 hours for complaints alleging, or when there is substantial evidence, that a vulnerable adult is not in need of immediate care or protection but is allegedly neglected.

Subp. 3.

Investigations related to a facility.

When an investigation involves an alleged incident or situation related to a facility, the local social services agency shall make an on-site visit to the facility to assess the validity of the complaint. This investigation shall include the following activities when necessary to make an accurate assessment, but activities specified in items A, C, and E need not occur on the site of the facility:

A.

discussion with the reporter;

B.

discussion with the facility administrator or responsible designee;

C.

discussion with the physician or other professionals, or any corroborating contacts as necessary;

D.

contact with the alleged victim;

E.

discussion with the alleged perpetrator;

F.

examination of the physical conditions or the psychological climate of the facility; and

G.

inspection of the alleged victim's record.

The local social services agency shall also determine whether the reported abuse or neglect places other vulnerable adults in jeopardy of being abused or neglected.

The local social services agency shall immediately send a report of its findings to all other agencies notified concerning the complaint in question.

Subp. 4.

Investigations not related to a facility.

When an investigation involves an alleged incident or situation which is not related to a facility, the local social services agency shall assess the validity of the complaint. This investigation shall include the following activities where necessary to make an accurate assessment:

A.

discussion with the alleged victim;

B.

discussion with the reporter or any corroborating contacts, as necessary;

C.

discussion with the alleged perpetrator;

D.

discussion with the physician or other professionals; and

E.

examination of the physical conditions or the psychological climate of the residence.

The local social services agency shall also determine whether the reported abuse or neglect places other vulnerable adults in jeopardy of being abused or neglected.

Subp. 5.

Investigations by agencies which are not in the county of financial responsibility.

When a complaint involves a vulnerable adult who is receiving services from a facility located in a county other than the adult's county of financial responsibility, the local social services agency of the host county shall:

A.

investigate the complaint in accordance with subpart 3 and determine whether the complaint is substantiated, inconclusive, or false;

B.

notify each relevant licensing agency, the police or sheriff, and the county of financial responsibility;

C.

consult with the county of financial responsibility, unless the host county must take immediate emergency measures and representatives of the county of financial responsibility are not available;

D.

take whatever measures are necessary to correct the situation or to remove the adult from the facility and notify the county of financial responsibility of the actions taken to correct the situation or of the removal of the adult from the facility; and

E.

complete and transmit all required written forms and findings to appropriate agencies.

The local social services agency of the county of financial responsibility shall then resume responsibility for ensuring ongoing planning and services for the vulnerable adult.

Subp. 6.

Use of outside experts.

When it is investigating alleged abuse or neglect of a vulnerable adult, the local social services agency shall consult persons with appropriate expertise if the local agency believes that it lacks the expertise necessary for making judgments pertaining to the allegations. This consultation may include matters of physical health, mental health, specialized treatment such as behavior modification, geriatrics, or other matters.

Subp. 7.

Investigations after initial complaint assessment.

If upon the initial assessment required by subparts 1 to 6 there appears to be substance to a complaint, the local social services agency shall attempt to determine the following:

A.

the risk posed if the vulnerable adult remains in the present circumstances;

B.

the current physical and emotional condition of the vulnerable adult, including the history or pattern of abuse or neglect or related prior injuries;

C.

the name, address, age, sex, and relationship of the alleged perpetrator to the vulnerable adult; and

D.

in a complaint of neglect, the relationship of the caretaker to the vulnerable adult, including the agreed-upon roles and responsibilities of the caretaker and the vulnerable adult.

9555.7600 ACTIONS ON BEHALF OF A VULNERABLE ADULT WHO REFUSES SERVICES.

If a vulnerable adult who is the victim of abuse or neglect by a caretaker refuses an offer of services from a local social services agency and in the judgment of that agency the vulnerable adult's safety or welfare is in jeopardy, the agency shall seek the authority to intervene on behalf of that adult. If the agency believes it to be in the adult's best interest, it shall seek or help the family or victim seek any of the following:

A.

a restraining order or a court order for removal of the perpetrator from the residence of the vulnerable adult pursuant to Minnesota Statutes, section 518B.01;

B.

guardianship or conservatorship pursuant to Minnesota Statutes, sections 525.539 to 525.6198, or guardianship or conservatorship pursuant to Minnesota Statutes, chapter 252A;

C.

a hold order or commitment pursuant to the Minnesota Hospitalization and Commitment Act, Minnesota Statutes, chapter 253A; or

D.

a referral to the prosecuting attorney for possible criminal prosecution of the perpetrator under Minnesota Statutes, chapter 609.